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Shining a Spotlight on Depression

Several weeks ago, a terrible tragedy occurred: a young woman named Faigy Mayer committed suicide from a Manhattan building. According to reports, Ms. Mayer was a single woman who had grown up Chasidish, but had moved away from religion as a young adult. By some accounts, she felt abandoned and ostracized by her family as a result of becoming irreligious and this likely contributed to intense and overwhelming feelings of depression.

Faigy’s suicide shines a brutally stark light on mental illness within the Jewish community, and so, I would like to talk about depression this week.

Depressive disorders are one of the most common types of mental illnesses, second only to anxiety disorders. As one psychologist once put it, depression and anxiety are the common cold of emotional problems. Approximately 25 percent of women and 12 percent of men will suffer a major depressive episode in their lifetime.

What is depression exactly? Everyone feels sad and down from time to time, but not everyone develops a depressive disorder. Regular sadness, if you will, is what people often feel in response to the death of a loved one or when going through a difficult life event such as separation or divorce. Some feelings of sadness, emptiness, low energy and lack of interest are normal and part of being human.

On the other hand, a person might have clinical depression if he or she begins to experience a large enough collection of symptoms for a minimum length of time. For example, people feel depressed, experience disturbances in their sleep and appetite (usually, too much sleep and too little appetite), no longer take pleasure in activities they usually enjoy, appear sluggish and withdraw themselves from social interaction. This last symptom is particularly harmful because self-isolation feeds the depression.

One of the more common symptoms found among people with severe depression is suicidal thoughts. Such thoughts are generally described as either passive or active. Passive suicidal thoughts are ones in which a person wonders what it would be like to be dead, but the person has no plans as to how they would kill themselves and no intention of actually attempting suicide.

Active suicidal thoughts are ones in which a person not only thinks about being dead, but has come up with a plan as to how they would kill themselves and may also intend to carry it out.

Certainly, we are very concerned if someone has passive suicidal thoughts, but less so than if the person’s thoughts are active. It isn’t that uncommon for people to have passive suicidal thoughts and most people with depression never try to take their own life.

Loving and caring for someone with significant depression can sometimes be frustrating and can lead people to feel helpless. One of the insidious things about depression is that it robs a person of his or her ability to think clearly and objectively. To outsiders, a person with depression has a much brighter future and greater potential for happiness and success than the depressed person thinks. A person with depression often has black-and-white thinking and their ability to problem solve is impaired. This makes it very difficult to develop, or to carry out, a plan of action to improve their depression and to resolve whatever problems triggered their depression.

Treatment Options

The most effective treatment for mild-to-moderate clinical depression is psychotherapy. For severe depression, antidepressant medication is usually necessary in combination with psychotherapy. Even with moderate depression, antidepressant medication can be helpful in boosting the effectiveness of therapy.

There is no question that people differ in how open they are to psychotherapy or to taking medication. Trying to force medication (or any treatment, for that matter) on people who don’t want it doesn’t work. As desperate as we may be for someone to feel better, they ultimately are the ones who have to decide they want treatment.

Having said that, there are times when we are so concerned for a person that we have to take drastic steps to keep them safe for the immediate future at the very least. When talking about very bad depression, people with active suicidal thoughts need immediate psychiatric treatment, typically the kind that is provided in hospital inpatient units. Sometimes, a person agrees to this treatment and voluntarily checks himself or herself in (though, it’s typically with the support and physical presence of a loved one at the time of check-in).

Sometimes, a person who is suicidal will refuse to voluntarily receive inpatient treatment. In this situation, the person may need to be involuntarily hospitalized. One can imagine the feelings of resentment and anger a person may feel toward their parent, spouse, child or friend for having them hospitalized against their will. However, it is always preferable to have someone be temporarily angry with you, but alive.

Most, if not all, hospitals employ mental health clinicians whose job it is to evaluate people in order to determine if they need inpatient mental health services due to a psychiatric crisis. For example, Bergen County has several hospitals that provide such services and they are available to residents 24/7.

Professional help aside, one the best things we can all do for our loved ones who feel depressed is to be there for them. While not a miracle cure, social and familial support is a very effective antidote to depression.

We can do much second-guessing about what could have been done differently to help Faigy Mayer in her desperate struggle with depression. It is my hope that her life and death will spur us in the Jewish community to do more for those who have a mental illness. This includes outreach efforts to educate people, continuing to work to remove the destructive stigma that still surrounds mental illness and continuing to develop programs and treatments for those in our community who struggle with mental illness. I think that would be a wonderful way to honor Faigy Mayer’s memory.

Dr. Gur-Aryeh is a clinical psychologist with a private practice in Saddle Brook, NJ. He works with a wide variety of clients seeking mental health treatment and specializes in mood disorders and addiction in particular. If you would like to contact him, you can do so at [email protected], at 201-406-9710 or through his website at www.shovalguraryehphd.com.

By Shoval Gur-Aryeh, PhD

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