DEPRESSION: Feed it or Starve it?

Image result for emotional eatingThe old adage goes, “Feed a cold, starve a fever.” I don’t know if food has anything to do with colds or fevers, but it is such an important ingredient in diagnosing major depression that it’s classified as a symptom. My interest? Last month (November 2017) I gained 15 lbs., but more about that in a moment.

I started pastoring my first full-time church at 20 years of age. Yes, I was young, inexperienced, idealistic, unqualified; a babe in grown-up clothes. My weight was 165 lbs., two years later it was 212 headed toward 230. You see, I’m a stress eater and that first church needed a far more mature and experienced person than I.

There were several stressors. I was a full-time student trying to finish college. The church was a full-time charge with heavy expectations. It had a reputation of disgruntlement, but I was naïve and thought I would be different. I wasn’t. My idealism was shattered, a world-rocking stressor for me. The church more than doubled in two years. That’s a good kind of stressor, but it is stress none the less.

After a round with stomach ulcers and with my blood pressure rising, my doctor sat me down for a talk. She said that if I didn’t get control of my eating habits, my health could be negatively affected. I made eye contact with her and shot back a reply, “Food is the only thing I have in my life right now that doesn’t talk back.” And thus, I fixed my course for obesity over the next 31 years.

However, weight gain or loss alone is not enough to suggest depression. Although my weight gain was significant in those early years and eventually topped out at 280 lbs. three decades later, it lacked rapidity. To be considered as one of the nine symptoms of major depression, weight is limited in both time and amount.  It must be both rapid – within a single month – and significant – plus or minus five percent of your body weight – without conscious effort. During my six episodes of depression since 1999, weight was a factor twice. In the spring of 2014 I lost 20 lbs. in a single month – eight percent of my body weight, and last month I gained approximately eight percent.

Since late August, I have been in a mild clinical state of depression. In November, I dropped to a moderate state and I fed it like a growling grizzly. I raided the children’s left-over Halloween candy. Ate two bowls of ice-cream a day. Lunch consisted of cookies, candy, or any other sweets I could find. Thanksgiving was indulgent. My appetite was insatiable. I hated myself for doing it, but regardless of the every-morning-promises I made to myself; I couldn’t stop. It was a primeval scream for gratification; an urge, a drive, a hunger that had to be satisfied. For 2017 I vowed to lose 20 lbs. Before November I had lost 23. If I hadn’t already been depressed, that alone was enough.

Mood and food have long been related, but more research has gone into what moods we feed and what ones we starve. “Many people with depression lose both energy and interest. This can include a loss of interest in eating” or cooking, or lacking the energy to prepare meals, says Dr. Gary Kennedy, of Montefiore Medical Center in New York. (Major Depression Resource Center)

Sadness, worthlessness, guilt, and other negative emotions appear to be connected with eating. “Depression can also result in emotional eating, a common event in which the need to eat is not associated with physical hunger,” notes Debra J. Johnston, RD, of Remuda Ranch in Wickenburg, Arizona. Some may eat to avoid feeling or thinking. (ibid.) (Depression’s Effect on Your Appetite by Chris Iliades, MD)

Anger, frustration, and excessive and prolonged stress are also associated with eating. (Ibid.) Here, I must plead guilty. Generally, I can handle a single stream of stress, but multiple streams tend to bring me down rapidly. August, September, and October saw a convergence of stressors until it became an overwhelming torrent. An education problem, a family relationship issue, and six medical matters of which half pointed toward cancer was more than I could bear. Although, the medical issues were less problematic by November – after informative or negative results from tests and retests, a surgery, and a new medication – it was too little too late to make a difference. My stress had to be fed.

I just love the way the literature addresses this subject. Make wise nutritional choices, it says. I’ve reached two conclusions about the depression advice givers: First, I think their intended audience is people who have symptoms of depression but do not meet yet the clinical definition of a major depressive disorder and/or those who have met the very minimum of requirements. Please don’t misunderstand my words as discounting or belittling the seriousness of depression at any stage, but at this point rational thought and wise decisions are easier to come by.

