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Archive for the ‘mental illness’ Category

How to Stop People Pleasing and Focus on Your Own Goals

SOURCE:  Karl Shallowhorn/bphope

Learning to define and set your own goals can free you from other people’s expectations and allow you to go beyond your previously conceived limitations.

Growing up as a young child my mother used to reinforce the need for me to try to excel at whatever I did. “Even if you’re a ditch digger, be the best ditch digger there is,” she would reiterate. This regular kind of prodding produced a dual-pronged response. At first, I accepted her challenge eagerly, thinking that I did have the ability to be the best at whatever I attempted to do. As I got older I came to realize that being “the best there is” wasn’t always possible (if ever).

Then—at the age of 18—bipolar disorder hit. I went from a promising future to one that was very unclear in a matter of weeks. At that point, my hopes and dreams were dashed against the rocks. I was being told what I needed to do just to get better. Essentially, I was powerless.

This whole experience was difficult for my mom. She had such high hopes for me and seeing her only child dealing with such a disabling disease hurt her dramatically. Eventually, she could no longer bear seeing me in the hospital. It was just too much for her.

However, there were times early in my life with bipolar disorder that I had brief periods of remission when I was able to continue school and eventually earn my Bachelor’s Degree. I vividly recall my mom’s mantra during this time, “Either you go to school or get a job. But you’re not going to lay around the house on me!”

Say what you want about this, but it worked, and sometimes too much. During those years of transition, I struggled to meet the expectations of others—not only my mother but also family, school faculty, and even my therapeutic team.

It got to the point that I was trying to please others and failing to take into account my own aspirations (and limitations). I was still healing during this period and I felt the pressure to have to perform in some way or manner to satisfy others.

There were many times during this period that the stress of having to live up to the expectations of others caused me to seriously question what I was capable of. What I came to learn, the hard way was to set goals for myself. In traditional mental health therapy, treatment plans are often utilized for this purpose.

One way I learned later was to approach this using the SMART method of goal setting:

  • Specific
  • Measurable
  • Achievable
  • Reasonable
  • Timely

Setting SMART goals are great because they:

  1. Help one to be more objective
  2. Quantify what the goal is
  3. Allow for the individual to set a goal which requires effort and challenges one to go beyond their comfort zone
  4. Set a distinct time-frame in which to accomplish the goal

So what does this all have to do with expectations? By being clear on what my personal goals are I then have the capacity to understand the difference between what I want to accomplish versus what others want.

In recovery, I’ve strived to go beyond my previously conceived limitations. These are things that I want to do and not what others want me to do. This is the whole idea behind self-determination. I’m the one in the driver’s seat. It’s empowering to realize that I don’t have to live up to anyone else’s standards. Mind you, I work, have a family, and take on other responsibilities. I’m not saying that I just settle for what I need to do to just get by. Actually, it’s the opposite. I like to go a little bit further in what I try to achieve in life. Some would say that this means I’m goal driven—and yes I am. But these are my goals—not someone else’s.

If you find yourself questioning your ability to succeed in recovery, break your goals into small parts. Remember you don’t have to do it all at once. Even achieving small goals can be a huge victory.

