Choose Your Insanity, Part I

Source: Choose Your Insanity, Part I

Untreated or Under-Treated Depression

NOT A CHANCE!

Image result for no chanceWithin the past couple of weeks someone asked if one could function normally and have severe depression. I responded with an emphatic “No!” There is no way one can go about his/her day without “a change from previous functioning” if they have a major depressive disorder. Even a person with dysthymia or a mild-to-moderate depressive disorder will have some impairment. However, severe depression is in a different league all together. In no way am I trying to minimize depression in whatever form it may take, but by definition severe depression severely interrupts one’s routine. According to the Diagnostic Criteria from the DSM, severe depression is marked by “several symptoms in excess of those required to make the diagnosis, and symptoms markedly interfere with occupational functioning or with usual social activities or relationships with others.” In order to meet the criteria of a major depression diagnosis, one must have at least five of the nine symptoms for a minimum of two weeks and have a change from previous functioning. Severe depression requires eight or all nine symptoms to be present. A depressive disorder is not to be equated with sadness, grief, or a “terrible, horrible, no good, very bad day.”

Four years ago this month I wrote the following attempt at a poem.

Ode to Despair

What can you say when there are no words to express                                    The pain, the sadness, and the foreboding hopelessness.                  Statements, remarks, and speeches reverberate like a round                       That goes on and on without end in meaningless sound.

“Due despair and agony on me, deep dark depression,                          Excessive misery,” is an all too common sad expression                                  For the weary and worn who go through life damaged,                           Hidden, misunderstood, in anguish, wounds un-bandaged.

“Who can deliver me from this body of death?” I shout,                                   But only an echo returns with scorns and mocks all about.                        “There is no help for him in God,” I hear as trouble multiplies,              Gloomy and cheerless, I want not to live and am afraid to die.

“It is enough! Now LORD, take my life,” I earnestly pray.                             “What are you doing here?” the LORD whispers in the fray.               “Forsaken, torn down, killed all the day through,” I reply.                              GOD listens with compassion HIS grace ready to supply.

Strong winds tear at mountains and break rocks into slivers.         Earthquakes alter the contour of the land and courses of rivers.                   Fire purges the grass from the field and fells the trees.                                    But, the LORD passes by gently and speaks to my needs.

As you can infer, I was severely depressed. As a Christian I could not end the poem in absolute despair, so I included a stanza of hope. To be truthful, it was not how I felt at the time. Death, I thought, would be a relief.

I had all the symptoms – depressed mood, diminished interest in activities, weight gain, hypersomnia, psychomotor agitation, fatigue, diminished ability to concentrate, and recurrent thoughts of death with suicidal ideations – of a major depressive disorder. To put it succinctly, I was a mess. Depression had been hounding me for a year as I spiraled downward into a bottomless free-fall. And, for the next eighteen months I trudged through a morass of thick, endless darkness with no hope of escape. Normal functioning? That was an unknown cloud in cuckoo-land. Severe depression destroyed everything I spent my life building and it very nearly destroyed me, too.

Thank the good LORD I have been in partial remission for over two years. Although I have accepted the fact that I will never be “normal” again, I find that life is well worth living. I have hope, fulfillment, happiness, and contentment. If you can function normally, thank God, address whatever is troubling you, and march on toward health and wholeness. On the other hand, if you are falling and cannot seem to right yourself, there is hope. Reach out to a professional who will help you begin to heal.

The peace, mercy, and grace of our LORD be with you. Amen!

*image from 123RF.com

The Disease That Shuns

Image result for Jesus heals leprosyAs I sat listening to our pastor describe the plight of people with leprosy during Bible times, I began to listen more intently. Not that I did not know already from my own studies, but in that moment there was an epiphany. What I heard about the person with leprosy in the first century had an uncanny similarity with what I have experienced as a person with a mental illness in the 21st century.

A person with leprosy – which included far more skin diseases than what the modern “Hansen’s Disease” diagnoses, together with mold on clothing and in houses – was immediately cast out of the community. There was no quarantine period or time given to put personal or business affairs in order. Instantly the person was told to leave his home, family, job, and city. He was condemned to live alone or in the company of people who had the same illness as he. Not permitted to live in any walled city – the equivalent to our metropolitan cities – and outside any town or village, he was left to live in a separate dwelling, in caves, or in the open air. The religious orders of the day banished him from the temple or synagogue and it was often thought of as punishment from God. In his Middle Eastern culture, a greeting involved an embrace and a kiss, but no one was allowed to touch him nor could he touch anyone because he was “unclean.” This is why it is sometimes referred to as the disease that shuns. The day that he was told that he had leprosy EVERYTHING changed.

Yes, I understand that most people with a severe mental illness do not experience extreme measures, but notice the similarities. As a person with a severe, recurrent major depressive disorder, I isolated myself at first. I did not want to be around people. That demands energy and I had none to give. But, as my illness progressed people did not want to be around me. After all, who wants to be around a person with depression? What fun is in that?

People with mental illness – for more reasons other than that they are not always the life of the party – are often shunned because people do not understand mental illness and are poorly prepared by our society to communicate with people who are so afflicted. Still others think it is “all in your head” – which is ironic since that is exactly where the problem lies. And, there are still ill informed or misinformed religious leaders that proclaim and congregants who believe that it is all a punishment from God for sins we have committed. We are “plagued” and therefore, isolated. It can be a lonely existence at times.

I experienced the loss of my home, going homeless a few times. After 34 years of marriage, my wife abandoned me because she could no longer deal with the effects or extent of my illness. Two of my children turned their backs on me for the same reason. One job discharged me for my inability to carry out my assignments. Another demoted me twice until I gave up and quit. Yet another broke my heart when I resigned because I recognized that I could never again carry out the responsibilities of that position. I reinvented myself twice and am now trying to do it again as a writer. My story is an all too common scenario among we who have a severe mental illness. Sometimes we are stripped of our rights and given a guardian or assigned a conservator to look out for our affairs. Others of us are sent to a mental facility to live out our lives, out of the sight of the community at large, or allocated a spot in the world where we will not be a bother. We, too, lose home, family, job, and city.

