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What is depression like?

D   amn, damn, damn, I want to scream when I hear the word depression.

E   veryone seems to have it.  Every time I turn around, another story, another victim.

P   ain and despair fill every waking moment.  People searching, aching for an answer.

R   unning away from it doesn’t help.  Rapidly it takes over a person, not caring.

E   arnestly the victim and the caregiver look for answers.  Easy answers don’t exist.

S   lowly, slowly, the medicine takes hold.  Slowly, slowly, not good, another to try

S   eeping in, the negativity grabs hold.  Seeping sea tentacles crushing the heart.

I   ronically the positiveness that would help is missing.  Ironically the smile gone.

O   stracizing begins, the sigma strong.  Only a few speak truth about the monster

N   ight comes, another day to hope.  Never going to let the monster triumph.


Love, Forgiveness, and Other Wildly Cosmic Subjects

At the risk of being WAY too theological, here goes…

Our nuclear family has created a lot of traditions through the years.  One that we’ve enjoyed since the kids hit their teen years is watching “Jesus Christ Superstar” together sometime during the three days at the end of Holy Week.

It took a lot of convincing for them to get me to even consider giving this musical a try, though I’m generally a big fan of the musical theater genre.  I’d seen bits of the 1973 version, and the freaky hippies with really fairly rotten voices turned my stomach.  But a new incarnation came out in 2000, and suddenly I got it.  The excellent acting and brilliant voices bring Jesus’ story to life in a way you might only get if you’re a theater geek…but it’s really meaningful to me (even with its often-questionable interpretation of the story).  A lot more so than the somber, solemn, liturgically correct Holy Week worship services I’d been going to for years.

Every year something new hits me when I experience the music and emotions of the characters in this film.  This year what struck me most was the theme of giving and accepting of love, probably because I’ve been forced to do a lot of thinking recently about life, the universe, depression, and everything (apologies to Douglas Adams).

In this 2000 production, it’s clear that Jesus wants desperately to show his continued love, acceptance, and forgiveness of Judas after the betrayal.  He himself feels pain as he sees Judas’ suffering. It’s equally clear that Judas believes himself utterly out of the reach of Jesus’ love and compassion.  He’s unable to believe in it so he doesn’t recognize it, and his despair over this fact and over his actions, which he believes are unforgivable, leads him to kill himself.

I can’t help but wonder if similar feelings aren’t sometimes behind depression and suicide in our world.  Living in close quarters with a depressed person, I’ve seen how completely depression robs people of their ability to see themselves as lovable and worthy.  The illness can make a depressed person believe that every single mistake they’ve made or hurt they’ve caused is of monstrous, unforgivable proportions. Certainly  we very fallible humans can have a hard time loving and forgiving when someone is unpleasant and difficult to live with, even if these negative traits are caused by mental illness.

My heart aches when I consider how very many people believe that even God can’t love them when they feel unlovable. Too many people have been taught that we have to live a certain kind of life, do certain things, hate our natural selves, in order to earn God’s love.

So this year, what I’m taking away from our annual JCS viewing – and I’m sure this sounds ridiculously corny – is the look of love in Jesus’ eyes and the tenderness with which he reaches out and tries to touch and comfort his friend Judas.  I’m convinced that’s the truth of God – unconditional love, compassion, and mercy for all.

May we all, through whatever pain and suffering we may experience in our lives, learn to accept and feel that love and comfort.

Happy Easter!



Enduring Depression in a Relationship

How does depression affect a relationship?  How can someone else’s depression affect me? How do you survive when someone you love is depressed?

These are questions Bernadette and I deal with all the time.  We discuss it with each other, as our own two-person support group.  We discuss it with others, in workshops, presentations, and support groups.  And most of the time the response we get is along the lines of “Oh my gosh, I can’t believe someone else is having the same experiences and feelings I’m dealing with.  I thought I was the only one.”

As with most issues involving mental illness, fear and stigma tend to rule the day.  No one wants to talk about what’s going on at home when what’s going on at home involves a loved one collapsing into tears at the drop of a hat, sleeping all day or never, growling constantly, hyperventilating due to panic or anxiety. We’re still burdened by the archaic belief that such symptoms are due to character flaws, that people should just “buck up,” “put on a positive face,” “look on the bright side.” So we keep quiet, and we continue to believe we’re the only ones suffering.