My second conclusion: the writings are not for people with severe depression. I’m not whining or looking for a “poor Jay, he’s had it so rough.” Save your sympathy. I’m observing a deficiency in the literature that lacks the ring of truth or practicality for a woman who can’t get out of bed, regardless of her best effort. The man who every day exhausts the resources he has in a desperate attempt to stay alive. Stop asking people to make rational and wise decisions when the biggest choice of the day, the only important choice, is to live or die.

So, I gained 15 lbs. in November. I feel terrible and don’t like myself much right now. But, by the grace of God I will overcome.

By the way, I’ve lost six lbs. so far in December.

The LORD be with you.

 

 

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My Sometimes Visitor: Catalepsy

Related imageIt was a Sunday afternoon and the third day of my first psychiatric hospitalization. I woke up from a nap feeling unusual – the kind of unusual you get help for quickly. It was a heaviness that seemed to engulf my torso and limbs, a restraint without visible binders. I got up and made my way down the long hall toward the nurse’s station. My room was the last on the unit. It felt like a short walk up a steep hill. By the time I arrived I was laboring for each step. One of the attendants noticed my strain and asked what was wrong. “I don’t know what’s wrong with me,” was all I managed to fearfully say. At that point I went rigid and mute.

It was my first experience with catalepsy – a paralysis like state in which one’s posture remains in the same position – and mutism – an inability to speak. Both are among the 12 symptoms of catatonia – a state of being involuntarily immobile or having abnormal movement. In either case you are unable to respond to your environment. Your motor activity is markedly decreased or meaningless. “Catatonia is typically diagnosed in an inpatient setting and occurs in up to 35% of individuals with schizophrenia,” (DSM5) but it presents most often with a mood disorder. Mine occurred in the context of my severe depression.

When this occurred, I was completely aware of my surroundings and heard everything that was being said, I simply could not interact with or respond to my would-be helpers. They managed to put me in a wheelchair, take me back to my room, and sit me on the side of the bed. Not long after the on-duty psychiatrist came in with a neurologist in tow.

It was perfectly logical for him to do so. Before diagnosing a person with a mental illness, other options have to be ruled out. Catatonia can have neurological causes. He asked me to explain to her what was going on. I wanted to answer. I tried to answer. I formulated a response. The words were on the tip of my tongue. But, nothing came out. We sat there for a few minutes in a staring contest before he rose with a snotty remark, “Well, when you get ready to talk, come find us.” I got mad. I wanted to talk, tried to talk, but nothing came out. I later told him he was rude and needed to learn better bedside manners.

Catalepsy and the other symptoms of catatonia are easily missed. I suppose a psychiatrist or a counselor could work through an entire career without seeing or recognizing a case. With catatonia some people can move while others can’t. Some can be posed into gravity defying positions while others resist such posturing. Some can speak while others are mute. Some can be unresponsive while others are agitated.  Immobility may be severe, moderate, or mild.

When I was young, our family enjoyed putting puzzles together. It would be laid out on the dinning room table and you could place a piece or two as you passed by. There was a competition to see who would put in the last piece. I wanted to be the winner, so I would tilt the contest to my advantage. I hid a piece and waited while others searched before miraculously “finding” that last one that made the picture complete. The same could be said about the difficulty of diagnosing catatonia or its separate components. There’s always a hidden piece.

Perhaps it was wrong of me to expect the psychiatrist and neurologist to recognize it. But, this was a teaching hospital. The biggest and best hospital in the state, attached to the biggest and best university in the state. I depended on them to tell me what was wrong with me, but they missed it.

A couple of days later it happened again. It was about 2:00 AM and I was answering a call of nature. As I walked toward the restroom my legs quit working in mid-stride. There I was cemented to the floor, unable to move. My upper torso was moveable, my arms were moveable, and I quickly proved that my vocal cords were usable as I cried out, “Help!” Again, the night staff helped me first to the restroom and then on to bed.

A short time later another doctor came into the room. It was not to be a repeat session with a neurologist, but a visit with an orthopedist. (I told you it was hard to diagnose.) As he began to move my legs about, bending my knees, moving my ankles and toes, I said, “Doc, I don’t think the problem is in my legs. I think it is in my head.” And, once again, they missed it.

