A Priest’s Thoughts on Depression, Anxiety, the Soul, Your Body and Your Brain

I was 19 years old the first time I had a panic attack. I was trying to go to sleep in my dorm room, when suddenly my heart began racing, my mind speeding forward, with what seemed like crazy, desperate thoughts. That was in the early 70’s and the phrase “panic attack” had not been invented. What I did not know was that this was the beginning of a syndrome that would stay with me over the next 40 years. At times, it limited my life in terrible, embarrassing ways. I began a typical pattern of adjustment, in which I avoided various things that felt like “triggers.” Sometimes it felt like everything and nothing was a trigger. It was also the beginning of a journey of self-education, driven both by repeated treatment failures as well as eventual success and freedom. I have been panic-free for about five years, though I do not assume that it cannot return.

Panic is not in your head. It is not a set of thoughts, even though it sets certain thoughts racing. My dog has panic attacks during thunderstorms (he’s in the middle of one right now). He does not have a “set of thoughts.” Panic is physical. It is, essentially, an “adrenalin storm,” a cascade of chemicals that the body produces quite normally when it perceives immediate danger (the “fight or flight” syndrome). In that sense, panic is a gift from God. In the wrong situation (like trying to go to sleep), it feels like a gift from hell.

Though the advent of panic is unknown, people who suffer from anxiety and depression are far more vulnerable. Indeed, it is treated as a subset of anxiety. It can be the result of trauma or a delayed result from stress or other such things. The first attack, most often, just seems to come out of nowhere.

Panic is not your fault. Telling someone, “But there’s nothing to be afraid of,” is useless. The thoughts come after the attack has begun. It is more accurate to describe the “thoughts” accompanying panic as something other than “thoughts.” They are not the result of reasoning or beliefs. They are the noise your brain makes when it has been hit with an adrenalin bath.

The same thing is generally true about depression and anxiety. These mental experiences are also clearly physical states that can be described, measured and diagnosed. They are, however, physical states that involve the neurobiological system. As such, they produce thoughts, affect our emotions, and create other psycho/physical symptoms.

Somewhat problematic, I think, is the not infrequent distinction made between anxiety and depression as physical/medical problems and as so-called “spiritual” problems. There is no such distinction. We do not have “spiritual” problems that are not also physical problems, simply because we do not exist as some sort of divisible creatures. We could say that the whole thing is spiritual (including medicine). We do not have a “spiritual” life that is not connected with our body. We are human beings. Among the most torturous things I endured in my first year of suffering was having a group of well-meaning Christians gathered around me to cast out the demons, some of them convinced that there was some “unconfessed sin” in my life. I’m fortunate that my belief in God survived.

That said, healthy spiritual disciplines are an important part of the healing and recovery from these problems. If you search patristic material you may wonder where the references to depression and anxiety are. They are hidden in a word that is quite common: acedia (sometimes spelled “accidie”). It is described as the most difficult of all the passions and garnered the nickname “the noonday devil.” Here is a brief description from St. John Cassian:

He looks about anxiously this way and that, and sighs that none of the brethren come to see him, and often goes in and out of his cell, and frequently gazes up at the sun, as if it was too slow in setting, and so a kind of unreasonable confusion of mind takes possession of him like some foul darkness.

Gabriel Bunge, the Orthodox hermit and scholar on the works of Evagrius, offers this understanding of what he terms “despondency:”

Acedia manifests itself, then, as a type of slackening of the natural powers of the soul. Evagrius defines it in exactly the same way: Spiritual despondency is a slackness (atonia) of the soul, namely a limpness of the soul, which does not possess what is appropriate to its nature.

It interests me that modern discussions of anxiety and depression tend to alternate between a very physical account (“you have a chemical imbalance”) to very a psychological/emotional account (as in Cognitive Behavioral Therapy). The truth is that it is both/and. We do not have moods, thoughts and emotions that have no basis in the electrical chemical components of our brain. Our thinking and feeling is not detached from our body. However, our bodies are not unresponsive to our thoughts. The complex of our existence means that we can and should deal with our health in a manner that involves the whole person.

The fathers of the desert had no psychotropic medication. Their insights were drawn from what they did have. It must be borne in mind that suicide was not unknown among them (there are any number of stories that recall such things). It would be a mistake, therefore, to assume that they knew everything there was to know on the subject or that following their lead is always and entirely sufficient. It is not.

But they knew a lot. Much that they knew is buried beneath and within the terminology of desert asceticism. Just as acedia is largely the equivalent of anxiety and depression, so, many of the remedies are equally disguised. Humility is frequently described as important in overcoming acedia. Modern readers are left puzzled. How is being humble useful with depression? The humility they describe, of course, is deeply rooted in the discipline of confession. It is, in fact, the practice of “bearing a little shame.”

Modern research in Affect Theory has identified shame as the “master emotion,” and as a primary root of anxiety and depression. Of course, we live in a culture that, though riddled with shame, often treats it as a taboo topic. This is especially true for men. A book I read several years ago on male depression was aptly named, The Problem Men Never Discuss. If depression is taboo, shame is more so. The desert fathers attacked the Noonday Devil at its very roots, discovering that the “way up is the way down.” Following the path of Christ in His voluntary acceptance of the shame of the Cross, they discovered the freedom that comes when the very deepest of all wounds is healed. In that healing, they found true peace, the ability to love and forgive, and the place of the deep heart.

I recently watched an interview with Fr. Zacharias of Essex in which he said, “Only the work we do to find the deep heart remains with us beyond the grave.” That is knowledge that only comes from experience.

Again, there are many who continue with a false distinction between psychological/emotional/physical/spiritual matters. This, I think, is a product of an inadequate understanding of our human makeup. The crippling pain of depression and anxiety are often helped greatly by current medications (SSRI’s and the like). Sometimes they are life-savers. They are not, however, a “treatment” for depression and anxiety. They do not address its cause or provide healing. They simply make it bearable – and that’s nothing to be despised.

The book, Our Thoughts Determine Our Lives, recounts the life and teachings of the Elder Thaddeus of V., a contemporary Serbian monastic. He battled with anxiety issues for many years, suffering two nervous breakdowns. He tried medications to no avail (of course it was at a time well before the current protocols). His story describes certain profound spiritual conclusions, including the radical acceptance of the providence of God, that eventually gave him peace. It is worth a read by anyone who struggles with these things – at the very least for an example of holiness in the midst of this terrible form of inner struggle.

A contemporary elder of Mt. Athos makes this observation:

The image which we can use to describe the relationship of soul and brain is the violin with the violinist. Just as even the best musician cannot make good music if the violin is broken or unstrung, in the same manner a man’s behavior will not be whole (see 2 Tim 3:17) if his brain presents a certain disturbance, in which case the soul cannot be expressed correctly. It is precisely this disturbance of the brain that certain medicines help correct and so aid the soul in expressing itself correctly. (Elder Epiphanios Theodoropoulos)

It is interesting that men in contemporary culture are so shame-averse. It is, of course painful to everyone at all times. However, the fear to go there requires courage – something our culture tends to praise. I have often been struck with astonishment at the courage of some very broken people, people whom others would consider “losers,” who found a way to enter the darkest places, bear the unbearable, and return with a measure of wholeness. They are my heroes.

We are all Christians in the desert – and the desert is the landscape of our souls. The fathers of the desert found what everyone would find if they dared enter that place for the simple fact that they were humans in the same manner that we are. They did not enter the desert in order to “get away from things.” They entered the desert in order to do battle with the deepest of things and the greatest of demons. They went there in order to avoid any distraction that might draw them away from the battle.

Our culture is full of distractions. However, the noonday devil has made his way into the cities and every corner of our culture. In some segments of American society, as many as 50 percent take some form of anxiety/depression medication. Again, this is not a cure. But it points to how widespread the battle has become.

St. Seraphim of Sarov famously said, “Acquire the Spirit of Peace, and a thousand souls around you will be saved.” This is a work of courage in our day and time, one that requires wisdom and patience. Easy quips from the sidelines only belong to those who have never been there, or are afraid to admit it. I shudder when I hear someone describe medication as a “crutch.” I’ve heard the same thing said of religion. Given how crippled we are, it makes little sense to despise crutches.

It is important to move beyond the stop-gap measures that simply “keep us going.” There is a serious work of the heart to which the gospel calls us. St. Macarius observed:

The heart itself is but a small vessel, yet dragons are there, and there are also lions; there are poisonous beasts and all the treasures of evil. But there too is God, the angels, the life and the kingdom, the light and the apostles, the heavenly cities and the treasuries of grace—all things are there. (H.43.7)






  1. There is a homeopathic that works both for dogs and humans. Rescue Remedy. That it works for dogs shows that it is not placebo, but how it really works, I don’t know. Dog owners whose dogs panic in storms find it helpful

  2. There was I time when I discovered that if I was depressed, that it was not usually a sin, but if I was depressed about being depressed that was the sinful aspect that led to a downward emotional spiral. I learned that if I gave thanks for the depression, that the downward spiral would be stopped.

    Got of a pill.

  3. Great reflection, Father. I predict most readers will not fully comprehend it because most have not had a real panic attack. It’s like a joke: You either get it out you don’t. There is nothing more futile than trying to describe a panic attack to someone who has merely experienced anxiety. It is simply an excercise in frustration. After years of suffering, I have finally learned to live very quietly with the lion sleeping in the corner ( I use diet, excercise and 20 minutes of contemplative prayer each day). By the way, my attacks were less physical. They involved derealization and were more akin to the sudden feeling of being on a strange, ominous planet…. kind of like a short psychotic break. Nasty stuff. I think the roots of all of this lie in your use of the word epigenesis some weeks ago. The sins and traumas of our ancestors impact our DNA (somewhere between ancestral sin and collective unconscious?) It’s one reason my spiritual father emphasizes the need to pray each day for any reposed relatives I know of.

  4. This could be calming for the dog (or perhaps all in the animal kingdom) as Rescue Remedy is 27% alcohol and has not been proven that the herbs (flowers) have any benefit when given as an aid to panic-hence, why it is labeled Rescue Remedy. Fortunately dogs do not drive so they would not blow numbers.

    By no means being critical and if my comment is a sin I ask forgiveness. There are many homeopathic concoctions on the market and allergic reactions are possible, etc. I love dogs and other living things.

    Thank you again Fr. Stephen for your insight. I am encouraged when I read your words.

  5. Thank you Father. This is a very helpful post in understanding the connections. I also now understand the reference in Psalm 90 to the “Demon of Noonday.” Apparently, Acedia was even around in David’s time and the wisdom of our Desert Fathers in dealing with it is more ancient than them.

  6. Today I experienced a mild anxiety attack for the first time in many months. It is scary how anxiety suddenly resurfaced after I assumed it was completely gone. It’s very comforting to read this post and think of how these feelings can drive us towards the truth.

  7. These are the best, most comforting my words I’ve ever read on anxiety and depression. Thank you! I’m going to share this post with a few friends.

    Jut a quick Rescue Remedy comment…the version for animals is alcohol free…I used in combination with herbs for a cat with a horrible autoimmune skin disease. She’s free of it now. Sure, this is anecdotal, but there is something to it, I think, though that I understand, and share, the skepticism.

  8. Thank you for sharing, Father. It is important to hear this from clergy. Unfortunately, there is still a stigma about mental health in some Orthodox circles.

  9. It is interesting that ‘akidia’ is the closest we have to depression in patristic writing. However, it is far more akin to the ‘effects of depression’ on the spiritual life than depression or even despondency per se. The Greek literally means lack of care/interest. The “a” is a negation of the ‘kidia’ (Kidia is actually the same word as we have for the “caring” of a body in a funeral or for the ‘caring’ of a parent –‘kidemon’), and in patristic language this lack of care/interest is clearly a despondency towards the spiritual struggle, a lack of care for my soul.
    So when I suffer from ‘akidia’, it means I am specifically struggling to find any interest in me for the spiritual life, it becomes exceedingly boring or difficult. Depression and anxiety have this effect obviously, but it’s noteworthy how the prism is all to do with the Spiritual life in patristic thought. The overcast ‘sky’ that one is called to try to ignore [this is the constant admonition of most spiritual Fathers as a practical action towards this internal soul-choker – pay it no heed, ignore your own feelings and thoughts while realigning your being to the Prince of peace] is essentially the dark cloud of a subjectively perceived, vague or severe God-forsakeness. Akidia has certainly been expanded of late to include modern notions of depression though, but the interpretative prism is spiritual.
    When it seems to us as though God is far off and that there are copious reasons for fear or gloominess, this sudden loss of the connection with our loving God makes the fundamental emotion of fear or even desperation into a powerful stimulus that subconsciously directs our thoughts and our actions when it should never be allowed such an entry into the soul.
    Even when this happens, this “pararapismos” [is the term in the Ladder for a fully completed thought that appears without one having had the customary stages for its development available to them for battle at a more manageable level e.g.: you see a vision all of a sudden, or you wake up with a completed panic attack unable to breath], one who has struggled with the mind-to-heart ascesis of the invocation of God’s name has a head start in the simple calming of the breathing process, as well as in the ‘thou will be done’-ignoring-of-self that is the only true solution when there is no solution because you are truly drowning (you could really be subjected to water boarding for example)
    I appreciate Father Alexis Trader’s words on these matters as well as some of Father Lev Gillet which I will paraphrase here for anyone interested:
    Thinking about fears that were realized in the past may make us feel depressed, but thinking about fears in the future, can truly fill us with dread. Fearful emotions habitually rise to the surface when we engage in “what-if” thinking, with thoughts such as “what if I lose my job?” or “what if my child becomes seriously sick?” And although such misfortunes do happen in life, we feel as though our own personal answers to such questions are too distressing to even imagine. The history of redemption that we are called to make our own then seems like some far away dream. Those “what if” thoughts – a self-perpetuating stream of anxiety-producing ruminations – lead us to obsessively focus on the material, transitory aspects of our earthly existence and flee from the present moment and from our God Who is found therein. The strength that comes from the union with the person of Christ abandons us and we stop carrying within ourselves the peaceful and intensely real image of Jesus, our Divine Provider. Such thinking leads us to focus on matters that are very often outside of our control and influence. Yet, because they have seized our thought process, they become the focus of our attention, draining all our energy…

