The Efficacy and Limits of Pilgrimage as Therapy for Depression

Abstract

Western notions of pilgrimage produce images of religious adherence to known beliefs and their ritual expressions. Definitions of pilgrimage have expanded in recent decades to embrace treks to sites unattached to the sacred landscapes of traditional faith groups. Along with this expansion of meanings and practices has come a wider acceptance of travel for psychological transformation. Tourism can be argued as a modulated form of pilgrimage and traditional journeys of faith overlapping with instances of entirely secular tourism. Another purpose of pilgrimage can be as a therapeutic practice for those suffering from depressive disorders and related conditions. Its efficacy as therapy, along with its limits, are discussed in clinical and personal contexts with a view to including religious as well as secular perspectives. The pragmatics of such therapy are mapped against current trends in treatment.

1. Introduction

Research by psychologists and other mental health professionals tries to identify effective ways to manage and prevent emotional turbulence including depression. Because interventions may blend multiple techniques, aspects of traditional Western pilgrimages now encompass more than religious activities and traditional beliefs. New definitions acknowledge that individuals can craft their own versions of the pilgrimage out of personal belief systems. This study offers an in-depth explanation of how new forms and interpretations of travel can be deployed as self-monitored therapy for anxiety or depressive episodes. Embarking on journeys long and short can provide temporary relief from stress and upsets brought about by internal and external conflicts.

2. Materials and Methods

Archival research was conducted to explore the interrelations between the concepts of pilgrimage and mental health. This review was undertaken to find supporting sources that prove the benefits of embarking on pilgrimages in order to improve mental well-being. This study is based on the accounts of selected people, including our personal experiences as two academics and researchers, who were diagnosed with major depressive disorder, to find common elements among the narratives. We present these journeys through depression and the personal pilgrimages that were undertaken to overcome depressive episodes. We recount specific individual versions of pilgrimages such as travel and walking and examine their benefits to mental health. Theories and research from the fields of pilgrimage studies and psychology are used to analyze the narratives, prove the efficacy, and present the limits of pilgrimage as a form of therapy.

3. Discussion

3.1. Depressive Episodes

Feelings of depression are something that everyone goes through and usually fade away after a few days or weeks. Major depressive disorder (MDD), sometimes called clinical depression, on the other hand, is a mood disorder that lasts more than two weeks. An individual with MDD experiences low mood or loss of interest in actively participating in life events. There are other general symptoms such as tiredness, changes in appetite, feelings of worthlessness, and, sometimes, thoughts of death. Depressive episodes have varying durations but usually last about six to eight months (Ada’s Medical Knowledge Team 2022). Specific symptoms include weight loss or gain, trouble falling or staying sleep or a feeling of constant sleepiness, feeling restless and agitated or very sluggish, being tired and without energy, feeling guilt, and having trouble concentrating or making decisions. Other more specific symptoms are anxious distress, melancholy, and agitation (Bruce 2023).

When the feeling of depression exceeds the amount of time indicative of MDD, it becomes persistent depressive disorder (PDD), the kind that lasts for at least two years. Similar types of depression may also be diagnosed as dysthymia or chronic depression, which might not be as intense as MDD but can still affect relationships and make functioning difficult. The severity of its symptoms lessen over time but can worsen again eventually. PDD episodes can last for years at a time, which can cause people with PDD to feel as though these occurrences are part of their normal lives.

There are other types of depressive disorders that have more severe symptoms: bipolar disorder, which was formerly called manic depression, depressive psychosis, perinatal depression, premenstrual dysphoric disorder, seasonal depression, situational depression, and atypical depression (Healthline Website n.d.). All of these types can be addressed with combinations of medication and therapy.

Usually, depressive disorders are treated with various modalities such as pharmacological, psychotherapeutic, interventional, and lifestyle modification. FDA-approved medications include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), serotonin modulators, atypical antidepressants, tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), and other medications such as mood stabilizers and antipsychotics. Under psychotherapy, on the other hand, are cognitive behavioral therapy (CBT) and interpersonal therapy (Bains and Abdijadid 2022).

There are particular events in a human’s life that can act as triggers for depressive episodes. Some of these include (1) changes in daily routines; (2) disrupted sleep; (3) poor eating habits; (4) stress at work, home, or school; (5) feeling isolated, alone, or unloved; (6) living with abuse or mistreatment; (7) medical problems such as Alzheimer’s disease, stroke, or erectile dysfunction; (8) medications such as antibiotics and blood pressure drugs; (9) significant life events such as bereavement or divorce; and (10) traumatic occurrences such as accidents or sexual assault. These are just a few instances that can cause or trigger depressive episodes.

