Depression. We’ve all been there. While some experience relatively light and sporadic symptoms of this disorder, others seem to walk around with a permanent cloud affixed to their heads.
Our workshop tonight is designed to provide you information on the disorder we refer to as Depression. In the short time we have together, I cannot hope to give you an exhaustive study, but I expect the following information will be very helpful to you.
What is Depression?
I have often reflected that as many as a third of the thousands of clients I have counseled over the past twelve years exhibited depressive symptoms. And I have often told these clients that the symptoms of the disorder virtually define it.
Let’s look at several potential symptoms and then consider the genesis of this mood disorder.
These symptoms may be divided into a formula represented by the letters A, B, C.
A = Affect – Affect refers to facial characteristics. Discouragement and “The Blues” are often evident in the eyes of the depressed person. There may be a seeming lack of life there,
and the mouth is often set and unsmiling. Seemingly, even the pigment of the skin may be blanched or gray in color.
B=Behavior – The appetite may be reduced or unusually large. The depressive person often “takes to his bed,” and sleeps hours beyond what has been usual. Obversely, he may not be able to sleep or awake early. His energy is often reduced.
C=Cognition – It is not unusual for a depressive person to lose focus or forget easily, and their mental mindset is often negative in nature. An increasingly selfish, reflective or introspective attitude may be evident.
There are any number of factors which contribute to Depression. We will consider these characteristics and factors in language common to lay people.
When I think of “Genesis Events or Stimuli” which contribute to depressive feelings, I immediately think of two broad headings: External and Internal.
In terms of the External Factors that contribute to Depression, - Loss, Traumatic Events, and other difficult circumstances are often present.
Stress or Overload is an equally common stimulus that predisposes the body to depressive emotions.
In relation to Internal Factors there are Hormonal Imbalances and Chemical Imbalances. Women most often suffer the effects of imbalance related to their three major gender hormones: Estrogen, Progesterone and Testosterone. They are twice as likely to suffer with Depression. Both genders may suffer from chemical imbalances such as Bipolar Disorder or Schizophrenia; mental disorders related to chemicals within the brain.
In addition, what I refer to as Faulty Thinking or Dysfunctional Mindsets are internal factors which may translate into feelings of hopelessness and correspondingly negative behaviors. I have prepared an excellent handout for you which details some traditional mindsets.
Feelings of Low Self Esteem and Guilt related to past events may contribute to depressive emotions.
Unforgiveness, without doubt, predisposes people to Depression, Anger, Bitterness, and a host of other physical maladies.
Depression may last an hour, a day, a week or a lifetime. In terms of treatment, two major characteristics signal the need for intensive care:
1. The severity of the symptoms (as evidenced by how the “candidate’s” life is being effected,) and 2. The length of time the symptoms persist.
Depression is a disorder that may significantly reduce one’s ability to function and enjoy life. It may be so pervasive that sleep seems to be the only respite to dreary days and tortured nights. As a handout you will be given implies, it has the potential to close you off from relationships and social interaction and virtually suck air and life from you. I have said that “It is like falling asleep with your feet in a wet gray mixture, only to wake up and find out its concrete.” Depression contributes to something I refer to as “Stuckness,” or the tendency to remain emotionally stuck.
Depression should not necessarily be thought of as a negative or sinful thing. We’ll be reflecting shortly on some very godly men who were familiar with hopelessness and despair. Depression is a normal part of the grieving process. Depression is a normal response to life’s circumstances.
Symptoms like disappointment may be light and fleeting, while discouragement and hopelessness may require medical attention. Depression may be successfully dealt with on our own, or the severity and length of it may require professional attention.
I feel inclined to accent something in the early portion of my lecture. Moderate to Major Depressive symptoms cannot be taken for granted. I have dealt with such emotions among clients, friends and relatives for years. The suggestions you will receive tonight have the potential to make a large difference, but there is no panacea. Sometimes Depression lingers for years, and especially among the chemically imbalanced, treatment may require a great deal of patience, and some trial and error.