    Peter walks on the water. As long as he looks at Jesus, as long as he goes towards Him, he is able to walk on the waves of the lake. But when he looks about him, when he notices that the wind is strong, he is struck with fear. He begins to sink. Jesus has to stretch forth His hand to save him. If Peter had paid no attention to the waves and wind, if he had concentrated his gaze on Jesus alone, he would not have found himself in danger. His faith would not have been shaken.
    This is the cause of our falls. If I were capable of looking at Jesus alone, if I did not give way to consideration of danger or temptation, to begin a kind of dialogue with them, I too would be able to walk on the water. All my faults originate by a fading or disappearance of the Saviour’s image.
    In Saint Matthew’s Gospel, the Lord addresses “what-if” thinking when he commands, “Seek ye first the kingdom of God and His righteousness and all these things will be added unto you.” Our “what-if thoughts” are not so much about seeking God’s eternal heaven, but about maintaining our transitory earth. In giving ourselves over to them, we are not putting first things first, but putting first things last. From the broader perspective of eternity, the very things we fear might even be the way we find our way back to God.
    We are anxious and fearful to the extent that we are enslaved to our often, uncontrollable environment. And we are enslaved to our surroundings to the extent that we are not in communion with God who is both absolutely beyond and ineffably present in our environment.
    But how do I set up before me an image of Jesus strong enough to prevail over the fear of danger, the agony of suffering or the enticement of sin?
    Such an image is not the work of one minute or of one day. It is the work of months, of years, of a whole lifetime. A hasty, superficial image of Jesus is as one drawn on water. It vanishes with the first breeze, with the first jolt.
    I have to form this image of Jesus slowly and deeply, or rather, I must develop and then preserve a certain docility so that Jesus might engrave His face on my heart.
    The beauty of the Saviour’s face does not only attract, it acts and transforms. If our interior gaze is persistent, the Saviour’s beauty touches us deeply, in proportion to this persistency.
    We all have a spiritual heart that we can strive to discover through simple repentance and by calling upon the name of our Lord. It will take time for our fears, anxieties, and imaginings to weaken. Remembering God, remaining in the present, vigilantly guarding the heart against fears by trust in God will help. This is also ‘our work’ towards fulfilling the commandment of love for God. Love, we are reminded in Scripture, casts out all fear. He has overcome death and cast out all fear, trampling down death by death. Whatever we fear, whomever we fear has been conquered by the glory of the Cross and Resurrection. If we have fear ever dwelling in our hearts, we are harming our physical, mental, and spiritual health. Such fear is certainly not of God. Such fear keeps us chained to illusory and deceptive thoughts that alienate us from God and one another. Yet, that chain has been broken, Satan has been conquered, fear has been overcome. We need only recognize this and be glad in Him who has made us a new creation.
    In life, there are certain inner difficulties that spawn a host of enduring, dysfunctional patterns causing continual distress and constituting new, serious problems in their own right. And although the Christian faith advises looking within to the thoughts of the heart, we habitually shift our focus from the inner difficulty to the warning signals of distress and naively suppose that if we take care of the distress by external means such as taking the right kind of medication, things are as they should be. In fact, we are simply becoming dependent on other external supports without any deeper healing taking place. God “desires that we be delivered from the bondage” of depression and anxiety “into the glorious liberty of the children of God,” becoming vessels of love, bearers of peace, instruments of His own compassion for creation. Unfortunately modern society encourages us to set our sights far too low.
    The interpretation we give to our situation or our physical responses is intimately related to anxiety. Of course, we can try to change our physical responses or modify our situation, but the only approach that can really bolster human freedom is to be able to change our way of interpreting our world. This is in keeping with the fundamental teaching of Christianity that it all begins in the disposition of the heart. The most beneficial treatment that expands our real choice is an examination of problematic thoughts and an exploration of methods to cope with them. Often, pharmaceutical treatment options merely mask the underlying causes of anxiety disorder and only temporarily affect one’s emotions.
    Mood disorders are more than just unpleasant emotions sabotaging life’s activities. Such conditions are about a restricted freedom that does not allow people to do all that they are called to do. Medicines have their use, but the only way to outward freedom is to acquire inner freedom. And the path to inner freedom is to learn how to respond to the thoughts, when to respond to the thoughts, how to judge the thoughts, how to act in spite of the thoughts, and above all, how to cultivate thoughts that bring peace, hope, and love.
    A situation or thought becomes anxiety producing because it falsely tells us that “it” is inevitable and there is nothing to be done but await with dread to go through the ordeal and to suffer the consequences. This is not true. The “it” that produces anxiety is fleeting and will pass if we do not give in to the despair and inevitability it suggests. And that victory begins when we learn what the wise Solomon once taught, “Trust in the Lord with all thine heart; and lean not unto thine own understanding” (Proverbs 3:5).

  10. Dear Father.
    Thank you for this post. It is the first time I came to realize what ‘acedia’ actually is, even though I am Greek!
    On the subject of panic attacks, please let me share this:
    A couple of weeks before Elder Joseph of Vatopedi, of Mount Athos reposed, he called me to Thessaloniki to say ‘good bye’. This was in June 2008. He reposed on the 1st of July 2008! At the time I was in the midst of suffering crippling panic attacks and I was scared even to go out. Don’t ask me how I flew to Thessaloniki … It must have been his prayers. Anyway, during my blessed last encounter with this holy elder ( he was the spiritual child of Elder Joseph the Hesychast) I met a priest there, who brought up the subject of panic attacks out of the blue. He just looked at me and said: ”I am going round the hospitals looking for people who are having panic attacks to teach them to say the Jesus prayer!” Needless to say that on that same night I had a huge panic attack while at the hotel and didn’t sleep at all, but was continuously reciting ‘Lord Jesus Christ have mercy on me, the sinner’. I must confess, this didn’t help much with the string of panic attacks that night, but it did help me in keeping my sanity. It is now nine years since and my panic attacks have become very infrequent and less severe. But every time I feel one coming, I begin saying this prayer slowly , concentrating on each word. This helps taking my mind off the sinister thoughts until the panic attack subsides. Then my logic takes over and , Glory be to the Lord, the panic attack is gone…
    I would love to hear if anyone is harnessing panic attacks in this way. Thank you for reading this .

  11. When I became an inquirer in Orthodoxy I was surprised to find despondency on the lists of passions. It just never occured to me that it would be there. There is a certain comfort in wallowing in such a thing; it is an odd form of narcissism, I think, to just feel hopeless/worthless. The whole of creation revolves around oneself; there is no room for anyone or anything else.

    I have never had a panic attack but it seems to me to be far opposite of the same thing. Moving from “wallowing” in the self to a bizarre form of extreme intensity. Am I correct to state that they exist at opposite extremes of the same spectrum? Or are they completely unrelated?

  12. Olga,
    I think there is no better way! In fact, I personally think that during abrupt onslaughts, even the ‘have mercy on me’ can be left out. Everything you can do to totally fixate on Christ and not return to ‘me’, to not await or expect anything, must be done. So, I think that the slow invocation: “Lord Jesus Christ” -as you describe- is the best thing one can do.

  13. The neurons in our brains follow the laws of physics: An electrical potential created by a chemical gradient across a phospholipid bilayer that propagates along the axon activating voltage gated channels along the way with back propagation inhibited by sodium-potassium pumps which restore the gradient…and so on result in synapses. From the frequency or oscillation of all the collective neurons (the temporal component) global behavioral patterns emerge from the hierarchical and modular architecture which correlates with our conscious experience. All of this electrochemical hardware exists in complete submission to the laws of physics, regardless of whether or not we want to believe that. Then there’s the mind. In the neurosciences the relationship between the mind and brain is known as the “hard problem.” How does something that is really salty, loaded with lipids, and really gooey give rise to the expression of personality, emotion, awe, beauty, poetry, and mathematics? Why does the balance between serotonin, dopamine, and oxytocin and their associated receptors and reuptake and degradation mechanisms result in feelings of well-being and even love? Why do lesions in the parahippocampal gyrus diminish the ability to recognize faces? Where does color come from? The universe exterior to our brains has NO color.

    So, if the brain obeys the laws of physics, what is a person? Is a person just the total repertoire of neuronal patterns embedded in the network architecture of the brain? If so, where is “freedom”? Where is the “soul”? What is the “heart”?

    As Fr. has said human beings are a mystery second only to God himself.

    We are not as free as we think.

    For all that we might say there is just so much more that we cannot say.

    The dichotomy between the spiritual and physical doesn’t exist. All “problems” are spiritual “problems”. What this thread emphasizes to me is the need to withhold judgment and to always pray for mercy for ALL.

  14. Olga,
    maybe a further clarification of the above: The ‘not awaiting or expecting’ bit is obviously a ‘guard’ against what might become a (self-centerdness-produced) God-forsakeness, which can be brought on when we seem to not be ‘heard’; but the being present to our Lord Jesus Christ without demanding Him to be present to us, is indeed what makes Him present right here and now if I can just stay in this present moment and in Him.

  15. Profound, sagely wisdom rarely found on such a prevalent matter. Thank you!

    Do you have a suggested reading list you would recommend besides what you referenced in the article for extended studies of these matters?

  16. I haven’t had a panic attack in the last 10 years. I’ve had some close calls, but I’ve learned how attain enough calm to placate them when they start to rise up.

    Anyway, I still function at higher levels of anxiety than most. I drive my husband nuts when driving in the car – being on the road is one of my ‘triggers.’ I identify my anxiety and fear of driving with my personal lack of control, in that their are far too many variables outside of my control to prevent a crash.
    My anxiety always has to do with having no control over a potentially dangerous or harmful situation. After reading your blog I am having trouble in seeing how my anxiety could possibly be rooted in shame. I’m not trying to avoid shame, I’m trying to do the impossible, which is to control the uncontrollable in order to avoid death or harm.

  17. Dino,
    I just now read your post that very adequately addresses my above concerns. Thank you!

  18. Father,

    I wish you would read this book, then revise.

    I have a histamine intolerance for various underlying reasons which causes me panic attacks occasionally. If I eat too much high histamine foods I get tremendous feelings of anxiety, racing heart, insomnia, amd even panic. I am working with a functional medicine doctor to resolve the underlying cause of this since conventional doctors have literally nothing to offer to heal this. Low blood sugar also causes many of the same symptoms for me. Cutting out acellular sugars like refined sugar and white flour from my diet and eating a high-fat, high-protein diet has helped stabalize my symptoms and mood.
    I think there are many “psychiatric pretenders” such as thyroid problems, food intolerance, histamine intolerance, gut imbalance in general. Its a shame in our pharmaceutical medical world that these causes are neither explored nor understood and instead people are just given symptom suppressing drugs that never offer healing but only stifle the body’s cry for help as the pathology deepens.
    There is another huge cause of depression which is called in the literature “paleo deficit disorder,” which means the degree to which our lifestyle is at a mismatch with our biology. Our genes and every fiber of our being comes into the world expecting clean unpolluted water and air, whole food, a rich ecology of microbes, a mother to nurse us at her breast, movement, life-long attachment relationships, the natural rhythm of sunrise and sunset, a natural enviromnent, etc. Instead we come into the world in hideous flourescent sterile hospitals after a stressful and heavily medicated birth and are immediately taken from our mothers in that first hour when it is most imperative at a biological level that we are with her, given dead, denatured gmo formula, watching screens almost immediately, spending all our time indoors, breathing polluted air and drinking polluted, chemical treated water, eating pesticide ridden food grown in depleted soil, sitting all day, assulted endlessly by the sight of hideous atrocities called cities, etc, etc. Our nervous systems don’t even have a chance in this world. To me its strange that *anyone* could not be depressed.
    It helped my depression and anxiety tremendously to do a lifestyle overhaul and try to live as close to nature as possible. Getting rid of the chemicals in my home and my food, getting rid of all my unnecessary possessions, getting away from screens and going outside often, regular daily movement like walks and silly family dance parties, being silent, using artificial light as little as possible, learning how to grow stuff in dirt, etc, etc.
    My prayer rule, the liturgies, and a minimalist lifestyle have helped rewire my nervous system to not be so sympathetic dominant. I think our pharmaceutical “health care” system exists to silence the messengers and seperate us from our wise feelings of wrongness that would cause us to make real changes for our lives and our world.

  19. Michelle,
    Early shame, and the trauma associated with it, can literally leave our neurobiological system turned up on “high” and far more sensitive to anxiety-producing events. Some are born that way, possibly from trauma in the womb, or even an inherited tendency. Sometimes, I think, it’s a “chicken and egg” sort of thing.

    If we remove the “psychology” of shame, the emotion of it, from the equation, and simply think about the biology of shame, the neural-Affect that is set off by certain kinds of situations, then it’s easier to see the connection between shame and anxiety/depression. The “feelings” of shame are themselves actually secondary to the primary “Affect” of shame. Affect is the biological component of emotions.

    Anxiety can, of course, be triggered by fear as well – real danger. But, oftentimes, things we experience as “dangerous” are really more about their potential to cause us shame and embarrassment – this is especially true of social anxiety. For example, in the early years of my panic attacks, I was always afraid of throwing up in a public setting. I never did. But when I had a panic attack, it made me feel nauseous, which made me feel anxious, etc. and the chain went on like a loop until I fled the situation. My years in seminary were terribly beset with this.

    But what you’re describing might well be real, genuine fear. However, it’s something to think about. Are you really in true danger, or do you perceive yourself to be in danger? What’s the actual nature of the danger? And, what would it mean if the fear danger actually happened and you were injured or killed?

  20. Sunny,
    The “Affect” of shame that underlies the emotions I’ve described – is quite biological rather than emotional. It can be triggered by many things – including shameful situations, things that remind us of shameful situations, even certain thoughts. It can certainly be affected by diet and chemicals (it’s biological, after all). What you’ve suggested is indeed a healthy track towards recovery and management.

    I noted in the article that psychotropic medications are not a form of healing. They “turn down” certain of the most unpleasant effects of what we’re experiencing. They should not be used to mask things – I think I made that clear. In some cases, however, they are life-savers. If the pain of anxiety and depression are so crippling that waiting on the much slower work of diet/life-style change to kick in would be unbearable, then they are of tremendous value.

    If I have a driving point – it would be to think about the biology of these things as much as all the rest of our tools – they are all interconnected. Your comment clearly points this out. I suspect that the chemicals and hormones and genetic modification in our modern diet is going to create more and more problems as you’ve described. And they’ll most likely be undiagnosed in their cause and contributory elements.

    In the meantime, it’s good to survive long enough to get well. I do not think I would have lived long enough (possibly) to find my present measure of wellness had it not been for my wife and some other supportive people around me. It’s not a battle to be fought alone, if possible.

  21. I have found 12 step work to be helpful in this. Within the first year of becoming Orthodox, the Faith, began to point me to issues that I had. I noticed that I did not trust God. I began attending ACoA (Adult Children of Alcoholics and Dysfunctional Families) to help me address this and other issues. For the Alcoholic, Resentment is the triggering poison. For those of us who are recovering from growing up in a dysfunctional family (and that is all of us) Shame is the poisoning trigger. The journey into that trigger is very fruitful and very freeing. Thank you for sharing this.

