Severe depression and the Camino

[Walter1407]

Good day!

A close female friend of mine has been suffering from severe depression for a few years. Psychotherapy does not help much, and the medication she is taking makes her sleep for 10 or even 12 hours per day. She has become more and more afraid of things and especially of people.

On the few occasions when I managed to motivate her to join me for a day of cycling or hiking, she brightened psychologically, even if she was very tired physically.

I have recently suggested to her to join me from the outset of my pilgrimage which will begin in March next year. She'll of course be able to quit any time she wants. I am starting 1400 miles from Santiago, planning to take it easy all the way, and especially during the first days.

My hope is that the Camino will help her get away from the circles of dark thoughts that are turning in her head. My fear is that things, something, will run out of control, and that her situation could become worse than it was before. Currently, she would not be able to walk alone. I believe that the Camino could be of great benefit to her, but I cannot be sure. And I don't want to encourage her to do something that could hurt her.

Assuming that she joins me, and assuming that things go well, I think she'll have to adjust (reduce) her medication at some point. We would have to sort this out by contacting the doctor by telephone. Probably because of her medication, my friend cannot handle strong sunlight and heat well. Should we manage to get as far as Spain together, this could become an issue, and is one of the reasons I would prefer to walk the (physically harder) Camino del Norte.

I have talked to my friend's psychiatrist who is hesitant. As she doesn't know much about the Camino I would much appreciate any feedback (forum reply or private message) that might help us take the right decisions. Thanks!

 

[Olivares]

Your friend seems to be lacking Serotonin, a chemical naturally produced by the body and used as a neurotransmitter by the brain. For many reasons (genetics, food, lifestyle) very often people's systems sometimes fail to reach the needed levels of serotonin and this translates into symptoms such as depression, irritability, stomach problems, etc...EXERCISE is known to spike the levels of serotonin dramatically. It would appear to me (opinion) that the Doctor is treating the symptoms (imsomnia) and may not be in tune withthe underlying cause(s). The fatigue she experiences may also be a side effect of the meds she is in. A Catch-22.

I would definitely encourage her to engage in an Exercise Plan where she gradually increases the duration and frequency of exercise activity. As she gains endurance, to start lowering the dossage of the meds. The exercise should NOT be done right before going to bed, but anywhere between a couple of hours after getting up to 4 hours before planning bed time.

I think that you are very well intended but that you may be over-simpliflying a recovery plan for your dear friend. It takes a lot of hard work and time to get out of a severe depression cycle(s), and three months (March 2015) may be a bit too soon. While working on recovery, she should stay closer to her medical support. I think it is a fantastic idea to plan a travel adventure that involves physical activity, but I would advise you to plan such closer to home and more limited in scope...but by all means, you are definitely on the right track. Best of luck!

 

[naplesdon]

You are talking and walking on some very fragile grounds. Not to sound too lighthearted but I am reminded of Robert Plant's lyrics, "Doctor, doctor give me the news...." which is not exactly on point, but I think you need some qualified medical advice to do what you are planning to do with your friend.
I have walked every year for the last 4 years to remember my daughter's suicide in 2010. I never sought psychological advice. However, I'm sure I'm suffering from some form of depression but the planning of my annual trek on the Camino, walking for 40+ days and reliving the experience on this forum is the mental therapy that helps me to continue to live my life.

 

[Walter1407]

Your friend seems to be lacking Serotonin, a chemical naturally produced by the body and used as a neurotransmitter by the brain. For many reasons (genetics, food, lifestyle) very often people's systems sometimes fail to reach the needed levels of serotonin and this translates into symptoms such as depression, irritability, stomach problems, etc...EXERCISE is known to spike the levels of serotonin dramatically. It would appear to me (opinion) that the Doctor is treating the symptoms (imsomnia) and may not be in tune with the underlying cause(s). The fatigue she experiences may also be a side effect of the meds she is in. A Catch-22.

I would definitely encourage her to engage in an Exercise Plan where she gradually increases the duration and frequency of exercise activity. As she gains endurance, to start lowering the dossage of the meds. The exercise should NOT be done right before going to bed, but anywhere between a couple of hours after getting up to 4 hours before planning bed time.

I think that you are very well intended but that you may be over-simpliflying a recovery plan for your dear friend. It takes a lot of hard work and time to get out of a severe depression cycle(s), and three months (March 2015) may be a bit too soon. While working on recovery, she should stay closer to her medical support. I think it is a fantastic idea to plan a travel adventure that involves physical activity, but I would advise you to plan such closer to home and more limited in scope...but by all means, you are definitely on the right track. Best of luck!

Thanks a lot for your advice, Olivares. It helps to clarify things. However, having had to watch my friend getting worse over the years despite medical support, I feel it's time to try something new. The doctors never supported my suggestion for more exercise, despite all the signals that it helps, just as you outline so well.

 

[Rebekah Scott]

I suffer from periodic clinical depression. Not so debilitating as your friend's, (gracias a Dios) but I can see myself in the symptoms you list.
Depression is not "solved by walking," but it is surely pushed back into its place. If I did not have the Way, and the walks, I would be less than half the person I am now.
I recommend it.

 

[J Willhaus]

Thanks a lot for your advice, Olivares. It helps to clarify things. However, having had to watch my friend getting worse over the years despite medical support, I feel it's time to try something new. The doctors never supported my suggestion for more exercise, despite all the signals that it helps, just as you outline so well.

