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Depression
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I have split this lot up into numberd sections,
Hope this is a help and comfort...

  1. Why Do I Get So Depressed?
  2. Drawing Comfort from the Scriptures
  3. Consolation for the Depressed
  4. Relief from Depression
  5. You Can Deal with Depression
  6. They Want to Help
  7. Mental Distress—When It Afflicts a Christian
  8. How to Help Depressed Ones Regain Joy
  9. Winning the Battle Against Depression
  10. You Can Find Joy in a Depressing World!
  11. Consolation for the Depressed
  12. Are You Suffering From Depression?
  13. Dealing With Depression
  14. Depression—How to Treat It
  15. Depression—How Does It Feel?
  16. Help From ‘the God of Comfort’
  17. Living With a Mood Disorder
  18. Winning the Battle
  19. Understanding Postpartum Depression
  20. I Won My Battle With Postpartum Depression
  21. Recognizing the Signs
  22. Uncovering the Roots
  23. Coming to Terms
  24. A Definition of CFS
  25. Fighting a Relentless Foe
  26. Depression: All in One’s Head?
  27. The Psychological Roots
  28. Winning the Fight Against Depression
  29. Defeating Depression—How Others Can Help
  30. Why Do I Get So Depressed?
  31. What if It’s More Than Just the Blues?
  32. Is It All in the Mind?
  33. How You Can Fight Depression
  34. How Others Can Help
  35. Attacking Major Depression—Professional Treatments
  36. How Dangerous Really Are Drugs?
  37. Mental Depression Afflicts Millions—Why?
  38. What Can You Do About Being Depressed?
  39. Useful links I found

Part 1

1.  Why Do I Get So Depressed?

Melanie had always lived up to her mother’s ideal of the perfect child—until she turned 17. Then she withdrew from school activities, stopped accepting invitations to parties, and didn’t even seem to care when her grades dropped from A’s to C’s. When her parents gently inquired what was wrong, she stormed away saying, “Leave me alone! There’s nothing wrong.”
Mark, at 14, was impulsive and hostile, with an explosive temper. At school he was fidgety and disruptive. When frustrated or angry, he would race across the desert on a motorcycle or shoot down steep hills on his skateboard.
MELANIE and Mark both suffered forms of the same malady—depression. Dr. Donald McKnew of the National Institute of Mental Health says that 10 to 15 percent of schoolchildren may suffer mood disorders. A smaller number suffer from severe depression.
At times there is a biologic basis for the problem. Some infections or endocrine-system diseases, the hormonal shifts of the menstrual cycle, hypoglycemia, certain medications, exposure to toxic metals or chemicals, allergic reactions, an unbalanced diet, anemia—all of these can trigger depression.
Pressures at the Root of Depression
However, the teen years themselves are often the source of emotional stress. Not having an adult’s experience in handling life’s ups and downs, a youth can feel that no one cares and could become painfully depressed over relatively commonplace matters.
Failing to measure up to the expectations of parents, teachers, or friends is another cause of melancholy. Donald, for example, felt that he had to excel in school to please his well-educated parents. Failing to do that, he became depressed and suicidal. “I have never done anything right. I have always let everybody down,” lamented Donald.
That a sense of failure can kindle depression is evident from the case of a man named Epaphroditus. During the first century, this faithful Christian was sent on a special mission to assist the imprisoned apostle Paul. But when he reached Paul he soon fell sick—and Paul, instead, had to care for him! You can imagine, then, why Epaphroditus might have felt like such a failure and became “depressed.” Apparently he overlooked all the good he had performed before he got sick.—Philippians 2:25-30.
A Sense of Loss
Francine Klagsbrun wrote in her book Too Young to Die—Youth and Suicide: “At the root of many emotionally caused depressions lies a profound sense of loss, of someone or something that has been deeply loved.” Thus the loss of a parent through death or divorce, the loss of a job or career, or even the loss of one’s physical health could also be at the root of depression.
A most devastating loss to a young person, though, is the loss of love, the feeling of being unwanted and uncared for. “When my mother left us I felt betrayed and alone,” revealed a young woman named Marie. “My world suddenly seemed upside down.”
Imagine, then, the bewilderment and pain some youths feel when faced with family problems such as divorce, alcoholism, incest, wife beating, child abuse, or simple rejection by a parent who is swallowed up in his or her own problems. How true the Bible proverb: “Have you shown yourself discouraged in the day of distress? Your power [including the ability to resist depression] will be scanty”! (Proverbs 24:10) A youth may even mistakenly blame himself for his family’s problems.
Recognizing the Symptoms
There are different degrees of depression. A young person might temporarily be demoralized by some upsetting event. But usually such blues fade in a relatively short time.
However, if the depressed mood lingers and the youth has a general negative feeling along with feelings of worthlessness, anxiety, and anger, this can develop into what doctors call low-grade chronic depression. As the experiences of Mark and Melanie (mentioned at the outset) show, the symptoms can vary considerably. One young person may have anxiety attacks. Another may be tired all the time, have no appetite, experience trouble in sleeping, lose weight, or suffer a series of accidents.
Some young persons try to hide depression by embarking upon a pleasure binge: an endless round of parties, sexual promiscuity, vandalism, heavy drinking, and the like. “I don’t really know why I have to be going out all the time,” confessed one 14-year-old boy. “I just know if I’m by myself, alone, I realize how bad I feel.” It is just as the Bible described: “Even in laughter the heart may be in pain.”—Proverbs 14:13.
When It’s More Than Just the Blues
If low-grade chronic depression is not dealt with, it can progress to a more serious disorder—major depression. (See page 107.) “I constantly felt as if I were ‘dead’ inside,” explained Marie, a victim of major depression. “I was just existing without any emotions. I had a feeling of constant dread.” In major depression the gloomy mood is unrelenting and may continue for months. Consequently, this type of depression is the most common ingredient in teen suicides—now considered a “hidden epidemic” in many countries.
The most persistent emotion connected with major depression—and the deadliest—is a deep sense of hopelessness. Professor John E. Mack writes of a 14-year-old named Vivienne, who was a victim of major depression. To all outward appearances she was a perfect young lady with caring parents. Yet, in the depths of despair, she hanged herself! Wrote Professor Mack: “Vivienne’s inability to foresee that her depression would ever lift, that she had any hope of ultimately obtaining relief from her pain, is an important element in her decision to kill herself.”
Those affected with major depression thus feel as if they will never get better, that there is no tomorrow. Such hopelessness, according to experts, often leads to suicidal behavior.
Suicide, however, is not the answer. Marie, whose life had become a living nightmare, confessed: “The thoughts of suicide definitely came into my mind. But I realized that as long as I didn’t kill myself there was always hope.” Ending it all indeed solves nothing. Unfortunately, when confronted with despair, many young persons cannot even visualize alternatives or the possibility of a favorable outcome. Marie thus tried to hide her problem by injecting herself with heroin. She said: “I had plenty of self-confidence—until the drug wore off.”
Dealing With Minor Distress
There are sensible ways of dealing with feelings of depression. “Some people get depressed because they’re hungry,” observed Dr. Nathan S. Kline, a New York specialist on depression. “A person may not eat breakfast and for some reason miss lunch. Then by three o’clock he begins wondering why he doesn’t feel right.”
What you eat can also make a difference. Debbie, a young woman plagued with feelings of despair, admitted: “I didn’t realize that junk food was so detrimental to my mood. I ate a lot of it. Now I notice that when I eat fewer sweets, I feel better.” Other helpful steps: Some form of exercise may lift your spirits. In some cases, a medical checkup would be in order, since depression can be a symptom of physical illness.
Winning the Battle of the Mind
Often depression is brought on or made worse by having negative thoughts about yourself. “When you’ve been through a lot of people cutting at you,” lamented 18-year-old Evelyn, “it makes you think you’re not worth anything.”
Consider: Is it up to others to measure your worth as a person? Similar ridicule was heaped upon the Christian apostle Paul. Some said that he was a weakling and a poor speaker. Did this make Paul feel worthless? Not at all! Paul knew that meeting God’s standard was the important thing. He could boast over what he had accomplished with God’s help—regardless of what others were saying. If you, too, remind yourself of the fact that you have a standing with God, the gloomy mood will often leave.—2 Corinthians 10:7, 10, 17, 18.
What if you are depressed because of some weakness or sin you have committed? “Though the sins of you people should prove to be as scarlet,” God told Israel, “they will be made white just like snow.” (Isaiah 1:18) Never overlook the compassion and patience of our heavenly Father. (Psalm 103:8-14) But are you also striving hard to overcome your problem? You must do your part if you are to ease your mind of feelings of guilt. As the proverb says: “He that is confessing and leaving [his transgressions] will be shown mercy.”—Proverbs 28:13.
Another way to fight the blues is to set realistic goals for yourself. You don’t have to be top in your school class to be successful. (Ecclesiastes 7:16-18) Accept the fact that disappointments are a part of life. When these occur, rather than feel, ‘No one cares what happens to me and no one ever will,’ tell yourself, ‘I’ll get over it.’ And there’s nothing wrong with having a good cry.
The Value of Accomplishment
“Despair doesn’t go away on its own,” advises Daphne, who successfully lived through bouts of discouragement. “You have to think on a different line or physically get involved. You have to start doing something.” Consider Linda, who said when working hard to fight a sullen mood: “I’m on a sewing spree. I can work on my wardrobe and, in time, I forget about what’s troubling me. It really helps.” Doing things that you are good at can build your self-esteem—which is usually at rock bottom during depression.
Also beneficial is engaging in activities that bring you pleasure. Try shopping for some personal treat, playing games, cooking your favorite recipe, browsing through a bookstore, dining out, reading, even working at a puzzle, such as those that appear in Awake! magazine.
Debbie found that by planning short trips or setting little goals for herself, she could cope with her depressed mood. However, doing things to aid others proved to be one of her biggest helps. “I met this young woman who was very depressed, and I began to help her to study the Bible,” revealed Debbie. “These weekly discussions gave me opportunity to tell her how she could overcome her depression. The Bible gave her real hope. This helped me at the same time.” Just as Jesus said: “There is more happiness in giving than there is in receiving.”—Acts 20:35.
Talk to Someone About It
“Anxious care in the heart of a man is what will cause it to bow down, but the good word is what makes it rejoice.” (Proverbs 12:25) A “good word” from an understanding person can make all the difference in the world. No human can read your heart, so pour it out to someone you trust who has the ability to help. “A friend is loving at all times, and becomes a brother in times of trouble,” according to Proverbs 17:17. (The Bible in Basic English) “When you keep it to yourself it is like carrying a heavy load all alone,” said 22-year-old Evan. “But when you share it with someone who is qualified to help, it becomes much lighter.”
‘But I’ve already tried that,’ you may say, ‘and all I get is a lecture to look on the bright side of life.’ Where, then, can you find someone who will be not only an understanding listener but also an objective counselor?—Proverbs 27:5, 6.
Finding Help
Begin by ‘giving your heart to’ your parents. (Proverbs 23:26) They know you better than anyone else does, and they can often help if you let them. If they discern the problem is severe, they might even arrange for you to receive professional help.
Members of the Christian congregation are another source of help. “Over the years I had put up such a pretext that no one really knew how depressed I was,” revealed Marie. “But then I confided in one of the older women in the congregation. She was so understanding! She had gone through some of the same experiences I had. So I was encouraged to realize that other people have gone through things like this and have come out just fine.”
No, Marie’s depression did not clear up immediately. But gradually she began to cope with her emotions as she deepened her relationship with God. Among Jehovah’s true worshipers you too can find friends and “family” who are genuinely interested in your welfare.—Mark 10:29, 30; John 13:34, 35.
Power Beyond What Is Normal
The most powerful aid in dispelling gloom, however, is what the apostle Paul called “the power beyond what is normal,” which comes from God. (2 Corinthians 4:7) He can help you fight off depression if you lean on him. (Psalm 55:22) With his holy spirit he gives power beyond your normal resources.
This friendship with God is truly reassuring. “When I have sad times,” said a young woman named Georgia, “I pray a lot. I know that Jehovah is going to provide a way out no matter how deep a problem I have.” Daphne agrees, adding: “You can tell Jehovah everything. You just pour out your heart and you know, even if no human can, he really understands you and cares about you.”
So if you are depressed, pray to God, and seek out someone wise and understanding to whom you can bare your feelings. In the Christian congregation you will find “older men” who are skillful counselors. (James 5:14, 15) They stand ready to help you maintain your friendship with God. For God understands and invites you to throw your anxieties upon him “because he cares for you.” (1 Peter 5:6, 7) Indeed, the Bible promises: “The peace of God that excels all thought will guard your hearts and your mental powers by means of Christ Jesus.”—Philippians 4:7.
[Footnotes]
Most medical experts advise that victims of major depression should receive professional help because of the danger of suicide. For example, there may be a need for medication that can only be dispensed by a medical professional.
Questions for Discussion
□ What are some things that can cause a youth to become depressed? Have you ever felt that way?
□ Can you identify the symptoms of low-grade chronic depression?
□ Do you know how to recognize major depression? Why is this such a serious malady?
□ Name some ways of battling the blues. Have any of these suggestions worked for you?
□ Why is it so important to talk matters out when you are seriously depressed?
[Blurb on page 106]
Severe depression is the most common factor in teen suicides
[Blurb on page 112]
A personal friendship with God can help you to deal with major depression
[Box on page 107]
Could It Be Major Depression?
  Anyone may suffer temporarily from one or more of the following symptoms without having a serious problem. However, if several symptoms persist, or if any is severe enough that it interferes with your normal activities, you may have (1) a physical illness and need a thorough examination by a doctor or (2) a serious mental disorder—major depression.
  Nothing Gives You Pleasure. You can’t find pleasure in activities you once enjoyed. You feel unreal, as if in a fog and just going through the motions of living.
  Total Worthlessness. You feel that your life has nothing important to contribute and is totally useless. You may feel full of guilt.
  Drastic Change of Mood. If you were once outgoing, you may become withdrawn or vice versa. You may often cry.
  Total Hopelessness. You feel that things are bad, there’s nothing you can do about them, and conditions will never get better.
  Wish You Were Dead. The anguish is so great that you frequently feel that you would be better off dead.
  Cannot Concentrate. You go over and over certain thoughts or you read without comprehension.
  Change in Eating or Bowel Habits. Loss of appetite or overeating. Intermittent constipation or diarrhea.
  Sleeping Habits Change. Poor or excessive sleep. You may frequently have nightmares.
  Aches and Pains. Headaches, cramps, and pains in the abdomen and chest. You may constantly feel tired for no good reason.
[Picture on page 108]
Failure to live up to one’s parents’ expectations can cause a youth to feel depressed
[Picture on page 109]
Talking to others and pouring out your heart is one of the best ways to cope
[Picture on page 110]
Doing things for others is yet another way to beat the blues

Part 2


 
2.  Drawing Comfort from the Scriptures

“I have remembered your judicial decisions from time indefinite, O Jehovah, and I find comfort for myself.”—Ps. 119:52.
IN THE ancient Middle East, the solitary shepherd tending his flocks in the open fields often carried some musical instrument, perhaps a pipe. With it he would break the night’s stillness and entertain himself. Though lonely, he could draw comfort from music. It can stir the emotions, or produce a soothing effect, resulting in a feeling of peace and contentment.
2 Appropriately then, the psalmist said of Jehovah God’s just rules: “Melodies your regulations have become to me in the house of my alien residences. In the night I have remembered your name, O Jehovah, that I may keep your law.” (Ps. 119:54, 55) At times beautiful strains would flow from a harp in the hands of a skillful instrumentalist, perhaps during songs of praise to God. “Cry out joyfully, O you righteous ones, because of Jehovah,” exclaimed the psalmist, adding: “On the part of the upright ones praise is fitting. Give thanks to Jehovah on the harp; on an instrument of ten strings make melody to him. Sing to him a new song; do your best at playing on the strings along with joyful shouting. For the word of Jehovah is upright, and all his work is in faithfulness.” (Ps. 33:1-4) David did not forget the melodies and lyrics of such musical compositions, for he said: “I will remember my string music in the night; with my heart I will show concern, and my spirit will carefully search.”—Ps. 77:6.
3 As music can soothe a person and produce a feeling of contentment, so too does the Word of Jehovah God, the Bible, have a helpful and comforting effect upon those turning to it for spiritual aid. It is not uncommon for imperfect humans faced with trials to experience depression, grief or fear. Yet words written centuries ago under divine inspiration were penned for the instruction of Christians, so that by enduring and “through the comfort from the Scriptures we might have hope.”—Rom. 15:4.
DEALING WITH DEPRESSION
4 “It is hopeless. It seems everything I do goes wrong. I’m a failure!” Words like these are not unusual. Many voice such sentiments. Even faithful Christians are sometimes the victims of depression. However, the Scriptures show that some of Jehovah’s faithful servants of ancient times also had these feelings. For instance, when Esau took Hittite women as wives, “they were a source of bitterness of spirit to Isaac and Rebekah.” And unhappy Rebekah was moved to say: “I have come to abhor this life of mine because of the daughters of Heth. If Jacob ever takes a wife from the daughters of Heth like these from the daughters of the land, of what good is life to me?” (Gen. 26:34, 35; 27:46) During his severe test, Job spoke like a man who felt God had abandoned him. (Job 29:2-5) Nehemiah, concerned about the devastated state of Jerusalem and its walls, was gloomy while before King Artaxerxes. (Neh. 2:1-3) So depressed and distressed was the apostle Peter over his denial of Jesus Christ that he “wept bitterly.” (Luke 22:62) The apostle Paul said of his trials and feelings: “We are pressed in every way, but not cramped beyond movement; we are perplexed, but not absolutely with no way out; we are persecuted, but not left in the lurch; we are thrown down, but not destroyed.” (2 Cor. 4:8, 9) Evidently because depression beleaguered some Christians in Thessalonica, Paul admonished fellow believers there to “speak consolingly to the depressed souls.” (1 Thess. 5:14) So, feelings of depression on the part of Christians today are not without ancient parallels. But, what might be done to cope with depression?
5 At times depression develops because a person has several serious problems. Life becomes dismal because these seem to add up to one great plight. But, instead of viewing them as such, why not deal with them individually, as far as possible? Making suitable efforts to resolve one at a time is surely better than linking these problems together in one’s mind and experiencing frustration. For example, a Christian woman may have a marriage mate opposed to her religion. This is one problem and she may be able to cope with it successfully by applying such inspired advice as that found at 1 Peter 3:1-6. However, possibly the children have also been misbehaving at school. This is another problem. Perhaps she needs only to report this to her husband, so that he can take remedial measures. Or, the children may need to have God’s requirements explained to them, such as what is said at Proverbs 6:16-19. Possibly a difference has developed between this woman and another Christian. This is a separate problem and Christians should handle such matters in the manner outlined by Christ. (Matt. 18:15-17) So, then, instead of becoming depressed by looking upon several rather unrelated problems as though they formed one major dilemma, handle these matters separately and effectively by applying the Word of God in life.
6 Sufficient rest and sleep are needed too. A person may fail to schedule his activities properly. He may stay up late at night, viewing television or engaging in some form of recreation, only to find that the good effects he had hoped to achieve thereby are nullified by the depression that often afflicts one who is fatigued. To avoid or fight against depression, balanced activity and adequate rest are important.
7 Some Christians do not have many material possessions; they are not materially rich. This may give rise to discontent or depression. Yet, think of Jesus Christ. He once said: “Foxes have dens and birds of heaven have roosts, but the Son of man has nowhere to lay down his head.” (Luke 9:58) Despite this, was Jesus happy? Indeed he was, in doing his heavenly Father’s will. (Heb. 10:5-9; Ps. 40:6-8) He did not need many material possessions to be contented. He frankly stated: “Keep your eyes open and guard against every sort of covetousness, because even when a person has an abundance his life does not result from the things he possesses.” This Jesus proved by means of an illustration showing that one is not preserved alive just because he has “many good things laid up for many years.” Life depends upon being rich toward God. (Luke 12:13-21) Christ advised his disciples not to be anxious about such things as food and clothing and pointed out that God knows of such needs and sees that they are supplied for those who “seek continually his kingdom.”—Luke 12:22-31.
8 During his prehuman existence in heaven, Christ enjoyed spiritual things of far greater value than anything material. (John 1:1-3; Col. 1:15-17) Yet he divested himself to become a human. (Phil. 2:5-8) As a perfect man on earth, Jesus did without material riches and worldly splendor and in him true Christians who may not be wealthy have a superlative example of godly contentment. Peter and other apostles gave up many material things to follow Jesus, Peter himself once saying: “Look! We left all things and have been following you.” (Mark 10:28) But were they not richly rewarded? Once they walked with Jesus Christ and heard him speak as a man on earth. Today they enjoy marvelous blessings with him in heaven, having been resurrected to spirit life in heaven for their faithfulness till death. (Rev. 2:10; 11:18; 1 Cor. 15:20-23, 50-52) Of course, not all Christians have a heavenly hope. But Christians with earthly prospects realize that marvelous blessings are in store for faithful ones here on earth and that it will not be long before they realize the complete fulfillment of these words: “Jehovah of armies will certainly make for all the peoples, in this mountain, a banquet of well-oiled dishes, a banquet of wine kept on the dregs, of well-oiled dishes filled with marrow, of wine kept on the dregs, filtered.” (Isa. 25:6) Right now Jehovah is supplying rich spiritual fare for those who love him and he will still more abundantly furnish spiritual and material things for those having his favor. Of him, the psalmist truthfully said: “You are opening your hand and satisfying the desire of every living thing.” (Ps. 145:16) This is not the time to feel great discontent or to yield completely to depression over scarcity or lack of material things. It is the time to draw comfort from Scriptural promises of grand things ahead and to serve Jehovah loyally and joyfully.
9 Christians plagued with depression for various reasons will do well to pray to Jehovah for his holy spirit and for his aid in cultivating and displaying joy, a fruit of the spirit. (Luke 11:13; Gal. 5:22, 23) Jesus advised: “Never be anxious about the next day, for the next day will have its own anxieties. Sufficient for each day is its own evil.” (Matt. 6:34) The apostle Paul recommended prayer, not apprehensive care, when he wrote the Philippians: “Do not be anxious over anything, but in everything by prayer and supplication along with thanksgiving let your petitions be made known to God; and the peace of God that excels all thought will guard your hearts and your mental powers by means of Christ Jesus.” (Phil. 4:6, 7) Similarly, Peter said: “Humble yourselves, therefore, under the mighty hand of God, that he may exalt you in due time; while you throw all your anxiety upon him, because he cares for you.” (1 Pet. 5:6, 7) Yes, Jehovah really cares for those trusting in him. Of course, it is not wrong to think about a problem and take practical and suitable steps to solve it, if possible. But, after we have done what we can respecting the matter, worry will achieve nothing more and can never take the place of prayer. Fittingly, David said: “Roll upon Jehovah your way, and rely upon him, and he himself will act.”—Ps. 37:5.
ENDURING GRIEF
10 When King David heard of the death of Absalom, he was grief-stricken, gave way to weeping, and exclaimed: “My son Absalom, my son, my son Absalom! O that I might have died, I myself, instead of you, Absalom my son, my son!” (2 Sam. 18:33) Centuries earlier, when Abraham lost his beloved wife Sarah through death, he bewailed her and wept over her. (Gen. 23:2) Jesus Christ was also greatly grieved when his friend Lazarus died, for before going to the tomb to raise him from death “Jesus gave way to tears.” (John 11:35) While there are various reasons for grief, death of a relative or close friend is certainly one cause of great, sometimes nearly overwhelming, sorrow.
11 When death claims a cherished acquaintance, it is only natural to experience sadness. However, like the apostle Paul, Christians realize and have confidence in the fact that there will be a “resurrection of both the righteous and the unrighteous.” (Acts 24:15) Hence, they do not “sorrow just as the rest also do who have no hope.” (1 Thess. 4:13) While Jehovah God determines who qualifies for a resurrection, billions of human dead will be raised, and Scriptural assurances of that are comforting. Especially can one draw consolation from the Bible when the deceased loved one was a faithful Christian. If that individual had the hope of an earthly resurrection, for instance, relatively soon, during Christ’s thousand-year reign, he will be awakened from the sleep of death right here on earth. (Rev. 20:11-13) One does not usually experience prolonged sadness when a dear friend goes on a long journey, for he expects to see him again upon his return. Taking a somewhat similar view of the death of such a faithful Christian acquaintance may help to lessen grief.
12 Solomon once observed: “A name is better than good oil, and the day of death than the day of one’s being born.” (Eccl. 7:1) That is true if a person has a good name with God at death, built up due to godly works, for then he is in line for a resurrection. Often the grief resulting from the death of a Christian loved one is increased by meditating on past experiences one has shared with the deceased. But, how much better it will be to give more consideration to the wonderful prospects of the future, as assured by the Word of God. Prayerfully, the bereaved Christian should look for aid to Jehovah, “the God of all comfort.” (2 Cor. 1:3) He should endeavor to center his thoughts on the wonderful promises Jehovah has made in the Scriptures, drawing comfort from them. There is also consolation in the Biblical assurance that Jehovah will deal tenderly with fatherless and widowed ones who love him. In an inspired song David exclaimed: “Sing you to God, make melody to his name; raise up a song to the One riding through the desert plains as Jah, which is his name; and jubilate before him; a father of fatherless boys and a judge of widows is God in his holy dwelling. God is causing the solitary ones to dwell in a house; he is bringing forth prisoners into full prosperity.”—Ps. 68:4-6.
COPING WITH FEAR
13 Today mankind is faced with many perils, and fear stalks the earth. This highly detrimental emotion may sometimes be felt to an extent even by persons dedicated to God. Concerning fear it has been said: “On many persons the influence of fear is far more serious in its effect than the worst form of any dreaded malady. In epidemic diseases the terror they inspire is often as fatal as the infection—paralyzing the system, and robbing the body of the natural elasticity of its nervous stamina, and the mind of the buoyancy of hope, making victims of those who, from age and strength, had the best probability of escaping. Fear is a mental poison, and the most potent of all antagonists to health and medicine; it is often fatally active in the morbid developments which result in various forms of insanity; and as faith has cured more diseases than physicians ever prescribed for, so fear is more destructive than the worst physical malady.”—The Encyclopedia Americana, 1956 Edition, Volume XI, page 74.
14 Obviously, there is good reason to avoid or conquer such fear. Persons having faith in Jehovah can face the future without apprehension, for despite worsening and fear-producing conditions throughout the earth, they can draw comfort from the words of Jesus Christ. After disclosing that fearful happenings would mark these “last days,” he said: “But as these things start to occur, raise yourselves erect and lift your heads up, because your deliverance is getting near.” (Luke 21:25-28) Also, Peter gave inspired admonition to shun worldly fears, saying: “The object of their fear do not you fear, neither become agitated.”—1 Pet. 3:14.
15 If a person permits his mind to dwell upon matters that cause fear, it is unlikely that he will make much progress toward overcoming this emotion. So, efforts should be made to replace such thoughts with those that produce other feelings. Filling the mind with spiritually wholesome things is always wise and beneficial. The apostle Paul wrote: “Finally, brothers, whatever things are true, whatever things are of serious concern, whatever things are righteous, whatever things are chaste, whatever things are lovable, whatever things are well spoken of, whatever virtue there is and whatever praiseworthy thing there is, continue considering these things.”—Phil. 4:8.
16 Yet there is a fear that the Scriptures recommend. It is not morbid dread, but the proper and beneficial fear of displeasing Jehovah God. Thus, we are told in the final words of the book of Ecclesiastes: “The conclusion of the matter, everything having been heard, is: Fear the true God and keep his commandments. For this is the whole obligation of man. For the true God himself will bring every sort of work into the judgment in relation to every hidden thing, as to whether it is good or bad.” (Eccl. 12:13, 14) Jehovah has always supported those having proper fear of him. The patriarch Abraham was one such man, and regarding him Genesis 15:1 states: “After these things the word of Jehovah came to Abram in a vision, saying: ‘Do not fear, Abram. I am a shield for you. Your reward will be very great.’” David said: “Even though I walk in the valley of deep shadow, I fear nothing bad, for you are with me; your rod and your staff are the things that comfort me.” (Ps. 23:4) Those fearing Jehovah will be able to stand though fearful occurrences surround them and they can share the sentiments of Psalm 46:1-3: “God is for us a refuge and strength, a help that is readily to be found during distresses. That is why we shall not fear, though the earth undergo change and though the mountains totter into the heart of the vast sea; though its waters be boisterous, foam over, though the mountains rock at its uproar.”
17 Some persons fear man, but Jesus said: “Do not become fearful of those who kill the body but cannot kill the soul; but rather be in fear of him that can destroy both soul and body in Gehenna.” (Matt. 10:28) At most, man can only take away one’s present life. However, God can destroy a person in Gehenna, from which there is no resurrection and thus no future life as a human soul. Even the demons cannot block a person’s resurrection. So Christians should not fear them. Furthermore, these wicked spirit creatures cannot gain control of the servant of God as long as he takes full advantage of Jehovah’s spiritual provisions by studying the Bible and Christian publications, attending Christian meetings, praying to God and engaging in the Christian ministry faithfully. An individual doing these things is equipped with the protective suit of spiritual armor from God. (Eph. 6:11-18) Nonetheless, should a Christian be beset by fears, let him pray to Jehovah for aid, as did David, who said: “I inquired of Jehovah, and he answered me, and out of all my frights he delivered me.”—Ps. 34:4.
18 If you sometimes experience depression, grief or fear to some degree, you may then find it highly beneficial to increase your effort to aid others, as through expanded ministerial activity. This will probably take your mind off of matters of great personal concern. Jehovah comforts us so that “we may be able to comfort those in any sort of tribulation through the comfort with which we ourselves are being comforted by God.” (2 Cor. 1:4) Aiding others is in itself a rewarding work.—Acts 20:35.
19 Remember, too, that present trials and tribulations will be short-lived, especially since we now stand at the very portals of Jehovah’s promised new order. (2 Cor. 4:16-18; 2 Pet. 3:11-13) A significant factor that has undoubtedly helped to sustain God’s servants under the most trying circumstances, as while suffering brutal persecution or incarceration, is keeping in mind the marvelous hope ahead. Paul admonished: “Rejoice in the hope ahead.” (Rom. 12:12) “For the joy that was set before him [Christ] endured a torture stake, despising shame.” Following his example will enable Christians to avoid getting tired and giving out in their souls. (Heb. 12:2, 3) Jehovah helps the faithful in time of distress or hardship, as Psalm 37:39, 40 shows in stating: “The salvation of the righteous ones is from Jehovah; he is their fortress in the time of distress. And Jehovah will help them and provide them with escape. He will provide them with escape from wicked people and save them, because they have taken refuge in him.” Those of the spiritual body of Christ who have died in faithfulness have had a resurrection to heavenly life and this has already done away with the imperfect human emotions they once had and that may have caused them distress. For the “great crowd” of faithful Christians with earthly hopes today there is the prospect of eventual human perfection, which certainly will not be accompanied by highly detrimental emotions.—Rev. 7:9, 10.
20 Always remember Jehovah’s judicial decisions and find comfort for yourself. (Ps. 119:52) Draw consolation and aid from the Scriptures. Let them lift your spirits, just like beautiful, soothing music. Make certain that you are regularly among those throughout the earth who maintain happiness by singing praises to Jehovah. “Praise Jah, you people, for it is good to make melody to our God; for it is pleasant—praise is fitting.”—Ps. 147:1.
“Jehovah is my Shepherd. I shall lack nothing. In grassy pastures he makes me lie down; by well-watered resting places he conducts me. My soul he refreshes. . . . Even though I walk in the valley of deep shadow, I fear nothing bad, for you are with me; your rod and your staff are the things that comfort me. . . . My cup is well filled.”—Ps 23:1-5.

