All My Hope on God is Founded: Mental Health and Hymns that Heal

Over two years have passed since my last blog post. As one might expect, I am still pressing forward  on the journey toward mental health and wellness. On the up-side, the last two years have brought me better insight into my illness. Each time I experience an episode, I learn more about my depression and how it changes each time it surfaces. I learn that it is always best to error on the sides of more communication, more preventative therapy, and more self-care initiatives. I learn that no matter how accomplished I become at being able to take responsibility for my own mental health, my depression is still difficult on my spouse.

The last two years have also been a struggle. Until very recently, I have been in a constant state of low-lying depression. I've also tried to figure out, with no success so far, how to shed the weight I have gained since being on antidepressants. It's a love-hate relationship, me and my medications. I know they serve me well. I feel better when I take them regularly. This I know to be true. But I never thought I'd witness the transformation my physical body has undergone since beginning the meds just over four years ago. Despite all of this, at least for now, I know that taking the meds is a necessary part of my mental health regimen. This was confirmed by a stay in a psychiatric facility this past December when I became suicidal. I missed an appointment with my psychiatrist a couple weeks before and failed to get my meds adjusted. The affect it took on my brain was one I didn't see coming. Suddenly, in a huge wave of tearful despair, as I held several pill bottles in my hands, I considered an act that could have ended my life.

So I admitted myself.

Five days and four nights later, I realized I never want to go there or feel that way again.

I have a couple of reasons for wanting to resurrect this blog, one being the reason I started it in the first place: because I believe that in reaching out and talking about mental health, together we help reduce the stigma that still surrounds mental illness. My other reason is to share a recent presentation I gave at the Hymn Society Conference a week or so ago. Some of you have asked to see a copy of it, so I will paste a slightly edited version of it below.

For those of you who may be unfamiliar with this organization, The Hymn Society was founded in 1922 as a way to affirm that congregational song is an integral part of worship. The Hymn Society advocates that the singing and writing of new hymn texts should be promoted while honoring our hymnic past by studying the origin of preexisting texts, tunes, and performance practice. My presentation was entitled All My Hope on God is Founded: Mental Health and Hymns that Heal and focused on the role that music ministry leaders can play in the healing journey of others through the communal singing of hymns.

Please enjoy:

HillaryJ. Doerries

“All My Hope on God is Founded: Mental Health and Hymns that Heal”

The Hymn Society in the United States and Canada

Tuesday, July 14, 2015, 4:00 – 5:15 pm

Begin by singing verses 1, 2, & 3 of ALL MY HOPE ON GOD IS FOUNDED 

Evangelical Lutheran Worship, #757

All my hope on God is founded
who will all my trust renew,
who through change and chance will guide me,
only good and only true.
God unknown,
God alone,
call my heart to be thine own.

Mortal pride and earthly glory,
sword and crown betray our trust;
what with care and toil we fashion,
tow'r and temple, fall to dust.
But thy pow'r,
hour by hour,
is my temple and my tow'r.

Great thy goodness, e'er enduring;
deep thy wisdom, passing thought;
splendor, light, and life attend thee,
beauty springing out of naught.
Evermore
from thy store
new-born worlds rise and adore.

Text by Joachim Neander, 1650-1690; para. by Robert Bridges, 1844-1930

Welcome to the sectional entitled “All My Hope on God is Founded: Mental Health and Hymns that Heal.” I am delighted to see so many of you here this afternoon. That tells me the issues we’re going to talk about and the music we’re going to sing are of great importance to what it means to be a welcoming church to all people. I am a former Austin Lovelace Scholar, and am thrilled to be back at this year’s conference as a presenter. For our discussion purposes today, I hope to begin by clarifying: just what is mental illness? What are some of its different names and forms? Who is affected by it? And what can be done? After which we’ll focus on the Church and its relationship to those with mental health disorders. In the midst of all of this, we’ll be doing some hymn-singing and carrying on some discussion. And most importantly, we’ll discuss how we as church musicians play not just musical, but pastoral roles in the healing journey of others. Let’s now sing a hymn that talks about a spirit of Christian service to the poor in spirit and the mournful – a beautiful text by Delores Dufner. 

All sing THE SPIRIT SENDS US FORTH TO SERVE

Evangelical Lutheran Worship, #551

The spirit sends us forth to serve;

we go in Jesus’ name 

to bring glad tidings to the poor,

God’s favor to proclaim.

We go to comfort those who mourn

and set the burdened free;

where hope is dim, to share a dream

and help the blind to see.

We go to be the hands of Christ,

to scatter joy like seed

and, all our days, to cherish life,

to do the loving deed.

Then let us go to serve in peace,

the Gospel to proclaim.

God’s Spirit has empowered us;

we go in Jesus’ Name.

Text: Delores Dufner, OSB, b. 1939

 What Is Mental Illness?

First, let’s talk about what it means to suffer with a mental illness. The World HealthOrganization defines mental health as: 

“a state of well-being in which every individual recognizes his or her own potential, can cope with the normal stresses of life, can work fruitfully, and make a contribution to his or her community.”

 Winston Churchill had his own name for his manic depression – his little black dog -which often appeared for a month or so at a time as manic depression. DBSA, or the Depression and Bipolar SupportAlliance, tell us that depression is an imbalance of brain chemicals called neurotransmitters and neuropeptides. No one is certain what exactly causes depression, but many believe it is a combination of genetic, biologic, environmental, and psychological factors. I’m sure you’ve all experienced bouts of situational depression in your lives at some point in time. Maybe you lost a job, went through a divorce, or had to say goodbye to someone you really cared about. The feelings of sadness and pain that arise from occurrences like these are valid and real. People who suffer from clinical depression often have long lingering, persistent symptoms that last for years, even decades. When I first acknowledged my struggles with mental illness out loud, I remarked that, 

“things that seem so easy for other people just aren’t easy for me.”

That was the best way I knew how at the time to describe the battle I had to fight everyday just to survive. Getting out of bed in the morning to go to class was a momentous effort. Taking a shower seemed exhausting. I turned to drugs and alcohol to numb the disgust I harbored for myself and for the life that I was stuck inside. And a social life? Forget about it. Sometimes I holed myself up in my apartment for several days at a time seeing no one and speaking to nobody. I knew in my heart this was no way to live. 

Later, when I was 27, I found out that all of these behaviors were symptoms of common illnesses called Major Depressive Disorder and Generalized Anxiety Disorder. Anxiety is also a common affliction for many people, but those people who suffer of GAD are prone to obsess over their concerns. They can’t relax, startle easily, have difficulty concentrating, and have trouble falling or staying asleep. Anxiety is often accompanied by fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, feeling out of breath, and hot flashes. These symptoms may seem manageable when listed one by one, but for those suffering with a mental health disorder, they are chronic and debilitating. 

Everyone experiences depression and anxiety differently, but the National Institute ofMental Health (NIH) clearly describes Major Depressive Disorder as severe symptoms that interfere with your ability to work, sleep, study, eat, and enjoy life for a period of two weeks or more. Other types of depression include Persistent Depressive Disorder, otherwise known as Dysthymia, where symptoms of depression are consistent for a period of two years or more. There is also Psychotic Depression, where people experience severe depression plus some form of psychosis, delusions and/or hallucinations. Another form of depression that has been around for many years and is just now beginning to be talked about in the mainstream media is Post-Partum Depression, or when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth. Maybe you or someone you know often has the ‘winter blues.’ Seasonal Affective Disorder is characterized by the onset of depression during the winter months, when there is less natural sunlight. Finally, Bipolar Depression, is characterized by cycling mood changes—from extreme highs known as mania to extreme lows of depression. 