A man with leprosy in the first century had to proclaim to all his disease. Whenever people approached him or he approached people, he had to cry out in a loud voice, “Unclean, unclean!” He had to show the world his disease by rending his outer garment, keeping his hair unkempt or be bald with his head uncovered. His beard and upper lip was to be covered by his mantle when in the presence of people without leprosy. Around others he appeared to be in a constant state of mourning as if wailing about his impending death.

Many of us with mental illness understand the posture of such a man. Although not required, we sometimes appear unkempt and sloppily dressed. It is because the task that calls us into public requires a focused effort and we cannot be distracted with peripheral things. But, often we are put into that box of “publicly proclaimed separation” by society.

When I was a boy, a diagnosis of cancer was almost always a death sentence. You did not want to be around that dying person; there was an associated fear that hovered over them. If you were, you did not know what to say or what to talk about. One rule was clear though; never say the word “cancer” to or near them. They were going to die; the stench of death reeked from every pore of their body and we were told to be silent about it. Thank God, times have changed for the cancer patient. My doctor told me I had cancer in 2015; I hardly blinked an eye, took my treatments, and have been cancer-free for 18 months. Many others tell the same story.

Today, mental illness is the cancer of yesteryear. We do not talk about it in polite society. None of us volunteer our diagnosis to others and they do not ask. And, it would be totally uncouth to actually have a conversation with someone about their illness. We have a forever disease whose symptoms can be treated, but whose cause is incurable. People fear us because they do not understand us or the nature of our illness.

Jesus did not follow the first century rules concerning leprosy. He touched them, which as I mentioned above included an embrace and kiss. These banished people flocked to Jesus in large numbers because He welcomed them and was not embarrassed or afraid to be with them. He was not put off by the missing fingers, toes, noses, and ears that were often a result of their disease or the brilliant white spots that threatened to destroy their ethnic identity. In multiple instances throughout the Synoptic Gospels, Jesus had compassion on these ostracized people, healed them, and restored them to a life free from shunning.

Although I am no Jesus (far from it), I have great compassion for we that struggle with mental illness. One of the reasons I am so open about my depressive disorder and the effects it has had on my life is to help someone else feel not so lonely and misunderstood. Another reason is to educate others about our disease. You and I have intrinsic value, dignity, and worth. We are not our disease. There is hope. We who suffer and society at large are redeemable. Let us carry that message to the masses.

Depression and the Holidays

anderson-at-christmasIt was the year 2000, the first full year since I had become clinically depressed. I was so severely ill that my job had forced me to take a leave of absence. My brother invited me to come and stay with him for a few days. I accepted. My dad and a family friend took me the 200 miles south, southwest to his house where they planned to go fishing. I was supposed to go home after the fishing trip, but I stayed, and a few days turned into a few weeks.

During the day my brother and his wife were away at work and I had the house to myself. There were no responsibilities to be a husband and parent, no pressure from work to finish reports or perform daily tasks, no meetings to attend, speeches to give, or places to go. I was free to toddle around the house, watch TV, do some light housekeeping, play on the computer, or take a nap. Reformation of spirit and body was easy to claim in this environment. But, . . . Thanksgiving was coming.

I have always loved the Thanksgiving/Advent/Christmas season. Gatherings of family and friends. Feasts that included my mother’s special egg noodles. Music from long known church hymns to carolers on the streets and other holiday songs. Performances by school children, high school students, the local theatre troupe, and church plays. Did I mention food? Shopping for special and thoughtful gifts to give to my wife, children, parents, brothers, and the rest of our family. Putting up the Christmas tree and decorations. Being part of a caravan that went through town looking at the lights and seeking the best holiday display. Giving and receiving gifts. It was all great fun and I looked forward to it every year . . . except this year.

My wife and children, parents, niece and nephews gathered in to celebrate. The house suddenly became smaller and the opportunities for alone time fewer. Feasting, conversation, and playing games were expected. I could hear myself protesting silently, “I’ll take my meals in the bedroom, thank you.” And, the only contribution to the conversation was, “I would like to die now, please.” Games required concentration which was in quite limited supply at the moment. The worst was yet to come. When the festivities were over I was expected to return home and resume my role as a husband and parent, and prepare to go back to work.

Upon my return I tried to go shopping at the local mall with my family. It was unexpected how exhausted I became after walking through the first department store. One store . . . and all my strength for that trip was wasted and I had no reserves. My family deposited me in the courtyard for the remainder of the outing. I sat quietly alone, anxious for their return in order that I may go home and back to bed. It was the only attempt I made to go anywhere that season.

It was a miserable holiday season. I did not want to be around people because I fatigued too rapidly. It was nearly impossible to smile and laugh. There was no enjoyment to be found in the lines my children were learning for their school and church programs or the new songs my wife was using that year as she directed the annual Christmas cantata. I stayed home from church all but one Sunday during the season. If a genie had given me a wish, I would have wished to skip the holidays. It was too hard.

There have been other holiday seasons in which I was experiencing depression, but that first one was the worst.  I did not know how to cope or compensate. Where was a Rip Van Winkle when you needed him?