I have personally dealt with what has been referred to as Suicidal Ideation which can be a result of Major (or Clinical) Depression. Several of my clients attempted to permanently harm themselves. Thankfully, none succeeded in the attempt.
We will be discussing treatment and intervention in the second portion of my lecture. You will also be given a packet of materials tonight which include my lecture and some additional handouts which have been prepared by my associate counselor and myself.
Let’s return to the predisposing factors which may lead to the symptom we call Depression. Again, they are primarily External and Internal in nature. The catalysts for Depression are either Circumstantial or Reactive in nature or are a result of Physical, Spiritual, Chemical or Emotional maladies within the human body.
It’s interesting, (if that’s the correct word,) that Depression is often generated by both Circumstantial and Internal causes. It is often a mixed bag of sorts.
I’d like us to spend a few moments with some historical examples. Since I administer a Christian counseling agency, I can think of no better source than scripture. Let’s look a several examples from the Old and New Testaments, and let me attempt to analyze these fellows and their conditions.
Elijah knew the pain and disillusionment of Depression. In 1st Kings, Chapter 19 he has just experienced a great victory, and then, confusingly, he runs away in fear. We see him sitting by a brook feeling sorry for himself. He figuratively or literally shakes his finger at God and says, “Take my life from me. Nobody knows the troubles I’ve seen” and “I am the last righteous man in Israel.” Immediately God corrects him, and encourages him that there are many who have not bowed down to Baal. The lingering effects of Depression often follow a great accomplishment. In Elijah’s case we are witnessing Circumstantial Depression since he is in fear for his life, and that sort of Depression brought on by his own internal mindset. Something I call Faulty Thinking.
Then we have Job; Depression Incarnate. Hardly ever a man suffered like this man. The loss of his children, the alienation of his wife, the theft of his possessions, the destruction of his body, the clutter of his mind, the evil intervention of Lucifer, himself. Again we see dualistic factors contributing to the horrendous emotions of a godly man. And we follow Job through 42 chapters of some of the most depressing verbiage ever written. But in all of it he refused to curse God, and said in one place, “Though He slay me yet will I trust in Him!” (Job 13:15)
Then again, we see Jesus, very man and very God, as He enters into a garden, just prior to his crucifixion. Scripture tells us that He was troubled and distressed, and He sweat what appeared to be great drops of blood. His words transfix us. “My soul is very sorrowful, even to the point of death. Please let me avoid this part in Your plan.” (Mark 14) The environmental influences surrounding Him correlated with His emotional responses. He was preparing to take on the physical pain of execution and the emotional pain of our sin.
And who can forget the two unnamed disciples traveling to Emmaus. (Luke 24) Loss beyond losses. Their Lord has been crucified and buried, and all hope seems lost. Their words betray Depression generated by the most negative of circumstances. “But we had hoped…” The past tense word “had” says it all. Again, Faulty Mindsets leading to the most negative of emotions. Sometimes correct information is all that is needed. For their morose attitudes were changed in a moment. For “their eyes were opened,” and they recognized their living Lord.
Finally, at least in terms of these human examples, consider my favorite Apostle; Paul. He who every reason and right to be Depressed, but one who fought it tooth and nail. For even in the Caesar’s prison he is found to say, “You should be glad and you should rejoice even as I do” and “I have suffered the loss of all things and count them all but loss that I may gain Christ.” (Phil. Chap. 2 & 3) Our brother Paul realized that his life was a loss worth losing in the grand scheme of things. He defeated Depression in terms of the comparative mindset that the Eternal awaited him just beyond the prison’s threshold.
TREATMENT AND INTERVENING FOR THE DEPRESSED
Treatment for Depression tends to be singular in nature. Once we begin to pull together pat answers or generic remedies, we discover our limitations. That is, what may benefit one, may seem all but useless to another. Therefore, it is crucial to discover the intervention or combination of interventions that tend to alleviate Depression in a particular individual. One effective possibility is to ask ourselves, “What have I tried in the past?” or “What has worked for me that might work for me again?”