  22. What about poisoning? Most of us are poisoned by toxic metals and don’t even know it. The effects are so varied that it is not possible to group people according to the toxins they are dealing with. But, I have learned, that if in my distress from said poisoning, I beg God for relief, even before I knew what was hurting me, He teaches me how to get well. I begged for a long time. I did not go to doctors after several demonstrated that they had no clue how to help. I went back to God. No, I was not particularly saintly in my begging. I was desperate, scared, and dying. But He actually showed me the way to health, one step at a time. I realize this is not the experience everyone has, but I do think that choosing to turn to God completely for healing (not miraculous healing, but guidance for recovery) is a path many people ought to try. God heals. Every single time we do not die of any injury big or small, it is because God heals us.

  23. Thank you for this. It’s not often that I find a balanced, Orthodox approach to what some psychologists call “disorders” but others, such as myself, refer to more as afflictions of the soul.

    As such, you rightly point out that medications are not curative. They are not healing in and of themselves. In my work, I find that they are only really helpful in the most extreme of cases; that is, when people simply cannot function at all, due to their distress, and in the short-term, until we have enough relief to do the deeper work. We actually need to feel our symptoms to a degree. We need to experience the dis-ease in our souls, in order to search our hearts as to the stories our afflictions have to tell, to pray and receive awareness, grace and healing from God. The goal of the true therapy of soul (psycho-therapy) is nothing less than transformation, experiencing the Resurrection of Christ in some small, yet awesome way, as we are able to surrender our maladies to God, and through the Holy Spirit, working through various – and often unexpected – ways. Sometimes this happens, in part, through medications, sometimes through goofy psychotherapists such as myself, through prayer and openness and courage to face what is necessary, but always through the power of the Holy Spirit, present in all places and filling all things.

    As you stated, panic is automatic, physical. However, when, in the midst of panic, we are able to practice and practice and practice again the discipline of breathing diaphragmatically, then we can begin to think and pray. When our mind becomes engaged, then we can use the kinds of insights we have received through prayer and soul-searching about the causes of our specific flavor of panic. It is definitely a battle of courage and acceptance of what is, but also, a real discipline of prayer. And that journey of going to hell and back, and being able to finally overcome such an intense affliction – to any degree – is an awesome experience of God’s compassionate mercy, and gives us tremendous wisdom that we are able to impart to others.

    One more thing. You mentioned, Fr. Stephen, that “In some segments of American society, as many as 50 percent take some form of anxiety/depression medication. Again, this is not a cure. But it points to how widespread the battle has become.” I think this is true, but let me add that it points to some deep, multigenerational sins of our culture, for instance, the belief that our intellects and science/technology are our gods, and the belief that being validated externally will heal our souls. (Much more to be said about this, of course.) Also, we have this cultural value that we need to “fix” and eliminate our symptoms – that they are the enemy – rather than to search our souls and do the harder work and prayer that allows us to be truthful to ourselves and God, which is the work of repentance. Thinking of all the prescriptives of soul that we have to our avail makes me so grateful that we have our Orthodox Faith to guide us!

  24. Nöel,
    My deepest intention in the article was to “de-mystify” the disorder – both psychologically and emotionally – as well as physically and “spiritually.” I think that, on the whole, people are very resistant to seeing all of these things as one single thing described from different perspectives. It is never either/or. Sometimes, a single aspect can be used and get a nice result – but then it still results in a tendency to think that “this is the answer.”

    At the core, all work is “soul work.” That includes my “body work.” Changing how the body responds – changing its chemistry, or its neurobiological reactions is a very(!) difficult thing. People should understand this and be patient with themselves. It takes time. For most people, a medication will be quite temporary. For a few, it may be life-long (for various reasons).

    In my own experience, I’ve never seen an SSRI that was so effective that it “masked” symptoms. At most, it toned them down enough to be bearable. There’s nothing out there that will take you from depressed to pleasantly happy all the time. The real dangerous drugs are things like the benzodiazepenes (xanex and its family). These can indeed stop a panic attack – but they work on the gabba-receptors in the brain in exactly the same way as alcohol. Essentially, you’re getting drunk with a pill (with somewhat different side-effects). They can be highly addictive and extremely hard to quit once addicted (often requiring hospitalization for de-tox). I do not include them in what I have described as “psychotropic” medications. Their just tranquilizers – “numbing things.”

    Our Orthodox faith is a good guide. But I find lots of clergy who are ill-informed about these things whose advice is hurtful rather than helpful. We have much to learn from each other in this great struggle of salvation.

  25. Dear Fr. Stephen
    Thank-you for this post!
    I haven’t been officially diagnosed, not sure I want to be, but in my own writings I’ve referred to myself as living in “Sunshine’s Shadows” or more recently as trying to “escape the gravitational pull of a fallen world”. A friend of mine, a former Navy officer referred to his emotional boat as more of a submarine. But as a Christian, depression is as little understood as it is acceptable. We are supposed to be happy (joyful, I think is a different species). It is difficult to have a tender heart and live in a place of such widespread misery. I once heard depression described as a defensive devise in this context, but like the “shields” on the Starship Enterprise, once the shields are up, there can be no beaming up or down. Defenses are also inherently limiting.

    Thank-you again for your compassionate treatment of a difficult condition. Perhaps there is a way through that condemnation will never reveal. At least I can accept myself as I am.

  26. Father,
    With all due respect, I highly doubt you would maintain even those allowances if you read the book I suggested. However, my strongest conviction on the matter is in informed consent (hence, once again, that book). The vast majority of people given these drugs haven’t the faintest idea of the risks, insidious long-term effects, and addictive potential of these psychiatric drugs. It is certainly not a harmless palliative made by people with our best interests at heart. If people were made aware of the real risks and dangers of these drugs and still thought it was worth it, I fully respect that. But I think most would think twice before taking these drugs if they were fully informed and would look for better and effective means to heal that don’t come with the risks and side-effects. Dr. Brogan (a psychiatrist trained in the most prestigious institutions in her field) and other functional doctors like her see people starting to recover almost immediately without the use of any psychiatric drugs. I think a critical element of informed consent is knowing who funded the advertisements and research behind any given claim. Many of them are patently false and unsupported by research, such as depression being a serotonin deficiency. That myth is a result of the fact that America is one of two countries in the world where it is legal for Pharmaceutical companies to have direct-to-consumer advertising, yet it is repeated so much that people cling to it religiously. Just read the book.

  27. Fr. Stephen:
    SSRIs do indeed mask symptoms frequently. This is very common. Often people tell me that they do not have sad/anxious thoughts any more, but they become apathetic and don’t really care about much anymore. Yes, benzos are dangerous, and to be avoided for the most part. But even I, in throes of PTSD from a plane crash that I survived, used benzos as a means to get on a plane again, then titrated off as the PTSD became more tolerable.

  28. In my understanding, SSRI’s and other such medications are like band aids for a wound. They don’t heal the problem but they can alleviate it to some degree. Having studied the methods/procedures of prescription of these medications, I am very leery of them. Basically they inhibit the re uptake of Serotonin and alter the chemistry of the brain. This works if the balance of brain chemicals is really out of balance, but they cannot actually test a person’s brain chemistry so they could actually make the situation much worse (hence all the side effects warnings). They have some use in stabilizing a person for a period but they will not make them better. They also can be very detrimental.

  29. Noël,
    Yes. SSRI’s are not a treatment…they’re a help when you can’t stand it and the such like. The best route is obviously the most “natural” route if possible. Even Benzo’s in situations as you describe help. For myself, they made flying possible. But I eventually experienced all the problems that can come along with them.

    If this little article has removed a bit of the mystification or even some of the nonsense of the stigma associated with these things, then it’s useful. But there is no substitute for compassionate, empathetic and well-informed assistance – whether by priest, therapist, group, etc.

  30. Anecdotal wisdom gets a bad rap. At its most basic from it is the traditioning of experience. When it comes to matters of the faith it is the best evidence.

    The modern project hates it because it is beyond the control of power. It cannot be systematized.

    Still discernment is always good because it can be faked and used to bolster the consumer mentality and for propaganda.

    I recommend “Where the Roots Reach for Water” by Jeffrey Smith. Helped me a lot.

  31. Great reflection, Father. I predict most readers will not fully comprehend it because most have not had a real panic attack. It’s like a joke: You either get it or you don’t. There is nothing more futile than trying to describe a panic attack to someone who has merely experienced anxiety. It is simply an excercise in frustration. After years of suffering, I have finally learned to live very quietly with the lion sleeping in the corner ( I use diet, excercise and 20 minutes of contemplative prayer each day). By the way, my attacks were less physical. They involved derealization and were more akin to the sudden feeling of being on a strange, ominous planet…. kind of like a short psychotic break. Nasty stuff. I think the roots of all of this lie in your use of the word epigenesis some weeks ago. The sins and traumas of our ancestors impact our DNA (somewhere between ancestral sin and collective unconscious?) It’s one reason my spiritual father emphasizes the need to pray each day for any reposed relatives I know of.

  32. I would be very eager to read your appraisal of it. Alongside a diet and lifestyle overhaul, she talks about meditation, and specifically yoga, as a way to send the nervous system a signal of safety. While attractive, I haven’t followed this advice because of principle. I just stick with my prayer rule. It’s deeply unfortunate that the neurobiological effects of Orthodox prayer and practices haven’t been studied like eastern mind-body practices have. Besides the yoga thing, it’s an extremely solid book and I have been wishing that somebody more steeped in Orthodoxy than me would engage with it intelligently.

  33. With respect to affective disorders there are standard approaches in terms of how these problems may be resolved biochemically: Reuptake and degradation mechanisms. There are others, but they are in principle trying to address the more general issue of chemical concentrations (too much/too little) at the synapse. The brain is a complex organ that is defined by biochemistry. It makes all the sense in the world to address these issues biochemically. Yes, there are side effects for ANY medication…but not always. Most of the side-effects listed for any medication are an “artifact” of the double-blind experimental design, and the probability that anyone would have one of those side effects has nothing at all to do with the treatment.

  34. Thanks Steve. Retired a couple of years ago to Charlotte–fight notion that I am not adequately serving God (sounds like a shame issue!). Dawns on me in the quiet moments that he may want no more than my company. Thanks for opening up this topic. -Rick

  35. I think that we have romanticized the word “natural” and demonized the word “chemical”.
    Science isn’t full of people who are looking to accomplish their ends regardless of the cost like you ALWAYS see in the movies. In every movie where there is a scientist–he is the bad guy. There are many scientists who are Christian (of one stripe or another) or religious.

    The idea that if it’s made in the lab then it’s unnatural is absurd. Every experimental process obeys the laws of physics. And the last I heard the laws of physics are universal.

  36. In cases they work, but altering chemicals in a brain by guess work does not seem to me to be a very good way to do business. I have personal experience with a person whom the doctor decided her brain chemistry was out of balance and assigned Prozac as the remedy. The results were not pretty. While, technically, David, your argument has merit, I would suggest that someone should find an effective way to measure somebody’s brain chemicals so that it is not aa much trial and error.

  37. I apologize, I’m weighing in on the science side of this conversation.

    David Foutch, I appreciate your input here. Strictly speaking, my work has been in physical chemistry although I have been involved in biophysics once upon a time.

    Where I have spent a great deal of professional time has been in academic institutions that were engaged in ‘academic upgrades’ (this is a mild statement). Toward that end, I was heavily engaged in helping both academics and students recognize what science looks like, or rather how to recognize ‘real’ science from that which is not. This is termed ‘science literacy’. The general US public is sadly uneducated in science literacy, which doesn’t help the public to be able to discern a science ‘fact’ from that which is not.

    One of the things I helped an institution to recognize is what constitutes a real scientific background, or a ‘real’ degree in science, which is to say how not to be swayed by the pedigree of the institution from which the degree came, but the specifics of the program taken at the institution, and looking specifically at the course content of specific degrees. This type of evaluation takes time. So, my point is simply this: when a person speaks as an “authority” one might ask, on what grounds they speak as an authority. If it is on the grounds of the academic credentials, then check them out. One word of caution: two semesters in which someone might take only first year science courses to fulfill electives (and that would be the only sciences courses they would need to take to obtain their “science degree” would not be considered a science degree (no matter what school they graduated from) in most of the institutions I have worked in. When someone of this sort of background speaks about science as though they were an authority, I wonder how they are capable of synthesizing science literature with such a meager background in any science field.

    Fr Stephen, you have never presented yourself as an authority in topics of science, but I have always found your own contributions about the Orthodox outlook in the world of the physical and spiritual and clear and helpful and have been very grateful for your measured treatment of science topics as well. Your priestly patience is a role model for me. I wish I wasn’t so much an infant in the faith, but I know that I am.

    To all my elder brothers and sisters in the faith, I have held the opinion that the fathers (and mothers perhaps) in the Tradition have indeed described spiritual/psychological warfare involving both prayer and diet to help the mind, soul, heart and body. Isn’t this what the Lenten “diet” is? And isn’t it the case that monasteries follow some sort of dietary ‘rule’ as well as prayer rule?

    Might this Tradition be considered part of the approach to engage in these battles?

    BTW, I have had experiences with panic attacks as well that were professionally identified as PTSD.
    I can sympathize with the need to resolve a crisis situation quickly, in order to be able to engage with a long term treatment to resolve the trigger source (if there is one–in my case there was). This was before I became Orthodox. Confession is now an enormous help for which I am grateful.

  38. I was once in the world of these chemicals-no more!!! Doctors do not listen when told…sure others have been here and I am sorry and I am thankful to still be living.

  39. Dee of St. Herman,

    I have three years of research in bioinformatic approaches in transcriptomics. During that time I used differential equations and graph theory to model gene regulatory networks. Last semester I used data from MD simulations to do graph theoretical analyses of amino acid networks. Presently I am developing a proposal for evaluating the contribution of the 7 human Apobec3 proteins on HIV escape. I have experience in comparative genomics and UG experience in Neuroscience, human and animal. Presently my PhD is in the ORNL-UT Genome Science and Technology program. My advisor is Russian trained and he is quite demanding in terms of what we call “science”.

    Your comments are timely.

  40. Nicholas,
    That is a huge drawback with current medications – it’s guesswork and experimentation. It’s also why the harder work of therapy is essential (regardless of the setting).

  41. I concur absolutely Father. Sometimes medications can help to keep the person focused while the therapy does the healing. I liken it to putting on the antibiotic cream first (the Therapy) and then protecting the wound and the cream with a band-aid. Without the band-aid, the cream gets wiped off and the wound re-injured.