Part 3


 
3.  Consolation for the Depressed

“I FEEL so depressed. Why is this happening to me? What have I done? I should be comforting others, but I cannot comfort myself. Have I committed the unforgivable sin? I think God has abandoned me!” You may recognize this as the cry of a Christian who unexpectedly finds himself very depressed.
Depression is a miserable feeling, but not uncommon. For example, a mature overseer nearing the end of a period of intense study is suddenly gripped by depressing thoughts. A middle-aged woman who works hard to meet her obligations is sad-faced and dejected. A zealous servant in a congregation, although having many living letters of recommendation, feels miserably depressed. A young mother with several Bible studies to her credit is painfully downcast and complains that God does not seem to be as close as she had hoped he would be. A young full-time minister raised “in the discipline and authoritative advice of Jehovah” is suddenly crushed by depressing doubts. An elderly Christian with long years of full-time ministry behind him fears that somehow he has lost the race for the heavenly crown of life.
COMMON EXPERIENCE
These true experiences are not news to students of the Bible. In 50 (A.D.) the apostle Paul exhorted the Christians in Thessalonica to “speak consolingly to the depressed souls.” (1 Thess. 5:14) After denying Christ the third time, Peter “went outside and wept bitterly,” undoubtedly very depressed by personal failure. On the road to Emmaus, Cleopas and another disciple “stood still with sad faces” and poured out their disappointment at the death of Jesus, who they had hoped was destined to deliver Israel. (Luke 22:62; 24:13-21) Paul, in his second letter to the Christians at Corinth, wrote: “We are pressed in every way, but not cramped beyond movement; we are perplexed, but not absolutely with no way out; we are persecuted, but not left in the lurch; we are thrown down, but not destroyed.” “In fact, when we arrived in Macedonia, our flesh got no relief, but we continued to be afflicted in every manner—there were fights without, fears within. Nevertheless God, who comforts those laid low, comforted us by the presence of Titus.”—2 Cor. 4:8, 9; 7:5, 6.
Faithful servants of Jehovah also suffered depressed feelings long before the Christian Era. Integrity-keeping Job had so many burdens that he spoke as if God were no longer with him: “As in the days when God was guarding me; . . . when intimacy with God was at my tent; when the Almighty was yet with me.” (Job 29:2, 4, 5) The Israelites worked so hard in Egyptian slavery that even when Jehovah sent a message of hope through Moses the discouraged people did not believe. (Ex. 6:6-9) Elkanah’s beloved wife Hannah was so disappointed over barrenness and vexed by a rival wife that “she would weep and not eat.” (1 Sam. 1:5-7) The harassed psalmist, feeling sad and abandoned, wrote: “I will say to God my crag: ‘Why have you forgotten me? Why do I walk sad because of the oppression of the enemy?’” (Ps. 42:9) These depressed feelings that leave one cheerless and unable to smile with ease are obviously a common experience that has befallen God’s servants from ancient times to our day. And the causes are still basically the same.
THE CAUSES
Depression is a temporary loss of optimism, courage and hope often termed “low spirits.” As we have seen, it can be induced by personal trials, a sense of personal failure, bitter disappointment, lack of clear understanding of God’s purpose and oppression. Often, however, the cause cannot be easily pinpointed, since a combination of circumstances is involved. A girl away from home may be out of work, alone and homesick. Physical and mental fatigue also team up to cause depression. Sometimes it may simply be poor health or worry. Periodic adjustments in one’s body chemistry may be accompanied by low spirits. Women frequently undergo depression during the menopause. Elderly people may be dejected because of failing physical strength or suspicion that they are unwanted. If one is fatigued by steady hard work or his mind is wearied by intense study and improper rest, he may begin to view life pessimistically, negatively. These are some common causes of the miserable state of depression. Occasionally depression may lean more toward spiritual sickness, with weakened faith and a corresponding inability to get comfort from the Scriptures. The spiritually sick one imagines that for some reason God has turned His back on him, and God-given promises of hope and sympathy are doubted. Whatever the particular cause, depressed feelings are never pleasant.
THE REMEDY
Just as the causes for depression may be one factor or a combination of factors, so the remedy may require one or more steps. Since the depressed mind often is not thinking properly on the facts, it must be refreshed. Then problems will be seen in a clearer light. First, give your body proper rest and attend to its other needs as far as possible. If you have been putting unreasonable demands on your physical stamina, make some adjustments in your schedule. See that late televiewing is not depriving you of needed sleep. Very often depression passes with simple remedies, since the healthy, rested person is able to approach his problems optimistically. He is able to weigh reasons for discouragement against reasons for hope and thereby keep his thinking controlled.
In any depressed state, and particularly where the cause is not easily removed, the Christian will earnestly call on Jehovah in the name of Jesus. The inspired psalmist urges us: “Throw your burden upon Jehovah himself, and he himself will sustain you. Never will he allow the righteous one to totter.” “Jehovah is giving support to all who are falling, and is raising up all who are bowed down.” (Ps. 55:22; 145:14) Confirmation of God’s keen interest in our low spirits comes through the prophet Isaiah: “For this is what the High and Lofty One, who is residing forever and whose name is holy, has said: ‘In the height and in the holy place is where I reside, also with the one crushed and lowly in spirit, to revive the spirit of the lowly ones and to revive the heart of the ones being crushed.’”—Isa. 57:15.
After throwing your burden upon Jehovah, devote as much time as you can drawing close to God through reading the Bible. The proverb says: “Anxious care in the heart of a man is what will cause it to bow down, but the good word is what makes it rejoice.” (Prov. 12:25) That God’s good Word can bring joy back into the heart and light to the sad eyes is attested by Psalm 19:7, 8: “The law of Jehovah is perfect, bringing back the soul. The reminder of Jehovah is trustworthy, making the inexperienced one wise. The orders from Jehovah are upright, causing the heart to rejoice; the commandment of Jehovah is clean, making the eyes shine.”
If your saddened state is due to bitter disappointment in yourself or others, or results from tribulation, remember that trial accomplishes much good when endured. Peter declares that “the person that has suffered in the flesh has desisted from sins, to the end that he may live the remainder of his time in the flesh, no more for the desires of men, but for God’s will.” (1 Pet. 4:1, 2) Yes, tribulation makes us see that our sure hope is in doing God’s will; we come through trial more appreciative of that fact. Apart from discipline, the Christian expects various trials of his faith: “In this fact you are greatly rejoicing, though for a little while at present, if it must be, you have been grieved by various trials, in order that the tested quality of your faith, of much greater value than gold that perishes despite its being proved by fire, may be found a cause for praise and glory and honor at the revelation of Jesus Christ.” (1 Pet. 1:6, 7) Of course, Jehovah is not bringing trials and depression upon you. He is the God of all comfort and it is not desirable with him “for one of these little ones to perish.”—Matt. 18:14.
DOUBTS
But what if depression and doubts leave you uncomforted by the Scriptures? Do not assume that Jehovah has become your foe because your faith is weak. Doubts were not unknown among his faithful servants in Bible times. He did not abandon the Israelites for not believing at the beginning, but delivered them. (Ex. 12:51) Instead of having the apostle Thomas disfellowshiped for doubting eyewitness reports of the Lord’s resurrection, Jesus lovingly helped Thomas get over his unbelief. (John 20:24-29) Jesus’ fleshly brothers James and Jude did not exercise faith in him until after his death and resurrection, yet their early doubts did not prevent them from becoming devoted and useful servants of his later on. With understanding James could compare the doubting man to “a wave of the sea driven by the wind and blown about.” (Jas. 1:6) Sympathetically Jude could instruct Christians by his inspired letter to “continue showing mercy to some that have doubts; save them by snatching them out of the fire.” (Jude 22, 23) That one can survive such fiery ordeal is indicated by Paul when writing at 1 Corinthians 3:10-15: “But let each one keep watching how he is building on it. For no man can lay any other foundation than what is laid, which is Jesus Christ. Now if anyone builds on the foundation gold, silver, precious stones, wood materials, hay, stubble, each one’s work will become manifest, for the day will show it up, because it will be revealed by means of fire; and the fire itself will prove what sort of work each one’s is. If anyone’s work that he has built on it remains, he will receive a reward; if anyone’s work is burned up, he will suffer loss, but he himself will be saved; yet, if so, it will be as through fire.”
In the unhealthy spiritual state where your own prayers seem ineffective, obey James’ instruction and ‘call the older men of the congregation to you, and let them pray over you, greasing you with oil in the name of Jehovah. And the prayer of faith will make you well, and Jehovah will raise you up.’ (Jas. 5:14, 15) Jehovah’s mature overseers understand your condition. They will rub in the soothing “oil” of comfort from Jehovah’s Word and prescribe a schedule of Bible study and service plus association with zealous Christians, all of which in time will get you over your depressing doubts.
Because there is always happiness in Christian giving, one of the surest antidotes for a depressed, cheerless frame of mind is to seek out others who are “sighing and groaning over all the detestable things that are being done” in this pre-Armageddon era. By comforting them you will bring comfort to yourself. (Ezek. 9:4; 2 Cor. 1:3-7) Many mature Christians can testify to the truthfulness of this, calling to mind Psalm 126:5, 6: “Those sowing seed with tears will reap even with a joyful cry. The one that without fail goes forth, even weeping, carrying along a bagful of seed, will without fail come in with a joyful cry, carrying along his sheaves.” Whether in favorable season or in trial and depression, sow the Kingdom seed and reap a happy reward!—Mark 4:14, 20.
We have seen that periods of depression have been endured by faithful servants of Jehovah in pre-Christian, Christian and modern times. Since it is a condition that responds to assistance from Jehovah, his Word and organization, as well as to proper care of the physical man, depressed souls have every reason to be consoled and courageous. Remember, faithful Job was not actually abandoned by Jehovah; Hannah’s disappointment and vexation passed with the birth of Samuel and five other children; Peter’s denial of the Lord was not unpardonable; Paul’s pressed-down feeling gave way to rejoicing and Thomas’ doubts did not disqualify him in the race for eternal life. Neither must depression or any other test be allowed to disqualify you. Rather, as Paul declared, “no temptation has taken you except what is common to men. But God is faithful, and he will not let you be tempted beyond what you can bear, but along with the temptation he will also make the way out in order for you to be able to endure it.” (1 Cor. 10:13) No less is this true of depression. So do not give up in doing what is right. And “may the God who gives hope fill you with all joy and peace by your believing, that you may abound in hope with power of holy spirit.”—Rom. 15:13.

Part 4


 
4.  Relief from Depression

Are you feeling depressed? If so, there is much you can do about it.
CASIMIR was a very happy person. For years he had served as a Christian missionary in a foreign land. Then one day, due to DDT poisoning, he became partially paralyzed. This brought him back from the missionary field but not to a life of idleness.
Though never fully regaining the use of his limbs, he kept on in the full-time ministry the best he could until one recent day when he succumbed to a heart attack at the age of sixty-six. He could have felt deeply depressed because of the great difficulty he experienced in getting around, but did he give way to any such feeling? No; he kept his joyous, outgoing disposition, to his own blessing as well as to the blessing of those about him. He set a fine example for others who may at times be victims of hardships and so inclined to feel depressed.
A WIDESPREAD PROBLEM
To be depressed means to feel sad, gloomy, dejected. It means to be discouraged, to be low in spirits. It means to be pessimistic about the present and the future.
Many people today are depressed because of the wretched conditions in the world. Others feel dejected because of poor health, old age or some physical handicap such as failing eyesight. Not a few are depressed because of loneliness, such as single men and women who are no longer young and those who have lost a loved one in death.
Still others let the wrongs, hardships and injustices they have endured make them low in spirits. At times lovers of righteousness are discouraged because of their weaknesses and shortcomings. Then again, a Christian minister may feel gloomy because of the opposition or indifference he encounters as he keeps on preaching the good news of God’s kingdom.
DO WORLD CONDITIONS DISTRESS YOU?
Do they? If so, at least that is better than for you to get so heated up that you resort to violence as so many are doing today. Such persons only make matters worse for themselves and for others. Happily, there is yet another alternative. You do not have to be either depressed or explosive with anger. You can take comfort from God’s Word. He sees what is going on.—Heb. 4:13.
Yes, take heed to wise King Solomon who advised: “If you see any oppression of the one of little means and the violent taking away of judgment and of righteousness . . . do not be amazed over the affair, for one that is higher than the high one is watching, and there are those who are high above them.”—Eccl. 5:8.
Not only does Jehovah God see all that is going on, but in his due time he will also set matters straight, even as Solomon assures us: “Because sentence against a bad work has not been executed speedily, that is why the heart of the sons of men has become fully set in them to do bad. Although a sinner may be doing bad a hundred times and continuing a long time as he pleases, yet I am also aware that it will turn out well with those fearing the true God, because they were in fear of him. But it will not turn out well at all with the wicked one, neither will he prolong his days that are like a shadow, because he is not in fear of God.”—Eccl. 8:11-13.
True, those words were written long ago, but fulfillment of Bible prophecy gives us reason to believe that this generation will see Jehovah God rising up in burning zeal to devour all wickedness. (Matt. 24:3-34; Zeph. 3:8) Since this is so you have reason to do as Jesus said, ‘Raise yourself erect and lift your head up, because your deliverance is at hand.’—Luke 21:28.
IS THE CAUSE PHYSICAL?
Or is your depression due to a rundown physical condition? Often poor health makes circumstances seem depressing; much worse than they actually are. If so, then try to remedy matters by exercising moderation in all things, in work, in pleasures and in food. Learn to relax, and make certain that you get sufficient rest and sleep. If yours is a sedentary occupation or way of life, you may find daily exercise of some kind to be quite helpful.
A feeling of depression can also be caused by some physical handicap. If that is your problem then call to mind the apostle Paul. He tells that he suffered from “a thorn in the flesh,” which he repeatedly asked God to remove. But instead of freeing Paul of this burden, God told him: “My undeserved kindness is sufficient for you; for my power is being made perfect in weakness.” Far from feeling depressed because this obstacle had not been removed, Paul said: “Most gladly, therefore, will I rather boast as respects my weaknesses, that the power of the Christ may like a tent remain over me.” Yes, make your handicap a cause for boasting in the Lord rather than a cause for depression and do this by continuing on in spite of it! For a modern example consider the minister Casimir, referred to earlier.—2 Cor. 12:7-9.
On the other hand, it could be that your depression has a more deep-seated cause. It is known that hypoglycemia, a lack of sugar in the blood, can cause one to feel depressed. Then again, a woman’s vicissitudes or the ‘change of life’ may cause her to feel that way. In such instances the remedy may lie in the right kind of therapy or medication.
COULD IT BE LONELINESS?
Loneliness can be very painful. And for young folks so also can homesickness. If either is the cause of your depression, then work at remedying it. Accept the fact that under present conditions it simply cannot be that everyone will enjoy a happy family life. If having a mate is denied you, remember that not all married persons are happy and that married persons can be lonely even though not alone. How so? Because of a failure to communicate with each other the way they should.—1 Cor. 7:28.
That is something all lonely persons should work at, learning to communicate with others. Be outgoing, ready to start conversations. Why not go out of your way to show unselfish interest in others? Seek out those who also seem to be lonely. This will be beneficial to both yourself and others. As the apostle counsels: “Speak consolingly to the depressed souls.”—1 Thess. 5:14.
Cultivate a closeness with your Creator, Jehovah God, by turning to his Word, the Bible. Especially are the Psalms, the Gospels and the inspired letters of the Christian Greek Scriptures filled with antidotes for depression. But do not read these in a hurry; you cannot gain much comfort from speed reading. Read aloud if circumstances permit; but even when reading silently, read in a way that you clearly feel the right expression. Heed Jesus’ words: “Come to me, all you who are toiling and loaded down, and I will refresh you. Take my yoke upon you and become my disciples, . . . and you will find refreshment for your souls.”—Matt. 11:28-30.
Another fine aid for overcoming depression caused by loneliness is to turn to Jehovah God more frequently in prayer, not just at certain times of the day. Heed the counsel to “persevere in prayer,” and to “pray incessantly.” Because of having this precious privilege of prayer you need never feel lonely, for you always have someone to whom you can talk, Jehovah God. No question about it, prayer is one of the ways you can heed the counsel: “Throw your burden upon Jehovah himself, and he himself will sustain you. Never will he allow the righteous one to totter.”—Rom. 12:12; 1 Thess. 5:17; Ps. 55:22.
Nor to be overlooked is the fact that you may be able to get comfort and refreshment from playing the recordings of Kingdom songs as produced by the Watch Tower Society. Not only does the beautiful music itself act as an antidote for depression but the words that are associated with these songs, such as, for example, No. 97, “Balsam in Gilead” also do.
DEPRESSED BECAUSE OF INJUSTICES?
Are you depressed because of the wrongs, or crushed because of the injustices you have to endure? Are you among the many victims of racial discrimination? Or are you depressed because of having been wronged by a relative or friend?
The trend today is to retaliate in kind against those causing one to suffer, but God’s Word repeatedly counsels against it: “Return evil for evil to no one. . . . Do not avenge yourselves, beloved, but yield place to the wrath; for it is written: ‘Vengeance is mine; I will repay, says Jehovah.’”—Rom. 12:17, 19.
Rather than rendering evil for evil, tell Jehovah God about it in prayer and seek to do good to those who have harmed you. Find comfort in God’s promise that he resides “with the one crushed and lowly in spirit, to revive the spirit of the lowly ones and to revive the heart of the ones being crushed.” Think of that! The “High and Lofty One,” the great universal Sovereign, Jehovah God, takes an interest in the lowly and crushed ones!—Isa. 57:15.
Bear in mind that Jehovah is not only a just but also a wise and loving God. He waits to act until the best time to end injustices. As King Solomon so well noted, God has an appointed time for everything, a time for tolerating evil conditions and a time for ending them and bringing in righteousness, joy and peace. So exercise faith and do as God’s prophet Micah said he did: “I will show a waiting attitude for the God of my salvation.” It is to your interest to learn to wait and to endure these things.—Eccl. 3:1, 8; Mic. 7:7.
WEAKNESSES AND SHORTCOMINGS
Depression may be your lot because as a lover of righteousness you grieve over your own weaknesses and shortcomings. You may have trouble controlling your tongue or your temper. Or you may have some secret vice that keeps troubling you. God’s Word assures us that “if we confess our sins, he is faithful and righteous so as to forgive us our sins and to cleanse us from all unrighteousness.” And if Christians are to forgive each other seventy-seven times, certainly God will also.—1 John 1:9; Matt. 18:22.
Take comfort also from the fact that no less a Christian than the apostle Paul had to struggle against sin in his body. He wrote: “The good that I wish I do not do, but the bad that I do not wish is what I practice.” He even spoke of himself as a “miserable man”! But then he gave thanks to God because with his mind he could keep serving God.—Rom. 7:19-25.
IS IT INDIFFERENCE, OPPOSITION OR PERSECUTION?
Are you a servant of Jehovah that is feeling depressed because of the apathetic or hostile attitudes you meet in your ministry? Have you labored hard and yet have seen meager results from your labors?
But what do the Scriptures say? Do they not give us to understand that that may be the lot of Christians? Surely! What then does the disciple James (5:10) tell us to do? “Brothers, take as a pattern of the suffering of evil and the exercising of patience the prophets, who spoke in the name of Jehovah.” One such prophet was Jeremiah. Though at times he got depressed he did not despair or quit. Even after Jerusalem was destroyed he could say: “Good is Jehovah to the one hoping in him, to the soul that keeps seeking for him.”—Lam. 3:25; Jer. 20:8, 9.
Or consider what the apostle Paul had to endure as he tells about it at 2 Corinthians 11:22-33. Yet he could write: “We are pressed in every way, but not cramped beyond movement; we are perplexed, but not absolutely with no way out; we are persecuted, but not left in the lurch; we are thrown down, but not destroyed.”—2 Cor. 4:8-10.
Let also Jesus’ words bring you comfort: “In the world you are having tribulation, but take courage! I have conquered the world.” (John 16:33) As long as you keep pushing ahead zealously in the Christian ministry despite indifference or opposition you are conquering the world. Doing so, you are proving God true and Satan the Devil a liar, thereby gaining everlasting life and making the heart of Jehovah God glad. What more could you want?—Prov. 27:11; Matt. 10:22.
“ACCORDING TO YOUR FAITH”
Once two blind men asked Jesus to have mercy on them. Jesus in turn asked them: “Do you have faith that I can do this?” When they answered that they did, Jesus restored their sight, saying: “According to your faith let it happen to you.”—Matt. 9:27-30.
Whatever may be the cause of your depression—world conditions, bodily infirmity, loneliness, hardships, sins and shortcomings, indifference or persecution—there is dependable, unfailing help available for overcoming it. The Word of God is filled with assuring promises. But you must exercise faith, as Jesus told those blind men: ‘According to your faith it will happen to you.’ And it must be a real faith, a faith that proves that it is alive by works, a faith that puts forth a genuine effort. As the disciple James stressed: “Indeed, as the body without spirit is dead, so also faith without works is dead.”—Jas. 2:26.
Just reading this article is not enough. Do something about it! Spend more time reading God’s Word, give thought to talking to God, be outgoing, seek to comfort others, associate with genuine Christians. Doing so, you can expect the words of the psalmist to come true in your case: “Those sowing seed with tears will reap even with a joyful cry.”—Ps. 126:5.

