When pastoring or counseling there is no need for a diagnosis but there is a real need to be aware of the various conditions and subset of conditions. In fact diagnosis is dehumanizing and obstructs the process. Fortunately when engaging in Christian counseling and pastoring there is no clinical barrier there is only the journey. Depression seems to be a pandemic in the states but in fact it is endemic in our society (Abbot Meletios Webber). It functions as a disease and a bi product of affluent living. There is a luxury associated with the condition.
We are all plagued with such introspective waste. Depression is expected to cover an enormous range is it acute or chronic? Is it a normal malaise or is it more conditional? There is a normal reaction to certain events like death and transitional periods of grief resolve over time. If there is no disruption in the course of the life of the person then its more organic or more likely a learned condition a learned helplessness.
In the social sciences, The Diagnostic and Statistical Manuel drives the methodology of the diagnosis and therefore drives treatment. There is the debate over the actual conditions sited. For example, if the conditions are so pervasive that the larger population has it then you are not describing illness but sociological conditions or states or characteristics. Lethargic heaviness or slothfulness, laziness is the dominant factor of depression. (Think the Prayer of Saint Ephrem to find spiritual warfare). When you fail to recognize the need for intervention then you are out of your mind.
Clinical or therapeutic approaches take it for granted that it is organic but that is a huge 'leap of faith'. It is maintained that medications can manipulate the problem. Medication or even self medicating is a natural result of this thinking. Psychotropics do not cure the condition but rid the person of the symptoms. The symptom however can be helpful to the person because it forced there hand to deal with the condition. Removing the emotional pain is not the cure or answer. Think and heal the cause of the pain root out the cause. Get the message and then do something about it. "Physician heal thyself".
The chasm between the mind and the heart is to pray. The isolation and fractured existence of individuals removed from a community creates existential anxiety. Communal life and even parish life is a way of controlling the existential anxiety: isolation from others opens the individual to many malformities which include, meaningless, alienation, purposelessness, pain as an inevitability. We are broken but we are glorious.
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