The subsequent holidays have not been as difficult for the following reasons:

I pick and choose the public things I can do and inform my family about my decisions. When I am in the midst of a depressive episode I find it especially difficult to be around crowds. Therefore, it can be very intimidating to go to a play or program in a small venue. Last year our grandson was in a play at his school. The performance was planned for the school gym, if you can call it that. I have played on backyard courts that were bigger. Well, not exactly, but you get the picture. All six grades, faculty, staff, parents, older and younger siblings, grandparents, godparents, and the rest were all jockeying for position, sitting shoulder to shoulder, and standing about, leaving only a single-person-wide aisle to the exits. The press of people was suffocating and there was no place to go to make it any better. I was stuck for the duration without a means of escape. If I had been in a moderately or severely depressed state at the time I most likely would have ended the musical in the fetal position.

One shopping trip in a crowded mall may be all you can abide. One program. One church event. One community affair.  And, that is alright. You know your limits and it is to your own personal hurt that you press beyond them. Explain yourself to those who need to know, offer your regrets, and do not allow yourself to be guilted by anyone, including yourself. You are your own most competent advocate and you know best your boundaries.

I pick and choose the people I want to be around. Large family, church, work, or club gatherings can be nerve-racking, unpredictable, and ruinous to one’s already fragile health. Expectations to be festive, joyful, and participatory can feel overwhelming. A game face can only last so long. And, after that there are the ones who love and care about us, but always seem to say the wrong thing. “Snap out of it.” “Have you tried . . .?” “I have a friend who is just like you. . .” We have heard all the “help lines” before. We smile because we know they mean well, but on the inside we want to scream.

Then there is that person who belongs to your group, but is toxic to you. You know the one that makes your teeth grind and your stomach churn. The one you love and would do anything for so long as you did not have to be around them. That one! It may be that a more intimate setting and an invitation only gathering is necessary this year.  The key is control. The more you can manage and arrange the less likely you are to find yourself in a detrimental environment.

I do what I can and leave the rest. My mother made a table top ceramic Christmas tree back in the 1970’s that I inherited. For about three years it was the extent of my decorating. Although it is becoming common to shop online, I have done it for about ten years as a means to escape the daunting crowds.  As you become more aware and in tune with your personal needs and constraints, you will better be able to rightly judge what is best for you during the holidays.

This year I am in a pretty healthy state. I can enjoy the events and happenings with more spirit than in previous years. Thanksgiving, Christmas, and New Year’s will bring added happiness for me. I await joyous times with family and friends. The festivities of the season are anticipated with excitement. It has not always been so and may not be in some future holiday, but for now I will revel in the moment.

God bless you! Merry Christmas and a happy New Year!

Living with Fear and Anxiety

Image result for fear and anxietyWhen I was about ten there was a boy in my neighborhood who decided he wanted to fight me. He had no reason – no offensive words or gestures were exchanged, no challenges made, no insults traded. I can only surmise that it was my turn to be tested in his effort to advance on the neighborhood “toughest” scale. I had no interest in participating in any such primitive ritual; therefore, I avoided any contact with him. My life was miserable for a couple of weeks. I ran home daily from school, stopped playing outside, and suffered humiliation piled on by my scornful friends. Besides lacking any reason to fight or interest in the same, I was sorely afraid of being hurt. It was a fear that would torment me for years to come.

Fear and anxiety are closely related, but there is a distinction. Anxiety is an alerting signal – like palpitating heart or sweaty palms – to a threat that is not immediately present. When you have alarm bells going off relative to that trip you are taking in a couple of months – that is anxiety. Fear, on the other hand, is an alerting signal to threats that are more immediate. Several years ago my dad turned left in front of a heavy line of traffic. My mother screamed out, “Oh, God!” Dad rebuked her saying, “Jenny, you know we don’t use God’s name except in prayer.” “I was praying!” was her quick reply. Mom responded with fear.*

Everyone experiences fear and anxiety. It is part of our innate nature when danger, real or perceived, presents itself. It can be both hereditary and experiential, both nature and nurture. You may have a generalized anxiousness about the stresses in your world, a phobia that has been passed from your parent to you, or a traumatic event that alters your sense of safety. When these fears and anxieties begin to disrupt your daily functioning, it is called a disorder. According to Kaplan and Sadock’s Synopsis of Psychiatry, “Anxiety disorders are among the most prevalent psychiatric conditions in the United States.”*

My fears and anxieties were varied. In my early teens I had recurring dreams about someone breaking into our house through the back door. It was so real that I frequently got out of bed, checked the back yard for any sign of intruders, and made sure the door was secure. Often I put a table knife in between the door and the interior casing to prevent easy entrance and noise makers in front of the door to alert me to trouble. This dream and behavior persisted until I went to college and then it inexplicably went away.

When I was fourteen I started working with my brother roofing houses. The heights and the wooden ladders he used did not bother me. It was not until I was hired out to scrape and paint exterior window casings on an old Victorian house that I discovered I had a real issue with aluminum ladders. I could not finish those third story windows while that ladder was fully extended. No, I was too busy hanging on for dear life to free a hand to do the necessary work. Bouncy aluminum ladders and I do not get along.

My fear of ledges and falling can be dated to that job. For our twenty-fifth wedding anniversary my wife and I visited the Grand Canyon. Picture a forty-something fat man crawling on all fours and eventually dropping on down to a belly crawl in order to get close enough to the edge to take a look at the canyon below. If video camera capable phones would have been as ubiquitous then as they are today, I am sure my experience would have gone viral.

As a new father of a darling baby girl, I was very anxious about her well-being. During those first several months I was up multiple times a night every night to check on her. I would silently tiptoe into her room to steal a gaze upon her chubby cheeks, gently touch her little torso to check for breathing, and adjust her blanket for warmth and comfort. It was not until she was old enough to climb out of her crib and into bed with my wife and me that I brought that behavior to an end.

