Tag Archives: Depression

December 20, 2012 · 10:42 am

When all you see is brokenness…what then? A thought from Jeremiah 29


As a counselor and a Christian it is easy to see that the world is breaking. Suicides. Shootings. Affairs. Cancer. Addiction. Corporate Greed. Abuse. In addition, we hear about

  • Christian leaders who either perpetrate abuse or fail to protect when they hear of it
  • rampant immorality
  • political corruption

When we face these kinds of things, it is easy to fall into one of two unhelpful patterns. For some of us, we fight. We try harder. We attack others with sarcasm. We lay blame at the feet of others. While fighting harder to correct injustice is a good thing; while pointing out blame where it should lie is not a bad thing, the pattern of fighting may reveal a dangerous value system: if I can control my little corner of the world, things will get better. Sometimes this is true but most of the time, the “getting better” motif is an illusion. The wrong kind of fighting usually leads to embitterment.

Others of us choose a pattern of giving up.We stop trying to make a difference because it won’t. We turn down the volume on suffering. We avoid others who are obviously suffering. We move towards embittered discontentment. Now, it is not wrong to turn off the 24/7 “news” and to not read up on every tragedy. It is good not to fill our brains only with brokenness. But, giving up can sometimes lead to lamenting that the “good ole days” were better.

Enter the Prophet Jeremiah

In chapter 29, he writes to those who are experiencing brokenness. Israel is no more. A mass of Jews have been carried off into captivity. They live in a land that is not theirs as foreigners and likely without rights, privilege or land. They have lost connection with the promised land, with family, with language, with custom. Around them would be idol worshippers and a society not built on the Torah. There are some individuals who have been prophesying that in 3 years they will return home to Israel in triumph.

Jeremiah says, “Not so fast. No, you guys will die in captivity.” Well, no, he doesn’t exactly say that. He says it will be 70 years and then you (meaning your children and/or grandchildren) will get to return to the Land.

Nice. Jeremiah responds to their suffering and says, “Yup, it’s bad. And it is going to stay that way.”

But read on because he tells them God has a message for them to hear: (in Phil’s loose translation)

Obey me [the Lord, not Jeremiah]. Because I love you dearly, I will protect your soul. I will be blessing you even though there are dire consequences happening to you. Here’s what I want you to do:

  1. Look for the blessings I am sending you NOW. Don’t overlook them. They are really there for you to find.
  2. Live holy lives, not out of fear, but in confidence that I am keeping my promises to raise of a kingdom for my people.
  3. Live. Don’t put your life on hold. Build houses. Plant gardens. Harvest. Marry. Have kids. Help your kids get married. Enjoy your grandchildren. Be present and rooted where you are at. Live. Enjoy it.

Notice that to live, you have to move, act, have impact, even as you are accepting that you cannot avoid the consequences of living in a fallen world. I think this can be helpful for us in a season of much brokenness. Without denying the suffering that is everywhere, we can also choose to notice the little and the big blessings. We can simplify our lives to, “What do you want me to do today?” We can be mindful of the small activities of life. The grocery store is drudgery. Laundry is never-ending. And yet, we have the opportunity to act in our world and to pray for the peace of the city (as Jeremiah gives encouragement to do).

Maybe your joy is pretty tiny these days. That is okay. Just find it and savor it as a gift from God for the few minutes you have. Not all is broken. In a few days, hours, years, God will indeed put all to rights. Every heartache will become untrue. Still, even now, hang on to the signs of life and growth.

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Filed under Biblical Reflection, Christianity, Depression, Despair, Meditations, suffering

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June 20, 2012 · 1:27 pm

Depression and your internet usage?


Have you seen news articles suggesting that one might be able to predict depression on the basis of how you use the Internet? If not, read about it here in a very brief essay. Bottom line, the study may find that depressed college students use more P2P (peer-to-peer) file sharing than their non-depressed counterparts. The depressed group may also do far more application switching (e.g., check email, look up sports scores, open other apps, etc.) suggesting an appearance of bored surfing for something to stimulate them out of their negative mood.

