Category Archives: Depression

Sunshine as Suicide Prevention

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photo (16)Sunny days may reduce the incidence of suicide. These are findings published this week by researchers who analyzed of 30 years suicide data in Austria, comparing the number of suicides on a given day to the corresponding history of cloudy days .

Two findings emerged. First, a single day of cloudiness may be the final straw for the person muddled in suicidal thinking. Second, a long period of cloudy days increases the risk of suicide.

Two take-away messages may be important for those who struggle with depression. First, you may not feel like going outside on sad days but these may be the most essential days to get into the sunlight. Second, when cloudy days follow cloudy days, it is vitally important to do things that stabilize or elevate your mood. Exercise, call a friend, or do that good thing that helps you feel better. And, reach out to a counselor or physician without delay if destructive thoughts begin to dominate your thinking.

Whether you experience periods of depressed mood or not, get outside in the sunshine this week. It may lighten your eyes as well as your spirit.

(1) Benjamin Vyssoki and others. Direct Effect of Sunshine on Suicide. JAMA Psychiatry. Published online September 10, 2014

Bad Things Happen to Good People

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photo (53)Spiritual beliefs may get distorted in times of depression; especially when bad things happen to good people. Viewing God as uncaring or unreal can be a part of the black mood experience. So how are we to think about a god who allows bad things to happen to good people?

In responding to this question, I will begin placing quotation marks around the words ‘good’ and ‘bad’ because sometimes what appears to be ‘bad’ is actually ‘good’. This, I believe, is frequently true in our view of life events.

Often, in the grand scheme of the universe as God knows it, what looks to be ‘bad’ is ultimately ‘good’. Look at Christ on the cross. Wow! Did a very ‘bad’ thing happen to a ‘good’ man? Or, did an ultimately very good thing happen to a very good man?

In smaller ways, God may be using ‘bad’ things to bring ‘good’ things into your life and the lives of those you love. Accepting this suggestion is not easy. Keeping faith when life hurts is hard.

We need a renewed perspective, like the writer of Trustful Surrender who said:

“If we could see all He sees
we would unhesitantly wish all He wishes.
We would beg Him on bended knees for those afflictions
we now ask Him to spare us.”(1)

Bad things do happen to good people. When they do, may God help us to submit to his will so that, in these hardships, we might be transformed into the man or woman he intends us to become.

(1) Jean Baptiste Saint-Jure and Claude de la Colombiere. Trustful Surrender to Divine Providence, The secret of peace and happiness. St. Benedict Press, Charlotte, NC. 1980 (originally written in 17th Century).

Encouragement for Periods of Depression

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125There are dark clouds.
There are blue skies.
You have to know that there are blue skies beyond the dark skies.
Right now, clouds obstruct your view.
Right now, you have to know with intuition and faith, that good days are a reality and when the clouds pass you will experience again the joys of a beautiful day.

The key is to know that bad days will pass – better days will come.
It happens.
As you wait through cloudy days, hang onto a long-range vision and focus your mind on faith.
Strength will rise and clouds will part.

Robin Williams – Drunk on Despair?

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Photo source: UptownMagazine.com

Photo source: UptownMagazine.com

Outside appearances can be deceiving. A great actor made many of us smile, chuckle, and overflow with laughter. Few people would list him as one of the people we suspect of being depressed, yet Robin Williams died one week ago of apparent suicide. Somewhere underneath, he struggled with and succumbed to hopelessness.

Depression can be an illness of the brain, an injury to neurons, an imbalance of biochemistry. In Breaking Through Depression (BTD), I describe a process in which repeated stressors injure the brain, leading to depressive illness.

In my conversations with people who struggle with thoughts of suicide, I have come to think of depression as a chemical imbalance that is similar to the intoxication produced by excessive alcohol use. In this state of chemically-induced confusion, people form false impressions of their value and potential. Chemically overpowered and drunk on despair, they become sick of themselves and their lives, believing a lie that they tell to themselves – that loved ones would be better off without them. This has always been untrue of the people I have counseled who have survived the loss a loved one to suicide.

