Thursday, February 28, 2008
During such a episode, I dread to wake up each morning as I couldn't bring myself to face each day. Every morning, when I wake up, I found myself asking over and over again, What is the meaning of life? What is the point of going on like this day after day? I can't see any light at the end of the tunnel. There is no way out of this depths. I have no energy to fight on. So many times I prayed that God will take me home. Living on without the ability to enjoy His love, His Words, public worship, personal devotions, family, friends, work, hobbies, etc is so meaningless. During severe depression, nothing seems to help. Day in day out, night in night out, is the same thing and it goes on for days, weeks, months. Others said they have been depressed before and they just prayed, look to God and they are better. But in severe clinical depression, nothing helps. So no one will understand. What is the meaning of life? Why am I here to go through this suffering over and over again as I have been through it some 12 times by now?
I thank God for leading me to seek help at Counselling and Care Centre in Singapore in January 2007. In my first 2 sessions with my counsellor, Sarah, I recounted to her my past relapses of severe clinical depression in the last 20 years. Sarah noted at the end of my second session with her that there is a phrase I keep repeating and that is during every depressive episodes I will wonder "What is the meaning of Life?". Sarah felt that there is a necessity for me to explore this question and to see how I can get a more realistic and biblical view on this question as that will have an impact in my recovery.
When I first saw Sarah in end January 2007, I had just sought medical help and was on anti-depressant (20mg Fluoxetine or common brand name Prozac). Thank God that I am very sensitive to medication and 1 week after taking Fluoxetine, I was feeling better and more functional. The anti-depressant did not cure me totally but it lifted me up to a more functional level so that I can pray and read the Bible once again and find comfort in God and His Words. I was able to wake up without dreading to face each day and therefore able to cope better with work and life in general. The anti-depressant helped to lift up to a level where my thoughts and feelings are more normal, and I can think more rationally. It was then that I can benefit from counsellings/psychotherapy.
So I was more rational and able to think more clearly when I saw Sarah. After hearing my accounts, Sarah asked me what I think is the meaning of life? Sarah wants me to go home and think about this question and to discuss with her in our next counselling session the following week.
At that time, I was seeing Sarah once a week for about an hour each session. Thank God for my employer and colleauges who allowed me to take time off during working hours to see Sarah. Sarah works in a team with several other counsellors, and our sessions are video taped with my permission. In the room where Sarah counselled me, I only get to see her. Her other colleagues in her team were in the next room, watching the video of our taped session. Towards the end of the session, Sarah will go for a short break of 10 mins to discuss with her team members. She will then come back and conclude the session with me by highlighting some discoveries we made during our sessions and to post some question for me to take home and think and pray about. This was how she helped me to explore my thoughts as I do have some faulty or unhelpful thinking patterns which are so ingrafted in me that I am not conscious of them. But they have tremendous negative effects on my life and learning to identify them will help me to challenge them and turn them to more realistic and biblical thoughts and actions. This is the gift of Cognitive Behavioural Therapy (CBT) or counselling/talk therapy/psychotherapy. I will share more about CBT in future posts.
So on my second session with Sarah, I took the question "What is the meaning of Life?" home with me to pray and explore it further.
To be continued......
Tuesday, February 12, 2008
One of the discovery I made from reading some self-help book and through some of my counsellings sessions with some counsellors, was that I do have some faulty thinking patterns which may have either contributed to some relapses of clinical depression in the past or worsened their symptoms. These faulty thought patterns are most prominent during my relapses of depression.
These are not just occasional thoughts but a rigid thinking pattern which I was not conscious or aware off. Though at times I realized that I was not thinking correctly, but most of the times I wasn’t aware that some of my thought patterns were incorrect as they were so much a part of me. It is only recently through the relapse in Dec 2006, when I sought professional help and started reading deeper into depression, that I came to the realization.
I thank God for enabling me to see these faulty thought patterns more clearly now and enabling me to slowly learn how to recognize them, challenge them and correct them by using the Word of God so that I can think more biblically and live for the glory of God.
I am still trying to recognize some of these faulty thinking patterns. I know that sometimes I do have quite a number of the faulty thinking patterns that is listed in the articles below. I am also quite a perfectionist which means my expectation of myself can be rather high, and indirectly I stressed myself up unknowingly. I am also not an assertive person. I have problem saying “no”. So I also put myself through a lot of difficulties or take on more than I can handle. I used to have difficulty relaxing or taking breaks. In some sense, I am a workaholic. I am also fulfilling the role of care-givers in quite a number of context, and having little respite. All of the above or the combinations of some of these, could well have weakened my body and mind, and lead to the relapses of clinical depressions.