There are also psychotic mental health disorders, which we’ll just touch on briefly. The most common psychotic mental health disorder is Schizophrenia, a chronic, severe, and disabling brain disorder that occurs in 1 percent of the general population – that’s 3.2 million people - but it occurs in 10 percent of people who have a first-degree relative with the disorder, such as a parent, brother, or sister. People with the disorder may hear voices and may believe other people are reading their minds, controlling their thoughts, or plotting to harm them. Treatment helps relieve many symptoms of schizophrenia, but most people who have the disorder cope with symptoms throughout their lives. However, with proper treatment and guidance, many people with schizophrenia can lead rewarding and meaningful lives in their communities. Let’s move on to another hymn, “When Hands Reach Out and Fingers Trace,” a text by Carolyn Winfrey Gillette. As the footnotes read, this hymn celebrates the richness of our human diversity through all of the different ways we serve the church and the world. Acknowledging this diversity witnesses to the hospitality of Christian community and to the inclusive nature of God’s love. 

ALL SING WHEN HANDS REACH OUT AND FINGERS TRACE

Glory to God #302

When hands reach out and fingers trace
The beauty of a loved one’s face,
We thank you, God, that love relies
On gifts of grace not seen with eyes.

When fingers spell and signs express
Our prayer and praise and thankfulness,
We thank you, God, that hands can sing;
You bless the silent songs we bring.

When broken bodies will not mend,
We thank you, God, for Christ our Friend.
In him, our healing can begin:
He welcomes all the wounded in.

And when the ways we learn and grow
Are not the ways that others know,
We thank you, God, that we have learned
Your love’s a gift, and never earned.

Your Spirit gives us differing ways
To serve you well and offer praise.
When all are joined as one, we’ll be
Your able, strong community.

Text by Carolyn Winfrey Gillette, 2001

What Does Mental Illness Look Like

Ultimately, mental illness looks like you and me. Mental illness is mainstream and does not discriminate. It can affect anyone regardless of age, gender, income level, social status, race, religion, or any other cultural identity factor. One in four people struggle with a diagnosable mental illness in any given year. This equates to 80 million people in the United States alone, which is equal to the total number of people diagnosed with cancers, heart disease, HIV/AIDS, and diabetes each year. Mental health disorders are the number-one cause of disability in North America. Today, in many churches, there is an emphasis on successful Christian living that seems to say that real Christians don’t have problems. Or at least, there are no problems that prayer can’t remedy. How many of us have heard that? However, in her 2013 book entitled, “Troubled Minds: Mental Illness and the Church’s Mission,” author Amy Simpson points out that this idea is in direct contradiction to what Jesus told us in John chapter 16:

“Here on earth you will have many trials and sorrows, but take heart, because I have overcome the world.”

So what do all of these facts and figures mean for us as faith leaders? They mean there are people right now in our pews, on our church staffs, and in our ensembles who are battling mental illness. The good news is that mental illness is treatable, and we as faith leaders can be a part of this healing process. If we are called to be pastors to our flocks, it’s certainly appropriate that we be aware of how we can better serve those who are struggling. It is part of our job, yes – even as church musicians – to be prepared to help care for those individuals who so often come to the Church first when seeking help for their most intimate and personal of life’s problems. The fellowship, good will, and emotional support that a church can offer can promote healthier living and encourage better mental stability. But changing a part of any community’s culture can be a challenge. Everyone must start somewhere, and author and mental health advocate Amy Simpson started with the numbers.

What Mental Illness Looks Like in the Church

Simpson writes about a survey she conducted in conjunction with the Leadership Journal and other Christianity Today publications. She interviewed pastors and other worship leaders in 500 different churches and asked them about their experiences with mental illness among members of their congregations, in their families, and personally. Simpson also took time to ask what their churches believe about mental illness, how they treat people with mental health disorders, and how frequently they mention mental illness in their sermons. The data is fascinating and very telling. Let’s take a look:

·      84% of church leaders are aware of some type of anxiety disorder in their congregation

·      91% of these church leaders have seen mood disorders such as depression within their churches

·      37% of church leaders indicated that someone in their congregation had suffered from a psychotic disorder such as schizophrenia

·      38.% of these church leaders admitted they themselves had suffered from a mood disorder such as depression or bipolar disorder. 

·      Of those surveyed, 29% said that on average, mental illness is NEVER mentioned in sermons at their church; 20% said mental illness is mentioned once a year, and 29% two to three times a year.

As you can see, we’ve got some work to do, but progress is possible. No matter our affliction, we all come together week after week to confess our sins, listen to the proclamation of the Word, sing the psalms, hymns, and spiritual songs that reaffirm our Christian stories, and partake in the Eucharistic meal. We are then told to “go out to love and serve the world!” But what about those who cannot “go out to love and serve” because their own pain is so debilitating they cannot even get out of bed in the morning? We cannot change everything about the suffering involved with mental health disorders. We can’t take mental illness away, but as the church, we can do better by striving to be a place of refuge and acceptance for all the afflicted. The hymn we’re going to sing now by Ruth Duck is like a sung prayer for people whose lives exist in constant pain, often without hope. I think it’s appropriate to mention here that all of the hymns we’re singing today are just as much for the mentally ill as they are for their tireless caretakers, who also need recognition, love, and reassurance of hope for the future where they and their loved one can one day exist without pain. 

ALL SING WHEN WE MUST BEAR PERSISTENT PAIN

Glory to God #807

When we must bear persistent pain

and suffer with no cure in sight,

come, Holy Presence, breathe your peace

with gifts of warmth and healing light.

Support us as we learn new ways

to care for bodies newly frail.

Help us endure, and live and love.

Hear our complaint when patience fails.

We thank you for the better days

when we may smile to greet the sun,

to do your work with clearing mind,

and bless your name when day is done.

In ease or pain, in life and death,

to you our fragile lives belong,

and so we trust you in all things.

You are our hope, our health, our song.

Text by Ruth Duck, 2004

“Just Be a Pastor”

As I mentioned to you earlier, when I was 27, I was diagnosed with a mental illness. I continued to work and attend graduate school during this time. As a church musician interested in building community and spreading awareness for mental health advocacy, I knew that voicing my struggles would somehow help other people. I figured that since we all happen upon difficult times, we should not only be talking about them; we should also be SINGING about them as a means to heal. I suspected that by singing about our pain collectively, hymns could become a vehicle for people to address their struggles in the Church in the presence of a loving God who walks by our side as we navigate our way through this fallen, broken world. 

I once received some very astute advice from a fellow church musician friend of mine that has stuck with me through the years because it speaks to what I believe is part of my ministry as a church musician. I had just accepted my first full-time church position in a Lutheran Church – a denomination I had never served in before.  Excited and nervous, I asked my friend if he had any advice for me as I began my new position. He said to me, “Hillary, just be a pastor.” 

      Just be a pastor. Of course. 

The Apostle Paul writes to us in the third chapter of Colossians that the mission of the church is to treat each other with 

“tenderhearted mercy, kindness, humility, gentleness, and patience.”

 If any of you have ever dealt with mental illness in your families or circles of friends, you know that all of these things are necessary for both parties as they deal with the illness. Paul writes further: 

“Teach and counsel each other with all the wisdom God gives. Sing psalms and hymns and spiritual songs to God with thankful hearts.”

Most of us in this room have the psalms, hymns, and spiritual songs part covered, but to counsel each other with patience and wisdom requires us to take on other roles in addition to being musicians. 

I had known for several years that being a church musician entailed much more than what we’re taught in our church music classes. There is so much we are not exposed to within the safe confines of the conservatory walls: working with fellow church staff and clergy, navigating church polity, collaborating with others while serving on various committees, and of course, tending to the often non-musical needs of parishioners. We should all expect to bump up against mental illness in our ministries. After all, the Church is where all of the broken gather; where the lost and the marginalized come looking for rest. Let’s sing again, this time, a text by Bryan Jeffrey Leech that speaks to our mission to be the hands of Jesus to those in need. I love this hymn because it reminds us that it is a privilege to care for a world in want. One by one, we can let our hearts soften as we tend to God’s creatures in their time of need.

