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.

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.

 

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

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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.

Image result for a trail in the nightmalcommacgregorphotography.com

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.