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Posts tagged ‘mental illness’

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.

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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

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.

A Prayer for Sufferers

SOURCE:  Scotty Smith

A Prayer for Bringing Broken Friends and Stories to Jesus

     Some men came, bringing to him a paralyzed man, carried by four of them. Since they could not get him to Jesus because of the crowd, they made an opening in the roof above Jesus by digging through it and then lowered the mat the man was lying on. When Jesus saw their faith, he said to the paralyzed man, “Son, your sins are forgiven.”  Mark 2:3-5

Dear Lord Jesus, after sitting with a mom in crisis yesterday, I woke up this morning hurting for friends whose lives are marked by chronic illnesses—those with mental and emotional illnesses in particular. I come, very much in the spirit of this text, bringing you both the sufferers and the caregivers, confident of your great compassion.

Jesus, I cry out to you on behalf of the sufferers—these precious men and women whose capacity to think and feel is painfully distorted—those who are in early and later stages of dementia and Alzheimer’s. And I pray for those who suffer with various degrees of depression—from clinical to post-partum blues to bouts of paralyzing melancholia. And I pray for friends trying to make sense of hard providences and your promises—those who wonder how you can be good, when life is so hard.

I pray for those unable to grieve losses and betrayals in a healthy way. I pray for those who live in the angry vortex of despair and hopelessness—generated by old and new wounds. I pray for those whose war with self-contempt makes death, or at least self-harm, look like a good—even the only way out. You know the names and the details, and you alone have the grace.

Jesus, I know you are merciful and I know you are mighty. Only you know what’s going on in each story and heart. It’s not always easy to discern what’s physiological, psychological, demonic, or just the absence of vital relationship with you. As friends and caregivers, give us what we need to love and to serve these broken ones well.

When we’re fearful and confused, when we are fed up and used up, give us all the wisdom, compassion, and faith to love well. Jesus, it’s these kinds of sufferings that me wish for miracles on demand.

How we long for the Day when every form of brokenness will give way to the endless joys of spiritual, physical, mental, and emotional health. So very Amen I pray, in your holy and healing name.

Mental Illness and the Church’s Mission

SOURCE:  Rick Warren/American Association of Christian Counselors (AACC)

“Your illness is not your identity,” Pastor Rick Warren shared this week. “Your chemistry is not your character. It’s not a sin to be sick.”

Returning to the pulpit for the first time since his son Matthew’s tragic suicide in April, Warren broke away from his notes to talk frankly about his grief and the challenge of living with his son’s mental illness.

According to USA Today, “Matthew Warren, after a lifetime of struggle with depression, shot and killed himself in what Warren at the time called ‘a momentary wave of despair.’ ”

“I was in shock for at least a month after Matthew took his life,” Warren said. In a world where many Christians often feel the pressure to “put on a happy face,” Pastor Warren’s honesty is refreshing.

“For 27 years I prayed every day of my life for God to heal my son’s mental illness,” Warren said. “It was the number one prayer of my life…And it didn’t make sense.”

As Christian counselors, we must remember the daily challenges facing family members of an individual who struggles with depression, addiction, an eating disorder, or other mental health concerns.

“How proud I was of Amy and Josh, who for 27 years loved their younger brother,” Warren said. “They talked him off the ledge time after time. They are really my heroes.”

As churches and communities we need to rally around and provide support, care and a listening ear to those who live with the daily reality of mental illness, reminding them, as Warren said, that their illness is not their identity.

“It’s not a sin to take meds. It’s not a sin to get help. You don’t need to be ashamed.” This message needs to reverberate through churches all across our nation, where misunderstandings about mental illness and false theology that “faith is enough” often results in unnecessary suffering.

In Troubled Minds: Mental Illness and the Church’s MissionAmy Simpson points out, “Mental illness is the sort of thing we don’t like to talk about. Too often, we reduce people with mental illness to caricatures and ghosts, and simply pretend they don’t exist.”

“They do exist, however. Statistics suggest that one in every four people suffers from some kind of mental illness—from depression to schizophrenia and beyond.

Many of these people, and the family and friends who love them, are sitting in churches week after week, suffering in stigmatized silence.”

Simpson reminds us that people with mental illness are our neighbors—our brothers and sisters in Christ. We are called to love them and care for them.