  42. We are thankful as well. I have seen the effects on someone close to me. The doctor kept increasing the dose level and the symptoms got worse to the point of breakdown.

  43. Been there…some of the damage physically is probably permanent. I can live safely now that I made my great escape from the mental health system…better off.
    Thank you for your kind comment.

  44. Not all doctors practice the art of medicine. Anecdotal evidence, good and bad, always needs to be placed in context. Also, we should remember that there is a distinction between medical practice and scientific/medical research.

  45. Nicholas,

    I am sympathetic to your remarks. Twice my mother was hospitalized for lithium poison before her psychiatrist killed himself. Lithium poisoning is no joke. But, that doesn’t undermine my confidence in quality research and medicine.

  46. I am loving this conversation! Although I do not understand the science, thank you, science people, for making your contributions.

    I took antidepressants for a time, and despite potential side effects, I am grateful I took them. You see, within 10 months I gave birth to my first child, held my mother’s hand while she died, and moved from the Pacific NW in Canada to the southwestern desert in Arizona. One day I realized I was losing my motivation to get out of bed and take care of my little daughter. Thank God I had the idea to get help! The drugs were short term. Yes, side effects were a concern. However, not getting treatment had even more dire side effects I am loathe to think about.

    Meds are not for everyone. There is no panacea for anxiety and depression. Meds have a place however.

  47. Sunny, (and et al)
    You are spot on!! Thank you for sharing the very important and oft overlooked aspect of how our environment effects the affects of our well being. Please allow me to support your case with the following to anyone who doubts the validity of your comment.

    I have recently been made aware of the rapidly increasing percentage of individuals suffering from severe reactions to our chemically toxic environment. I cannot even begin to describe the severity of their reactions which seem to progress into full on rejection of their bodies to almost everything on the planet. These folks have no where to go. They cannot live in a house, cannot eat most food, cannot take “approved” medicine, cannot see the light of day, cannot work, cannot wear clothes, cannot be around the faintest magnetic emmission, etc, etc. They cannot see a regular physician because they have no idea what to do for them. They cannot even be around people because their deoderants, soaps and clothes are even toxic to them.

    The medical industry rejects outright these cases as purely psychological and con jobs to get free assistance. Their situation has indeed forced them into severe psychological fears and thus “panic attacks” that come daily, if not lasting for weeks. I dare to say that most(?) of these cases are women. I personally know of two. And there are many, many more like them. And I might add, these cases are severe, but they are increasing and serve as warnings to the more generalized apathy we suffer from in this failed modern experiment. We are the lepors to them. They have to live in an ultra-pure environment that in many ways has become completely foreign to us. It is us “outsiders” that their bodies reject–they often have no choice in the matter. Essentially, because of our lifestyle choices, we are the rejects….

  48. Agree…no panacea. My body and mind are in , at times, disagreement. I no longer have trust with doctors or therapists. The anxiety can be ferocious and so embarrassing when it attacks in public. Anyone experiencing such understands. I have seen some whom are helped by medications…most discouraging upon hearing the words “treatment resistant”-thankful as those medications have done terrible things to this person and others as well.

  49. My experience with anti depressants was short lived and a long time ago, almost 20 years.

    I am currently working through anxiety and panic attacks. I believe, with me, they occur as a result of food, hormones, my time in life, sending my oldest child off to college….I am new to Orthodoxy and am finding solace and help. My 12 yo daughter notices my increasing distress at times and puts her hand on my shoulder saying, “Lord grant that I may meet all that this coming day brings to me with spiritual tranquility.” This from a prayer from the last elders of Optina which we are memorizing. My husband eagerly prays for me while reminding me of the Jesus prayer. Little phrases come to mind-that He is everywhere present and fillest all things. We asked our priest to be our spiritual father, a huge step for a used-to-be Protestant not-yet-Orthodox believer.

    Prayer…discipline…fellow believers…doctors…nutrition…sleep…there are so many variables, and so many things that can help ease these sometimes ever present troubles.

  50. For what it’s worth:
    My story extends from when I was 19 until the present (63). Most of those years included occasional efforts with medications and off and on work with therapists. All of the years had confession, communion, and some spiritual guidance.

    Until 5 years ago, there were no years of being panic-free. There were no years without anxiety and depression. There were only years of managing it better or managing worse. Various events could send me falling head-over-heels into a darkness.

    But all of the years were marked by spiritual struggle. Not all of them had any marked effect, other than a deepening respect for suffering, a steady increase in empathy and compassion for others and a spiritual understanding that always brought me back to the Cross.

    My conversion to Orthodoxy in 1998, was a guaranteed leap into some pretty wild, uncontrolled times of the worst panic attacks I had ever had. I knew it would be, but I did it anyway, because I believed Orthodoxy to be the truth. I’d rather be crazy than wrong. 🙂

    Orthodoxy has been the context in which I found healing – though much of that healing came directly in the context of treatment rather than the traditional spiritual disciplines.

    What I have found is that the traditional disciplines make it possible to bear suffering and to be transformed by it for the better. They do not make you sicker (and that’s saying a lot!).

    I am utterly convinced that the healing I found was the work of grace and providence. So much so that I can say that I’m grateful for everything that went before. I have a much greater journey to complete, God willing.

    I appreciate the anecdotal sharing. I have been all of those people/stories at some point. God is good and will not ever abandon us. May He help us never to abandon one another.

  51. I appreciate you sharing your story with your friends.

    Also, it is a powerful testimony to the power of the Tradition to use our brokenness as a catalyst for transformation.

  52. My Uncle, who was a Doctor and practiced for many years once told me, when I was very frustrated that my problems could not be addressed, “you have to understand. The practice of medicine is nearly 5,000 years old. We call in “practicing” because we still have not got it right. We know some things work, but we don’t really know why. So we don’t “do” medicine, we still are practicing.”

  53. David,
    I don;t reject medicine, I take piles of it at my age. I just don’t trust everything without a warranted questioning.

  54. Father, your story is inspiring. Thank you for your candor. I made a decision in my life some years ago that I would live by trusting God. Medicine I may doubt, our government I distrust, my own being I know to be a sinner and broken but in God I trust. He has never and will never leave me.

  55. Nicholas,

    I agree with you that we should NOT assume that doctors know what’s best.
    I have several anecdotal evidences of my own to that effect.
    My personal philosophy is that my health is really my responsibility. The doctor is little more than a consultant. I make it clear up front with every doctor I deal with that I am paying them for information and recommendations. In the final analysis I have to make the decision as to whether we will take the direction they recommend. I’m not there to be dictated to. It isn’t arrogance. It’s just good sense.


  56. Thank you so much for sharing this, Father, it is more helpful than you can know.

    I have been free of panic attacks for many years. I had about a dozen of them between the ages of nine and twenty five. I am now in my mid forties. The first one was triggered by acrophobia. I was trying to overcome my fear of heights by going to higher and higher places. After succeeding with heights of 30, 40, 50 feet, I went to the top of an open tower that was several hundred feet high. I looked down from there, and collapsed utterly. I writhed on the deck in the worst agony of my life.

    All my subsequent panic attacks, I now realize, had the same trigger- the fear of a panic attack. That realization came to me in my mid twenties. Coupled with regular physical exercise and daily religious devotions, it has enabled me to manage my anxieties effectively enough that I have gone over twenty years without an attack.

  57. Wonderful discussion. Thank you, Fr. Stephen for bringing a balanced perspective to the topic as well as all of your personal sharing.

    I only have time to write a brief comment now but I want to share a thought or two. None of us who have suffered (anxiety, panic, depression) have exactly the same condition. Each of us, from the time we were conceived, has had a brain/body that continually interacted with its environment – and that interaction impacted the development of that brain/body. Children in the same family, even identical twins raised together, do not have the same experience in this interacting bio-psycho-social recipe.

    I say this because, while sharing may be helpful, we need to also remember that what helps one person may hurt another – and vice versa. Fr. Stephen, you said that your panic came out of the blue – and that is true for many people. My panic almost always emerged from my thoughts – but my thoughts were not voluntary nor were my reactions to them. Each person’s story is a bit different. And this is what makes the use of psychiatric medications so very tricky.

    Having worked in the mental health field for most of my adult life, I have seen people’s lives saved by medications that brought raging symptoms into remission. And I have observed others who experienced no benefit or who could not tolerate them. And I must say the same about psychotherapy. I have also personally experienced an abundance of both psychiatric medications and psychotherapy – and am grateful for both.

    Mostly, however, I am grateful to God – who was with me through my many years of suffering and who guided me to the people who could help me. I never consider myself “cured” but I am immensely grateful to have been minimally symptomatic for many years. As a psychologist, I am pretty open with my patients about my own past suffering (when appropriate) because, as with everything in life, we are all in this together.

    Let us pray with and for each other, trusting that God will sustain and guide us if we ask. Sometimes when we are highly symptomatic, it may seem nearly impossible to pray and to trust – but that is why we are given community. Like the paralyzed man in the Gospel, our friends can carry us to Christ when we cannot walk to Him on our own. I have been carried. Now I am blessed to help carry others.

    To Him be glory.

  58. tony,
    sorry but it’s not quite from one book but I found it in one of my personal collections – I used to amass useful gems like that from articles, talks, homilies, saints, elders, counsels etc. But none of it in a properly referenced manner, just for future personal reference -and therefore some of it I cannot always point to sources. God be with you.

  59. David,
    I agree with your position 100%. I make it my business to know what my problem is, what is normally done to deal with it and all the big medical words that doctors use for the condition so I can fully understand them. More than once I have decided that I needed a second opinion (funny how doctors say that) because what the doctor was recommending did not square with what I had learned previously.

  60. I’m so happy to read this post. It perfectly articulates something I’ve been thinking about a great deal regarding the often unhelpful neuro/spiritual/psycho/physical distinctions of experience.

    Just wanted to add that, in my own case, sticking to a Ketogenic diet has greatly reduced my symptoms of panic/anxiety/depression. The notion that these symptoms are caused by inflammation in the brain, which can be largely driven by diet, is gaining a great deal of traction right now.

  61. Dino,
    Oh. I see. I liked so much that I was willing to translate to my language and post in a Orthodox blog I manage. But I thought it was from one author only… If its a mix of various authors then I would need to know where it came from in order to put the source of the text in the end of the post. Thank you anyway!

  62. Bless, Father!
    Thank you for your article, and if the intention was to make the point that it is not an either/or situation between body and soul, between medicine and spiritual life, it’s refreshing that someone is saying this. Dina, Olga, and Byron all had some inspiring and useful responses, as to what we can do about this, as did Fr. Steven Clarke (everyone had something interesting to say, just mentioning the ones that gave the most direction…)
    One thing I would like to touch on is the word “shame.” This one English word can really be divided into two different meanings: 1) “embarrassment” or even “humiliation” – which I think is what you may have meant in your article, and perhaps other readers did, too, and 2) “shame” the feeling we have from our God-given conscience when we do something bad. These are often confused to the absurd point where today many say we should have no shame (i.e. be proud of your sin).
    The first, embarrassment or humiliation, is self-centered and destructive. It may ultimately be rooted in pride (that is, in the world centering around us; arrogance; not wanting to look bad). Its Christian opposite is “humility,” which also is misinterpreted today in secular society. Humility is not artificially denigrating yourself; it is rather not artificially exalting yourself, realizing that all comes from God. A small example: When a friend of mine first had to make a speech in high school, he was terrified and shook like a leaf. “They will all laugh at me! What if I make a mistake?!” But when other members got up to speak, he realized that, as part of the audience, he was not focussed on whether the speaker made a little mistake, was willing to overlook it, and just wanted them to impart something to him. So the key to losing his anxiety was to want to *please* the *other* person – his audience – rather than focussing on himself, his potential or real mistakes. Get rid of pride (“It’s all about *me*) and get hold of humility (“Let me think about the *other* person’s benefit.”) (I am not neccessarily equating this level of nervousness, however, to a panic attack, which may or may not have more hormonal/biological causes, though not unrelated.)
    The second meaning of shame, as in one’s conscience speaking, is constructive. If we’ve done something bad, we need to go to confession and repent. Then God will forgive us and we, as Orthodox Christians, can be free of things that others who do not have either God or confession cannot be. The trouble comes when a person cannot or refuses to distinguish between a sin committed, and one’s whole self. That is, while the healthy way is to realize that one’s sin is something that can be forgiven and “fixed,” and does not change God’s love for us as a whole person, the unhealthy way is to think: “I did something wrong; that means I am a bad person.” The latter attitude leads either to depression or often the defensive mechanism of refusing to admit that any wrong has been done, because it’s inconceivable/inadmissable that I could be a “bad person.” A person with this attitude will likely lash out at others, project blame on others. It is a totally flawed conclusion and fights against repentance and healing.
    That is just a small two cents’ worth on the ambiguous word “shame.”
    Again, thank you for your article, and thank all the readers for their comments and sharing of life’s experiences.

  63. I began to see the relation of the physical and spiritual in my Bibilical Counseling classes at the Southern Baptist Seminary. My professors pointed out this dichotomy within secular psychology and tried to tie it together for us using Scripture, but I don’t think they were working from the big picture of Christian Tradition. We certainly did not get any teaching from the desert fathers in Spiritual Life Dynamics! 😀

    While in my senior year, I began thinking about the “theology of the body” (as I called it- not aware that Pope John Paul II had written an entire encyclical with that exact title), but to my dismay, even though I had one of the largest theological libraries in the world a few hundred yards away from me, I could not find any writings on the subject of the relation between the spiritual and physical in worship. So, I got a hold of the Pope’s book, which ironically, set me on my way to Orthodoxy. The Orthodox Church continues to connect all the dots I saw as an Evangelical.

  64. Nicholas,
    Just to add my own anecdotal story to the confusion. I was diagnosed with testicular cancer back in 2012. At first the urologist said I could have as little as 6 months (he could not have been more wrong. However, just to give you a sense of urgency. I went on Monday (May 14) to see my doctor to have a node looked at, Tuesday (May 15) the imaging center performed an ultrasound, Wednesday (May 16) my doctor and I reviewed the results, and I received alarming news, and on Thursday (May 17) the urologist performed the orchiectomy. I was scheduled to follow up with an oncologist one month later because I was getting married June 9, 2012 and then going on our honeymoon. When we met with the oncologist I had a series of questions to ask regarding my risks. He almost completely ignored my questions in order to insist on two rounds of chemo and one round of radiation to be given over a 9 week period. I pressed him to answer my questions because form what I had been reading this cancer may not need the standard treatment. He insisted that we follow a decision tree map that he had in his hand. And I said “I am not interested in your decision tree” to which he said and I quote, “I don’t like your attitude.”