Part 5


 
5.  You Can Deal with Depression

DEPRESSION is an experience common to all humans. When it occurs only occasionally it is no cause for alarm. Rather, it is a signal to do something constructive to dispel the depression. These brief periods in which we may feel very “low” are not normally the true depression. Calamities such as the death of a loved one, loss of a job, financial reverses, accidents, and so forth, are generally overcome by most persons in a relatively short period of time. But they trigger real depression in a few people.
An article on depression in Science World of December 16, 1975, cites Dr. Nathan S. Kline, Clinical Professor of Psychiatry at Columbia University in New York city, as saying that the most common symptom of true depression is not depression itself, but anhedonia (from the Greek), which he defines as the “absence of joy and pleasure. The inability to appreciate things which really make life worth living.”
The article goes on to say that the loss of interest in eating, resulting in weight loss, is one symptom of depression. The person finds it difficult to sleep, and even if getting a good night’s sleep, he still feels tired. He or she cannot concentrate and loses the ability to work. On the other hand, some oversleep, spending most of their time in bed. For them, sleep becomes an escape from life.
In order to fight depression, first try to analyze the reasons for your condition, and examine your own inmost feelings and motives. See if your situation is really “all that bad,” if circumstances warrant your depressed feeling. Also, since depression can have a physical cause, check to see if you have some metabolic disturbance, low blood sugar, anemia, mononucleosis, diabetes, or some other disease that might contribute to weakness and discouragement. Discern how much of your depression lies in your own mental attitude, and what influences bear upon you to produce that “down” feeling. You may even find that you are manifesting an “escapism” reaction or that, in a morbid way, you even “enjoy” your depressed state—a sort of self-pity.
WHAT YOU CAN DO
What can you do, especially if you find no medical basis for your depressed condition? While psychiatry may be able to give help in some cases, the very best and the really lasting help can be obtained from the Bible and from the Christian congregation. Why? Because God created the human body and mind and he knows the human makeup. The psalmist says: “O Lord, you have probed me and you know me; you know when I sit and when I stand; you understand my thoughts from afar. My journeys and my rest you scrutinize, with all my ways you are familiar.” (Ps. 139:1-3, The New American Bible) God’s counsel is, therefore, the best mental therapy.
The foremost need for the depressed one, then, is prayer to Jehovah God. God’s servant David was more than once in a greatly depressed state, sometimes because of his own errors, and again because his enemies were about to close in with the intent to kill him. In these situations he always prayed fervently. On one occasion he expressed his dejection in his appeal to God:
“Show me favor, O Jehovah, for I am fading away. Heal me, O Jehovah, for my bones have been disturbed. Yes, my own soul has been very much disturbed; and you, O Jehovah—how long? Do return, O Jehovah, do rescue my soul; save me for the sake of your loving-kindness. For in death there is no mention of you; in Sheol who will laud you? I have grown weary with my sighing; all night long I make my couch swim; with my tears I make my own divan overflow.”—Ps. 6:2-6.
We know from the Bible record that God answered David’s prayers and strengthened him to go ahead and accomplish something worth while. Even if we feel that no human understands, we know that God does. He says of himself: “There is no searching out of his understanding. He is giving to the tired one power; and to the one without dynamic energy he makes full might abound. . . . Those who are hoping in Jehovah will regain power. They will mount up with wings like eagles. They will run and not grow weary; they will walk and not tire out.”—Isa. 40:28-31.
The apostle Paul counsels: “Be persevering in prayer, remaining awake in it with thanksgiving.” (Col. 4:2) But you may feel overwhelmed, everything seeming to be closing in on you. If so, recall Jonah sinking down into the sea, with seaweed wrapping around his head. His ‘soul was fainting away.’ But he prayed. Later, he was greatly angered and dejected through his own wrong attitude. He felt that dying would be better than living. Nevertheless, he prayed. In both cases he was delivered.—Jonah 2:5-7; 4:1-8.
But you may get so depressed that you feel that you cannot pray to God. You may feel that you do not qualify to approach God. For our comfort in this situation, the apostle John wrote:
“By this we shall know that we originate with the truth, and we shall assure our hearts before him as regards whatever our hearts may condemn us in, because God is greater than our hearts and knows all things. Beloved ones, if our hearts do not condemn us, we have freeness of speech toward God; and whatever we ask we receive from him, because we are observing his commandments and are doing the things that are pleasing in his eyes. Indeed, this is his commandment, that we have faith in the name of his Son Jesus Christ and be loving one another, just as he gave us commandment.”—1 John 3:19-23.
John here tells us that when our own heart seems to condemn us, when we feel unfit or unworthy to pray to God, God does not feel that way toward us. God can see and understand the dark state of feeling that we are in. He knows that we do not want to be that way. If we realize this, we will overcome our doubts or fears and will approach God and pour out our distresses to him. He will hear with sympathy and he will act to set our minds again in the proper balance.—1 John 4:17, 18; 1 Pet. 3:12.
However, if you just cannot bring yourself to pray, you can receive help by calling on the elders of the Christian congregation. Jesus’ half brother James tells us: “Is there anyone sick among you [in a spiritual way]? Let him call the older men of the congregation to him, and let them pray over him, greasing him with oil in the name of Jehovah. And the prayer of faith will make the indisposed one well, and Jehovah will raise him up. Also, if he has committed sins, it will be forgiven him.”—Jas. 5:14, 15.
In addition to prayer, get the good, balancing wisdom and comfort from God’s Word by reading and meditating upon it daily. If you do not feel like reading, get someone to read to you. Discussion of what is being read will help greatly to lift up your spirits.—Josh. 1:8; Ps. 63:6, 7; 77:12.
EFFORT REQUIRED
In all of this you must also have the attitude of wanting to recover from your depression. Even with the help and prayers of others, you must make some effort in harmony with faith. Jesus said to Peter, in foretelling Peter’s future denial of him and the extremely depressed state that Peter experienced afterward: “I have made supplication for you that your faith may not give out; and you, when once you have returned, strengthen your brothers.” (Luke 22:32; compare Luke 22:54-62.) Peter had to have feelings also for his Christian brothers, who, after Jesus’ death, needed encouragement and help, and he had to have the desire to help them. Interest in others is one of the greatest helps in overcoming depression. Think of those near you, consider their needs and your responsibility toward them. To some extent they also suffer as you do because of your depression. Consider how happy they will be when you recover from your dejected state.
You should never feel that your case is different from everyone else’s, and that your burden, whatever it may be, is more than you can bear. Do not feel that it is impossible to face the situation with hope for a victorious outcome. The apostle Paul described a situation that depressed him deeply. “In the district of Asia,” he says, “we were under extreme pressure beyond our strength, so that we were very uncertain even of our lives. In fact, we felt within ourselves that we had received the sentence of death. This was that we might have our trust, not in ourselves, but in the God who raises up the dead.” (2 Cor. 1:8, 9) Paul assured the Corinthian Christians, who also endured sufferings, that their tribulation was not impossible to survive: “No temptation has taken you except what is common to men. But God is faithful, and he will not let you be tempted beyond what you can bear, but along with the temptation he will also make the way out in order for you to be able to endure it.” (1 Cor. 10:13) There is no situation from which God cannot recover us if we express faith.
Even if you should feel that no one understands your situation—if you feel forsaken by everyone, take comfort from David’s words: “In case my own father and my own mother did leave me, even Jehovah himself would take me up.” (Ps. 27:10) Of course, your brothers in the Christian congregation are not going to forsake you. True, their counsel may sometimes appear to you to be missing the mark—to lack understanding of how you feel. In trying to stir you to make some efforts to help yourself, they may sound too firm. But remember, they are trying to help you, and in your depressed state you are prone to be more easily offended. Listen to what they say, appreciate their interest and do what you can as they offer suggestions.
In addition, make every effort to associate with fellow Christians. They have God’s spirit and can incite you to love and fine works. Where the spirit of Jehovah is, there is freedom—freedom from bondage of depression. (Heb. 10:24; 2 Cor. 3:17) Avoid isolating yourself. (Prov. 18:1) Invite your friends to call on you. Attend Christian meetings.—Heb. 10:25.
Since depression is a state in which there is lack of joy, the depressed person must try to have joy in the good things he has and experiences. Dwell on the things for which you should be grateful and joyful; dismiss negative, morbid thoughts. (Phil. 4:8) This will help you to avoid the illnesses that depression can bring, or, if you are depressed because of illness, such wholesome thinking can alleviate your suffering. It may help you to spend a few days or weeks in different surroundings—some pleasant place where you are not constantly reminded of the things associated with your trouble. It is acknowledged in medical circles that “a heart that is joyful does good as a curer, but a spirit that is stricken makes the bones dry.” It is also true that “a joyful heart has a good effect on the countenance, but because of the pain of the heart there is a stricken spirit.”—Prov. 17:22; 15:13.
OTHERS MUST BE LONG-SUFFERING TOWARD DEPRESSED ONES
On the part of relatives and friends, they must remember that it is difficult for the depressed person to help himself or herself. It is also important to be patient, not feeling that the depressed one is trying to be cantankerous or irritating to others. Always speak with kindness and love. There are times, however, when you may need to speak firmly to convince the depressed one of the need to exert himself.
Those in the Christian congregation should do all that they can to comfort and help the dejected individual. Use good sense as to when and how often to call, but do not get discouraged if your efforts do not immediately bear fruit. Do not give the person up as being beyond help. There were depressed ones in the early Christian congregation, prompting the apostle Paul to write: “We exhort you, brothers, admonish the disorderly, speak consolingly to the depressed souls, support the weak, be long-suffering toward all,” and, “Straighten up the hands that hang down and the enfeebled knees.”—1 Thess. 5:14; Heb. 12:12.
Everyone, in his own heart, wants to be happy. If we recognize this fact, we will be sympathetic with the one that is unhappy, realizing that an obstacle very real to that person is blocking the way. With a deep desire to help, we will try to find out, if possible, what the obstacle is, and do what we can to restore happiness. On the other hand, the unhappy, depressed person must strive for a happy state of mind, accepting help in the spirit in which it is offered and making an effort toward recovery, first through prayer and then by doing what is found to be necessary.
[Blurb on page 261]
“You should never feel that your case is different from everyone else’s, and that your burden, whatever it may be, is more than you can bear.”
[Blurb on page 262]
“There is no situation from which God cannot recover us if we express faith.”

Part 6


 
6.  They Want to Help

“WE EXHORT you, brothers, . . . speak consolingly to the depressed souls.” (1 Thessalonians 5:14) With these words to the Thessalonian congregation, the apostle Paul showed that the Christian congregation is an important resource provided by God to support those who are depressed. Any Christian who feels overwhelmed by bad emotions can find comfort and help among his Christian brothers.
The disciple James recommended asking the appointed congregation elders for help. He said: “Is there anyone sick among you? Let him call the older men of the congregation to him, and let them pray over him, greasing him with oil in the name of Jehovah. And the prayer of faith will make the indisposed one well, and Jehovah will raise him up.”—James 5:14, 15.
What if someone is reluctant to ask the elders for help? One woman who had a serious problem was, and she explains why: “In the back of my mind, I felt that the elders would not understand. They would consider it my fault.” But after a severe domestic crisis she was moved to go to them. What did she find? “The elders are not perfect. But they did understand.”
Remember, though, the apostle Paul encouraged the whole congregation to ‘comfort the depressed souls.’ The elders want to help. But the depressed ones can go to any mature person they feel comfortable with. Youths will likely go to their parents. Women may prefer to discuss things with experienced Christian sisters who are “teachers of what is good.” (Titus 2:3) The important thing is: TALK TO SOMEONE.
But what if a downhearted person comes to you for help? Or what if you take the initiative in trying to help such an individual? There are things you should remember.
Consolation and Fellow Feeling
Remember not to make quick judgments about the spirituality of depressed persons. Paul said that they need comfort. Hence, we do well to express toward them the qualities he spoke about in writing to the Philippians: “If, then, there is any encouragement in Christ, if any consolation of love, if any sharing of spirit, if any tender affections and compassions, make my joy full in that you are of the same mind and have the same love.” (Philippians 2:1, 2) Encouragement, love, consolation, sharing of spirit, tender affection and compassion can have a wonderfully healing effect on a depressed person.
The apostle Peter added another fine quality. He said: “All of you be like-minded, showing fellow feeling, having brotherly affection, tenderly compassionate.” (1 Peter 3:8) Anyone who has “fellow feeling,” who can put himself in the other person’s place, win his trust and speak consolingly to him, has a fine gift for helping depressed souls.
Major Depression
But what if someone in the congregation suffers major depression? Suppose he suffers feelings of deep worthlessness, guilt, hopelessness or despair and nothing that anyone says seems to help? First, he should be advised to get medical advice, since major depression often has a physical cause. But whatever professional help he seeks, there is still an important role for the congregation to play.
Members of the congregation should avoid criticizing the depressed one or telling him to ‘pull himself together,’ or ‘snap out of it.’ A man whose wife suffers depression said that she has been suicidal from time to time. Why? The husband admits that in part it was because of the lack of understanding that he and others expressed toward her.
Some have found it good to speak to the depressed ones about things they once knew but perhaps now find hard to believe because the depression has confused their mind. Speak of Jehovah, “the Father of tender mercies and the God of all comfort.” (2 Corinthians 1:3) Remind the person that Jehovah is ready to forgive in “a large way.” (Isaiah 55:7) Talk about the beauties of Jehovah’s creation, and remind him of any pleasant experiences he might have had in this regard. Speak of the happy fellowship he has enjoyed in the congregation, of how much he loves his family and his family loves him. Stress that even though you cannot fully understand how bad he feels, the experience of others shows that it will get better. Be willing to listen with ‘brotherly affection and tender compassion’ to whatever he has to say, however illogical his emotional distress might make him.
If he should speak about suicide, take it seriously. And if he does not mention suicide, but you have reason to think it is on his mind, do not be afraid to bring the subject up. You may wish to say something like this: “I know you feel very bad right now, probably much worse than I will ever understand. You know, when people feel as bad as you do, sometimes they get the idea that the best thing would be just to end it all. Have you ever felt like that?” If he has, it will bring the whole subject out into the open and help relieve him of the guilt such thoughts bring.
‘Machine Not Working Right’
A doctor who is also a Christian elder reports: “Sometimes I use the analogy of a calculator. If the batteries get run down, no matter what numbers you punch in you will not get a reliable answer. So I tell someone suffering from major depression that his ‘batteries’ have run down temporarily. He is going to get some strange ideas and come to some weird conclusions. But that will only be while the disturbance is there. When the problem goes, things will be better.”
This same doctor adds: “It is not always what we say that matters when people are in this state. We try, as best we can as fellow Christians, to sympathize with them. The elders may be able to find someone who has had a lot of experience in life and have them sit down and talk with them, or just listen. Many times I have found that a depressed person got the most help from an elderly Christian sister who has suffered major depression herself. She may just sit down, pat the sufferer on the shoulder and say: ‘I know how you feel.’”
It Can Be Done
True, to the one suffering bad emotional feelings, it may seem like a huge effort to overcome them. And the last thing a depressed person may feel like doing is making any effort at all. But suicide is not the answer. One woman was depressed for a long period. She did not want to eat, could not sleep, had no energy, was nervous, tense and wanted to die. Now she writes: “Take courage. No matter how long you have been suffering and no matter what the problem is, Jehovah can and will help you. I’m proof of it.”—Philippians 4:13.
There is another thing we can do to help the depressed souls. We can pray on their behalf, following the thoughts of the apostle Paul: “May our Lord Jesus Christ himself and God our Father, who loved us and gave everlasting comfort and good hope by means of undeserved kindness, comfort your hearts and make you firm in every good deed and word.”—2 Thessalonians 2:16, 17.
[Footnotes]
For a more complete discussion of the causes and treatment of depression, see the articles “How You Can Fight Depression” and “Attacking Major Depression—Professional Treatments,” in our companion magazine, Awake!, (issues of September 8 and October 22, 1981). For further suggestions on how to help depressed ones, see the article “Speak Consolingly to the Depressed Souls” (The Watchtower, April 15, 1982) and “An Educated Tongue—‘To Encourage the Weary’” (The Watchtower, June 1, 1982).
[Box on page 10]
Is Someone You Know Thinking About Suicide?
He may be, if he is deeply depressed and also has symptoms such as the following:
● Talks or thinks about suicide.
● Loses interest in living, in family and friends.
● Is unable to sleep.
● Has no appetite.
● Has low sex desire.
● Is suddenly calm after a marked upset.
● Settles his affairs, changes his life-style or neglects himself personally.
● Becomes depressed when a relative or a friend dies or commits suicide.
● Has a serious physical illness.
● Loses his job or is separated from his family.
Based on a list that appeared in the magazine Medical Tribune.