It wasn’t until I came home, dived into my DSM4 and my copy of Sadock’s Synopsis of Psychiatry, 11th Edition, consulted reputable sources on the internet, like Mayo Clinic, and talked with other professionals that the light shone forth. Since then, I’ve never had another episode of mutism. However, there have been several recurrences of catalepsy.

It’s a problematic diagnosis. Treatment from hospital staff and other caregivers can range from the harsh to the cruel. I’ve been slapped, pushed, berated, misunderstood, and treated rudely. Others have had it far worse by being posed, humiliated, and other such degradations.

Until this past November (2017) it had been nearly five years since an instance of catalepsy. During the month I had two episodes that lasted up to 18 hours. It’s not as scary as it used to be. I now know what’s happening and am familiar with the routine. By God’s providential grace, none have lasted more than several hours and never more than a day. When it comes, I’ve learned to accept it as my mind’s way of coping with stress and depression when my otherwise conscious efforts have failed. I wouldn’t call it a friend. It’s more like an occasional acquaintance that shows up for coffee now and then.

Hakuna matata!

The LORD be with you.

Letters from Jail #5 Part 1 of 3

The following are excerpts from letters I wrote while serving a 360-day sentence in Hopkins County Jail in Kentucky. Normally, I edit and arrange the material for readability, but this month I offer it to you in chronological order with little editing.

My purpose for these excerpts is to: first recognize the grace of God under very different circumstances, open a window into my thoughts and struggles that may relate to yours, and hope that you may be moved to empathize for the jailed and mentally ill.

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June 13, 2013

I didn’t get back to the cell until late, therefore I didn’t write as much today.

Thank you for your prayers. I’ve learned that prayer is more than a session at morning and night, although that is important. Prayer is a relationship with the Heavenly Father all day long. There was a statement I read today that I liked, “Prayer is not a pious decoration of life, but the breath of human existence.” It lifts my spirit to know that others are praying for me.

Last night I talked to the chaplain about not getting to work. (For every day you work, you get a day off your sentence.) He said he would speak on my behalf. But, I’m content whatever the outcome. My brother told me it was the nature of my offense. (During a dissociative episode, I attacked two police officers.) He called the jail on my behalf, too. It’s in God’s hands.

Thank you for praying that this may be a time of healing and rest for me. It is peaceful except for the constant noise of the T.V., but rest comes easily. As for my healing – well? The battle between forgiveness and bitterness remains won as long as I don’t dwell on the offense or create alternative scenarios in my mind. The “old timers” used to talk about putting things on the altar and leaving them there. I find my hurts want to crawl off and I have to put them back on the altar. The more attentive I am to my sacrifice the quicker it is consumed by His holy flames.

Healing for some areas continues to elude me. I seek healing for the things that contribute to my depression. Sometimes I wonder if I should not embrace it. The Apostle Paul had his thorn that was at once his greatest weakness and his most glorious strength. I find depression is that for me. But, somehow there has to be a way to control the deeper and darker moments. (See II Corinthians 12:7-10.)

Healing of conscience is also an area in which I struggle. Often, I replay past sins and failures hoping for a different outcome. Then, when I realize that, in spite of my best efforts, it ends the same, I question my standing with God. However, I would rather be too conscientious than hardened to my deeds and my human condition.

Sincerely,

Jay

May the LORD be with you. 

*Because of the length of this letter, I have divided it into three posts. Monday November 27, 2017, Wednesday November 29, 2017 and Friday December 2, 2017. Thank you for reading.

WITHOUT DEPRESSION, I WOULD . . .

A person sent me a note last week that read in part, “I am so sorry you have to suffer from the illness of depression.” Immediately I responded with a “Don’t be sorry for me.”

The 19th century pastor, Charles Haddon Spurgeon, had a mega-church before that phrase was coined. By age 22 he hadImage result for charles haddon spurgeon crowds that surpassed the 10,000-seat capacity of the largest auditorium in London. Yet, he was plagued with disabling depression. However, he credited his depression with making him a better minister.  “The way to stronger faith usually lies along the rough pathway of sorrow,” he said.

