Beyond the Blues

What’s wrong with me? thought Stacey. I feel so sad and I can’t seem to concentrate. Could I be depressed?

Sound familiar? If so, you’re not alone. An estimated one-fourth of all women have a major bout with depression at some point in their lives, according to The Healthy Life, Women’s Self-Care Guide. More women suffer from depression than men, but it strikes all racial and ethnic groups and all ages. No one, not even a Christian, is immune.

Sadly, when Christians are depressed they often blame themselves. “The thing that has surprised me the most is not that so many Christians are depressed, but that so many keep this fact to themselves, as if they’ve committed some unpardonable sin, ” writes Herbert Wagemaker, M.D., in his book The Surprising Truth About Depression.

Christians who are depressed often think they should be able to “fix it” themselves. A close friend who was depressed once confided, “God seems far away and my life is meaningless and flat. But I know if I would just spend more time reading the Bible and praying this emptiness would go away.””

Why do we blame ourselves rather than get help? Many Christians believe that “real” Christians don’t get depressed. Dr. Wagemaker says, “Many of my depressed patients see themselves as sinful, estranged from God.” We are sinful, but we are also precious to God. Tragically, many depressed people “do not see themselves in the light of God’s love.”

Are you, or is someone you love, suffering in silence?

How do you know if you’re depressed? And what is depression? How can we fight depression when it strikes a friend, a loved one, or even us?

Depression is a condition marked by sadness and hopelessness. Your entire body slows down, pulling you back from life.

Depression can have many triggers–both internal and external. Internal triggers include brain chemical abnormalities, hormonal changes, major nutrient deficiencies, or illnesses such as flu or cancer. Some people react to certain high blood pressure medicines or birth control pills by becoming depressed. Some people become depressed from lack of exposure to natural sunlight. Women are vulnerable to depression that is triggered by the hormonal changes associated with menstruation, menopause, childbirth, or the cessation of breast feeding.

Over a cup of tea, my friend Stacey told me about her post-partum depression. “I just loved being pregnant,” she said, “but the baby came early. When I came home from the hospital the house was a mess and I was worn out and unprepared. I felt so out of control, so hopeless. I cried every day for six months before I finally got help.”

Any loss or grief can be an external trigger that leads to depression. The death or loss of a loved one, financial problems, or life changes such as a divorce, job loss, or moving to another location can result in depression.

Even healthy grieving over these losses produces a depressed mood. According to Walter Byrd, M.D. of the Providence Clinic an affiliate of Byrd and Associates, “a healthy person will let themselves grieve, gradually working through the grief. But sometimes there are so many losses that one can’t resolve them–and they get stuck.”

A person can also get stuck if they don’t let themselves grieve. “The emotion of grief must be allowed in extreme loss,” says Dr. Archibald Hart, author of Depression Help For Those Who Hurt. “The more freedom we give ourselves to grieve, the more rapidly we recover from the grief. Unfortunately, many Christians suspect they are failing spiritually if they give in too much to their grief, and this leads to guiltiness which in turn leads to more depression.”

A few days after my friend Francine suffered a late-term miscarriage, her husband left her. Depression followed. “It was as if a dark curtain had come between me and life,” she explained. “I was reeling from the miscarriage and furious with my husband. But what made the depression even worse was that the divorce triggered childhood pain that I had never grieved.”

When a person gets stuck in grief their depressed mood can rapidly deteriorate into clinical or major depression. “Eventually, your brain becomes depleted in the neurotransmitters that fight a depressed mood,” says Dr. Byrd. “If the depressed mood lasts more than two or three months you are probably experiencing a clinical depression and need medication to replenish the depleted neurotransmitters in your brain.”

What should you do if you are depressed or think you might be? First, get a complete medical exam. A thorough medical exam is necessary to determine the roots of your condition. If your depression is internally based, your doctor may prescribe medication or change your current medication. For example, some women who become depressed at the onset on menopause completely recover when they are given estrogen supplements. Even if your depression is externally based, your doctor may recommend taking an antidepressant so you can be more objective about your life. “Depressed people,” says Dr. Wagemaker, “think the world and everything in it is dark and threatening.”

Second, unless your doctor says your depression is entirely internal, seek the help of a trained counselor. Studies show that most depressed people need psychotherapy as well as medication to recover without suffering a relapse, according to Dr. Wagemaker. Your counselor should be someone you trust, whom you can share your feelings with, and who can be objective about your situation.