I will try and share more about my own experiences when I am more clear about them. But in the meantime, I will just share the following excerpts from a few people whom I found to be very useful and instructive :
1) Dr David P Murray in Lecture 3 “The Condition” of a series of 6 messages on “Depression and the Christian” said:
“Perhaps, the most obvious symptoms of depression are the unhelpful patterns of thinking which tend to distort a depressed person’s view of reality in a false and negative way, and so add to the depression or anxiety.
While we often cannot change the providences we have passed through, or are passing through, we can change the way we think about them so as to present to ourselves a more accurate and positive view of our lives, and so lift our spirits.
We will focus on ten false thought patterns which reflect and also contribute to the symptoms of depression. We will summarise each thought habit, and look at three examples of each, one from ordinary life, another from our spiritual life, and another from the Bible. The Biblical examples are not necessarily examples of depressed person but they are examples of false thinking often present in depression.
It is important to see how our depressed thought patterns affect our ordinary life; and even more important to see how that is then carried into our spiritual life. It is almost always that order in which our thoughts are transferred – false thinking in ordinary life is eventually transferred into our spiritual life.
1. False extremes
This is a tendency to evaluate our personal qualities in extreme, black or white categories – shades of grey do not exist. This is sometimes called “all-or-nothing thinking”.
Life example: You make one mistake in cooking a meal, and conclude you are a total disaster.
Spiritual example: You have a sinful thought in prayer, and conclude that you are an apostate.
Biblical example: Despite most of his life being characterised by God’s blessing and prosperity, when Job passed through a time of suffering he decided he must be an enemy of God (Job 13:24; 33:10)
2. False generalisation
This happens when, after experiencing one unpleasant event, we conclude that the same thing will happen to us again and again.
Life example: If a young man’s feelings for a young woman are rebuffed, he concludes that this will always happen to him and that he will never marry any woman
Spiritual example: When you try to witness to someone you are mocked, and you conclude that this will always happen to you and that you will never win a soul for Christ.
Biblical example: At a low point in his own life Jacob deduced that because Joseph was dead, and Simeon was captive in Egypt, that Benjamin would also be taken from him. (Gen.42:36). “All these things are against me,” he generalised.
3. False filter
When depressed we tend to pick out the negative detail in any situation and dwell on it exclusively. We filter out anything positive and so decide everything is negative.
Life example: You get 90% in an exam but all you can think about is the 10% you got wrong.
Spiritual example: You heard something in a sermon you did not like or agree with, and went home thinking and talking only about that part of the service.
Biblical example: Despite having just seen God’s mighty and miraculous intervention on Mt Carmel, Elijah filtered out all the positives and focussed only on the continued opposition of Ahab and Jezebel (1 Kings 19:10).
4. False transformation
Another aspect of depression is that we transform neutral or positive experiences into negative ones. Positive experiences are not ignored but are disqualified or turned into their opposite.
Life example: If someone compliments you, you conclude that they are just being hypocritical, or that they are trying to get something from you.
Spiritual example: When you receive a blessing from a verse or a sermon, you decide that it is just the devil trying to deceive you.
Biblical example: Jonah saw many Ninevites repent in response to his preaching. But, instead of rejoicing in this positive experience his mood slumped so low that he angrily asked God to take away his life (Jonah 4:3-4).
5. False mind-reading
We may often jump to negative conclusions which are not justified by the facts of the situations.
Life example: A friend may pass you without stopping to talk because, unknown to you, he is late for a meeting. But you conclude that he no longer likes you.
Spiritual example: Someone who used to talk to you at church now passes you with hardly a word, and so you decide that you have fallen out of her favour. But, unknown to you, the person’s marriage is in deep trouble and they are too embarrassed to risk talking to anyone.
Biblical example: The Psalmist one day concluded that all men were liars, a judgment which on reflection he admitted to be over-hasty (Ps.116:11)
6. False fortune-telling
This occurs when we feel so strongly that things will turn our badly, our feelings-based prediction becomes like an already-established fact.
Life example: You feel sure that you will always be depressed and that you will never be better again. This, despite the evidence that almost everybody eventually recovers.