Marijuana, Mental Illness, and Violence

SOURCE:  Alex Berenson/Imprimis

The following is adapted from a speech delivered on January 15, 2019, at Hillsdale College’s Allan P. Kirby, Jr. Center for Constitutional Studies and Citizenship in Washington, D.C.

~~~~~~~~~~~~~~~~~~~~~~~

Seventy miles northwest of New York City is a hospital that looks like a prison, its drab brick buildings wrapped in layers of fencing and barbed wire. This grim facility is called the Mid-Hudson Forensic Psychiatric Institute. It’s one of three places the state of New York sends the criminally mentally ill—defendants judged not guilty by reason of insanity.

Until recently, my wife Jackie­—Dr. Jacqueline Berenson—was a senior psychiatrist there. Many of Mid-Hudson’s 300 patients are killers and arsonists. At least one is a cannibal. Most have been diagnosed with psychotic disorders like schizophrenia that provoked them to violence against family members or strangers.

A couple of years ago, Jackie was telling me about a patient. In passing, she said something like, Of course, he’d been smoking pot his whole life.

Of course? I said.

Yes, they all smoke.

So marijuana causes schizophrenia?

I was surprised, to say the least. I tended to be a libertarian on drugs. Years before, I’d covered the pharmaceutical industry for The New York Times. I was aware of the claims about marijuana as medicine, and I’d watched the slow spread of legalized cannabis without much interest.

Jackie would have been within her rights to say, I know what I’m talking about, unlike you. Instead, she offered something neutral like, I think that’s what the big studies say. You should read them.

So I did. The big studies, the little ones, and all the rest. I read everything I could find. I talked to every psychiatrist and brain scientist who would talk to me. And I soon realized that in all my years as a journalist I had never seen a story where the gap between insider and outsider knowledge was so great, or the stakes so high.

I began to wonder why—with the stocks of cannabis companies soaring and politicians promoting legalization as a low-risk way to raise tax revenue and reduce crime—I had never heard the truth about marijuana, mental illness, and violence.

***

Over the last 30 years, psychiatrists and epidemiologists have turned speculation about marijuana’s dangers into science. Yet over the same period, a shrewd and expensive lobbying campaign has pushed public attitudes about marijuana the other way. And the effects are now becoming apparent.

Almost everything you think you know about the health effects of cannabis, almost everything advocates and the media have told you for a generation, is wrong.

They’ve told you marijuana has many different medical uses. In reality marijuana and THC, its active ingredient, have been shown to work only in a few narrow conditions. They are most commonly prescribed for pain relief. But they are rarely tested against other pain relief drugs like ibuprofen—and in July, a large four-year study of patients with chronic pain in Australia showed cannabis use was associated with greater pain over time.

They’ve told you cannabis can stem opioid use—“Two new studies show how marijuana can help fight the opioid epidemic,” according to Wonkblog, a Washington Post website, in April 2018— and that marijuana’s effects as a painkiller make it a potential substitute for opiates. In reality, like alcohol, marijuana is too weak as a painkiller to work for most people who truly need opiates, such as terminal cancer patients. Even cannabis advocates, like Rob Kampia, the co-founder of the Marijuana Policy Project, acknowledge that they have always viewed medical marijuana laws primarily as a way to protect recreational users.

As for the marijuana-reduces-opiate-use theory, it is based largely on a single paper comparing overdose deaths by state before 2010 to the spread of medical marijuana laws— and the paper’s finding is probably a result of simple geographic coincidence. The opiate epidemic began in Appalachia, while the first states to legalize medical marijuana were in the West. Since 2010, as both the epidemic and medical marijuana laws have spread nationally, the finding has vanished. And the United States, the Western country with the most cannabis use, also has by far the worst problem with opioids.

Research on individual users—a better way to trace cause and effect than looking at aggregate state-level data—consistently shows that marijuana use leads to other drug use. For example, a January 2018 paper in the American Journal of Psychiatry showed that people who used cannabis in 2001 were almost three times as likely to use opiates three years later, even after adjusting for other potential risks.

Most of all, advocates have told you that marijuana is not just safe for people with psychiatric problems like depression, but that it is a potential treatment for those patients. On its website, the cannabis delivery service Eaze offers the “Best Marijuana Strains and Products for Treating Anxiety.” “How Does Cannabis Help Depression?” is the topic of an article on Leafly, the largest cannabis website. But a mountain of peer-reviewed research in top medical journals shows that marijuana can cause or worsen severe mental illness, especially psychosis, the medical term for a break from reality. Teenagers who smoke marijuana regularly are about three times as likely to develop schizophrenia, the most devastating psychotic disorder.

After an exhaustive review, the National Academy of Medicine found in 2017 that “cannabis use is likely to increase the risk of developing schizophrenia and other psychoses; the higher the use, the greater the risk.” Also that “regular cannabis use is likely to increase the risk for developing social anxiety disorder.”

***

Over the past decade, as legalization has spread, patterns of marijuana use—and the drug itself—have changed in dangerous ways.

Legalization has not led to a huge increase in people using the drug casually. About 15 percent of Americans used cannabis at least once in 2017, up from ten percent in 2006, according to a large federal study called the National Survey on Drug Use and Health. (By contrast, about 65 percent of Americans had a drink in the last year.) But the number of Americans who use cannabis heavily is soaring. In 2006, about three million Americans reported using cannabis at least 300 times a year, the standard for daily use. By 2017, that number had nearly tripled, to eight million, approaching the twelve million Americans who drank alcohol every day. Put another way, one in 15 drinkers consumed alcohol daily; about one in five marijuana users used cannabis that often.