Walter,
Some people suffer from a type of depression called Seasonal Affective Disorder (SAD) and the treatment is either to increase the amount of sunlight the individual gets or use a special light each morning which mimics sunlight. The improvement comes when the light/sunlight is able to reach the retina which in turn boosts serotonin in the brain. Olivares is right that exercise also increases serotonin, but being outside in the sunlight or even the natural daylight is also helpful. My husband finds that exercise helps him with his chronic depression, but that outdoor exercise (especially in the morning) helps him even more. In the winter, he uses a special light box each morning and found that when he could not get out in the summer (or did not get out because he was too depressed) the light therapy was also a useful treatment in addition to his medications. Although I have not been on the Camino myself yet, I am assuming your friend would get plenty of natural light if you are out walking each day. She may find that she is also less tired from her depression and has a more natural physical tiredness from the exertion. Medications should not be adjusted without the consult of a provider so this would need to be worked out in advance as you suggest. If your friend is having anxiety about other people, this may be a separate symptom and should not be lumped in with the depression. Many times people have multiple or concurrent behavioral health conditions. Your friend might work with her healthcare team to make a plan which may allow her to join you for all or part of the journey.

 

[Kitsambler]

I have a few personal thoughts, in no particular order. If your friend's current treatment plan is not working for her, then perhaps a second medical opinion would be useful. Mental health issues have a variety of causes and treatments/coping mechanisms. She seems reluctant to make the walk, and her provider also - perhaps this is something that needs to be listened to, as there may be information you are not privy to. The Camino experience is great for many people, but not necessarily for everyone. While I applaud your urge to help your friend, I wonder if this verges on a desire to "fix" her, whereas her greater need is for acceptance and support. Regardless of all that, I'm completely unconvinced the stretch from Zurich to Le Puy is the right one for such a situation: I'd recommend a more populated, better resourced section. Can she meet you in Le Puy, Cahors or Pamplona?

 

[mikevasey]

Hi, I respect your effort in trying to help your friend, I was going to walk my third Camino with my closest buddy who suffered from severe depression and was being prescribed several medications, in the end the whole enterprise felt to much for him and he backed out. I can write about it now because he passed away a few months after. Your friend will feel vulnerable when she thinks about doing this camino.With my friend even photos of people looking happy, content could provoke social anxiety, there was an inner mechanism that would make him want to hide from such situations, part of him felt not worthy of being amongst happy people,so sometimes even selling it as a place of transformation could be unsettling, he could not imagine the change for him only other people. We were only going to walk 500+ km's, for me distance is not can issue anymore I know that its just a matter of taking that 1st step, but on reflection I think I underestimated the fear he felt, I realised I should have given him the options of bailing out on camino when he wanted and would have reassured him that I would have helped him get home safely, I didn't at the time and I think he felt it, I am not sure why I have written this, possibly because we hold mirror up to our experiences so that other people can look at them and maybe take something which will be of use to them and avoid the same pitfalls.
Good Luck to you, If I have one bit of advice learn to be skillful in being very gentle with her.

Buen Camino

 

[Walter1407]

Your friend will feel vulnerable when she thinks about doing this camino.With my friend even photos of people looking happy, content could provoke social anxiety, there was an inner mechanism that would make him want to hide from such situations, part of him felt not worthy of being amongst happy people,so sometimes even selling it as a place of transformation could be unsettling, he could not imagine the change for him only other people.

Thanks Mike!
Your post is really very helpful, as you describe very clearly the things that I would worry about. It think the situations of our friends have a lot in common. My proposition to her is a bit different: I have invited my friend to join me, without any plan for how long that might be. Should she decide to return home while we are still in Switzerland, this will be easy. Further along the Camino, I would arrange for someone to pick her up.
It's probably best if I don't raise the issue with her again. I think she is discussing it with herself at the moment. I'll get an answer when she's ready.

 

[dougfitz]

@Walter1407, I was fortunate enough a couple of months ago to attend a viewing of the Australian documentary 'The Unlikely Pilgrims' which took the tagline 'nothing heals like a little distance''. Its blurb states:

The film follows Ronan, a counsellor, who believes that rescuing can do a lot of damage. He also believes in the healing power of long-distance trails. Ronan invites a group of recovering addicts to walk the 800km Camino de Santiago, with him as their guide. The walk challenges them to breaking point, and there is immense growth, but there is significant cost to Ronan as a result.
​

For me, it reinforced that anyone who encourages someone who is mentally fragile to join them on a venture like this takes on an enormous responsibility. Amongst other things, it really requires the person who acts as a guide to determine what is most important - the achievement of any personal pilgrimage objectives or the welfare and care of their companions. If it is the former, my view is that you should re-think whether you are in a position to meet whatever care needs guiding your friend will bring.

I can sense the objection that your friend would walk as an individual, and be completely responsible for themselves. All I would say to that is if this was going to be your approach, you would be abrogating your responsibility to her having encouraged and perhaps supported her so far. You know her condition, and you are encouraging her to undertake a journey that requires both physical and mental endurance. If you are a key part to her mental endurance on this venture, then you have to be with her wherever and whenever she needs you while you are walking.

As an aside, the screening was arranged by the University of Canberra Faculty of Health, with a panel of mental health and drug rehabilitation experts available to discuss the film afterwards. The general view was that the documentary failed to demonstrate its underlying premise, ie the healing power of long-distance walks.

Both the counsellor (Ronan) and one of the participants in the walk were present. The particular participant admitted that this screening was the first time he had been in contact with Ronan since the documentary was filmed almost a decade before. Their relationship had been fatally damaged in the process. While that might not happen with your friend, I think it worth considering that such an activity will put enormous pressures on any relationship, more perhaps, than you might realise in your enthusiasm to find a way to help her.

 

[Mark Lee]

For some people depression is caused by an experience or experiences in their lives. The best psychiatrist or medicines in the world will not reverse the negative experience/s. For some walking the Camino is the best non-prescribed medicine around.
I found it to be the healthiest thing I have ever done physically, spiritually and mentally.

 

[simply B]

@Walter1407 -

My sentiments are with @dougfitz, @Kitsambler, and @biarritzdon on this one. I can only augment their words a bit.

On the few occasions when I managed to motivate her to join me for a day of cycling or hiking, she brightened psychologically, even if she was very tired physically.