Severe depression with its suicidal notions can most often be relieved with professional treatment and patience. Quite often people look back with wonder, questioning: “How did I ever get to that place in my life?” For others, thoughts of suicide persist but are balanced by the awareness of goodness in life and their value to others. Suicide is often the wrong short term solution to a long term, yet treatable, illness.

If you or a loved one are struggling with depression, get help! Tell your friend, your doctor, your pastor or priest, your mother or your brother – tell somebody! Then seek professional help and learn more about this hidden illness by reading a book like BTD

 

Mind-Body Medicine in the Forest

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iphone June 2014 085Relaxing in the woods may reduce the risk of developing anxiety and depressive disorders. Scientists in Japan compared the physical signs of stress in city and forest settings. They studied the levels of stress hormone (cortisol) and blood pressure in 300 people, and found that spending time in the woodsy setting was associated with fewer signs stress (1).

In the book Breaking Through Depression, I describe the links between prolonged stress, cortisol elevation, anxiety, and depression. In the simplest way, it can be said that chronic high stress damages the brain which may lead to depression.

We all have a lot to do this month – many things to manage in our work and personal lives. So how do we reduce the risk of stress injuries in the brain which may lead to or worsen depression?

One answer appears to be spending some time in the woods. Relax. Enjoy the green colors of summer, the yellow leaves of fall, and the curiously bare trees of winter. As you focus on the novelties of nature, forgetting about problems with work and relationships, your mind and body relax… Be calm… Be quiet… Enjoy the beauty of nature for a while.

(1) Bum Jin Park, and others. The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing): evidence from field experiments in 24 forests across Japan. Environmental Health Preventative Medicine. Jan 2010; 15(1): 18–26.

(2) Donald Hall. Breaking Through Depression. Harvest House, 2009.

Treating Depression with Time Outdoors

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iphone June 2014 148Scientists have proven what mothers have been telling children for years: “Get outside of the house for a while. The fresh air will do you some good.”

Citing a collection of five studies*, researchers show that enjoying the sights and sounds of nature can produce noticeable improvements in physical and mental energy. Exposure to novel objects in wilderness settings tends to replenish attention and spark mental energy.

Even viewing pictures of nature, they say, may help to restore healthy moods, “including lower feelings of stress and depression.” These observations help to explain why popular vacation choices often involve spending time in novel nature settings.

So do as mothers and scientists suggest: go for a walk outdoors. Experience something new and natural along the way, allowing the experience to rejuvenate the energies of your mind, body, and spirit.

* Richard Ryan and others. “Vitalizing effects of being outdoors and in nature”. Journal of Environmental Psychology, 30 (2010) 159-168.

Medication Vs Counseling

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Photo source: jigsawhealth.com

Photo source:
jigsawhealth.com

To Medicate or Not to Medicate? That is the question.

In managing depression, the answer quite often is to do both. When it comes to treating depressive illness and preventing its return, talking therapies and antidepressant medication work better together than either alone. A leading medical journal recently validated this point by reviewing research on more than 100,000 patients (1). Of the studies focusing on depression, researchers found that adding medication to counseling treatment reduced symptoms. Likewise, adding counseling to medication treatment reduced symptoms.

This should be no surprise. Research discussed in my prior blogs shows that psychotherapy and medication both change the brain. When a counselor says the right words and the counselee applies the right thinking, then brain chemistry may be rebalanced. From another perspective, when antidepressant medication corrects chemical imbalance, then healthier moods promote more effective participation in counseling.

Managing depression can be a long term proposition. As with any illness, keep searching for the right treatment or combination of treatments. Restore the chemical balance that facilitates good thinking with medication and develop healthier choice-patterns with psychotherapy. Remember that depression is an illness of body, mind, and spirit; and seek ways to care for each part of yourself.

1. Huhn, Maximilian and others. Efficacy of pharmacotherapy and psychotherapy for adult psychiatric disorders: A systematic overview of meta-analyses. Journal of the American Medical Association – Psychiatry. Published online April 30, 2014.

The Heart – Brain Connection

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photo (16) As a psychiatry intern at Walter Reed Army Medical Center, years ago, I was asked to evaluate a woman admitted to the ICU due to chest pain. I asked the standard questions.