    To make a long story short, I ended up seeing an oncologist at the Siteman Cancer Center in St. Louis. He was in complete agreement with my reservations regarding chemo and radiation. As it stands, it has been 5 years no chemo, no radiation and no signs of cancer.

    Take home: Own it and do your research!

  65. David
    Glory to God for All Things. I am glad you stuck to your guns.

  66. David you’re absolutely correct people do need to take responsibility and do the research. Yet most are not able to see quality research from that which is drawn up to sell product or to promote an industry. And most will only accept what they already want to believe.

    There was a time I asked a doctor some questions and the response she gave me was “I’m the doctor and you’re the patient”. My polite response to her was you’re indeed a doctor but I’m no longer your patient and then excused myself and left and never went back.

    But we need to remember our spiritual life is enmeshed in the physical, as we are taught in the Orthodox Way. The discipline of the fasts given to us is more than just discipline (at least for me) it is also food for soul and body for healing.

  67. David,
    Have you ever considered setting up some kind of service to do the research for us common folk who do not have the where-with-all to “own it” and do it our own research?
    On the other hand, I have been down in the pits of psychological/spiritual torment and sought help with the medical profession. Within time, and by the mercy of God, I’m doing much better….and that without doing the footwork of “owning it and doing research”, because I simply couldn’t.
    Then again, I just assume you are not addressing folks like myself.
    By the way, I’m glad you’re still here and are making it through your battle with cancer.

  68. Paula,

    First, if I can do it…anyone can do it.

    However, that is an interesting idea actually. Medical consultation for the big decisions…hmmm. I will ask my advisor about this. It might have some potential…

  69. I have a question that I would sincerely like the input of this community.

    A thought occurred to me earlier today and I haven’t been able to shake it: Do you think that if we could see the world as it is, an ongoing creation sustained by uncreated Divine Light, that our suffering, the darkness, the confusion, the alienation, and the disintegration would seem like a grain of sand before an ocean of light? I don’t posit that as an explanation that diminishes significanced of suffering. But, I have been wondering if the reason the world is so overwhelming to us is that our bodies in an unenlightened state is just so weighed down by the heaviness of it that the world cannot help but overwhelm it. Perhaps with greater theosis, the world would seem “lighter” more tranlucent.

    Any thoughts? Have the Fathers commented on this?

  70. @david foutch

    I cannot comment on what the Fathers have to say about this, but here are my personal 2 cents. The Divine Light that created, sustains, and will ultimately perfect the world, is indeed immeasurably greater than all the evils throughout history. If we were to be able to comprehend the infinite unconditioned goodness of God we would see as St. Paul did that “the sufferings of this present time are not worthy to be compared with the glory which shall be revealed in us.” I think you are right to conjecture that the world would not overwhelm us if we were to have our minds illuminated by this reality.

    I do not know that this present world would seem at all lighter to our eyes though. In fact, I think that it may even appear darker if we had the view of Divine Light with which to contrast the black stains of sin and evil.

    If we could see the full force of God’s glory, I think we would experience our sufferings more completely yet they would be overwhelmed by the power of infinite goodness and love, so that they would appear to us as nothing. That God will someday become all-in-all and this world of suffering will be gone, gives us the hope that we need.

  71. Matthew Hryniewicz,
    “I do not know that this present world would seem at all lighter to our eyes though. In fact, I think that it may even appear darker if we had the view of Divine Light with which to contrast the black stains of sin and evil. If we could see the full force of God’s glory, I think we would experience our sufferings more completely yet they would be overwhelmed by the power of infinite goodness and love, so that they would appear to us as nothing.”

    This makes more sense and is more meaningful. Anything that reduces the severity of suffering and thus reduces the Cross I would immediately regard with suspicion.

    Thank you for your response!

  72. Wow, Father you have moved and touched so many with this piece, given the response it has generated.
    I only offer my words out of an intention to help and add.
    When you speak of shame, I think a lot of shame comes from a lack of love or distrust of oneself which can exacerbate or even cause anxiety or depression. Once you learn to love yourself, you can overcome shame. We can only love ourselves once we are open to God’s love for us.
    I think one of the driving forces behind high medication usage is pharmaceutical companies driving products through doctor’s offices. I am a physician myself and have observed this dynamic directly. Medication absolutely plays a critical role but should be prescribed with discretion and caution.
    I think one thing that helped me overcome my struggles was accepting pain and suffering as a normal and perhaps a healthy part of life. Our society and culture reject pain and reject suffering which leads to self-medicating, avoidance and a worsening of our spiritual state.
    My favorite book of all time about accepting our suffering with grace and humility is Henri Nouwen’s “Turn My Mourning into Dancing”. I highly recommend it.
    On a final note, traditions outside of Christianity also have great insights into our mind-body connection, particularly Zen and Buddhist traditions. I found exploring them to be very helpful too.
    Thank you Father and I hope I helped someone too.

  73. I began to see the relation of the physical and spiritual in my Bibilical Counseling classes at the Southern Baptist Seminary. My professors pointed out this dichotomy within secular psychology and tried to tie it together for us using Scripture, but I don’t think they were working from the big picture of Christian Tradition. We certainly did not get any teaching from the desert fathers in Spiritual Life Dynamics!

    Fellow Alumni (maybe)! I too went to SBTS and I will admit to having some very good professors there (back in 1991). But teaching from the Desert Fathers and the Tradition of the Church? I didn’t even know they existed and no one there bothered to enlighten me concerning that! LoL!

  74. Hi Byron!

    I take it you are Orthodox now? I graduated in 2010, and from what I heard, the school had changed quite a bit since ’91, for the better. Indeed there were some great professors, but still no desert fathers. I think there was a brief mention, but as I recall, the whole Eastern Church was made out to have quickly descended into Universalism early on and embraced some kind of weird hyper-mysticism. .. But it was what God used at that point in my life to bring me to the EOC. .

  75. Davd bigger conclusion. Don’t trust doctors who do not treat you as human beings and listen and respond to what you say. Especially specialists.

    Dee is corect though it can be difficult to sort out the real from the false.

  76. Hello Matthew! Well, I was there during the great split within the convention. I thought the professors I learned under, for the most part, were exceptional teachers and very intelligent. However, they were far from Orthodox. I couldn’t speak to the teachers there now, of course. I don’t recall any teaching on the Orthodox Church (of which, you are correct, I am now a part) during my time there.

  77. Michael Bauman,

    Good science has a strong philosophical component: Multiple hypothesis testing (to reduce bias) and falsification (to eliminate alternatives).
    The most naive thing I ever hear scientists talk about is truth. There is no truth in science. There are theories that are falsifies and those that are unfalsified. Truth in science is the trivial case, i.e. the facticity of data.

    I was nominated to receive an award by my advisor on the sole basis of my understanding of the scientific method…and lo and behold I got it! But, to no one’s dismay I didn’t bother to show up to get it. People put those events together just to pat one another on the back and I just couldn’t care less.

    I prefer to stay busy.

  78. david foutch,
    Regarding your question above to the community: The story by C.S. Lewis, The Great Divorce, I think regards your question with an interesting answer perhaps? Not sure if that is where our reality is but a crack in heaven? And the visitors cannot bear to tread on the grass of heaven for it is like rigid, cutting steel cutting into their feet. Its been awhile since I’ve read it, but it immediately came to mind when I read your comment above. I’ll let you make the appropriate correlations….

  79. mary benton,
    I am interested in your comment above: “My panic almost always emerged from my thoughts – but my thoughts were not voluntary nor were my reactions to them.” If you care to explain perhaps what you mean here? I am perhaps mistaken that our thoughts are voluntarily chosen? Or would this be the case while in a panic state?

    As you have read from my comments in the past, I have suffered from the ragings of PTSD in past years and subsequently agonized in deep shame over these reactions that I thought I should have been able to control: especially for one who refined control under extremely intense circumstances very much out of control and it was my job to bring order and fix the chaos and damages. Its as though I internalized the chaos only for all of it to gush out later upon my retirement.

  80. David A Foutch,
    Your above description of the physics of the brain is incredibly interesting. I am going to venture a question that is way above my pay-grade, but here goes:

    Is there a frequency from outside the brain (like from strong magnetic emmissions or maybe even certain lights or wi-fi like frequencies) which can manipulate these “switches” to shut (or be opened) and not allow the normal flow of chemicals or cause a flood of these chemicals? You mentioned frequencies and these are everywhere? Can these cause interferences in the brain? Is our DNA helix like somekind of frequency receiving antennae? Does prayer operate on a certain “frequency”? And what about our electrical discharges when we are “grounded” by walking barefoot on exposed earth–does this affect these neuro switches? Just wondering at the possibilities….and connections.

  81. David,
    Your response to Michael B has got me thinking and reflecting these thoughts.

    When I taught chemistry to first year students, I said something similar to your comment about Truth and science. At that time, when I was teaching, I went further to make the point that the objective in science (and specifically in chemistry) is to understand the physical (chemical) world, and to recognize that our understanding will never be quite complete, that we need to maintain our humility before ‘nature’ and that we can never ‘know it all’. (note if you will, I taught these courses long before I became a Christian) There will always be more to learn, and whatever we learn next, might well overturn a significant portion of what we thought was correct (or true) before. That is the limitation of what we are capable learning of at any given time, due to lack of instrumentation, or available knowledge or theory.

    I suppose one might call what I just wrote here ‘a philosophy’ of science. Yet I don’t know if I would stop there with that description, with regard to describing the endeavor in science as a philosophical approach only, because there are such things as integrity and validity in science (and these too can be subjects of philosophical discussion). For many reasons (personal and historical) I have stopped seeing science as something that belongs only to the western history version of science that posits its beginnings in the times when it was called ‘philosophy of nature’.

    The scientific method that we teach in school explains well the process that scientists use to select viable theories or hypotheses. But it doesn’t describe the process of exploration itself very well which seems to be a very human (for want of better words) practice that generally isn’t tied to deductive logic. Although some exploration in some areas of science might be so constrained. When once we stumble on something interesting (and/or unexpected), sometimes the only way we might come to understand it is through a process of induction which might not map well to the standard scientific method. That doesn’t mean it isn’t part of the process of conducting science.

    Please forgive me of these ruminations. Anyway, my point that I think Michael referenced is that “results” in “research” can be purposefully slanted to obfuscate facts, to benefit an industry or an individual. Do we not agree that it would not be appropriate to call that ‘science’? Perhaps there might be a valid reason to want to call it ‘poor quality’ science, but honestly, I’m not so inclined. I don’t think it is appropriate to call it science. I’ve got history with chemists who prefer to promote misinformation or obfuscate ‘inconvenient’ findings.

    It was when I submitted my dissertation in chemistry that I received a good dose of what bias looks like in science. My conclusions didn’t sit well with a couple of the chemists on my dissertation defense committee for various reasons, which had nothing to do with the integrity of my work (this I was told in private). Rather, they simply ‘didn’t like’ the work. Since the methods, data, and logic were appropriate, they couldn’t ask me to change the methods, data or the logic (that would get them into too much ‘hot water’) in writing. Rather they asked me to put that part of the study with the data and the conclusions in an appendix, to render it less conspicuous. This was the required action for them to give the dissertation a “pass”. Apparently, this interesting experience in ‘science’ to graduate with a PhD isn’t as unique as one might think. BTW, this was a ‘major’ school in a ‘major’ city in the US.

    It doesn’t sound like you’re encountering this sort of problem. And I’m grateful for that.

    Now getting back to the Orthodox Way. I’ve said it before and for the sake of someone who might think science as an endeavor to understand the physical world is at odds with God or Christ, I’ve decided to say it again: It was through science that I encountered what I now call the icon of Christ’s Death and Resurrection within data. In retrospect, I can see how my training enabled me to have the skill set (and the courage/confidence) not to reject outright the observation. But it was grace that gave me (that led me into) that skill set to obtain the eyes to see. And it was grace that helped me finally accept what I saw. Perhaps this was the only way I would have responded to God’s call to become a Christian and Orthodox, I don’t know. But what I do know is that this discovery was water and bread for my soul that fed a hunger that I had long denied even existed, and yet it was likely due to the thirst and hunger in my soul that I became a scientist in the first place. But if I was searching for Christ in data (of all things), I wasn’t aware of it. I would have flatly denied it to myself or anyone else I was looking for Christ. Rather, it seems Christ found me.

  82. Father Freeman –
    Thank you so much for this piece!! I am now 56 years old, but when I was in my early 20’s I had experienced panic and anxiety so severely that it became crippling and I did not think I would even live to be 25. While I did not take medication I had some wonderful people in my life and wonderful Therapist, Sister Pat Rourke – a Catholic Sister who took a very holistic approach in her work. I also had some older friends who were very supportive. What at the time seemed like going through hell ended up becoming a very healing time and in the rear view mirror I see how God was there with me in ways that I could not even imagine or see when I was in the middle of that period. What is sad is that it seems so many people now who go through this experience often suffer alone and in terrible isolation. Thank you again Father for touching on this important subject.

  83. Perhaps medications would work better if we would offer them to God in Thanksgiving as we took them?

  84. Michael Bauman,

    Maybe they wouldn’t work, but perhaps that would facilitate whatever disorder was being treated as a means for transformation.

  85. Father,
    I lost my father in early adolescence and pretty much swallowed the trauma. A year later, I started to hyperventilate and have panic attacks. Trying to control this phenomenon, I became a full blown agoraphobic. The further I walked away from home, the greater the dread of having a panic attack. It left my teen years as an empty landscape of wondering if I was mad, or if this was what life would always be. The cure was strangely enough dropping out of school, my social connections, and becoming homeless and a wanderer. The loss of a room to hide in provided me the opportunity to suffer weather, hunger and eventually illness, but not have the luxury to spend time in a panic attack.. Even though I continued to have bouts of these issues, they only manifested themselves when I became settled in. I was able to enter college, work my way through it and face these attacks, since as you say, they pass like a sudden mental storm. To dig in one’s heels and refuse to retreat makes one stronger each time. Of course Christ was with me in all of this, and if anyone told me that I would someday stand up and provide sermons and celebrate Liturgy it would have seemed impossible.

  86. Olga said:
    “I would love to hear if anyone is harnessing panic attacks in this way.”

    My prayer is slightly different, and probably stems from my exposure to the faith through attending Saturday night Vespers and not much else.

    “Glory to the father, and to the son, and to the holy spirit, both now and forever, unto ages of ages, Amen. Hallelujah, Hallelujah, Hallelujah, father bless.”