Taken as true, you have the experience to also realize that the long string of days are an entirely different, and more taxing, experience.

I served as a guide for a long-time friend with neurological problems on my last Camino. Here's the deal - it was not really "my" Camino in the typical sense, at all. (It was an act in the service of friendship of 40 years which, as it turns out, was an entirely different Camino in itself.)

But more to the point, some questions:

1. One does not get psychologic counseling over the phone, not well at least. Are you schooled in understanding how/when to balance the meds being taken?

2. Can you set aside your expectations of daily distances achieved to be a careful watcher and interpreter of your friends mental status?

3. Can you set aside hopes of how and when they are supposed to get better?

4. Are you ready for the inevitable "crash and burn" where everything turns to ashes in a heartbeat, despite your best plans and intentions?

5. Do you have the experience and skills to make the call as to how to proceed when #4 occurs?

6. A lot of the psychoactive meds out there have strange impacts on nightly behavior at times of transition* - are you ready for many sleepless nights and able to function well despite them?

(* "transition" - physical changes impacting brain chemistry requiring either change in dosage, or cessation of the drug entirely.)

I think you are a great person for wanting to help in this manner but I think that you have to be able to answer "Yes" to these questions before proceeding blithely. #1-3 have to deal with how much objectivity you can muster in the face of your friendship. #4-6 are a measure of how well you will handle the really bad days. Because they are going to happen.

B

PS. If you have specific questions, feel free to PM me. That will alert me via e-mail. (I am not getting much time at the moment to log in here to my favorite on-line haunt.)

 

[cher99840]

@Walter1407, a 1400 mile walk would be daunting to many people, including me. I sense that your motive for wanting to include your friend in this potentially healing endeavor is loving kindness, but I wonder if you aren't being a bit overly optimistic. There is potential healing, but there is also potential breaking. You say that she could quit whenever she wants to, but will she recognize the need to do so should it arise, and more importantly, will she act upon it if she does recognize it? Are you willing to interrupt your Camino at any moment to escort her back to her "safe" world? If you see that she is improving by doing day trips, have you considered postponing your long journey and continuing with day, then multiday, etc while her healing progresses. Your priorities are unknown to me so I can't guess where her healing fits in or how much personal sacrifice you are willing to endure. I do think that you would be taking on a huge responsibility. As for the medication question, I agree that it could be dealt with along the way, but again, dealing with it could result in delays to your progress. Only you know how such delays would effect you. Finally, can you maintain your own well being on such an arduous slog, with the added burden of concern for a fragile companion?

 

[Walter1407]

@Walter1407, a 1400 mile walk would be daunting to many people, including me. I sense that your motive for wanting to include your friend in this potentially healing endeavor is loving kindness, but I wonder if you aren't being a bit overly optimistic. There is potential healing, but there is also potential breaking. You say that she could quit whenever she wants to, but will she recognize the need to do so should it arise, and more importantly, will she act upon it if she does recognize it? Are you willing to interrupt your Camino at any moment to escort her back to her "safe" world? If you see that she is improving by doing day trips, have you considered postponing your long journey and continuing with day, then multiday, etc while her healing progresses. Your priorities are unknown to me so I can't guess where her healing fits in or how much personal sacrifice you are willing to endure. I do think that you would be taking on a huge responsibility. As for the medication question, I agree that it could be dealt with along the way, but again, dealing with it could result in delays to your progress. Only you know how such delays would effect you. Finally, can you maintain your own well being on such an arduous slog, with the added burden of concern for a fragile companion?

Thanks. Lots of questions, Cher, some of which I cannot (yet) answer.
I don't really expect that my friend will overdo things. She routinely underestimates herself. She'll say "I can walk no more than two hours" in the morning, proceed to walk for five and then feel rather pleased about it. Her behaviour is rarely erratic, she is "just" very depressed, very demotivated and does not believe in herself. Managing just a small part of the Camino would hopefully inject her with some confidence.
The main reason I put this post is that I want to avoid what you call "potential breaking", get a better idea what it could be caused by, understand how to recognise "hidden problems", and get an idea of how to deal with them. I understand that my friend's needs will be more important than mine all the while. As I have walked the 1400 miles or so before, I am confident that I can manage the walk to SdC being "her" Camino. I don't consider this a sacrifice. I'll have "my" Camino when I walk back alone.
My friend is physically fitter than me, but even so I am suggesting initial distances of 13, 15 and 16 km on the first three days, after which we'd have our first rest day. I would not mind if we took five months or even more to get to SdC (90 to 100 days are average for the distance). So it should not be an "arduous slog" for either of us.

 

[cher99840]

@Walter1407, it sounds as if you are prepared to make whatever sacrifices are necessary. (You may not consider them sacrifices but I do.). I wish you both the very best. Buen Camino, and please keep us posted.

 

[Walter1407]

@Walter1407, it sounds as if you are prepared to make whatever sacrifices are necessary. (You may not consider them sacrifices but I do.). I wish you both the very best. Buen Camino, and please keep us posted.

Thank you, Cher. I won't post anything while I am on the Camino, but I might do when I am back home.

 

[4d3fect]

I applaud your heroic effort on behalf your friend. In fact, I (and tout le monde) would do well to have a friend like you. Sounds like the beginning of...a grand adventure. However, to paraphrase a remark made in a "sci fi" novel (Philip K. Dick) in which a therapist advises his patient: "you've got to stop wanting to help people"

 

[mikevasey]

I applaud your heroic effort on behalf your friend. In fact, I (and tout le monde) would do well to have a friend like you. Sounds like the beginning of...a grand adventure. However, to paraphrase a remark made in a "sci fi" novel (Philip K. Dick) in which a therapist advises his patient: "you've got to stop wanting to help people"

I cannot remember that one, but I liked the authors ironic humour.

