Depression is a major medical illness that causes feelings of dispassion and lessens productivity in individuals. It is usually manifested as a feeling of hopelessness and associated with sadness or the lack of pleasure from otherwise enjoyable activities. Depressed people may be irritable, anxious, or have low energy levels without even being aware of these symptoms. The prevalence of depression in the US is 9%, according to the Center for Disease Control (CDC) reports. The data about the prevalence of depression in other countries is variable, however the rate of depression is estimated to be around 8%.

All health issues are best understood and treated with a combination of biological, psychological, and social factors rather than with purely biological means. This context entails thoughts, emotions, behaviors, social factors, and environment, all of which play significant roles in human functioning and overall health. Therefore, it is important to gather input from all aspects of an individuals’ life to get better insight into depression.

Many people use the word “depression” to explain the feeling of sorrow, but depression is much more than just sadness. Sadness is a normal reaction to life’s struggles, setbacks, and disappointments. However, depressed people don't feel sad—they may feel lifeless, empty, apathetic, and hopeless. Depression starts with just a feeling and then manifests in physical behaviors. The feeling of helplessness, hopelessness, and worthlessness are intense and unrelenting. An unwanted complication of depression is suicide, which in fact has a higher rate than homicides in the US (1).

Hopelessness is the main indicator leading to suicide, a trapped pattern of thinking where individuals believe things will never get better. The deep despair and hopelessness that accompanies depression can make suicide seem like the only way to escape from the overwhelming circumstances. Therefore, suicidal thoughts must be considered as a cry for help and dealt with accordingly.

Psychosocial context appears to be the commonly associated culprit that may predispose people to depression instead of genetic predisposition and other secondary etiologic factors. Depression in the psychosocial context is related to a person’s perception of daily events. A specific event in a person’s life can trigger the beginning of a vicious cycle. Examples could include: changes in occupation, loss of a loved one, etc.

Modesty

In addition to hopelessness, avarice can lead to depression because it contributes to dissatisfaction, disappointment, and loss of sincerity. Sometimes, the lack of material goods can make a person happier than having them. Jealously chasing material things that others have can lead a person into depression. For example, the ancient philosopher Plato was wise but not wealthy; despite his lack of money he was content with his life. One day, as he was passing by a spring, he noticed a boy drinking water with his hands. The average person, having witnessed this, would give the child a cup, but Plato asked himself if the cup is even needed. If you focus on what you do not have, you will always be disappointed. Actually focusing on what you need in the present time can decrease the damage one incurs from his or her problems. The child was thirsty and he only needed water, so the cup was unnecessary.

If a person is only concerned with his or her own situation and not noticing the condition of those around them, it can turn trivial problems into mountains. By comparing one’s own problems with greater problems of others, the person can get a more accurate perspective. Though a person’s burden may appear unbearable, God has created each person with the ability to handle these burdens. It is recommended to keep hope by exercising patience and concerning yourself with the present condition rather than bringing problems up from the past or worrying about the future. The patience given to human beings is sufficient to all types of difficulties, unless used inappropriately to obsess about what already happened in the past or to worry about distant future.

Never lose hope

As shown in Table Figure 1, The American Psychiatric Association (APA) has established the universal criteria for health professionals to diagnose depression. According to The Diagnostic and Statistical Manual of Mental Disorders IV (DSM IV) criteria, physicians diagnose an individual as having depression, which is further classified as minor or major in terms of the severity of the symptoms (2).

Hopelessness deserves special concern because it often triggers the other symptoms which may eventually lead to inertia.

Belief and prayer have found to be extremely helpful in combatting hopelessness by keeping hopes high. This can help to prevent serious depression or even suicide, for even in the most difficult times, belief can allow a person to stand firm with the conviction that even a single leaf would not drop without God’s knowledge. The Qur’an states: “Say (God gives you hope): ‘O My servants who have been wasteful (of their God-given opportunities and faculties) against (the good of) their own souls! Do not despair of God's Mercy. Surely God forgives all sins. He is indeed the All-Forgiving, the All-Compassionate’” (The Qur’an 39.53).

The Bible echoes a similar tone when it says, “For as high as the heavens are above the earth, so great is his steadfast love toward those who fear him; as far as the east is from the west, so far does he remove our transgressions from us (Psalm 103, 8-12).

What does the literature say about belief?

A survey revealed the fact that 82% of Americans believe that prayer can cure serious illness, 73% believe that praying for others can cure illness, and 64% want their physicians to pray with them. Health professionals - especially doctors and nurses - should be aware of the spiritual needs of their patients, should be familiar with literature on the effectiveness of prayer, and should integrate it into their comprehensive care plans (3).

From the biological perspective, as shown in Figure 2, symptoms and signs of depression shown in Figure 1 occur as a result of the change in the level of neurotransmitters - namely serotonin, norepinephrine, and dopamine. Today, pharmacological interventions to heal depression are mainly provided by drugs. These regulate the levels of the neurotransmitters. There aren’t many scientific studies focusing on depressing and religion, however McCullough’s review of literature clearly states that “People with high levels of general religious involvement, organizational religious involvement, religious salience, and intrinsic religious motivation are at reduced risk for depressive symptoms and depressive disorders” (4).

In conclusion, depression may arise from the lack of staying active. In order to keep away from the negative thoughts which serve as a starting point for depression’s vicious circle, praying and seeking help from the All-Knowing, All-Wise serves as a shelter from the negative feelings of temporary worldly troubles. Praying may provide a protection against negative thoughts that may arise from an external or internal source, eventually leading to a distortion of healthy thinking.

Subjective healing and improvement in health after praying, psychological therapy, and family and social support may stimulate some neurotransmitters, though this needs to be further clarified by comprehensive studies (5). However, even simple words may have an impact on the mood of any individual. Hearing a compliment may cause a smile, or receiving a phone call giving a bad news might cause sadness. How could sincerely pouring one’s heart out to the All-Knowing not reverberate from His eternal source into the body, even if the circumstances appear overwhelming?

Mucteba Muezzinoglu is a freelance currently living in Illinois, US.

Nate Emru is a Mental Health Counselor in Indianapolis, Indiana, US.

References

1. Further information is available at http://www.sprc.org/basics/about-suicide. Reached in April 25.
2. The Diagnostic and Statistical Manual of Mental Disorders (DSM). American Psychiatric Association provides a common language and standard criteria for the classification of mental disorders.
3. Ameling A. 2000. “Prayer: an ancient healing practice becomes new again.” Holist Nurs Pract. Apr;14(3):40-8.
4. McCullough ME, Larson DB. 1999. “Religion and depression: a review of the literature.” Twin Res. Jun;2(2):126-36.
5. National Institute of Mental Health. What medications are used to treat depression? Reached from the website. http://www.nimh.nih.gov/health/publications/mental-health-medications/complete-index.shtml#pub5