“I am afraid that all the grace that I have got out of my comfortable and easy times and happy hours, might almost lie on a penny. But the good that I have received from my sorrows, and pains, and griefs, is altogether incalculable.… Affliction is the best bit of furniture in my house. It is the best book in a minister’s library.”

At another time he wrote, “I would go into the deeps a hundred times to cheer a downcast spirit. It is good for me to have been afflicted, that I might know how to speak a word in season to one that is weary.”

Since I received that note, I have thought about what I would have lost without depression.

Without depression, I would not have the understanding or insight I possess today. The food of despair, the drink of hopelessness, the bitter cup of feeling forsaken by God, the acrimonious prayers to die, and the dish of suicidal ideations have plagued my soul. I can sit with people who lounge in the cellar of darkness and understand the depth of their agony. I have more authority than most to speak to them in their misery, because I sat where they sit.

Without depression, I would not have discovered my capacity for empathy and compassion. Because of the losses I have experienced I can sit at the table of sorrow with others and weep with those who weep. It brings a modicum of comfort and mollifies the feeling of aloneness when someone who has hazarded the treacherous waters before you enfolds you with arms of mercy.

Without depression, I would not be able to effectively advocate for those hidden and forgotten by society. I was homeless four times, penniless – without a cent to my name – for seven months, without transportation, unable to get housing or employment because of my criminal record, prevented from being near my fiance’s grandchildren, slandered, shunned, and denied a path to ministerial restoration without a hearing. Many doors were bolted against me because governments erected hundreds of barriers for the criminally convicted that prevent housing, employment, and stability. The floor attachment of a vacuum is being used to clean the fine furniture. As a result the beautiful upholstery is being sucked in along with the intended dust. The resulting damage far outweighs the harm the dust could ever have done. Federal, state, and local governments demand science based outcomes, but they are guilty of ignoring that same science when it comes to making laws and regulations. I have experienced the injustice and can now give voice to righteous causes.

Without depression, I would not know the need to fight against the stigma of mental illness. I become angry when I hear others define the life and character of an individual with a mental illness diagnosis, “He is schizophrenic” or “She is autistic.” In every other health discipline stigmatic vocabulary has been eliminated. “He is a dwarf,” thankfully has passed from formal usage. To say, “She is retarded,” is considered cruel. There would be a rousing chorus of fervent criticism against any hospital staff that referred to its patients as “the heart attack at the end of the hall,” or “the cancer in room 303.” The purveyors of kindness in our society have overlooked the labeling, prejudice, discrimination, and separation experienced by the mental health community. This needs to change.

Without depression, I would not have experienced the freedom that came inside a jail cell. Imprisonment was the only thing that stopped me cold on the path of personal destruction. A year of confinement gave my mind and body the rest it desperately needed after nearly forty years of abuse. Most importantly, it gave me an opportunity to renew my relationship with God.

Without depression, I would not be on the path to becoming the man I always thought God wanted me to be. Gone is the uncontrolled anger and yelling. In its place has come a capacity and ability to love others unconditionally, forgive, humble myself, and grow as a husband, father, and grandfather. What I had aspired to be all my life is becoming a reality and the boundaries of who I can become are being moved higher.

Without depression, I would not know the joy of being in right relationship with Jesus Christ. Beyond elevated emotions, beyond a rule book and a uniform, beyond correct dogma and doctrine, and beyond creeds and rituals; I have come to know that abiding place in Jesus where I as a branch receive nourishment from Him as the Vine, submission of myself and the desires and plans I may have to the Lordship of Christ, and a desire to know God in His revealed character and attributes, the splendor of His creation, and the grace of His redemptive work.

Spurgeon professed, “This depression comes over me whenever the Lord is preparing

a larger blessing for my ministry; the cloud is black before it breaks, and overshadows before it yields its deluge of mercy. Depression has now become to me as a prophet in rough clothing, a John the Baptist, heralding the nearer coming of my Lord’s richer benison (blessing).”

Do not be sorry for me. Without depression, I would not have the experience, knowledge, and wisdom I have today. Several years ago I quit praying for healing. My prayer now is to learn the lessons God is trying to teach me through each depressive episode.

May the LORD be with you.