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 a quarter of a century 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 major 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 2003
Copyright 2003
No comments:
Post a Comment