There was a time when I became concerned about my eternal destination and especially a secret rapture of all Christians and children. Did I love God? Was I truly saved? For a couple of years I roamed our house during the night checking on my wife and children to see if they had been raptured and I had been left behind.  I had given my heart to Jesus when I was fourteen, graduated from a Bible college, and served in pastoral ministries, but still I was haunted by the ghosts of doubt. It was not until the truth of I John 4:10, “Herein is love, not that we loved God, but that he loved us . . .” (KJV) soundly penetrated my heart and soul that I was able to put these doubts to rest.

I was reminded very recently during Grandparent’s day at our grandson’s school that I am claustrophobic, too. As several dozen of adults and children squeezed into a space no bigger than a great room for the annual book fair, I realized hastily that there was no room for me. My personal bubble had not only been breached, it had also been burst. Needless to say, I left the room quite abruptly.

But, back to my fear of being hurt. There is a name for that, traumatophobia. It is the fear of war or of getting physically injured. It may be harsh to say, but it made a coward out of me. I walked away, ran, or hid from the possibility of physical confrontation for over forty years. My self-esteem took hit after hit and I questioned if I could fulfill my role as my family’s protector if and when the time came. It was not until I was immersed for a year into a place where physical confrontation was a constant probability that I put that fear behind me. I did not realize that I had conquered it until I put myself at grave risk of bodily injury for a family member. I did not think about it, I just did it, and only awakened to the fact of what I had done after it was all over.

There are no easy or quick cures for fear and anxiety. If anyone tells you they can relieve you of your fears in three easy steps, walk away and write in your journal that you met a charlatan today. Medication can help, but be wary of depending on it or allowing it to mask the heart of your issue. Behavioral therapy involving some kind of desensitization is effective, but prepare for a long journey. Cognitive behavioral therapy also helps. By God’s grace I have overcome some of my fears, yet some persist. Thankfully, it has been rare that my phobias have disturbed my functioning for more than a few hours, days, or months.

By the way, my father caught wind of the neighborhood boy that was making my life unbearable. He threatened to whip me if I ran away again. I was more afraid of my father’s belt than I was of the bully from across the alley so I confronted him. In the end he went home crying. It was the last time I ever willingly had a physical confrontation with another human being.

__________

*Kaplan & Sadock’s Synopsis of Psychiatry, 9th edition p. 591

 

Compassion: A Life Lesson

Compassion can be defined as seeing a person(s) in need and finding a way to help them. It was one of the essential characteristics of Jesus during His ministry on earth and has been a mark of the Christian faith going forward.

Image result for giving meal to homeless man I learned and observed compassion from my family. My great-grandmother had nearly one hundred foster children come through her home. One became mayor of the town some years later. Grandma took in and adopted a boy that was abandoned on her doorstep by his mother. She was also known as the “bread lady.” On Saturdays she purchased all the bread she could squeeze into her car and distributed it among the poor. My mother fostered teenage girls and it was not unusual to come home from school to find a man sitting on our front porch eating a meal my mother had prepared. Dad was known as the “candy man” at the large orphanage at the edge of town where he regularly visited and distributed treats to the waiting hands of children in residence there. My father also hired men who were too proud to ask for a handout, but needed help. He paid them more than the job was worth, thus preserving their dignity and helping them get through a rough patch. My first opportunity to help someone in need without prompting or assistance from an adult was in fifth grade. That year our local school district began the effort to integrate physically challenged, but mentally capable children into a regular classroom. I eagerly volunteered to help one of the guys during recess by pushing him in his wheelchair out on the playground. It was a rewarding experience.

Coming from a family like mine, compassion can become an obligation of tradition to which one might have no personal connection. But, I have discovered there is another teacher of compassion beyond our family of origin – life experience. There are some who may become bitter, cynical, crass, and hardened as a result of the vicissitudes of life, but for many of us it softens our edges and makes us more thoughtful and tolerant of others. Here are three lessons in compassion I have learned along this pilgrim pathway.

  • It is easy to hold dogmatic positions until it happens to you or someone near you.

I believe in absolutes, but my list of always right and always wrong has become much more narrowly defined. You have the luxury of a long list of unbendable rules until life happens. It is quite simple to question the genuine faith of a person who does not attend Sunday school, Sunday night, or mid-week church services until you live in a community where those choices are severely limited or unavailable altogether, not to mention the obstacles of poor physical or mental health, familial obligations, or other hindrances.

A theology of the family can be rigid until you or a loved one goes through a divorce. It is only then that some of the idealism must give way to realism. You still do not deny the way it ought to be, but you find yourself learning to live with the way it is.

While teaching a college level Old Testament course, the subject of capital punishment came up for discussion. One young man was adamant that everyone who murders another person should be put to death. Several times I tried to guide him toward a more nuanced position, but he grew all the more vociferous and dogmatic with each effort. At last I closed the subject. Several hours later he sought me out and profusely apologized for his words. I thanked him and expressed appreciation for his demonstration of sorrow. Did my argument persuade him to make such a sudden change? No. It was being made aware of my experience that caused a rethinking of his position. You see, at that time I had a close relative awaiting trial for murder.

  • It is easy to judge others until you become the one being judged.

“Alcoholics and addicts are that way because they choose to be that way.”     “Why don’t homeless people get a job?” Or, “Why don’t poor people just get a better job?”      Here’s a classic, “Mental illness is all in your head.”

How quickly we judge what we do not understand. I am ashamed to confess that I was critical of twelve-step programs without having read the twelve steps. Only when I started going into jails, hang-outs, under bridges and cliffs, and into the hovels and shelters people called home did I realize what a devastating illness this disease of addiction was. Some had lost everything – property, family, job, freedom – and still could not quit. The physical and mental chains were so interwoven throughout the critical mass of mind and body that to stop instantly meant certain death or such anguished and intolerable mental pain as to drive one mad.