On the one hand, these possible results make some sense. Depressed people may be looking for stimulus and social connection to raise their mood. They may have less focus on more mindless activity on the net. However, as this essay reminds us, there are a number of problems with the research that show up in many of the “newsy” items that show up on the Internet or on television news.

Despite the caveats we must place on such “news”, it does provide a great opportunity for each of us to evaluate our Internet habits.

What are we doing on-line…really?
What do our habits say about what we are looking for, desiring, etc.?
What are we avoiding while we are on-line?  What are we trying to fill?

I can tell you that my usage, at times, tells me I am not wanting to engage some bit of work that I have on my plate. Far better to check email than to write a difficult section of an upcoming lecture. Far better to read an important blog than to go talk to my kids about something that I’ve been avoiding. Or…so it seems at the moment.

What does your Internet usage tell you about you?

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Filed under counseling, counseling science, Depression, Psychology

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February 8, 2011 · 11:26 am

Godly depression?


Last night my psychopathology class focused on the topic of depression. We covered the usual stuff: various experiences and features of depression and bi-polar disorder, potential medical causes, common medical and psychological treatments, etc.

Depression, as you most likely know, comes in all sizes and shapes and is multifactorial in etiology. Depression involves the body, the mind and spirit, and the environment. Thus, treatments should also cover the gamut, focusing on thoughts, faith, body, and environment. I ended the class pointing briefly to the fact that the English Puritan treatment of depression covered pretty much the same. They encouraged their parishioners to treat their despair and melancholy with these ideas,

  1. Seek the benefit of “Physick” or medical interventions
  2. Accept the comfort of Scriptures and in community with friends (and they also counseled others to avoid over-use of exhortation)
  3. Be mindful of God’s present and past mercies
  4. Utilize the sacraments and other spiritual disciplines
  5. Avoid too much time in introspection, but
  6. Examine oneself to see if there are also hidden issues to be dealt with

Notice the “heart surgery,” as one of my students put it in her paper, doesn’t happen til much work has been done to stabilize and comfort the despairing individual.

KEY QUESTION: Is there such thing as Godly depression?

If so, what would it look like? This question comes out of the view that depression and accompanying hopelessness reveals, to some degree, that a person is failing to trust the Lord.

Or does it? Is it possible to be depressed and spiritually mature? I believe so. So, what signs might you look for to determine that the person in front of you was experiencing a Godly depression? Was St. Paul despairing to the point of death but wholly trusting the Lord at the same time? (2 Cor 1:8f)

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Filed under christian counseling, christian psychology, Christianity, counseling, counseling science, Depression, Doctrine/Theology

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October 18, 2010 · 11:11 am

Practicing new ways of feeling?


As you fall asleep, do you have a common thought or feeling pattern? As you wake up? In the shower? We are creatures of habit in this regard–we maintain our perceptions (of self, of the world) even in the light of contradictory information or experiences. This is why a pessimist always expects the worst and a narcissist always expects to be right. If you could categorize all your thoughts and feelings, what would your perception pattern look like? Hypervigilant? Discouraged? Embittered? Hopeful?

Now, can you change this pattern? For example, if you are not inclined to be hopeful, can you practice hopeful responses–even when things really do go south? And if you can change the pattern, what does that change look like?

Here are some of my thoughts…I would love to hear from you about what you do to practice something other than your usual way of looking at the world.

1. It is possible to re-write our narratives. How we talk to ourselves about an event either will solidify a feeling or begin to change it. For example, my wife recently had a sleepless night. She was able to use that time to talk to the Lord even while she was feeling out of sorts. In the morning, she had a positive, if also tired, way of feeling about the night.

2. Change does not look like zero experiences of an old narrative running through our head. Change looks like being able to recognize the old but also a new pattern as well. This change is not merely talking yourself out of one schema and into another. Rather, mindful awareness of threads of your experience that have been there all along get more play and so therefore become more salient over time.

3. Change isn’t permanent. Just as a professional athlete cannot go without practice, we cannot expect effortless maintenance of a new way of feeling.