 

[lettinggo]

Hola

I think some good answers has been given already in this thread and will share some of my own.

Generally speaking, I do believe that walking a Camino can be an life changing experience for any person and especially for one whom is in a crisis in their life.
Often the crisis is connected to ones surroundings and to change the surroundings can be a way to rediscover one self, remembering that we are not static beings, but permanent change is possible.
Ones past actions and memories is what most people battle with psychologically and to actively engage in new endeavors will create new experiences that can be a bridge to advancing life.
I have personally experienced this, so I know that it (sometimes) can work.

But there are many personally issues that comes into play. Issues that makes it near to impossible to advice for or against your plan, as your friends condition is unknown.
The impression I get from your description is that your friend suffer a depression, is unsuccessfully in her therapy and might be on anxiety reducing medication which often also is a strong sedative resulting in her sleeping much.
It makes me wonder if she has some other diagnosis that is untreated?, does she suffer from suicidal thoughts?, does she suffer from loneliness?, does she have a job?, friends (apart from you)?, does she have a hard time or history of failing?
The questions that I wonder about is to establish how fragile she is to anticipate the outcome of your proposition.

You ask if it can hurt her.
It may hurt her.
And it may be the best thing in her life up until now.

I think it is crucial that she wants to do this herself.
In order to progress when being in a crisis, the personal self insight; needing the change, has to be present.
Very few project or therapy will be successful if the individual does not want it, but of course the person might not see the potential of a proposition unless someone (you) explains it for them. So I do absolutely think you are doing the right thing, proposing an activity she cannot discover herself.
In the end though, she needs to want to do this herself.
And to make it less frightful, I think one approach could be to make a plan based on one day at the time.
Maybe have a goal of walking for one week. Thats it.
After one week, a new decision is to be made.
Do bear in mind that 1400 miles can seem next to crazy for even the most balanced and prepared person. (sounds great to me)

Regarding her medication, I am hesitant to foresee a possible reduction, as it would depend on how well she responded to walking.
One good thing about walking a camino is the daily physical exercise which result in the natural sleep, which could make her require less medication.
But if one has long term psychologically challenges, and is taking medication for it, some times it result in a fear for relapse.
A fear of the fear, can result in not wanting to stop or reduce the medication.
Whether this would happen or be a problem, I think the right thing would be to to have professionals evaluate the situation, unless she would be strong enough to go through this alone.

I am sorry that this reply ask more questions than gives answers, but it is what your post made me think of.
I hope it in some way is useful for you and will finish of with saying that I think you are doing the right thing,
You are aiding a friend in hard times, you are suggesting activities that she is not able to find herself, you are seeking answers different places to grasp the potential outcomes. Sometimes a friend is all that is needed.

Lettinggo

 

[Walter1407]

It makes me wonder if she has some other diagnosis that is untreated?, does she suffer from suicidal thoughts?, does she suffer from loneliness?, does she have a job?, friends (apart from you)?, does she have a hard time or history of failing?
The questions that I wonder about is to establish how fragile she is to anticipate the outcome of your proposition.

Thank you for sharing your thoughts, Lettinggo. And yes, there have been some fantastic replies. Apart from depression, my friend has been diagnosed with an anomaly in her brain function. According to doctors, there is no damage, even though the anomaly is in precisely the spot on which she fell when she had an accident. There could be other, undiagnosed conditions. Passive suicidal thoughts exist, as must be expected in such a case. She has many good friends but has herself withdrawn more and more over the last two years. She is not working anymore; we are (or rather I am) engaged in a legal dispute with the insurance, but a lawyer is now taking over.

You ask if it can hurt her.
It may hurt her.
And it may be the best thing in her life up until now.
I think it is crucial that she wants to do this herself.
In order to progress when being in a crisis, the personal self insight; needing the change, has to be present.
Very few project or therapy will be successful if the individual does not want it, but of course the person might not see the potential of a proposition unless someone (you) explains it for them. So I do absolutely think you are doing the right thing, proposing an activity she cannot discover herself.
In the end though, she needs to want to do this herself.
And to make it less frightful, I think one approach could be to make a plan based on one day at the time.
Maybe have a goal of walking for one week. Thats it.
After one week, a new decision is to be made.
Do bear in mind that 1400 miles can seem next to crazy for even the most balanced and prepared person. (sounds great to me)

My friend finds it hard to understand what a Camino is about. And she does not know what she wants, not just re. the Camino but re. just about everything. The whole thing comes down to whether her trust in me is stronger than her fear of things unknown to her. My concrete suggestion is that she joins me on the first day with just a short hike, and then decides whether she wants to continue, and does the same on day 2, 3, 4, 5 ... Her current thinking is that she will join me for a bit at the beginning and then again later, e.g. for the beautiful stretch between Le-Puy and Conques/Figeac. I doubt though that she'll feel up to travelling to France when the time comes.

I think the right thing would be to to have professionals evaluate the situation, unless she would be strong enough to go through this alone.

The professionals that have been dealing with my friend's case so far, have (let me put this diplomatically) not done too well. Three circulatory collapses were the result. From January, a new and much better psychiatrist will be in charge. She will see my friend twice a week at the beginning.

 

[lettinggo]

Thank you for sharing your thoughts, Lettinggo. And yes, there have been some fantastic replies. Apart from depression, my friend has been diagnosed with an anomaly in her brain function. According to doctors, there is no damage, even though the anomaly is in precisely the spot on which she fell when she had an accident. There could be other, undiagnosed conditions. Passive suicidal thoughts exist, as must be expected in such a case. She has many good friends but has herself withdrawn more and more over the last two years. She is not working anymore; we are (or rather I am) engaged in a legal dispute with the insurance, but a lawyer is now taking over.