Medical News Today (Medical News Today Website n.d.) released an article that contains tips on how individuals can cope with these episodes. Treating depression involves a lot of work on the self. Per the article, one must: (1) Track triggers and symptoms. This helps in understanding one’s emotions and behaviors; (2) Stay calm to help prevent severe episodes such as anxiety and panic attacks. This can be achieved through meditation, mindfulness, and breathing exercises; (3) Understand and accept depression. This can teach individuals to take control of the depression and be more open to receiving treatments, changing lifestyles, taking medication, and seeking therapy. Accepting does not necessarily mean that depression has become part of their identity; (4) Learn to separate oneself from the depression; (5) Recognize that self-care reduces the chances of having severe episodes. This includes eating a healthy diet, engaging in creative activities, and taking a soothing bath. Any activity that enhances mental, emotional, and physical health is considered a form of self-care. Some of the other tips are to (6) breathe deeply and relax the muscles; (7) challenge negative thoughts; (8) practice mindfulness; (9) create a bedtime routine; (10) exercise; (11) avoiding alcohol; and (12) record positive experiences.

Aside from these self-improvement steps suggested to fight depression, it is also important to ask for help—whether from family and friends, a doctor, a therapist, or from support groups. There are many other ways to alleviate depression. Some of these are not necessarily conventional, and more studies are being written about them.

3.2. Travel and Depression

Travel can improve one’s mental health. It can provide the mind with a sense of calm and healing and relieve tension and stress brought about by work or school. Travel allows for regular resets where people can feel the positive impacts of vacation for up to five weeks after return. Even the motivation to be productive and focused increases.

Traveling also helps individuals become more artistically and culturally inclined while providing a new perspective on life. Exposure to new cultures, making new friends, studying new languages, and experiencing different types of food and music can even aid in establishing and developing better problem-solving skills. Traveling, or going out in general, leads to creating new experiences and knowledge enrichment, which improves brain function and boosts mental health. Having something to look forward to causes individuals to feel happy and excited. It also helps in appreciating the environment at home after getting back from a different country. Travel is usually seen as a positive way to alleviate stress and depression (Brennan 2021).

Prior studies showed that there is a bidirectional relationship between not traveling and depression. Particularly during the COVID-19 pandemic, a study was conducted in Korea to test the tendencies of adults to develop depression when not able to travel or leave their homes. It may not be that traveling directly prevents depression itself but rather inhibits the potential triggers that may prompt a depressive episode. It seems that symptoms of depression can be reduced through distractions from routine life patterns, which can allow one to feel refreshed. This can also be achieved by separating oneself from the daily living environments that cause depression. Meeting new people and having unique social interactions and developing peripheral social ties can play vital roles in preventing social isolation among adults. Going on trips as informal social engagement is common in adults, and this is a plausible solution to reducing loneliness and social isolation (Hyun et al. 2022).

3.3. Travel and Pilgrimage

While travel and pilgrimage are two independent endeavors, it may be ascertained that there is an intersection between the two. Pilgrimage has its roots in religion, with such journeys being undertaken by certain people of faith to feel more connected to their spiritual beliefs. Religions such as Christianity, Hinduism, Islam, Buddhism, Judaism, and others include pilgrimage as an important tenet of their beliefs. Believers of these religions take perilous, sometimes expensive journeys for various reasons: prayer, penance, or sacrifice. In Christianity, for example, pilgrimages that are undertaken to shrines of saints are believed to possess divine healing powers (de Botton 2012).

Pilgrimages have long been exclusive to people of religious backgrounds. New Age pilgrimage has gained popularity over the years, offering the same spiritual experience to those who do not identify with any particular religion (Reader n.d.). Secular pilgrimages have also gained popularity over the years, offering journeys that are not necessarily spiritual but might be personal to the pilgrim. The journey undertaken during a pilgrimage by itself can and does heal.

Pilgrimages offer other forms of healing beyond the spiritual. Idler discusses the physical and psychological benefits of spiritual and religious practices, including pilgrimage (Idler 2016). According to her, these practices enable us to view ourselves as part of a much larger picture. Spiritual practices may also lead us to healthier lifestyles, but she reiterates that while these activities provide healing, they must not be considered a means to an end.

3.4. Pilgrimage as Therapy for Depression

In 1982, a study was conducted to identify the effects of pilgrimage on anxiety, depression, and religious attitude. The specific pilgrimage studied was undertaken to Lourdes. Some of the participants had issues not only with mental health, but also with physical health. The levels of anxiety, depression, and religious attitude were measured using rating scales via three instruments: the State-Trait Anxiety Inventory, the Depressive Inventory, and the Religious Attitude Scale. These levels were reassessed one month and ten months after the participants had returned.