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Filed under counseling, Mindfulness, Psychology, Uncategorized

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May 28, 2010 · 8:38 am

insomnia and suicidality


Counselors need to keep regular watch over the insomnia of their clients. Untreated or unresolved insomnia predicts poor recovery and lesser benefit from therapy. It ought not be treated as a secondary problem. But a recent abstract sent to me via email suggests that insomnia may also be a significant factor in suicidal ideation and action. Some researchers at Wake Forest followed 60 adults with both insomnia and major depression for 9 weeks. All received antidepressants but some received a sleep aid as well. Both were assessed by using the Hamilton Depression Scale and an insomnia severity scale.

Their findings suggest that insomnia is a factor in suicidal ideation independent of depression or lack of pleasure. Insomnia leads to more intense suicidal thoughts. Thus, counselors ought to redouble their efforts to ask about insomnia, to track it and to especially follow-up with questions about suicidal ideation or plans when complaints of insomnia increase.

Interested readers may find the abstract of the research here.

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Filed under christian counseling, counseling, counseling science, counseling skills, Depression, Uncategorized

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February 26, 2010 · 5:43 am

Belief in a loving God and Depression?


Thanks to a friend’s sharp eyes, I learned of this news release from Rush University Medical Center:

Research suggests that religious belief can help protect against symptoms of depression, but a study at Rush University Medical Center goes one step further.

In patients diagnosed with clinical depression, belief in a concerned God can improve response to medical treatment, according to a paper in the Journal of Clinical Psychology.

The release goes on to say that the positive benefit did not stem from hope but in belief in a caring God. What it doesn’t say is whether or not those NOT taking medications get positive benefit from a belief in a caring God.

What do you make of this? Should we get excited when research confirms our established beliefs? Should we look for alternative explanations? I would be curious how they separated hope and belief. Hope and belief that God is active and looking out for you probably encourages you to look for and remember evidence! The more you look for the evidence the more you practice being mindful of something bigger than your despair.

What is your reaction?

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Filed under Depression, Despair, Psychiatric Medications

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May 1, 2009 · 5:42 am

Physiology Phriday: Dieting starves your brain?


I heard a psychiatrist recently tell her depressed client that she should not go on a diet to lose weight. The client was confused. She thought that losing weight would help her with her self-esteem. She had not been exercising and had put on 15 pounds over the past 3 years. So, she asked her doctor why not. This was the explanation (paraphrased):

Exercise does provide a natural antidepressant and so I heartily encourage you to start an exercise program. However, many diets consist of decreasing foods rich in carbohydrates. Getting more protein is good but your brain needs glucose to produce neurotransmitters (e.g., serotonin) and foods rich in carbs are more easily turned into glucose. When you starve your body of glucose, your brain is the first place that starves.

Maybe this explains a bit of yo-yo dieting. The person is feeling poorly about weight, reduces foods that provide simple sugars in order to lose weight, starves their brain of serotonin (thereby creating a greater feeling of depression), and then caves to a binge in order to feel better. 

Don’t know if this supposition is true, but it might be important for those on antidepressants to make sure that they are keeping a balanced diet and exercising frequently.

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Filed under counseling, counseling science, Psychiatric Medications

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April 24, 2009 · 2:16 pm

Physiology Phriday: Depressed? Check your thyroid


One of the most common mistakes made by counselors is to forget to encourage their clients to get specific medical work-ups. There are three key reasons for this problem.

1. Most clients describe their struggles with causes already in place. “I’m depressed because I have a bad marriage, because life isn’t going the way I had hoped.” We counselors accept their initial diagnosis and fail to dig further.

2. We know that counseling works. And so we help them work on their thinking, feeling, and behaviors. We do what we do best

3. When we do send someone to the doctor, we rarely get a clear answer.

Nonetheless, it is essential that your clients have had recent blood work. Case in point. Low thyroid levels often leads to experiences of confusion, mental dullness, and depression. (FYI, overactive thyroid may lead to irritability and anxiety). While there may be real counseling work to be done (everybody needs some help), it would be a tragedy to miss real mercy care (i.e., a better functioning thyroid).  