Cannabis users today are also consuming a drug that is far more potent than ever before, as measured by the amount of THC—delta-9-tetrahydrocannabinol, the chemical in cannabis responsible for its psychoactive effects—it contains. In the 1970s, the last time this many Americans used cannabis, most marijuana contained less than two percent THC. Today, marijuana routinely contains 20 to 25 percent THC, thanks to sophisticated farming and cloning techniques—as well as to a demand by users for cannabis that produces a stronger high more quickly. In states where cannabis is legal, many users prefer extracts that are nearly pure THC. Think of the difference between near-beer and a martini, or even grain alcohol, to understand the difference.

These new patterns of use have caused problems with the drug to soar. In 2014, people who had diagnosable cannabis use disorder, the medical term for marijuana abuse or addiction, made up about 1.5 percent of Americans. But they accounted for eleven percent of all the psychosis cases in emergency rooms—90,000 cases, 250 a day, triple the number in 2006. In states like Colorado, emergency room physicians have become experts on dealing with cannabis-induced psychosis.

Cannabis advocates often argue that the drug can’t be as neurotoxic as studies suggest, because otherwise Western countries would have seen population-wide increases in psychosis alongside rising use. In reality, accurately tracking psychosis cases is impossible in the United States. The government carefully tracks diseases like cancer with central registries, but no such registry exists for schizophrenia or other severe mental illnesses.

On the other hand, research from Finland and Denmark, two countries that track mental illness more comprehensively, shows a significant increase in psychosis since 2000, following an increase in cannabis use. And in September of last year, a large federal survey found a rise in serious mental illness in the United States as well, especially among young adults, the heaviest users of cannabis.

According to this latter study, 7.5 percent of adults age 18-25 met the criteria for serious mental illness in 2017, double the rate in 2008. What’s especially striking is that adolescents age 12-17 don’t show these increases in cannabis use and severe mental illness.

A caveat: this federal survey doesn’t count individual cases, and it lumps psychosis with other severe mental illness. So it isn’t as accurate as the Finnish or Danish studies. Nor do any of these studies prove that rising cannabis use has caused population-wide increases in psychosis or other mental illness. The most that can be said is that they offer intriguing evidence of a link.

Advocates for people with mental illness do not like discussing the link between schizophrenia and crime. They fear it will stigmatize people with the disease. “Most people with mental illness are not violent,” the National Alliance on Mental Illness (NAMI) explains on its website. But wishing away the link can’t make it disappear. In truth, psychosis is a shockingly high-risk factor for violence. The best analysis came in a 2009 paper in PLOS Medicine by Dr. Seena Fazel, an Oxford University psychiatrist and epidemiologist. Drawing on earlier studies, the paper found that people with schizophrenia are five times as likely to commit violent crimes as healthy people, and almost 20 times as likely to commit homicide.

NAMI’s statement that most people with mental illness are not violent is, of course, accurate, given that “most” simply means “more than half”; but it is deeply misleading. Schizophrenia is rare. But people with the disorder commit an appreciable fraction of all murders, in the range of six to nine percent.

“The best way to deal with the stigma is to reduce the violence,” says Dr. Sheilagh Hodgins, a professor at the University of Montreal who has studied mental illness and violence for more than 30 years.

The marijuana-psychosis-violence connection is even stronger than those figures suggest. People with schizophrenia are only moderately more likely to become violent than healthy people when they are taking antipsychotic medicine and avoiding recreational drugs. But when they use drugs, their risk of violence skyrockets. “You don’t just have an increased risk of one thing—these things occur in clusters,” Dr. Fazel told me.

Along with alcohol, the drug that psychotic patients use more than any other is cannabis: a 2010 review of earlier studies in Schizophrenia Bulletin found that 27 percent of people with schizophrenia had been diagnosed with cannabis use disorder in their lives. And unfortunately—despite its reputation for making users relaxed and calm—cannabis appears to provoke many of them to violence.

A Swiss study of 265 psychotic patients published in Frontiers of Forensic Psychiatry last June found that over a three-year period, young men with psychosis who used cannabis had a 50 percent chance of becoming violent. That risk was four times higher than for those with psychosis who didn’t use, even after adjusting for factors such as alcohol use. Other researchers have produced similar findings. A 2013 paper in an Italian psychiatric journal examined almost 1,600 psychiatric patients in southern Italy and found that cannabis use was associated with a ten-fold increase in violence.

The most obvious way that cannabis fuels violence in psychotic people is through its tendency to cause paranoia—something even cannabis advocates acknowledge the drug can cause. The risk is so obvious that users joke about it and dispensaries advertise certain strains as less likely to induce paranoia. And for people with psychotic disorders, paranoia can fuel extreme violence. A 2007 paper in the Medical Journal of Australia on 88 defendants who had committed homicide during psychotic episodes found that most believed they were in danger from the victim, and almost two-thirds reported misusing cannabis—more than alcohol and amphetamines combined.

Yet the link between marijuana and violence doesn’t appear limited to people with preexisting psychosis. Researchers have studied alcohol and violence for generations, proving that alcohol is a risk factor for domestic abuse, assault, and even murder. Far less work has been done on marijuana, in part because advocates have stigmatized anyone who raises the issue. But studies showing that marijuana use is a significant risk factor for violence have quietly piled up. Many of them weren’t even designed to catch the link, but they did. Dozens of such studies exist, covering everything from bullying by high school students to fighting among vacationers in Spain.