The patients did not feel physically improved, but they claimed that they still found the pilgrimage beneficial because of their strengthened religious faith and that the pilgrimage had caused them to feel more relaxed, more content, and more able to accept their physical disabilities. The general emotional improvement noted could, then, be seen as a direct result of (1) merging with a community and experiencing companionship and solidarity and (2) sensations perceived internally such as being on holiday, a change of environment, and a spiritual atmosphere or ambiance (Morris 1982).

Warfield wrote in an article that there are general stages in the journeys made by pilgrims. She states that the moment a person decides to partake in a pilgrimage, their first stage has begun, and all the activities that happen from there are part of the journey (Warfield 2012). The second stage refers to the detachment from normal daily life, which includes the processes of buying travel necessities, filing leaves of absence, preparing oneself to be away from loved ones, and the like. The third stage is the actual journey to the sacred space, where the pilgrim could be in connection with other pilgrims or retreating into themselves. Documenting the journey could also be part of this stage. The fourth stage is the final preparation to enter the sacred space. The separation of this activity from everyday life is emphasized. During common rituals, pilgrims often become silent, remove their shoes, keep their faces turned toward on the shrine or sacred space, and clasp their hands as a sign of reverence. The fifth stage of the pilgrimage is the actual experience at the site. Various culture-specific practices are performed during this stage such as placing offerings, worshipping with or without sound, bell ringing, touching a part of the sacred space, weeping, kissing the sacred object, praying in front of the image, or placing an object at the shrine. The last stage is focused on the completion of the journey and on the return home to one’s familiar surroundings.

Given these stages, one can see that the individual is taken both physically and mentally from their usual routine. They are introduced to a foreign land, environment, and state of mind. This serves as a break for the individual and allows for self-contemplation. Pilgrimage, then, becomes a significant process and event that provides a holistic framework for individuals to engage themselves in a biological, psychological, social, and spiritual manner. It can be used to address issues of healing, identity formation, group belonging, and spiritual development.

Often, pilgrimages require long treks through unfamiliar landscapes, giving the body physical exercise. People who lead these pilgrimages often warn of the physical toll that the journey might take. This physical exertion is a part of both the journey and the experience. In a world where technology encourages lack of physical activity, experiences that include physical exertion are of great value. This journey through unfamiliar landscapes may also require problem-solving skills not necessarily called upon in one’s usual environment. Being taken outside of one’s daily environment might cause shifts in perspective, which can lead not only to a more enriched world view, but also to a new way of looking at and dealing with problems.

One aspect that is also essential to the pilgrimage is the journey itself. By focusing on something besides oneself, pilgrimages offer mental healing to the pilgrim. At the very least, going on a pilgrimage encourages one to focus on the journey, taking one’s mind away from personal problems.

It is known that experts in the field of psychology and pilgrimage studies have conducted research on the interconnection between the two. However, research on the relationship between pilgrimages and neuroscience is quite rare. Jahangir and Maftoon discussed in their work that neuroscience plays a significant role in human belief systems through Paul McLean’s concept of the triune brain (Jahangir and Maftoon 2012). He states that these three types of brains work within in a single brain, like a biological computer that is interconnected, but each type has its own function. Psychologists and neuroscientists believe that the acts of worship have a luminous quality and that a particular part of the brain is responsible for transcendent human characteristics and appropriate social behaviors. This same part contains the feeling of courage that people require to get to know each other and feel a sense of togetherness. It is a place of empathy and common feeling. They also suggest that if God were to connect with humans, it is through this part of the brain. Given that there could be connections among pilgrimage studies, psychology, and neuroscience, pilgrimage can then be seen as a spiritual practice that can have positive effects on psychological behavior and could result in reducing antisocial behavior.

3.5. Personal Pilgrimage

The term pilgrimage no longer refers only to religious activities. Some participate in secular pilgrimages without believing that these journeys will bring them closer to the sacred. They seek these experiences to have time and space to reflect. As they journey, there is also an inner pilgrimage that progresses in an equal manner to the physical distance covered. It is said that every pilgrimage is a struggle with nature’s terrain, silence, and the mind itself. The outer journey mirrors the inner journey into the pilgrim’s psyche.