Spiritual example: You are convinced that you will never be able to pray in public. Again, this
despite the evidence that though difficult at first, with practice almost everybody manages it.
Biblical Example: Anticipating the opposition that Jesus would face in Bethany, Thomas falsely predicted not only his own death there but also that of the Lord and the other disciples (John 11:16).
7. False lens
This is when we view our fears, errors, mistakes through a magnifying glass, and so deduce
catastrophic consequences. Everything then is out of proportion.
Life example: When you make a mistake at work, you conclude, “I’m going to be sacked!”
Spiritual example: You focus on your sins from the distant past in a way that leads to continued feelings of guilt, self-condemnation, and fear of punishment.
Biblical example: When Peter sinfully denied the Lord, he not only wept bitterly but decided that as his mistake was so spiritually catastrophic, there was no alternative but to forget about preaching Christ and go back to catching fish (Jn.21:3).
8. False feelings-based reasoning
In depression we tend to take our emotions as evidence for the truth. We let our feelings determine the facts.
Life example: You feel bad, therefore conclude that you are bad.
Spiritual example: You feel unforgiven, therefore conclude you are unforgiven. You feel cut off from God and so conclude that you are cut off from God.
Biblical example: At one of his low points, David felt and so hastily concluded that he was cut off from God. “I said in my haste, I am cut off from before thine eyes” (Ps.31:22).
9. False “shoulds”
Our lives may be dominated by “shoulds…” or “oughts”, applied to ourselves or others. This heaps pressure on us and others to reach certain unattainable standards and causes frustration and resentment when we or others fail.
Life example: The busy mother who tries to keep as tidy and orderly a house as when there were no children is putting herself under undue pressure to reach unattainable standards.
Spiritual example: The conscientious Christian who feels that despite being responsible for meals and raising children, that she ought to be at every prayer meeting and service of worship, and also reading good books and feeling close to God.
Biblical example: Martha felt deep frustration that Mary was not fulfilling what she felt were her obligations and complained bitterly about it (Luke 10:40-42).
10. False responsibility
This is when we assume responsibility for a negative outcome, even when there is no basis for it.
Life example: When your child does not get “A” grades you conclude that you are an awful mother. The reason may be instead that your child has a poor teacher or that his gifts are not of an academic nature.
Spiritual example: When your child turns against the Lord and turns his back on the church you assume that, despite doing everything you humanly could to bring him up for the Lord, it is all your fault.
Biblical example: Moses felt responsible for the negative reactions of Israel to God’s providence and was so cast down about this that he prayed for death (Num.11:14-15).
1. False thinking patterns are compatible with being a Christian.
2. False thinking patterns will have a detrimental effect on our feelings, our bodies, our behaviour, and our souls; usually in that order.
3. One of the first steps in getting better is recognising these false thinking patterns which do not reflect reality.
4. While we can do little if anything to change our providence (our life situation), we can change the false way we may think about our providence.
Obviously, these unhelpful false thought patterns are going to give you unhelpful emotions and feelings. If you are always thinking about problems and negatives, or imagine the future is hopeless, or think everyone hates you, etc., then you are going to feel down very quickly. Your feelings about ordinary life and your spiritual life are going to reflect what you think in each arena (Prov.23:7).
Here, we shall briefly look at some of the emotional symptoms of depression. And, as with the area of our thoughts, let us honestly examine the area of our feelings in order to consider whether our emotions are related to a depressive tendency or illness. Also, as with the area of our thoughts, in this area of feelings we shall also highlight Biblical examples of true believers also experiencing such emotions, in order to show that such feelings are compatible with being a true believer.
1. Do you feel overwhelming sadness?
Everyone feels sad and down from time to time, but depression-related sadness is overwhelming and long-term. It often results in tearfulness and prolonged bouts of unstoppable sobbing.
Biblical Examples: Job (Job 3:20; 6:2-3; 16:6, 16), David (Ps.42:3,7).
2. Do you feel angry with God or with others?
A common characteristic of depression, especially in men, is a deep-seated and often irrational irritability and anger.
Biblical Example: Jonah (Jonah 4:4,9), Moses (Num.20:10-11).
3. Do you feel your life is worthless?
It may be that despite your life being highly valued by others, and despite you being useful to others and to the Lord, that because of your distorted view of yourself you feel your life is worthless. Indeed you may feel your life is just a burden to and a blight upon others.