When I asked about the picture of a man displayed on her bedside table, she burst into tears and clutched the picture to her chest. She began sobbing about the recent loss of her husband. Nurses rushed into the room and asked what was going on. Her EKG monitors were showing signs of ischemia and risk of myocardial infarction. Grief was leading to heart-attack. Nurses gave her nitroglycerin and her heart recovered without injury.

The mind-body connection is real. It can promote health or lead to death. Our stress response system, mediated by the hypothalamus of the brain and the adrenal glands in the abdomen, needs to be regulated.

We can work toward a healthy balance of stress and relaxation by making smarter behavioral choices. Exercising five times per week has been shown to reduce mild depression, a stress-related injury of the brain. Practicing meditation has been proven to relieve unhealthy levels of anxiety, a gateway to physical illness. Even a walk through the woods has been studied and found to promote brain and cardiovascular health.

It’s a busy world out there, where taking time to relax or to focus on emotional health seems like a waste of time. Relaxing from a busy schedule is not a waste of time. Healthy levels of rest promote improved brain efficiency and a sense of emotional wholeness. Put that on your schedule and do it!

Donald Hall. A Widow’s Grief: Language of the heart, Journal of the American Medical Association, 1992. 268:871-872.

Sin on the Brain

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photo (39)Life experiences change the brain. As we learn new things, brain cells sprout new branches and make new connections. These synaptic connections create new pathways on which nerve impulses travel.

Learning new things is like forming a path through an open field. If you walk through a meadow, following the same route many times, you will tromp down the weeds and create a path. The more you use that pathway, the more entrenched it becomes.

Choosing to obey God also produces pathways. The more you travel paths of righteousness, the easier it gets for your brain to go that way.

Disobeying God creates alternate pathways. The more you make wrong turns and choose sin-pathways, the easier it becomes for your brain to go that way again.

Sin is not caused by the brain but is reflected in brain cell networks. Sinful choices leave marks – changes in synaptic connections. When too many pathways lead to the amygdala (anger center) unrighteous rage erupts. If too many connections lead to the nucleus accumbens (pleasure center) addictions corrupt healthy ways to find pleasure.

Spiritual growth, on the other hand, can be reflected by building healthy behavioral choice pathways to the prefrontal cortex, the region responsible for reasoned responses. Growing connections to the prefrontal cortex, through spiritual experience and religious practice, may facilitate wise choices.

So, open your mind to God. Meditate on the life of Jesus. Read something that stirs your spirit. Brain cells will spout in new directions.

It may be hard at first. Treading out a new pathway though a meadow may cause scratches and bruising. Likewise, building new behavioral choice pathways around your brain may provoke annoyance and frustration at times; but God never promised an easy path. He promised the Holy Spirit to comfort you along the way.

For a video clip of brain cell pathways, click: http://www.youtube.com/watch?v=hRLhlf6hDgU

The 3-Letter S-Word

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photo (8)Some have commented on references to sin in my last blog. Specifically, the phrase: “the stench of sin”, has triggered some annoying levels of guilt with some people. The words were described as “fire and brimstone” by one reader and as “Catholic guilt” by another.

Assuredly, getting stuck in guilt was not my intent. The purpose of the blog was to acknowledge the problem of sin and suggest a remedy: repentance, acceptance of forgiveness, and renewal of a right spirit.

Guilt can be healthy or unhealthy. Too much focus on sin leads to unhealthy guilt – an obsessive scrupulosity that handicaps people through overwhelming self-criticism. Too little focus on guilt, on the other hand, leads to self-serving behavior and gross disregard for the concerns of others.

Good guilt is a psycho-spiritual state of conviction that leads to repentance and acceptance of forgiveness. Daily victory over wrong-doing comes through acknowledging our weakness and our utter reliance on the power of God.

As influential psychiatrist Karl Menninger encourages readers in his book, Whatever Became of Sin?, “If we believe in sin – as I do – we have a responsibility for trying to correct it.” Correction starts with repentance and is lived-out through seeking a new way – a process, not perfection.

Menninger, Karl. Whatever Became of Sin? New York, Hawthorne Books, 1973.