ALL SING LET YOUR HEART BE BROKEN

Community of Christ, #353

Let your heart be broken for a world in need:

feed the mouths that hunger, soothe the wounds that bleed,

give the cup of water and the loaf of bread – 

be the hands of Jesus, serving in his stead.

Blest to be a blessing, privileged to care,

challenged by the need – apparent everywhere,

where the world is wanting, fill the vacant place.

Be the means through which the Lord reveals his grace.

Add to your believing deeds that prove it true.

Knowing Christ as Savior, make him Master, too.

Follow in his footsteps, go where he has trod;

in the world’s great trouble risk yourself for God.

Let your heart be tender and your vision clear;

see the world as God sees, serve him far and near.

Let your heart be broken by another’s pain;

share your rich resources, give and give again. 

Text by Bryan Jeffrey Leech, b. 1931

Linking Hymns and Mental Health

It’s nothing new that music has many healing properties. So much, in fact, that the relatively new field of music therapy emerged and is a part of healing regimens for many ailments, including mental illness. I want to delve in a bit further and draw your attention to a study that was completed by a team from the University of the Highlands and Islands in Inverness, Scotland, and a group from the Christian Council on Ageing, an advocacy group from the United Kingdom. The study, entitled “Hymns and mental health: A survey of church attendees” was partly inspired by the man sometimes known as the “Father of pastoral care,” Anton Boisen (1876 – 1965), who was from my home state of Indiana. Boisen suffered from mental illness to the point of several hospitalizations. In 1937, he published a hymn collection called “Hymns of Hope and Courage,” which was intended for:

“those who are passing through the valley of conflict and shadow. It provides a compact collection of hymns and prayers and passages of scripture designed to deepen the aspiration for a better life, to strengthen faith in the love and healing power of God, and to foster attitudes of hope and courage.”

Anton Boison (1876-1965)

The collection includes some very familiar hymns, such as “Abide with Me,” “Dear Lord and Father of Mankind,” and “Guide Me O Thou Great Jehovah,” along with several Christmas carols. Boisen was particularly influential in this study because he believed that hymns were a medium for deep emotional response, especially in situations of group therapy.

ALL SING TWIXT GLEAMS OF JOY AND CLOUDS OF DOUBT I GO

Hymns of Hope and Courage, #32

‘Twixt gleams of joy and clouds of doubt

Our feelings come and go;

Our best estate is tossed about

In ceaseless ebb and flow.

No mood of feeling, form of thought 

Is constant for a day;

But thou, O Lord, thou changest not;

The same thou art always.

Our of that weak, unquiet drift

That comes but to depart,

to that pure heaven my spirit lift

Where thou unchanging art.

Lay hold of me with thy strong grasp,

Let thine almighty arm

In its embrace my weakness clasp,

And I shall feel no harm.

Thy purpose of eternal good

Let me but surely know;

On this I’ll lean – let changing mood

And feeling come or go – 

Glad when thy sunshine fills my soul,

Nor lorn when clouds o’ercast,

Since thou within thy sure control

Of love dost hold me fast.

This study was conducted on 394 men and women in order to examine the subjective effect that hymns can have on one’s overall well-being. The team analyzed whether or not singing or listening to hymns could help mental health by uplifting the subjects’ spirits to overcome depression.  The study measured participants’ responses to four main objectives:

·      What religious group (or denomination) they affiliated with

·      Whether or not they found certain hymns to be able to raise their spirits and make them feel better

·      Whether it was the text, tune, or both text and tune that gave them the most positive affect

·      Whether they preferred to sing or just listen to the hymn

It was discovered that most of the participants considered themselves moderately to highly religious and/or spiritual people. The team’s hypothesis that hymns are able to lift one’s spirit when feeling down or depressed was supported by a mean score of 3.52 out of 4; a very high indication that their hypothesis was correct. The study also concluded that 244 participants, or 64% of those questioned indicated they preferred to experience the words with the tune, meaning the relationship between text and tune is important to how they experienced a hymn. And now, for my favorite part: 63.4% of the people questioned said they felt they needed to sing the hymn – or actively participate – in order to feel like they had received all of the benefits of the hymn. Martin Luther would certainly be pleased with this result. We can conclude that at least for those who profess a faith, hymns play an important role in their lives. The subjects were also asked to name their top three hymns. Just for fun, let’s take a look at the list of highest ranked favorites:

1.)  Dear Lord and Father of Mankind [REPTON]

2.)  Love Divine [BLAENWERN]

3.)  O Lord my God [HOW GREAT]

4.)  Great is Thy Faithfulness [GREAT IS THY FAITHFULNESS]

5.)  The Lord’s My Shepherd [CRIMMOND]

6.)  Make Me a Channel of Your Peace [PRAYER OF ST. FRANCIS]

7.)  What a friend we have in Jesus [CONVERSE]

8.)  Praise My Soul the King of Heaven [PRAISE MY SOUL]

9.)  And Can It Be [SAGINA]

10.)                 Guide Me, O Thou Great Jehovah [CWM RHONDA]

ALL SING DEAR LORD AND FATHER OF MANKIND

The Hymnal 1982, #653

 Dear Lord and Father of mankind,
forgive our foolish ways;
reclothe us in our rightful mind,
in purer lives thy service find,
in deeper reverence, praise.

 In simple trust like theirs who heard
beside the Syrian sea
the gracious calling of the Lord,
let us, like them, without a word
rise up and follow thee.

 O Sabbath rest by Galilee,
O calm of hills above,
where Jesus knelt to share with thee
the silence of eternity,
interpreted by love!

 Drop thy still dews of quietness,
till all our strivings cease;
take from our souls the strain and stress,
and let our ordered lives confess
the beauty of thy peace.

 Breathe through the heats of our desire
thy coolness and thy balm;
let sense be dumb, let flesh retire;
speak through the earthquake, wind, and fire,
O still, small voice of calm!

Text by John Greenleaf Whittier (1807 – 1892)

Hymns & Music for Further Study

Depression is a disease of loneliness. Depressed people feel alone, isolated, even forgotten. They may feel that God has overlooked them and their cries for help. The Church has a responsibility and an opportunity to create a community around our sorrows just as it forms a community around our joys. When planning a service of healing or a hymn festival to bring awareness to the presence of mental illness in the church, I often turn to an anthem by Mark Miller called “I Believe.”  The text is a very simple poem:

I believe in the sun
even when it is not shining
I believe in love,
even when I cannot feel it.

I believe in God,
even when God is silent.

This poem, thought to be written by a Nazi war prisoner at a concentration camp, is powerful, even haunting. It reminds us of the choice some of us have to hope for those things we cannot see or feel. Sometimes, however, some folks are not well enough to make certain choices. How can we enable these people who are struggling to voice their inmost longings to be heard and healed? There is a hymn in Evangelical Lutheran Worship (ELW) that gives this darkness a voice by acknowledging that sometimes in the midst of our pain, we simply have nothing to give. Let’s all sing:

ALL SING IN DEEPEST NIGHT

Evangelical Lutheran Worship, #699

In deepest night, 

in darkest days,

when harps are hung,

no songs we raise,

when silence must suffice as praise,

yet sounding in us quietly

there is the song of God.

When friend was lost,

when love deceived,

dear Jesus wept,

God was bereaved;

so with us in our grief God grieves,

and round about us mournfully

there are the tears of God.

When through the waters 

winds our path,

around us pain,

around us death:

deep calls to deep a saving breath, 

and found beside us faithfully

there is the love of God.