So Bern and I have made it one of our goals in life to talk about this stuff as much as possible.  Often that’s in groups of people who have been there themselves.  But often it’s with people who might be shocked to hear mental illness brought up in the course of regular conversation.  We encourage others to do the same – every time we speak the truth in public, we chip away at that hurtful, stifling stigma.

So when I read a blog post yesterday in which a wife interviewed her husband about his depression, I sat up and took note.  Here was someone else who had the guts to speak the truth.  She begins with: “I have many friends who have a spouse who struggles with depression. We share that story. I asked my husband, if I could interview him, with the hope that we could be of some support to those couples who are in the midst of “the black dog.”  Visit this blog and read the whole post at http://creatingsacredcommunities.wordpress.com/2013/03/26/talking-to-your-spouse-about-depression/

It focuses on what it’s like to be depressed and how a person can support a depressed spouse.  Important stuff, and we applaud the effort to get the word out there in public that this is a real illness for real consequences for many people – more people than we know.

A big part of surviving depression in a relationship is supporting the depressed person through the process of treatment and healing.  We want them to get better because A) we love them and care about how they feel and B) depression can be contagious, and we want to get it out of our household and lives. But just as important as helping the depressed person is the survival of the caregiver.  We have to take the time to focus on self-care, or we won’t make it ourselves.

If you have depression, anxiety, or other mental illnesses in your home/relationship, be assured that there are, indeed, others out there dealing with this stuff.  Know that there is help available (check out NAMI, which offers support groups for loved ones of people with  mental illnesses, link to the right). And know that you have the right (as well as the need) to take care of yourself through this time – you deserve health and wholeness.


Depression, Suicide, and Aging – Not a Love Story

Recently in the Times-Tribune of Scranton, Pennsylvania there was an article by Kathy Wallace, a suicide prevention specialist.  An official from a local hospital, Lehigh Valley, described the murder-suicide of an elderly couple as “a love story.”  Ms. Wallace took them to task and rightly so because, in her words, “this is an injustice to everyone who has lost someone to suicide.  We don’t know the people involved and they may have loved each other very much but it is still wrong to romanticize this terribly sad tragedy

However, we as a society too often romanticize people ending their lives.  Whether it is Romeo and Juliet or the couple from West Side Story, the act is not one of love but rather one of tragedy.  How can we get into the minds of someone who commits suicide?  We don’t know what went into their decision to end their life.  We do know, though, that it is not weak character or a selfish decision that causes suicide but rather a brain that has undergone changes due to depression or other mental illness.  The brain tells these individual who are in a great deal of psychological pain that suicide is the only choice

And so looking at this elderly couple, were they alone in life or did they have a family?  Were they aware of the decision they made or was the decision compromised by an already existing depression in one or the other?  Did they both see this as the only way to stop the pain?

We know that older adults are at higher risk of suicide but it is not always or only because of all the losses older adults face.  Increasing the risk is the inability of others to identify and then give appropriate care to depressed older people.  Thus the rate of suicide in the elderly only increases.

Loss is a given as we age.  There are many small and large losses that cause extreme sadness and grief.  Sleep disturbances, mood swings and other signs of physical and emotional illness might be part of aging but these same signs could be symptoms of depression.  . Older adults can go through sleep disturbances, mood swings, and other signs of physical and emotional aging, but these signs could also be symptoms of depression.

Ms. Wallace urges in her article that “if you see unusual changes or know that family members or friends are going through serious loss, isolating themselves, or stating a perception of themselves as being a burden, please ask them how they are coping. Physicians, please ask your older patients a few simple questions during their visits about how they are doing emotionally. It could stop a tragedy.”

Amen, sister!


The Monster in Our Bed

Image credit to WotansKriegerin

Image credit to WotansKriegerin

Okay, so there’s not really a monster in our bed.  My husband’s two-week-old CPAP actually sits next to the bed.  All that’s actually in the bed is a substantial hose and a large plastic mask that constantly emits a gale-force wind.  We feel pretty confident this contraption is doing him a lot of good.  And, to be honest, it’s not bugging me too much, even though I’m a light sleeper. But imagine trying to sleep with an air compressor hose strapped to your bed partner and trained on your face. It’s weird.