In most cases, studies find that the risk is at least as significant as with alcohol. A 2012 paper in the Journal of Interpersonal Violence examined a federal survey of more than 9,000 adolescents and found that marijuana use was associated with a doubling of domestic violence; a 2017 paper in Social Psychiatry and Psychiatric Epidemiology examined drivers of violence among 6,000 British and Chinese men and found that drug use—the drug nearly always being cannabis—translated into a five-fold increase in violence.

Today that risk is translating into real-world impacts. Before states legalized recreational cannabis, advocates said that legalization would let police focus on hardened criminals rather than marijuana smokers and thus reduce violent crime. Some advocates go so far as to claim that legalization has reduced violent crime. In a 2017 speech calling for federal legalization, U.S. Senator Cory Booker said that “states [that have legalized marijuana] are seeing decreases in violent crime.” He was wrong.

The first four states to legalize marijuana for recreational use were Colorado and Washington in 2014 and Alaska and Oregon in 2015. Combined, those four states had about 450 murders and 30,300 aggravated assaults in 2013. Last year, they had almost 620 murders and 38,000 aggravated assaults—an increase of 37 percent for murders and 25 percent for aggravated assaults, far greater than the national increase, even after accounting for differences in population growth.

Knowing exactly how much of the increase is related to cannabis is impossible without researching every crime. But police reports, news stories, and arrest warrants suggest a close link in many cases. For example, last September, police in Longmont, Colorado, arrested Daniel Lopez for stabbing his brother Thomas to death as a neighbor watched. Daniel Lopez had been diagnosed with schizophrenia and was “self-medicating” with marijuana, according to an arrest affidavit.

In every state, not just those where marijuana is legal, cases like Lopez’s are far more common than either cannabis or mental illness advocates acknowledge. Cannabis is also associated with a disturbing number of child deaths from abuse and neglect—many more than alcohol, and more than cocaine, methamphetamines, and opioids combined—according to reports from Texas, one of the few states to provide detailed information on drug use by perpetrators.

These crimes rarely receive more than local attention. Psychosis-induced violence takes particularly ugly forms and is frequently directed at helpless family members. The elite national media prefers to ignore the crimes as tabloid fodder. Even police departments, which see this violence up close, have been slow to recognize the trend, in part because the epidemic of opioid overdose deaths has overwhelmed them.

So the black tide of psychosis and the red tide of violence are rising steadily, almost unnoticed, on a slow green wave.

***

For centuries, people worldwide have understood that cannabis causes mental illness and violence—just as they’ve known that opiates cause addiction and overdose. Hard data on the relationship between marijuana and madness dates back 150 years, to British asylum registers in India. Yet 20 years ago, the United States moved to encourage wider use of cannabis and opiates.

In both cases, we decided we could outsmart these drugs—that we could have their benefits without their costs. And in both cases we were wrong. Opiates are riskier, and the overdose deaths they cause a more imminent crisis, so we have focused on those. But soon enough the mental illness and violence that follow cannabis use will also be too widespread to ignore.

Whether to use cannabis, or any drug, is a personal decision. Whether cannabis should be legal is a political issue. But its precise legal status is far less important than making sure that anyone who uses it is aware of its risks. Most cigarette smokers don’t die of lung cancer. But we have made it widely known that cigarettes cause cancer, full stop. Most people who drink and drive don’t have fatal accidents. But we have highlighted the cases of those who do.

We need equally unambiguous and well-funded advertising campaigns on the risks of cannabis. Instead, we are now in the worst of all worlds. Marijuana is legal in some states, illegal in others, dangerously potent, and sold without warnings everywhere.

But before we can do anything, we—especially cannabis advocates and those in the elite media who have for too long credulously accepted their claims—need to come to terms with the truth about the science on marijuana. That adjustment may be painful. But the alternative is far worse, as the patients at Mid-Hudson Forensic Psychiatric Institute—and their victims—know.

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Alex Berenson
Author, Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence

8 Things People with High-Functioning Depression Want You to Know

SOURCE:  Meagan Drillinger/healthline.com

Even though it might not be obvious, getting through the day is exhausting.

It can be difficult to spot the signs of someone with high-functioning depression. That’s because, on the outside, they often appear completely fine. They go to work, accomplish their tasks, and keep up relationships. And as they’re going through the motions to maintain their day-to-day life, inside they’re screaming.

“Everyone talks about depression and anxiety, and it means different things to different people,” says Dr. Carol A. Bernstein, professor of psychiatry and neurology at NYU Langone Health.

“High-functioning depression isn’t a diagnostic category from a medical standpoint. People can feel depressed, but the question with depression is for how long, and how much does it interfere with our capacity to go on with [our] life?”

There’s no difference between depression and high-functioning depression. Depression ranges from mild to moderate to severe. In 2016, about 16.2 million Americans had at least one episode of major depression.

“Some people with depression can’t go to work or school, or their performance suffers significantly because of it,” says Ashley C. Smith, a licensed clinical social worker. “That’s not the case for people with high-functioning depression. They can still function in life, for the most part.”