Text by Susan Palo Cherwien, b. 1953

            

Susan Palo Cherwien wrote this text in 1994 as a “Christian response to grief.”  Paul Westermeyer notes in his hymnal companion to the ELW that in all three stanzas, Cherwien manages to point back to “God’s presence in our pain, numbness, silence, awareness, lack of awareness, and questions.” In my church, we often sing this hymn as part of our Blue Christmas service. Sometimes we sing it together. Other times, the congregation sits and listens to it as it is sung by a solo voice. Regardless of how it and other hymns like it are sung, the very act of coming together to sing about our pain as a church community creates healthy connections with other people – especially people who will point each other toward Christ. Blue Christmas services provide a healthy outlet to those for whom the holidays are a particularly tough time. If your congregation has never experienced a Blue Christmas Service, I urge you to comb through Susan Gregg-Schroeder’s website, where you can obtain sample services along with several other valuable resources for churches wanting to incorporate issues of mental health into their worship life. It’s often helpful at these types of services to plan several shorter, Taize-type songs that people can latch onto easily. Songs such as:

Calm to the waves [CALM SEAS] Glory to God #184

Stay with Me [STAY WITH ME] Evangelical Lutheran Worship #348

Jesus, Remember Me [REMEMBER ME] Evangelical Lutheran Worship #616

Nada te turbe, Community of Christ #241

Other appropriate choices include, but are not limited to:

This is a Day of New Beginnings [BEGINNINGS] New Century Hymnal #417

How Long, O Lord [HOW LONG, O LORD] Glory to God #777

We Cannot Measure How You Heal [YE BANKS AND BRAES] Glory to God #797

Heal Me, Hands of Jesus, Wonder, Love, and Praise # 757

ALL SING HEAL ME, HANDS OF JESUS

Wonder, Love, and Praise #773

Heal me, hands of Jesus,

and search out all my pain:

restore my hope, remove my fear 

and bring me peace again.

Cleanse me, blood of Jesus,

take bitterness away;

let me forgive as one forgiven

and bring me peace today.

Know me, mind of Jesus,

and show me all my sin;

dispel the memories of guilt,

and bring me peace within.

Fill me, joy of Jesus:

anxiety shall cease

and heaven’s serenity be mine,

for Jesus brings me peace.

Text by Michael Perry, 1982

~

I will admit to you that during the darkest days of my depression, I often wondered where God was when my pain was the deepest. For a long time, I continued to serve the church and follow through with my musical programming, but I often felt that I was going at it alone. Like others who try to reconcile their spirituality with their mental illness, I often felt that I was crying out to a silent God. Amy Simpson writes, 

“what hurting people need…is to know that they are not alone, that someone else will hear their story and will love them just as much after they tell it. They need to know that the pain does not mean God has turned his back on them.”

Simpson adds, if we as the church are silent to a person in pain, it “can sound remarkably like silence from God.” For me, it became necessary to decipher for myself just what is my illness, what is just me, and accept the fact that just because I cannot sense him does not mean God is not with me.

ALL SING O GOD, MY GOD

 NEW CENTURY HYMNAL, #515

Refrain:

O God, my God, O gracious God,

why do you seem so far from me,

O God, my God, O gracious God?

Night and morning I make my prayer:

Peace for this place and help for there;

Waiting and wondering, 

waiting and wondering,

does God care?

Does God care?

REFRAIN

Pain and suffering unbound and blind

Plague the progress of humankind,

Always demanding,

always demanding,

does God mind?

Does God mind?

REFRAIN

Why, oh, why do the wicked thrive,

poor folk perish, the rich survive;

Begging the question,

begging the question,

is God alive?

Is God alive?

REFRAIN

Turn again as you hear my plea;

Tend the torment in all I see:

Loving and healing,

loving and healing,

set me free.

Set me free.

REFRAIN

I like that hymn from the New Century Hymnal by John Bell because it is a direct cry to God. As the hymnal says in the footnotes, “it exhibits the kind of stark honesty before God” that is characteristic of so many of the Psalms. Better yet, almost each verse ends with an open-ended question, which for me was like looking into a poetic mirror. Verse three strikes me particularly: “Is God alive? Is God alive?” 

As they always do, the really dark days did eventually pass, and as I began to put the pieces of myself back together, a new yearning was born within me. When I think about the team of people it took to get me through the worst of my illness, I realized that I wanted to be one of those people for somebody else. I wanted to use my experiences with clinical depression to help bring others closer to healing, and like many of you, the vehicle I’ve been given to complete this task is music and ministry.

ALL SING WE ALL ARE ONE IN MISSION

Wonder, Love, and Praise #778

We all are one in mission,

we all are one in call,

our varied gifts united 

by Christ, the Lord of all.

A single, great commission 

compels us from above

to plan and work together

that all may know God’s love.

We all are called for service

to witness in God’s name.

Our ministries are different,

our purpose is the same:

to touch the lives of others

by God’s surprising grace,

so people of all nations

may feel God’s warm embrace.

We all behold one vision,

a stark reality;

the steward of salvation 

was nailed upon a tree.

Yet resurrected Justice

gives rise that we may share

free reconciliation

and hope amid despair.

Now let us be united

and let our song be heard.

Now let us be a vessel

for God’s redeeming Word.

We all are one in mission,

we all are one in call,

our varied gifts united

by Christ, the Lord of all.

Text by Rusty Edwards (1986), b. 1955

What Can We As Faith Leaders Do?

As you probably know, it takes time, endless efforts, and a strong will to change the culture of any organization, including the church. If you feel it is important that your church take up this cross and become an open and accepting safe haven for persons with mental illness, here’s a look into some good places to start.

Do Your Research

Like many of you, I am a collector of hymns and texts. When I began this journey toward bringing mental illness into the forefront of my church’s worship life, I began putting together a notebook of hymns and texts that deeply spoke to me about hope, healing, and the importance of community. I found and read books and articles authored by people whose writing on the subject I found to be insightful and encouraging. The works of Anton Boisen, Henri Nouwen, and Andrew Solomon are just a few examples. I took every chance I got to hear people sing or speak about what makes their heart whole..

            Engage Your Community’s Resources

When I served a mid-size United Methodist church in agrarian Southwest Indiana, there were very few resources available concerning mental health. So I turned to national organizations such as NAMI (National Alliance on Mental Illness) and DBSA (Depression and Bipolar Support Alliance). I sent away for free information about what it’s like living with a mental illness and what one can do to seek treatment. These were openly displayed around the church for people to read and share at their will. I shared my story with people in my ensembles and wrote devotions on the subject that were read at the end of each rehearsal during Mental Health Awareness Month. I organized a Mental Health Sunday in October where we sang hymns, listened to lessons, and heard a sermon that tied together the ideas of healing, wholeness, and God’s love for all struggling people. My current church is unique in that it actually has a counseling center attached to it, called the Samaritan Center. It was started in the mid-sixties by a minister who attends our church and still works at the center. That just goes to show you the power in one person! And what an opportunity to engage local mental health workers in a growing dialogue about mental illness and the church! Last year we combined forces and put together a community hymn festival that honored the 40^th anniversary of the center. It also allowed people – some from the church and some not – to come together for a time of singing, readings, anointing, and community support.

            Enlist the Help of Your Pastors and Staff

Once you’ve gathered your music and research together and enlisted the support and involvement of your local mental health resources, it’s time to take your ideas to your pastors and staff. Together, you will hopefully be able to make a collective effort to begin to create a more inclusive, welcoming congregation around issues of mental health. It is here that you can dream your ideas into reality Maybe you want to:

·      Plan a community hymn festival around topics of mental health or healing

·      Begin a Blue Christmas service this coming winter

·      Invite local mental health advocacy groups to conduct workshops

·      Give closing devotions about mental health topics after your rehearsals and end in singing an appropriate hymn together.

·      Invite or initiate the formation of a support group for those dealing with mental illness. NAMI, DBSA, and Emotions Anonymous are a few such groups that often meet in churches

·      Make note of and even celebrate Mental Health Awareness Month in May. Include information in your rehearsals, in your announcement pages, on the church’s website, and in your worship services through music and the Word. 