Homelessness and under-employment have a myriad of causes. Five different times in my life I have been homeless for various reasons. After I got out of jail no one would give me a job or a place to live. I called a place in San Antonio that advertised they could get a place to live for anyone with a record. When all was said and done the kind lady told me, “There is nothing I can do with nine misdemeanors.” Is it any wonder that people commit another crime just to get back into prison? They need a place to live. At least they know there they will have three hots and a cot. On the outside there are a thousand obstacles and even more uncertainties.

  • It is easy to have answers for others’ problems until you become the one doing the questioning.

“Why did it have to happen to me?” That question makes a religious leader, physician, or counselor tremble. Many times there are no fixed answers or ready solutions. Sometimes situations do not present themselves as right or wrong, good or bad. Often the choice is between good, better, and best or bad, worse, and intolerable. You learn to trust God, believe in yourself, and allow others to help you make an informed decision with the options before you.

As a seventeen year old college freshman  in Cincinnati, Ohio I saw my first prostitute standing on a street corner. At that time I judged her prospects slim-to-none for finding a paying john because of her large size. Today, I would look at that same woman braving the cold winter with a barely there short skirt and four-inch spiked heels and wonder what drove her to such desperation and compelled her to sell her dignity and risk her safety for a pittance of what she is truly worth. Today, I would listen to her story and try to help her find a way out if given the opportunity. Today, this old fat man would choose compassion learned through the sometimes hard experiences of life.

 

Depression: Reaching for the Dawn

Image result for dawnhdwpro.com

In my last two blogs, Depression: A Way Through, I discussed my journey through deep depression and the beginning steps I took to achieve stability. Here is a recap:

  • Admit that you have a problem.
  • Get on the right medications.
  • Go to professional counseling regularly.
  • Develop a support network.
  • Set achievable goals for yourself.

After you have conquered the above you may be ready to tackle some more steps that will help you reach for the light at the end your prolonged night.

  • Take care of your body

See to your hygiene. Sometimes I went days without showering, shaving, or brushing my teeth. If I had an appointment, I washed my hair at the sink to make it look like I had showered, brushed my teeth, put on clean clothes, and plenty of deodorant and cologne.

Force yourself to take a shower at least every other day and brush your teeth at least once daily. Put on clean clothes, even if it is only fresh pajamas. You will feel so much better and be able to tolerate your body more until the next shower, not to mention the people around you will appreciate it too.

  • Regulate your sleep

Depression may cause you to sleep more or less. I have experienced both in separate episodes.  Sometimes I slept 12, 14, or more hours a day. At other times it was three, four hours at best. Keep yourself on a regular schedule of going to bed and getting up if you can. Avoid the things that may make you sleep less – naps, caffeine, and nicotine. Be aware of the things that cause you to sleep more – alcohol, synthetic and natural opioids, and benzodiazepines. If you suspect you have hypersomnia consult your doctor.

  • Eat healthy and with moderation

Depression can affect your appetite. You may each too much or too little. My family doctor cautioned me about my weight gain. I told her, “Food is the only thing in my life right now that doesn’t talk back.” I gained weight topping out at 280 pounds. During a separate depressive episode I lost 60 pounds (and purposely lost 20 more).

Moderation is the key. Eat your vegetables, fruits, and whole grains. Get protein, but limit the fat. Keep hydrated. Cut back on caffeine, sugar, processed food, junk food, and fast food. I have tried eating organic and natural with fish and fowl, but I have not found a diet specifically for depression. There are some mood positive foods, but stay away from the gimmicks and supplements that profess to “cure” you. There are no food or supplement cures.

  • Let in the light

Open up the curtains. Sit on the porch or in the yard. Turn on the lights. Some studies have indicated that a black light while you sleep may help.

  • Exercise

Studies show that exercise can enhance your mood and help you sleep. I do not like to exercise; I do not see the point of walking without a destination, but I do stay active. Washing down walls, painting, mowing the yard and trimming the bushes, doing laundry, cleaning house, washing windows both inside and out, washing the outside of the house, washing the car, light remodeling, and building things have all kept me moving. With my experience aside, regular exercise will enhance your mood.

  • Recognize your triggers

Stress is my greatest issue. It is impossible to eliminate all stress, but it can be managed. Name your stressors: work, relationship(s), bills, loss, change, etc. Make a plan to address each one until it becomes manageable. You may have to reduce your hours at work or transfer to a less stressful position, even if it means a cut in pay. You may need marital or family counseling to work through relational issues. End or moderate toxic relationships. Address co-dependency. Learn some relaxation techniques. You get the picture. Do not tackle the whole, it will be overwhelming, take small bites. Practice the serenity prayer, “God, grant me the serenity to accept the things I cannot change, Courage to change the things I can, And wisdom to know the difference.” (Reinhold Niebuhr)

Perfectionism is another of my triggers. I hold myself to an impossible standard for my work, actions, and thoughts. It takes me a long time to complete a project because I want it perfect. When it is done all I can see are the flaws and I am embarrassed to show it to anyone else. One pastor told me I was a “frustrated perfectionist.” There were many things I would not try because I could see no way to make them perfect. My wife and counselor both tell me I am very hard on myself. At this writing I am struggling with forgiving those who have hurt me in my past. I expect myself to have no bitterness, rancor, or grudge. Instead I want peace and to only recall the good times. Is it too high of a standard? I do not know, but that is my expectation of myself.

Unresolved issues from your past or present contribute to depression. Physical, sexual, mental, or emotional abuse holds you down. Violence in any form, dysfunctional family life, and traumatic experiences (especially those where you thought you might die) impede healing. Work with a therapist to face, overcome, or cope with these issues.

  • Give back

I find that helping someone else is one of the most therapeutic things I can do for myself. The 12th step of Alcoholic Anonymous is, “Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.” Telling your story and how you have learned to overcome or cope with your depression may be of great benefit to someone else. “Carrying the message,” that depression does not have to trap you or define you, to others edifies them and encourages you.

