Tuesday, February 12, 2008

Complexity of Depression

Tomorrow, my church will be observing the Lord's Supper. It is a day we will remember as a church, the Lord Jesus Christ's death on the cross for us and our partaking of spiritual blessings through His sacrifice for us.

The Shorter Catechism Q96: What is the Lord's Supper?
Answer: The Lord's Supper is a sacrament, wherein, by giving and receiving bread and wine, according to Christ's appointment, his death is showed forth; and the worthy receivers are, not after a corporal and carnal manner, but by faith, made partakers of his body and blood, with all his benefits, to their spiritual nourishment, and growth in grace.

As I prepare myself to partake of this Lord's Supper, I remember afresh the Lord Jesus Christ's great sacrifice on the cross to redeem us from sins and eternal damnation. It is through the severe relapses of depression in my life, that I am able to understand a little better, the sufferings of Christ our Lord.

I am thankful to God for my family, friends and church for their understanding (or willingness to seek to understand) the complexity of bipolar or severe depression, the prayers, encouragements, kindness and supports they have rendered to me. These are tokens of God's love and faithfulness to me. These have been invaluable in my process of recovery.

But it has been my painful experiences in the past that whenever I am down with severe depression there will be people who think that the problem is definitely due to something wrong with my spiritual life. They think I am not trusting in God or I am not obeying God. Or they will think that if I pray and trust in the Lord, I will get well. There might be instances when they are right, but not always so. Severe depression can be due to various causes. And whenever I am down with severe depression, I do trust in God and pray whenever I can. I cast myself upon God daily as I could not find the strength to cope with anything daily. But I still do not recover until a few months later.

Actually, depression can sometimes be rather complex and not that straight forward or simple. Pastor David P Murray has 6 very informative video on “Depression and the Christians”. In his 6th lecture on “The Carers”, he wrote on the importance of studying mental illnesses, “As Christians, we surely want to be the person whom our loved ones turn to in time of need. And, when they do turn to us, we want to be able to help them and not hurt them further. It is, therefore, imperative that we learn about depression and other mental illnesses in order to avoid the very common mistakes that lay-people often make when dealing with the mentally ill, and in order to be of maximum benefit to those who are suffering.”

In his second lecture, Pastor David did a very excellent analysis on “The Complexity” of depression which I found to be very balance in his views, to avoid dogmatism and the danger of viewing mental illnesses as purely physical, purely spiritual or purely mental. He encouraged us to recognise the exceeding complexity of mental illness and resist the temptation to propose and accept simple analysis and solutions.

As for Bipolar Disorder which is also known as manic-depressive illness, it is a brain disorder that causes unusual shifts in a person’s mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. They can result in damaged relationships, poor job or school performance, and even suicide. But the good news is bipolar disorder can be treated, and people with this condition can lead full and productive lives.

As a person with bipolar, I have experienced severe mood swings over the last 20 years. I experience severe depression which alternates with hypomania or normal moods, each lasting a few months and is cyclical. I realized that often there are various misconceptions, misunderstandings and stigmas associated in particular with depression. Most people still associate depression with feeling down or blue. When they feel that way, all they need to do is do something they enjoy and they will get better. For Christians, we usually pray and read God's Words, fellowship with His people, etc and we will feel better. If the depression is due to our sins, once we confessed our sins, God forgives us and we will experience the joy of the Lord again. If we do not confess our sins and seek God's forgiveness, God will hide His face from us and He will not hear our prayers. In time of severe backsliding, we can experience spiritual desertion or spiritual depression. But thank God that with Him there is forgiveness of sins. He is faithful to forgive us of our sins (1 John 1:9).

But some of us may suffer from a different form of depression or our depression may worsened till it became a condition that need to be treated through medication, counsellings, correcting some faulty lifestyle and thought patterns, taking some Omega-3 supplements or for some people St. John's Worts, vigorous exercise, etc etc. These are times in our life when somehow due to hormonal changes or some stress or strain in our life, the chemical in our brain became imbalance. Some of us are born with a brain that is prone to depression or bipolar because of its makeup. Just as I am born with a lung that is hypersensitive to cold air, etc and I am prone to asthmatic attacks during cold rainy season. Or a prolonged cold or flu will trigger off asthmatic attacks in me while it does nothing to another person, because I have a weak and sensitive lung. So it is the same with some of us who suffers from chronic depression and bipolar because of our brain condition. We are more prone to these mood swings than other people.