·      Celebrate Mental Illness Awareness Week the first week of October. Have information available to your parishioners either in the Narthex or inserted into the worship folder. 

·      TELL YOUR STORY; reaching out to others, sharing your experiences, whether privately or publically, begins to carve out a safe space within the church for conversations about living with mental illness to begin. It begins with each of us. 

Use these and other ideas as opportunities to talk about and sing about mental health in your congregations. You will be surprised at how many people will be so thankful you did. Doing these kinds of activities can help reduce and even eliminate the stigma that so often surrounds mental illness. As faith leaders, we are all in unique positions to help educate people about mental health disorders in order to avoid the shame that often accompanies these issues. My belief is that if we can begin to talk about issues of mental health in our churches, we can certainly sing about them, too, in order to help people change their lives for the better. Again, the Church is on the front lines when it comes to dealing with those seeking help for mental illness. Those suffering often seek out a pastor or another staff member first. It is our responsibility as leaders of the Church to be equipped with the appropriate resources so we can point these folks towards further help. So go forth, educate, be aware, compassionate, collaborative, and just be a pastor. 

ALL SING ALL MY HOPE ON GOD IS FOUNDED, Verse 4

Still from earth to God eternal

sacrifice of praise be done,

high above all praises praising 

for the gift of God’s own Son.

Christ doth call one and all:

ye who follow shall not fall. 

Making friends with Old Man Winter

This week has been tough. I've slept a lot, worked minimally, and for the past several days have struggled to make myself do much of anything.

And I hate it.

This has been the longest depressive episode I have had in a long time. Sure, there have been others over the past year, but they have only lasted a day or two - a quick turn-around. This week, I've gone to bed every night (or, in some cases, every afternoon) wishing and hoping that the next day I'll wake up and be my real Self again, but She has yet to fully surface.

*        *        *

It's always been a pet-peeve of mine to feel like my time is being wasted. If I have only one life on this earth, I'd rather it be fruitful, productive, creative, meaningful, and lived out among the people and experiences that fill my days with beauty, challenges, and love. My true Self wants to learn and love and live as much as she can - not waste away in a prison of her destructive thoughts and irrational mind games.

Depression SUCKS because it wastes my time. In fact, depression the ultimate time-waster in the most frustrating way because I am often helpless when I'm up against it. I'm left without much of a choice. I have to live through it and treat the symptoms, and that's about all I can do until it passes.

This week, I've wasted away in my bed - sleeping far into the afternoon, getting up to eat or maybe do a little work, and then finding myself back in bed. I am embarrassed to the core about how many Law & Order: SVU episodes I have consumed over the past few days. I keep going back to Hulu, however, because it helps to numb my mind. 

I had a frightening experience one night last week when I was trying to fall asleep. My mind was absolutely spinning. I felt like I wanted to wail but I couldn't. So I tossed and turned and debated whether or not I should cave and take a pill to help calm me down. Should I get up? Should I read? Normally when my head hits the pillow I'm out within a few minutes, but suddenly I was lost in a whirlwind of random anxieties:   

What I am doing here? Why do I even bother taking organ lessons? It's not like I'm good enough to actually get into the DMA program! The only reason I'm here is because I'm just following my husband around. I told myself I'd never do that and now here I've gone & done it! Nobody really wants me here. Maybe even M. doesn't want me here. I'm not right for the work I'm supposed to be doing. I don't even care about the work I'm doing most days. There's nothing here for me. How will I ever find my way when I can't even bring myself to get up in the morning! What will M. think of me? Sure, he's helpful now, but what if this goes on for several more days - or WEEKS?! Will he tire of me? Will he become angry? Will he accuse me of using my depression as an excuse? I don't make enough money. I don't contribute anything to our little family. Family?! Oh my God I'm twenty-nine. What's wrong with me? What if I get too old to have a child, or worse, what if I just forget to have a child? It's exhausting just taking care of myself, how will I ever have the strength to raise a little person? I'll fail my family. My mother. Myself. Some days I don't even know if I want a child. Some days I fantasize about Motherhood until it hurts. How old will my child be when he or she realizes its mother is crazy? Should I try to hide it or just out myself before all the questions start? After all, kids are smart and they sense things...

You get the idea. (I got up and took the pill, in case you were wondering).

*        *        *

This week, I've ashamedly backed out of commitments, made stupid excuses as to why I cannot be social with people, and have completely neglected my creative work - or, any work, for that matter. I have not practiced. I have not written any music, and until this moment, have not done any meaningful writing.

I've been at this for a little while now, and I now know enough about how my depression works to know that it does not do any good to shake my fists and get angry at it. 

It always wins. 

It is always stronger than me despite my will and my best efforts to "beat it." But I think I can honestly say I got a leg up on it today...

*        *        *

Last night, after another evening of fitful sleep, I finally went downstairs and slept in the guest bedroom. M. had a lot of writing to do the next day and I didn't want to keep him awake with my tossing and turning and frustrated 'ha-rumphing!' He woke me up around 10AM and I begged him to let me keep sleeping. It was almost noon before he came in to gently nudge me awake - again. 

I made myself get up and eat. I threw together a pretty tasty fruit and chia seed smoothie. I dumped it in a glass, shoved a straw in it, and of course, took it back to bed with me. Nearly two Law & Order: SVUs later, I decided I should bathe. (When I am depressed, the whole idea of getting ready exhausts me, so this was quite an achievement). In order to minimize my efforts, I chose to take a bath instead of a shower. This way I would only have to turn on the water, squeeze in some bubble bath, and sit in the tub, letting the suds do the work. I couldn't have been in that much of a mental fog, as I made sure I retrieved my laptop from the bedroom to prop it up on the closed toilet seat so my Law & Order: SVU marathon would continue in the bathroom.

After my afternoon bath, I managed to dress myself. Okay, I was that much closer to getting out of the house. But before I did, of course I had to putter. I spent some time debating whether I should make the bed. I looked at the dirty dishes and wondered if I should rinse them instead of letting them sit in an impressive tower in the sink. I spent some time looking for my favorite gloves, and then came the decisions about what I should take with me - my organ music? My organ shoes? My journal? That stack of newspapers I've been meaning to comb over and clip through? Argh, too much! I finally threw my laptop in my book bag and headed out the door, but not before checking the mail for the second time today.

Okay. I'm in the car. I call M. I figure he should know where I'm going, considering my scatter-brained state. I tell him I'm going to cross the border into Michigan and head to a little cafe by by water and write. But of course - [insert Murphy's Law] - the cafe is closed for the day. I'm too late.

*        *        *

So, without thinking, I drove toward the water. When I reached the beach, I was surprised to see a lot of other people there: young couples, old companions, Moms and Dads with their young kids. I already felt better hearing the swish of the icy lake paired with the voices of others cutting through the frigid air. Just then I was reminded I'm not alone, but amidst a bunch of other spring-seekers walking the beach in the hopeful February sun.

This was a big step for me, as I HATE the cold. But there I was, facing it head-on. (The only way I find it somewhat tolerable is when it occurs with sunshine and no wind, and living near one of the Great Lakes, you almost always have the wind chill factor). Today was different. I just kept putting one foot in front of the other. Yes, it was freezing and I forgot my gloves, but I knew I needed this. On my journey, I came across some beautiful things, and managed to capture them to share with you:

Seeing snow on a beach still amazes and somewhat 
confuses me. But I found this treasure underneath 
some of the white fluffy stuff...

 Frozen in time...

 A little 'ice cove.' The sound of all of those little frozen 
bits of lake water clashing together was fantastic!

 If I were wearing different shoes, I may 
have attempted to climb atop this ice mountain...
NOT!

 Who knew Old Man Winter could be 
so stunning? I give him props.