My friend finds it hard to understand what a Camino is about. And she does not know what she wants, not just re. the Camino but re. just about everything. The whole thing comes down to whether her trust in me is stronger than her fear of things unknown to her. My concrete suggestion is that she joins me on the first day with just a short hike, and then decides whether she wants to continue, and does the same on day 2, 3, 4, 5 ... Her current thinking is that she will join me for a bit at the beginning and then again later, e.g. for the beautiful stretch between Le-Puy and Conques/Figeac. I doubt though that she'll feel up to travelling to France when the time comes.




The professionals that have been dealing with my friend's case so far, have (let me put this diplomatically) not done too well. Three circulatory collapses were the result. From January, a new and much better psychiatrist will be in charge. She will see my friend twice a week at the beginning.

Thank you for your thorough explanation.
It sounds to me as you have an extensive view of her condition which makes it much easier to be positive about your proposed plan.
Regarding the anomaly in her brain, it makes me think of this year winner of the Nobel Prize in the field of Neuroscience; how memory functions and the plasticity and adaptability of our brain.
This may of course not have relevance to your friends condition, yet it confirms that overall treatment and cure to trauma do exists.
With the plan you sketched up, I now think you should proceed and see if you can inspire her to decide to go.
Many times a person in a condition of mental illness can find it hard to take action and needs a helping hand.
Sometimes it can help the person to talk with other persons who suffer the same condition.
You may want to direct her to the local 'union for people suffering depression' (sorry, I do not know the proper english translation).

As I said before it sounds to me as you are a good friend to her and instead of me complicating things, it could be as simple as just go for a walk and let things sort themselves out as they arise.

Do not hesitate to ask further questions in the months to come.
Lettinggo

http://www.nobelprize.org/nobel_prizes/medicine/laureates/2014/press.html

 

[Wanderer64]

I think this is an important discussion to publicly air on this forum for the simple fact that there are countless people suffering mental illness (and their loved ones, friends) who are prospective Camino pilgrims and they, too, seek any information, support and feedback on the logistics unique to their medical or psychological issues. I'm glad Walter posted his question because if nothing else, he is realizing, through the excellent feedback, just how complex this issue is for he and his friend. I don't see Walter as seeking permission or expert opinion, nor do I see him as potentially putting his mentally ill friend at risk by asking questions about a possible Camino adventure they might take together. Essentially, he surely knows the ultimate decision rests with his friend in conjunction with the counsel of health care providers back home.

Disclosure: I have suffered from chronic depression and anxiety disorder most of my adult life (decades). My 32-day Camino didn't cure my depression, but it sure gave me a heck of a reprieve and offered me a new perspective on my disposition. Just because we suffer mental illness, doesn't mean we should not try new things, like a Camino adventure. Having said this, I've lived with this disorder long enough to know not to seek or offer critical psychiatric or medical counsel via an Internet forum, even an exceptionally good-hearted one like this forum. But there's nothing wrong with asking questions and gathering general information on such matters.

 

[Sixwheeler]

So much good advice and do many caring contributions here that I can't really add anything. I do know that I always find a good walk is " healing" but that's me. Overall I'm left with the feeling that you !might be biting off more than you can chew. Whatever happens I wish you well.

 

[4d3fect]

I cannot remember that one, but I liked the authors ironic humour.

Valis, or A Scanner Darkly...Can't find the relevant phrase in Google atm so I have to reread them both anyway--in one of "those" headspaces.

 

[t2andreo]

Most of the folks who already posted have covered nearly all the pros and cons of undertaking this endeavor. I think I offer a slightly different perspective.

I suffer from life-long, mild to moderate depression symptomized by anhedonia and dysthymia (you can look them up), combined with SAD (seasonal affective disorder). Basically, and in lay-person's terms, I go through life in a grey cloud.

In later years, this was compounded by the onset of work-related PTSD (post traumatic stress disorder) and anxiety. Taken together, these conditions compelled my early retirement over seven years ago. I take a few medications daily to treat the symptoms.

Despite this, I am a very high-functioning person. I rather suspect this is because of my confidence and faith. I hope your friend has these strengths and can function at a high level independently.

On the other hand, if she has a "bad day," or cannot "get with the program," YOU will need to be her "whipping boy," "cry shoulder," and all-around helping hand. I suspect, that is why several posters mentioned the daunting possibilities for someone like your friend, and you undertaking to walk a Camino. ou, both of you, need to think this through and understand the possibilities.

Paradoxically, sunshine combined with physical exercise is one of the naturally occurring things that definitely helps at least a few of my symptoms, but the medication I take makes me more susceptible to heat and humidity, just like your friend. However, I have learned a few things from doing the Camino Frances both in 2013 and 2014 the entire route.

1. You CAN manage your environment to a large degree by dressing properly, wearing a broad brimmed sun hat, long sleeves, and avoiding dark sunglasses. On the Frances, the sun is most always BEHIND you, as you walk from East to West.
2. The Vitamin D one needs to manufacture and metabolize serotonin naturally comes largely from your exposure to natural sunlight. This is the paradox I mentioned.
3. I took my daily medication every day. My symptoms improved over the course of the Camino. However, I did not seek to "wean" myself off the medication on the first Camino. This year, I did try to wean myself off he antidepressants for about 10 days. However, and as is customary when walking in the Spring, more than half my days walking contained rain or snow showers, or just totally cloudy skies. After the 10 days, I realized that I needed to go back on the antidepression medication, as the available sun was just not enough. But, there was no harm in trying.
4. You must recognize that most antidepressant medication takes three to four weeks to reach the proper level in one's bloodstream. Coming off the medication must be done, similarly, by slowly weaning one off, by reducing the dosage daily, or taking the medication at longer intervals,until it is no longer needed Under no circumstances should anyone go "cold turkey," stopping medication abruptly, no matter how good the person claims they feel. Antidepressants are not like taking aspirin or paracetamol. Those who have advocated seeking a doctor's opinion and supervision of any effort to come off the daily medication are totally correct.