But being able to get through the day doesn’t mean it’s easy. Here are what seven people had to say about what it’s like to live and work with high-functioning depression.

1. You feel like you’re constantly “faking it”

“We hear a lot now about imposter syndrome, where people feel that they are just ‘faking it’ and aren’t as together as people think. There’s a form of this for those who deal with major depression and other forms of mental illness. You become quite adept at ‘playing yourself,’ acting the role of the self that people around you expect to see and experience.”

— Daniel, publicist, Maryland

2. You have to prove that you’re struggling and need help

“Living with high-functioning depression is very hard. Even though you can go through work and life and mostly get things done, you’re not getting them done to your full potential.

“Beyond that, no one really believes you’re struggling because your life isn’t falling apart yet. I was suicidal and close to ending it all in university and no one would believe me because I wasn’t failing out of school or dressing like a complete mess. At work, it’s the same. We need to believe people when they ask for support.

“Lastly, a lot of mental health services have needs-based requirements, where you have to appear a certain amount of depressed to get support. Even if my mood is really low and I am constantly considering suicide, I have to lie about my functioning to be able to access services.”

— Alicia, mental health speaker/writer, Toronto

3. The good days are relatively “normal”

“A good day is me being able to get up before or right at my alarm, shower, and put on my face. I can push through being around people, as my job as a software trainer calls me to. I’m not crabby or anxiety-ridden. I can push through the evening and have conversations with co-workers without feeling total despair. On a good day, I have focus and mental clarity. I feel like a capable, productive person.”

— Christian, software trainer, Dallas

4. But the bad days are unbearable

“Now for a bad day… I fight with myself to wake up and have to truly shame myself into showering and getting myself together. I put on makeup [so I don’t] alert people about my internal issues. I don’t want to talk or be bothered by anyone. I fake being personable, as I have rent to pay and don’t want to complicate my life any more than it is.

“After work, I just want to go to my hotel room and mindlessly scroll on Instagram or YouTube. I’ll eat junk food, and feel like a loser and demean myself.

“I have more bad days than good, but I’ve gotten good at faking it so my clients think I’m a great employee. I’m often sent kudos for my performance. But inside, I know that I didn’t deliver at the level I know I could.”

— Christian

5. Getting through the bad days requires an enormous amount of energy

“It’s extremely exhausting to get through a bad day. I do get work done, but it’s not my best. It takes much longer to accomplish tasks. There’s a lot of staring off into space, trying to regain control of my mind.

“I find myself getting easily frustrated with my co-workers, even though I know there’s no way they know I’m having a hard day. On bad days, I’m extremely self-critical and tend to not want to show my boss any of my work because I fear that he’ll think that I’m incompetent.

“One of the most helpful things I do on bad days is to prioritize my tasks. I know the harder I push myself, the more likely I am to crumble, so I make sure I do the harder things when I have the most energy.”

— Courtney, marketing specialist, North Carolina

6. You can struggle to focus, and feel like you’re not performing to the best of your ability

“Sometimes, nothing gets done. I can be in a long drawn out daze all day, or it takes all day to complete a few things. Since I’m in public relations and I work with individuals and companies that champion a great cause, which often pull at people’s heartstrings, my work can take me into an even deeper depression.

“I can be working on a story, and while I’m typing I have tears streaming down my face. That may actually work to the advantage of my client because I have so much heart and passion around meaningful stories, but it’s pretty scary because the emotions run so deep.

— Tonya, publicist, California

7. Living with high-functioning depression is exhausting

“In my experience, living with high-functioning depression is absolutely exhausting. It’s spending the day smiling and forcing laughter when you are plagued by the feeling that the people you interact with only just tolerate you and your existence in the world.

“It’s knowing that you’re useless and a waste of oxygen… and doing everything in your power to prove that wrong by being the best student, best daughter, best employee you can be. It’s going above and beyond all day every day in the hopes that you can actually make someone feel that you’re worth their time, because you don’t feel like you are.”

— Meaghan, law student, New York

8. Asking for help is the strongest thing you can do

“Asking for help does not make you a weak person. In fact, it makes you the exact opposite. My depression manifested itself through a serious uptake in drinking. So serious, in fact, I spent six weeks in rehab in 2017. I’m just shy of 17 months of sobriety.

“Everyone can have their own opinion, but all three sides of the triangle of my mental health — stopping drinking, talk therapy, and medication — have been crucial. Most specifically, the medication helps me maintain a level state on a daily basis and has been an intricate part of my getting better.”

— Kate, travel agent, New York

“If the depression is greatly impacting your quality of life, if you think that you should be feeling better, then seek out help. See your primary care doctor about it — many are trained in dealing with depression — and seek a referral for a therapist.

“While there’s still considerable stigma attached to having mental illness, I would say that we are starting, slowly, to see that stigma abate. There’s nothing wrong with admitting you have an issue and could use some help.”

— Daniel

Depression: Fighting Dragons

SOURCE:  /Faithgateway

Being the Hunted

What did Jesus call people who were attacked by dragons, regardless of the righteous way they were conducting their lives? Jesus called these people normal. Jesus made a few promises about what would happen to us, regardless of our faith. Here is what Jesus promised those who love Him the most:

In this world you will have trouble. – John 16:33