Educate yourself about your depression.  Learning more will make you an informed consumer about yourself and your treatment.

Replace negative thoughts of hopelessness and worthlessness with their positive opposites. (This takes time and almost always requires therapy.)

Do not make any “big” decisions. For those you cannot avoid, get help from your support network to guide you in taking the right step.

Give yourself time to feel better, especially if you have severe depression. Improvement is gradual, not immediate. There will be setbacks, but do not let the dark days stop you from reaching for the dawn. You can do it, God being your helper.

Depression: A Way Through, Part II

According to a 12 month study published by the Substance Abuse and Mental Health Services Administration (SAMHSA), over eight percent of the female population and nearly five percent of the male population of the United States had a depressive episode in 2014. Among that population over 65% were diagnosed as severe. Depression is the fifth leading cause of disability in the U.S.A.

It has been a year and nine months since my last severe depressive episode. This is my longest stretch of relative stability since becoming clinically depressed in 1999. Although I am no expert I would like to share with you some of the things that have helped me along my journey.

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In part one of my last blog I addressed the following issues:

  • Admit that you have a problem.
  • Get on the right medications.
  • Go to professional counseling regularly.

This week I conclude with two more steps for finding your way through depression.

  • Develop a support network.

Start with your family and friends – the positive, compassionate, understanding, and helpful ones. The ones you can trust to listen to your pain without offering a lot of advice, just a healthy dose of caring and listening. You do not need a toxic person in your support network and that may disqualify some of your family and friends.

Include your psychiatrist, counselor, and depression group(s). I have my counselor’s personal cell phone number and that brings great comfort to know I can turn to her when I am feeling particularly low or in crisis. Some of the members of the groups I attend have also exchanged contact information.

Reach out to your pastor(s), priest(s), or other faith based leaders. Invite them to become a part of your support network. Attend a small Bible class or spiritual growth group where you feel comfortable enough to share your story and know you will be loved. Join a depression group online or on Facebook that is condemnation free. Celebrate Recovery has a mental health component in some areas.

A support system will help you to get out and connect with people rather than isolating for lengthy periods of time. It helps you to be more open instead of mysterious and secretive. You will find understanding without disapproval. And, you will get helpful hints from people who are living with depression.

  • Set achievable goals for yourself.

In much of the literature I have read, it encourages the person with depression to stay active. Continue your regular activities, try new activities, go to a movie or out to dinner, get out to a museum or library, attend a ballgame or take up a hobby; the literature says. This may be good advice for those with mild or moderate depression, but it just piles on the guilt for those of us who have severe depression. Yes, there will be a time for all that as you move toward your goals, but not right now. Some days it took all the energy I had just to get out of the bed in order to go to the bathroom.

After getting out of the hospital in May of 2014, I started attending a men’s depression group. Every week we were to fill out an accountability sheet which included our goals for the next week. I wrote down the same three goals for at least four months – get up by 7:00 AM, journal, and walk every day. I did not attain a single goal in those four months. Making my doctor’s, counseling, and group appointments was all I could do. Looking back, that was quite an accomplishment.

By September I quit trying to achieve those three goals and decided that getting out of bed at a reasonable hour (before noon) was where I would start. Having accomplished that, I started setting time goals. I started with 9:00 AM and slowly decreased the time by 15 minute increments. It took me past December to get down to 7:00 AM.

On my way to achieving my first goal, I decided to add journaling. It took me two months before I went to the dollar store and purchased a journal. By then I was ready to write – two or three times a week at first, then daily. Both are still daily habits.

Setting high, unrealistic goals for yourself only bring on more condemnation and feelings of failure. Trying to rush to achieve each goal causes frustration and a sense of being overwhelmed. You do not need more of those thoughts; God only knows how many you already have. Ask a friend or family member to prompt you toward your goals. It sure helped me to have an older brother swing open the bedroom door and say, “It’s time to get up.” I always did.

Fighting severe depression is a journey of inches. Courage, faith, and determination, although these may be in very short supply, are needed to move forward. Chuck Swindoll titled one of his books, Three Steps Forward and Two Steps Back, and that is often the way you will advance, but advancing you are. Be patient. Do not expect too much of yourself. Give yourself time.

 Depression is not who you are, it is an illness you have. You are not a “failure.” You do not have a “character flaw.” You have not “sinned.” (Yes, these things may contribute to depression.) You have a mood disorder, perhaps known or unknown in origin, but in almost all cases improvable.

Seeing my way through depression is an ongoing endeavor. It may be for you, too. I offer this prayer for those of us who are walking this path.

O Holy Father of great compassion and mercy as shown through Your Son, Jesus, who healed the anguished mental illness and insanity of the men living among the tombs, be gracious to we who fight this beast called depression that threatens to devour us. Our LORD and our God, strengthen us in our work to cope with this illness. Turn our sadness into joy, emptiness into fulfillment, fatigue into energy, worthlessness into value, guilt and condemnation into acceptance, fear into courage, and helplessness into hope. Drive away the thoughts of death and suicide and cause us to embrace life.     Walk this trail with us in a way that glorifies Your name. In the strong name of Jesus our Savior, who is worthy of all our praise and thanksgiving, we pray. Amen.

Depression: A Way Through, Part I

According to a 12 month study published by the Substance Abuse and Mental Health Services Administration (SAMHSA), over eight percent of the female population and nearly five percent of the male population of the United States had a depressive episode in 2014. Among that population over 65% were diagnosed as severe. Depression is the fifth leading cause of disability in the U.S.A.

It has been a year and nine months since my last severe depressive episode. This is my longest stretch of relative stability since becoming clinically depressed in 1999. Although I am no expert I would like to share with you some of the things that have helped me along my journey.

Admit that you have a problem.