We had read and heard quite a bit about the connection between depression and sleep apnea.  So when my husband’s depression and anxiety ramped up AND we realized he couldn’t stay awake in the afternoons/evenings to save his life (literally – one day he fell asleep and completely missed our smoke alarms going off when I burned our supper), the psychiatrist’s suggestion that we try a sleep study made sense.

Three months later we know he does have sleep apnea, we know he probably has “atypical narcolepsy,” and we know the CPAP does him a lot of good in terms of staying awake and alert.  Unfortunately, we also know that for him, anyway, treating sleep apnea does not currently have any effect on his level of depression and anxiety.  Instead of being sleepy, depressed, and panicky he is now wide awake and even more depressed and panicky.  Progress, yes, but certainly not enough.

So far this post has been pretty breezy and light-hearted, right?  Well, now for the reality.  Someone I love is currently leading a life of misery.  His life is so dark right now he can’t even recognize that he’s sinking under the crushing weight of depression and anxiety.  I have to be his mirror; I explain to him what I see, how he seems to feel.  I remind him that he has an illness and it’s not being adequately treated.  I encourage him to keep busy, to exercise, to call his psychiatrist and get an appointment to re-start the quest for more effective medication.

I live in close quarters with all this misery. I experience gut-wrenching pain as I watch someone I love, someone who has so much potential, someone who is such a good and lovely person, collapse into tears regularly.  I feel guilty when I’m secretly relieved and at peace when either he or I is out of the house.  I feel uncomfortable when I have to speak the truth at work, explaining that I’m falling behind and dropping balls because I’m dealing with so much at home (though I have extremely supportive coworkers who genuinely care and rush in to pick up the slack – thanking God for that).  And I feel resentful, because my own emotional state isn’t a picnic.  I’m still coming off SAD, I’m grieving about impending empty-nest syndrome, I’m stressed constantly about our financial issues, which are a fairly direct result of long-term depression in a family member.  But my emotional state has to take a back seat.

And that, in a nutshell, is what it’s like to live with and care for someone with a mental illness.  All this is why Bernadette and I do what we do; we know how hard it is, and we know how little support there is for people living through this stuff.  So we write about it, we talk about it, we lead workshops and support groups to help people learn how to cope and to help decrease the stigma.  We hope we’re making a difference to the people we work with.  I know it makes a difference for me.


Suicide – No Judgment, No Guilt, No Blame

Not long ago I read a piece about suicide, which focused on the emotions of those left behind.  I’m thankful this is not an experience I’ve had to live through,.  And because I haven’t had this experience, I can’t say for sure how I would feel if I were in those shoes.  But here is an important statement Bern and I were given when we were interviewing both a psychiatrist and a psychologist for the purposes of “Let Me Sow Light: Living With a Depressed Spouse.”  We’ve both gone back to these words again and again in our work with people who care for a depressed person:

Suicide is, sadly, sometimes the fatal outcome of the illness called depression.

In other words, sometimes people die from depression.  Sometimes people die of cancer, or diabetes, or any number of other illnesses. When people die of most illnesses  there is no blame assigned, family members rarely feel guilty.  When people die of most illnesses, “religious” people don’t tell us the dead are headed for hell.

But when a person suffering from the illness called depression dies through suicide caused by that illness, all of these painful and hurtful consequences come into play   There are plenty of reasons why: stigma, fear, a history of demonizing suicides within the established church.

I appreciate the words of David K. Flowers on this subject.  David is a pastor and a counselor with a B.S. Clinical/Community Psychology and an M.A. in Counseling.  I recommend you check out his blog at http://davidkflowers.com/ for excellent thoughts on faith, spirituality, the state of the world, and mental/ emotional health.  Here’s what David had to say in a post about suicide:

“Someone recently asked my opinion on what happens to those who commit suicide.  Will they ‘go to hell?’