When my friend Francine became depressed, her medical doctor prescribed Prozac, but didn’t recommend counseling even though he knew she had just gone through a miscarriage and divorce. She felt much better after a few weeks on medication, but wasn’t dealing with the issues that lead to her depression. “Taking an antidepressant was like coating a lake with a thin sheet of ice,” she told me. “It only covered up the issues. When I stopped taking Prozac, the depression returned. Later, I went to see a Christian counselor who helped me work through my grief. Now I don’t need the antidepressants.”

If your health care provider recommends antidepressants be aware that not everyone reacts the same way to the same medication. According to Walter Byrd, M.D. of the Providence Clinic, “Only about 60 percent of the patients who use an antidepressant find it helpful. The other 40 percent may be helped by using a different type of antidepressant or may not respond to medication at all.”

Keane’s advice: Let your health care provider know if you do not feel significantly better within a few weeks of starting medication. You may need a change in dosage or different medication.

Once you begin taking medication be sure you continue to take it until your health care provider says you can stop. Dr. Wagemaker usually asks his patients to continue their medication for one year after they begin to feel better. But some people, for example those who suffer from a biological brain disorder, probably need to take antidepressants for the rest of their life. Just like a diabetic needs insulin, these people need to take their medicine.

Today, my friend Stacey is no longer depressed. “When I look back on it,” she says thoughtfully, “I realize that I was judging myself so harshly. All I could see were my flaws. Now I realize that the Lord sees every flaw, but still accepts and loves me. It is very freeing. I will always be vulnerable to depression. I have days when I feel so blue, so overwhelmed. But I’ve learned to take those feelings to the Lord. I’ve had to learn to deal with it like any handicap. Every day I’m careful to exercise, eat right, and get enough sleep. I also try to have an interesting project going–something that lets me focus my creative energy. I guess it all comes down to loving myself enough to choose every day to do things that will keep me healthy.”

Eleven Steps to Feeling Better Faster

Once you’ve seen your doctor, there steps you can take to feel better faster. Even if you’re just feeling blue, following these suggestions could keep a depressed mood from spiraling into clinical depression:

1. Exercise! Recent studies show that people who exercise regularly are less likely to be depressed. According to James Blumenthal, professor of medical psychology at Duke University, “for some clinically depressed patients, exercise is as effective as the best medications we have.” The positive effect is long-lasting, too. One study showed that those who exercise regularly for nearly 20 years were one and a half times less likely to become depressed as those who exercise sporadically. “Exercise is a way of doing something positive for yourself–often a first step toward breaking the cycle of depression,” says Stanford University psychiatrist C. Barr Taylor.

2. Avoid drugs and alcohol. Both can make you more depressed.

3. Try to be outside every day. Exposure to natural sunlight may help you overcome depression.

4. Eat a well-balanced diet. Limit your intake of caffeine and refined sugar.

5. Take vitamin and mineral supplements. Dr. Archibald Hart recommends that depressed people take vitamin B complex.

6. Take inventory of your life. What activities make you feel worse? What makes you feel better? Choose to do activities that make you feel better. Is there sin you need to confess? Confess it and let God forgive you. Then forgive yourself.

7. Don’t suffer alone. Write or talk to a friend and share your thoughts and feelings. Remember, God is the best friend any of us have and He is always willing to listen. Don’t be afraid to pour your heart out to Him. You can be honest. He will never reject you because you’re struggling.

8. Associate with encouraging, not negative people.

9. Do something to help someone else. Encourage a friend who is struggling. Pray for people in need. Your prayers will make a difference.

10. Do something creative that lets you express yourself, like writing, painting or drawing.

11. Make yourself get out of bed and do something every day. If you have a job, go to work. If you are in school, attend classes. If you are home, make plans that will force you to get up, get dressed and get going.

Think you might be depressed? Take this test

Do you feel sad, low or unhappy?

Have you lost interest in things you used to enjoy, like reading or visiting with friends?

Do you feel restless or unable to sit still?

Do you feel worthless, hopeless or guilty? Like nothing in your life will ever improve?

Are you anxious or worried?

Are you irritable or angry?

Have you lost your appetite or have you experienced a significant weight loss or gain?

Do you have recurring thoughts of death or suicide?

Do you have problems concentrating, thinking, remembering or making decisions?

Do you have trouble sleeping or sleep too much?

Do you have no energy or feel tired all the time?

Do you have frequent headaches or other aches and pains?

Do you have digestive problems?

Everyone has days when they feel blue, but if you answered yes to at least five of these questions and have felt this way for most of the day, nearly every day, for more than two weeks, you are probably experiencing depression.

Modified from the American Psychiatric Association

©2005 Elizabeth Stalcup

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