These four things stated, my recommendations would be to:

1. Take each day as it comes. Try to have no limiting conditions when you start walking.
2. Remain flexible, take what comes each day. Walk only as far as you both agree.
3. Try, each day, to consider that walking a Camino, your proverbial glass is always at least half-full, and never empty.
4. You must be your friend's support person. There may be days when she needs more or less "hands on" direct involvement. You need to be there for her. Involvement could include: finding the sort of food she likes or can eat; finding pharmacias to provide anything of a quasi-medical nature she might require (paracetamol, antihistamine or decongestant tablets, or Voltaren pain ointment), locating palliative care such as foot massage, pedicures, etc., locating medical care should that become necessary; and making return travel arrangements if that should become necessary.

However, remember that the Camino DOES heal. I and many others found that the Camino provide what you NEED, not necessarily what you think you are seeking. Pilgrims need to take each day as it comes. Living in the present is integral to the experience. You are making a wise choice to attempt this. The odds of gaining more than you stand to lose are very much in your favor, at least in my view.

As regards route, I recommend the Frances for your friend as there are more services and places where you can arrange alternative lodgings and transportation. If the finances support it, consider staying in hostals (one-star hotels in Spain, mostly private and family run), as opposed to albergues most days.

I found that my personal space and quiet time was very important to my emotional well-being. Also, and this is important, avoiding contracting a bronchial infection from the closeness of albergues is important if you are susceptible to colds, bronchitis, etc. Staying in a room you paid for, with a locking door and private bathroom, and likely heat when you need it is a luxury along the Camino.

In closing, I sincerely hope this information is helpful to your friend and you. I wish you good health and a positive Camino.

 

[obinjatoo@yahoo.com]

Just thought I'd weigh in. I've worked in Adventure Therapy for many years both as a guide and therapist. I would not want to underestimate the power adventure can have on the human psyche. I also applaud you for being such a supportive friend. I just want to throw out there that this is not something I would take on myself. The responsibility, liability and emotional toll it has on you could be more than you expected. I met a few folks on my last walk who were working out emotional issues, depression and anxiety based for the most part on environmental factors and developmental issues. I also met one or two with more serious conditions in dire straits. More than one finally went home. One did very well and what ever she was grappling with seemed to begin to resolve. In these cases, I don't think there were many medical complications. This is a consideration when screening for AT programs.
Here is a link to the Adventure Experience Paradigm. I've posted this before. It is a simple theory and not difficult with basic training and practice to facilitate an adventure experience for let's say a moderately healthy group of adolescents in an Outward Bound Course. But when we consider the addition of a serious mental and physical health issue, the risk increases geometrically while competency decreases. You'll see when you read the article and see the flow chart. And it is a skilled professional indeed who can pull this off. Good Luck!
http://www.wilderdom.com/philosophy/PriestAdventureExperienceParadigm.html

 

[tploomis]

If this were her idea, I would be cautiously optimistic, but since this is your idea for her, I am far less so.

 

[Walter1407]

My thoughts come from experience with a brother who was honorably discharged several decades ago from the United States Navy and unable to live independently due to his mild physical and severe mental illness. So the word "severe" stands out for me in the OP. Sometimes when he visits me, he is simply unable to participate in any activities all the while prior wanting to. And much sleeping due to the meds carefully sorted for number of days stay by his nurses. Sometimes I plan (many times) outings but after making the drive to him (three and a half hours), he feels unable. This puts an added pressure on him as he becomes very apologetic for being "unable" and I return home another three and half hours later not having had time with him. But the bottom line is what he is left with: his feelings that he let me down, his feelings of failure, which only exacerbate the condition. The feeling that he is not up to par with others. Of course he gets no pressure from me, and I am used to it. My other thought is regarding down dosing - not something to be done by a non-professional or over the phone but something which needs to be closely monitored. A few good days does not indicate a signal to down dose, but rather , in a severe case, perhaps aiding a stable dose. It is a very long trip to undertake, and I would advise you to seek professional advice from a medical professional both individually and together before chewing off such an arduous adventure. Buen Camino.

From what you describe, the condition of your brother does not really resemble that of my friend. Every time we decide to do some outdoor exercise, she actually goes ahead and does well. The 1400 miles on the Camino are what I want to do. If my friend joins me at the outset (I think this is the only realistic option) I would consider it a success if she stays with me for two weeks. But I want her to understand that she is welcome to continue with me for as long as she wants. If her condition improves while we are walking together, who knows how far she might want to go?

 

[Piccata]

I would like to suggest that if, after careful consideration, you do go on the Camino with your friend, the two of you pay special attention to her return to regular life. I sometimes suffer from depression and found the Camino experience to be, as others have said, wonderful medicine for my symptoms. However, when I returned home I was slammed with one of the worst periods of depression I have ever experienced. Whether it was the sudden decrease in the amount of exercise and sunlight I was getting or the termination of a deeply satisfying and spiritual experience I can't say--but it was very, very difficult to return to my regular life. I don't know yet what I will plan for my next Camino's end, but I am already thinking about how I can avoid a repeat of my previous experience.

 

[Walter1407]

I would like to suggest that if, after careful consideration, you do go on the Camino with your friend, the two of you pay special attention to her return to regular life. I sometimes suffer from depression and found the Camino experience to be, as others have said, wonderful medicine for my symptoms. However, when I returned home I was slammed with one of the worst periods of depression I have ever experienced. Whether it was the sudden decrease in the amount of exercise and sunlight I was getting or the termination of a deeply satisfying and spiritual experience I can't say--but it was very, very difficult to return to my regular life. I don't know yet what I will plan for my next Camino's end, but I am already thinking about how I can avoid a repeat of my previous experience.

Thanks, Piccata. That's a very important and helpful point you are making. Of course, nobody knows what my friend's reaction will be, but it's good to know that we'll have to pay attention to the time after the Camino, too.
I do hope you'll find a good solution for yourself!