In such an episode of severe depression, I do pray and trust in the Lord, but I still don't get well. There is a cycle to it which is usually 3 to 6 months, or more. Without medication it is possible to recover as there is somehow a cycle to it. But the long wait can be very painful and unbearable. Thank God that He sustains and deliver us. What is painful and difficult for me to bear is whenever I am very severely depressed, there are times when I can't even pray much or read the Bible much. My concentration level is extremely low. I have difficulties reading or understand what I read. Sometimes, when I read the Bible I will feel even worst as I could not feel any comfort from God's Words and I will mistakenly think that God has forsaken me. But no amount of confession, repentance and calling upon God will deliver me. Usually it takes 3 to 6 months or sometimes more, before I am finally better and then I can pray and find comfort from God's Words. Severe depression can cause our brain to degenerate over times. And each relapse of severe depression makes the next relapse more possible. The reasons why I finally sought medical help was because my episodes of relapses of severe depression have become closer and closer over the years and every episode has become harder and harder to endure. The temptation to do away with my own life during such a severe relapse of depression is always there and it worsens recently. My down time was becoming more regular and harder to manage. I know I need professional help besides praying as God does provide doctors and other helps when we are unwell. So it was with prayerful consideration that I finally decided to seek medical and professional help, so that I can be more functional and continue to seek and serve our Lord.

After my diagnosis, I am convinced that this is a medical condition that can be treated because I have benefited from the help of medications which is shortening my relapses and helping me to be more functional. The medication doesn't cure me completely but it lift me up to a level I can function so that I can pray and derive comfort from God's Words. I can also then tackle the stressful or straining situations in my life which might have caused the relapse or aggravate it. I also then can challenge and correct my thinking patterns which have become faulty during depression or some of my existing faulty thinking patterns which might have either caused or aggravated my condition when I am depressed. I noted that whenever I am depressed my thought patterns all became negative and so when I am better, I will challenge these negative thoughts and use God's Words to correct these wrong thoughts so that I can think more biblically. These faulty thoughts can result in detrimental spiritual consequences of not trusting in God or doubting His sovereignty or goodness. So it is imperative for me to recognize them and correct them prayerfully using God's Words. But often they are the consequences of depression rather than the cause, and they still need to be corrected so that we can live aright with God even in our darkness.

In the past, I also have the misconception that as Christians we should not take medication for depression. We should pray and wait for God to deliver us. So I never sought medical help. But now while I sincerely believe that God can heal us of all our diseases, I do believe from my own experiences and that I have read on the internet, that when our condition is a chronic medical condition God does provide medication or other helps (St. John's Worts and Omega-3 fish oil also work for some people, while vigorous exercise helps some) as means of healing. So in this case to take medication or use other helps are means of grace from God to help us to get better and not a sign of a lack of faith in God. And when we make use of medications, supplements, exercise and many other helps, we use it prayerfully knowing that God alone can make use of these to heal us. This is the same when we make use of anything God has given to us in this life. It is with the purpose of serving God more effectively. Anything that hinders us from trusting in God is an idol. If our medications, our exercise, our counsellings replaced our looking to God and His Words, then these too are idols and God will not make these means a blessing to us. These will become a curse to us and bring about our spiritual downfall. So means when used prayerfully and appropriately, can be of maximum benefit to us, so that we can be more functional and able to serve God and His people.

When I started to open myself up last year to share with my family, church brethren and friends, I knew that I was putting myself at risk of having to debate with people who still think depression is solely a spiritual matter and should be overcome by faith in God alone despite the means God has provided. I did have to contend with a few friends, Christians and non-Christians. But I also felt it is worth the difficulties and it is a risk worth taking, because depression and other mental illness still has such a terrible stigma in our societies, and the church sometimes instead of supporting such a member who suffered tremendous pain and anguish, can actually worsened his condition by accusing him of a lack of faith in God. This I learnt through my own painful experiences.

So it was with the great burden in my heart to bring some help and relief to fellow sufferer by telling them that there is help that I decided to start my website and blog. I was also greatly burdened to educate the carers and friends so that they may know how best to relate to such a sufferer so that they can be of maximum help and not hurt the person further or aggravate his conditions.

When I started my blog recently, I started it with the same burdens. But I know yet once again, that I must be prepared to receive comments or emails from friends or reader of my blog, on their own version of their understanding of depression, bipolar, etc and the appropriate treatments. I wasn't sure whether I will be able to answer these contentions. So I tried to put as many useful articles as possible on my blog to help others to understand the complexity of depression.

I know that there is a possibility that I might lose some friends because of what I am going through or what I have put on this blog. But the aim of this blog is foremost to help other sufferers of bipolar and depression, and so the goal is to help them to find helps in their sufferings and enable them to be more functional and able to serve God and His people. Whatever lose I shall suffer through my writings on this blog, if it is due to the efforts to help others to attain to a more biblical and compassionate view on this complex condition so that sufferers and carers can benefit, and it glorifies God, I shall humbly and prayerfully bear them, by God's grace.