And then...I spotted a sculpture at the
 end of the pier. Do you see it?

 At first, I thought it looked like an angel...
...or maybe an anchor...
 

But then I got closer...

 

...and it appeared to be some sort of watch tower. 

You can kind of make out the stairs.

   

 

But nobody will be climbing up these stairs anytime soon!

 

Brrrrrrr!

 

Wow!

Even the lighthouse is iced-over.
 

 A kind young couple offered to take my picture.

 What a day - and what a photo!

 My trek back to the car has ended...

And although today was a beautiful day, I'm very much looking forward to spring, warm weather, beginning my outdoor garden, and all the other gifts that spring and summer bring! But this evening, as I finish this long-overdue post, I am thankful to Old Man Winter for giving my mind an afternoon of reprieve. Tomorrow is the start of another week. May I awake inspired, motivated, and ready to face the day - hopefully without the cloud of my depression drooping over me. But if I can't just yet, may I be kind to myself so I may patiently nurse my spirit back health - and back to Self. 

And finally, my Friends - to your health!

h.

Causes of Mental lllness - Still a Mystery

This post is dedicated to the memory of Diane, her valiant fight, and her gentle spirit. May she rest in peace for eternity.

Yesterday morning, I awoke to the sound of my husband's iPhone as it blared the NPR morning news. This isn't anything out of the ordinary, but the story was particularly appropriate. I later looked it up. It was entitled "When It Comes To Depression, Serotonin Isn't The Whole Story" by Alix Spiegel (re-printed in full at the end of this post). According to this particular story, all the hype about chemical imbalances and correcting levels of serotonin and dopamine aren't flying with current research about mental illness anymore. 

I admit I was a little disheartened. As someone who currently takes medication for treatment of depression and anxiety, I could not help but feel a little out of the loop. Misinformed. Behind the times. Then again, the research does not rule out taking anti-depressants for help with and treatment of depression. Rather, it says serotonin and other brain chemicals may not be the sole cause of mental illness. 

Okay then, so what is? 

The last paragraph of the article states that "the real story is complicated, and in a way, not all that reassuring. Researchers don't really know what causes depression. They're making progress, but they don't know. That's the real story."

Okay, so we don't know. Maybe we don't even know as much as we thought we did. But science continues to surge ahead. Many brain scientists on the front lines have already moved beyond the serotonin theory and have begun to look for other underlying issues, such as identifying what genes might put people more at risk for developing mental illness than others. While this is an exciting development for the field and I am eager to see where it leads, it still leaves those of us currently fighting battles with depression in the lurch. After all, it is only natural for us to want to understand what is happening to our minds and bodies - and why. 

At the moment, we will just have to continue to wait. But that's not all we can do. We can still be advocates of mental health - for ourselves, and for others. We can continue our own individual journeys toward wellness. We can reach out. We can help others. We can stay informed. We can keep the conversation going, and more importantly, keep it open. We can make every day we are given a chance to better ourselves in mind, body, and spirit.

To our health,

h.

~     ~     ~

When It Comes To Depression, Serotonin Isn't The Whole Story

by ALIX SPIEGEL

When I was 17 years old, I got so depressed that what felt like an enormous black hole appeared in my chest. Everywhere I went, the black hole went, too.

So to address the black-hole issue, my parents took me to a psychiatrist at Johns Hopkins Hospital. She did an evaluation and then told me this story:

"The problem with you," she explained, "is that you have a chemical imbalance. It's biological, just like diabetes, but it's in your brain. This chemical in your brain called serotonin is too, too low. There's not enough of it, and that's what's causing the chemical imbalance. We need to give you medication to correct that."

Then she handed my mother a prescription for Prozac.

That was the late '80s, but this story of a chemical imbalance brought on by low serotonin has remained very popular.
"The problem with you," she explained, "is that you have a chemical imbalance. It's biological, just like diabetes, but it's in your brain. This chemical in your brain called serotonin is too, too low. There's not enough of it, and that's what's causing the chemical imbalance. We need to give you medication to correct that."
So to address the black-hole issue, my parents took me to a psychiatrist at Johns Hopkins Hospital. She did an evaluation and then told me this story:
When I was 17 years old, I got so depressed that what felt like an enormous black hole appeared in my chest. Everywhere I went, the black hole went, too.

Then she handed my mother a prescription for Prozac.

"I don't know of any story that has supplanted it," says Alan Frazer, a researcher who studies how antidepressant medications work. He is also chairman of the pharmacology department at the University of Texas Health Science Center at San Antonio.

"It definitely continues to live — absolutely," agrees his colleague Pedro Delgado, the chair of the psychiatry department at UT. "If you go to your community doctor, you're likely to hear some version of that."

But for many scientists who research depression, this explanation is no longer satisfying.

"Chemical imbalance is sort of last-century thinking. It's much more complicated than that," says Dr. Joseph Coyle, a professor of neuroscience at Harvard Medical School. "It's really an outmoded way of thinking."

Coyle, who is also the editor of the journal Archives of General Psychiatry, says that though serotonin plays a role in depression, low serotonin is likely not the cause of depression. Scientific thinking has clearly shifted, he says.

Still, the story of serotonin remains. Why does it continue to have such a powerful grip on the popular imagination?

The Link

According to Frazer, to understand how the story of low serotonin came to dominate our understanding of what causes depression, you need to go back to the late '50s, to a psychiatric hospital in Switzerland.

That's where psychiatrist Roland Kuhn gave a newly developed drug to 10 patients who had been paralyzed by depression for years. Over the course of three weeks, he watched a near-miracle occur.

"There was this lightening of their mood," Frazer says. "They became more energized, more interested in things around them."

This was the birth of the very first antidepressants, called tricyclics. And with that birth came a question: How could these drugs possibly be working? Researchers had some ideas, but it really wasn't until the mid '60s, when the cause of Parkinson's disease was discovered, that a real narrative began to take shape.

It turned out that Parkinson's — a brain disorder — was caused by a deficiency of a chemical in the brain called dopamine. This discovery influenced the way scientists thought about depression.

"There is no doubt in my mind that the Parkinson's story had a strong impact on the way that people were thinking about depression," Frazer says. "It became easy to speculate that depression was due to a deficiency."

The question, of course, was what was deficient? Which chemical was too low? For decades researchers argued this question, but no one candidate took the lead. And then came Prozac.

Prozac's Pull

Almost as soon as it was introduced in 1987, the antidepressant Prozac, which selectively targets the chemical serotonin, became a blockbuster. "Prozac just blew everything else out of the water," Frazer says.

This had less to do with the efficacy of Prozac (it is not better at treating depression than tricyclics, the earlier generation of antidepressants) than with the fact that the drug had relatively few side effects.

"It was very free of side effects," says Pedro Delgado. "And so it began to be used very widely, and there was a lot of enthusiasm for it."

That understates the case. In a very short time, Prozac became wildly popular, and again, Prozac worked on just one chemical in the brain: serotonin.

And really, it is because of the popularity of Prozac that the low-serotonin story took hold, even though, Frazer argues, the scientific research has not borne that out.

"I don't think there's any convincing body of data that anybody has ever found that depression is associated to a significant extent with a loss of serotonin," he says.

Delgado also makes this argument. In the 1990s, he carried out a study that showed that if you take a normal person and deplete them of serotonin, they will not become depressed. He says he feels this demonstrates that low serotonin doesn't cause depression.

Coyle is less absolute in his dismissal of the evidence on serotonin. His take is that while low serotonin probably doesn't cause depression, some abnormality in the serotonin system clearly plays a role. But most researchers have moved on, he says, and are looking at more fundamental issues like identifying the genes that might put people at risk for developing depression.

"What's being looked at are processes that are much more fundamental than just serotonin levels," he says. "We need to move beyond serotonin, and I think the field is."

Serotonin Sticking Around

So why are so many people still talking about low serotonin causing depression?

