One of Two Books I've Read on Depression: Speaking of Sadness


Over the last year or more I’ve read a number of books on or about depression in different ways. When I could concentrate enough to read. Two books I read early on I’ve mean to write about for some time. Here is the first one. The second will follow:

Speaking of Sadness
By David A. Karp

Karp is a sociology professor at Boston College. He is not a Christian (neither is the other writer). However, Dr. Karp’s book is profound. He has suffered from depression himself, and so the book is part auto-biographical, part sociology, and part explanation of what is happening to you and how others around you are reacting to it.

Some of the topics he discusses are disconnection, illness as identity, medication, coping, family, and depression’s impact on our society. It was probably the sections on disconnection and illness as identity that were the most useful to me. Depression forces one to withdraw into yourself. You shrink, so that you feel like you are in a deep dark hole and can only barely see out at all. Friends fall by the wayside, family even. Many a divorce has had depression as one of the chief causes. So to understand how and why this disconnection is happening is quite important.

Perhaps equally important is the concept of illness as identity. I remember having a conversation with my wife’s brother once. He said that he hated being called a diabetic. He had diabetes. In his mind, the illness did not define him, and so he wanted to create separation between himself and the illness. That can be done with physical diseases and illnesses to some degree. No one says “I am a flu-er”, you say you have the flu. Even this has it’s limits. Paraplegic. Diabetic. These are but a couple examples of where the illness is incorporated socially into the identity of a person.

But with mental illness it is different. Because depression and mental illness are so invasive, because we can’t seem to separate our minds from ourselves, depression quickly gloms itself on to the identity. You are marked as unclean or not quite right in the head. There is a social stigma that goes along with depression. Are you trustworthy, or will you just crash? Jobs, family, church, all of these areas an more can make depression become a part of you. I am surprised that no one has coined a term like “I am a depressionic” or something to that effect. Karp addresses this phenomenon with a great deal of insight.

Now where is the Gospel in a secular book like this? There isn’t any, directly. He goes through the journey down into the valley and back up again. It is descriptive, with many helpful insights along the way. I would highly recommend this book, for example, to anyone suffering from depression and especially to their family. It is very good for understanding this. What he doesn’t do (and I have yet to find) is a real treatment of the relationship between mental illness and faith. How is it that I can cry, “I trust when dark my road” and yet mentally not believe there is a future for me? Is the mind the sole place for faith, so that if my mind isn’t right, it must mean my faith isn’t right?

God forbid. Faith is a gift, not an achievement. It is a gift that God continues to give, no matter how difficult the circumstances. In fact, the harder it is, the sweeter God’s gift will become. Even if you don’t feel it. Even if you can’t see past the next fifteen minutes. That doesn’t mean God abandons you. It means that he is hidden for a time so that He may reveal Himself more fully to us at the proper time. There is hope. There is a future. There is a Messiah who comes.

-DMR

One of Two Books I've Read on Depression: Speaking of Sadness


Over the last year or more I’ve read a number of books on or about depression in different ways. When I could concentrate enough to read. Two books I read early on I’ve mean to write about for some time. Here is the first one. The second will follow:

Speaking of Sadness
By David A. Karp

Karp is a sociology professor at Boston College. He is not a Christian (neither is the other writer). However, Dr. Karp’s book is profound. He has suffered from depression himself, and so the book is part auto-biographical, part sociology, and part explanation of what is happening to you and how others around you are reacting to it.

Some of the topics he discusses are disconnection, illness as identity, medication, coping, family, and depression’s impact on our society. It was probably the sections on disconnection and illness as identity that were the most useful to me. Depression forces one to withdraw into yourself. You shrink, so that you feel like you are in a deep dark hole and can only barely see out at all. Friends fall by the wayside, family even. Many a divorce has had depression as one of the chief causes. So to understand how and why this disconnection is happening is quite important.

