So much of depression is loneliness, that self-selecting symptom of the illness.  Depressed people are isolated people. Like their brothers-in-arms, the pessimists, proven by science to have a more accurate perception of reality, they can lay out a pretty convincing argument in support of misery, insisting on the unadulterated view of reality that is the dubious gift of the illness.  Not a lot of fun. Even the best of friends will not show up at the door with homemade soup; that is fantasy, the stuff of romantic comedy as portrayed by Kay Redfield Jamison.  Fair-weather friends find you exasperating, or worse, fodder for gossip.

What if, in addition to medicine, a doctor could prescribe a depression doula?  The episiotomy– er, etymology— of doula is servant. What if the  depressed person had an able servant to mirror, to work beside: “Let us chop the wood, let us carry water.” Someone with whom to sit on the sofa, under a blanket, to help craft gratitude lists, gently extracting blessings from the depressive’s cloudy head with the precision of a surgeon removing shrapnel;  a doula, like all doulas, charged with bringing forth life.

Even someone to be shadowed by at work, offering encouragement to make that call, to finish that spreadsheet, to tell you perhaps today is not the day to quit your job.  No extroverts need apply…no Maria Von Trapps strumming guitars and singing a lyrical version of a self-help book. No self-respecting depressive would open the door with that on the other side. When the dog bites, when the bee stings– stitches, lawsuits, anaphylactic shock.  Sad business, that.

The depression doula would needs be a resilient optimist, but a stoic one, preferably with a wry sense of humor, like, say, St. Thomas More:

“[how can anyone] be silly enough to think himself better than other people, because his clothes are made of finer woolen thread than theirs. After all, those fine clothes were once worn by a sheep, and they never turned it into anything better than a sheep.”  ― Thomas More, Utopia

When someone says, “I’ve been a little depressed lately,” it is a lie.  Relying on “earrings and a bit of lipstick,” in whatever their forms— false smiles, forced small talk, nervous, upbeat chatter—depressed people try to keep a “normal” facade. They do not often mention they are “a little depressed”  for they are always a little depressed. “I’ve been a little depressed lately,” from someone who doesn’t talk about it is something more.

A few years ago, a woman with whom I was acquainted began to stop me after Mass on Sundays. On the church patio, drinking bad coffee with powdered creamer out of styrofoam cups because, regrettably, Catholics lack the de rigueur of the Episcopalians, she told me weekly how depressed she was. Her medicine wasn’t working. She was French,  married to a Frenchman who had that flirtatious, French twinkle in his eye, and she wore pressed cotton dresses reminiscent of 1950’s garden parties.

I had been in her home, a tidy little ranch, but we were just acquaintances. I wasn’t quite sure why she was sharing her deep sadness with me, other than the fact she had a general knowledge that I had hoed the same row. I thought, self-centeredly, she was just plumbing the depths for common ground,  for small talk. A few months into it, she shot herself dead.

I would have been honored to have been her doula. I was a lonely mother of young children home all day; I would have considered it a privilege to visit her, pick the oranges from her trees, squeeze fresh juice. We could have chopped onions together and fried them and stirred in the broth. I could have been present.  She had been asking, but we hadn’t had the mutual language to interpret her request.

As Pope Francis instructs us, “In life, God accompanies persons, and we must accompany them, starting from their situation. It is necessary to accompany them with mercy.”

You will have to cancel plans because your cousin’s birthday/crisis at work/can’t write, panicked over visas/sorry, dog to vet today/big project due, the regular practicalities of daily life and obstacles to presence. Would we not accompany with mercy if we knew the language of despair?

“I’m not much one for driving now,” means he physically can’t drive. “There doesn’t seem to be a place for me in the world,” means  she’s thinking of checking out.

We need a lexicon for help.

If you hear the muted drumbeat of profound loneliness and desperation, even late at night, even if the house is dark, show up at the doorstep in your apron. There is hope to be birthed in the world.