Part 7


 
7.  Mental Distress—When It Afflicts a Christian

MENTAL-HEALTH experts say that perhaps 1 in 5 individuals in the United States suffers some sort of recognizable mental disorder. The World Health Organization adds that there may be as many as 40 million untreated cases of mental illness in developing lands. Mental problems have even been discovered among some inhabitants of the paradisaic Pacific isles.
It should therefore not surprise us that a number of Christians today experience mental or emotional difficulties ranging from simple anxiety and mild depression to serious illnesses such as major depression, bipolar disorders (manic-depression), phobias, and schizophrenia. Some had such problems before becoming Witnesses, while others have begun suffering distress in their older years.
Why Christians Are Not Immune
One Christian woman with over 20 years of dedicated service reports being tormented by forceful and unrelenting voices. “I’ll be thinking on any other subject,” says she, “and up comes the voice saying, ‘kill yourself.’ . . . Over and over you hear these voices until you can’t take it anymore.” How is it possible for a faithful Christian to suffer this way? Does not 2 Timothy 1:7 say: “God gave us not a spirit of cowardice, but that of power and of love and of soundness of mind”?
Yes, but soundness of mind generally refers less to psychological well-being than to a Christian’s ability to exercise Bible-based judgment. Unlike a person of the world who is “in darkness mentally,” or “corrupted in mind,” a Christian has ‘made his mind over’ by studying God’s Word. (Ephesians 4:17, 18; 2 Timothy 3:8; Romans 12:2) This unquestionably does much to promote a Christian’s emotional and mental balance, yet it does not make him immune to mental health problems. Some faithful servants of God in Bible times, such as Epaphroditus, suffered forms of mental distress.—Philippians 2:25, 26; Luke 2:48.
“In Adam all are dying,” the apostle Paul reminds us. (1 Corinthians 15:22) Many of us have obvious physical ailments. Others suffer from mental or emotional sickness.
Causes of Mental Distress
Physical factors appear to be at the root of many cases of mental distress. For example, the Bible tells of a person whose eyes “see strange things.” The cause of such mysterious hallucinations? “Staying a long time with the wine”! (Proverbs 23:29-33) Clearly, alcohol can cause the brain to hallucinate. Doctors say that in a similar way, faulty brain chemistry, genetic factors, and possibly even diet can cause brain malfunctions. Mental and emotional difficulties can result.
Strong psychological pressures, such as stress, may also trigger emotional problems. Simply trying to maintain moral purity and a Christian personality in these “critical times hard to deal with” can be a source of stress. (2 Timothy 3:1-5) Why, Lot “was tormenting his righteous soul” over the wickedness he was daily exposed to in Sodom! (2 Peter 2:8) Furthermore, some Christians have been mentally affected because of having been raped, sexually abused, or owing to past acts of promiscuity or drug abuse. Such things can exact a fearsome toll on a person’s mental health.
What Elders Can Do
Elders are concerned with shepherding all the flock entrusted to their care—including those suffering emotional distress. (1 Peter 5:2; Isaiah 32:1, 2) True, they are not doctors, and they cannot cure individuals of their ills any more than the apostle Paul cured Epaphroditus of his physical sickness or subsequent depression. (Philippians 2:25-29) Yet, by showing real concern and fellow feeling, they can often do much to help and encourage such ones.—1 Peter 3:8.
What, then, if a brother begins behaving peculiarly or complains of emotional upheaval? The elders may first try to draw out the sufferer, trying to determine just what is bothering him. Has some personal calamity or unusually stressful circumstance—perhaps the loss of a job or death of a loved one—temporarily thrown him off balance? (Ecclesiastes 7:7) Is the afflicted one mildly depressed due to loneliness and thus in need of someone to “speak consolingly” to him? (1 Thessalonians 5:14) Or could it be that the brother is disturbed over some personal shortcoming? Reassurance of God’s love and mercy—along with appropriate counsel—may help to alleviate his anxieties. (Psalm 103:3, 8-14) Much good may be accomplished simply by praying with the distressed brother.—James 5:14.
Elders can also share practical wisdom with the sufferer. (Proverbs 2:7) For example, we noted that some emotional disturbances may be related to diet. The elders may therefore suggest that the brother eat balanced meals and avoid dietary extremes. Or they may discern that the distressed one has been under great pressure on his job and would benefit greatly from “a handful of rest”—more regularly getting a good night’s sleep.—Ecclesiastes 4:6.
Those Who ‘Need a Physician’
When severe distress persists, though, it is well to recall Jesus’ words: “Persons in health do not need a physician, but the ailing do.” (Matthew 9:12) Many distressed persons are reluctant to see a physician. Elders and family members may thus need to encourage a brother to seek medical attention, such as having a thorough examination by a trusted doctor. Says Professor Maurice J. Martin: “A wide variety of physical diseases masquerade as psychiatric disorders.” And even where mental illness really is involved, effective treatments often exist.
The wife of an elder tells how her disturbed husband “became afraid to be around the brothers and didn’t want to go to the meetings. . . . He desperately wanted to die!” But after he received professional medical attention, his wife was able to report: “He is no longer deeply depressed, nor does he want to stay away from meetings. This morning he gave the public talk!”
Admittedly, not all situations are resolved so easily. Science is just beginning to unravel the mysteries of mental problems. Getting properly diagnosed and treated can be a long, complicated process—but it often pays off.
Afflicted by the Demons?
Some victims of mental difficulties fear they are under demonic attack, claiming at times to hear “voices.” True, the demons have been known to make sane individuals behave irrationally. (Mark 5:2-6, 15) There is no proof that the demons are involved in most cases of bizarre behavior, any more than that they are involved in all cases of speechlessness, blindness, and epilepsy. Yet, back in Bible times, the demons sometimes caused (or at least aggravated) these very ailments! (Matthew 9:32, 33; 12:22; 17:15-18) The Bible makes a clear distinction, though, between “those who were ill and those demon-possessed.” (Mark 1:32-34; Matthew 4:24; Acts 5:16) Obviously, then, the vast majority of cases of blindness or epilepsy today are caused by physical—not demonic—factors. The same no doubt can be said of most cases of mental distress.
Still, it must be remembered that Satan and his demons are ‘waging war’ with God’s people and have been known to harass faithful Christians. (Revelation 12:17; Ephesians 6:12) The demons are fiendish, and it should not surprise us that they take sadistic delight in tormenting some mentally distressed souls—compounding their difficulties.
So if the elders have good reason to suspect that demonic influence is involved, there is no harm in their making some inquiry. Has the person, for example, received any suspicious items directly and deliberately from individuals who are involved in some form of demonism? Disposal of such objects may bring relief. (Acts 19:18-20) Since Christians are told to “oppose the Devil,” the elders can also advise the afflicted one to reject any strange “voices” that could be of demonic origin. (James 4:7; Matthew 4:10) If a person feels under attack, he should pray fervently, calling upon Jehovah’s name out loud.—Ephesians 6:18; Proverbs 18:10.
Demonic involvement, however, appears to be the exception—not the rule. One sister relates: “I thought I was possessed by a demon until I sought medical help and was informed that I had a chemical imbalance. It gave me great relief to find out that it was an illness that was causing my actions and not some demon person that was inside of me!”
Psychiatric Medications
A variety of medications are now used by doctors in the treatment of mental disturbances. Medically supervised use of some such medications has permitted severely ill Christians to function normally. Some well-intentioned brothers, though, have discouraged patients from taking prescribed medication, perhaps fearing that it might be harmful or addictive. There are, of course, risks involved with any kind of medical treatment, and “the shrewd one considers his steps,” considering long-term results.—Proverbs 14:15.
Interestingly, however, many psychiatric drugs are not hallucinogenic, tranquilizing, or addictive; they serve merely to correct chemical imbalances in the brain. Antipsychotics, for example, may help to tame the often bizarre symptoms of schizophrenia. Lithium can help to ease depression and level the highs and lows of manic-depression.
Granted, powerful drugs are sometimes used to tranquilize a patient or to suppress suicidal tendencies. Yet, if a brother is taking prescribed medication not for pleasure but so that he can function normally, this can be viewed in much the same way as a diabetic’s using insulin.
It should be remembered that psychiatric medications are often slow acting and may have unpleasant side effects. At times, too, there is a measure of trial and error in a doctor’s finding an effective medication and/or dosage that produces the fewest side effects. Patients often become discouraged. Family members and others can therefore be supportive of the person undergoing treatment, encouraging him to be patient and to cooperate with qualified medical personnel. What if he has questions about a certain medication? Or what if problems develop or a treatment seems ineffective? Such problems should be discussed with his physician. If necessary, a second opinion can be obtained.
Talk Therapies
In some cases, consideration may also be given to having the patient talk matters out with a trained professional. Perhaps a trusted family doctor who is personally acquainted with the patient can serve in this way. What, though, about accepting treatment from a psychiatrist or a psychologist? This would be a personal decision to be made with due caution. Therapists differ in their approaches to treatment. Some, for example, still practice forms of Freudian psychoanalysis, the validity of which is challenged by many in the mental health field.
Of even more concern is the fact that some well-intentioned practitioners have given advice that flatly contradicts the Bible. Failing to understand Christian principles—even viewing such as “foolishness”—some therapists have even concluded that following the Bible’s strict moral code is the source of a person’s difficulties!—1 Corinthians 2:14.
However, some practitioners, including psychologists and psychiatrists, offer forms of talk therapy that are not really psychoanalysis but are a means of helping a patient to understand his illness, reinforcing the need for medication, and ironing out practical problems. A Christian may find such therapies helpful, but he needs to get his facts straight before accepting treatment: Just what does the treatment involve? What kind of advice will be given? Does the physician understand and respect the beliefs of Jehovah’s Witnesses? If talk therapy is agreed to, ‘test out the words’ of a doctor instead of just accepting everything unquestioningly.—Job 12:11, 12.
For the most part, then, mental distress can be viewed as a medical problem—not a spiritual one. Understanding this fact, families, elders, and congregation members can better be of support to sufferers. At times distressed ones also need spiritual support. How the congregation can provide this will be considered in a future issue.
[Footnotes]
See the October 22, 1987, and September 8, 1986, issues of our companion magazine, Awake!
The Society does not recommend or pass judgment upon the various medications and treatments employed by physicians. Research in the Society’s publications may, nevertheless, prove helpful.
If an ill one has difficulty explaining his Bible-based stand to a physician or therapist, perhaps some mature Christian can assist him.
[Picture on page 26]
By being sympathetic listeners and counselors, elders can often help persons suffering emotional distress
[Picture on page 29]
Sometimes it is advisable for a mentally ill person to seek medical help

Part 8

 
8.  How to Help Depressed Ones Regain Joy

EPAPHRODITUS, a first-century Christian disciple, was depressed. He had been sent to attend to the needs of the imprisoned apostle Paul but had fallen seriously ill. Though Epaphroditus had recovered, he was depressed because his home congregation, which had sent him to Rome, had “heard he had fallen sick.” (Philippians 2:25, 26) Being so far away but wanting to ease their mind about this brought on depression. Likely, he also felt that they considered him a failure. How could he be helped to regain his joy?
Epaphroditus was sent back to his home in Philippi carrying a letter from the apostle Paul. Therein, Paul instructed the congregation: “Give him the customary welcome in the Lord with all joy; and keep holding men of that sort dear.” (Philippians 2:27-30) Philippian Christians were urged to draw Epaphroditus close to them in a way that would befit the distinctive quality of fellowship typical of the Christian congregation. Their consoling words would show him that he was highly valued, yes, ‘held dear.’ This joyful attention would go a long way in helping him to find relief from his mental depression.
This example shows that although Christians as a whole “rejoice in the Lord,” some among them suffer various forms of depression. (Philippians 4:4) Severe mental depression is a serious emotional disorder that has even led to suicide. At times, brain chemistry and other physical factors are involved. Nevertheless, depression can often be reduced through discerning help provided by others. Thus, Paul gave the exhortation: “Speak consolingly to the depressed souls.” (1 Thessalonians 5:14) Congregations of Jehovah’s Witnesses should, therefore, joyfully provide emotional support to depressed souls. This responsibility was recognized by the modern Christian organization way back in 1903, for The Watch Tower then said of depressed souls, or fainthearted ones: “Faint-hearted and weak, would need aid, support, encouragement.” But how can you help depressed souls?
First, by showing “fellow feeling,” you may be able to help the depressed one to reveal the “anxious care” in his heart. Thereafter, “the good word” from you may help him to rejoice. (1 Peter 3:8; Proverbs 12:25) Just letting him speak freely and sense your concern may bring much relief. “I had a couple of friends I could really pour my heart out to,” explained Mary, a single Christian who struggled with depression. “I needed someone to listen.” Having someone with whom to share innermost thoughts about the tribulations of life can mean very much.
More is needed, however, than just listening and giving such superficial advice as, “Look on the bright side of life” or, “Think in a positive way.” Such statements could betray a lack of empathy and be entirely out of place when another person is depressed, even as Proverbs 25:20 indicates in saying: “He that is removing a garment on a cold day is as . . . a singer with songs upon a gloomy heart.” Unrealistically optimistic remarks may also leave the depressed individual feeling even more perturbed. Why? Because such efforts do not address the reasons for his depression.
Strengthen With Words
A severely depressed person feels not simply sad but probably worthless and without hope. The Greek word translated “depressed souls” literally means “ones of little soul.” One Greek scholar defines the word in this way: “One who is labouring under such trouble, that his heart sinks within him.” Thus, his emotional resources have dried up, and his self-esteem has sagged.—Compare Proverbs 17:22.
The patriarch Job said: “I would strengthen you with the words of my mouth.” (Job 16:5) The Hebrew word for “strengthen” is sometimes rendered “fortify” or “reinforce.” It is used to describe how the temple was ‘made strong’ by means of structural repairs. (Isaiah 41:10; Nahum 2:1; 2 Chronicles 24:13) Your words must skillfully rebuild the depressed person’s self-esteem, brick by brick, as it were. Doing this requires that you appeal to his “power of reason.” (Romans 12:1) The 1903 issue of The Watch Tower cited earlier said regarding depressed ones: “Lacking . . . self-esteem, they need to be pushed to the front a little, in order to bring out what talents they really possess, for their own encouragement and for the blessing also of the entire household of faith.”
The Bible example of Elkanah and his depressed wife Hannah illustrates how you can strengthen with words, as Job did. Elkanah had two wives. One of them, Peninnah, had several children, but Hannah was barren. Likely, Hannah considered herself worthless. (Compare Genesis 30:1.) As if this load were not heavy enough, Peninnah vexed her to the point that she broke down in tears and lost her appetite. Though Elkanah was unaware of the depth of her distress, on seeing her situation, he inquired: “Hannah, why do you weep, and why do you not eat, and why does your heart feel bad?”—1 Samuel 1:1-8.
Elkanah’s kindly, unaccusing questions gave Hannah opportunity to put her feelings into words. Whether she replied or not, she was helped to analyze why she likely felt worthless. So, too, a depressed soul may say, ‘I am just a bad person.’ You could ask, ‘Why do you feel that way?’ Then listen carefully as he unburdens to you what he feels in his heart.—Compare Proverbs 20:5.
Elkanah then asked Hannah this very strengthening question: “Am I not better to you than ten sons?” Hannah was reminded of his affection for her, despite her barrenness. He considered her precious, and she could therefore conclude: ‘Well, I am not so worthless after all. I really do have the deep love of my husband!’ His words fortified Hannah, for she began to eat and went on to the temple.—1 Samuel 1:8, 9.
Just as Elkanah was specific and drew his wife’s attention to a legitimate reason for her to feel better about herself, those who wish to help depressed persons must do likewise. For example, a Christian named Naomi said this about what helped her to regain her joy: “Some of the friends praised the way I had raised my son, the way I kept my home, and even the way I kept up my appearance despite my depression. This encouragement meant so much!” Yes, deserved commendation helps a depressed soul to see his or her good qualities and make a proper estimate of self-worth.
If your wife is depressed, why not seek to build her up in harmony with the words of Proverbs 31:28, 29? There we read: “Her owner rises up, and he praises her. There are many daughters that have shown capableness, but you—you have ascended above them all.” Still, a depressed wife may not accept such an assessment, since she may feel like a failure because of being unable to care for household tasks as well as she thinks she should. By reminding her of the woman she is inside, and what she was like before experiencing depression, however, you may be able to convince her that your praise is not empty flattery. You might also acknowledge that what she now does represents a supreme effort. You could say: ‘I know what it took for you to do this. How commendable that you are putting forth that much effort!’ Receiving the approval and praise of one’s mate and children, those who know one the best, is vital for rebuilding self-esteem.—Compare 1 Corinthians 7:33, 34.
Use of Bible examples may help a depressed person to see what changes in thinking may be necessary. For instance, perhaps an individual is overly sensitive about the opinions of others. You might discuss the example of Epaphroditus and ask: ‘Why do you think he became depressed when he learned that his home congregation had heard of his sickness? Was he really a failure? Why did Paul say to hold him dear? Did the real value of Epaphroditus as a person depend on the privilege of service he held?’ Such questions may help the depressed Christian to make personal application and realize that he is not a failure.
“Support the Weak”
The Bible urges: “Support the weak.” (1 Thessalonians 5:14) The existence of a network of Christian friends who can provide practical care is another advantage of true religion. Real friends are those “born for when there is distress,” and they truly stick with a depressed person. (Proverbs 17:17) When the apostle Paul felt “laid low” and had “fears within,” he was comforted “by the presence of Titus.” (2 Corinthians 7:5, 6) Similarly, warmhearted visits and telephone calls at appropriate times are likely to be deeply appreciated by depressed souls. You might ask if there is any way you can give practical help, such as running errands, doing housework, or the like. A Christian named Maria says: “When I was depressed, a friend wrote to me several times and always included encouraging scriptures. I would read the letter over and over, crying as I read it. Such letters were like gold to me.”
After encouraging the congregation to help “the depressed souls,” Paul says: “Be long-suffering toward all. See that no one renders injury for injury to anyone else.” (1 Thessalonians 5:14, 15) Patience is vital, for because of mental pain, negative thinking, and exhaustion from a lack of sleep, a depressed person may respond with “wild talk,” as did Job. (Job 6:2, 3) Rachelle, a Christian whose mother became seriously depressed, revealed: “Many times Mom would say something very hateful. Most of these times, I tried to remind myself of the kind of person Mom really is—loving, kind, and generous. I learned that depressed persons say many things that they do not mean. The worst thing that one can do is to return evil words or actions.”
Some mature Christian women may especially be in a position to bring relief to other women suffering emotional anguish. (Compare 1 Timothy 5:9, 10.) These capable Christian women can make it a point to speak with such ones consolingly on fitting occasions. At times it is more appropriate that mature Christian sisters rather than brothers continue to help a woman. By organizing matters and supervising them properly, Christian elders can see to it that the depressed souls receive the needed care.
Elders With Educated Tongues
Especially must spiritual shepherds have “knowledge and insight” so that they will “know how to talk to encourage the weary.” (Jeremiah 3:15; Isaiah 50:4, Beck) If an elder is not careful, however, he might unintentionally make a depressed person feel worse. For instance, Job’s three companions supposedly went to “sympathize with him and comfort him.” But their words, motivated by a wrong view of Job’s predicament, served to ‘crush’ him rather than comfort him.—Job 2:11; 8:1, 5, 6; 11:1, 13-19; 19:2.
Various articles in Watch Tower publications have outlined principles that can be applied in counseling individuals. Most elders have applied such material. Yet, in some cases thoughtless statements by elders—either on a personal level or in talks—have been very harmful. So let elders not ‘speak thoughtlessly as with the stabs of a sword’ but with the ‘healing tongue of the wise ones.’ (Proverbs 12:18) If an elder thinks of the possible impact of his remarks before he speaks, his words can be soothing. Therefore, elders, be quick to listen and slow to draw conclusions without having the whole picture.—Proverbs 18:13.
When elders take a genuine interest in depressed persons, such individuals feel loved and appreciated. Such unselfish care may move these individuals to overlook any discouraging remarks. (James 3:2) Depressed persons are often overwhelmed with guilt, and elders can help them to get a balanced view of matters. Even when a serious sin has been committed, the spiritual care provided by the elders can help ‘what is lame to be healed.’—Hebrews 12:13.
When depressed persons feel that their prayers are ineffective, elders can pray with them and for them. By reading with them Bible-based articles dealing with depression, elders can ‘grease’ these individuals with soothing spiritual words. (James 5:14, 15) Elders can also help a depressed one to take Scriptural steps to resolve any personal differences he or she may have with someone, if this is a problem. (Compare Matthew 5:23, 24; 18:15-17.) Often, such conflicts, especially in the family, are at the root of depression.
Realize that recovery takes time. Even Elkanah’s loving efforts did not immediately relieve Hannah of her depression. Her own prayers as well as reassurances by the high priest finally led to relief. (1 Samuel 1:12-18) Hence, be patient if there is slow response. Of course, elders in general are not doctors and may therefore find their efforts limited in some cases. They, along with members of the depressed person’s family, may need to encourage that one to seek professional help. If necessary, elders or family members can clearly explain to any professional the importance of respecting the depressed one’s religious convictions.
Until God’s new world, no one will have perfect physical, mental, or emotional health. In the meantime, any Christian who loses his joy because of depression can draw strength not only from the Christian congregation but also from our heavenly Father, “who comforts the depressed.”—2 Corinthians 7:6, New American Standard Bible.
[Footnotes]
See the article “Defeating Depression—How Others Can Help” in Awake! of November 8, 1987, pages 12-16.
See the articles “An Educated Tongue—‘To Encourage the Weary’” in The Watchtower of June 1, 1982, and “‘Spiritual Words’ for the Mentally Distressed” in the issue of November 15, 1988.
[Box on page 29]
HOW TO SPEAK CONSOLINGLY
□ LISTEN CAREFULLY—With discerning questions ‘draw up’ the feelings of the person’s heart. Be quick to listen and slow to reach any conclusions before having the full picture.—Proverbs 20:5; 18:13.
□ SHOW EMPATHY—“Fellow feeling” should join with ‘tender compassion’ as you try to identify emotionally with the depressed one. ‘Weep with one who weeps.’—1 Peter 3:8; Romans 12:15.
□ BE LONG-SUFFERING—It may take repeated discussions, so be patient. Overlook “wild talk” that the depressed one may speak because of frustration.—Job 6:3.
□ STRENGTHEN WITH WORDS—Help the depressed one to see his or her good qualities. Give specific commendation. Show that problems, past bad experiences, or shortcomings do not determine one’s personal worth. Explain why God loves and cares about him or her.—Job 16:5.

Part 9

 
9.  Winning the Battle Against Depression

“THE most overwhelming thing that I had to deal with,” confessed Lola, “was the guilt of feeling hopeless since, as one of Jehovah’s servants, I thought I should not feel that way.” This common misunderstanding is often the first foe a depressed Christian must defeat. Lola added: “Once I quit mentally beating myself for feeling the way I did and concentrated on getting well, I could better cope with the depression.” Yes, depression in itself is no reason for you to think that you have failed God.
As mentioned in the previous article, the cause of depression may be physiological. In 1915, long before the recent research linking many physical ills with depression, The Watch Tower stated: “This heaviness of spirit, or feeling of loneliness and depression, is natural at times to all mankind . . . [It is] accentuated to some extent by the condition of physical health.” Thus, if a depressed mood lingers, a checkup by a doctor may be helpful. If the situation is extreme, one may want to have the disorder treated by a professional who specializes in depression.
But even when the cause is not physical, it is unrealistic to expect that one of God’s servants will never be sad or discouraged. Just consider how faithful Hannah became ‘bitter of soul and wept greatly.’ (1 Samuel 1:7, 10) Nehemiah also ‘wept and mourned for days’ and had “gloominess of heart.” (Nehemiah 1:4; 2:2) Job despised his life and felt that God had abandoned him. (Job 10:1; 29:2, 4, 5) King David said that his spirit fainted away within him and that his heart became numbed. (Psalm 143:4) And the apostle Paul spoke of having “fears within” and being “laid low” or “thrown down” emotionally.—2 Corinthians 4:9; 7:5, 6.
Though all of these were faithful servants of God, various distresses, apprehensions, or bitter disappointments had for a time caused them sorrow. Yet, God had not abandoned them or taken away his holy spirit. Their depressed mood was not due to spiritual failure. At a time when David was afflicted, he pleaded in prayer: “Make the soul of your servant rejoice.” God comforted David during this ‘day of distress’ and helped him, in time, to rejoice. (Psalm 86:1, 4, 7) Jehovah will likewise help his servants now.
Since depression is not in itself proof of either spiritual failure or mental weakness, a Christian plagued with it should not keep silent because of embarrassment. Rather, he should take one of the most important steps in fighting this disorder. What is that?
Pour Out Your Feelings
He should talk to someone about it. Proverbs 12:25 states: “Anxious care in the heart of a man is what will cause it to bow down, but the good word is what makes it rejoice.” No other human can know the intensity of the anxious care in your heart unless you open up and talk about it. By confiding in an empathetic person who can help, you will likely learn that others have had similar feelings and problems. Also, putting feelings into words is a healing process, for it relieves the heart to give expression to the painful experience rather than bottle it up. Therefore, depressed souls should confide in a marriage mate, a parent, or a compassionate and spiritually qualified friend.—Galatians 6:1.
Part of Marie’s problem (mentioned in the previous article) was that she bottled up the troubling emotions that led to her depression. “Over the years, I had put up such a pretense,” she said. “Others would never dream that I had such trouble dealing with these feelings of worthlessness.” But Marie opened up to an elder in the congregation. The elder through discerning questions ‘drew up’ from her heart the anxiety she carried and helped her to understand herself better. (Proverbs 20:5) His good words from the Scriptures gave her reassurance. “For the first time, I began to get help to deal with certain feelings that contributed to my depression,” explained Marie.
So talking to an understanding elder may provide spiritually refreshing “water” to one whose “soul is like an exhausted land.” (Isaiah 32:1, 2; Psalm 143:6) A discerning spiritual counselor may even help you to see how you can take practical steps to deal with what you might have considered to be a hopeless situation. (Proverbs 24:6) But more is needed than just confiding in another.
Recognize Your Real Value
Feelings of worthlessness are a big factor in depression. Perhaps because of an unhappy childhood, some Christians have low self-esteem. But even though physical, emotional, or sexual abuse in the past has left emotional scars, this does not change a person’s worth. Thus, you must strive to have a balanced view of your true value as a person. “I would say to every one of you,” urged the apostle Paul, “not to estimate himself above his real value, but to make a sober rating of himself.” (Romans 12:3, Charles B. Williams) While guarding against arrogance, you should try not to go to the other extreme. Those who have a relationship with God are precious, desirable to him, for he selects humans to become his “special property.” What an outstanding privilege!—Malachi 3:17; Haggai 2:7.
Also, what an honor to be “God’s fellow workers” by engaging in the Christian work of disciple making. (1 Corinthians 3:9; Matthew 28:19, 20) Many depressed Christians have found that this work builds self-worth. “Even after becoming a Christian, I felt very inadequate,” admitted Marie. Still, she persisted in the preaching work, and one day she met a brain-damaged young woman who wanted to be taught the Bible. “She needed someone who would be patient with her, since she was a slow learner,” said Marie. “Because she took so much of my attention, I forgot about myself and my inadequacies. She needed my help, and I realized that I could give it to her in Jehovah’s strength. Seeing her get baptized encouraged me beyond words. My self-esteem grew, and the serious depression vanished for good.” How true that “the one freely watering others will himself also be freely watered”!—Proverbs 11:25.
Still, many depressed persons respond as did a severely depressed Christian woman, who admitted: “Though I work very hard to clean and cook and to be hospitable, I turn around and pick myself to pieces about every little fault.” Such unreasonable faultfinding greatly undermines self-esteem. Remember that our God is understanding and does “not for all time keep finding fault.” (Psalm 103:8-10, 14) If Jehovah, who has a higher sense of right than we have, does not badger us about every little fault and is willing to show such forbearance, should we not endeavor to imitate him in our dealings with ourselves?
All of us have flaws and weaknesses. Yet, we have strengths as well. The apostle Paul did not expect excellence of himself in all his endeavors. “Even if I am unskilled in speech, I certainly am not in knowledge,” he stated. Paul did not feel inferior simply because he may not have excelled as a public speaker. (2 Corinthians 11:6) Likewise, depressed ones should focus on the things that they do well.
“Wisdom is with the modest ones,” or with those who recognize and accept their limitations. (Proverbs 11:2) Each of us is a unique soul with differing circumstances, physical stamina, and abilities. As you serve Jehovah whole-souled, doing what you can, he is pleased. (Mark 12:30-33) God is not one who is never satisfied with the efforts of his devoted worshipers. Leora, a Christian who successfully fought her depression, said: “I do not do as well as everybody else in some things, such as presentations in the field ministry. But I am trying. What I do is my best.”
Handling Mistakes and Misunderstandings
What, though, if you make a serious mistake? Perhaps you feel like King David, who ‘walked about sad all day long’ because of his errors, or sin. But this very feeling may be evidence that you have not gone too far and committed an unforgivable sin! (Psalm 38:3-6, 8) Feelings of guilt may show that one who has sinned has an honest heart and a good conscience. So how can the guilt be handled? Well, have you prayed for God’s forgiveness and taken steps to right the wrong? (2 Corinthians 7:9-11) If so, have faith in the mercy of the One who forgives in a large way, while determining not to repeat the sin. (Isaiah 55:7) If you have been disciplined, do not ‘give out when you are corrected, for whom Jehovah loves he disciplines.’ (Hebrews 12:5, 6) Such correction has the purpose of helping to reestablish a straying sheep. It does not detract from his value as a person.
Even if our own heart condemns us, we need not conclude that Jehovah has condemned us. “We shall assure our hearts before him as regards whatever our hearts may condemn us in, because God is greater than our hearts and knows all things.” (1 John 3:19, 20) Jehovah sees more than our sins and mistakes. He knows of extenuating circumstances, our whole life course, our motives and intentions. The greatness of his knowledge enables him to hear with sympathy our earnest prayers for forgiveness, as he heard David’s.
Misunderstandings with others and being overly concerned about having their approval also contribute to having a lack of self-worth, perhaps even to a feeling of being rejected. Because of imperfection, a fellow Christian may speak to you in a way that seems insensitive or unkind. Still, many misunderstandings can be cleared up by telling the person how you were affected by the remark. (Compare Matthew 5:23, 24.) Also, Solomon advised: “Do not give your heart to all the words that people may speak.” Why? “For your own heart well knows even many times that you, even you, have called down evil upon others.” (Ecclesiastes 7:21, 22) Do not unrealistically expect perfection of yourself or of your relationships with other imperfect humans. Be quick to forgive and put up with others.—Colossians 3:13.
Furthermore, your true value is not measured primarily by whether you are loved by others or not. Christ was “held . . . as of no account,” and he was ‘valued from [the] standpoint of others’ at very little. (Isaiah 53:3; Zechariah 11:13) Did this change his real worth or the way God valued him? No, for even if we were perfect, like Jesus, we could not please everyone.
Power to Endure
At times, serious depression may linger despite our efforts to overcome it. The emotional pain may even cause some Christians to feel as did Jonah: “My dying is better than my being alive.” (Jonah 4:1-3) Yet, his anguish was not permanent. He got over it. So if depression makes your life seem unbearable, remember that it is like the tribulation that Paul said was “temporary.” (2 Corinthians 4:8, 9, 16-18) It will come to an end! No situation is hopeless. Jehovah promises “to revive the heart of those who are in pain.”—Isaiah 57:15, Lamsa.
Never stop praying, even if your prayers seem in vain. David pleaded: “Do hear, O God, my entreating cry . . . when my heart grows feeble. Onto a rock that is higher than I am may you lead me.” (Psalm 61:1, 2) How does God lead us to an inner confidence that seems inaccessible by our own strength? Eileen, who has struggled with depression for years, answers: “Jehovah has not let me give up. This gives me the hope that if I keep on trying, he will keep on helping. Knowing the truth of the Bible has literally kept me alive. Through many different ways—prayer, the ministry, meetings, the publications, family, and friends—Jehovah has provided strength for me to keep trying.”
View the disorder as a test of your faith. “You can trust God,” the apostle Paul assures us. “He will not let you be tested more than you can stand. But when you are tested, He will also make a way out so that you can bear it.” (1 Corinthians 10:13, Beck) Yes, God will give you “power beyond what is normal” to carry any emotional load.—2 Corinthians 4:7.
A New World Without Depression!
God has promised soon to remove, by means of his heavenly Kingdom, all the depressing conditions on our earth. His Word declares: “I am creating new heavens and a new earth; and the former things will not be called to mind, neither will they come up into the heart. But exult, you people, and be joyful forever in what I am creating.” (Isaiah 65:17, 18) These words were initially fulfilled back in 537 B.C.E., at the time when the ancient nation of Israel was restored to its homeland. His people then sang: “We became like those who were dreaming. At that time our mouth came to be filled with laughter, and our tongue with a joyful cry.” (Psalm 126:1, 2) How much grander will be the soon-to-be-realized final fulfillment of this heartwarming prophecy in God’s new world!—2 Peter 3:13; Revelation 21:1-4.
Under God’s Kingdom (the “new heavens”), a righteous society of people on earth (the “new earth”) will be restored to perfect emotional, physical, and spiritual health. Not that these ones will have no recollection of the past, but in view of all the pleasant things they will then have to think about and to rejoice over, there will be no reason for them to call to mind or to focus on all the sad experiences of the past. Imagine, each morning to awaken with a crystal-clear mind, eager to get on with the day’s activity—no longer hampered by a depressed state!
Fully convinced of the reality of this hope, Lola (mentioned at the outset), said: “Remembering that Jehovah’s Kingdom will straighten out this problem was my greatest help. I knew that the depression would not last forever.” Yes, you can be sure that God soon will make possible absolute victory over depression!
[Footnotes]
See “Attacking Major Depression—Professional Treatments” in the October 22, 1981, issue of Awake!