Perhaps equally important is the concept of illness as identity. I remember having a conversation with my wife’s brother once. He said that he hated being called a diabetic. He had diabetes. In his mind, the illness did not define him, and so he wanted to create separation between himself and the illness. That can be done with physical diseases and illnesses to some degree. No one says “I am a flu-er”, you say you have the flu. Even this has it’s limits. Paraplegic. Diabetic. These are but a couple examples of where the illness is incorporated socially into the identity of a person.

But with mental illness it is different. Because depression and mental illness are so invasive, because we can’t seem to separate our minds from ourselves, depression quickly gloms itself on to the identity. You are marked as unclean or not quite right in the head. There is a social stigma that goes along with depression. Are you trustworthy, or will you just crash? Jobs, family, church, all of these areas an more can make depression become a part of you. I am surprised that no one has coined a term like “I am a depressionic” or something to that effect. Karp addresses this phenomenon with a great deal of insight.

Now where is the Gospel in a secular book like this? There isn’t any, directly. He goes through the journey down into the valley and back up again. It is descriptive, with many helpful insights along the way. I would highly recommend this book, for example, to anyone suffering from depression and especially to their family. It is very good for understanding this. What he doesn’t do (and I have yet to find) is a real treatment of the relationship between mental illness and faith. How is it that I can cry, “I trust when dark my road” and yet mentally not believe there is a future for me? Is the mind the sole place for faith, so that if my mind isn’t right, it must mean my faith isn’t right?

God forbid. Faith is a gift, not an achievement. It is a gift that God continues to give, no matter how difficult the circumstances. In fact, the harder it is, the sweeter God’s gift will become. Even if you don’t feel it. Even if you can’t see past the next fifteen minutes. That doesn’t mean God abandons you. It means that he is hidden for a time so that He may reveal Himself more fully to us at the proper time. There is hope. There is a future. There is a Messiah who comes.

-DMR

Going bananas over cognitive reframing

For as he thinks in his heart, so is he. -Proverbs 23:7


cognitive therapy
n.

A form of psychotherapy using imagery, self-instruction, and related techniques to alter distorted attitudes and perceptions.

Cognitive reframing is a type of cognitive therapy where the basic premise is this: as you think about yourself, so you are. So the question basically is this: can you rethink how you view your world, and particularly the stressors or other events in your life so that you can handle them?

First the theological question. How does this jive with a biblical view of original sin? The problem with most psychological theories is that they begin with the false premise that man is either inherently good or morally neutral. This is why psychotherapy methods based on the works of Jung or Freud are inherently suspiscious, if not flawed from the start. Neither of these jive with a biblical view of human nature.

Cognitive reframing, however, works not with underlying questions or good and evil, but with the question of behavior. When certain events occur in your life, it has a physiological and psychological effect upon you. The high from a great run. The low from getting fired. A family meal. A friend or family member dying, or even simply moving away. Sex. All of these and more clearly have both mental and physical aspects to them.

That really is at the foundation of understanding many aspects of depression. Depression is a mental illness that has physical manifestations. Furthermore, one suffering from depression can have “trigger” events that will send them into a mental and physical tailspin. Stress. Family. Work. A combination. Particular parts of work or family life. You get the idea.

The premise behind cognitive reframing is how we view these events mentally will shape our mental outlook as well as our physical outlook to things. No, this is not some Zig Zigler type motivational nonsense (you may see Little Miss Sunshine for a great parody on that). What cognitive reframing teaches us is that we can change our mental outlook on things, just as a good counselor or psychologist can.

My counselor tells me that they could raise my body temperature by several degrees just by talking to me about heat in great detail. If this is true, is it so hard to believe that we can reframe how we look at things?

For me, we’re talking about stress. Stress triggers a mental and physical overload, so that I cannot function. I may know at some level that I’ll be fine, I’ll handle it, and that there is a future. But my mind and my body is telling me otherwise. My brain gets foggy. I can’t think. I can hardly move or listen. In really bad cases, it probably isn’t safe for me to drive.