Frazer says it's probably because it has had, and continues to have, important cultural uses. For one, he says, by initially framing the problem as a deficiency — something that needed to be returned to normal — patients felt more comfortable taking a drug.

"If there was this biological reason for them being depressed, some deficiency that the drug was correcting," Frazer says, then taking a drug was OK. "They had a chemical imbalance and the drug was correcting that imbalance." In fact, he says, the story enables many people to come out of the closet about being depressed, which he views as a good thing.

Still, there's no question that the story also has downsides. Describing the problem exclusively in biological terms has convinced many people to take antidepressants when other therapies — like talk therapy — can work just as well.

One critic I talked to said the serotonin story distracted researchers from looking for other causes of depression. But Delgado agrees with Frazer and says the story has some benefits. He points out that years of research have demonstrated that uncertainty itself can be harmful to people — which is why, he says, clear, simple explanations are so very important.

"When you feel that you understand it, a lot of the stress levels dramatically are reduced," he says. "So stress, hormones and a lot of biological factors change."

Unfortunately, the real story is complicated and, in a way, not all that reassuring. Researchers don't really know what causes depression. They're making progress, but they don't know. That's the real story.

It's not exactly a blockbuster.

A Life in the Making: Two Years Later

This past weekend, I celebrated a unique anniversary.

Two years ago last Sunday, I acknowledged that the way I was living my life was not working anymore.

I was unmotivated, doing only the bare minimum to get by in my classes and at my job. I was fearful of everything: that I would never graduate, that I would be a failure, that my friends didn’t like me, that the people I loved would leave me. Despite the presence of all of the people in my life, I felt alone and slept my days away to avoid this feeling of emptiness. I was either agitated or anxious most of the time. The changes in my mood came on suddenly and were often unpredictable. I got worked up over the most miniscule things. Sometimes a perfectly good day would be ruined because someone looked at me the wrong way.

Somewhere, deep down, I knew this was no way to live my life.

Two years ago last Sunday, I stood face to face in a local bookstore with the man who would later become my husband. We were in the middle of an argument and were about to walk away from the whole thing when he asked me, “Do you think you’re depressed?” I tearfully replied, “Yes. Things that seem easy for other people just aren’t easy for me.”

And so began the journey. We even nicknamed 2009 the “Year of Health.”

Two years ago last Sunday, I named my depression for what it was. There would be no turning back, no more denying. I took the first step toward getting my life back.

And now?

Do I still struggle with depression? Yes, of course. But now I have the tools and the resources to separate the disease from the real me, hence the title of this blog: “I Am Not This Disease.” The art of self-awareness has been an invaluable tool for me in this journey. This might be the most important thing I took away from my time spent in Cognitive Behavioral Therapy. I had to re-learn how to think: how to logically process my thoughts, how to use situational evidence to uncover rational information, how to recognize when I am falling back into the old, destructive thought-patterns of my past.

And medication? Once I found a combination of drugs that worked for me, I can honestly say in amazement that my brain chemistry has changed. To think that I used to feel guilty and ashamed for taking anti-depressants is astounding. Now, I look at that little pill in my hand and feel nothing but thankfulness. I’m thankful for developments in science and medicine. I’m thankful for my doctors. I’m thankful that I’m insured and can therefore afford my medications. We all know that this simply isn’t the case for all people living in this country, and I eagerly await the day when universal health care will be able to touch the lives of people who so desperately need mental health care.

The greatest gift this journey toward mental health has given me was quite unexpected. I have emerged from this experience with a greater appreciation for the people in my life. I now find myself reaching out to others in ways I would not have during my illness. Lately, I notice I have within me a new-found desire to help others. Recalling how so many people sat and waited quietly with me through some of my darkest hours, I now want to be that kind of support for others. I want to give back because I spent so much time on the receiving end.

I also think my depression has made me a better listener and therefore a better partner and a better friend, or so I hope. Now that my life is not consumed with my anxiety and depression, I have the capacity within me to consider the needs of others in ways I have not been able to before. Finally, I am present. Really present. To myself and to others.

I am currently reading a wonderful book written by Methodist minister Susan Gregg-Schroeder called “In The Shadow of God’s Wings: Grace in the Midst of Depression.” I came across a chapter entitled The Gift of Living with Paradox. I had never thought about my depression in this way. She explains that our culture thrives on instant gratification, so living within a paradox, or a mystery as some might call it, does not come easily to us. But this is exactly what living with depression is like. We constantly find ourselves between two polarities: sickness and health, rationality and irrationality, darkness and light, until we can learn how to achieve a balance in our lives. This doesn’t always come easy for a depressive because so often we think in black or white terms, or what some therapists might call “all or nothing thinking.” But this isn’t a life at all, is it? All of us, depressed or not, must learn to accept what Susan calls the “intermingling of the darkness and the light and learning to appreciate the areas of gray.”

Anyone who has gone to battle with a major illness knows that the journey toward health is never fully upward. We take a few steps forward, and a few steps back. Wash – rinse – repeat. And yet this is how we learn. We must come to appreciate all the steps of the journey. Perhaps Susan sums this up best when she goes on to say that:

“The paradox lies in the fact that the parts of ourselves that we have buried in the shadow of subconscious are essential to our becoming integrated, whole persons. When brought into the light, these qualities we have rejected are transformed by God’s grace. They, in turn, strengthen our whole personality.”

So, here’s to living with paradox.

Here’s to two years of journeying toward sound mental health.

And here’s to you and your journey, wherever you might find yourself at this very moment.

May 2012 be another “Year of Health” for us all.

To our health,

h.

Listen to me!

It was now early spring, just a few weeks before Easter. It became clear to me that my elevated anxiety was at the heart of my most recent and lengthy depressive episode. For some time, I had suspected that my medications might be at the root of my problem. Maybe my system had built up a tolerance to them overtime? Maybe they were never the right combination of meds to begin with? Whatever the case, I was at a point where I knew I was feeling no different. It made me wonder why I was taking them at all.

At this time I was taking Wellbutrin, a unique anti-depressant that I had been on for over a year. I was also on Buspar – an oldie but goodie – for my anxiety, but looking back now, it never worked that well for me. If I took the highest recommended dose, I felt sick to my stomach. I tried to tell my psychiatrist on more than one occasion that I didn’t think my meds were helping me like they should. His next step was to prescribe Levothyroxine – a thyroid hormone that when taken at a very low dose was said to help elevate mood. When I contacted him again after several weeks hoping for yet another option, he told me we were running out of choices. Knowing that my body did not respond well to SSRI’s (Prozac, Lexapro, Zoloft), he said our next step might be a low dose of Lithium.

I never called him again.

I may have been depressed, but I knew there had to be other options out there before we pulled out the big guns. Lithium? Now that IS crazy!

I asked my therapist for a referral, explaining to her that I just couldn’t believe Lithium was my last option. She agreed. I knew there had to be another way. I knew my doc just wasn’t listening to me. I was screaming out to him: “Treat my anxiety! Treat my anxiety!” and his solution was to prescribe a drug normally given to patients with bi-polar depression. I had always known I was not bi-polar. My depression just never worked that way. It didn’t happen in extremely high and low fits. I never had the urge to stay awake for days or find myself maxing out my credit cards. It was more like a constant, undulating pulse that weighed me down – some days more than others. I only wanted to sleep. Besides, my therapist assigned me a formal diagnosis of Major Depressive Disorder (MDD) back in February. (For more information on MDD, check this out: http://www.dbsalliance.org/site/PageServer?pagename=about_depression_overview).

My therapist eventually put me in contact with a psychiatric nurse at a local mental and behavioral hospital. Finally – a new plan! The only drawback was that she was booked until mid-May. One evening when my anxiety was particularly horrible – racing thoughts, short of breath, pacing, etc. – I gave in and drove myself to an immediate care center. I told them every med I was on and my entire mental health history. I asked to be put on something that would help calm me down until I could get in to see this new psychiatric nurse.

