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
is not always 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. One client actually ran her car
into a telephone pole on her way to her first session with me. Another hung
herself off a tree with a clothesline. Thankfully both lived.
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.
And He took with Him Peter and the
two sons of Zebedee, and He began to be sorrowful and deeply distressed. Then
He said to them, “My soul is exceedingly sorrowful, even to death” Matthew
26:37,38
We have not a high priest who cannot
be touched by the feelings of our infirmities, but was in all points tempted
like as we are, yet without sin (Hebrews 4:15)
I believe
Jesus experienced a sorrow and depression that no man before or after him has
known. For He was about to experience a death that no man before or after Him
ever knew. He willingly took on Himself all the sins of mankind. Imagine that!
All the sins of every man who would ever populate the earth throughout all the
ages, and in the space of a few hours in time!
Depression
has many causes. There are two general primary catalysts; external and internal
factors contribute to the presence and severity of depression.
Among the
symptoms of depression are a morose demeanor, inability to sleep, a tendency to
sleep too much, loss of appetite, agitation, withdrawal from socialization,
loss of control, and in severe cases, suicidal thoughts and actions.
The external
factors that contribute to depression relate to circumstances in which we feel
helpless to exercise any control. Internal factors that contribute to a
depressive mood include spiritual guilt, hormonal imbalances, chemical
imbalances and organic trauma.
Depression
need not be an all-consuming, never-ending mood. There are things one can do
when depression begins to overwhelm one’s entire life.
If you are
experiencing moderate to severe depression I recommend you admit these symptoms
to someone you can trust. Discuss your problems and issues with a good friend.
Seek medical
attention. There’s no sin in relying on medication for a season. There are
wonderful (but mild) antidepressant medications available that have the
potential to help you function during intense circumstances or internal imbalances.
Seek Godly
counsel. I have seen literally hundreds work through their pain, through a
counseling process. Counseling can help you plan and enact action-oriented
remedies to your problems and symptoms.
Seek God.
Ultimately our reliance must be on the One who created our bodies, minds and
emotions, and Who keeps us in all our circumstances.
by William McDonald, PhD. Copyright 2000
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