Studies indicate that the number of major depressive episodes a person has is a predictor of future episodes. There is a 50-60% chance that a person with one major episode will have another. That number increases to 70% for those who have had two episodes. And for those who have had three or more episodes there is a 90% chance that they will have another.

After 14 years, four major depressive episodes, and four hospitalizations, I was still mostly in denial that I had a long-term illness. When I was well enough to get going again I always returned to the same old lifestyle and pressures that contributed to my depression. Nothing changed. By just sheer will and determination I thought I could handle it. Counseling was sporadic and I used a family doctor instead of a psychiatrist for medication adjustments and refills. It was not until I faced the reality of my illness that I began to take steps toward stability.

The events leading up to my last hospitalization scared me enough to face facts. Suicidal ideations came on so strong that they nearly overwhelmed me. Broken, powerless, with no internal resources left, I stumbled into an emergency room and admitted I had a need I could not handle anymore. You may think this sounds like the first step of Alcoholics Anonymous (AA) (We admitted we were powerless over alcohol – that our lives had become unmanageable.) and you would be correct. Perhaps the first step toward wellness of any mental illness, disease, or addiction is coming face to face with the wall that alone is unclimbable.

Get on the right medications.

See a psychiatrist. Family doctors are notorious for under-medicating their mentally ill patients. Also, your family doctor, however great s/he may be, does not have the expertise nor does s/he keep up with the medications available with the same intensity or proficiency that a psychiatrist does. Find one that you can trust and with whom you can have a rapport. If you are like me and have to see the psychiatrist that is available at your local mental health agency, do not be a sheep. Take charge of your care and do not settle for what s/he is giving you until the medication(s) you are taking works for you.

During my effort to find the right medication I have taken Zoloft, Paxil, Effexor, Prestiq, Wellbutrin, Trazadone, Lithium, Abilify, and Brintellix; and a multitude of dosage changes. It was not until the fall of 2014, 15 years past my initial major depressive episode, that I found a cocktail of medications that worked. Persistence and a psychiatrist that was willing to work with me paid its dividends.

Do not expect medication alone to have you clicking your heels and living a happy life. Depression is a journey hundreds of miles in length. The best medication can do for you is get you out of bed and perhaps into the car. The rest of the trip depends on you.

Go to professional counseling regularly.

Attending regular one-on-one counseling sessions and professionally led support groups is essential to stabilizing and living with your depression. Find a counselor who is knowledgeable about mood disorders and stays current with his/her field. Choose one who is compassionate and understanding, but is not afraid to confront you with your “stinkin’ thinkin’,” to borrow a phrase that Zig Ziglar made famous. And, believe me; we that have a major depressive disorder can have any number of false beliefs. As with a psychiatrist, do not settle for the first counselor you meet until you know for sure that that person is helping you wade through your morass.

I paid the price for not going to counseling on a regular basis. My work suffered, my marriage fell apart, my family was uncertain, and more. Often I would see a counselor once or twice and quit. “It’s too far to travel,” “I do not have the time,” or “I can do this on my own;” were some of the excuses I used. For nearly 15 years I started and quit, started and quit, started and quit. In May of 2014, after admitting I had a lifetime problem, I started with a counselor and have not quit. Ask for weekly sessions at first, twice monthly sessions if that is what you can get, or a minimum of once a month. You do not have to settle for less.

Find a gender specific, professionally led depression group. Gender specific, because it is easier for men and women to discuss their issues and feel understood and accepted when in a single sex group. Professionally led, in order that s/he will help the group stay on task, guide the discussion, and recognize when one particular member needs the support of all.  Peer led groups are good and worthwhile, but I have found that a professionally led group is far more focused. Personally, I attend a men’s group twice a week. Contact your local mental health agency or your local NAMI chapter for information on groups in your area.

The Costs and Blessings of Depression: Freedom Part IV

People diagnosed with depression are roughly three times more likely than the general population to commit violent crimes such as robbery, sexual offenses and assault.

The story continues of one such man who went to jail for committing crimes while seriously depressed and paranoid. His marriage of 33 years was essentially over. His wife announced she was going to leave him after seven months of an attempted reconciliation. He completes his story in his own words.

My paranoia took control at this moment. I overwhelmingly felt the urge to get them out of the house. It was either they leave or I would die. My walking stick was close and I opened the bedroom door with it in my hand. “O, look, he has a stick in his hand,” I heard one of them say jeeringly. Then they started taunting me and laughing at me again. I retreated to the bedroom, but with irresistible force, the paranoia pushed me to make them vacate the premises. If they did not respect me, I thought, nor my walking stick, maybe they would respect my shotgun.

It was totally and completely wrong, but I was driven to make them leave. My life was in danger, or so I thought. When I came out of the bedroom with the shotgun in hand they retreated, but not without taunting me more. Like a desperate man I followed them out the door (a felony) to make sure they left. All the way to the SUV they taunted me and laughed at me. As they drove away, or so I am told, I pointed my shotgun at them (another felony). I have no recollection of pointing the gun at them directly at any time, but there is a video that shows that I did.

I was too weak, too emotionally drained, too mentally spent, too sick to walk away. I broke one of my fundamental principles – do not fight over material things. Too tightly did I hang on to the loaves and fishes and missed the Christ passing by. It begs the question, did I own my possessions or did my possessions own me?

After they left I put away the shotgun and sat down on the front porch until the police arrived. Three police cars drove into the driveway and my estranged wife and our daughter were right behind them. I jumped off the porch, pointed my finger at the two of them, and shouted, “Get them off my property.” An officer grabbed my arm and twisting it shoved me back onto the porch. I told him he had no cause to manhandle me in that manner. Another officer joined him and asked me to sit down, which I did. I started telling him that they were violating the “status quo” order. He aggressively replied that he had been on the force for 14 years and had never heard of a “status quo” order. I said that he had better go down to the courthouse and educate himself. With a glaring eye and a stern voice he barked that if my estranged wife and daughter want to go in the house and take everything out he would make me stand aside and watch them. It seemed many of my fears were becoming reality with the blessing of the police.