Part 10

 
10.  You Can Find Joy in a Depressing World!

MARIE has a bright, cheerful disposition. It is hard to believe that just a few years ago, this 32-year-old woman described herself as being dead inside. Marie had been a victim of serious depression. “It was like a big dark cloud that gradually lifted,” she explains. Yes, happily she recovered and regained her joy.
Each year a hundred million persons worldwide are crippled with severe depression! This disorder is not a mere passing blue mood that most of us experience from time to time. Severe depression involves an unrelenting gloominess. The depressed person loses interest in life, finds no pleasure in anything, and has feelings of general hopelessness and worthlessness. In 1983 the World Health Organization stated: “There is at present little doubt that depressive disorders occur in all parts of the world.”
Careful Bible students are not surprised at this report. The Bible identifies our time as “the last days,” characterized by “critical times hard to deal with.” (2 Timothy 3:1-5) Social structures that in the past lent support in times of emotional crisis have deteriorated. In the article “The Age of Melancholy?”, Dr. Gerald Klerman attributes the current increase of depression to this change. He explains: “The three most common social support systems have been the family, the church, and the immediate neighborhood. . . . It is a characteristic of the present time that all three of those social support systems are in various degrees of disarray.”
It was the disruption of Marie’s family that led to her despair. “When my stepmother left without a word, I felt betrayed and alone. I was 12 years old, and suddenly my world seemed upside down,” recalls Marie. Shortly afterward she had to leave home because her father made immoral advances toward her, and she admits: “I felt abnormal, and I lost all confidence in myself.” Thus began her plunge into serious depression.
One day when Marie was extremely depressed, two of Jehovah’s Witnesses called at her home. Immediately she showed great interest in their cheerful Bible message. “Previously, I saw just the utter uselessness of life and so many ugly things, but now I became convinced that I could live in a new world where God would correct all these injustices. With God’s help I could qualify for such a blessing; thus, my life took on real meaning.” As she attended the meetings of the Witnesses, she found genuine love and emotional support. (John 13:34, 35) The skillful counseling of the congregation elders also helped her begin to change her negative thinking. (James 5:14) Her depression began to subside. Multitudes of other people who, like Marie, are depressed by world conditions have found “the joy of Jehovah” by coming to an accurate knowledge of Bible truth.—Nehemiah 8:10; 1 Timothy 2:4.
Yet, did Marie’s depression instantly clear up? Should we assume that Christians are immune to depression? To answer these questions, we must take more than a superficial look at this disorder and its complex causes. Knowing the real roots of depression can make you more successful in dealing with it in yourself or in helping someone afflicted with it.
The Roots of Severe Depression
In some cases depression has physiological causes, such as disease, nutritional deficiencies, and hormonal problems. It may also be a reaction to some toxins, pollutants, medications, and allergens. However, the Bible reveals that one’s own “disquieting thoughts” also may be a cause.—Psalm 94:19.
Most people who become depressed, like Marie, have encountered a number of painfully unpleasant experiences or stressful situations. Many feel like the psalmist: “My soul has had enough of calamities . . . They have closed in upon me all at one time. You [Jehovah] have put far away from me friend and companion; my acquaintances are a dark place.” (Psalm 88:3, 17, 18) So like the psalmist, they feel overwhelmed by problems or losses and view their life in general as hopeless. They may feel as if they were all alone in a dark place and that even God has cast them off.
Why do they reach such a discouraging conclusion, in effect developing a stricken spirit? It is not just because of their external problems; it is also due to painful feelings or misgivings about themselves. They feel inadequate to deal with the problem or loss. “Because of the pain of the heart there is a stricken spirit,” explains Proverbs 15:13. Such pain of heart would include feeling that one is a failure or that others think so. Even the first-century Christian Epaphroditus, after recovering from a serious illness during a mission arranged by his home congregation, became “depressed because [the congregation] heard he had fallen sick.”—Philippians 2:25-30.
Since ‘a stricken spirit makes the bones dry,’ or undermines one’s very being, feelings of low self-esteem are often at the root of serious depression. (Proverbs 17:22) Pain of heart might also be brought on by too great a concern about how others view us, perfectionism, unresolved anger, resentment, unsettled conflicts with others, or guilt (real or exaggerated).
So the causes of serious depression are many. Yet, Marie found real joy after becoming a Christian. “I then had hope,” she said. But for some time she still had to endure depression. How can such persons eventually overcome it?
[Footnotes]
See “Depression: All in One’s Head?” in the October 22, 1987, issue of Awake!

Part 11


 
11.  Consolation for the Depressed

8 Sickness may cause mental depression. A seriously ill Christian, who sometimes lacks enough strength even to read, relates: “This runs me through many emotions of depression, feelings of lack of worth, and even tears,” he says. Knowing that Satan wants to crush him with discouragement, he is fighting back, aware that with Jehovah’s help he cannot fail. (James 4:7) This man is an encouragement to others who know that he is trusting in God. (Psalm 29:11) Even when hospitalized, he telephones sick ones and others to build them up spiritually. He himself is upbuilt by listening to audiocassette recordings of Kingdom melodies and articles in this journal and its companion magazine, Awake!, and by association with fellow Christians. This brother says: “I regularly talk to Jehovah in prayer, asking him to give me strength, guidance, comfort, and help to endure.” If you are a Christian experiencing serious health problems, always trust in Jehovah and make his everlasting arms your support.
9 Depression is an old problem. While under test, Job spoke as a man feeling abandoned by God. (Job 29:2-5) Concern over the devastated state of Jerusalem and its walls made Nehemiah gloomy, and Peter was so depressed about denying Christ that he wept bitterly. (Nehemiah 2:1-8; Luke 22:62) Epaphroditus was depressed because Christians in Philippi heard he had fallen sick. (Philippians 2:25, 26) Depression plagued some Christians in Thessalonica, for Paul urged the brothers there to “speak consolingly to the depressed souls.” (1 Thessalonians 5:14) So how does God help such individuals?
10 A personal decision must be made about treatment for severe depression. (Galatians 6:5) Adequate rest and balanced activity may help. Instead of viewing several problems as one major plight, a depressed individual may find it helpful to work at solving them one at a time. Comforting help from congregation elders may be very beneficial, especially if this emotional problem is causing spiritual concern. (James 5:13-15) Above all, it is vital to rely on Jehovah, ‘throwing all our anxiety upon him, because he cares for us.’ Persistent and heartfelt prayer can bring one ‘the peace of God that will guard the heart and mental powers by means of Christ Jesus.’—1 Peter 5:6-11; Philippians 4:6, 7.
Jehovah Helps Us to Endure Grief
11 Another distressing experience is the death of a loved one. Abraham bewailed the loss of his wife, Sarah. (Genesis 23:2) When his son Absalom died, David was grief-stricken. (2 Samuel 18:33) Why, even the perfect man Jesus “gave way to tears” over the death of his friend Lazarus! (John 11:35) So there is sadness when death claims a loved one. But what can help to allay such sorrow?
12 God helps his people to endure the extreme grief of bereavement. His Word says that there will be a resurrection. Hence, we do not “sorrow just as the rest also do who have no hope.” (1 Thessalonians 4:13; Acts 24:15) Jehovah’s spirit helps us to have peace and faith and to meditate on the wonderful future promised in his Word, so that we are not completely overwhelmed by sad thoughts about a dead loved one. Solace also comes from reading the Scriptures and praying to “the God of all comfort.”—2 Corinthians 1:3, 4; Psalm 68:4-6.
13 We can draw comfort from the resurrection hope as did godly Job, who exclaimed: “O that in Sheol you [Jehovah] would conceal me, that you would keep me secret until your anger turns back, that you would set a time limit for me and remember me! If an able-bodied man dies can he live again? All the days of my compulsory service I shall wait, until my relief comes. You will call, and I myself shall answer you. For the work of your hands you will have a yearning.” (Job 14:13-15) Great sadness is not usually experienced when a dear friend goes on a journey, for we expect to see him again. The deep grief that loss of a loved one causes may be somewhat lessened if we look upon the death of a faithful Christian in a similar way. If he had an earthly hope, he will be awakened from the sleep of death here on earth during Christ’s Thousand Year Reign. (John 5:28, 29; Revelation 20:11-13) And if we hope to live on earth forever, we may be here to greet our resurrected loved one.
14 After her husband’s death, one sister knew that she had to get on with her life in God’s service. Besides keeping busy with ‘plenty to do in the Lord’s work,’ she made a quilt with 800 pieces. (1 Corinthians 15:58) “This was a good project,” she says, “because all the time I was working I could listen to Kingdom melodies and Bible tapes, which kept my mind occupied.” She fondly recalls a visit by an experienced elder and his wife. From the Bible, the elder pointed out that God really cares for widows. (James 1:27) Another Christian woman did not yield to self-pity when her husband died. She appreciated the support of friends and took greater interest in others. “I prayed more often and developed a closer relationship with Jehovah,” she says. And what a blessing it is to have the support of God’s everlasting arms!
Help When We Err
15 Though we love Jehovah’s law, we err at times. This no doubt distresses us, as it did David, to whom God’s laws, reminders, orders, and judicial decisions were more desirable than gold. He said: “Your own servant has been warned by them; in the keeping of them there is a large reward. Mistakes—who can discern? From concealed sins pronounce me innocent. Also from presumptuous acts hold your servant back; do not let them dominate me. In that case I shall be complete, and I shall have remained innocent from much transgression.” (Psalm 19:7-13) Let us analyze these words.
16 Presumptuous acts are much more serious sins than mistakes. Saul was rejected as king for presumptuously offering sacrifice and for sparing Amalekite king Agag and the best spoil, though God had commanded that the Amalekites be devoted to destruction. (1 Samuel 13:8-14; 15:8-19) King Uzziah was stricken with leprosy for presumptuously seizing priestly duties. (2 Chronicles 26:16-21) When the ark of the covenant was being taken to Jerusalem and the cattle drawing the cart nearly caused an upset, God struck Uzzah dead for irreverently grabbing hold of the Ark to steady it. (2 Samuel 6:6, 7) So, if we do not know what to do or whether we are authorized to do something, we should display modesty and consult those having discernment. (Proverbs 11:2; 13:10) Of course, if we have ever been presumptuous, we should pray for forgiveness and ask God to help us guard against presumptuousness in the future.
17 Concealed sins may cause distress. According to Psalm 32:1-5, David tried to hide his sin, but he said: “When I kept silent my bones wore out through my groaning all day long. For day and night your hand was heavy upon me. My life’s moisture has been changed as in the dry heat of summer.” Trying to repress a guilty conscience wore David out, and anguish reduced his vigor as a tree loses life-giving moisture during a drought or in summer’s dry heat. He apparently suffered ill effects mentally and physically and lost joy because of failure to confess. Only confession to God could bring pardon and relief. Said David: “Happy is the one whose revolt is pardoned, whose sin is covered. . . . My sin I finally confessed to you, and my error I did not cover. I said: ‘I shall make confession over my transgressions to Jehovah.’ And you yourself pardoned the error of my sins.” Loving help from Christian elders can help to promote spiritual recovery.—Proverbs 28:13; James 5:13-20.
18 Sin may have long-lasting effects. It did for David, who committed adultery with Bath-sheba, maneuvered her husband’s death, and married the pregnant widow. (2 Samuel 11:1-27) Though God showed mercy because of the Kingdom covenant, David’s repentance, and his merciful treatment of others, David experienced ‘calamity out of his own house.’ (2 Samuel 12:1-12) The adulterine child died. David’s son Amnon raped his half sister Tamar and was killed at her brother Absalom’s order. (2 Samuel 12:15-23; 13:1-33) Absalom disgraced David by having relations with David’s concubines. He tried to usurp the throne but met death. (2 Samuel 15:1–18:33) Sin still has an aftermath. For example, a disfellowshipped wrongdoer may repent and be reinstated in the congregation, but it may take years to overcome the tarnished reputation and emotional trauma resulting from sin. Meanwhile, how comforting it is to have Jehovah’s forgiveness and the support of his everlasting arms!
Rescued From the Stresses Upon Us
19 When severely tried, we may lack sufficient wisdom and strength to make a decision and carry it out. In such a case, God’s spirit “joins in with help for our weakness; for the problem of what we should pray for as we need to we do not know, but the spirit itself pleads for us with groanings unuttered.” (Romans 8:26) If Jehovah brings about a change of circumstances, we should be grateful. Yet, his arm may save us in another way. If we pray for wisdom, Jehovah may by his spirit indicate what we should do and supply the strength needed to do it. (James 1:5-8) With his help, we can endure when “grieved by various trials” and come through them with tested and strengthened faith.—1 Peter 1:6-8.
20 Let us never tire of turning to God in prayer. “My eyes are constantly toward Jehovah, for he it is that brings my feet out of the net,” said David. “Turn your face to me, and show me favor; for I am solitary and afflicted. Distresses of my heart have multiplied; from the stresses upon me O bring me out. See my affliction and my trouble, and pardon all my sins.” (Psalm 25:15-18) Like David, we will enjoy divine deliverance, favor, and forgiveness if we really make Jehovah’s everlasting arms our support.
[Footnotes]
See articles on mental depression in Awake! of October 22, 1987, pages 2-16, and November 8, 1987, pages 12-16.
How Would You Respond?
□ How does Jehovah help his servants who are sick?
□ What may be helpful when we are trying to cope with mental depression?
□ What can help to allay grief over the death of a loved one?
□ How can those concealing their sins get relief?
□ What help is there when Jehovah’s people are severely tried?
[Study Questions]
1, 2. Why can Jehovah’s people be confident of his support?
3. When will obedient mankind fully enjoy “the glorious freedom of the children of God”?
4. Instead of complaining about our lot in life, what should we do?
5. What encouragement may ailing ones find at Psalm 41:1-3?
6, 7. How did God help David when he was on a sickbed, and how can this encourage Jehovah’s servants today?
8. How has one ailing Christian shown his dependence on God?
9. What examples show that mental depression sometimes troubles godly people?
10. What may be helpful in trying to cope with mental depression?
11-13. What can help to allay sorrow over the death of a loved one?
14. How did two Christian widows cope with the death of their husbands?
15. What is the substance of David’s words at Psalm 19:7-13?
16. Why should we avoid presumptuousness?
17. How can concealed sins affect a person, yet how can forgiveness and relief be obtained?
18. What evidence is there that sin can have long-lasting effects, but what can be a source of comfort in such circumstances?
19. How can God’s spirit be of help when we are severely tried?
20. What will we enjoy if we really make Jehovah’s everlasting arms our support?
[Picture on page 16, 17]
We can draw comfort from the resurrection hope, as did godly Job

Part 12

 
12.  Are You Suffering From Depression?

“If the 20th century ushered in the Age of Anxiety, its exit is witnessing the dawn of the Age of Melancholy,” notes the International Herald Tribune of London. It adds that “the first international study of major depression reveals a steady rise in the disorder worldwide. In nations as diverse as Taiwan, Lebanon and New Zealand each successive generation is growing more vulnerable to the malady.” Those born after 1955 are said to be three times more likely to suffer a major depression than were their grandparents.
That was the case with Tomoe, who suffered from major depression and spent most of her days in bed. As she could not take care of her two-year-old son, she moved back to her parents’ home. A neighbor who had a daughter the same age as Tomoe’s son soon befriended her. When Tomoe told the neighbor how worthless she felt, the neighbor showed her a text from a book. It read: “The eye cannot say to the hand: ‘I have no need of you’; or, again, the head cannot say to the feet: ‘I have no need of you.’ But much rather is it the case that the members of the body which seem to be weaker are necessary.” Tears welled up in Tomoe’s eyes as she realized that everyone has a place in the world and is needed.
The neighbor recommended that she look into the book that contained those words. Tomoe nodded in agreement, even though up till then she had not been able to do anything, not even commit herself to make a simple promise. The neighbor also helped her shop, and she prepared meals with Tomoe every day. One month later Tomoe was getting up every morning, doing the laundry, cleaning the house, shopping, and preparing dinner, just as any housewife would do. She had to overcome many difficulties, but she said, “I was confident that if I just followed the words of wisdom I had found, I’d be fine.”
By applying the wisdom she had found, Tomoe overcame the gloomy days of her depression. Now Tomoe works full-time at helping others to apply the same words that enabled her to cope with her problems. Those words of wisdom are contained in an ancient book that has a message for all people today.