I am still new to understanding depressions, bipolar and other mental conditions. I have much to learn and am open to learning. It is my sincere prayers that I do not make my own experiences the norm. I understand that there are various reasons that can caused depression and various treatments available. God is also able to heal us without using any means. When medications or men failed us, God still never leaves us nor forsake us.

I agree with Pastor David P Murray that for Christians at times there will need to be a balance between medicine for the brain, counsel for the mind, and spiritual encouragement for the soul. Recovery will usually take patient perseverance over a period of many months, even years.

There may be reasons why God sometimes wants us to go through depression for extended periods of time and no medication or human help will bring any relief. It is at such times, that we are thrown completely upon our Lord. No one understands, no one can help us. Only to the Lord can we go daily and only to Him alone can we find deliverance. During such experiences we may find God to be truly our refuge and strength. We can identify with the many struggles and anguish of believers in the past when they undergo extreme sufferings. The psalmists often recounted their deep depression of the spirit when they are deprived from going to the house of God or when they were persecuted for righteousness sake. David also talked of his spiritual depression when he sinned in his adultery and murder. He also spoke of the forgiveness of sins when he confessed his sins to God.

Another reason why sometimes God allows us to go through severe depression without any relief is so that we may understand a little better what our Lord has gone through when He was on the cross. When our Lord was on the cross, He cried out "...My God, my God, why hast thou forsaken me?" (Matthew 15:34). When we go through severe depression, we often feel as if God has forsaken us. Many of us often prayed and cried unto God too "...My God, my God, why hast thou forsaken me?" It is through my many relapses of severe depression, that I am able to understand a little better the great sufferings our Lord has gone through on the cross for us to redeem us from eternal damnation. He took upon Himself the curse for our sins and suffered as a sinner though He Himself is without sin. He endured being forsaken by God so that we will not be forsaken by God. Ah, the depth of His love for us, is immeasurable! "Greater love hath no man than this, that a man lay down his life for his friends." (John 15:13). Our Lord Jesus Christ demonstrated His love for us by laying down His life for us. Our Lord Jesus Christ becomes more and more precious to me throughout the years, despite my many episodes of severe depression, because I become more and more aware of His love as I understand a little better of His sufferings for my sins. His sufferings was infinite in comparison to my sufferings, and it has eternal value. Gladly therefore will I endure my darkest moments, if it is His wills, that I may be drawn closer to Him and enjoy His love even more. This is a paradox. Depression is awful and painful beyond words and yet it can have such a sanctifying influence and advantage. Truly, God is faithful. He is working all things for His glory, our good and that of the church! (Romans 8:28). I never ceased to be amazed by His sovereignty and love, and it is this that thrown me upon Him completely. May He enable us to comprehend with all saints what is the breadth, and length, and depth, and height; And to know the love of Christ, which passeth knowledge, that ye might be filled with all the fulness of God. (Ephesians 3:18-19).

But having said that, when depression is clinical and a medical condition, God does send healings by providing ways out for us through usage of medicine, supplements, counsellings, exercise, etc. At such times, we must recognize God's goodness and faithfulness in working a way out for us and delivering us so that we can be more functional and serve Him.

No one can really understand what is severe clinical depression unless he has gone through it himself. It is so different from the normal ups and downs we experience every now and then. Even among sufferers of depression, the experiences, causes and cures can be so varied. We are made to be dependent upon God alone to deliver us whether by means or without means.

I thank God that now my family, friends and church are more understanding whenever I suffer relapses of severe depressions and their prayers, encouragements, kindness and supports have been invaluable in my process of recovery. I thank God for them and for His mercies in using them, and for encouraging and strengthening me day by day.

Pastor David P Murray wrote a very conclusion to his article on "The Complexity” of depression as follows:


Let us try to recognise the exceeding complexity of mental illness and resist the temptation to propose and accept simple analysis and solutions. Just as no two hearts are identically diseased, and just as no two cancers are the same, no two mental illnesses are the same in cause, symptoms, depth, duration and cure. Therefore, we must avoid making our own experience the norm for others.

The body, the soul, and the mind are extremely complicated entities and the inter-relation of the physical, the spiritual, and the mental is even more complicated. Unravelling the sequence of what went wrong in a depressed person’s brain, soul, or thoughts is usually a humanly impossible task. Analysis of the mental, physical, and spiritual contributions to the situation is equally difficult.

Consequently, the prescription of solutions is often a matter that takes much time and even trial and error. There are no quick fixes. For Christians there will need to be a balance between medicine for the brain, counsel for the mind, and spiritual encouragement for the soul. Recovery will usually take patient perseverance over a period of many months, even years.

Great care is therefore required in coming to conclusions about our condition or that of others. We finish by underlining our two main principles. Avoid dogmatism and seek humility. Avoid extremes and seek balance.

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