No help whatsoever. They wouldn’t prescribe me any anti-anxiety medication and proceeded to inform me that if I needed further treatment I would have to go to the local hospital, admit myself, and stay overnight for evaluation. I was seething mad and completely discouraged – again. I just needed some help. I felt like no one was listening to me – again. Even after the doc inquired if I was suicidal, which I have never been even in my darkest moments, she still turned me away. Unbelievable. I knew I couldn’t go home. I would be alone with my thoughts and I wouldn’t be able to calm myself down. When I managed to finally pull myself together again, I took myself to a concert at the music school. A three hour event, it helped soothe my anxiety and lifted me up to a better place. I knew I could return home to an empty apartment and maybe get some sleep. I was going to be okay.

*                       *                       *

Since seeing my psychiatric nurse, who took my complete mental and family health history in handwritten notes, I was prescribed a drug called Cymbalta. Ads for it run on TV all the time: “Depression hurts. Cymbalta can help.” In my case, this is true. Cymbalta is in a class of drugs known as SRNIs, which target serotonin and norepinephrine. I began at 30mg daily, and eventually worked my way up to the full 60mg dose without any problems and minimal side effects. At 60 mg, Cymbalta is said to treat the symptoms of GAD, or Generalized Anxiety Disorder. She also prescribed me a daily low dosage of Klonopin, commonly known as a “benzo,” to further aid in the treatment of my anxiety since I told her I thought this was my most immediate problem. I was told to take a pill in the evening before bedtime; the idea being that I would wake up a little less frazzled and edgy.

So I had a new med cocktail that overtime proved to be effective for the treatment of BOTH my depression and anxiety. All of this arrived at a very providential time in my life. By early May, I had been on my new meds for about two and a half weeks. I also graduated from school – finally – after nine years of work. I even attended the ceremony, which I didn’t do as an undergrad. I felt it would help bring closure to what seemed like an unending chapter of my life. I woke up every morning and could breathe just that much easier knowing that I would never have to go back to this particular school. No more pressures of academia, no more constant evaluation, no more grades assigned to my art. This chapter was done. Over. FINITO!

Some weeks later, my husband and I decided to relocate to the small town in which he was teaching. We found a small house to rent, which for someone who has lived in apartments for the last nine years, this was very exciting! Around this same time, I found a great part-time position at a Methodist church about 35 miles away from where we had chosen to live. I felt so lucky to have found meaningful work during this time of transition. Moving to a small town immediately begs the question: “What the hell am I going to do around here?” But I had been given an opportunity, and for that I am grateful.

Most importantly, it was summer, and I decided to make it a REAL summer vacation. After all my husband and I had been through, after all I had been through between doctors and meds and recitals and this and that, it was time for my mind and body to heal themselves over. This meant no recitals. No conferences. No special projects. I limited myself by taking a very part-time job at a local ice scream shop to give myself a little something different to do during my last few months in town. I spent time with friends and family. I read and caught up on all the stupid TV that I missed during the school year. I joined the local YMCA. Some days, I gave myself permission to stay in my PJs until dinnertime. Big deal, I thought. I earned this. I also kept up on my therapy through individual and couples sessions, still journaling like crazy. I even tried writing some poetry. On the whole, it was a great summer. Without challenges? Of course not. But these challenges were all the more bearable now that I had an advantage over my depression. I had finally – with the help and support of my doctors, my husband, and my family – found a combination of drugs that worked for me.

It took over a year and a half, but we found each other.

To our health,

h.

"The moment you can visualize being free from the things that hold you back, you have indeed begun to set yourself free."---Unknown

Sculpture by: Zenos Frudakis "Freedom" 

Growing pains...

(Continued from July's post:)


In the weeks that followed my father-in-law's death, my husband and I found ourselves in different worlds. He needed time to grieve, time to sort, and time to think. Of course these are all complicated learning processes - especially for someone who has just experienced a major loss for the first time. My depression was still raging. No matter how hard I tried to push it aside or keep it at bay for the sake of my husband's grief, it still managed to rear its ugly head at the most inopportune moments. I wanted to give my time and attention to my husband during this extreme time of need, but my support wavered in and out as I tried to be available to him while remaining attentive to my own emotions - a direct result of my depression and anxiety. Again, I found myself confused. I was still caught up in the fact that I had tried to do everything "right" for myself and for my healing process. I took my meds, I kept my regular therapy appointments, I constantly journalled through my feelings, and I reached out to my friends more than I ever had. No matter how much I hated to admit it, the hard truth was at the end of the day, I wanted to husband to take care of me - to make me feel better - as he had done for the past three years. My disease did not want to allow him the time he needed to tend to his own wounds. We were totally and completely unavailable to each other. 


As a result, the weeks that followed were some of the most trying and difficult times in our infant marriage. Some days we could not hold a normal conversation that did not lead to arguing and screaming. Doors slamming. Hurtful words dropping like bombs. Various things flying across the room. It was terrible. We later admitted to each other that it was during these times we both considered leaving the relationship. Maybe our marriage had been a mistake. Maybe we would become a stereotype of our generation by continuing to prove that marriage just does not last. In my heart, this was the last thing I wanted, but I was too sick and he was in too much pain and no longer able to fulfill the role of caretaker that I had come to depend on. What was harder was for me to accept this fact and figure out how to finally do something about it. 


My therapist was a great help and trustworthy advocate to me during these times. We began to meet frequently - once a week. I remember feeling so reassured and empowered after our visits. It was as if for a few moments I was able to access the real me again. Even if people close to me did not understand what I was going through or told me I could not change, I was still shedding a skin - still making positive changes in my life despite the fact that I was still very ill. The process was painful. I had to face harsh realities about myself, my self-worth, and my issues with dependency. I had to relearn and rediscover who I am. The real Me. I had to learn that I was never only one thing at any given time - never only a wife, never only a student, etc. The only thing I could ever wholly be at any given time is myself. This is what my therapist helped me to discover. 


I had to do some re-evaluating: What were my goals? (With and without my husband). What did my progress look like so far? Where was this progression going? What new cognitive tools did I now have? What were the warning signs that would alert me that old habits and behaviors might be setting in? She also taught me to remain hopeful and proud of the fact that I had already come so far! That those undermining, self-deprecating, negative thought-processes were slowly being chipped away and replaced with affirmations: "I am a good person. I have done good work. I am capable of change. I am capable of healing. I take responsibility for my health. I am allowed to fail and learn from my mistakes." This is at the heart of cognitive behavioral therapy. At the time, these statements were - and still are - the stepping stones that allowed me to walk towards my goal of stability and sound mental health. 


There was still one thing that did not add up. In the midst of all of my progress, I still experienced profound bouts of depression, or what I sometimes call episodes. I had little motivation to do anything. Even my music was unsatisfying most of the time. If I was out of the apartment, I was usually social and active, but most of my remaining time was spent in front of the TV or in bed asleep. My husband and I still argued and fought frequently, which over a period of time added to my already high anxiety about the future of our relationship. In our couples' counselling sessions, I vowed to work on this and that, but in my head I still wondered if I could really trust my husband to stay by my side. What if I had another horrendous episode? Would he tire of me? Of my depression? Would he leave? Or would he stay out of duty or guilt and end up angry and resentful toward me? I did not know which was worse! I was torn, and these destructive thoughts flooded my mind every time I found myself alone. And since my husband was still teaching classes in the next state over, I had a lot of alone time - especially in the evenings. It wasn't long before this way of thinking became unbearable. I had anxiety attack and anxiety attack. I tried to busy myself and distract myself with the larger world, but I could not stand being by myself and fighting with my own mind. Days were hard; nights were harder. 


I needed help.


(to be continued...)