Part 13 (and there is no such thing as bad luck (Click hear and have a look)

 
13.  Dealing With Depression

Depression is not new to humans, even to faithful servants of God. Nearly two thousand years ago, the apostle Paul had to advise fellow Christians: “Speak consolingly to the depressed souls.” (1 Thessalonians 5:14) In our stressful times, that need is even greater. Regrettably, though, depression in older ones often remains undiagnosed or is misdiagnosed.
Because of prevailing misconceptions that people become more dejected and moody with advanced age, symptoms may be viewed—by others as well as the elderly themselves—as a normal part of aging. “However, this is not the case,” states the book Treating the Elderly. “Depression among the elderly is not a part of the normal aging process.”
Prolonged clinical depression—in contrast with normal sadness or a bout of the blues—is a serious illness with potentially serious consequences and should not be ignored. Untreated depression can worsen and become so entrenched that some despairing patients resort to suicide. The tragedy of depression in older patients, explains Dr. Levy, is that “the most treatable of all psychiatric illness is also potentially the most lethal.” If the depression persists, the patient may need to be treated by a professional with experience in mood disorders.—Mark 2:17.
Depressed individuals can be assured that Jehovah “is very tender in affection and compassionate.” (James 5:11, footnote) He “is near to those that are broken at heart.” (Psalm 34:18) Indeed, he is preeminently the one “who comforts the depressed.”—2 Corinthians 7:6, New American Standard Bible.
No Need to Feel Useless
“Do not throw me away in the time of old age; just when my power is failing, do not leave me,” prayed faithful King David over 3,000 years ago. (Psalm 71:9) Even in the 21st century, such sentiments are not unusual for older individuals who fear that they will no longer be viewed as useful. Limitations that are due to poor health easily contribute to feelings of inadequacy, and compulsory retirement can undermine one’s sense of self-worth.
However, by concentrating on what we are able to do rather than being discouraged by what we can no longer do, we can retain a sense of self-worth and usefulness. In this connection a UN report recommended ‘continuing growth through formal and informal learning, participation in community organizations, and religious activities.’ Ernest, one of Jehovah’s Witnesses who is a retired master baker from Switzerland, is an example of the benefit of ‘continued growth through learning.’ In his 70’s, he decided to buy a computer and learn how to use it. Why did he do so, when many at his age are intimidated by technology? “First,” he explained, “to keep my mind active as I get older. And second, to keep up with technology that can help me in my Bible research and my activity in the Christian congregation.”
Engaging in productive activity can fill many fundamental needs of older ones: It provides a sense of meaning and fulfillment and may even provide some income. Wise King Solomon observed that it is a gift of God for man “to rejoice and to do good during one’s life; and also that every man should eat and indeed drink and see good for all his hard work.”—Ecclesiastes 3:12, 13.
Doing as Much as We Can
In many societies it is the elderly who convey knowledge, as well as moral and spiritual values, to succeeding generations. King David wrote: “Now that I am old and my hair is gray, do not abandon me, O God! Be with me while I proclaim your power and might to all generations to come.”—Psalm 71:18, Today’s English Version.
What, though, if older ones become severely limited by health or circumstances? This predicament upset 79-year-old Sarah, one of Jehovah’s Witnesses, who expressed her discouragement to a Christian elder. He reminded her of the Bible principle that ‘a righteous person’s supplication has much force.’ (James 5:16) “Over the years,” he explained, “you have built up an intimate relationship with God. Now you can let the rest of us benefit from that relationship when you pray privately for us.” She was very encouraged when he said, “Sarah, we need your prayers on our behalf.”
As Sarah realized, prayer is a rewarding and meaningful way for many older ones to exert themselves night and day in behalf of others. (Colossians 4:12; 1 Timothy 5:5) At the same time, such prayers help faithful older ones draw closer to the “Hearer of prayer,” Jehovah.—Psalm 65:2; Mark 11:24.
Older adults who have limitations but are generous with their experience and resources are precious assets in their communities. They prove that “gray-headedness is a crown of beauty when it is found in the way of righteousness.”—Proverbs 16:31.
We might well ask, though: What does the future hold for us as we get older? Can we realistically look forward to a better life in our later years?
[Footnotes]
Some researchers claim that “almost 90 percent of all people older than 65 years are free of dementia.” For more information on the treatment of dementia, please see the series “Alzheimer’s Disease—Easing the Pain,” in the September 22, 1998, issue of Awake!
Awake! does not endorse any particular approach. Christians should make sure that the treatment they pursue is in harmony with Bible principles. Please see the series “Understanding Mood Disorders,” in the January 8, 2004, issue of Awake!
[Blurb on page 5]
Older ones often feel they are being left behind in our modern fast-paced world
[Box/Picture on page 7]
How You Can Help the Elderly
▪ Preserve Their Dignity. “Do not sharply rebuke an older man, but be appealing to him as a father, . . . [to] older women as mothers.”—1 Timothy 5:1, 2, Analytical-Literal Translation of the New Testament of the Holy Bible.
▪ Listen Carefully. “Be swift about hearing, slow about speaking, slow about wrath.”—James 1:19.
▪ Show Empathy. “All of you be like-minded, showing fellow feeling, having brotherly affection, tenderly compassionate, humble in mind, not paying back injury for injury or reviling for reviling.”—1 Peter 3:8, 9.
▪ Discern When Encouragement Is Needed. “As apples of gold in silver carvings is a word spoken at the right time for it.”—Proverbs 25:11.
▪ Include Them in Your Activities. “Follow the course of hospitality.”—Romans 12:13.
▪ Offer Practical Assistance. “Whoever has this world’s means for supporting life and beholds his brother having need and yet shuts the door of his tender compassions upon him, in what way does the love of God remain in him? Little children, let us love, neither in word nor with the tongue, but in deed and truth.”—1 John 3:17, 18.
▪ Be Long-Suffering. “Clothe yourselves with the tender affections of compassion, kindness, lowliness of mind, mildness, and long-suffering.”—Colossians 3:12.
By caring for the elderly, we show respect for God’s own standards because his Word states: “You must show consideration for the person of an old man [or old woman].”—Leviticus 19:32.
[Picture on page 6]
A thorough medical examination may be beneficial

Part 14

 
14.  Depression—How to Treat It

“MY HUSBAND and I have sought out medical treatment, made lifestyle changes, and worked hard to develop a routine that I can cope with,” says Ruth, who has suffered with depression for many years. “We seem to have found an effective medication, and I am doing better. But during the time when nothing else seemed to work, the constant love of my husband and friends helped me not to give up.”
As Ruth’s experience indicates, patients who suffer from clinical depression need all the support they can get, including whatever medical approach might be advisable. It can be risky to ignore depression because in some cases when left untreated it can be life-threatening. About two thousand years ago, Jesus Christ acknowledged that those with medical experience could provide needed help, when he said that ‘those who are ill need a physician.’ (Mark 2:17) The fact is that physicians can do much to alleviate the suffering of many depressed patients.
Some Helpful Options
There are a number of treatments for depression, varying according to the symptoms and the severity of the illness. (See the box on page 5, “What Kind of Depression?”) Many people may be helped by their family physician, but some need more specialized treatment. The doctor might prescribe antidepressant medication or recommend some other form of assistance. Some people have experienced good results with herbal medications, dietary adjustments, or a controlled exercise program.
Common Issues
1. Well-meaning friends with little or no medical training might try to tell you which method of treatment to accept and which to reject. They might also have strong opinions about whether you should take herbal medicine, prescribed medication, or nothing at all.
Consider: Make sure that any advice you accept comes from a reliable source. In the end, you are the one who must make an informed choice.
2. Discouragement may make patients discontinue their choice of treatment because they do not seem to be getting better or because of unpleasant side effects.
Consider: “There is a frustrating of plans where there is no confidential talk, but in the multitude of counselors there is accomplishment.” (Proverbs 15:22) A program of medical therapy is more likely to succeed if there is good communication between doctor and patient. Frankly explain your concerns or describe your symptoms to your doctor, and ask whether you need to adjust the treatment or simply to persevere before you will begin to experience benefits.
3. Overconfidence can make patients stop their medical remedy abruptly after a few weeks because they feel better. They may forget how debilitating their symptoms were before they started their medication.
Consider: Suddenly terminating medical treatment without consulting a doctor can have serious and even life-threatening consequences.
Though the Bible is not a medical textbook, its Author, Jehovah God, is our Creator. The next article will examine the comfort and guidance God’s Word provides both for those who suffer from depression and for their caregivers.
[Footnote]
Awake! does not endorse any particular treatment. Each individual should carefully evaluate his options before making a personal decision.
[Box on page 5]
WHAT KIND OF DEPRESSION?
The effectiveness of any particular medical approach depends on what type of depression a patient has.
▪ Major depression has symptoms that are severe enough to last six months or longer if untreated and that impact on most aspects of a sufferer’s life.
▪ Bipolar disorder is also known as manic depression. Sufferers may experience emotional extremes that careen between prolonged episodes of intense hyperactivity (manias) and devastating lows (depressions).—See the article “Living With a Mood Disorder,” in the January 8, 2004, issue of this magazine.
▪ Dysthymia, although not as disabling as major depression, has depressive symptoms that make it difficult for the patient to function normally. Some may also experience intermittent periods of major depression.
▪ Postpartum depression is a debilitating emotional condition that affects many mothers after they give birth.—See the article “Understanding Postpartum Depression,” in the June 8, 2003, issue of this magazine.
▪ Seasonal affective disorder likely occurs as a result of a lack of sunlight during autumn and winter. It usually clears up during spring and summer.

Part 15

 
15.  Depression—How Does It Feel?

“I WOKE up one morning when I was 12 years old,” remembers James, “sat on the edge of my bed, and wondered, ‘Is today the day I die?’” James was in the grip of major depression. “Every day of my life,” says James 30 years later, “I have fought this emotional and mental illness.” James felt so worthless when he was young that he tore up his childhood photographs. “I didn’t even think that I was worth remembering,” he recalls.
Because we all contend with feelings of sadness occasionally, we could conclude that we understand what depression is all about. But how does it feel to have clinical depression?
A Cruel Intruder
More than just a spell of melancholy blues, clinical depression is a grave disturbance that often hinders a person from carrying out daily activities.
For example, for more than 40 years, Álvaro has been afflicted with “fear, mental confusion, anguish, and deep sorrow.” He explains: “My depression made it difficult for me to deal with the opinions of others. I always felt responsible for everything that went wrong.” He describes depression as “having a terrible pain without knowing where the pain is located, fear without knowing why and, worst of all, absolutely no desire to talk about it.” Now, though, he has found some relief. He knows the cause of his symptoms. He says, “Knowing that others have the same problem that I have has made me feel better.”
In Brazil, 49-year-old Maria was afflicted with depression that caused insomnia, pain, irritability, and “a seemingly unending feeling of sadness.” When her condition was first diagnosed, Maria was relieved to put a name to the cause of her suffering. “But then I became more anxious,” she explains, “because so few people understand depression and it carries a stigma.”
Nothing to Be Sad About?
Although depression sometimes has an obvious trigger, it often intrudes on a person’s life without warning. “Your life is suddenly darkened by a cloud of sadness for no apparent reason,” explains Richard from South Africa. “Nobody you know has died, and nothing distressing has occurred. Yet, you feel dejected and listless. And nothing will make the cloud go away. You are overwhelmed by feelings of despair, and you don’t know why.”
Depression is nothing to be ashamed of. Yet, Ana in Brazil felt ashamed to be diagnosed with depression. “In fact, eight years later I still feel ashamed of myself,” she admits. In particular, she finds it difficult to deal with her emotional anguish. “The suffering is sometimes so intense,” she explains, “that I feel physical pain. All the muscles in my body hurt.” At such times it is almost impossible to get out of bed. And then there are the times when Ana cannot stop crying. “I sob with such intensity and become so exhausted,” she says, “that it feels as though my blood has stopped circulating.”
The Bible acknowledges that people can become dangerously low in spirit. For instance, the apostle Paul’s concern about one man was that he might be “swallowed up by his being overly sad [“swallowed up in overwhelming depression,” Jewish New Testament].” (2 Corinthians 2:7) Some depressed people become so distraught that they wish they could just fall asleep in death. Many feel as did Jonah the prophet: “My dying is better than my being alive.”—Jonah 4:3.
What can depressed ones do to treat and cope with this distressing malady?
[Footnote]
Names in this series of articles have been changed.
[Blurb on page 3]
“Your life is suddenly darkened by a cloud of sadness for no apparent reason”

Part 16

 
16.  Help From ‘the God of Comfort’

KING DAVID was a man who experienced much anguish and many “disquieting thoughts.” Yet, he never doubted that the Creator understands us in every way. “O Jehovah, you have searched through me, and you know me,” he wrote. “You yourself have come to know my sitting down and my rising up. You have considered my thought from far off. For there is not a word on my tongue, but, look! O Jehovah, you already know it all.”—Psalm 139:1, 2, 4, 23.
We too can be certain that our Creator understands us and the debilitating effect that depression can have on our imperfect minds and bodies. He knows what causes depression and how we can best cope under present circumstances. Furthermore, he has revealed how he will cure depression forever. We could wish for no one better to help us than our compassionate “God, Who comforts and encourages and refreshes and cheers the depressed.”—2 Corinthians 7:6, The Amplified Bible.
But depressed ones may wonder how God can help them when they experience distressing emotions.
▪ Is God accessible to the depressed?
God is so close to his depressed servants that it is as if he resided with the “crushed and lowly in spirit, to revive the spirit of the lowly ones and to revive the heart of the ones being crushed.” (Isaiah 57:15) How comforting to know that “Jehovah is near to those that are broken at heart; and those who are crushed in spirit he saves”!—Psalm 34:18.
▪ How can the depressed get comfort from God?
At any time of the day, God’s worshippers have approach to the “Hearer of prayer,” who can help us to cope with distressing feelings and circumstances. (Psalm 65:2) The Bible urges us to pour out our hearts to him: “Do not be anxious over anything, but in everything by prayer and supplication along with thanksgiving let your petitions be made known to God; and the peace of God that excels all thought will guard your hearts and your mental powers by means of Christ Jesus.”—Philippians 4:6, 7.
▪ What if feelings of unworthiness make us think that our prayers are not being heard?
Depression may cause us to conclude that our attempts to please God are not adequate. However, our heavenly Father is sensitive to our fragile emotions, “remembering that we are dust.” (Psalm 103:14) Even if “our hearts may condemn us,” we can “persuade our hearts” that “God is greater than our hearts and knows all things.” (1 John 3:19, 20, footnote) Therefore, you can use expressions in your prayers that you glean from such Bible passages as Psalm 9:9, 10; 10:12, 14, 17; and 25:17.
▪ What if we are too distraught to put our feelings into words?
When painful emotions are so overwhelming that rational speech is difficult, do not give up! Keep approaching “the Father of tender mercies and the God of all comfort,” knowing that he understands your feelings and needs. (2 Corinthians 1:3) Maria, mentioned earlier in this series, says: “At times, when I feel very confused, I do not know what to pray about. But I know that God understands and helps me.”
▪ How does God answer our prayers?
The Bible does not suggest that God removes all our difficulties now. However, God does impart the strength to cope with “all things”—including depression. (Philippians 4:13) “When I first suffered from depression,” admits Martina, “I prayed for Jehovah to heal me immediately because I thought I would not be able to bear it any longer. Now I am content to pray for strength each day.”
The Scriptures are a vital source of spiritual strength to help afflicted individuals to cope with depression. Sarah, who has battled depression for 35 years, personally experienced the practical value of daily Bible reading. She relates: “I truly appreciate what the medical profession has done for me. Above all, though, I realize the spiritual and practical value of reading God’s Word. I have made a habit of reading it.”
No More Depression—Ever!
When Jesus Christ was on earth, he demonstrated his God-given power to cure painful maladies. Jesus was eager to bring relief to people who suffered from grievous sicknesses. Moreover, he himself knows the agony of distraught emotions. On the night before he was to die a painful death, “Christ offered up supplications and also petitions to the One who was able to save him out of death, with strong outcries and tears.” (Hebrews 5:7) As distressing as that was to Jesus at the time, we benefit now because “he is able to come to the aid of those who are being put to the test.”—Hebrews 2:18; 1 John 2:1, 2.
The Bible reveals that God purposes to remove all the distressing conditions that contribute to depression. He promises: “I am creating new heavens and a new earth; and the former things will not be called to mind, neither will they come up into the heart. But exult, you people, and be joyful forever in what I am creating.” (Isaiah 65:17, 18) The “new heavens,” God’s Kingdom, will restore the “new earth,” a society of righteous people on earth, to perfect physical, emotional, and spiritual health. All sicknesses will be wiped out permanently.
[Blurb on page 9]
“I have called out your name, O Jehovah, from a pit of the lowest sort. My voice you must hear. Do not hide your ear to my relief, to my cry for help. You have drawn near in the day that I kept calling you. You said: ‘Do not be afraid.’”—Lamentations 3:55-57
[Box/Pictures on page 7]
“SPEAK CONSOLINGLY TO THE DEPRESSED”
When Barbara’s depression and feelings of worthlessness are more than she can bear, she and her husband phone Gerard, a family friend who is a Christian overseer. He always listens patiently as Barbara sobs uncontrollably and repeats the same anguished thoughts she has expressed before.
Gerard has learned to listen without being judgmental, argumentative, or condemning. (James 1:19) As the Bible advises, he has learned to “speak consolingly to the depressed.” (1 Thessalonians 5:14) Patiently he reassures Barbara that she is very precious to Jehovah God, to her family, and to her friends. He usually reads one or two comforting passages from the Bible, even though he has read some of them to her before. Then, without fail, he offers to say a prayer with her and her husband over the phone, something they always find very consoling.—James 5:14, 15.
Gerard is very aware that he is not a trained physician, and he never tries to take over the role of Barbara’s doctors. He does, however, complement her medical treatment with something few doctors give—consoling scriptures and comforting prayers.
To “speak consolingly to the depressed”
You might say: “I just wanted to let you know that I’ve been thinking of you. I know you don’t always feel very well. How have you been lately?”
Remember: Speak sincerely and listen with empathy, even if the depressed person says the same things he or she has said before.
You might say: “I am amazed at what you are able to do (or “I am impressed by the Christian qualities you display”) despite your health limitations. Even if you wish you could do more, Jehovah loves and appreciates you, and so do we.”
Remember: Be compassionate and kind.
You might say: “I came across this encouraging scripture.” Or “I thought of you when I reread this favorite Bible verse of mine.” Then read or quote the verse.
Remember: Avoid a preachy tone.
[Box on page 9]
Consolation From the Scriptures
Lorraine is strengthened by Jehovah’s promise found at Isaiah 41:10: “Do not be afraid, for I am with you. Do not gaze about, for I am your God. I will fortify you. I will really help you. I will really keep fast hold of you with my right hand of righteousness.”
Álvaro says that the words of Psalm 34:4, 6 often console him: “I inquired of Jehovah, and he answered me, and out of all my frights he delivered me. This afflicted one called, and Jehovah himself heard. And out of all his distresses He saved him.”
Naoya says that reading Psalm 40:1, 2 always comforts him: “I earnestly hoped in Jehovah, and so he inclined his ear to me and heard my cry for help. . . . He firmly established my steps.”
Psalm 147:3 reassures Naoko that Jehovah “is healing the brokenhearted ones, and is binding up their painful spots.”
Jesus’ words recorded at Luke 12:6, 7 help Eliz trust in Jehovah’s care: “Five sparrows sell for two coins of small value, do they not? Yet not one of them goes forgotten before God. But even the hairs of your heads are all numbered. Have no fear; you are worth more than many sparrows.”
Other Bible verses:
Psalm 39:12: “Do hear my prayer, O Jehovah, and to my cry for help do give ear. At my tears do not keep silent.”
2 Corinthians 7:6: God “comforts the depressed.”—“New American Standard Bible.”
1 Peter 5:7: “Throw all your anxiety upon [God], because he cares for you.”

Part 17

 
17.  Living With a Mood Disorder

MOOD disorders are alarmingly common. It is estimated, for example, that more than 330 million people worldwide suffer from serious depression, a condition characterized by overwhelming sadness and a loss of pleasure in everyday activities. It has been estimated that in 20 years, depression will be outranked only by cardiovascular disease. Little wonder that it has been called “the common cold of mental illness.”
In recent years bipolar disorder has received greater public attention. Traits of this illness include severe mood swings that vacillate between depression and mania. “During the depressed phase,” says a recent book published by the American Medical Association, “you may be haunted by thoughts of suicide. During the manic phase of your illness, your good judgment may evaporate and you may not be able to see the harm of your actions.”
Bipolar disorder may affect 2 percent of the population in the United States, meaning that there are millions of sufferers in that country alone. Sheer numbers, though, cannot describe the tormenting experience of living with a mood disorder.
Depression—Overwhelming Sadness
Most of us know what it is like to experience a wave of sadness. In time—perhaps in just a matter of hours or days—the feeling subsides. Clinical depression, however, is far more serious. In what way? “Those of us who are not depressed know that the rides our emotions take us on eventually end,” explains Dr. Mitch Golant, “but the depressed individual experiences the ups and downs, twists and turns of his feelings as if on a runaway train without a clear sense of how or when—or even if—he can ever get off.”
Clinical depression can take many forms. Some people, for example, have what is called seasonal affective disorder (SAD), which manifests itself during a particular time of year—usually winter. “People with SAD report that their depressions worsen the farther north they live and the more overcast the weather,” says a book published by the People’s Medical Society. “While SAD has been linked mainly to dark winter days, in some cases it’s been associated with dark indoor work spaces, unseasonable cloudy spells and vision difficulties.”
What causes clinical depression? The answer is not clear. While in some cases there seems to be a genetic link, in most instances life experiences appear to play an important role. It has also been noted that it is diagnosed in twice as many women as men. But this does not mean that men are unaffected. On the contrary, it is estimated that between 5 and 12 percent of men will become clinically depressed at some point in life.
When this type of depression strikes, it is all-pervasive and affects virtually every aspect of one’s life. It “shakes you to the core,” says a sufferer named Sheila, “corroding your confidence, self-esteem, your ability to think straight and make decisions, and then when it reaches deep enough, it gives a few hard squeezes just to see if you can hold on.”
There are times when a sufferer can gain much relief by talking out his or her feelings with an empathetic listener. (Job 10:1) Even so, it must be acknowledged that when biochemical factors are involved, depression cannot simply be willed away with a positive outlook. Really, in such a case, the dark moods of this illness are beyond the sufferer’s control. Furthermore, the sufferer may be as baffled by the condition as family members and friends are.
Consider Paula, a Christian who endured crippling episodes of intense sadness before her depression was diagnosed. “Sometimes after Christian meetings,” she says, “I would rush out to my car and weep, for no reason at all. I just had this overwhelming sense of loneliness and pain. Although all the evidence showed that I had many friends who cared for me, I was blind to it.”
Something similar happened to Ellen, whose depression required that she be hospitalized. “I have two sons, two lovely daughters-in-law, and a husband—all of whom I know love me very much,” she says. Logic, it seems, would tell Ellen that life is good and that she is precious to her family. But on the battlefield of depression, dark thoughts—no matter how irrational—can overwhelm the sufferer.
Not to be overlooked is the significant impact that one person’s depression can have on the rest of the family. “When someone you love is depressed,” writes Dr. Golant, “you may live with a chronic sense of uncertainty, never really knowing when your loved one will recover from a depressive episode or fall into a new one. You can feel profound loss—even grief and anger—that life has deviated, maybe permanently, from the norm.”
Often, children can detect a parent’s depression. “A depressed mother’s child becomes highly attuned to his mother’s emotional states, carefully observing every nuance and change,” writes Dr. Golant. Dr. Carol Watkins notes that children of a depressed parent are “more likely to have behavioral problems, learning difficulties, and peer problems. They are more likely to become depressed themselves.”
Bipolar Disorder—Consistently Inconsistent
Clinical depression is indeed challenging. But when mania is added to the equation, the result is called bipolar disorder. “The only consistent thing about bipolar disorder is that it is inconsistent,” says a sufferer named Lucia. During mania, notes The Harvard Mental Health Letter, bipolar patients “can be unbearably intrusive and domineering, and their reckless and restless euphoria may suddenly change into irritability or rage.”
Lenore recalls her experience with the exhilaration of mania. “I was absolutely brimming over with energy,” she says. “Many called me a superwoman. People would say, ‘I wish I could be more like you.’ I often felt a great sense of power, as though I could accomplish anything. I exercised furiously. I functioned on very little sleep—two or three hours a night. Yet, I woke up with that same high energy level.”
In time, however, a dark cloud began to hover over Lenore. “At the height of my euphoria,” she says, “I would feel an agitation from somewhere deep inside, a motor running that could not be shut off. In a flash, my agreeable mood would become aggressive and destructive. I would verbally pounce on a family member for no apparent reason. I was furious, hateful, and completely out of control. After this frightening display, I would suddenly become exhausted, tearful, and extremely depressed. I felt worthless and wicked. On the other hand, I might switch back to my amazingly cheerful self, as if nothing had ever happened.”
The erratic behavior of bipolar disorder is a source of confusion to family members. Mary, whose husband suffers from bipolar disorder, states: “It can be confusing to see my husband happy and talkative and then suddenly become despondent and withdrawn. It’s a real struggle for us to accept the fact that he has little control over this.”
Ironically, bipolar disorder is often just as distressful—if not more so—to the sufferer. “I envy people who have balance and stability in their lives,” says a bipolar patient named Gloria. “Stability is a place that bipolar people visit. None of us actually live there.”
What causes bipolar disorder? There is a genetic component—one that is stronger than that of depression. “According to some scientific studies,” says the American Medical Association, “immediate family members—parents, siblings, or children—of people with bipolar depression are 8 to 18 times more likely than the close relatives of healthy people to develop the illness. In addition, having a close family member with bipolar depression may make you more vulnerable to major depression.”
In contrast with depression, bipolar disorder seems to afflict men and women equally. Most often, it begins in young adulthood, but cases of bipolar disorder have been diagnosed in teenagers and even children. Nevertheless, analyzing the symptoms and arriving at the proper conclusion can be highly challenging even for a medical expert. “Bipolar disorder is the chameleon of psychiatric disorders, changing its symptom presentation from one patient to the next, and from one episode to the next even in the same patient,” writes Dr. Francis Mark Mondimore of the Johns Hopkins University School of Medicine. “It is a phantom that can sneak up on its victim cloaked in the darkness of melancholy but then disappear for years at a time—only to return in the resplendent but fiery robes of mania.”
Clearly, mood disorders are difficult to diagnose and can be even more difficult to live with. But there is hope for sufferers.
[Footnotes]
In part, this may be due to their susceptibility to postpartum depression as well as hormonal changes at menopause. Then, too, women are usually more inclined to seek medical attention and, hence, receive a diagnosis.
Some names appearing in this series have been changed.
Doctors report that often, each mood persists for many months. However, they note, some “rapid cyclers” vacillate between depression and mania several times per year. In rare cases, sufferers switch from one extreme to the other within a 24-hour period.
[Blurb on page 6]
“Stability is a place that bipolar people visit. None of us actually live there.”—GLORIA
[Box/Picture on page 5]
Symptoms of Major Depression
● A depressed mood, most of the day, nearly every day, for at least two weeks
● Loss of interest in once pleasurable activities
● Significant weight loss or gain
● Excessive sleep or the opposite, insomnia
● An abnormal speeding or slowing of motor skills
● Excessive fatigue, with no discernible cause
● Feelings of worthlessness and/or inappropriate guilt
● Diminished ability to concentrate
● Recurring thoughts of ending it all
Some of these symptoms may also indicate dysthymia—a mild but more chronic form of depression
[Footnote]
This list is presented to serve as an overview and not to provide a basis for making a self-diagnosis. Also, some of the symptoms by themselves may be symptoms of other problems besides depression.