In today’s demanding world, people have come up with the idea of personal pilgrimages that require one to stop using gadgets, unplug from all obligations, and get away from the noise of daily life without actually traveling to a distant land. Instead of traveling to remote areas in the world, there is a need to seek a remote part of the self in the midst of daily life. People are in search of a quiet mind and inner peace, with the aim, as well, of placing awareness on the mind and the heart. This can be attained not only through hours of meditation and strict discipline, but also through the pilgrim’s trust in making their own retreat and finding their own self-discovery (Davis 2013).

Self-awareness plays a significant role in pilgrimages and in addressing depression. In the 1970s, Professor Jon Kabat-Zinn of the University of Massachusetts Medical School introduced the mindfulness-based stress reduction (MBSR) exercise. This program significantly relieved suffering in and improved the well-being of participants in his research. Psychologists have studied this technique’s effectiveness on various aspects from cognition to emotion, as well as in stress management. Initially, self-awareness and meditation are practices that have been considered to be religious or cultural, but the program has since been recognized as a scientifically based practice (Pardue n.d.). In 2013, Pardue defined MBSR as a psychological process of bringing one’s attention to the internal and external experiences occurring in the present moment, which can be developed through the practice of meditation and other training (Crumpler n.d.). When considering the concept and definition of mindfulness, this practice is quite observable in the practice of pilgrimage. Being focused on the present and the experience helps the individual become self-aware. The physical activities involved in traveling to different places keeps the individual’s mind and body in the present.

3.6. Personal Pilgrimages and Depression (Narratives)

3.6.1. An Academic on a Motorcycle

In September 2015, I went to the northern part of Luzon, the largest and most populous island in the Philippines, to attend an annual academic conference of the country’s professional organization for statisticians, in which I hold a lifetime membership. From the metropolis, where I live, I traveled roughly 900 km on a Kawasaki ZX-14R motorcycle, to and from Ilocos Norte, where the conference was held. That specific ride was a dream fulfilled for my teenaged self. Riding the motorcycle and hearing its engine roar, facing but aware of the perils, felt liberating. Riding a motorcycle takes strategy, from managing one’s own weight to practicing the right signals to continuously being on guard while undertaking a precarious journey—elements that are similar to being in service, according to veterans (Harper 2018).

I would say that despite having poor genes, everything else about my body is healthy and still at its peak condition, apart from my eyes. Months before that motorcycle ride to Laoag, Ilocos Norte, I was diagnosed with glaucoma. I understood that, more than going on an impromptu road race, I was on a race against time, knowing full well that my motorcycling career was likely to be truncated by this diagnosis. I then suffered from a retinal detachment in 2016 and was diagnosed with uveitis in 2017. Due to the pars plana vitrectomy for the retinal detachment, I had to maintain a facedown position for three days. I could sleep only on my left side or facedown. Octafluoropropane (C₃F₈ or perfluoropropane), a gas similar to air-conditioning refrigerant, was pumped into my eye. This same gas that saved my left eye also called for a travel ban of sorts; I was not allowed to travel by air during the entire seven weeks that the gas was in my eye.

In February 2018, a Baerveldt shunt was implanted in my left eye, a 1 mm tube that enables my eye’s aqueous humor to drain properly. My medical team, including my brother who is a physician, advised me, and to their credit persuaded me enough, to let go of this hobby. Riding comes with the risk and probability of suffering head trauma, something that may lead to another retinal detachment. After my left eye started giving up, my resolve followed. I was diagnosed with major depressive disorder. These were dark times; even as I was receiving outstanding teacher awards and grant money, among other accolades, I was quietly bleeding, wishing to die, and entirely willing to sever my carotid artery myself.

Because good health calls for one to seek healing when one notices that something is wrong, I sought help from a therapist that my physician brother recommended. While this meant the expansion of my medical team by one more person, I say with full conviction that my therapist gave me back my life. After being prescribed medications to regularize my sleep patterns and mood, I got back on my feet and resumed working and traveling. Post-therapy though, I was at my best. The whole experience of major depressive disorder, no matter how high-functioning I was, no matter how unfortunate, allowed me to recalibrate and be more focused than ever, such that even amidst the worst of my depression I was productive: all the bills were paid on time, all the student grades were submitted on time. Even in the worst of times, I was always on time.

One thing I may deduce from the whole experience of going through literally and figuratively dark days, because of the maladies of my eye and from the depths of depression, is the belief that life has not been and will never be perfect, but we can always dance to the rhythm of it all and be in search of a new normal.

