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Recognizing Chronic Mild Depression: Case Study

LukeNotes, Fall 2013

Father Mike has been assigned to increasingly larger parishes over the years and, in addition to his work as a pastor, recently was elected to the presbyteral council. His humor, compassion and intelligence have made him a natural leader.

Yet, Father Mike saw himself in a different light. He saw himself as an imposter. In his own mind, his faults were exaggerated and his strengths were diminished. He always felt a bit empty, a bit melancholic. Little did he know that he was experiencing a chronic mild depression.

Father Mike came from a big family but grew up feeling like the black sheep. His parents and siblings would poke fun of him for his interest in music and art. While well-intentioned, his family’s sarcastic way of showing affection was abrasive and made Father Mike feel like an outsider.

His grandfather was the only family member who offered him acceptance and unconditional support throughout his childhood. Every Sunday afternoon, the two would listen to jazz and talk about music. Fr. Mike felt he could let his guard down and be himself.

He adapted to the rejection he felt by his family by developing a charismatic style that helped him make friends easily as he grew up. His friends gave him a sense of belonging and acceptance he desperately wanted. Yet, he was afraid of expressing hurt, sadness or anger with them. He pushed these feelings down and presented an easygoing front.

Eventually, his self-esteem worsened as he kept his feelings in, internalized negative comments and brushed off compliments. When his grandfather died, Fr. Mike felt that he lost the only space where he could be himself.

At that point, Father Mike’s fragile self-esteem crumbled. When a parishioner would pay him a compliment, he would find a humorous way to disown the sentiment. Initially, this tendency to play down compliments won him favor with his parishioners. Yet, over time, people started to question his authenticity. While he had many friends, he continued to feel disconnected from others and struggled with fostering close relationships.

Using Food to Cope

He began to use food as a way to cope. After a long day of work, Father Mike would sit in front of his television and mindlessly eat junk food. Without realizing it, he would consume an entire bag of potato chips or half a pan of brownies. Food brought a feeling of fullness to his life, albeit a temporary feeling. He became overweight.

When the scale tipped 250, Father Mike realized that his eating had become problematic. He made an appointment with a therapist to discuss his eating issues and to learn some techniques to manage his food intake. During his first session, it became clear that Father Mike’s eating problems were symptomatic of his low mood and poor self-esteem. Father Mike was relieved to learn there was a term for the chronic mild depression he had been living with: pervasive depressive disorder.

Father Mike continued individual therapy. He addressed his eating first and developed alternatives to mindless eating, such as spending time with friends and exercising outside. He made deliberate efforts to stop buying junk food and resolved never to eat while watching television. Though his health improved, he continued to feel depressed and so, with his therapist, he began addressing deeper emotional issues. He worked on accepting his feelings as legitimate, appropriate and worthwhile. As he became less avoidant of his feelings, Father Mike learned additional coping strategies. Running outside and playing the trumpet became outlets for his emotional energy while breathing exercises and talking with friends provided a sense of renewal.

Six months into therapy, Father Mike found a way to use his love of jazz as a resource. He joined a group of jazz musicians he had discovered. The group offered the support and acceptance he so desperately missed since his grandfather’s death.

Developing Self Acceptance

Over time, Father Mike began to identify and eradicate negative thinking patterns, such as his tendency to externalize the positives and internalize the negatives. He was shocked by how often he entertained such destructive thoughts about himself. As his thoughts about himself improved, he experienced a greater sense of self-acceptance.

After eight months of psychotherapy, Father Mike began sharing more of his feelings with friends and genuinely accepting compliments from others. As his self-acceptance and sense of connectedness strengthened, he noticed that more parishioners reached out and sought his counsel.

Father Mike found a profound freedom in his ability to be himself without judgment. He noticed that his relationships were emotionally richer and more satisfying and his depression diminished. Slowly, Father Mike no longer saw himself as an imposter. He saw himself for who he truly was: a talented, genuine and resilient person.

For confidentiality reasons, names, identifying data and other details of treatment have been altered.