Part 18

 
18.  Winning the Battle

Even after a diagnosis has been made and treatment has begun, it is likely that a mood disorder will present continual challenges to the sufferer. Kelly, who battles major depression, is grateful for the professional help that has addressed the medical aspects of her condition. In addition, though, she has found that the support of others is crucial. At first, Kelly was reluctant to reach out to others because she did not want to be perceived as a burden. “I had to learn not only to seek help but also to accept it,” she says. “It wasn’t until I opened up that I was able to stop the downward spiral.”
As one of Jehovah’s Witnesses, Kelly attends meetings with fellow believers at the Kingdom Hall. At times, though, even these happy occasions present challenges. “Often the lights, the milling around of people, and the noise can be overwhelming. Then the guilt sets in, and the depression increases because I feel that my disorder must be a reflection of a lack of spirituality.” How does Kelly deal with this situation? She says: “I have learned that depression is an illness that needs to be dealt with. It is not a reflection of my love for God or for my fellow Christians. It is not a true reflection of my spirituality.”
Lucia, mentioned previously in this series of articles, is grateful for the excellent medical care she has received. “Seeing a mental-health professional has been absolutely vital for my learning to deal with and ride out the mood swings that accompany this disease,” she says. Lucia also emphasizes the value of rest. “Sleep is an important key to dealing with mania,” she says. “The less sleep I get, the higher I climb. Even when sleep won’t come, instead of getting up I have trained myself to lie there and rest.”
Sheila, also mentioned earlier, has found it helpful to keep a daily journal in which she can pour out her feelings. She sees a marked improvement in her outlook. Still, there are challenges. “Fatigue, for some reason, lets negative thoughts percolate in my brain,” Sheila says. “But I’ve learned to silence them or at least lower their volume.”
Comfort From God’s Word
The Bible is a strengthening aid for many who suffer from “disquieting thoughts.” (Psalm 94:17-19, 22) Cherie, for example, found Psalm 72:12, 13 to be particularly encouraging. There, the psalmist states about God’s appointed King, Jesus Christ: “He will deliver the poor one crying for help, also the afflicted one and whoever has no helper. He will feel sorry for the lowly one and the poor one, and the souls of the poor ones he will save.” Cherie was also encouraged by the words of the apostle Paul recorded at Romans 8:38, 39: “I am convinced that neither death nor life nor angels nor governments nor things now here nor things to come nor powers nor height nor depth nor any other creation will be able to separate us from God’s love.”
Elaine, a bipolar patient, finds her relationship with God to be an anchor. She is greatly comforted by the words of the psalmist: “A heart broken and crushed, O God, you will not despise.” (Psalm 51:17) “It has truly been a comfort to know that our loving heavenly Father, Jehovah, understands,” she says. “It has been strengthening to draw close to him in prayer, especially in times of great anxiety and distress.”
As can be seen, living with a mood disorder presents unique challenges. However, Cherie and Elaine found that prayerful reliance on God along with appropriate treatment enabled them to improve their lot in life. How, though, can family members and friends help those who suffer from bipolar disorder or depression?
[Footnote]
Awake! does not endorse any particular approach. Christians should make sure that any treatment they pursue does not conflict with Bible principles.
[Blurb on page 10]
“Once I started getting help, the black cloud over me began to lift. I felt so much better!”—BRANDON
[Box on page 9]
A Spouse’s Observations
“Before the onset of Lucia’s illness, she touched the lives of many with her keen insight. Even now when people visit my wife when she is calm, they seem drawn by her warmth. What most do not realize is that Lucia alternates between extremes of depression and mania. Such is the legacy of bipolar disorder, the illness she has endured for the past four years.
“During the manic phase, it is not unusual for Lucia to be up until one, two, or even three o’clock in the morning, with creative ideas reeling through her mind. Energy just pours out of her. She will overreact to the minutest things and spend money impulsively. She will walk into the most dangerous situations, feeling that she is invincible, that there is no danger—morally, physically, or otherwise. Related to this impulsiveness is the risk of suicide. Always on the heels of mania is depression, the intensity of which is usually proportionate to that of the preceding mania.
“Life for me has changed dramatically. Even with Lucia’s treatment, what we can accomplish today may be different from what we could accomplish yesterday or will tomorrow. It changes as our circumstances do. I found myself forced to become more flexible than I ever thought possible for me.”—Mario.
[Box/Picture on page 11]
When Medication Is Prescribed
Some feel that taking medication is a sign of weakness. But think of it this way: A diabetic must submit to a program of treatment that may include taking insulin injections. Is this a sign of failure? Hardly! It is simply a means of balancing the body’s nutrients so that the sufferer can remain healthy.
It is much the same with taking medication for depressive and bipolar disorders. Although many people have been helped by a program of counseling that has enabled them to understand their illness, a caution is in order. When a chemical imbalance is involved, the illness cannot be simply reasoned away with logic. Steven, a bipolar patient, relates: “The medical professional who treated me illustrated it this way: You can give a person all the driving lessons in the world, but if you give that person a car with no steering wheel or brakes, then those lessons won’t do much good. In the same way, giving only cognitive counseling to a depressed person may not attain the desired results. Balancing the brain’s chemistry is a valuable first step.”
[Picture on page 10]
The Bible is a strengthening aid for many who suffer from negative thoughts

Part 19

 
19.  Understanding Postpartum Depression

What’s wrong with me? I just gave birth to a beautiful, healthy baby. I should be happy and proud, but I feel so down and anxious, even angry. Am I a bad mother? Why am I so depressed?
AS A new mother, you may have experienced feelings like the above. If so, you are not alone. It is estimated that 70 to 80 percent of new mothers have such feelings at times. But what is postpartum depression (PPD), and what causes it? How can PPD be coped with? What support can family members and others give?
Disorders
The term “postpartum depression” refers to depressive episodes following childbirth. These can occur after the birth of any child, not just the first. Depressive episodes can even follow a miscarriage or termination of a pregnancy. According to the Office on Women’s Health of the U.S. Department of Health and Human Services, there is a wide range in the severity of the symptoms.
Many women experience postpartum blues, or baby blues, characterized by mild sadness, anxiety, irritability, fluctuating moods, and fatigue. These blues are considered normal and are short-lived, resolving themselves without medical help within about ten days after childbirth.
However, the American College of Obstetricians and Gynecologists estimates that in 1 out of 10 new mothers, these feelings escalate and go beyond the first few days. They can even appear several months after the birth. This may be full-fledged postpartum depression, in which the feelings of sadness, anxiety, or despair are so intense that the new mother has trouble coping with her daily tasks.
Additionally, between 1 and 3 new mothers in every 1,000 suffer from an even more severe form of depression called postpartum psychosis, in which the mother has delusions or hallucinations that often focus on hurting herself or her baby. This latter condition requires immediate medical attention.
Causes
There is no single clearly defined cause of postpartum depression. Both physical and emotional factors seem to be involved. One physical factor may be that in the first 24 to 48 hours after delivery, estrogen and progesterone levels drop sharply, to a point lower than before conception, creating an abrupt change in the physiological state of the body. This may trigger depression in much the same way as mood swings and tension are triggered before menstrual periods. The level of hormones produced by the thyroid may also drop after childbirth. This could result in symptoms that mimic depression. For these reasons researchers are calling PPD a “biochemical and hormonal disorder.”
Interestingly, one medical newsletter suggests that postpartum depression may be caused by a nutritional imbalance, perhaps a B-complex deficiency.
Fatigue and lack of sleep can also play a role. Says Dr. Steven I. Altchuler, a psychiatrist at Mayo Clinic in Minnesota, U.S.A.: “In the period shortly after childbirth, lack of energy and an inability to sleep may make minor problems seem much more major. Some women might be frustrated to find that they have difficulty coping with things that they had handled well before delivery, without the baby blues, and with a full night’s sleep.” Emotional factors such as an unplanned pregnancy, a premature birth, loss of freedom, concern about attractiveness, and lack of support can also add to depression.
Additionally, there are several common myths about being a mother that can contribute to a woman’s feeling depressed and feeling that she is a failure. These include the idea that motherhood skills are instinctive, that bonding should be immediate, that the baby will be perfect and never fussy, and that the new mother should be perfect. In real life this is not the case. Mothering skills need to be learned, bonding often takes time, some babies are easier to care for than others, and no mother is perfect or a supermom.
Gaining Recognition
Until recently, postpartum depression was often not taken seriously. Dr. Laurence Kruckman points out: “Women’s mental health issues have been overlooked and labeled in the past as hysteria, not worthy of concern. The American Psychiatric Association’s diagnostic manual (DSM IV) has never fully acknowledged the presence of postpartum illness, and as a result, doctors have not been educated about it nor has reliable data been obtained. . . . And unlike 30 years ago, mothers often go home from the hospital within 24 hours. Most postpartum psychoses, blues and some depression occur within three to 14 days following birth. So the mothers are already at home and not screened by professionals who know the symptoms.”
However, according to Dr. Carol E. Watkins of the Northern County Psychiatric Associates in Baltimore, Maryland, if left undiagnosed or untreated, postpartum depression can lead to long-term depression and difficulty in bonding with the baby. Depressed mothers may passively ignore their baby’s needs or, conversely, lose control and use physical punishment to discipline their infants. This can negatively affect the cognitive and emotional development of the child.
For example, an article in the journal American Family Physician suggests that young children of depressed mothers perform more poorly on cognitive tests than those of mothers who were not depressed. Additionally, postpartum depression can adversely affect the other children and the husband.
Treatment
What can be done? Do you just have to tough it out? It is comforting to know that postpartum depression has been found to be both temporary and treatable. While rest and family support may be all that is needed for mild symptoms, the key sign that medical attention is necessary is if the depression disrupts your ability to function, says the Office on Women’s Health.
Common treatments are antidepressant medication, talking with a mental-health expert, hormone treatment, or a combination of these, depending upon the severity of the case. Kangaroo, or skin-to-skin, care of the baby may also lessen maternal depression. There are also such alternative treatments as herbs, acupuncture, and homeopathic remedies.
However, there are some things that you can do personally to cope. These include eating a nutritious diet (including fruits, vegetables, and whole-grain cereals); avoiding caffeine, alcohol, and sugar; exercising in moderation; and taking a nap when your baby is asleep. Zoraya, a Christian mother who cried morning, noon, and night for days after the birth of a healthy baby girl, says that what helped her to get over the depression was to get involved as soon as possible in her normal ministerial activities as one of Jehovah’s Witnesses.—See the accompanying box for additional tips.
How Can Others Help?
Since a major factor in postpartum depression is lack of proper rest, other people can help by assuming some of the household chores and sharing in child care. Studies show that far less postpartum depression occurs where the extended family rallies around to provide support and instruction. Many times a person can be of great assistance by just being a sympathetic listener, giving the new mother reassurance, and avoiding criticizing or judging. Remember, PPD is a physical disorder and is not self-induced. As the organization Postpartum Education for Parents points out, “a woman cannot ‘pull herself together’ any more than she could if she had the flu, diabetes, or heart disease.”
From the foregoing, it can be seen that although the postpartum period can be a wonderful time for new mothers, it can also be stressful. Understanding it can help us to give the support new mothers need.
[Footnotes]
Postpartum depression is not to be confused with post-traumatic stress disorder, which some mothers experience after a stressful delivery, although both can be experienced at the same time.
See the article “I Won My Battle With Postpartum Depression,” in the July 22, 2002, issue of Awake!
Some drugs can contaminate breast milk, so if you wish to breast-feed, consult your doctor for the most suitable option.
See the article “‘Kangaroo Mother Care’—Solution to a Life-Threatening Problem?” in the June 8, 2002, issue of Awake!
[Box/Pictures on page 23]
Tips for Coping With Postpartum Depression
1. Talk to someone about your feelings, particularly other mothers.
2. Ask others to help you with child care, household chores, and errands. Ask your husband to share in nighttime feeding duties and household chores.
3. Find time to do something positive for yourself, even if it is for only 15 minutes a day. Try reading, taking a walk, taking a relaxing bath.
4. Even if you can get only one thing done in any given day, this is a step in the right direction. There may be days when you cannot get anything done. Try not to be angry with yourself when this happens.
5. Isolation often perpetuates depression. Get dressed, and leave the house for at least a short while each day. Fresh air and a change of scenery will do you and your baby a lot of good.
[Credit Line]
Adapted from the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the Office on Women’s Health.

Part 20

 
20.  I Won My Battle With Postpartum Depression

I remember watching my husband playing happily with our new baby girl and thinking that they would be better off without me. I felt I had become a burden to them. I wanted to get in the car, drive away, and never return. I had no idea that I was a victim of postpartum depression.
MY FIRST ten years of marriage were happy years. Jason and I were enjoying raising Liana, our first daughter. So when I became pregnant again, all of us were delighted with the news.
But this pregnancy was very difficult. In fact, I nearly died from complications after the birth. But prior to that, late in the pregnancy, a fog seemed to settle over my mind. It became worse after we brought our little baby girl, Carly, home from the hospital. I was constantly tired and felt incapable of making even simple decisions. I found myself phoning Jason at work many times a day just to ask what household job I should do next or to seek his reassurance that something I had just said or done was correct.
I became afraid of being in the company of people, even old friends. If someone came to the door unexpectedly, I hid in the bedroom. I let the house become a mess, and I became easily distracted and confused. I love to read, but reading became almost impossible because I could not concentrate. I found it hard to pray, so my spiritual health suffered. I felt emotionally numb, unable to feel love for anyone. I was afraid that my children would be harmed because I was not thinking properly. My self-esteem plummeted. I thought I was going mad.
During that time, Jason would come home from work and help me by cleaning up the house or by preparing a meal for the family—and I would be angry with him for helping! I felt that his actions showed me up as being an incompetent mother. On the other hand, if he failed to offer help, I would accuse him of not caring. Had Jason not handled things as maturely and lovingly as he did, my postpartum depression might have spelled disaster for our marriage. Perhaps Jason can best describe how my condition affected him.
My Husband Tells How He Was Affected
“At first, I could not believe what was happening to Janelle. She changed completely from being her usual happy, outgoing self and started behaving like a different person. She began taking everything I said as personal criticism, and she even became resentful when I tried to ease her work load. Initially, I felt like telling her to pull herself together, but I realized that such a response would only make things worse.
“Our relationship was under constant strain. Janelle seemed to think that the whole world had turned against her. I had heard about other women who suffered from similar symptoms as a result of postpartum depression. So when I began to suspect that she was suffering from the same thing, I started reading all the information I could about the subject. What I read confirmed my suspicions. I also learned that Janelle’s illness was not her fault—that it was not the result of any neglect on her part.
“I admit that the extra care she and the children needed left me emotionally and physically exhausted. For two years I had to juggle my secular work and my responsibilities as a congregation elder and as a husband and father. Happily, I was able to adjust my secular work so that I could be home earlier, especially on the nights we attended Christian meetings. Janelle needed me at home in time to help prepare dinner and to dress the children. As a result, we were all able to attend the meetings.”
My Road to Recovery
Without my husband’s loving support, my recovery would no doubt have been much slower. Jason listened patiently as I unburdened myself of my fears. I found it very important not to bottle up my feelings. At times, I would even sound angry. But Jason constantly reassured me that he loved me and that we were in this together. He always tried to help me see the positive side of things. Later I would apologize for words spoken in anger. He reassured me by saying that it was my illness that was talking. As I look back now, I realize how much his thoughtful comments meant to me.
Together, we finally found a very kind doctor who took the time to listen to how I felt. He diagnosed my condition as postpartum depression and suggested that my treatment include medication to help control my frequent anxiety attacks. He also encouraged me to seek the help of a mental-health professional. In addition, he recommended regular exercise, a therapy that has helped many to combat depression.
One of the biggest obstacles on my road to recovery was coping with the stigma associated with postpartum depression. People often find it hard to show empathy for someone with an illness that they do not understand. Postpartum depression is not like, say, a broken leg, which others can see and thus make allowances for. Still, my family and close friends proved to be truly supportive and understanding.
Loving Help From Family and Friends
Jason and I greatly appreciated the help my mother provided during this difficult period. At times, he needed a respite from the emotional turmoil at home. Mom was always positive and did not try to take over my work. Rather, she supported me and encouraged me to do what I could.
Friends in the congregation also proved to be a wonderful support. Many sent brief notes telling us that they were thinking of me. How I cherished those kind expressions! This was especially so because I found it hard to talk to people, whether on the phone or face-to-face. I even found it difficult to associate with fellow Christians before and after meetings. Thus, by writing to us, not only did our friends show that they were aware of the limitations my depression imposed on me but they also confirmed their love and concern for me and my family.
This Is Not a Life Sentence!
I am now much improved—thanks to my doctor’s advice, a very supportive family, and understanding friends. I still exercise regularly, even when I feel tired, as this has helped me in my recovery. I also try to respond positively to the encouragement others provide. During difficult times, I listen to audiocassettes of the Bible and to Kingdom Melodies—spiritually and emotionally uplifting music prepared by Jehovah’s Witnesses. These fine provisions help to strengthen me spiritually and to keep my thoughts positive. Recently, I even started giving Bible-based student talks again at congregation meetings.
It has taken me more than two and a half years to reach the stage where I can more fully feel and express love for my husband, children, and others. Although this has been a difficult time for my family, we feel that our bonds are now stronger than ever before. I especially appreciate Jason, who more than confirmed his love for me by enduring the depths of my depression and by always being there to support me when I needed it. Above all, both of us now have a much closer relationship with Jehovah, who truly strengthened us during our trials.
I still have my down days, but with the help of my family, my doctor, the congregation, and Jehovah’s holy spirit, the light at the end of the tunnel continues to get brighter. Yes, postpartum depression is not a life sentence. It is an enemy we can defeat.—As told by Janelle Marshall.
[Footnote]
Postpartum depression is also called postnatal depression.
[Box/Picture on page 20]
Factors That May Contribute to Postpartum Depression
A number of things besides hormonal changes may sometimes be a factor in postpartum depression. These include:
1. A woman’s personal ideas about motherhood, which may result from an unhappy childhood and poor parental relationships.
2. Unrealistic expectations imposed on mothers by society.
3. A family history of depression.
4. Marital dissatisfaction and a lack of support from one’s immediate or extended family.
5. Poor self-image.
6. Feeling overburdened or overwhelmed by caring for young children full-time.
This list is by no means comprehensive. Other factors may also contribute to postpartum depression. Indeed, its causes are still not completely understood.
[Box on page 21]
More Than Just the “Baby Blues”
Postpartum depression should not be confused with common postnatal mood swings. Dr. Laura J. Miller says: “The most common type of postnatal mood change is what has come to be known as the ‘baby blues.’ . . . About 50% of women who give birth experience this tearful, emotionally labile (i.e., changeable) state. It usually reaches a peak between the third and fifth days after birth and then gradually fades away on its own within weeks.” Researchers suggest that these moods may result from changes in a woman’s hormone levels after she gives birth.
Unlike the “baby blues,” postpartum depression involves prolonged feelings of depression that might begin at the birth of a child or even weeks or months later. A new mother with this condition may find herself elated one minute and depressed—even suicidal—the next. In addition, she may be irritable, resentful, and angry. She may experience a persistent feeling of inadequacy as a mother and a lack of love for her baby. Dr. Miller states: “Some clinically depressed mothers know intellectually that they love their babies, yet they have trouble feeling anything but apathy, irritation, or disgust. Others have thoughts of harming or even killing their babies.”
Postpartum depression is a phenomenon with a long history. As far back as the fourth century B.C.E., Greek physician Hippocrates noted the dramatic psychological changes suffered by some women after childbirth. A study published in the Brazilian Journal of Medical and Biological Research explained: “Postnatal depression is a significant problem affecting 10-15% of mothers in many countries.” Regrettably, though, “most cases of such depression do not receive a correct diagnosis and are not properly medicated,” said the Journal.
A less common but more serious disorder occurring after childbirth is postpartum psychosis. A sufferer might experience hallucinations, hear voices in her head, and lose touch with reality, although she may be rational for intermittent periods lasting for hours or days. The causes of this psychosis remain unclear, but Dr. Miller notes that “genetic vulnerability, perhaps triggered by hormonal changes, seems to be the most influential factor.” A skilled medical professional may provide effective treatment for postpartum psychosis.
[Box/Pictures on page 22]
How to Help Yourself
1. If depression persists, seek professional help. The sooner you do so, the sooner you can be on the road to recovery. Seek out an understanding doctor who is familiar with the condition. Try not to feel ashamed of your postpartum depression or to feel embarrassed if you need to take medication.
2. Exercise regularly. Studies have shown that regular exercise can be an effective therapy for depression.
3. Tell those who are closest to you how you feel. Do not isolate yourself or bottle up your feelings.
4. Remember that you do not have to have a perfect house. Try to keep your life simple by focusing on things that are essential.
5. Pray for courage and patience. If you find it difficult to pray, ask someone to pray with you. Recovery may only be delayed if you hold on to feelings of guilt or worthlessness.
[Footnote]
Awake! does not recommend any particular kind of treatment. The suggestions for both women and men outlined in this article do not cover every situation, and some points may not even apply in certain cases.
[Box on page 23]
Tips for Men
1. Recognize that postpartum depression is not your wife’s fault. If her condition persists, cooperate with her in seeking the help of a doctor who understands the problem and is sympathetic.
2. Listen patiently to your wife. Acknowledge her feelings. Do not get upset at her negativity. Kindly help her to see the positive side of things, and reassure her that she will get better. Do not assume that you must fix all the problems she mentions. She may simply want comfort, not logical answers. (1 Thessalonians 5:14) Remember, postpartum depression makes it difficult for sufferers to think logically and clearly.
3. Cut back on nonessential activities so that you have more time to support your wife. Your doing so may speed up her recovery.
4. Make sure that you have some time for yourself. Good physical, mental, and spiritual health on your part will enable you to be a better support to your wife.
5. Find someone to talk to who will encourage you, perhaps another spiritually mature man whose wife has suffered from postpartum depression.
[Picture on page 23]
The Marshall family

Part 21

 
21.  Recognizing the Signs

“Sadness is a normal, healthy emotion; depression is a disease. The challenge lies in understanding and recognizing the difference.”—Dr. David G. Fassler.
LIKE most other disorders, depression has telltale symptoms. But the signs are not all that easy to recognize. Why? Because nearly all teens get in a low mood now and then, as do adults. What is the difference between a mere case of the blues and depression? Much has to do with the intensity and duration of the condition.
Intensity involves the degree to which negative feelings afflict the youth. More severe than a minor bout with despair, depression is an all-consuming emotional illness that seriously impairs the teen’s ability to function normally. Dr. Andrew Slaby describes the severity of the condition this way: “Imagine the worst physical pain you’ve ever had—a broken bone, a toothache, or labor pain—multiply it tenfold and take away the cause; then you can possibly approximate the pain of depression.”
Duration refers to how long the listless state continues. According to clinical professors Leon Cytryn and Donald H. McKnew, Jr., “a child who shows no signs of being comforted or of resuming a normal life within a week after falling into a low mood (for whatever reason)—or within six months after undergoing what is to him a severe loss—is at risk of developing a depressive disorder.”
Common Symptoms
Depression is diagnosed only when a youth exhibits a number of symptoms every day, most of the day, for at least two weeks. A relatively brief bout is referred to as a depressive episode. Dysthymia, a more chronic form of mild or moderate depression, is diagnosed when symptoms persist for at least a year with no more than two months of relief. In either case, what are some common symptoms of depression?
Sudden change in mood and behavior. The previously docile teen suddenly is confrontational. Rebellious behavior and even running away from home are common among depressed teens.
Social isolation. The depressed adolescent withdraws from friends. Or it may be that friends withdraw from the depressed youth, noticing an undesirable change in his or her attitude and behavior.
Diminished interest in almost all activities. The teen is unusually passive. Hobbies that were just recently considered intriguing are now perceived as boring.
Notable change in eating habits. Many experts feel that disorders such as anorexia, bulimia, and compulsive overeating often coexist with (and may at times be caused by) depression.
Sleep problems. The teen sleeps either too little or too much. Some develop confused sleeping habits, being up all night and sleeping throughout the day.
Drop in academic performance. The depressed adolescent has problems getting along with teachers and peers, and grades begin to plummet. Soon the teen is reluctant to go to school at all.
Risky or self-destructive acts. Behaviors that ‘cheat death’ may show that a youth has little interest in living. Self-mutilation (such as cutting the skin) may also be a symptom.
Feelings of worthlessness or inappropriate guilt. The teen becomes highly self-critical, feeling like a complete failure, even though the facts may indicate otherwise.
Psychosomatic problems. When no physical cause can be found, headaches, back pain, stomachaches, and similar problems may indicate underlying depression.
Recurring thoughts of death or suicide. A preoccupation with morbid themes can point to depression. So can suicidal threats.—See box below.
Bipolar Disorder
Some of these same symptoms may be present in another baffling ailment—bipolar disorder. According to Drs. Barbara D. Ingersoll and Sam Goldstein, bipolar disorder (also known as manic-depressive disorder) is “a condition characterized by depressive episodes interspersed with periods in which mood and energy are excessively elevated—elevated, in fact, well beyond normal levels of a good mood.”
This elevated phase is called mania. Its symptoms may include racing thoughts, extreme talkativeness, and a decreased need for sleep. In fact, the sufferer may go for days without sleep with no evident loss of energy. Another symptom of bipolar disorder is highly impulsive behavior without regard for consequences. “Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment,” states a report by the U.S. National Institute of Mental Health. How long does the manic phase last? Sometimes just a few days; in other cases, mania lingers for several months before giving way to its counterpart, depression.
Those most at risk of developing bipolar disorder include individuals with family members who have the illness. The good news is that there is hope for sufferers. “Diagnosed early, and treated appropriately,” says the book The Bipolar Child, “these children and their families can live infinitely more stable lives.”
It is important to note that no single symptom on its own indicates depression or bipolar disorder. Most often, it is a cluster of symptoms manifested over a period of time that leads to a diagnosis. Still, the question remains, Why does this baffling disorder afflict teens?
[Footnote]
The symptoms herein presented are intended to serve as an overview and not as criteria for making a diagnosis.
[Box on page 6]
WHEN A CHILD WANTS TO DIE
According to the U.S. Centers for Disease Control, in one recent year more young people in the United States died from suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, and chronic lung disease combined. Another disturbing fact: There has been a dramatic increase in reported suicides among people between the ages of 10 and 14.
Can adolescent suicide be prevented? In some cases, yes. “Statistics show that many suicides are in fact preceded by attempts or verbal hints and warnings,” writes Dr. Kathleen McCoy. “When your teenager even hints about suicidal thoughts, it’s time to pay close attention and possibly seek professional help.”
The prevalence of teen depression underscores the need for parents and other adults to take seriously any indications that a young person gives of wanting to take his or her life. “In nearly every case of suicide I have reviewed, clues to the adolescent’s plans were overlooked or downplayed,” writes Dr. Andrew Slaby in his book No One Saw My Pain. “Family members and friends did not understand the enormity of the changes they were seeing. They focused on the consequences and not on the underlying problem, so that ‘family problems’ or ‘drug use’ or ‘anorexia’ became the diagnosis. Sometimes the anger, the confusion, and the irritability were treated but not the depression. The underlying problem remained, torturous and festering.”
The message is clear: Take all clues of suicidal tendencies seriously!
[Picture on page 7]
At times, rebellious behavior is a sign of underlying depression
[Picture on page 7]
Depressed teens often lose interest in activities that once fascinated them