 

[mikevasey]

I sometimes suffer from depression and found the Camino experience to be, as others have said, wonderful medicine for my symptoms. However, when I returned home I was slammed with one of the worst periods of depression I have ever experienced.

I was not going to talk about my own experience but here goes. I had depression in 2005, it was a cumulation of things which left me unable to carry on working at the time and close friendships dissolved, I did not want people to be around me and so hid away. My saving grace was that I knew somehow, somewhere, eventually it would pass even if at the time my inner landscape felt like it had fallen under a dark, deep harsh winter. Eventually the time came again to start the walk forward again. I reconstructed my life as best I could. People who know me now but not before can not believe that I suffered from depression. But for me I did not feel complete yet, I found it hard to laugh freely and naturally, I realised that when I was listenining to people I was mostly hearing my own inner dialogue, anything creative(imagination) had been destroyed during the deepest depression and lots of other things which when I tried to talk about them ended up being dismissed as meaningless fears.
When I walked my 1st camino, on two occasions I started laughing in two humorous situations, a deep gut, body shaking, hard to breathe, tears rolling down the face laughter, pre-depression I would have tried to control it, not on those two moments.
On my 1st Camino a lot of things flowered, which hadn't for a long time. I walked into Santiago not with tears in my eyes, but an almost estactic sense of happiness, I laid in the square on some steps and just basked in what was flowing through me for a couple of hours and listened to the haunting(to me) bagpipes echoing around the square. Why have I explained this so much? Its because when I came home, I could feel old patterns reasserting themselves, a hardness had marched back in. It almost threw me in to depression again. This reasserting has happened every single time, 2nd, 3rd, 4th, 5th. I go on a 16 day Camino at the beginning of January, it will happen after that as well. When you have no prior experience it is very difficult to cope with, some people know it as Camino blues, there is a thread knocking about the forum with that title, where people have written about their experience. Experiencing a Camino allows very special things to come into your life, if you want them, there is a downside, if the ground of your life you live away from the Camino cannot hold and allow these special experiences to grow, then you will feel it as they wither. For me I am looking at my own life off Camino and slowly changing it where I feel the most discomfort.

 

[Walter1407]

Thanks again for the many valuable contributions!
I have to postpone my Camino to 2016, as I have to undergo an operation in March.
I now plan to do some hiking in the Scottish Highlands & Islands in June and in the Alps at weekends between July and October.
My friend intends to join me in Scotland for a 7-day walk around the island of Arran. I hope that after this she'll be less afraid of the Camino.

 

[cher99840]

So sorry for your health hic-cup but I do think it is wonderful that you have the seven day Scotland trip planned. That will indeed be a mini Camino for your friend and hopefully will strengthen her emotionally for the longer walk.

 

[Al the optimist]

Hope all goes well for you both. I also have a friend who finds it difficult to move forward with her life. So my prayers are with you.

 

[hecate105]

It has to be your friends own decision to go - knowing that she has the support of yourself to rely on. I suffered from fibromyalgia for 22 years which crippled me physically and mentally and led to a breakdown, depression and years of panic attacks. After trying SO many medical, alternative and anything else I thought would help - several things transformed my life. Firstly getting proper treatment for a non-working thyroid - often the tests come back as ok - but are known to 'disguise' in some people. Once I was being treated - it made a huge difference to the amount of energy I had to use. People that haven't had a condition that leaves you with no energy find it hard to understand how HUGELY it affects your life. You literally cannot think straight, or talk to people and it tends to make you withdraw totally. Secondly a specialist (only the third I'd seen in 20 years!!) mentioned that 'fibro' people often are deficient in Vitamin D. This was about 6 months before the medical authorities started realising that so many people were deficient on vit D. So my own Dr was loathe to test me and thought the specialist was 'just harping on her pet subject'!!! Turned out I had hardly any - it took over a year of taking massive doses to get to a reasonable level. Again the difference in energy and mood were quite acute. As you mentioned with your friend - I always felt better when out in nature and during a walk/pedal. This had always confused me as activity in general just brought more pain and exhaustion. But it was probably to do with the Vit D - if you are ill/suffering ,you tend to stay in and rest and so you do not get any Vit D. Some of us just do not process it easily. I still have to take a daily dose.
Thirdly I read a book called 'The Divided Mind' by John Sarno - a doctor. This was the jigsaw piece that saved my life! After reading the book and understanding the concepts - I realised that I held the key to my own healing - and over a VERY tough year I did the worst part and got myself 95% better. I still work on myself daily and I have had to step away from some relationships/activities/patterns. But I now feel 'normal' again, I can work, I can walk, cycle etc without feeling like a limp dishrag. We are all different but so many people do not get the help they need from the medical establishment, just a reliance on drugs and a feeling of despair. So please mention these three things to your friend in case any of them are helpful to her.
Whether she joins you on Camino or not - I'm sure you could find some local short 'pilgrimages' that you could undertake together. My husband, dog and I spent 6 days cycling the Saint's Way in Cornwall before I dared to believe I could undertake our Camino, and before that many day cycles. It is a huge, huge mental and emotional barrier your friend needs to climb, but she is lucky to have you beside her.
I wish you both the very best of luck and healing.

 

[Sixwheeler]

If you and your friend can survive the highland midges you can survive anything. Ultrëia

 

[Walter1407]

To Hecate
Thanks a lot for sharing your story. I will send you a PM with some questions.

 

[Al the optimist]

Thanks for sharing that Hecate. I was married to someone suffering with a very over-active thyroid for a long time before it was diagnosed so I can relate to part of this. Hope things continue to be OK with you.

 

[Kathy F.]