But what if I can think of these trigger events differently? What if instead of looking at them as “stressful” I look at them as “pickles” or “opportunities” or “bananas”? Crazy? Maybe. But try it. Consistenly try it. It works.

Think through the events that drag you down, that make you crazy, that turn you into that zomebie or down that deep, dark hole. Come up with a word for those events that are absurd. Take the fear out of them, and with it, you will find that over time, events that terrified you or filled you with dread will come back to the realm of normalcy, or at least a whole lot closer.

Here is one link to cognitive reframing I found interesting. There are others I’m sure.

-DMR

Going bananas over cognitive reframing

For as he thinks in his heart, so is he. -Proverbs 23:7


cognitive therapy
n.

A form of psychotherapy using imagery, self-instruction, and related techniques to alter distorted attitudes and perceptions.

Cognitive reframing is a type of cognitive therapy where the basic premise is this: as you think about yourself, so you are. So the question basically is this: can you rethink how you view your world, and particularly the stressors or other events in your life so that you can handle them?

First the theological question. How does this jive with a biblical view of original sin? The problem with most psychological theories is that they begin with the false premise that man is either inherently good or morally neutral. This is why psychotherapy methods based on the works of Jung or Freud are inherently suspiscious, if not flawed from the start. Neither of these jive with a biblical view of human nature.

Cognitive reframing, however, works not with underlying questions or good and evil, but with the question of behavior. When certain events occur in your life, it has a physiological and psychological effect upon you. The high from a great run. The low from getting fired. A family meal. A friend or family member dying, or even simply moving away. Sex. All of these and more clearly have both mental and physical aspects to them.

That really is at the foundation of understanding many aspects of depression. Depression is a mental illness that has physical manifestations. Furthermore, one suffering from depression can have “trigger” events that will send them into a mental and physical tailspin. Stress. Family. Work. A combination. Particular parts of work or family life. You get the idea.

The premise behind cognitive reframing is how we view these events mentally will shape our mental outlook as well as our physical outlook to things. No, this is not some Zig Zigler type motivational nonsense (you may see Little Miss Sunshine for a great parody on that). What cognitive reframing teaches us is that we can change our mental outlook on things, just as a good counselor or psychologist can.

My counselor tells me that they could raise my body temperature by several degrees just by talking to me about heat in great detail. If this is true, is it so hard to believe that we can reframe how we look at things?

For me, we’re talking about stress. Stress triggers a mental and physical overload, so that I cannot function. I may know at some level that I’ll be fine, I’ll handle it, and that there is a future. But my mind and my body is telling me otherwise. My brain gets foggy. I can’t think. I can hardly move or listen. In really bad cases, it probably isn’t safe for me to drive.

But what if I can think of these trigger events differently? What if instead of looking at them as “stressful” I look at them as “pickles” or “opportunities” or “bananas”? Crazy? Maybe. But try it. Consistenly try it. It works.

Think through the events that drag you down, that make you crazy, that turn you into that zomebie or down that deep, dark hole. Come up with a word for those events that are absurd. Take the fear out of them, and with it, you will find that over time, events that terrified you or filled you with dread will come back to the realm of normalcy, or at least a whole lot closer.

Here is one link to cognitive reframing I found interesting. There are others I’m sure.

-DMR

Mental Health and Disability 105: The Reentry Plan


Once you have gotten your medication under control, the disability people to believe that you and your doctor actually want you to get back to work, then at some point down the road (weeks, probably months) you will start to be ready to come back to earth.

This presents its own sets of challenges. If you are at the beginning of the journey, it may be hard to fathom being at this point, so I’ll try to describe it a bit. Any or all of these may apply. You are

  • Bored with sitting around the house all day.
  • Anxious to get moving, even if it is just a little.
  • Start to feel jealous of other people being in your pulpit, and taking care of other pastoral duties for you.
  • Longing for normalcy in a much more concrete way before. You can remember what it was really like.
  • Not despairing over every event that takes place. You can start to do tasks, face responsibilities, and do some of those things you enjoyed before depression.