What can churches do to help advocate on behalf of mental illness? Simpson offers several starting points:

  • Get help if you’re struggling. Break the silence by telling your story.
  • Get educated about the issues—read, learn and seek to truly understand.
  • Talk about mental illness and address common stigmas—in the pulpit, small groups, etc.
  • Build genuine relationships—don’t just help as a “project.”
  • Ask families living with mental illness how you can help with practical needs.
  • Accept people unconditionally—look past their diagnosis and see the real person God created and loves.
  • Start support groups for families living with mental illness.
  • Collaborate with local mental health professionals.

“There are people with mental illnesses in every church, whether this is known or not,” one church leader writes. “Jesus came to love and serve everyone. He feared no one. All churches can learn to serve the Lord better in caring for His people.”

In the midst of unspeakable grief, Pastor Warren shared, “God wants to take your greatest sorrow and turn it into your life’s greatest message.”

How does God want to use you to help those struggling with mental illness and their families?

Christian counseling is far more than a career…it’s a calling to minister and offer hope to those who need it most.

Discerning Depression (and Medication)

SOURCE:  Based on an article by  SUSAN PALWICK

Anyone who works with psychiatric patients will tell you how difficult it can be to get them to take their medication. No one with a chronic illness, whether bipolar disorder or high blood pressure, likes taking pills every day; everyone with chronic illness, whether diabetes or depression, sometimes slides into imperfect self-care. We’re people, not machines. We don’t like doing the same thing all the time, and we don’t always function at the highest level.

There’s a popular belief that creative people are more prone to mental illness, or that mentally ill people are more prone to creativity, than the general population. This is a dangerous attitude on several levels: it romanticizes mental illness, portrays creativity as dangerous, and denies the creativity present in everyone. But like most myths, this one contains a kernel of truth. Kay Redfield Jamison, a clinical psychologist and expert on bipolar illness who suffers from the disorder herself, observes in her book Touched by Fire that bipolar tendencies and extreme creativity tend to run in families. Distinguished poet Anne Sexton, who according to her close friend Maxine Kumin heard the trees talking to her every June, found herself unable to write on any of the medication she was given to quiet those voices.

I may have bipolar tendencies. As I’ve written here before, I’ve had depression for most of my life. I’m a writer. And my relationship to medication is ambivalent, at best.

I’ve been on antidepressants for two extended periods. I took them for four years starting near the end of graduate school, and then, after a hiatus of eight years, began taking them again about four years ago. Let me emphasize that I’ve never been suicidal, hospitalized, or completely unable to function: at my worst, I’ve merely been riddled with self-loathing, wracked by daily or hourly crying jags, and unable to imagine a tolerable future. The meds largely remove those handicaps. They make me more resilient to stress, more graceful in social situations – including the teaching by which I earn my living – and generally happier and more optimistic.

They also deaden my writing, which loses the spark and verve it has when I’m off meds.

My husband has also noticed this, so I don’t think it’s my imagination. My psychiatrist believes that I have to be on meds for the rest of my life. But writing’s a huge part of my life and my career, and also my deepest and truest joy. Not being able to do it as well as I can when I’m not on antidepressants (and yes, I’ve tried a variety of meds) makes me, well, depressed.

The situation challenges my spirituality. God gave me the gift of writing, as well as the particular brain chemistry that predisposes me to depression. My depression is as much blessing as curse, if only because it’s given me more compassion for others with mental illnesses. I believe that God wants me to write as well as I can. I also believe that God wants me to be as happy as I can. How, then, am I to respond to the fact that the two seem incompatible?

The easiest answer would seem to be that I should learn to be happy without meds, as I’ve done with some success for the all-but-eight years I haven’t been on them. Those hard-won joys, though, have come at the cost of a social isolation I’m not quite willing to endure again, at least not right now. People seem more comfortable with me when I’m on meds.

This isn’t a problem I can solve quickly or easily, and having it makes me very sympathetic to people who won’t take their medication. I do take mine, although I pray daily about whether I should keep doing so. My current plan is to try to go off it again in a year or two. I’ve recently lowered my dosage, with my psychiatrist’s blessing. I’m writing a little better now, but I’m also a little less comfortable in my own skin. I doubt that God wants me to be a creature of halves and compromises. For now, I take each step as it comes, trying to discern God’s will and my own health, trying to see the path ahead.

—————————————————————————————-

A practicing Episcopalian, Susan Palwick volunteers as an ER Chaplain at a hospital in northern Nevada. She currently teaches as an Associate Professor of English at the University of Nevada, Reno, and is also a Clinical Associate Professor of Medical Education at the University of Nevada School of Medicine, where she specializes in Narrative Medicine.

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