NEW YORK — Jane has been struggling with depression her whole life.

“People who have a melancholic personality like me are more prone to get depressed,” said the 29-year-old single Catholic who declined to use her real name. Her family situation has only aggravated her tendency toward depression. “My parents separated when I was a child. It was hard to deal with that and to see my mom struggling.”

As a teen-ager and young adult, she turned to alcohol and sex for escape. “I engaged in self-destructive behavior. I internalized everything. It would come out as anger and bitterness,” she said. “I had no self-worth and no self-esteem. It wasn't until my mom forced me to see a therapist that I started dealing with depression.”

Jane is not alone in her fight against depression. According to the National Institute for Mental Health (NIMH), approximately 18.8 million American adults, or about 9.5% of the U.S. population, have a depressive disorder of some kind. The NIMH also said mental disorders of all kinds are common in the United States and that roughly 22% of Americans — or about one in five adults — suffer from a diagnosable mental disorder.

Dr. Philip Mango, a Catholic psychotherapist and the director of the St. Michael's Institute for the Psychological Sciences in New York, said Catholics often confuse the spiritual with the psychological.

“The problem with Catholics,” Mango said, “is that for a long time they thought if they just prayed and frequented the sacraments everything would be fine. But the psyche and soul are different. St. Thomas Aquinas said that.

“You can have an extraordinarily good and holy person who is deeply psychologically troubled,” he continued. “We have saints who were psychologically troubled. Psychological troubles are not signs of bad character or a shoddy spiritual life.”

Mango said many Catholics are afraid to deal with mental disorders for various reasons. Some mistrust secular practitioners, he said, but with good reason. Indeed, Mango emphasized the tremendous need the Church has for devout mental health professionals.

“The problem we have is, we have very few highly trained psychologists and psychiatrists who are loyal to the Holy Father and the Church,” he said.

He said he thinks some Catholics have a lack of knowledge and unjustified fear of the sciences and many Catholics are misusing religion.

“Many are hiding behind a religious wall,” he said. “They refuse to look at their emotional wounds. Occasionally, Catholics will tell me, ‘I don't need therapy. I'm a daily communicant. I go to confession.’ But a humble person will say, ‘Christ wants me to go to a doctor.’ If you have a heart attack, you don't just pray.”

The Roots of Disorders

Mango said five basic types of psychological disorders exist: biological disorders such as dementia and Alzheimer's disease; major mental illnesses like schizophrenia and severe depression; anxiety disorders like phobias and post-traumatic stress disorder; character or personality disorders such as schizoid personality disorder; and psychosexual disorders like homosexual orientation. He stressed that sexual addiction — especially to masturbation — is extremely prevalent throughout the country.

Dr. Richard Fitzgibbons, a prominent Catholic psychiatrist, said emotional and mental illnesses start with emotional pain. According to Fitzgibbons, the roots of emotional pain can be genetic but are many times environmental. “The absence of a father is very traumatic,” he said, citing a common example. “As children, we're like sponges. People get wounded very early.”

“There's also a feeling of lack of safety — Sept. 11, scandals in the Church and upheaval in business and the stock market. People think, ‘Whom can we trust?’” he said.

Fitzgibbons said many people suffer from chronic depression as well because they suffer from loneliness. “‘It's not good to be alone,’ Genesis tells us. It's important to deal with loneliness.”

Moreover, Mango pointed out Americans' profound inability to grieve properly and thoroughly.

“Jesus said, ‘Blessed are they who mourn,’ but America has a very tight lid on mourning,” he said. “We have a quick-fix mentality: ‘Get over it as fast as you can.’ These feelings get repressed and that causes painful symptoms.”

By way of example, Mango said dealing with the loss of a parent at a young age can take years to get through. “We have to give people space to mourn so they naturally will come through it,” he explained. “People here [in New York City] are still traumatized. The World Trade Center horror is still going on.”

According to Mango, the mission of St. Michael's Institute is to “integrate Catholic theology and spirituality, psychology and psychiatry for the healing of individuals, marriages and families.”

Mango and his colleagues use a variety of techniques to aid people with psychological disorders. Such practices include hypnosis; dream analysis; transference and counter-transference analysis; cognitive restructuring; and medication. He said he and his associates also pray with their patients and go to the sacraments themselves. Even Mother Teresa, with whom Mango worked for 12 years, brought patients to him.

Role of Religion

Although it is difficult to pinpoint precisely how much a disorder is due to biological, psychological or environmental factors, one thing is certain: the need for religion.

“We know for certain that authentic religious commitment promotes physical and mental health,” Mango said. “A person who participates in [his] faith and does it from the heart enjoys a sense of contentment and well-being.”

Fitzgibbons concurred: “It's very hard to get over emotional pain without God.”

Jane said she has experienced contentment and well-being since she started seeing a therapist in addition to a spiritual director.

“My therapist was very good,” she said. “He helped me to deal with the loss of my dad. He helped me to heal that wound. I looked for my father. Now he and I have a relationship.”

She said her spiritual director — a Catholic priest — has also helped her to cope with depression and guilt.

“My spiritual director is very gentle, compassionate and an excellent listener,” Jane said. “He told me to write everything down, the story of my life. I gave the pages to him and used that as a basis for a general confession. I used to be obsessed with my sins. Now it doesn't weigh on me. I put it in God's hands.”

“Through my director, I learned to accept myself,” she added. “He helped me to feel sorry for my sins and to see the good I've done and the good I can do.”

Father C. John McCloskey, director of the Catholic Information Center in Washington, D.C., underscored the importance of regular spiritual direction in helping people detect whether they have a mental disorder.

“Everyone should have a spiritual director,” Father McCloskey said. “If you're a spiritual director, over time you get to know people just like a doctor. I'm trying to help spiritually, but I may sense that the person coming to me is also a person who needs help physiologically or psychologically. I try to discern what these persons need. It's a holistic solution.”

He said he refers people to faithful Catholic psychiatrists, psychologists or therapists but maintains that the Church will not alter its teachings on subjects such as sexual morality, homosexuality and contraception in order to rationalize immoral behavior that may stem from mental disorders.

“The Church is here to lay down a standard of morality that is liberating,” he said.

Father McCloskey encouraged those who are struggling with mental disorders to “get help.” He recommended a person “talk to a holy, intelligent priest or a very good woman religious” who is faithful to the Church.

He also suggested people turn to good books by prominent Catholic psychologists such as Father Benedict Groeschel's Arise from Darkness and The Courage to Be Chaste, which deal with depression and homosexual orientation respectively. Mango recommends Dr. Conrad Baars' Healing the Unaffirmed, and advocates The Journal of Psychology and Theology as a resource for mental health professionals.

In addition, Father McCloskey advised the family and friends of someone struggling with a mental disorder to “treat that person like another Christ.”

“It's important to stay away from a judgmental attitude. Be very positive about the possibility of their recovery,” he said.

Mango also emphasized the importance of affirmation. “A woman patient recently told me, ‘Thank you for believing in me when I couldn't believe in myself,’” he said. “The patient is Jesus Christ disguised. This is an incarnational, mystical reality. If Christ is the patient, then the patient is coming to help me.”

Although Jane still struggles with depression daily, she said the illness has taken on new meaning.

“It is no longer empty suffering,” she said. “The suffering has meaning, like Christ's suffering in the Garden. Through sound therapy and wise spiritual direction, I now know that life has meaning and that God created me for a purpose. Ironically, mental illness becomes an instrument of your salvation and sanctification.”

Martin Mazloom writes from Monterey Park, California.