Biblical Example: Job (Job 3:3ff), Jeremiah (Jer.20:14-18)
4. Do you feel extreme anxiety or panic?
“In anxiety, the person often overestimates the threat or danger they are facing, and at the same time usually underestimates their own capacity to cope with the problem.”
Biblical Example: David (1 Samuel 21:12), disciples (Matt.8:25)
5. Do you feel God hates you and is far from you?
Although to any outside observer your past and your present may be replete with examples of God’s good favour towards you, you feel that God has either become your enemy or else has given up on you. You feel as if you are in spiritual darkness
Biblical Examples Job (6:4; 13:24; 16:11; 19:11; 30:19-23, 26), Jeremiah (Lam.3:1-3).
6. Do you feel suicidal or do you have a longing to die?
Biblical Examples: Job (Job.3:20-22; 6:9; 7:15-16), Moses (Num.11:14), Elijah (1 Kings 19:4)
These deeply depressed feelings are movingly articulated for us by the depressed Charles Spurgeon, when commenting on the experience of Heman in Psalm 88.
“He felt as if he must die. Indeed he felt himself half dead already. All his life was going, his spiritual life declined, his mental life decayed, his bodily life flickered; he was nearer dead then alive. Some of us can enter into this experience for many a time have we traversed this valley of death shade, and dwelt in it by the month together. Really to die and to be with Christ will be a gala day’s enjoyment compared with our misery when a worse than physical death has cast its dreadful shadow over us. Death would be welcome as a relief by those whose depressed spirits make their existence a living death. Are good men ever permitted to suffer thus? Indeed they are; and some of them are even all their lifetime subject to bondage….….It is a sad case when our only hope lies in the direction of death, our only liberty of spirit amid the congenial horrors of corruption…. He felt as if he were utterly forgotten as those whose carcasses are left to rot on the battle field. As when a soldier, mortally wounded, bleeds unheeded amid the heaps of slain, and remains to his last expiring groan, unpitied and unsuccoured, so did Heman sigh out his soul in loneliest sorrow, feeling as if even God Himself had quite forgotten him. How low the spirits of good and brave man will sometimes sink. Under the influence of certain disorders everything will wear a somber aspect, and the heart will dive into the profoundest deeps of misery.”
2) And in Lecture 4 “The Causes“, Dr David P Murray wrote:2. Psychology (the way we think)
In Lecture 3 we looked at 10 false thinking patterns which contribute to depression. It cannot be emphasised enough how vital it is to learn to recognise these unhelpful thoughts by prayerful self examination. It is also important and useful to note that some of these habits of thinking may be involuntarily absorbed or learned in early life and so may be deeply ingrained. When we feel down, or when we are stressed, these latent false thinking patterns tend to occur more frequently and tend to dominate. This can often lead to depression, worsen an existing depression, and, if persisted in, make recovery from depression so much harder. Sometimes, the Church can reinforce or add to false thinking patterns by over-emphasis on the negatives in the Bible and in people’s lives, or by setting standards of commitment which may discourage or depress those who are unable to attain them.
3) In Lecture 5 “The Cures“, Dr David P Murray wrote:
2. Correct your false thoughts
As we have noted throughout these lectures, one of the most common contributory factors to depression is wrong and unhelpful thoughts. Many Christians, who wouldn’t dream of viewing God’s Word in a false way, yet view God’s world in a false way. As they view themselves, their situations, and their relationships with others, they tend to dwell on and magnify the negatives and exclude the positives. This distorted view of reality inevitably distorts and depresses their mood. Christians are obliged to challenge falsehood and distortions of reality, especially when found in themselves. In the appendix to this lecture you will find two questionnaires to help you do this. The first is to help you examine your thoughts, and the second is to help you challenge your false and unhelpful thoughts. Questionnaires such as these are recommended for use by many Christian and non-Christian psychiatrists. They may look a bit strange to you, and you may wonder, “Is this not all just psychological mumbo-jumbo?” However, I would like to show you here how each step is grounded in Biblical Christian experience. In Psalm 77 we have a perfect example of Asaph investigating and challenging his thoughts with God’s help, in order to raise his mood and spirits. There are also slightly more abbreviated versions of the same biblical strategy in Psalm 42, Psalm 73, Job 19, Habakkuk 3, etc. So, this is not “psychological mumbo-jumbo”, but true Bible-based Christian experience. Let us look at Psalm 77 to prove this.
Download the following file :
To be continued ….
My Coping Strategies:
4a. ExerciseCorrecting faulty thoughts patterns