Check here for some info on hypothyroidism: http://www.endocrineweb.com/hypo1.html

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Filed under christian counseling, christian psychology, counseling skills, Depression

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April 17, 2009 · 5:28 am

Physiology Phriday: Will I be on meds for the rest of my life?


During the course of discussing a person’s anxiety or depression, the conversation turns to the possibility of using antidepressants. Inevitably, I am asked, will I have to take them forever? Clearly, the questioner does not want to and sees the possibility of taking medication for the rest of their life to be unacceptable. So much so that many resist starting or even going to see a psychiatrist in order to consider whether they might take a medication. Rarely do they ever ask if the medications will help.

Consider for a minute why a person might ask this question. Here’s some of the reasons I think I’m asked this question:

1. Everybody is on them and they never get off (from the viewpoint that too many people take them for every little hangnail and then allow themselves to stay on the crutch forever, never solving their problem)

2. Medicines are for weak people, I’m not weak. (Not sure if the person would have the same response if their medical doctor said their thyroid wasn’t working and so they would need synthroid for the rest of their life)

3. It is only a spiritual problem. Taking the medication will solve the problem but not the spiritual problem. I’ll be avoiding the real issues.

4. I hate medicines of all kind. I hate remembering to take them and I hate their side effects.

5. I don’t think they will really work.

Can you think of other reasons? Now, antidepressants do work from a research vantage point. They are not the silver bullet. They will not make a bitter, angry, depressed person, less bitter. They may help them sleep better, improve their mood, and thus more clearly come to terms with their bitterness. Medications never block the heart from spiritual matters. Only the person who does not want to deal with spiritual matters will use them to avoid looking more deeply inside. God can be found in both suffering and comfort. Whether we will look for him is a bigger question.

So, what if you need them for the rest of your life? What if they really do make it possible to function well? Is our distaste for medicines due to their side effects or due to the fact that we have to accept that we are weak and broken people?

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Filed under Anxiety, biblical counseling, christian counseling, christian psychology, Depression, Psychiatric Medications

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March 20, 2009 · 5:43 am

Physiology Phriday: Repetitive thoughts?


Have you ever been tortured by a repetitive word, sound, phrase, song, or the like run through your head? Does it happen only during the day? At night when you wake up?

In psychological studies, there are a number of ways people talk about these experiences. Sometimes folks talk about intrusive thoughts/imagery, but this is usually in the context of PTSD or OCD studies. Others talk about rumination or repetitive thoughts, usually in the context of worry, depression, or anger. Finally, another batch talk about hallucinations in regards to psychotic disorders.

But what is going on in the more mundane repetitive thoughts? Diagnostically, they probably fit a bit more in the OCD genre than anything else (like counting, ordering, etc.).

1. Stress is usually a factor. They happen more frequently the more distressed a person is. It means the person is on higher alert than normal. The repetitions may be directly related to the stressor or may not. What is not know is whether the repetitions are a consequence of stress or a mediator of stress. What is known is that when a person, under stress, experiences repetitive thoughts salient to the stress, feels responsible to fix the problem, and attempts to suppress repetitive thoughts, their ruminations are MORE likely to increase.

2. Neuroticism is probably a factor as well. Sorry folks: those with anxious and depressive tendencies have more repetitive thoughts than others.

3. Emotional intensity as a native trait of the person may also be a factor. There is some evidence that individuals with strong emotions have a greater predisposition to PTSD (and therefore intrusive thoughts) if exposed to traumatic events.

But what to do about repetitive thoughts? Have you found anything helpful? There are certain things that are NOT helpful

1. Ruminating over the thoughts (Ugh, I can’t believe I’m still having that thought)

2. Trying to solve the problem they may be attached to

3. Trying not to think about pink elephants

Okay, so maybe those things don’t work. What does? Sad answer? We don’t know. Distractions do for a short time. Some actually give in to them and repeat them outloud to try to quell them. The more it is possible to pay them little notice, the easier it is to let them slide on out of the mind.

Maybe try to consider them an interesting mental quirk–like the lovable Monk (TV detective) 🙂

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Filed under Anxiety, counseling science, Depression, personality, Post-Traumatic Stress Disorder, Psychology

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