Awareness of Depression and Anxiety has increased
significantly in recent times in recognition of the extent and impact felt by
sufferers and the community as a whole. Surprisingly though, largely amongst the
Christian community, the discussion seems to arrive at a premature conclusion;
the prevailing attitude seems to be that if you’re a believer, ‘why would you
need medication for depression or anxiety? Why would you even be depressed or
anxious’ in the first place? This is not an open and shut case however. I say largely
this is the prevailing attitude, because there are some who do not regard this
topic through the judgemental lenses “well, the believer would not need
antidepressants”– refreshingly some Christian figures such as Charles Swindoll,
John Eldridge, and Mathew Stanford offer a balanced perspective, extending
grace to those who have suffered with depression, even to those who arrived at
the point of being prescribed anti-depressants.
Whilst many acknowledge the problems and respond with grace,
in contrast, still many insist that depression and anxiety are purely ‘spiritual
issues’ – thus the person should deal with their spiritual problems if
they want to get better – and sadly, this is a commonly held belief in our
churches. I remember the time when a woman who had been a regular and highly
functioning member of a congregation I attended; during what seemed to be an
acute depressive episode, disrupted the Sunday service – at which point the members
treated her as if she was possessed with an evil spirit and proceeded with
lengthy ‘deliverance’ ministry! I remember discussing this with the pastor and her family - sadly she was misunderstood and therefore unwittingly mistreated despite the best of intentions.
I must admit I was one who presumptuously made the same
blanket judgement on the matter in my earlier days of being a psychologist –
yes, to my untrained eyes and unexperienced soul, I thought that
antidepressants must be for the unbelieving – those who did not have ‘the joy
of the Lord’ with them. I remember making a comment to that effect to a couple
of colleagues in a conference for Christian psychologists - an older and wiser
Christian woman smiled and gently said ‘I’ve had my days on antidepressants’.
I know better now, and it is me saying ‘I’ve had my time on
antidepressants’. Not long ago, severe depression and anxiety dominated my
existence, and so for the better part of the last couple of years I have
struggled to regain ‘normality’. They knew no boundaries – neither night nor
day. It was not as if I did not experience sadness or anxiety earlier in life –
I think my personality and natural predisposition lend themselves to melancholy
and worry at times. Like most of us I have experienced hard times which left me
troubled for a season. I had been through a bout of depression following the
birth of my youngest child, it lasted a few months then it lifted to make way
for happier days.
This time though, my best efforts to function failed. I had
been going through severe grief at the time, but the weeks turned into months
and the darkness seemed to settle. Sleep left - and my nights just prolonged the nightmare of an
anxiety that would not loosen its grip. I could not eat - not only did I not
have a desire to eat but I could not taste food. I lost weight rapidly, had no
energy, even my physical health (down to my hair and skin) changed. I broke
down frequently, in tears and at times in uncontrollable fits of desperation
with life. I remember at some points I fell unconscious for a short while following
such breakdowns – I believe it was God catching me in his arms of mercy. I
tried to shield my children as best as I knew how – but I was unable to live
‘in the land of the living’. I tried to change and just walk through it, but I
knew I needed help when my strongest wish and prayers longed for life to end.
I sought help from a Psychiatrist, and he prescribed
medication for anxiety and depression as a first line of treatment. In hind
sight, the medication was nothing short of a life line. It enabled me to sleep,
and my appetite began to return. The frequency and intensity of breakdowns
lessened and I was able to hang on to life. It would take many months before I
felt that I was going to be well. In fact it was hard to see the progress in
some aspects, two steps forward, one step back - but looking back I am grateful
to be sure that I am out of the pit.
They may be overprescribed in some instances, but medication
is nothing short of life saving for many who suffer with depression and anxiety
– believers are no exception here. I state this as a mental health
professional, yet more confidently as a survivor of their darkness. The
following are facts to keep in mind, as well as a summary of what I found
helpful in survival and recovery.
Biochemical aspects to Depression and Anxiety:
The neurotransmitter Serotonin is the most implicated in depression
as one of the vital chemicals that the brain manufactures for normal
functioning (Norepinephrine also has a role to play). A lack of Serotonin (at
times, the brain’s over processing of the chemical) leaves its supplies
chronically depleted inturn leading to depression. The medical world knows
this, yet in most instances, so far a test of Serotonin levels is not utilised
in diagnosing and prescribing.
What does a lack of ‘healthy brain chemistry’ look like
experientially? It can vary between mild low mood (we sometimes mistakenly
attribute that to a person’s melancholic personality); to general fatigue and
lack of interest in daily activities, decreased sleep, low appetite and a lack
of enjoyment of life; to the extreme end of the spectrum where life is an
inconceivable burden and ending it seems like the only way out. This is all
influenced by a myriad of factors, including life’s circumstances, available
family and social support, genetic factors, as well as gender - women are more
prone to experience depression and this is attributed to hormonal factors.
Moreover, recent research strongly supports the involvement of diet factors,
which we will look at later on.
How antidepressants work
Most antidepressants act on one or more of the
neurotransmitter pathways such as the one mentioned above. We will look at just
one example, a class of antidepressants named Selective Serotonin Reuptake
Inhibitors (SSRIs) – well, you guessed it; they inhibit the re-absorption of
serotonin, leaving more of it to act in the synapse where it’s needed. They
work! While they don’t have a ‘magical effect’ on all there is to depression;
depending on what symptoms they are effective with some aspects of functioning.