3.6.2. Pilgrimage for Healing beyond the Physical

Travel and pilgrimage are undoubtedly interconnected. Despite identifying as an atheist, I find visits to temples and other places of sacred worship, as well as mausoleums and war memorials, to be pleasant moments that soothe and calm my mind. Traveling allows me to escape the mundanities of daily life. These travels, which I consider to be pilgrimages to and from the self, allow me to improve my ability to compartmentalize, that when I embark on a journey, I am able to reflect on my personal burdens, respond to professional correspondence, and fulfill my professorial duties, among others, all while still being able to bask in the moments throughout my journey. I find beauty in being far from home, on a journey that has either been undertaken by many before me or one that only a few people have taken. I find each journey truly refreshing, and despite being miles from home, it is in those moments that I refill my store of thoughts, including the will to go on living and the reasons to continue doing everything I do, back home.

3.7. Going Out of the Social Comfort Zone

“I know a planet inhabited by a red-faced gentleman. He’s never smelled a flower. He’s never looked at a star, He’s never loved anyone. He’s never done anything except add up numbers. And all day long he says over and over, just like you, ‘I’m a serious man! I’m a serious man!’ And that puffs him up with pride. But he’s not a man at all-He’s a mushroom!”.

-Antoine De Saint Exupery, The Little Prince

3.7.1. Pilgrimage Walk in the Metro

Before being diagnosed with major depressive disorder, I was already experiencing a constant state of anxiety. I have also had a few panic attacks while alone in the middle of normal daily activities. I had had it in my mind to seek professional help, but I always ended up putting it off, probably because I forced myself to function despite the situation. I am the kind of person who pushes these emotions to the back burner to focus on “more important matters.” Unfortunately, there were times when ignoring these emotions became too much. This is how I learned to cope through my own personal pilgrimage.

Living in a busy city is quite hard for people seeking solitude in nature. Luckily, I lived in a subdivision located on the boundary between the city of Manila and the province of Cavite. There are still places to go where one can find vast lands of nothing but greenery. The strong wind blows through the trees and the grass, the sun shines and sets perfectly without any buildings blocking it, and one can even hear goats as they roam with their kids. In a certain area of the greenery, there is a church with a cemetery behind it. Whenever I feel the void consuming me, I put on my running shoes and head toward this vast land—sometimes jogging, sometimes just walking. This, then, helps me clear my mind.

In 2020, the COVID-19 pandemic hit, and the whole world was affected not just physically, but mentally, too. According to the World Health Organization, for the last two years, the prevalence of anxiety and depression increased by 25%. Being forced into social isolation had become a major trigger for numerous young people (Kestel 2022). This pushed a lot of individuals to seek professional help, me included. I was having a hard time juggling work, studying, research, and personal matters. It was difficult to move around and go outside the way I usually did because of safety issues. The fear of catching the virus also caused anxiety. Because of these factors, I decided to consult with a psychiatrist to whom I was referred by one of my best friends. I found psychotherapy to be very effective, as I was able to better understand myself and my emotions. My psychiatrist, like any other, asked if I was physically active and I told her that I was, but the pandemic had disrupted my physical activity. She advised me to slowly ease back into finding my rhythm because moving around and being mindful of my surroundings would help improve my mental state. That was when I got back to jogging and walking, which I consider my personal pilgrimage.

Even when I moved to the province of Cavite, I still found myself running and walking when experiencing stress. The village I moved to did not have a lot of natural elements in its environment, but getting out of the house and feeling myself moving stimulates my mind and takes it off the stressors and things that bother me.

Pilgrimage, to me, is walking or jogging and being one with my surroundings, and doing these allows me to temporarily leave the realities of my normal day spent at home and at work. I enter a liminal zone where everything else in my life is paused and all I can think of is the strong wind, the earthy smell of the plants, the beautiful view of the sun, and the burn I feel in my legs, feet, and lungs. I am very much aware of my surroundings and myself. Doing this regularly aids in keeping my mind at peace because whenever I return home and resume my usual routine, my mind and my emotions are once again clean slates. I believe this form of pilgrimage is helpful in maintaining mental health and well-being.

3.7.2. Post-Traumatic Stress Pilgrimage

Kelly Isola is an anthropologist specializing in divinity. She has resided in and visited many countries including those in the Middle East, Africa, and Europe. Growing up, she was introduced to the cultures of the various countries she visited. Because she takes interest in the concept of the divine, she became an ordained unity minister. Around 2016, she had a traumatic illness that caused her to be on life support for a few weeks. During those weeks, she experienced two near-death experiences.

According to her, going through this kind of trauma causes a person to lose elements of the “self.” She felt lost in many ways and could not recognize herself. Functioning was difficult and simply living is a chore.