Jesus didn’t say, “In this world, there is a slight chance that you will go through hard times.” Jesus didn’t say, “If you don’t have enough faith, you will have trouble.” Jesus didn’t say, “If you go to church, stop cussing, don’t drink too much, and always keep your promises, then you won’t have any trouble.” Instead, Jesus said that trouble will hunt you. Period.

If you are alive and breathing, you will have trouble in this world. Either you will hunt the dragon, or the dragon will hunt you. There is no escaping it.

Jesus had every right to make this statement. Jesus believed all the right things, and He had stronger faith and loved God more than you and I will ever be able to. Still, soon after making this statement, Jesus was arrested and nailed to a cross.

Faith, belief, and love do not buffer or barricade your life from trouble and hardship. In fact, sometimes it feels like having faith and doing the right things can attract trouble.

I want to address the dragon that I most often see hunting the people around me: depression. This includes both the deep blues anyone can feel and the diagnosable imbalance that plagues so many. No one asks for this dragon, but he swallows up many people regardless. This dragon is big, heavy, overwhelming, and he has the potential to crush, suffocate, and swallow you up. This dragon doesn’t create bad days or bad weeks. He creates bad childhoods, bad decades, and bad lives. On and on, day after day, year after year, this dragon causes pain with no relief in sight.

Remember that overwhelmingly sad feeling when you learned that someone you loved died? Remember the guilt and embarrassment you felt after your biggest failure was exposed? Remember facing the biggest problem in your life and thinking that it was impossible to fix? Remember that time, as a little kid, when someone held you under the swimming pool too long, and you thought you were going to drown? Roll all of those emotions into one, carry them around with you every day from the time you wake up until the time you fall asleep, and you will begin to understand the dragon of depression.

When you experience the dragon of depression, your entire world is seen only through the lens of sadness, hopelessness, mourning, loss, emptiness, grief, pain, anger, frustration, guilt, and death. Death is always there, looming and lurking: “I can’t live another minute like this. Death has to be better than this. The people around me would be better off if I wasn’t here to hurt them. I can’t do this anymore. This is never going to get any better.”

The dragon of depression is a cyclical prison cell. It’s like a dog chasing its own tail: “I am depressed. Because I’m depressed, I can’t do what I need to do. This makes me feel like a failure. That makes me depressed. Because I’m depressed, I can’t do what I need to do. This makes me feel like a failure. That makes me depressed.”

David, the famous king from the Bible, knew these feelings well:

Have mercy on me, Lord, for I am faint; heal me, Lord, for my bones are in agony. My soul is in deep anguish. How long, Lord, how long? Turn, Lord, and deliver me; save me because of Your unfailing love. Among the dead no one proclaims Your name. Who praises You from the grave? I am worn out from my groaning. All night long I flood my bed with weeping and drench my couch with tears. – Psalm 6:2-6

How long, Lord? Will You forget me forever? How long will You hide Your face from me? How long must I wrestle with my thoughts and day after day have sorrow in my heart? How long will my enemy triumph over me? Look on me and answer, Lord my God. Give light to my eyes, or I will sleep in death. – Psalm 13:1-3

King David wasn’t alone, and you aren’t either. This might surprise some readers, but Jesus understands what depression feels like. In the Garden of Gethsemane, just before Jesus was arrested, He experienced the height of His depression:

Then He said to them, “My soul is overwhelmed with sorrow to the point of death. Stay here and keep watch with Me.” Going a little farther, He fell with His face to the ground and prayed, “My Father, if it is possible, may this cup be taken from Me. Yet not as I will, but as you will.” – Matthew 26:38-39

If you read Hebrews 4:15, it is clear that Jesus had been tempted in every way that we are, yet He walked through those temptations without sinning. But somewhere along the way, it seems some biblical scholar or translator decided “depression” was no longer included in the long list of ways that Jesus was tempted.

In my opinion, it’s tough to read, “My soul is overwhelmed with sorrow to the point of death” without concluding that Jesus was struggling with depression. Jesus essentially said, “I’ve been swallowed up to the core of My being with sorrow. The suffocating weight of My sadness is about to crush My life.” Elsewhere, the Bible says this about Jesus’ time in the garden:

Being in anguish, He prayed more earnestly, and His sweat was like drops of blood falling to the ground. – Luke 22:44

There is a medical condition (hematidrosis) brought on by extreme emotional anguish, strain, and stress during which the capillaries in the skin rupture, allowing blood to flow out of a person’s sweat pores. So for hours, alone in a dark corner of a remote garden, Jesus fell down, curled up on the ground, cried, and prayed so intensely for deliverance from His circumstances that the blood vessels burst inside His skin. You can call it whatever you want, but to me it looks like emotional depression.

Jesus understood, and still understands, depression.

Weeks before Jesus was in the garden, He came face-to-face with everything I’ve just described.

They went across the lake to the region of the Gerasenes. When Jesus got out of the boat, a man with an impure spirit came from the tombs to meet Him. This man lived in the tombs, and no one could bind him any more, not even with a chain. For he had often been chained hand and foot, but he tore the chains apart and broke the irons on his feet. No one was strong enough to subdue him. Night and day among the tombs and in the hills he would cry out and cut himself with stones. – Mark 5:1-5

Depression can be caused by many different things. In this guy’s case, depression was caused by satanic attack or demonic oppression. The man in this story was possessed by many demons. If you’re anything like me, you immediately think of The Exorcist or some sci-fi movie, but the reality is that, all through the Bible, we read descriptions of battles being fought in the spiritual realm. The New Testament teaches that while a Christian cannot be possessed by Satan or one of his demons, he can be oppressed.