    In my mind I hear the priest singing this over and over, and I’m comforted.

  87. I might add that I have found Orthodox Christianity to be infinitely more comforting than anything else I either grew up with, or investigated.

    Father Stephen’s Blog isn’t my sole source of exposure to Orthodoxy, but I have found things that spoke to me personally over the many years I have lurked here. I’ve been citing this blog for at least two years now when I email my protestant (SDA) pastor with concerns I have had with what he has said from the pulpit. I’ll admit that for many years, the only thing that kept me a nominal Christian was family. It wasn’t until I found Orthodoxy that I could proudly claim myself a Christian once again.

    Thank-you all for that.

  88. Since we’re on the topic of healing, and as someone who has experienced panic/anxiety, (I’ve had the outer space kind of anxiety John was referring to). I wanted to make the point that sometimes healing is difficult because I won’t let it happen. I think it’s a crazy dance between feeling unworthy of the healing, and or me trying to tell God that I must do such and such before I can accept His healing. Like when Peter was trying to negotiate during the washing of feet. I realize I do the same thing.

    Slowing down and reciting the Jesus Prayer helps. I get tripped up sometimes when I focus on my breathing, most of the time I just try to listen to the beating of my heart. That’s something I can’t control. I have to get quiet enough to hear it. When I do, I think …ahh and my prayer becomes more still and I become more grateful. I guess it that docility Dino was referring to (thank you Dino).

    Great conversation. So many helpful comments.

  89. Fr Stephen,

    what is good to read on shame, and as the “master emotion”? Thanks for your writing and thoughts

  90. Dee, thank you for your comment. I would add that I “found” Christ in my live for and study of history which included looking at how an historian’s bias effected the history they wrote. I have long contended that any endeavor if the human hear that is not evil will end up in Christ if followed deeply enough. He is everywhere present and fills all things.

    As to the anxiety/depression. I think we suffer more from this malady because we are so greatly removed from our bodies and what we can create through and with them.

    Craft is a great healer of souls. My late wife was only at peace when she crocheted.
    She was a master of the craft. The SSRI she took took the edge off but did not cure.
    Her whole family had seritonen disorders that went back generations. The men drank and beat their wives (or their daughters in my wife’s case). The women largely withdrew.

    The sins and disorder in our bodies seem to be the most difficult. But that points to yet another reason for the Incarnation.

    God is good.

  91. Sbdn Andrew,
    This is a response that you addressed to Mary. But since I’ve had ptsd and received helpful treatment for it, I hope I might offer some helpful thoughts.
    My experience with ptsd followed a car accident that severely injured my brother and I and killed my parents. When I became conscious after the accident I was outside and under the car. The first sense I had was the scent of burning flesh (my own) as I awoke. That scent became a trigger. Later in the hospital I woke up into a panic attack because my hair had that scent. I asked a nurse to cut off all my hair and she offered to wash it instead.

    This detail is offered to show how that trigger worked and there were more triggers related to that event, but I’m keeping this brief. The scent alone, not prior thoughts, threw my mind into an instant chaos. If I was capable of running, I would have gotten out of my bed and ran. My incapacity to run aggravated the attack and my whole body went into shock, complete with convulsions. I was given a sedative mainly to reduce the effects of shock I think (memory is rusty here on the treatment protocol).

    Later, approximately, two decades, I experienced another series of panic attacks when I went back to college. My life was going very well at the time and I was successful in school, so the attacks seemed to come ‘out of nowhere’. With the help of a school counselor I learned that the attacks came at that time because I was in a ‘safe place’ to process some of the experiences I had witnessed. The thoughts that come in the attack were disturbing and the councilor gave me simple physical means to deal with them rather than trying to stop them with rationalizations or other thoughts.

    Generally I believe the best approach is to seek help. Cognitive therapy might be helpful. Your confessor priest might be able to provide direction toward appropriate support.

    May God grant you peace.

  92. Todd,
    Most of what I’ve read on the topic has been secular and clinical material. The single volume I’ve liked most is Kaufman’s Psychology of Shame: Theory and Treatment. There’s a good amount of material out there.

  93. sbdn andrew,

    Sorry I am just now responding to your question – I had to step away for a couple of days. It is an interesting question – whether thoughts are voluntary…

    I have concluded that some are and some are not. (Perhaps there are some that are in-between as well). I may choose to think about something, such as, “What shall I have for dinner tonight?” This is largely a voluntary thought. Though hunger pangs may help it come into being, I am purposely producing the thought.

    Then there are times when a thought come into my head without my having invited it. For example, an uncharitable thought about someone may pop into my mind, unbidden. It might be an observation about their appearance or even a stereotype about their race. And I use the verb “pop” because it often appears suddenly and I might wonder, “where did that thought come from?” Especially I may wonder this if the thought is something I disagree with, as in the examples cited here. In my conscious mind, I do not want to ever judge anyone by their appearance or their race.

    Sometimes these thoughts can be particularly disturbing if they seem to directly oppose what I believe. These disturbing thoughts tend to provoke anxiety or panic because they are abhorrent and yet, coming from my mind, it seems they must be mine. The anxiety and panic then lead to greater focus on the disturbing thought as I try to prove to myself that I didn’t mean it, which keeps it from passing out of the mind as most pointless thoughts do. This creates a negative cycle, commonly known as obsessive-compulsive disorder (OCD), in which disturbing thoughts lead to panic and all efforts to dismiss the thoughts are unfruitful.

    This is largely the sort of panic I suffered from – and it is not uncommon. However, it can be very difficult to find one’s way out because the more you resist the awful thoughts, the more they persist. Yet it is hard not to resist thoughts that seem so alien to one’s beliefs or nature. Yucky stuff – but it can get better. Much better. I offer this as hope to anyone who suffers from it.

    With PTSD, there are also intrusive thoughts that are disturbing and often involuntary, typically replaying traumatic content. Most people experiencing unresolved trauma really, really don’t want to think about it but the brain insists. (The brain is actually trying to help when it does this but typically it backfires – which is why people often need help to heal from trauma.)

    BTW, in the context of sin, in some of my Orthodox reading I have read that thoughts are often not voluntary. There is no sin, for example, if a “bad” thought enters a person’s mind unbidden and then is dismissed. Things become more problematic if we start relishing the “bad” thought – making it voluntary and increasing the risk that we will act on it. This, however, is a totally different process that the OCD thought persistence. In this situation, unlike the OCD dilemma, the unbidden thought is welcomed and not experienced as disturbing. Such is the case with a fantasy (sexual, aggressive, etc.) that arrives unbidden but then is pursued because of its inherently gratifying nature. Such ventures are often spiritually unhealthy – depending on the circumstances, of course.

  94. Dee and Mary,
    Thank you so much for your careful and thoughtful responses. I am reading them over a couple of times each to let your insights sink in.

    Dee, I have indeed found much healing from my father confessor. All it takes is for him to put his arm around my shoulders as I kneel before the Holy Cross and Gospel and the stuff I’ve internalized leaks out. The unexplained ragings that I guess were like panic attacks would black out my memory. I would run to the wood shed when I felt them coming and take it out on big rounds of wood. It wasn’t always that tidy. I also smashed alot of things. My family would hide…. That was some 15 years ago. Now I get occasional flash backs. In those days, I did alot of extreme sports to deal with the involuntary adrenaline surges until I realized that those activities were just feeding my addiction, not to mention teasing death at every oppurtunity. It was like trying to create my own “trauma” experiences. I would often lie in bed and shake with “fear” responses to how crazy I had been. And, oddly, there was shame at my recklessness. Dee, it is also very meaningful to hear your side to these traumas. I would have been the one “on the other side” of your experience, so to speak–and yet we are both deeply touched by it. My panic would come as, “When is it going to happen to me?” And so I did a lot of crazy stuff to “bring it on.”

    Mary, those uninvited thoughts you mentioned. I think that is where much of the anger came from. So many “uninvited” tragedies and seemingly needless accidents, suicides, violence, and absolute carnage. I don’t want to seem over dramatic, but as you know, everything is internalized. Everything. And confessing this stuff is many times the only way to keep the cup from getting…well, not sure if that would be too full or too empty.
    Hope this helps anyone else reading this.

  95. Much welcomed food for thought. Thanks to all.
    Sight: Translates shadows and reflections of light
    Sound: Translates airborne vibrations
    Touch: Translates pressures, temperatures
    Smell: Translates environment
    Taste: Translates pleasing/or not
    I want to go back home.
    Lord Jesus Christ save me from this body of death.
    Oh, there we have it!
    Celebrate! He Is Was and Always Shall Be!

  96. sbdn andrew,
    Back when, I asked that the mad man be evicted. It was the beginning of healing. Not without it’s ups and downs… not complaining, just explaining. :^) Thanks for your insights. Christ is in our midst.

  97. Neighbor,
    So what is the sixth one? I think it translates into patience. Is life chosen or gifted? So also, death follows the same path. Are we homeless? Only in hell. Who has your back? It’s me, your brother!

  98. Good to know one is not the only one battling anxiety. I’ve have yet to find a cure for it. I do know when it started. It started in fear of my life, Life and death, fight or flight, terrifying situations and many there after I could not win, leave or have master over it. It is frozen energy that replays over and over when triggered, terrorizing my whole body, mind and soul, and I can’t shed it, untie it, release it or reason thru it. One feels captive to it, because it played out of a game script of winner and looser mentality totally unknown to me, and therefore I lost. Takes over when you’re most vulnerable. It is a horrible feeling and can leave you many nights and years sleepless and in endless battles over something that happened long ago. Culture war and culture shock can do it to you too, same as PTSD . Don’t suffer from depression to much, probably because I am a fighter and see every problem as a challenge and a learning point/center. But you can hit frustrating walls so high you think you will never make it. Gets tiring.
    I’ve prayed to no avail, sought counseling but does not work, drugs I can’t tolerate and leave me like a zombie and feeling worse. Even after you know everything about the symptoms and fully aware of it all, you still don’t know how to break or unlock it with a key to the emotional, physical and overall well being health. “The Key is still missing”
    At times when you are real busy it leaves you. Come quiet and space it surfaces at the slightest memory..
    It is like I am practice living my life out in HOPE, if nothing else changes, but would like to see……..freedom God willing.
    Thank you for all the posts and sharing including Fr. Freeman excellent essay on Anxiety. I am wishing everyone well and wellness even if it seems it never comes to me, but still happy if it comes to all who are suffering in this or some other similar way. Praises to his holy name.

  99. Father Stephen,
    the difficulty I have with Fr Zarcharias’ distinction between “giving thanks” best fitting those in the world and “keeping thy mind in Hell” best fitting monastics, is, why?
    I personally find great consolation and profound insight in St Silouan’s word, though I am steeped in the business of life in this world (very much to the point: we are all called to be in the world but not of it, and every monastic is also in the world, in this biblical sense).
    Where I struggle with a distinction of this sort, is where it is seen as a “leniency” for us in the world; that less can be asked of us. I do not see this sort of distinction in the Apostles appropriation of the Faith (none of them were monastics) or the early Church’s martyrs (all of them were ‘in the world’). How do we keep from letting this sort of distinction becoming an excuse for sin? I think here of the nonviolence required of all priests and monastics… this *should* be a calling and witness to all the faithful, which direction we are headed. But instead in practice it has become an artificial dichotomy: monks aren’t allowed to shed blood, so we in the world do the ‘dirty work’ for them, etc.
    This is one application but the same problem abounds in other moral distinctions.

    Father, can you help me with this?
    -Mark Basil

  100. Father Stephen,

    Thank you for sharing your story with all of us. I have only one brief comment regarding the use of medication to treat emotional disorders and substance abuse. I have suffered from depression pretty much all of my adult life and became dependent upon alcohol to “treat” the depression. For me the key to dealing with the depression was treatment with an SSRI, in my case Lexapro,. After the initial period of adjustment to the SSRI, which lasts in most cases for a month or so, I found that my mental state improved dramatically; my mood and energy level returned to normal levels and for the first time is years I was able to sleep through the night.

    The medication has also been key to my recovery from alcoholism. The mood disorder was a major cause of my dependence upon alcohol; therefore once my depression improved the urge to pick up lessened dramatically. I have been taking Lexapro for almost 4 years now, and have also been sober for the same period of time.

    Yes, SSRI’s or any other medications are not magical cures for emotional disorders or substance dependence. Psychotherapy, cognitive behavioral therapy and/or 12 step programs are also key. But in my case, as in many others I am sure, the continued use of a moderate dose of an SSRI on a daily basis is key to keeping both depression and alcohol dependence at bay.

  101. I have been keenly interested in the questions regarding the relationship between the mind and the brain. You certainly seem to need a brain to have a mind. But, the mind has a strong non-material “feel” to it: What’s the weight of a thought? What makes emotions differ from one another? For those so inclined there’s the “added” dimension of spirituality. I think many people wrestle with the question: If the fruit of the Spirit is love, joy, and peace, then why does my depression and anxiety rob me of those fruit of the Spirit? Are these fruits only for healthy people? Why should medication affect my ability to experience the fruit of the Spirit?

    We aren’t physical creatures–more precisely we are chemical creatures. More fundamentally, we are spiritual creatures. And I think the unfortunate circumstance that we find ourselves in is the harsh reality that when the channel is noisy (the brain) the signal (emotion/affect/duration) gets lost or skewed.

    However, I doubt that the psychological domain has a strong influence on God’s work in the soul. I think we often confuse psychological experience is where our interaction with God occurs and it’s not. More specifically psychological experience is where our interaction with the world occurs, or at the very least is represented.

    I don’t mean to create a strict dichotomy, but the mind-brain interfaces with the world and the heart-nous interfaces with God.

  102. David, a friend of mine with a deep understanding of words and the human heart created a diagram of the human being based on Orthodox.anthropology which puts the emotional and the psychological exactly where you do. The out most layer where we interact with the world.

    The place where we commune with God is in the heart of the third and deepest layer.

    I am convinced that depression and anxiety can ( emphasis on can) be part of the movement toward our deeper selves.

    It can be tough to let go of the idea that I am in control and the corollary that I am worthless because I can’t make things better. Thus the onset of the nameless dreads as I call them..

    There is something in there about our physical response too.

  103. David, Michael,
    I think that we may speak of the “deep self” and certainly identify it with the heart. I think it is quite the case that most people have very little knowledge of the true self, and that Christians generally have very little as well unless they have begun some disciplined asceticism with good direction. I suspect that if we truly knew the deep self, we would see God there. The soul is a mirror.

  104. Father, very little knowlege to be sure but a certainty that it is there buried under the piles of rubble that I have dumped over it. But I wonder if it might be uncovered through a discipline of thanksgiving to God?