“Over the last five years I have at times fought for life, consciously choosing life. Other times, there was no fighting needed. When in the grips of deep depression everything there is to do seems like hard work. When I see a voicemail on my phone, all I can think is that there is something else to take care of, something to manage, to be responsible for. And I have nothing left. I am empty.”

All these occurrences made her anxious every day. She felt so alone that she was unable to explain how she felt to other people, because she did not think anyone would understand. She was trying to function, not because she wanted to, but because she did not want to inconvenience anyone else. It seems as though living and functioning for herself was not something she could focus on.

Her path to recovery was not easy at all. She compared the process to the stations of the cross, where every part of the process was nothing but suffering. When one problem was close to being solved, another one appeared. She was in and out of the hospital because therapy and medication were not working the way they should. Eventually, she undertook more intense and more intrusive medications to help with depression. She decides to write about her journey and suffering. She claims that this whole process was her pilgrimage. Embracing her pain caused her to remember that she chose to live and still chooses to do so despite the hardships. She says that since beginning her pilgrimage, she has never forgotten how joy and suffering live side by side, and that neither lives without the other. It has helped her accept her depression and strengthen herself as she fights against it (Isola 2021).

3.7.3. Pilgrimage as a Break from the Mundane

Dr. Tamara McClintock Greenberg is a clinical psychologist based in San Francisco. She is the author of Psychodynamic Perspectives on Aging and Illness. According to her, traveling is a great stress buster. She claims that being stuck in our daily repetitive lives can take us away from what is actually meaningful and interesting to us, so taking a break is a must to allow the mind to relax, recharge, and rejuvenate. This can be achieved by crossing destinations off bucket lists. She says that traveling can take the mind off stressors. This results in lower cortisol levels, which makes people feel more content and calm. Based on a 2013 study, more than 80% of Americans surveyed had significant drops in stress just after a day or two of traveling. These forms of pilgrimage can be experienced simply by sightseeing, taking photographs, or exploring a destination on foot. Jacintha Verfegaal, the founder of Urban Pixxels, a travel and lifestyle blog, believes in this kind of break for self-discovery. To some individuals, such as the author Patrick Rothfuss, a long stretch of road can teach more about oneself than one hundred years of quiet. Experiencing travel in a foreign country or area can help one to reevaluate and reinvent their life. Valerie Wilson, an expert on solo traveling and the founder of the Trusted Travel Girl Blog, agrees with this ideology. She believes that one learns valuable lessons while traveling that will broaden one’s perspective and make one more aware of and open to new things. She says that being confronted with differences in her journeys has helped her reevaluate her own principles and values.

Marta Estevez, a travel aficionado and the founder of the Passport Memorandum, thinks that people are not meant to be tied down to just one place. She feels that life is most fulfilling when she is outside, living through new experiences and learning from them. She claims that new experiences help rewire the brain and boost one’s mood and self-confidence. Even preparing for a trip causes happiness and excitement in individuals. Based on a study conducted in Cornell University, anticipating a trip can increase happiness, even more than acquiring something tangible.

According to Allan Hinton, a photographer from London who quit his job to travel full-time, traveling can help a person deal with larger life issues more gracefully and patiently. He experienced unfortunate events while traveling that made him more understanding of and patient with the inconveniences in life.

Adam Galinsky, a Columbia Business School professor, believes visiting and exploring a foreign place and immersing oneself in the local cultures and environment increases cognitive flexibility. It also enhances depth of thought. This, then, gives creativity a boost. Galinsky has written multiple studies on the connection between creativity and international travel. Extended traveling also improves other aspects of life such productivity, problem-solving skills, and progress in general (Nazish 2018).

3.8. Intercultural Encounters

Traveling exposes an individual to other environments and cultures, opening the rest of the world to that person. These cross-cultural experiences increase one’s understanding of the world. As an atheist traveler, I count these among the many reasons why I set a goal to visit one hundred countries before I turn 40. I fully recognize my infirmities, and so, after I reach the nice, round number of 100, I will continue visiting the 96 or 97 remaining countries of the world, albeit at a slower pace. This secular pilgrimage allows for a full immersion in other cultures.

Many go on pilgrimages attempting to undergo not only a physical journey, but also a personal one. Part of this personal journey involves taking oneself out of one’s comfort zone, in order to glean more experiences. Greenia in his paper included the “displacement from one’s customary locale, daily routines and social position” as one of the essential elements of pilgrimage (Greenia 2014). Findings from a study by Higgins and Hamilton also reveal that a key theme that emerges from the understanding of pilgrimage by those who have undertaken it is that it involves a journey that is far removed from one’s daily environment (Higgins and Hamilton 2011). Being removed from your usual environment invites you to look at yourself through the eyes of others from different cultural backgrounds.