Antidepressants will not make life ‘happy’ again. The individual still lives
in, and has to cope with their reality and struggles in life whatever they may
be. What they do is lift the level of functioning in basic areas such as sleep,
appetite and they lower the intensity of the aversive mood. The person starts
to taste food again, he can get a decent shut eye at night, and consequently
the days are more bearable – in a real sense, antidepressants are a lifeline,
without them, life would be unbearable – no rest at night and so much to face
during the day.
A look at Recovery
A firm grasp of God’s love
As believers, we can not afford to detach from the love of
our God. The worst of times should be a catalyst for running to God, indeed the
biblical testimony is filled with the witness of the believer’s journey ‘through
the valley of the shadow of death’, and their God was with them. I can
testify that as dark as the darkness got, I knew God’s love as never
before. During the worst of times, my Lord was never far from me, whenever I
called out to him, he answered and poured out his strength on me. I knew the
meaning of the psalmist’s words - ‘My flesh and my heart may fail, but God
is the strength of my heart and my portion forever.’ I learned that I can
have joy even in the darkness, that this can take the form of a verse in due
season, a prayer, or the unmistakable understanding that I am not forsaken. Joy
was not in ‘happiness’ or in the acceptance and affirmation from others, but in
quietness and rest in Him.
God’s word became my constant companion and source of comfort
– my bread and breath. I had been a relatively new born again believer. During
this difficult time I was drawn to read the word from cover to cover, for the
first time. I started to go to Bible
College
Remembering food
Some of us are naturally hard pressed for an appetite, but
this is never felt so much as during depression. Eating becomes a chore that
one can easily forsake. Food loses its taste along with any associated feeling
of enjoyment or pleasure. This makes it hard to maintain consistent meals, and
thus medication can help in improving appetite which is essential in supporting
everyday functioning and in lifting mood.
Diet and supplements
Good food – particularly rich in the essential nutrients for
brain health goes a long way on the road to recovery. Certain types of fish are
rich in Omega 3, which is needed for repairing the coating on the nerve cells,
thus facilitating nerve signal transmission, among other benefits. In addition,
poultry products (particularly chicken meat) contain tryptophan, which is
converted to Serotonin – the neurotransmitter discussed earlier. There is also
a place for dietary supplements; I would highly recommend sufficient doses of a
marine oil (such as fish oil) and also a strong natural anti-oxidant such as
Astaxanthin which will aid in maintaining general physical and mental well
being.
Sleep
It’s during sleep that our bodies and minds regenerate, in
particular, healthy brain biochemistry relies on the sleep cycle. Getting
sufficient sleep is not optional – particularly during acute episodes of
depression or anxiety. Often when this line of defence fails, a relapse may be
looming. The longer the sleep disturbance continues, the harder life gets and
recovery is hindered. If all else fails to restore adequate sleep, medication
may be needed in order to aid with falling asleep and staying asleep for a good
duration.
Time for company
My struggle was a private battle for the most part – I did
not want people to know, I did not think they would understand, or be able to
help. Still I felt some would judge me, and so I kept up an ‘I’m well’ facade
in front of most for the sake of my privacy. I withdrew from most company -
except for attending non-assessable college classes. I know that the people who
were close enough and able to get a glimpse of my struggle prayed and lovingly
just offered their presence. Yet some of the closest people did not understand
or know how to respond. Their well-meaning efforts translated into advice on
how to get better quickly and fix my problems and get on with life - like Job’s
friends, at times they were quick to blame and assign remedy. Relationships
just became harder, I needed rest and the strain of expectations was too much
to bear – sadly, those pressures meant that I was loosing out on fellowship; to
withdraw from meaningful relationships was my way of maintaining peace.
It is tempting and often natural to withdraw from company
during depression. Very few people have insight or even awareness of the
experience of someone suffering from depression or anxiety – therefore being
amongst others may feel like one is among complete strangers, and thus
withdrawal from family and friends feels like the easiest thing to do. It’s
important to prevent avoidance of social contact from setting in, which in the
long run affects relationships and results in isolation. Left untreated, this
may be hard to change. I know it was easier for me to be amongst people I
hardly knew and who hardly knew me because they could not discern my
difficulties, and therefore in the absence of ‘expectations’ it was easier to
‘just be’ me.
Time for solitude and rest
Solitude for the believer never really means being alone. It
means that the time is spent wholly with God. There is healing and
renewal of strength in time spent in his presence. Jesus spent some time in a
solitary place with the Father – particularly in times when he needed comfort
and rest. This is never disappointing or fearful; it’s reassuring and
full of peace. So finding the balance between good company and times of
solitude with God is a way forward in God’s grace.
There are many aspects to depression and anxiety that need
to be exposed, talked about, shared, questioned and understood. The way forward
is not to deny, dismiss or even judge the experience of the depressed and anxious.
A good start would be to weep with those who mourn, pray for the afflicted and
seek God in desperate times.
“Praise be to the God and Father of our Lord Jesus
Christ, the Father of compassion and the God of all comfort, who comforts us in
all our troubles, so that we can comfort those in any trouble with the comfort
we ourselves receive from God.” (2 Corinthians 1:4)