  105. Where does someone go to find ‘good direction to guide disciplined asceticism’ ? Does a person have to be associated with a monastery? Or do you mean keeping the calendar fasts?

  106. Generally it’s done with a priest/confessor. Mostly I have in mind just the normal sort of calendar fasting – but far more the practice of sobriety (nepsis). It is a kind of attentiveness, and a “sorting.” In our culture especially, we have almost no mental/spiritual discipline. We treat emotions, for example, as things that happen to us over which we have no control. Rather than understanding what’s going on and how to go deeper, we flit about from this to that. No knowledge of the heart can come in that storm. Learning stillness (hesychia) is learning, on the one hand, to quieten the thoughts/emotions. The fathers call this attentiveness “nepsis,” that is, “sobriety.” It’s as though we’re “drunk” on all of the inner noise.

    It should be a normal part of every Christian life.

  107. Mark,
    Mind you, in the story related by Fr. Zacharias, he was not making the distinction between monastics and those in the world. Fr. Sophrony rebuked him for trying to force this understanding/practice on less mature monastics. Fr. Zacharias’ thoughts are very perceptive pastorally. There are plenty of people (monastic or in the world) who get tangled up in the paradox of “keep your mind in hell” and are simply overwhelmed. The word then is “don’t push it.” Giving thanks for all things certainly has a deep paradox and contradiction at its heart – but it’s easier to understand and has a very practical means of application. I have found in my work as a priest and writer that Fr. Z’s distinction has been of help in getting many more people on the road – including myself.

    I think there is nothing in the distinction that creates an excuse for sin. That excuse comes from our own desire to justify our sins, and, as such is merely convenient. We are not doing the “dirty work” by shedding blood. We are doing sin and should not seek to justify ourselves as though we were doing something necessary. We are not.

    The monastic life is not a different form of life. It is the same life engaged with greater intensity. But, for what it’s worth, I think many modern monasteries are far less intense than their predecessors, just as we in the world are less intense in our Christian practice. Modernity (particularly in the First World) has created very sensitive souls. At least that’s my honest observation. I could go on and on as to why I think this is so – but I’ll just put it all under the heading of First World modernity.

  108. Perhaps you might find a moment to comment on Colossians 2 and asceticism: “Therefore, if you died with Christ from the basic principles of the world, why, as though living in the world, do you subject yourselves to regulations—“Do not touch, do not taste, do not handle,” which all concern things which perish with the using—according to the commandments and doctrines of men? These things indeed have an appearance of wisdom in self-imposed religion, false humility, and neglect of the body, but are of no value against the indulgence of the flesh.”

    As Mark mentioned above, asceticism isn’t prescribed in the scriptures. And my impression here is that the scripture would even discourage it. So, are ascetic disciplines like voluntary offerings at the temple: Unprescribed, but optional.

  109. David,

    I think I would have to take issue with your contension asceticism is not prescribed in the Scriptures. Jesus words in the gospel talk about counting the cost of discipleship as the very condition of genuinely following Him. He is the One who calls us to take up our own cross to follow Him in self denial. He also taught in a context where, as an observant Jew, He would have observed ascetic traditions Himself such as regular liturgical prayer and fasting. He may have hotly criticized the *hypocritical* public observance of these ascetic traditions of His faith, but not their observance in themselves, which He rather enjoined. Note also His 40-day preparatory fast in the wilderness where He was tempted by Satan. St. Paul to whose teaching you allude in your comment talked about buffeting his body to make it his slave lest he be disqualified as a participant in the gospel after having preached it to others (1 Cor. 9:27). Along with the self denial preached and modeled by Christ and the Apostles, there are the Old Testament prophets of whom according to Christ, St. John the Baptist, a renowned ascetic, was the greatest.

    It seems only an excessive idolatrous asceticism is forbidden in the Scriptures. A true godly asceticism is implicit from the Genesis narrative of the Fall all the way through Revelation and explicitly enjoined on believers in many places, such as the many calls to prayer, fasting and almsgiving throughout the Scriptures.

  110. It seems to me Christians in the world and monastics alike are called to self-denial implicit in following Christ. It’s just that its outworking will look different. A monk or nun is in a setting that provides space for giving him or her self over to hours of prayer, while a wifely and motherly asceticism properly lived is also a continual denial of one’s own needs and preferences for the sake of the well-being of husband and children. The same self-denial for the sake of Christ will have opportunity for its outworking in parish life, in the workplace, and in all aspects of the communities of which we are a part. When we do all our work “as unto Christ”, this, too, is prayer it seems to me.

  111. Asceticism is normative for Christianity. Christ (Luke 5) specifically says that when the Bridegroom is taken away, his disciples will fast. The Didache (1st century) gives evidence that the Wednesday-Friday fast was normative even in the first century. St. Pauls mentions fastings and vigils. Acts refers as well to fasting and prayer. Christ makes it clear that some demons can come out “only by prayer and fasting.”

    There is this in 1 Cor.:

    And everyone who competes for the prize is temperate in all things. Now they do it to obtain a perishable crown, but we for an imperishable crown. Therefore I run thus: not with uncertainty. Thus I fight: not as one who beats the air. But I discipline my body and bring it into subjection, lest, when I have preached to others, I myself should become disqualified. (1 Cor. 9:25-27)

    The passage in Colossians is referencing the prohibitions in the Law, which, according to St. Paul, miss the point. In my experience, many Orthodox Christians, particularly among converts (of whom I am one), practice fasting in a misguided manner.

    Orthodox fasting is not a version of Christian kosher. There are foods we abstain from, simply as an ascetical effort – because it makes us struggle. But many seem to treat those foods as if they are “unclean” on Wednesdays and Fridays, etc. Reading labels in order to avoid “milk products” is an example. Or refraining from some soup because it’s been flavored with a bit of meat, etc. It’s a form of fastidiousness but can be a terrible and useless distraction.

    Christian fasting is not kosher – it is a struggle. For example, if what is available isn’t perfectly “fast compliant” then just eat less of it. There’s any number of ways to keep the fast. The published “rules” found on some calendars and websites can be very misleading. They are actually only extracts from a more complete set of directions that are found in the Typicon directing fasting for monastics. And I have never met any among the laity who actually keep a full monastic fast (nor should they). That being said, almost nobody among the Orthodox keeps a “strict fast.” It’s moderated. Though some think that if they’ve obeyed the calendar they’ve achieved something!

    Worse still, fasting, according to the Fathers is utterly without use or benefit if it is not accompanied by prayer. I would add to that the giving of alms. I think it is a tragic spirituality that dances fastidiously about delicate interpretations of what is proper or improper to eat in the fast – but take no thought to prayer and the giving of alms.

    In the same manner, some give great attention to women’s head-coverings and the length of a priest’s hair, as if careful observance of such things is a sign of a more pure Orthodoxy, while at the same time practicing a false fast, ignoring prayer and alms-giving. And, of course, they write at length on the internet about these things and damage and bind the conscience of the immature and the anxious.

    Christ actually points us towards the heart in these matters – and away from mere outward observance. He does not condemn fasting (He Himself fasted) but He condemned a false fasting that was not properly directed toward the heart. Asceticism is utterly normal in the Christian life – but it needs to be a rightly-directed asceticism. It’s fruit is easy to see – love of the brethren, love of enemies, gentleness, meekness, joy, kindness. If these things are absent, then our asceticism is deeply misguided.

  112. Fr Stephen
    In your response to Mark, do you mean a greater sensitivity in the sense of greater vulnerability to distraction, etc in First World modernity?

    I think that drawing an association of Orthodox Christian prayer rule and/or asceticism with Judaic practices is looking at these practices in a more ‘exterior’ kind of way., if I’m not mistaken myself. As an example, Christ fasted, and he without sin, therefore this practice isn’t a way ‘of law’ for the Orthodox. Although there was fasting in Judaic practice. Perhaps we need more elaboration, to understand these apparent associations. Also, we don’t restrict our practices to only those described in the Bible. The Orthodox Way is Tradition given to us.

  113. Dee,
    My answer to David has a bit more on the angle of proper fasting.

    As to the “sensitivity” statement…I mean that many modern personalities are quite neurotic. We do not bear suffering very well and cannot bear anything like a serious rebuke. There are many cultural reasons for this, I think. As an example, the use of the eucharist in a disciplinary manner, such that someone should refrain from the Cup for a period under certain circumstances, is a practice that is very difficult in our culture. The mere suggestion almost sends some people into a tail-spin of doubt, shame, etc., that they are unable to bear. I generally do not use it in my pastoral practice for that very reason.

    We are generally unable to engage in “strict” practices without doing so in the wrong manner, making it counter-productive. Some of this, I think, comes from a culture that is steeped in legalism and other things that have made us a very neurotic people. Guilt, in a healthy personality, should be a good and useful thing. In our cuture, it is rarely so. For most, our guilt is tied up in shame, and our culture is extremely ignorant of the dynamics of shame. In short, we’re crazy. I would point to the extreme dysfunctionality of our public life as an example of an extremely sick culture. Our present situation is, apparently, the best we can do and it is eroding day by day.

    It is as the fathers prophesied: In the last days, things will become so difficult that merely to believe will require more grace than was known by the great fathers of the desert.

  114. Yes now I understand, thank you Father. Indeed this culture does seem to be crazy when it comes to understanding our behavior and to discipline, for example, to eating.

    My Protestant relatives were quite ‘put out’ when they were informed they could not receive the Eucharist when they visited my Church.. This response is the sensitivity you describe I think. And as you say, we’re very uninformed about the nature and impact of shame. I’m grateful for your work and writing on this phenomenon which is almost invisible to us. I’m reading your recommendations and at this time, St Siluoan too.

  115. Father,
    Indeed, I agree with your assessment of our cultural condition, but why should there be “a serious rebuke” to begin with? Are we attempting a jab at “tough love” in some instances? I have been rebuked for drinking water while everyone else (of unmentionable clerical standings) downed shots of vodka. My point being, most of the serious rebuke I have experienced and seen has been largely misappropriated. I think it really takes a loving elder or priest to rebuke softly. It is rarely in how it is taken, as most rebuke is taken wrongly, but in knowing how to deliver it that makes the difference.

    And perhaps this from Fr. Sophrony:
    “On the whole, my days have passed without much outside contact. Because of this, I do not quickly arrive at conclusions. Now, however, I am not afraid of being seriously mistaken, supposing as I do that in our time millions of people of the most widely varying temperment and nationality live in a tragic merry-go-round of contradictions to one extent or another similar to mine.”

  116. sbdn andrew,
    I do not assume there needs to be a stiff rebuke – I never use them. However, my perception is that most people, probably myself included, would wither in the face of it. I’m saying that, particularly in our culture, gentleness is probably required at almost all times. The Scriptures say, “A word in due season, how good it is!” St. Silouan spoke about the gentleness of his father’s correction. And there is a reason why Silouan is as popular as he is – he is, indeed, a saint of our time. I do not suggest that we should be other than we are. I simply draw attention to how we actually are.

  117. Again, I agree and thank you for your continued gentle guidance, while realizing too that you are human and I strive to be like you in this respect.

  118. I have been thinking about the matter of ascetical striving. Some time ago, in my desire to follow more closely the teachings of Christ, I decided that one I could put into practice without much confusion or ambiguity was surely, “Give unto him that asks of you.” It’s something that is often qualified. But I remember how Kierkegaard said, (and I quote with much fuzziness) that Bible commentaries exist not to explain the teachings of Christ, but to explain them away. I thought I would take this one at least in a more direct fashion and train myself to have an open hand, for my automatic response to a request to be “yes”, without suspicion or judgement. If anything badly came of this, it would be “on” the other person, not me.

    I think this has been good for me, but not completely. I’ve been practicing it with my children too, for example, and they were turning out a bit whiny and spoiled. So I realized I also have a requirement to train them in self restraint.

    Then a few days ago, I was leaving a place of business and a man who had been loitering in the waiting area followed me out to my car. I had just sat down but hadn’t shut the door when he approached me. I try never to respond to anyone with fear, because I think that must be awful for them, but in some ways the situation was intimidating. There were no other people around. However, I sort of flipped to the default I had been cultivating. When he said, “Hey, ma’am” I didn’t shut the door or move to do so, I just replied causally, “Hey, how’s it going?”

    He said, “I’m doin’ all right, doin’ all right. Could I have a dollar or two?”

    I shrugged and reached for my purse. Meanwhile I was thinking sort of abstractly, “He could grab my pursue, he could seize the keys and take the car, kidnap and kill me, etc.” But I wasn’t having any physiological fear responses.

    Meanwhile he was saying, “Or it could be three or four dollars, whatever you think.”

    I opened my wallet and saw I had only a twenty. I asked him a little curiously (forgetting my manners, I suppose, but not in a “judgey” way) what he needed money for. He said he wanted to get a bite to eat. I handed him the twenty and he looked at me a little puzzled, at which point I kept my face carefully neutral and pragmatic, I did not want him to think I was “interested” in him. We exchanged a few more pleasantries and then he left.

    As he left, I felt he seemed mildly contemptuous and I felt tainted myself. . . by idiocy. A voice in my head said, “Jane, you are an idiot. You want to be a saint, but you are nothing but an idiot.”

    Then I thought maybe the “problem” was that I hadn’t explained to him that I only had the twenty after he had just asked for a couple dollars. Maybe that seemed a little condescending or something. Idk.

    I am not exactly sure why I am sharing this story here, but I know, Fr. Stephen, you and others who write here take the matter of spiritual development through ascetic discipline (which includes implementing Christ’s commandments as literally as possible, yes?) very seriously, and I hope to be on that road as well. This all felt mildly off to me, though, and I wondered about input. Please feel free to delete this comment if it doesn’t fit the spirit of the thread.

  119. Jane,
    I also wonder to myself why giving a twenty to someone should be so “heavy.” It really is such a simple thing. It is often just as heavy to write comments on this blog. You rarely get responses. Mostly, we are misunderstood and I often feel like you–quite foolish for thinking I have such smart things to say. If you decided to write nothing ever again, no one would miss you or know anything different by your absence. And I think it is the same with this man. You are just another handout to him. He’d go on to the next person and ask the same question, “got some spare change?” All we have here are words. All we have for panhandlers is change. Its on to the next blog post and on to the next handout.

    But I think the “ascetic” action or impact is in all the personal reflection that goes on while writing comments and responses. We work at handing out twenties and blog comments towards a “letting go” for “whatever it is worth.” I like to think that I get closer to a deeper life of silence by perhaps saying it “all” here. Not sure that is working…. But I often feel like I’m talking to myself here and maybe God is listening in the next room. In both instances, is often an attempt at prayer for me.