More than finding differences between yourself and someone else’s culture, going on a pilgrimage may also lead you to find people who share similar interests. Secular pilgrimages are often taken by people who have a personal connection to their particular interests. Shrines and Pilgrimage in the Modern World divides its list of secular pilgrimages into four categories: political; musical, sports, and life; spirituality; and death (Margry 2008). These include trails, memorials, and other significant locations. These pilgrimages offer insight into history, art, culture, and humanity. Just this year, people I know have been surprised upon learning of my trips to Central Asia. At the time of writing this paper, I have visited Uzbekistan, Tajikistan, Kazakhstan, and Kyrgyzstan. These countries, which are not seen in the usual traveler’s list, captured my interest for the mere fact that they are infrequently traversed. I am certain only of a few things in life, including that each country has its own story. Visiting war memorials, ruins, and mausoleums all remind me of how life can be short, and that after death we are likely to be consigned to oblivion after two generations. Having heard of the stories behind the people whose graves I visited also serves to remind me that greatness is earthly, that prominence is as temporary as our breath. Having such encounters contributed to my pragmatic approach in life, such that I can prepare for the contingencies of old age, while also embracing the possibility that I can die in the next minute.

The pilgrimages I have undertaken have also led me to interact with people from different ethnic and cultural backgrounds. Hearing their stories throughout the journey—their reasons for pilgrimage, personal histories, and travel anecdotes—has enriched my own experiences beyond what I initially expected. These interactions have taken me out of isolation and made me believe that I share the same issues and insecurities with people across the world, that I am truly never alone. I often leave these locations having gained a friend or two, mostly through my tour guides. Seeing the kindness of strangers toward people they do not know has also somewhat restored my faith in humanity, despite the social conditions that I face back home. In such pilgrimages, I find more reasons to appreciate what we have at home in the Philippines.

Each pilgrimage is its own experience. Traveling, more specifically going on pilgrimages, may take a toll physically and financially, but the holistic payoff is well worth the investment. The intercultural encounters may be physically exhausting but mentally invigorating at the same time, and for all this worth, I travel whenever I have the chance.

3.9. Cognitive Changes

After traveling, I often return home feeling refreshed, despite the physical tiredness that I feel from having gone through a long journey. Traveling affords me the necessary break from fatigue caused by toxic environments, disappointing social conditions, and exhausting workloads. Prolonged exposure to non-polluted air has its own healing benefits. Exposure to different climates and different elements are also valuable additions to the range of experiences I have from these travels.

Returning to my daily life after travel always feels like a fresh start. I feel invigorated, relaxed, and ready to approach life head-on once more. Traveling also affects how I think. I can apply new perspectives, which I have picked up from my travels, to my work and my life. Stressful work and unsatisfactory relationships can create toxic environments that we are forced to deal with daily. This in turn can cause emotional fatigue and mental stress. Disagreeable political climates and disappointing social conditions may also cause feelings of toxicity and aggravate mental health conditions. Traveling allows one to escape such toxic environments, even temporarily. Going on pilgrimages takes it one step further, allowing one to focus on the journey, on something beyond ourselves.

A study examining the experiences of visitors to different heritage sites reveals that the restorative benefits of their pilgrimages to these sites is the highest among other benefits felt, including spiritual, social, and mental (Bond et al. 2014). This proves that pilgrimages have healing capabilities, spiritual or otherwise, that might be felt by those who undertake them. Pilgrimage requires financial and physical investment, but the effects it has on one’s mind and soul are immaterial.

Spiritual practices have the capability of integrating different aspects of the human experience: emotional, mental, and physical. Going on a pilgrimage is one such spiritual practice. As I have reiterated many times, pilgrimages go beyond spiritual, as secular pilgrimages offer the same healing benefits.

Some may look at pilgrimages as mere distractions, but it is the kind of distraction that clears our minds, allows us to think more clearly, and turns us into more understanding beings. Going on pilgrimages broadens our horizons and offers us a look at the world in a way we have never seen before. This allows us to look beyond our own selves and appreciate that there is so much more of the world to be discovered.

Pilgrimages allow us to focus on the journey instead of focusing on ourselves. Often, these journeys take place in unfamiliar landscapes, forcing us to adapt, sharpening our wits and improving our skills. This adds to the overall cognitive benefits of going on pilgrimages. Everything you encounter during a pilgrimage can be charged to experience, to be used in the future.