There’s a few phrases which characterize what it takes to leave troubled emotions and moods behind.
“If you want something you’ve never had you may have to do something you’ve never done.”
And
“Why do you keep on doing the same things you’ve always done and expect different results?”
And
“Change is only possible when the pain is perceived as greater than the required action.”
And
“Change becomes possible when the Status Quo seems less acceptable than the Future Unknown.”
I’m convinced that treatment begins with a Decision to get better. I have never known anyone who exhibited chronic Depression who got better ‘til they made a purposeful decision to do so.
I will quickly add… certain physical and emotional maladies challenge the chronically sick on a daily basis, and Depression, Hopelessness and Despair may come and go often. But I think God still holds us accountable to take positive action steps to help alleviate our pain.
At the same time there are those among us who will need plenty of time to move through the stages that lead to emotional healing. I have counseled clients who required weeks of therapy to move through the early stages of the loss of a loved one; whether by divorce or death. The grieving process is just that; a process. Tremendous patience and compassion is required to adequately counsel such persons. At the same time, my skills have been tested by clients who cannot consign a loved one to memory, and resume a functional lifestyle. I think of one woman who continued to “hold out a candle” for her divorced husband years after he remarried another woman.
Let’s consider some potential remedies to the emotion and disorder we refer to as Depression.
Having spent well over a decade in the counseling arena, I have concluded that there are at least four major intervention types which contribute to healing: Counseling, Medication, Spirituality and an Action Orientation on the part of the depressive individual.
The essence of struggle, and relapse. The potential that some will experience Depression throughout life, but that the ability to cope and not sacrifice ourselves to our Depression is paramount.
Beyond the initial requirement that we make that healing Decision, we must move beyond theory into that rarified atmosphere called Action.
(See Philippians 2:13)
In terms of Action Orientation, I often recommend a particular assignment.
“FINERS” – Fun, Intimacy, Nutrition, Exercise, Rest and Spirituality
(Elements which allow us to progress past Stuckness)
An Action Orientation often includes Betraying Your Emotions. We are not required to “feel like it” to take positive action steps.
Such actions may include: Asking someone to forgive you, Rectifying a past wrong, Including scripture and prayer in your daily regimen, Letting go of harmful relationships, Listening to uplifting music, Taking medicine that has proven beneficial to you, Changing negative behavioral patterns, Successfully communicating your needs, Keeping journal entries, Attending Counseling, Quoting scripture aloud, “Thought stopping, Involvement in ministry, Goal-setting, Staying busy, etc.
Let me finalize our time together with the following guidance for caregivers, friends and relatives of those who experience depression.
Encourage the friend or relative to get help.
Don’t attempt to go it alone. Professional helpers may be necessary.
Communicate. Allow the depressed party to express themselves.
Don’t allow yourself to be manipulated by the depressed person.
Don’t take threats for granted. Bring in appropriate authorities if necessary.
Don’t tempt a depressive person.
Offer to participate in their counseling process, if applicable.
Act as an accountability partner.
Participate in the activities a counselor may recommend to your friend or relative. (As an example, offer to take daily walks with your significant loved one.)
Make counselors and physicians aware of any serious changes which occur in the demeanor of the patient.
Encourage the patient. Compliment the loved one for their emotional progress.
Monitor medication, when possible.
Make wise decisions about your capability to maintain a relationship or emotional intervention with the patient.
SUMMARY:
As I considered how to close this workshop, it occurred to me to leave you with this information and admonition:
Recognize the Genesis or Source of Depression as The Beast. Because it is. Granted it is more nebulous and less visible than its Symptoms, but it is the more tangible of the two. It is when we discover The Source that we can whip the Symptom.
When we discover and address The Sources of Depression that we are closest to a miracle. That’s where our major focus should be. We may have to do some emergency intervention in regard to the Symptoms that surround Depression, but I find that when people get relief from its Sources, they most often get the relief for which they have so diligently sought.
William McDonald, PhD.Copyright 2005
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