I have only flashes of memory for the remainder of the incident. The police report says that I stood up from my chair and hit one of the officers in the face with my fist. It continues that during their attempt to take me down I had put both officers in headlocks, one under each arm. (Two more felonies.) An officer escaped my grip and tased me. It had the effect of having an ECT (electroconvulsive therapy) treatment. I regained consciousness.

After spending the night in jail I checked myself into the hospital. Besides the severe depression, I was diagnosed with an episode of dissociative amnesia, defined as “a precipitation emotional trauma charged with painful emotions and psychological conflict” (Synopsis of Psychiatry, pp. 676-678). “Depression and anxiety are common predisposing factors.” Localized amnesia is the most common type and lasts for a short time. In laymen’s terms, I had a blackout.

According to the National Alliance on Mental Illness (NAMI) some “people may lose control of their emotions or actions during a dissociative event and can do things that are otherwise quite uncharacteristic.” “Almost half of adults in the United States experience at least one depersonalization/derealization episode in their lives, with only two percent meeting the full criteria for chronic episodes.” (NAMI.org) “Disassociation arises as a self-defense against trauma.” “The symptoms of dissociative amnesia usually terminate abruptly, and recovery is generally complete, with few recurrences.”

My episode lasted only a few moments during which time I did a very terrible thing by which I am horrified and have profound regrets. Without the disassociation, the assault would never have happened. The last time I had lifted my fist to hit someone, I was 10 years old. Without the paranoia, my shotgun would have never left the closet. Never had I pulled a gun on another human being. My last visit to see my psychiatrist was just a few days before the above incident. I walked into the office in a severely depressed state. The receptionist looked me in the eye and asked, “Do you need to go to the hospital?” I told her I would be all right. The psychiatric nurse practitioner asked the same question. I gave the same reply. On my way out the appointment secretary called me by name and said, “Are you sure you don’t need to go to the hospital?” You would think a long time professional clinical counselor would get the hint, but I foolishly repeated my previous statements. I missed the warning and paid the price. I was charged with seven felonies and two misdemeanors.

About four days after being released from the hospital I went back to court. I asked my lawyer to plead me not guilty by reason of mental disease or defect. He said that it was nearly impossible to prove in the state where I resided even if I was howling at the moon. The prosecution offered a plea deal that involved dropping all charges to misdemeanors and 360 days in county jail. Upon the advice of my lawyer I accepted the deal and started serving my time the same day. It was my first arrest and the first time to go to jail other than for a visit or to minister and/or teach.

Jail became my salvation. I used the time to be spiritually restored and grow in grace, and put behind me the demons of my past. For the first three weeks in jail I spent nearly every waking hour reading my Bible and repenting. I confessed materialism, sins of the flesh, pride, inconsistencies, wastefulness, anger, being a poor husband, being a poor father at times, tendencies to nurse my own views, resisting the good efforts of others, discourteousness, expecting too much of others, and a less than healthy relationship with God as my Creator, Savior, and Guide. At the end of those three weeks I sensed the forgiveness of God and a restoration to fellowship with Him.

Restitution was next. I wrote to the prosecutor, police officers associated with my case, and my boss asking forgiveness for my behavior and bringing a reproach on the Name of our Savior Jesus Christ. People from my church congregation came to see me; I wept and confessed my sorrow for tarnishing the name of their church. To family, friends, and whoever would listen I attempted to make things right. My oldest son came and I wept the longest and confessed the most with him. He was gentle and expressed concern for me, especially my spiritual condition.

Several days were spent forgiving people who I perceived had wronged me. In one particular writing I recorded 38 wrongs and wrote “forgiven” by each one. I was determined not to let any root of bitterness spring up in my heart. When wrongs came to mind I dismissed them with, “I forgive.” (This is a practice I continue to this day.) Someone gave an insight regarding Jesus charging Peter to forgive 70 times seven. He said it was not simply for the person who sought forgiveness, but also for the thoughts that try to take residence in our consciousness. As often as they come for forgiveness, as often as the wrong comes to mind, forgive! Lewis B. Smedes says it well, “To forgive is to set a prisoner free and discover that the prisoner was you.”

I began a devotional routine that included reading from the New Testament, the Psalms, and Proverbs daily. Devotional readings included, “Our Daily Bread,” hymns from a Presbyterian hymnal, and whatever Christian book I could find in the jail library. Quiet time was hard to come by so I began staying up after morning meds at 4:30am until breakfast at 7:00. Before I read I prayed that I may hear, understand, remember, and practice the Word of God.

After reading one particular book I began to pray in a systematic way. My prayer list included confession of my dependence upon God; submitting to the Lordship of Jesus Christ; that I may love God with heart, soul, mind, and strength; a longing to know God as much as I was capable and in the manner He has revealed Himself in the Word. I prayed for wisdom, for strength in trials and temptations, to grow in grace, for holiness, righteousness and purity, for humility, for my anger to be controlled, and for my depression to be stabilized.

Confession of sins, faults, and shortcomings was included. I prayed for reconciliation with my daughter and youngest son. (That prayer continues.) Prayer was made for others and thanksgiving to God was given. Time was spent praising God for His character and attributes, and His works of creation and redemption through Christ Jesus.

Chapel was available every Sunday and there was a Wednesday Bible study. Rarely did I miss. The “Walk to Emmaus” organization lead us on a four day spiritual journey.

In jail I found peace with God and myself. When I emerged from jail I was healthier spiritually than I had ever been. I continue to cultivate the spiritual practices I learned in jail. To God be the glory! His grace is amazing.