These are just a few. I’m sure a dozen more clinical answers could be provided. Here are a few things to consider on the way:

  • DON’T GO TOO FAST. After two false starts at returning to work, I know of what I speak. Trust your doctor and your therapist. I’m not sure if you could move back too slowly. This is hard. Really hard. At least for me. My therapist, in their lovely non-directive sort of fashion, has had to head me off at the pass many many times.
  • Trust your instincts. Now that is a very un-Lutheran thing to say, but in this case, it really is true. If you feel like you’re getting overwhelmed or that you are about to turn into a zombie (so to speak), you probably will. So stop before you get there.
  • Start with easy things before the tough stuff. This too may appear obvious, but it is critical. Start with the easiest things for you, things that will give you satisfaction and confidence in who you are and what your Office is as pastor of the flock. For me, that means starting with doing the liturgy. It is the most natural thing for me, like breathing. After that comes Bible Class and Preaching. Those two are more exhausting, because they require more creativity, but on the other hand they are very satisfying, and they are two things I do pretty well (at least according to others). The hardest things for me parish wise are still making calls, conflict, and sort of general socializing. Those will come last, I expect.
  • Focus on what is good and right, and recognize that the bad hours or days will pass. At the risk of misuing St. Paul, he speaks of this in Philippians four. I know how hard this is. It is a habitus of prayer and being soaked in the Word. But by the mercy of God, it will come in time.

That is what’s on my mind. What’s on yours?

-DMR

Mental Health and Disability 105: The Reentry Plan


Once you have gotten your medication under control, the disability people to believe that you and your doctor actually want you to get back to work, then at some point down the road (weeks, probably months) you will start to be ready to come back to earth.

This presents its own sets of challenges. If you are at the beginning of the journey, it may be hard to fathom being at this point, so I’ll try to describe it a bit. Any or all of these may apply. You are

  • Bored with sitting around the house all day.
  • Anxious to get moving, even if it is just a little.
  • Start to feel jealous of other people being in your pulpit, and taking care of other pastoral duties for you.
  • Longing for normalcy in a much more concrete way before. You can remember what it was really like.
  • Not despairing over every event that takes place. You can start to do tasks, face responsibilities, and do some of those things you enjoyed before depression.

These are just a few. I’m sure a dozen more clinical answers could be provided. Here are a few things to consider on the way:

  • DON’T GO TOO FAST. After two false starts at returning to work, I know of what I speak. Trust your doctor and your therapist. I’m not sure if you could move back too slowly. This is hard. Really hard. At least for me. My therapist, in their lovely non-directive sort of fashion, has had to head me off at the pass many many times.
  • Trust your instincts. Now that is a very un-Lutheran thing to say, but in this case, it really is true. If you feel like you’re getting overwhelmed or that you are about to turn into a zombie (so to speak), you probably will. So stop before you get there.
  • Start with easy things before the tough stuff. This too may appear obvious, but it is critical. Start with the easiest things for you, things that will give you satisfaction and confidence in who you are and what your Office is as pastor of the flock. For me, that means starting with doing the liturgy. It is the most natural thing for me, like breathing. After that comes Bible Class and Preaching. Those two are more exhausting, because they require more creativity, but on the other hand they are very satisfying, and they are two things I do pretty well (at least according to others). The hardest things for me parish wise are still making calls, conflict, and sort of general socializing. Those will come last, I expect.
  • Focus on what is good and right, and recognize that the bad hours or days will pass. At the risk of misuing St. Paul, he speaks of this in Philippians four. I know how hard this is. It is a habitus of prayer and being soaked in the Word. But by the mercy of God, it will come in time.

That is what’s on my mind. What’s on yours?

