In the fall of 2014, my wife, Carol, and I dropped off Josh, the oldest of our three children, at the University of California, San Diego. We left Josh in his dorm room amid the usual parental tears. The semester went well, and he came home to Palo Alto for winter break.

Sitting in our family room at the end of the two-week break, Josh confessed to suffering from major depression and suicidal thoughts. He was careful to tell us that he was getting good care from the school’s counseling and medical services and wanted to return to school. He also expressed relief in finally sharing with us what had been hurting him for some time. Josh assured us that he would get better. We sent him back to college but were left with heartache and a real sense of concern.

That next semester was a disaster. Josh’s grades were abysmal, and there were days when he could not even get out of bed; a friend brought him food and water. When Josh came home at the end of the second semester, he worried about going back. It was hard for us to think about him remaining at home. Our children, after all, are supposed to follow a set path—they go to college, live on their own, get jobs, start a family. The idea that Josh needed to take time off for his own mental health was hard to accept.

My wife and I found him an amazing psychiatrist who wisely advised us to let Josh stay home while he regained his health. That was the beginning of one of the most difficult journeys of my life.

Sometimes I would go into Josh’s room in the afternoon and find the shades still drawn and Josh in bed, curled up. I did not know what to say to him, and initially I said the wrong things: “Get up, Josh,” or “Here’s what you need to do.”

At first, when Josh did not return to college, My wife and I were embarrassed. We wanted to hide his homecoming because it felt like a failure.

I think of myself as a good parent. As a congregational rabbi, I have even taught parenting classes. And yet, my reaction was driven by ego and distrust. Ego to think that somehow my pain was unique, and distrust to think that friends and family would not respond with sympathy.

Once I was able to talk about my son’s condition, doors opened. People began to share resources with me. One friend, who did not know what to say, just sat with me while we drank beer, his way of offering care and compassion.

As I spoke about my pain and fears, people started  sharing their experiences with me. My family was far from alone in facing mental illness. I learned about families with children who could not leave their homes or engage in the world for months or years because of depression.

Even those I thought I knew well had stories to tell. One woman told me about her struggles with bipolar disorder. She would hide in her mania—become overinvolved in projects and ignore her health—knowing the crash was coming. The mania at least felt better than the lows, she explained. Then there was the woman who wanted to throw herself into a river and stopped only because it looked too cold.

There is an epidemic in the United States that is shoved into corners and suppressed. Fewer than a dozen people in the United States were diagnosed with Ebola in 2014, and it was all we read and talked about that year. Depression and mental illness affect millions, and yet we are too silent on the matter.

There are two types of sadness described in Hasidic thought. The first is merirut, a bitterness we feel because we care, because we experience pain and loss. It is the sadness of Naomi in the Book of Ruth; she names herself Mara, bitter one, after the deaths of her husband and sons. That bitterness dissipates when she holds her grandchild in her arms.

Even in extreme forms, there is value to this sadness. I knew a man everyone called Captain Marvel. He and his wife had a great romance. They loved eating ice cream together, dancing together. They learned from and with each other. And then he was diagnosed with brain cancer; six months later, he was gone.

His wife had imagined trips and adventures with him and time with grandchildren—and now she was alone. A few months after her husband passed away, she told me, “Sometimes I just want to stick my head into the oven.”

Her mourning, though intense, was merirut. It came from circumstance, and over time it ebbed in intensity. About a year after her husband died, she had a dream about him. He visited her and caressed her. He told her he loved her and that it was O.K. to love and be joyous again. She woke up with tears in her eyes and was able to begin the process of moving away from her merirut.

More paralyzing is atzvut, a grief that comes from nowhere. It can be unexpressed merirut, an unspoken sadness. But it can also be biochemical. After his military victories against Israel’s neighbors, King David does not leave Jerusalem for several years. Indeed, there is no evidence that he leaves his house. This paralysis may be a reaction to the violence he experienced during his years of fighting. Or it may simply have been the flip side of his incredibly productive, almost manic successes. Whatever its cause, King David became inert and depressed for years. Ultimately, only turmoil in his own life—the rebellion of his son Adoniah—brought him out of his dark mood.

How can we tell the difference? Merirut is expressed in tears and brings change; atzvut in blank eyes and deep disengagement. I have seen atzvut with Josh. Several months ago, we went to brunch with family at Greens Restaurant in San Francisco. Josh sat quietly through the two-hour meal, staring at nothing. A part of me wanted to shake him: Can’t you smile, talk, be with us? But another part of me, witnessing the foreign landscape of atzvut, just felt hurt and crushed.

It takes a community, doctors and sometimes medications to heal atzvut. It takes willingness on the part of the sufferer to express his or her pain. Even then, it may linger—or go away for a while and then reappear.

We have all experienced merirut, but not all of us understand atzvut. I need Josh to be my guide, to show me the way to help him.

My own experience, my own feeling of failure, is helping me realize what I really care about. And it is not my children’s college grades or career. I just want my kids to be able to get up in the morning, to be in touch with their own inner blessings and to find ways they can share them with others.

Josh, my beloved Josh, is so visibly hurting and I still don’t know how to help him. That is the greatest struggle for a parent. I have begun asking him what he needs from me. When he guides me, there can be good results.

I need to listen more to Josh; I now know how much shame and silence surrounds mental illness. It is my own impatience and frustration that leads me to angry or unhelpful remarks. I am learning that it is Josh’s role to heal; my role to offer him love.

And to love more, more than I thought was possible. The highest, truest expression of God is love, a love for being, for creation, for all that is. That means even when we encounter atzvut, we have the tools to respond, highest among them being love.

David Booth is the senior rabbi of Congregation Kol Emeth in Palo Alto, California. 

Depression by the Numbers

Data compiled from the National Institute of Mental Health and the American College Health Association:

Major depression is one of the most common mental disorders in the United States, affecting approximately 17.6 million Americans each year.

Only 50 percent of those with major depression receive treatment.

More than 30 percent of United States college students report symptoms of depression.

11 percent of adolescents have a depressive disorder by age 18.

 

Recommended Reading

 The Noonday Demon: An Atlas of Depression (Scribner) by Andrew Solomon

Darkness Visible: A Memoir of Madness (Vintage) by William Styron