3.10. Limits of Pilgrimage as Therapy for Depression

Pilgrimage and travel have been presented as beneficial to people’s mental health, but there are instances when it does not necessarily work as a form of therapy. There are numerous stories where people quit their jobs to travel the world and return with a fresh, new outlook in life. Sometimes, these stories are exceptions. Not all people who decide to leave their careers for traveling are successful at finding themselves, because sometimes this path has an endless number of uncertainties. Travel does not always prove to be helpful in battling depression.

Dr. Joseph Cilona, a psychologist from Manhattan, claims that escapism in the form of travel could be done impulsively—which will likely lead to a rebound or return of depression symptoms that become stronger than they were before. This is synonymous to turning your phone off for a while to get away from responsibilities, then turning it back on and finding that the notifications are overwhelming and difficult to handle. It is like running away from the causes of stress, only to find out that the depression still exists on the inside.

Traveling can be stressful, as well. Planning is not always exciting, because one has to make sure that everything is ready, and processes must be smooth. If one thing goes wrong, all the other aspects may be affected. This can become stressful. There are also uncontrollable factors in traveling such as flight delays and bad weather. This may be overwhelming and cause anxiety in someone with depression (Lauretta 2017).

Pilgrimage and travel also pose a negative effect in depression when they result in post-travel blues. This is when a person enjoys themselves as they forget their troubles and leaves them for traveling, and then return to the stressful reality. The trip planned was something they looked forward to, but when it is over, there is nothing left to be excited about, leaving them feeling stuck in their boring, routine lives (Kentucky Counseling Center Website n.d.). Pilgrimage may bring about tons of advantages in improving the mental health and lifestyle of humans, but it is not the cure for depression. It does not provide the complete benefits of therapy and medication. It helps in developing a positive attitude toward depressive episodes, but it cannot be the sole treatment.

4. Conclusions

The Pilgrim and the Patient

Modern times have redefined pilgrimage in that the word pilgrim is also used to describe a person who travels to foreign lands, regardless of whether for spiritual enrichment or sheer curiosity. As an atheist myself, I would rather frame my travels as pilgrimages as I do not travel for mere sightseeing and vacation the way a typical tourist might. It is during my travels that I recollect my thoughts best while gaining new perspectives that allow me to fine-tune the work that I do. Given these points, I cannot and will not recommend using pilgrimage alone to address depression. I have been on prescription medicine for two years, and I see my therapist every six weeks. Those factors, along with the work I do and the pilgrimages I take, are among the many that keep my sanity.

Even as the effects of pilgrimages are often examined using a spiritual lens, in that the pilgrim’s spiritual growth and transformation is observed, the marvel of modern pilgrimages is increasingly extending to the secular. While pilgrimages were initially undertaken in pursuit of a spiritual or religious reconnection, of renewing or recollecting one’s faith, non-believers like me undertake their own pilgrimages for various reasons, most of which are deeply personal.

Pilgrimages, as discussed previously in this work, do not only encompass journeys that are taken by the faithful for spiritual purposes. Pilgrimages include journeys that provide one with a transformative process: a chance to reconnect by temporarily disconnecting, a shift in perspective, a break from routine, a healthy diversion, and a holistic exercise for the mind and body. These pilgrimages, to illustrate the point in medical terms, work as food supplements do: no matter how high their sales figures have been through the years, and no matter how many people take them dutifully, these supplements are labeled as having no approved therapeutic claims. Food supplements, like pilgrimages, are taken with faith and in the pursuit of bettering one’s health, whether with or without a factual claim that they will work. Supplements are called such as they are often taken with prescription medicine to address the health issue head-on. This is also the case with mental health conditions and pilgrimages. Pilgrimages work like supplements, helping one cope with mental health conditions, in my case for instance clinical depression, while I unfailingly taking medicine prescribed to me by a psychiatrist.

An important concept to keep in mind is that of anhedonia, or the loss of pleasure in things that used to bring such. In my personal experience, this was the first and most powerful manifestation of major depressive disorder. Driving no longer appealed to me, although I had derived pleasure from it since I first got behind the wheel of the family car at the age of 16. At a certain point in 2018, traveling felt like a true burden, and any attempt at finding peace and quiet was met with ideations of suicide. My point is that pilgrimage, whether secular or religious, is not the first line of defense for mental health issues. To be blunt about it, it is difficult to be spiritual when you feel like killing yourself. It is nearly impossible to gather the strength to walk when you are not able to gather the strength to get out of bed to begin with. Pilgrimage is not a panacea but is rather part of a complementary approach.