Satan continues to wage war against Christians by attacking or tempting us.

Depression can also be caused by guilt. Sometimes the weight of our downfalls and sins can cause us to grieve and mourn to the point of depression. That’s one of the reasons King David was depressed. He had just been convicted of adultery and murder, and his child was about to die. He used phrases like, “My bones wasted away… my strength was sapped… Do not forsake me, my God… My heart has turned to wax… my tongue sticks to the roof of my mouth… Troubles without number surround me” (Psalm 32:3-4Psalm 71:18Psalm 22:14–15Psalm 40:12).

The apostle Peter understood depression after he denied knowing Jesus. After his sin of denying Jesus, Peter wept bitterly (Matthew 26:75). Judas understood depression after he betrayed Jesus to his death. When the weight and guilt of what he had done finally hit him, Judas decided that committing suicide was the only way out of the belly of the dragon in which he found himself swallowed (Matthew 27:1-5).

Depression can also be caused by the difficult circumstances of our lives. Life can get so hard that it makes us depressed, and that’s what Jesus was feeling in the Garden of Gethsemane. He understood why He needed to be sacrificed. He even knew the wonderful outcome that would result from His torture and death. Yet even though Jesus knew that the next few days would ultimately become the most wonderful event ever to occur in the history of the universe, the thought of them still caused Him to collapse to the ground, curl up, and cry until blood seeped from His pores.

Depression can also be the result of a physical illness. Sometimes the circumstances of our bodies can cause us to become depressed. I’m not talking about body image issues causing someone to become depressed (although that happens often). I’m talking about synapses misfiring and chemicals becoming imbalanced. I’m talking about diseases within our bodies. This can be the most difficult cause of depression to wrestle with because you can’t quite put your finger on the reason you are suffering. You’re simply suffering. More on this in a minute.

Regardless of the cause of depression, one factor remains constant: depression always centers on death and pain.

Depression is about death. The naked guy on the beach in Mark 5 lived in a cemetery. When you feel dead inside, you begin to dwell on the things of death, and eventually that place becomes your home. Depression is also about pain. The man would cry out and cut himself with razorsharp stones.

Depression has many causes, it revolves around death and pain, and it has no easy fixes.

Let’s continue with the story about the naked man on the beach:

When he saw Jesus from a distance, he ran and fell on his knees in front of Him. He shouted at the top of his voice, “What do you want with me, Jesus, Son of the Most High God? In God’s name don’t torture me!” For Jesus had said to him, “Come out of this man, you impure spirit!” Then Jesus asked him, “What is your name?” “My name is Legion,” he replied, “for we are many.” – Mark 5:6-9

Later in this story, Jesus sends the spirits away and heals the man. That’s when the crowd shows up:

When they came to Jesus, they saw the man who had been possessed by the legion of demons, sitting there, dressed and in his right mind; and they were afraid. – Mark 5:15

Jesus is bigger, stronger, and Most High over everything.

In the story about the naked man at the beach, the demon of depression recognized and yielded to the authority of Jesus. Jesus is bigger than depression. Whether you personally hunted down your dragon or it stalked and ambushed you, Jesus can set you free again.

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No More Dragons

18 Questions about Faith and Mental Illness

SOURCE:  Brad Hambrick

When engaging a difficult and highly personal subject, it is better to start with good questions than a list of answers. The better our questions are, the more responsibly we will utilize the answers of which we are confidant, the more humbly we will approach areas of uncertainty, and the more we will honor one another in the process of learning.

As I’ve read, counseled, and thought about the subject of mental illness, here are some of the questions that have emerged.

The purpose of these questions is to expand our thinking about mental illness. We all bring a “theory of mental illness” to this discussion. This theory, whether we can articulate it or not, shapes the questions we ask. Exposing ourselves to important questions from other perspectives is the first step in becoming more holistic in our approach.

Don’t allow these questions to overwhelm you. All of these questions existed before you read them. Speaking them didn’t create them. Actually, an appropriate response to this list would be the generation of more questions. Take a moment to write down the additional questions you have.

  1. Is mental illness a flaw in character or chemistry? Is this the best way to frame the question? What do we lose when we fall into the trap of either-or thinking?
  2. Why do we think of genetic influences as if they negate the role of the will or personal choice? Substance abuse can have a clear genetic predisposition, but every addiction program – even those most committed to a disease model – appeal to the will as a key component to sobriety.
  3. In the modern psychological proverb, “The genes load the gun, and the environment pulls the trigger,” where is the person? How do we best understand the interplay of predisposition (genetics), influences (environment), and the individual making choices (person)?
  4. What percent of those who struggle with “normal sorrow” are labeled as clinically depressed? What percentage of those who think their sorrow is normal are actually clinically depressed? How do we communicate effectively when the same word – depression – has both a clinical and popular usage?
  5. Would we want to eradicate all anxiety and depression if we were medically capable of doing so? What would we lose, that was good about life and relationships, if these unpleasant emotions were eradicated from human experience? Would that be heaven-on-earth or have unintended consequences that are greater than our current dilemma?