This thread makes me think of the problem of trying to make someone go on the Camino. Members of this forum, most of whom have experienced and enjoyed the exhilarating benefits of doing so, want to share what they know are the benefits with everyone! Since just talking to people gets redundant and annoying, we want people to actually experience the joy of the Camino.

But how many of us have also seen the many, many groups of people who started out together and split along the way. Not permanent splits, although that happens, but along the way people just get tired of being with the same person 24/7 and often have to go their own way.

School groups who end up spreading out, sometimes days apart. Roommates who flew in together but quickly found they had dissimilar interests as to where to stay, what to eat, whether a town was interesting or not, etc. Friends for whom it seemed like a good idea on paper but it turns out you can't stand them one on one, day in, day out.

I imagine that the added challenge of taking someone on the Camino who is in a fragile state of mind would be a challenge for both of you. What will happen on the day that you just want have some space and leave that person for a while? What happens on the day that the other person simply doesn't think they can continue? I suspect that people walking solo have a better opportunity of finding the "Camino family" than someone who is already walking with someone, and a Camino family can be a tremendous source of support that you may miss out on.

If I could, I'd make everyone I know walk the CF at least once in their life. I know how wonderful the experience would be for them. But I'm not ready to be held responsible for someone else's happiness. It's all I can do to take care of my own.

 

[CaminoKris2016]

Good day!

A close female friend of mine has been suffering from severe depression for a few years. Psychotherapy does not help much, and the medication she is taking makes her sleep for 10 or even 12 hours per day. She has become more and more afraid of things and especially of people.

On the few occasions when I managed to motivate her to join me for a day of cycling or hiking, she brightened psychologically, even if she was very tired physically.

I have recently suggested to her to join me from the outset of my pilgrimage which will begin in March next year. She'll of course be able to quit any time she wants. I am starting 1400 miles from Santiago, planning to take it easy all the way, and especially during the first days.

My hope is that the Camino will help her get away from the circles of dark thoughts that are turning in her head. My fear is that things, something, will run out of control, and that her situation could become worse than it was before. Currently, she would not be able to walk alone. I believe that the Camino could be of great benefit to her, but I cannot be sure. And I don't want to encourage her to do something that could hurt her.

Assuming that she joins me, and assuming that things go well, I think she'll have to adjust (reduce) her medication at some point. We would have to sort this out by contacting the doctor by telephone. Probably because of her medication, my friend cannot handle strong sunlight and heat well. Should we manage to get as far as Spain together, this could become an issue, and is one of the reasons I would prefer to walk the (physically harder) Camino del Norte.

I have talked to my friend's psychiatrist who is hesitant. As she doesn't know much about the Camino I would much appreciate any feedback (forum reply or private message) that might help us take the right decisions. Thanks!

Okay...well as someone who has suffered from depression, and had some dark moments on the camino (thus stopping in Pamplona), I would hesitate in this. For me, the walks were therapeutic BUT, I had issues later in the day after I had stopped and finished all the post walking chores. When there were people around that were able to speak English, I had nice evenings, but I also felt very isolated when as nice as the people where, if we were not able to carry on a converation, it became very lonely. It depends on your friend and if she is able to keep up with you without stressting herself and how you feel about walking at a slower or at least covering less differences. I am sure that if I had someone that I knew I would meet up with after walking what I was able to meet up with, I think I would have gone further.

I don't regret anything from my attempt (Now), and I'm working on trying to get in the right mindset for the future. I learned a lot. I think that considering your friend's severe depression, start with a mini Camino...maybe just a few days with your friend. For her to complete even a small walk will help with her frame of mind.

 

[Pattii]

Good day!

A close female friend of mine has been suffering from severe depression for a few years. Psychotherapy does not help much, and the medication she is taking makes her sleep for 10 or even 12 hours per day. She has become more and more afraid of things and especially of people.

On the few occasions when I managed to motivate her to join me for a day of cycling or hiking, she brightened psychologically, even if she was very tired physically.

I have recently suggested to her to join me from the outset of my pilgrimage which will begin in March next year. She'll of course be able to quit any time she wants. I am starting 1400 miles from Santiago, planning to take it easy all the way, and especially during the first days.

My hope is that the Camino will help her get away from the circles of dark thoughts that are turning in her head. My fear is that things, something, will run out of control, and that her situation could become worse than it was before. Currently, she would not be able to walk alone. I believe that the Camino could be of great benefit to her, but I cannot be sure. And I don't want to encourage her to do something that could hurt her.

Assuming that she joins me, and assuming that things go well, I think she'll have to adjust (reduce) her medication at some point. We would have to sort this out by contacting the doctor by telephone. Probably because of her medication, my friend cannot handle strong sunlight and heat well. Should we manage to get as far as Spain together, this could become an issue, and is one of the reasons I would prefer to walk the (physically harder) Camino del Norte.

I have talked to my friend's psychiatrist who is hesitant. As she doesn't know much about the Camino I would much appreciate any feedback (forum reply or private message) that might help us take the right decisions. Thanks!

I have Bi Polar. I have severe depressions and moments of "glory" as I call them. One of the things every doctor I have ever been to has told me is to get out and walk. Walking increases endorphins which actually help people with depression. But to jump into a Camino would be daunting. It is something you will have to work with her to help her. I would think the idea of it would be more difficult than the actual pursuit. Sometimes depressed people struggle with getting going or feeling out of place. Also for me I have to be aware of the highs created by an endeavour such as the Camino...coming down from the high of it could be difficult but I think with well laid plans and keeping my Dr and family and friends informed I should be ok. I have also asked my sister who lives in Sweden to join me when I get there so I am not alone at the end of it. I am walking alone and think if she is with someone she will be fine. ALSO the walking is a great way to work through some of the issues she may have that have led to the depression. My opinion for what it is worth is that it would be beneficial for her. Just make sure you take enough meds and replacement meds should they get lost and know how and where to contact medical help along the way.
I wish you both a Buen Camino!