-DMR

On Chase, Preaching and Other Signs of Light

As I continue on the road to recovery, there have been a couple bright spots that I thought would be worth mentioning here. You never can tell what is really going to be important to you somehow.

Chase
For my children, the mark of my illness and recovery is very simple. Chase. If I can play chase, I must be getting better. If I can’t play chase, then I’m still sick in the head (or something to that effect). Because right now the hardest thing for me to handle is my children, chase sort of represents a reentry into my family’s regular life schedule.

Chase is hard. I know, I know. It’s just running around like a crazy person with a few kids. But for the person suffering from depression, that kind of unwanton abandon, noise, suddon movement and general insanity is way outside of the normal comfort zone. It requires energy, excitement, the ability to say BOO at just the right time, etc.

In other words, just about everything that is difficult, all wrapped up in something that is so easy that most people do it even without thinking. But that is so often the case with depression. Things that you believe should be easy can become difficult on the way to impossible.

I think I’ve played chase once in the last year. This is down from at least once a day, maybe more. The once was last week. If we can move to once a week, that will be a huge step in the right direction

Preaching and Preparation
I’ve been preaching more and more the last couple months. Right now I’m pretty close to every week. Most of the sermons have been reruns, or last-minute throw together jobs. They were not my best were, or if they were, they were my best work from 2-5 years ago.

But last week was the first week that I had “normal” preparation for my sermon. Look at the text early in the week, read patristic and Luther sermons, see if there’s anything worthwhile that’s modern, and then write it down early enough in the week so I have time to edit it. Something like that. This happened last week. I don’t really even know why, it just did. So my Sermon on Sunday was much more relaxed, more “normal” for me. The congregation probably couldn’t tell the difference, but I could. It was a good sign.

Here are some questions for you:
1) What have you found the most difficult thing to come back to doing?
2) What made or is making it the most difficult?
3) What has been the easiest part of your life to return to “normal” and why?
4) What will never be the same?

Food for thought,
-DMR

On Chase, Preaching and Other Signs of Light

As I continue on the road to recovery, there have been a couple bright spots that I thought would be worth mentioning here. You never can tell what is really going to be important to you somehow.

Chase
For my children, the mark of my illness and recovery is very simple. Chase. If I can play chase, I must be getting better. If I can’t play chase, then I’m still sick in the head (or something to that effect). Because right now the hardest thing for me to handle is my children, chase sort of represents a reentry into my family’s regular life schedule.

Chase is hard. I know, I know. It’s just running around like a crazy person with a few kids. But for the person suffering from depression, that kind of unwanton abandon, noise, suddon movement and general insanity is way outside of the normal comfort zone. It requires energy, excitement, the ability to say BOO at just the right time, etc.

In other words, just about everything that is difficult, all wrapped up in something that is so easy that most people do it even without thinking. But that is so often the case with depression. Things that you believe should be easy can become difficult on the way to impossible.

I think I’ve played chase once in the last year. This is down from at least once a day, maybe more. The once was last week. If we can move to once a week, that will be a huge step in the right direction

Preaching and Preparation
I’ve been preaching more and more the last couple months. Right now I’m pretty close to every week. Most of the sermons have been reruns, or last-minute throw together jobs. They were not my best were, or if they were, they were my best work from 2-5 years ago.

But last week was the first week that I had “normal” preparation for my sermon. Look at the text early in the week, read patristic and Luther sermons, see if there’s anything worthwhile that’s modern, and then write it down early enough in the week so I have time to edit it. Something like that. This happened last week. I don’t really even know why, it just did. So my Sermon on Sunday was much more relaxed, more “normal” for me. The congregation probably couldn’t tell the difference, but I could. It was a good sign.

Here are some questions for you:
1) What have you found the most difficult thing to come back to doing?
2) What made or is making it the most difficult?
3) What has been the easiest part of your life to return to “normal” and why?
4) What will never be the same?

Food for thought,
-DMR