  6. Can we have a “weak” brain—one given to problematic emotions or difficulty discerning reality—and a “strong” soul—one with a deep and genuine love for God? If we say “yes” to this question in areas like intelligence (e.g., low IQ and strong faith), would there be any reason to say “no” about those things described as mental illness? C.S. Lewis in Mere Christianity says, “Most of the man’s psychological makeup is probably due to his body: when his body dies all that will fall off him, and the real central man, the thing that chose, that made the best or the worst of this raw material, will stand naked. All sorts of nice things we thought our own, but which were really due to a good digestion, will fall off some of us; all sorts of nasty things which were due to complexes or bad health will fall off others. We shall then, for the first time, see every one as he really was. There will be surprises (p. 91-92).”
  7. When do labels serve well (i.e., offering a sense of hope by breaking the sense of isolation and shame that comes with believing “my struggle is completely unique”) and when do labels serve poorly (i.e., diminishing hope by creating a sense of determinism and stigma)? How free should a counselor be to choose whether to use or not to use labels based upon these potential benefits and detriments for a given individual?
  8. What is happening when we “think” and “feel”? Are these experiences merely random neurological fireworks, the soul talking to itself using the physical organ of the brain like an internal telephone, or something else? Ed Welch in Blame It on the Brain? says, “It is as if the heart always leaves its footprints in the brain… The Bible predicts that what goes on in the heart is represented physically. But the Bible would clarify that such differences do not prove that the brain caused the thoughts and actions. It may very well be the opposite. Brain changes may be caused by these behaviors (p. 48).”
  9. Is mental illness a physical event with spiritual side effects or a spiritual event with physical side effects; do choices-emotions trigger biology or biology trigger choices-emotions?
  10. How do we best assess when the relief of medication would decrease the motivation to change versus when that same relief would increase the possibility of change? Pain can both motivate and overwhelm; is this simply about personal thresholds or should mental anguish be evaluated by a different set of criteria?
  11. Are our emotions more than the alarm system of the soul (moral) and the chemicals of our brain (biological)? Do these two categories tell us everything we need to know about emotions? Are these categories complimentary or competitive with one another?
  12. Can we have a collective disease? Is mental illness always personal or can it be cultural? Cultural changes necessarily add to or detract from the kind of stresses that influence mental illness. How should we understand this influence and when might an “epidemic” require a collective solution as much as personal choices?
  13. Why are we, culturally, more open about almost everything in our lives than we were a generation ago except mental illness? Why does this stigma / prejudice maintain its socially-accepted status when most others have been rejected? Kathryn Greene-McCreight in Darkness Is My Only Companion says, “The mentally ill are one group of handicapped people against whom it still seems to be socially acceptable to hold prejudice (p. 36).”
  14. Are we trying to medically create an idyllic sanguine personality?Is “normal” becoming too emotionally narrow? If not in the medical establishment, then are societal norms pushing people in this direction and the service-oriented medical profession trying to accommodate its well-intended, but misguided clientele? Joel Shuman and Brian Volck, M.D. in Reclaiming the Body: Christians and the Faithful Use of Modern Medicine say, “The consumer model to which medicine seems to be uncritically adopting pursuance is providing what the patient wants—that is, customer satisfaction in matters of health—is the measure of success (p. 26).”
  15. Does the alleviation of symptoms with medication always mean we are curing a disease? We medically treat the symptoms of many diseases and non-diseases to provide relief. This is good. Why have we allowed the debate over the disease model for mental illness to polarize the conversation about the roles of medication can play in mental health?
  16. How should we understand the effects of the Fall on the mind and brain? We know our bodies age and die. We know all of our organs are susceptible to disease and deterioration. We have “norms” for the frequency, duration, onset, and prognosis of these effects of the Fall; what are the equivalent expectations for the mind and brain?
  17. How do we understand the tension between “already” and “not yet” with regards to the health, development, and preservation of the mind? How much should we expect to be able to remedy the effects of the Fall upon the mind prior to the ultimate redemption that will occur when Christ returns (Revelation 21:4)?
  18. How much should we expect conversion and normal sanctification (spiritual maturity) to impact mental illness? Outside of medical interventions, most secular treatments for mental illness focus on healthy-thinking, healthy-choices, and healthy-relationships; so how much should Christians expect sound-doctrine, righteous-living, and biblical-community to impact their struggle with mental illness?

What do we gain from asking good questions? Humility. Humility may be more vital for this conversation than most other conversations we have. Why? Because the neurological, genetic, and medical research that have prompted many of these questions is still in its infancy. What we “know” in these areas will likely seem as outdated as a VHS tape 10 years from now.

“It is very likely that in the future, with increased research into depression and also increased understanding of the Bible’s teaching, much of the current confident certainty, which presently masquerades as biblical or medical expertise, will also look ridiculous, cruel, and even horrifying (p. 12).” David Murray in Christians Get Depressed Too

But if the Bible is timeless, do research developments in these areas matter? Yes. Not because new scientific discoveries will change what the Bible means, but those discoveries will likely change our application of the Bible. Did the discovery of epileptic seizures change the truthfulness of the Bible? No. But it did help Christians understand that these were not demonic events. It is likely, if God should tarry, that many similar discoveries will emerge in the area of mental illness.

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