    On a side note, our mission started putting together “care bags” that had water, basic hygiene stuff, chocolate bars, dried fruit, crackers, dog biscuits (many folks have dogs with them), kleenex, cookies, protein bars, Emergen C dry mix packets, instant coffee, etc. and a laminated icon of a saint with a prayer on the back. Sometimes we would include a few bucks, mittens and cap during winter months. And a prayer….

  120. Sbdn Andrew-

    Although commenting on this blog may seem an isolated activity between ourselves and God, I for one am quite enjoying getting to know frequent posters. I glean a great deal from the many people who comment here. I would love to meet so many of you in person and extend my hand in thanks.

    For what it’s worth, I am eager to read your posts when I see your name come up as a responder. You always have something interesting to say.

    I know that I do not know any of you deeply, and wouldn’t know any of you if I passed by you on the street, but this community is a precious thing. So much respect is given, wisdom expressed, and humility shown.

  121. Subdeacon Andrew,
    I’m just saying…you say things that just hit the nail on the head…not only that, but the way you say it … the comparison of the 20 bucks with blogging…your got some deep thinking going on, brother. I’m with Kristin…I look forward to seeing your name. But I get what your saying… blogging is not the optimum form of communication to say the least!
    About your side note…our local homeless man (small town) has two big dogs! I love the guy…we all know him!

  122. Thank you for this post, Father. I was tremendously relived when I read your comment about “the false distinction between psychological/emotional/physical/spiritual matters.” I heartily agree. We are not like automobile with their different parts: an engine block, a battery, a gas tank , a transmission. There is a not a part of me that is spiritual, a part of me that is psychological, a part of me that is physical and a part of me that is emotional. There is just me.

    The following are just some random thoughts about my experience.

    I have a condition called dysthymia, which the DSM-IV describes as “a serious state of chronic depression, which persists for at least two years.” I have suffered from dysthymia for over 40 years. It has been well controlled since I started taking Serzone and regularly seeing a therapist, some thirty-odd years ago. “Well controlled” means my family and I no longer have to endure the severe, paralyzing depressive episodes that made it almost impossible for me to even move.

    But that therapy, while necessary, has never been sufficient. I am also on a long spiritual journey that has lasted most of my life. That journey is not over, of course, because my life is not over.

    I guess my point is that it is all of a piece, I do not have a psychological problem here and a spiritual problem there. I have a cross to bear so, as commanded, I pick it up and bear it.

    Fortunately, Simon of Cyrene appears in various guises to help me out. Because of the way I have been made, I need medication to help me. I also need talk therapy, AA and a spiritual director to help me.

    But it is not a matter of having a flat tire and needing someone to fix that, and then having a dead battery and needing someone to fix that. I am a person, not a car, so I need help in growing and becoming more and more the person God meant me to be.

    I do not need to be fixed. I just need help to grow. I am a life, and life needs help to grow.

    Reminds me of St Paul.

    “What then is Apollos? What is Paul? Servants through whom you believed, as the Lord assigned to each. I planted, Apollos watered, but God gave the growth. So neither he who plants nor he who waters is anything, but only God who gives the growth. ” 1 Cor. 3:5-7

    Thanks be to God,

    Sorry to ramble. Just wanted to share. Thanks again for your wonderful blog.

  123. Thank you, Subdeacon Andrew, for the thoughtful reply. I read it through a few times.
    I believe I will remember what you wrote here:
    “But I think the “ascetic” action or impact is in all the personal reflection that goes on while writing comments and responses. We work at handing out twenties and blog comments towards a “letting go” for “whatever it is worth.” ”

    I had the thought that this also applies to the work of forgiveness. . . it is a “letting go” for “whatever it is worth.” Seeing our efforts as all of a piece in that spirit is a welcome vision.

  124. Jane, Kristin, Paula,
    Thanks for your personal presence reminder which says a lot about forgiveness and prayer being so much more impactful than the visibleness of it. Not sure if it was Maximus the Confessor that said something along those lines, where repentance and prayer, even on the smallest scale, affects reordering of the cosmos in quantum proportions.

    Incidently, I was reading a book of “world facts” this morning and one of the biggest explosions of a star seen by humankind and recorded was in 1054, the same year of the “official” schism of Constaninople and Rome (the East and West). That super nova is now seen with a telescope as the gas cloud Crab Nebula. The day this star was observed exploding is said to have occured on…July 4th!
    See you on the flip side.

  125. Sbdn Andrew!
    (shaking my head!) What an amazing story about the 1054 explosion…to be topped by exploding on July 4th. Now you tell me…coincidence?! God never ceases to leave me in awe! You just never know what’s next…..
    Yeah, I like the way you tie that in with The Confessor’s quote..

  126. Thank you so very much, Father, for this post!! It will be exceedingly valuable to many of us.

  127. There have been a few posts by Fr Stephen that have really grabbed me. Not that there would not have been more had I had the time to read them and peruse the comments. But this one, the comments very much included, have had me coming back and reading several times. Thanks for Fr S and everybody.

    I wanted to share a thought quickly. I realize the focus of the post is on the mind-brain connection and how we need to think holistically about that–“we are not physical vs spiritual beings.” I get that. But recently, in preparation for a lower level survey class in Asian religions I am going to teach to undergraduates, I have been re-reading lots of older books I read years ago on Buddhist meditation. I am Orthodox, or at least am trying to be, so I’d really love not to be attacked for thinking there is something to be gained from a basic awareness of the Asian traditions. You can study them and not embrace them.

    All of the Buddhist sects place emphasis on very basic concentration exercises. This can be as varied as counting breaths as you start to meditate, or even working on an art form like calligraphy or archery–as long as you do it regularly and work on the ability to stay focused–it can count. You go deeper from there of course. But not having this basic practice,it has been said, would be like trying to trying to play guitar without first learning how to tune a guitar and not knowing basic chords.

    I have Gabriel Bunge’s book on acedia (which Fr S mentioned in his post) upstairs and would like to find out how, if this is even there, basic concentration training exercises are part of the strategies developed in the desert to combat acedia. I suspect it is there somewhere. But I notice, just in a basic phenomenological sense, that when I stay focused on things I enjoy, as well as stay with my prayer rule and my practice of quite, and sometimes count breaths before I pray (something I did years ago when I actually practiced meditation) that I feel better. I am no Neurologist. But the front of the brain has the Frontal Cortex, which, as I understand, is where long-range planning and good decision making gets taken care of and built up. MRI scans of long-term meditators show this area getting stronger with practice. If we are to keep with the notion that we are material-spiritual beings and need an Orthodox world view and practice which reflects this, it seems to me that directing some thought to the issue of concentration training exercises could be of use. I also realize I am saying nothing new here. Forcing yourself to go to the Church’s service, to stand, to sing, to pray with the Church, to confess regularly, to give alms and pay attention to who might best receive alms–all that requires concentration. Priests tell us this all the time. But counting breathes before one says the Jesus prayer, or reads the lectionary readings, and training oneself to be really regular about this, can help too. I also think it can be an antidote to negative thoughts and a training of the mind against the addiction to the negative brain chemistry that gets reactivated every time we revisit certain thoughts. I know I am at my best when I simply stop dredging up negative scenarios that have not happened, and just stay on task with things I enjoy and give me a sense of purpose in the world and through the Church.

  128. Todd Isaac, the act of breathing itself is something that greatly focusing and calming in many Eastern philosophies and religions. I think of Yoga, which I used to practice, and how much focus simple breaths are given in that practice. The practice itself is not evil and has many benefits, both physically and psychologically. I can see where using this as a means of focusing one’s heart (and the emptying of it) on God in prayer and worship is of benefit. Physical benefits for the spirit take many forms, I think.

    Forgive me if I have misunderstood your question. Blessings to you.

  129. Todd Isaac,
    Archimandrite Meletios Webber, in his book, Bread, Wine, Water, Oil, treats a bit of the topic. He describes the heart, but pretty much what he describes is the practice popularly known as “mindfulness.” It is a technique. Techniques are not without their use, and we shouldn’t shun them if we use them with understanding.

    Breathing, sitting, etc. are discussed in the Philokalia and elsewhere. Some of the exercises for practicing mindfulness (which are shared with certain practices in Buddhism) are, I think, basic for prayer. But we should remember, Buddhists have beads, Catholics have beads, Muslims have beads, Hindus have beads. We have beads, too (the prayer rope). Most religions practice some form of prostration. These things are simply human, on only seem “religious” because we live in a secular society in which people have stopped doing a lot of human things.

    Knowing how to be mindful is one of the things that moderns have forgotten – so much so that they think it is some sort of exotic religious practice. And then some Christians (including some Orthodox) get all frightened and are afraid that if you do something like that you’ll invite demons, etc.

    We would say, “Let the mind enter the heart.” Letting go of judging, weighing, measuring, etc. all the things that make of dianoia (discursive reasoning), is simply part of good prayer.

    Sometimes Orthodox writing about such practices is so couched in patristic language that people actually have no idea what they’re reading. Then they read the same thing in the language of modern psychology and assume it must be something different. My experience is that they think it must be something different because they have no experience and don’t know what they’re talking about. They defend words but have no idea what they mean.

    I would say regarding anxiety, that anxiety is impossible to live with until you learn to breathe. One of the most important things I recovered when I was healed was breathing. I had gone years without taking a long, deep, relaxed breath. I was taught (by a psychologist) a breathing exercise that will stop a panic attack within about 10-15 minutes, and lower your blood pressure as well. I don’t have to use it often, but I’m glad to know it. It reminded me of the breathing techniques my wife was taught by the midwife for enduring labor.

    Christians can be such silly things and superstitious about their bodies and about techniques. We have become aliens to our own existence. Orthodoxy is Christianity with a body, in a body, transforming the body. This is to say – it’s normal. It’s good to breathe!

  130. Interesting that some think that practicing mindfulness lets in demons. The opposite is the case. They like to rile us up physically and psychology but true mindfulness goes where they cannot go without our direct and willful cooperation.

  131. I appreciate your characterization of panic attacks as a physical phenomenon. As a psychologist, I have seen many people who suffer from panic attacks. Over many years, I have come to the conclusion that they are caused by the adrenaline rush that you describe – something like a hiccup of the adrenal gland that keeps pumping until it realizes that there is no woolly mammoth to flee from after all. Anyone who has been through the misery of one is often concerned that another will occur, since they seem to come out of nowhere. Why our bodies would activate the extra adrenaline is not known.

    If people start diagnosing themselves as anxious or unable to cope, the problem only gets worse.

    In my experience, I’ve seen that panic seems to be a glutton for our attention. The more attention we give it (a natural response, especially if we have not had a panic attack before), the more it grows and the longer it lasts.

    I have had good results from working with patients during panic episodes by helping them to focus on other sensations, including breathing, warmth, an itch, or other systematically relaxing unusual places on the body like the ball of the foot or area beneath the knee, recalling how it felt to pet the cat or bait a fish hook. These are distracting tactics that seem to have the effect of slowing down that adrenaline “hiccup” until the system calms down, starving the panic reaction of the attention it needs to continue, so to speak.

    I did not come up with this approach on my own. I had a patient who was nearly disabled by panic attacks which occupied much of his day, every day, until he badly stubbed his toe while exiting the room during a panic episode. Naturally, his attention shifted to the throbbing pain in his toe, and when that subsided, he realized that his panic attack was diminished, too.

    He thought that maybe pain cured the panic, so he was thinking of pinching himself during a panic attack, but the cure was actually making a deliberate change of attention, distracting himself in a major way, and his panic attack, starved of attention, faded away. By keeping his mind on the panic symptoms and becoming fearful of having more, the problem had worsened.

    The lesson he taught me was that an intentional shift of attention to something else, even a little bit, starves the physical reaction of what it needs to continue. It might try to get attention again, but if the patient refocuses their attention on something else, considering the panic to be just a physical quirk and not a sign of some mental pathology, these panic episodes tend to get weaker and rarer over time. As they say, however, your mileage may vary. But for what it’s worth, here’s what I have seen to be helpful with some patients.

  132. As a Matushka and a mental health Nurse Practitioner your article is a balm to my soul. I sometimes feel I live in two worlds though I know in truth it is all one. The wisdom you have gleaned from your experience and study of the writings of the holy Fathers on what we now call depression and anxiety and your ability to share this with others is a wonderful gift of God I am very thankful for!

  133. Father bless. Fr. Daniel told me to read Dragon’s Wine and Angel’s Bread by Gabriel Bunge to help me with my anger. While reading about acedia I decided to see what you had to say, which brought me back here. (Back then I still called myself Learning To Be Still.) Re-reading your post and the comments teaches me how little I knew then, which teaches me how little I know now.
    I suspect I may come back to re-read all this again. Dino’s extended comment is especially helpful to me.
    All of the foregoing being nothing more than a very long way of saying, “Thank you, Father.”
    IC XC
    NI KA

  134. Father, how does one deal proactively and positively with the use of psychiatric medications to control people rather than helping

  135. How do we embrace our suffering without drowning in it? Is a similar question I think, Michael.

    I’ve not many positive words for the use of drugs to deal with pain. But my path that I took when I suffered most, while without drugs or drink, was not necessarily one I would recommend, either. I lived a hermit’s life in all the humility and humble circumstances that such a word might imply. It was therapeutic in its own way. Nevertheless, eventually I received counseling. Later, thanks be to God, I received Christ. The troubles are not over. There are different kinds now.

    Dear Michael I have sincerely appreciated your words over the years here in this blog. May God bless you and your wife and son this feast of the Nativity, many more years of love and joy.

  136. Dee, as I have appreciated yours. Thank you for your blessings may God multiply them and return them to you and those you love.

  137. As someone who deals with anxiety on a very regular basis and also battles depression, this has been a wonderful and encouraging read. Our family is newly Orthodox (we were chrismated one year ago) and I come from an Evangelical background where mental health issues are frowned up and connected with the demonic. I would love to know, since this article is a few years old, if there are books from an Orthodox perspective regarding this topic? I feel like Orthodoxy is SO much more helpful for someone battling mental health struggles such as anxiety/depression than my Evangelical upbringing so I am very interested in learning more.

  138. Bekah,
    Time and Despondency, by Nicole Roccas, is a good read. Our Thoughts Determine Our Lives, the life and teachings of the Elder Thaddeus of Serbia is a comforting and encouraging read as well. One piece of advice is that if you’re reading something and it troubles you, lay it aside. Just because it’s Orthodox doesn’t mean that it’s automatically the thing you might need.

    I’ve got a book on Shame and the spiritual life coming out in early 2023 that you might like as well…stay tuned…

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