Before I give my take on this, I must start off by saying that no one but God has any business saying who goes to hell and who doesn’t.  It’s not the church’s job, or any pastor or religious teacher’s job, to declare that any specific behvior puts someone on the fast track to hell.  Show me a pastor or religious teacher (or institution) making declarations about who is going to hell, and I’ll show you a case of spiritual megalomania, since this assumes levels of knowledge no human being could possibly have…

No, suicide is not mortal sin.  I suppose there may be cases where a man kills himself in the same state of rage from which he might kill someone else, and in this case there is no question that what is known as sin would be involved.  But to assume that this one act of sin leads immutably to hell is a huge leap.  It’s an even bigger leap to assume that any one act, especially an act committed from a place that is so clearly “not well” ties God’s hands and prohibits him from the exercise of mercy.  And finally is the fact that most suicides are not in any way rational.  They are based in a deep kind of illness which is deserving not of punishment but of compassion.  Suicide is painful enough for family members who have lost a loved one to it.  They do not need the additional pain of thinking their loved one has separated himself from them both physically and spiritually in that one act.  We need a more nuanced theology to deal with this, based less in fear and desire to control, and more in compassion and understanding of the love and goodness of God.” (This text originally appeared on DavidKFlowers.com. Check out the full post at:http://davidkflowers.com/2010/02/suicide-hell/)

Those of us who live with a depressed person recognize what a monstrous illness it is.  We commonly experience anger, loneliness, fear, and feelings of abandonment when someone we love suffers from deep depression. I’m hopeful that one day we’ll all realize that when suicide becomes the fatal outcome of this illness, those involved should not be left to experience guilt, blame, and shame.


Should I go with my husband to his first psychiatrist appointment?

In obsessively checking our blog stats recently, I found that someone had found Depression’s Collateral Damage by Googling “Should I go with my husband to his first psychiatrist appointment?”  Allow me to answer that question:

Yes.  Yes, yes, yes, yes, yes, yes, yes.  In other words, yes (assuming that you yourself are a reasonably mentally healthy and stable person).  If he’ll let you.  Some will resist or refuse, and the best you can do is keep trying. 

Here’s why: (Note: I’m using the word “husband” because that’s how the search was worded.  Substitute wife, partner, whatever fits your situation, as needed.)

• You have every bit as much at stake here as your husband does.  Depression and other mental illnesses SERIOUSLY affect the lives of everyone in the home and family system, and you deserve a say in and full knowledge of what’s going on regarding treatment.

•Depressed and otherwise mentally ill people are very often unable to articulate clearly and accurately what they’re doing/feeling/experiencing.  You can provide valuable perspective.  Don’t hijack the visit, don’t contradict, don’t argue.  Just offer what you’ve observed.

*Depressed and otherwise mentally ill people tend to have difficulty processing what’s being said to them.  They may misunderstand or forget what the doctor’s said.  Someone with a clear mind needs to hear what the plan is, ask questions, and take notes.

*The medical profession needs to understand that healing from mental illness does NOT have to be a one-on-one venture.  The involvement of close community in support and assistance not only helps the ill person, it helps the loved ones around him recover from the trauma of mental illness, as well.

*Psychiatrists are in the profession of dispensing medication for the relief of mental illnesses.  I realize that a good doctor is well aware that there’s a lot more to healing than throwing medications at a person.  However, in my experience (and I’ve had plenty) psychiatrists are likely to pile on the meds because that’s what works for some people.  It doesn’t work for everyone.  And you need to be on hand to remind him or her that your loved one is NOT everyone.

*This person who is struggling with mental illness is someone you care a great deal about.  You want him to have the best chance possible of getting on a path toward healing.  He probably can’t do it alone.

Helping someone through the treatment process is not an easy road to follow.  Don’t forget to take care of yourself along the way.


The Elephant in the Room

There is an elephant in the room and very few of us can see it.  The statistics about this elephant should wake us all up to action.  Sadly, they do not.

  • 121 million people world-wide have some type of depression (World Health Organization)
  • 14.8 million Americans experience clinical depression in any given year (National Association of Mental Illness)
  • Less than 25 percent of all people in the world suffering from depression have access to effective treatment (World Health Organization)
  • People 65 and over in America commit suicide at a higher rate than the national average (Senior Health)

And that is just the tip of the iceberg.  Several thousand miss work because of depression or are not effective in their jobs.  Depression left untreated can lead to a growing list of physical problems – high blood pressure, heart disease, dementia, to name just a few. There is also the loss of creativity and innovation that could come from such gifted individuals.

And then there are the caregivers.

Often stretched in many directions, caregivers themselves develop medical conditions and are always open to depression.  When one is working to maintain sanity while dealing with a loved one with depression, it can take a toll at home, in the workplace, and even with the depressed individual. Caregivers are called upon to do so much and are often not supported in their work.   Sadly, many of them seek support and receive none because of the vast misunderstanding of the disease.

Most people do not realize this ripple effect with depression – family, friends and co-workers are all impacted in different ways.  Whether it is dealing with the difficult job of coping with this mental illness or whether trying to heal the relationship disruptions or the physical conditions that come up, caregivers and those suffering from depression have an inordinate amount of stress in their lives.  

And many of us don’t recognize how hard it is. We ignore the elephant in the room.  We talk around it and refuse to see it is ruining the life of everyone in the room.  In fact, it is ruining everyone in the community.  Someone has to say something.  Silence is not an effective cure for depression.


A Monster Tale

Long ago in a village not too different than yours lived a monster.  This monster was not your usual run-of-the-mill, scary, three-horned, sharp-toothed monster.  This monster looked just like everyone else in the village.  And that is what enabled it to eat away at the minds and hearts of the villagers.

Whenever anyone in the village discovered a secret about the past that reflected not too favorably on the family, the monster was there to whisper in ears that this situation was not to be shared or they would be shamed. When something terrible happened, when someone took their own life, when a crazy illness crossed the family’s path, the monster was on their doorstep telling them that there was no one who would help, that it was the family’s fault that the illness came, that the loved one chose the route of suicide.  And again the monster whispered in their ears that they could not reach out for help because it would only bring shame, that they were indeed the ones at fault.

And so the villagers took to keeping many things secret.  They didn’t tell anyone that someone in their family was depressed.  They didn’t seek help when a loved one spoke of suicide.  They kept close to their hearts the pain they felt and the horror that came with the realization that they were all alone.  But they put on a smile and pretended that all was well. And thus the monster thrived, eating away at the minds and hearts of the villagers, growing and feeding on their fear and loneliness and sorrow.

One day a villager not older than you woke tired of being alone, tired of keeping all the secrets.  It was all just too much to face each morning and carry around all day.  The villager decided to seek help.   Knocking on the doors of the other villagers, she told them how she felt and how she needed help in dealing with the depression that had darkened their household.   Some of the villagers welcomed her with open arms, hesitantly sharing their own secrets and feeling the heaviness of their lonely secrets lift.  Others simply closed the door or told her that she should just take a deep breath and keep going.  One was even so bold as to offer her bootstraps to pull herself up with.

When the monster saw what was happening, panic began in the very bottom of the monster’s toes.  He didn’t want people realizing that they could get better, that they weren’t alone, that illness – particularly mental illness – was not something to be ashamed of.  He wanted them to be afraid, to be alone, to be ashamed.  That, after all, was where the power for the monster came.  If that changed, the monster would die.

And so a battle began between the villager whose name was Truth and the monster whose name was Stigma.  Who won?  Only your heart can tell you.


Rollercoaster Life with Depression

I realized today I haven’t followed up for some time about the continuing saga of my husband’s journey with a sleep doctor, going off and back on meds, and taking of a second job…

That’s where the rollercoaster in the title of this post comes from.  We’ve had surprisingly good days, painfully bad days, and some in between.  The highs have been accentuated by the hell-deep lows.  But on the whole, I’m hopeful we’re seeing improvement.  He was diagnosed with sleep apnea and probably “atypical” narcolepsy and is trying to get used to sleeping with a CPAP machine.  It’s a little noisy, but I can live with it because…drumroll please…he’s able to stay wide awake and alert all afternoon and evening, every day, for the first time in years.  And he’s actually joked and been fun to be with, in between bouts of grumbling about his second job (which are certainly justified).

Today I had coffee with an acquaintance I’d now call a friend…she reached out after discovering the book she’d been reading to help her deal with her depressed husband was actually written by someone she knew.  She’s at the beginning of her trip on this rollercoaster, and as we talked I recognized her relief in discovering that there are people out there who have experienced what she’s living.

So just a shout-out to everyone who’s living in any way with mental illness – whether in yourself or in someone you love. Hang on tight, enjoy the heights and let them hold you up when you dip into those lows.  And remember there are tons of other people on the ride with you, screaming just as loudly as you are.