Part 22

 
22.  Uncovering the Roots

“Usually, teenage depression is not due to one factor alone but to a combination of stressors.”—Dr. Kathleen McCoy.
WHAT causes teen depression? A number of factors may be involved. For one thing, the physical and emotional changes brought on by puberty can flood youths with uncertainty and fear, making them especially prone to negative states of mind. Also, teens are often vulnerable to negative emotions when they feel that they have been rejected by their peers or by someone for whom they had developed romantic feelings. Then, too, as noted in our opening article, today’s teens are growing up in a world that can be depressing in itself. We are indeed living in “critical times hard to deal with.”—2 Timothy 3:1.
Compounding the problem, youths are facing the pressures of life for the very first time, and they have neither the skills nor the experience of adults. Hence, teens often become like tourists navigating through unfamiliar territory—overwhelmed by their surroundings and, in many cases, not inclined to ask for help. These conditions can become fertile ground for the seeds of depression.
But there are a number of other factors that can contribute to teen depression. Let us consider just a few.
Depression and Loss
Depression sometimes follows a profound loss—perhaps the death of a loved one or the loss of a parent through divorce. Even the death of a pet can plunge a teen into despair.
There are also less obvious types of loss. For example, moving to a new neighborhood means leaving behind familiar surroundings and beloved friends. Even achieving a much-anticipated goal—such as graduating from school—can trigger feelings of loss. After all, embarking on a new phase of life implies losing the comfort and security of the past. Then there are youths who must endure some type of chronic illness. In such a circumstance, the pain of being different from one’s peers—perhaps even being ignored by them—can make a teen feel as if he or she has lost a degree of normality.
Granted, many youngsters face such losses without becoming entirely overwhelmed. They get sad, they cry, they grieve, they mourn—but in time they adjust. Why is it, though, that while most teens take on the pressures of life with resiliency, others succumb to the throes of depression? There are no easy answers, for depression is a complex disorder. But some teens might be more vulnerable.
The Biochemical Connection
Many mental-health professionals believe that a biochemical imbalance in the brain plays a key role in depression. The imbalance may be passed on genetically, for researchers have found that teens with a parent who suffers from depression are more likely to develop the condition themselves. “Depressed children more often than not have at least one parent who also suffers from depression,” says the book Lonely, Sad and Angry.
This raises the question, Do children truly inherit depression, or do they simply learn to be depressed from living with an afflicted parent? The ‘nature versus nurture question’ is difficult to answer, for the brain is incredibly complex, as are the many other factors that may contribute to teen depression.
Depression and Family Environment
Depression has been called a family affair, and for good reason. As already noted, there may be a genetic component that passes on a tendency toward depression from one generation to the next. But family environment might also play a part. “Children whose parents abuse them are at great risk for depression,” writes Dr. Mark S. Gold. “So are kids whose parents are overly critical and who focus on their child’s inadequacies.” Depression can also result when parents are smothering and overprotective. Interestingly, however, one researcher found that children are even more prone to depression when parents simply show a lack of interest in them.
This does not mean, however, that all depressed teens are victims of bad parenting. Such a sweeping assertion would ignore the host of other factors that can contribute to the problem. Still, in some cases family environment is a crucial part of the equation. “Children living in homes in which there is persistent tension between the parents are at higher risk for depression than children in less troubled environments,” writes Dr. David G. Fassler. “One reason is that the battling parents get so involved in their disputes that they neglect the needs of their kids. Another is that the parents often make children the focus of their arguments, which can make the youngsters feel guilty, angry, and resentful.”
These are just some of the factors that can contribute to teen depression. There are others. For example, some experts say that environmental factors (such as poor nutrition, toxins, and substance abuse) can induce depression. Others point out that certain medications (such as some antihistamines and tranquilizers) can have a bearing. It seems, too, that children with learning disabilities are especially prone to depression, possibly because their self-esteem tends to wane as they realize that they cannot keep up with their classmates.
Regardless of the cause, however, it is vital to consider the question, How can depressed teens be helped?
[Footnote]
Some suspect that while many sufferers are born with the imbalance, others start out healthy but become more susceptible to depression when a traumatic event alters brain chemistry.
[Pictures on page 8, 9]
Family tension is often a catalyst for depression

Part 23

 
23.  Coming to Terms

If your teen is clinically depressed, do not be ashamed of the situation. The fact is, depression can overtake the finest of young people. Indeed, the Bible shows that painful emotions have afflicted some who strove their best to serve God, regardless of their age. Consider faithful Job, who felt abandoned by God and therefore expressed a loathing for life. (Job 10:1; 29:2, 4, 5) Hannah was a servant of God who became so “bitter of soul” that she could not eat. (1 Samuel 1:4-10) Then there was the godly man Jacob, who mourned for many days after the death of his son and ‘refused to take comfort.’ Why, Jacob even expressed the desire to join his son in the grave! (Genesis 37:33-35) Hence, emotional distress is not always rooted in some spiritual flaw.
Nevertheless, depression in a teen can exact a heavy toll on parents. “I walk an emotional tightrope,” says the mother of one depressed teen. “I’m concerned, scared, hostile, angry and exhausted.” Another admits: “I would go out and see a mother shopping with her teenage daughter and my heart would break because I felt I had lost that with [my daughter] and I would never have it again.”
Such feelings are normal. At times, though, they may become overwhelming. If that happens, why not confide in a trusted friend? Proverbs 17:17 states: “A true companion is loving all the time, and is a brother that is born for when there is distress.” Also, do not neglect prayer. The Bible assures us that if we throw our burden upon God, he will sustain us.—Psalm 55:22.
The Tendency to Blame
Many parents of depressed teens become intensely discouraged and feel that they are somehow to blame for the situation. “When your child is depressed,” admits one parent, “you do feel guilty and no one can tell you any different. You keep wondering, ‘Where did we go wrong? Where was the turning point? How did I contribute to this?’” How can parents keep their thinking balanced in this regard?
There is no doubt that a harsh atmosphere in the home can adversely affect a child. For good reason, the Bible admonishes fathers: “Do not be exasperating your children, so that they do not become downhearted.” (Colossians 3:21) Therefore, parents would do well to analyze their methods of dealing with their children and make adjustments where necessary. But depression is not always the result of poor parenting. Indeed, the disorder can be found in the most loving of homes. Hence, parents who are doing all they can to help their children need not feel guilty.
It is equally important not to blame the depressed teen. After all, he or she likely has little control over the disorder. “I would never blame him for having chicken pox or pneumonia,” says one mother. “But with depression,” she admits, “that’s what I did. I blamed my child for getting sick—which makes me feel awful.” Viewing depression as a sickness rather than a weakness will help parents and others focus on how they can support the sufferer.
Raising a depressed teen can put a palpable strain on the relationship between the parents. “We blamed each other,” says one wife, “especially when we thought about the life we had expected to have and the life that we did have because of our son.” Tim, whose daughter suffers from depression, admits: “It’s easy to blame your mate. If parents have marital problems before the child starts showing signs of depression, the child’s puzzling behavior could be the last straw.” Do not let a child’s depression drive a wedge into your marriage! Really, little good is accomplished by pointing the finger—whether at yourself, your child, or your mate. The important thing is to provide support for the sufferer.
Providing Support
The Bible admonishes Christians: “Speak consolingly to the depressed souls.” (1 Thessalonians 5:14) If the depressed youth is plagued with feelings of low self-worth, you can help. How? Certainly not by making judgmental statements like, “You shouldn’t feel that way” or, “That’s the wrong attitude to have.” Instead, strive to be empathetic by showing “fellow feeling.” (1 Peter 3:8) Paul admonished Christians to “weep with people who weep.” (Romans 12:15) Remember, a person who is genuinely depressed really hurts. The pain is not imagined, nor is it feigned simply to elicit attention. After listening, try to draw out the sufferer. Ask why he or she feels that way. Then, gently and patiently help the teen to see why such a low assessment of himself or herself is not warranted. Reassurance of God’s love and mercy may help to alleviate the sufferer’s anxieties.—1 Peter 5:6, 7.
There may be further practical steps you can take. For instance, you may need to make sure that your depressed teen is getting a proper amount of rest, nutrition, and exercise. (Ecclesiastes 4:6) If medication is prescribed, it would be wise to help the teen see the importance of taking it. Never give up in providing support, and never let up in showing love.
Admittedly, depression in a teen can be a harrowing experience, for the sufferer and for the rest of the family. In the end, patience, perseverance, and love will provide a foundation for helping depressed teens.
[Footnote]
Reportedly, some medical conditions—including mononucleosis, diabetes, anemia, hypothyroidism, and hypoglycemia—can produce depressionlike symptoms.
[Blurb on page 11]
A person who is genuinely depressed really hurts. The pain is not imagined
[Box on page 13]
IF YOU ARE A DEPRESSED TEEN
You are not alone, and your situation is by no means hopeless. Your depression may be linked to either (1) a biochemical imbalance or (2) circumstances in life over which you have little or no control. Either way, you are not to blame for your condition. Still, what can you do about it?
The Bible states that “there exists a friend sticking closer than a brother.” (Proverbs 18:24) Why not find such a friend and pour out your feelings to that one? One of your parents or another mature adult can be your greatest ally in the fight against depression.
If your parents suspect that you are suffering from clinical depression, they may take you to a physician who is experienced in treating the disorder. This is a wise step, for often depression can be greatly relieved with treatment, where this is available. For example, when a chemical imbalance is involved, an antidepressant might be prescribed. If this is true in your case, do not feel ashamed of taking medication. It simply restores your body chemistry to its proper balance, and this can be the key to helping you regain a measure of joy and stability in your life.
Many sufferers of depression have gained comfort by reading the Bible and by drawing closer to God through prayer. The Bible assures us: “Jehovah is near to those that are broken at heart; and those who are crushed in spirit he saves.”—Psalm 34:18.
[Footnote]
For more information, see the article “Young People Ask . . . Should I Tell Someone That I’m Depressed?” which appeared in the October 22, 2000, issue of Awake!
[Box/Picture on page 14]
HELP AND HOPE FOR SUFFERERS
Since depression is a complex subject, not all aspects of the matter could be considered in this brief series of articles. Nevertheless, the publishers of Awake! are confident that the points presented can help teens and their parents to endure this debilitating disorder.
You may have noted that much of the guidance in the preceding article was based on the Bible. Granted, it is an ancient book. Yet, its counsel is as practical today as it was when it was penned. Why? Because although times have changed, human nature has not. We are confronted with the same basic issues that faced previous generations. The difference is that today these problems are greater and more far-reaching.
There is another reason, though, why the Bible is highly practical: It is inspired by God. (2 Timothy 3:16) As our Creator, he knows what we need in order to get the most out of life.
Of course, the Bible is not a medical textbook. Hence, it does not eliminate the need for us to seek appropriate treatment for sicknesses, such as depression. Still, the Bible contains principles that can help us to comfort sufferers. More than that, it contains God’s promise that he will soon heal all of our maladies. (Psalm 103:3) Yes, Jehovah purposes to “revive the heart of the ones being crushed.”—Isaiah 57:15.
Would you like to learn more about this grand hope? Please contact Jehovah’s Witnesses locally or write to the appropriate address on page 5 of this magazine.
[Picture on page 10]
Strive to show fellow feeling
[Picture on page 11]
If a teen’s depressed mood persists, it is wise to consult a physician
[Pictures on page 12]
As a parent, do not be too hasty to blame yourself, your mate, or your teen

Part 24

 
24.  A Definition of CFS

In March 1988 the CDC (U.S. Centers for Disease Control) published in Annals of Internal Medicine a group of signs and symptoms that collectively characterize CFS. (See accompanying box.)
The major criteria for diagnosing CFS are (1) the new onset of fatigue that lasts longer than six months and reduces one’s level of activity by 50 percent and (2) the exclusion of other medical or psychiatric conditions that could cause the symptoms. However, to be diagnosed with CFS, the patient also must suffer either 8 of the 11 symptoms on the list of minor criteria or 6 of 11 of these symptoms as well as 2 of 3 from the list of physical criteria.
Clearly, those who meet the diagnosis for CFS are extremely sick for a long time. The CDC made the definition of CFS very restrictive to identify these persons clearly. Those who have less severe forms of the syndrome are presently excluded by this definition.
Could CFS Be Depression?
What about doctors who say that CFS patients suffer from depression and other psychological disorders? Do these patients have the classic symptoms of depression?
CFS patients are commonly depressed, but as Dr. Kurt Kroenke, professor at a medical school in Bethesda, Maryland, U.S.A., asked: “Wouldn’t anyone be depressed if he or she stayed tired for a year or more?” So it is fair to ask: Is depression the cause of CFS, or is it a consequence?
That question is often difficult to answer. A doctor may consider the second point of the major criteria, which says that ‘psychiatric conditions that could cause the symptoms need to be excluded,’ and conclude that the patient suffers from depression and not from an organic or physical illness. Yet, in many cases this is not a satisfactory diagnosis.
The medical journal The Cortlandt Consultant noted: “The most compelling piece of evidence that CFS is an ‘organic’ illness is its sudden onset in 85 percent of patients. The majority of patients state that their illness began on a particular day with a flu-like syndrome characterized by fever, [sore throat, swollen lymph nodes, muscle aches], and related symptoms.” Physicians who have handled CFS patients are convinced that depression is often not the cause of symptoms.
“When we compared our cases,” reported Dr. Anthony Komaroff, chief of General Medicine at Brigham and Women’s Hospital in Boston, U.S.A., “we were struck by the fact that most patients said they had been perfectly healthy, energetic and successful in life until one day they developed a cold, flu or bronchitis and it never went away. The symptoms that could be considered psychological—depression, malaise, sleep disturbances and so forth—didn’t exist before the onset of the illness.”
One classic symptom of depression is loss of interest in everything. But Dr. Paul Cheney explained: “These patients are just the opposite. They’re terribly concerned about what their symptoms mean. They can’t function. They can’t work. Many are petrified. But they do not lack interest in their surroundings.”
Swollen glands, fever, unusual white-blood-cell counts, repeated respiratory infections, muscle and joint pains, and especially a peculiar malaise and muscle soreness that may occur after even moderate exercise—these symptoms just don’t fit a depression-related syndrome.
The Weight of Recent Evidence
In its November 6, 1991, issue, JAMA reported: “Preliminary data from an ongoing study of patients who meet the CDC’s definition of chronic fatigue syndrome (CFS) show that most patients with the illness are not victims of depression or other psychiatric problems.”
Dr. Walter Gunn, who closely monitored CFS research at the CDC, explained in this issue of JAMA: “Despite the fact that many physicians would have thought all of these patients [in the study] were depressed, we found that only 30% of the CFS patients had evidence of depression at the onset of fatigue.”
There may even be physical differences between many CFS patients and sufferers of depression. “Patients with major depression disorder (MDD) often have abnormalities in rapid-eye-movement (REM) sleep, whereas patients with CFS have abnormalities in non-REM [sleep],” noted the medical journal The Female Patient.
The magazine Science of December 20, 1991, reported another significant finding. It said that research indicates that “CFS patients have altered levels of certain brain hormones” and observed: “Although the differences from normal controls were modest, CFS patients consistently showed decreased levels of the steroid hormone cortisol, and increased levels of the pituitary hormone ACTH (adrenocorticotropin hormone), exactly the opposite of the changes seen with depression.”—Italics ours.
What if CFS Is a Real Disease?
The medical profession is skeptical of disorders it does not understand, such as CFS. “Skepticism permeates our profession,” wrote Dr. Thomas L. English. “Healthy skepticism is the ‘in’ attitude for intelligent, discriminating physicians.” Yet, Dr. English questions how healthy it is for the suffering patient “if CFS is a real disease.” He asks skeptical fellow doctors: “What if you are wrong? What are the consequences for your patients?”
Dr. English himself suffers from CFS, and last year JAMA published his article directed to fellow physicians. He invited them to put themselves in the place of the suffering patient, describing the syndrome:
“You catch ‘a cold’ and thereafter the quality of your life is indelibly altered. You can’t think clearly . . . Sometimes it’s all you can do to read the newspaper or to follow the plot of a television program. Jet lag without end. You inch along the fog-shrouded precipice of patient care, where once you walked with confidence. Myalgias [muscle aches] wander about your body with no apparent pattern. Symptoms come and go, wax and wane. . . . You too might wonder about some of your symptoms had you not talked to other patients with similar experiences . . . or talked with physicians who have seen hundreds of similar cases. . . .
“I have talked with scores of fellow patients who went to our profession for help, but who came away humiliated, angry, and afraid. Their bodies told them they were physically ill, but the psychospeculation of their physicians was only frightening and infuriating—not reassuring. It told them their doctors had little understanding of the real problem. . . . Are we to believe that just because symptoms are strange and unfamiliar they cannot be real? Are we to assume that our laboratory tests are capable of screening for new diseases as well as old? Distrust of new ideas is as old as humankind; so are the harmful consequences of that distrust.”—JAMA, February 27, 1991, page 964.
Value of Acknowledging Illness
“Doctors who spend a lot of time talking to patients with CFS hear a story that is absolutely repeatable; it’s a classic,” noted Dr. Allan Kind, an infectious diseases specialist. “I can tell you that Chronic Fatigue Syndrome is real.”
More and more doctors now agree. The Female Patient thus encouraged physicians: “Until a definite diagnosis and an appropriate treatment can be established, the physician has a special responsibility to tell these patients that they do indeed have a real illness, and that it is not ‘all in their heads.’”
The benefit of validating a patient’s illness can be tremendous. When a doctor told one woman she had CFS, she said: “The tears just welled up.” To hear a doctor say her illness was real, and that it had a name, was such a relief to her.
Yet, what causes CFS? What has research revealed?
[Box on page 7]
Diagnostic Criteria for Chronic Fatigue Syndrome
Major Criteria
1. New onset of fatigue lasting longer than six months with 50 percent reduction in activity
2. No other medical or psychiatric conditions that could cause the symptoms
Minor Criteria
Symptoms must begin at or after onset of fatigue
1. Low-grade fever
2. Sore throat
3. Painful lymph nodes
4. Generalized muscle weakness
5. Muscle pain
6. Prolonged fatigue after exercise
7. Headaches
8. Joint pain
9. Sleep disturbance
10. Neuropsychologic complaints, such as forgetfulness, confusion, difficulty concentrating, depression
11. Acute onset (over a few hours to a few days)
Physical Criteria
1. Low-grade fever
2. Throat inflammation
3. Palpable or tender lymph nodes
[Picture on page 8]
Doctors must be perceptive to distinguish between depression and chronic fatigue syndrome

Part 25

 
25.  Fighting a Relentless Foe

“THIS was the biggest trial of my life,” said Elizabeth. “To be on my feet again is wonderful. I feel as if I have a new lease on life. I can now smell the roses!” This 42-year-old woman had conquered a foe said to cause more suffering than any other mental disorder—depression.
Alexander was not as fortunate. This 33-year-old became very depressed, lost his appetite, and wanted to be by himself. “He felt like the whole world had come down and that nothing was worth living for anymore,” explained his wife, Esther. “He believed he wasn’t worth anything.” Convinced that he would never get better, Alexander plunged to his death in suicide.
Both Elizabeth and Alexander were among the reported 100,000,000 people worldwide who each year develop clinically recognizable depression. One out of every four Americans and one out of every five Canadians experience a major depressive episode during their lifetime. Depression is also reported to be a common ailment in Africa, and it is increasing in the Federal Republic of Germany. So chances are you may have a friend or a relative who is or has been a victim.
Alexander’s wife, who did all she could to help her husband, warns: “When someone talks about being depressed and feeling worthless, take it seriously.” Severe depression is thus more than a passing mood or just a case of the blues. It can be a killer, a relentless foe that can cripple and maim. Being able to recognize it could mean the difference between life and death.
“A Plague in My Brain”
All of us are subject to painful losses, frustrations, and disappointments. Sadness is a natural response. You close down emotionally, lick your wounds, and eventually begin to cope with the reality of the changed situation. You hope for a better day tomorrow and soon begin to enjoy life again. But in cases of major depression it is different.
“For eight months no shopping trip, nothing, made me feel better,” said Elizabeth. Another sufferer, Carol, added: “It was like a plague in my brain, like a terrible cloud hanging over me. You could give me a million dollars, and it wouldn’t stop the awful feelings.” One man said that ‘you feel as though you’ve put on smoke-colored glasses—everything looks unattractive. Also, the glasses have magnifying lenses, so that every problem seems overwhelming.’
Depression is a spectrum of emotions ranging from feeling sad to becoming hopeless and suicidal. (See box on page 4.) The number of symptoms, their intensity, and their duration are all factors in pinpointing when the blues become major depression.
Not Always Easy to Identify
Depression is often difficult to identify because the sufferer may also have physical symptoms. “My legs stung, and at times I had pain all over. I went to many doctors,” said Elizabeth. “I was convinced that they were overlooking some physical illness and that I was going to die.” Like Elizabeth, about 50 percent of depressed patients who seek medical help complain of physical rather than emotional symptoms.
“Usually, they will complain of headache, insomnia, anorexia, constipation, or chronic fatigue,” writes Dr. Samuel Guze, head of the Department of Psychiatry of Washington University in St. Louis, “but will say nothing about feeling sad, hopeless, or discouraged. . . . Some depressed patients seem unaware of their depression.” Chronic pain, weight loss or gain, and a diminished sexual desire are also classic symptoms.
Dr. E. B. L. Ovuga of Umzimkulu Hospital, Transkei, South Africa, reports that while depressed Africans rarely report feelings of guilt or worthlessness, they do complain of overactivity, withdrawal, and body pains. A 1983 report by the World Health Organization found that the vast majority of depressed persons studied in Switzerland, Iran, Canada, and Japan all had the same basic symptoms of joylessness, anxiety, lack of energy, and ideas of insufficiency.
Alcohol and drug abuse, as well as sexual promiscuity, are just some of the ways in which some try to cover depressed feelings. Yes, “even in laughter the heart may be in pain.” (Proverbs 14:13) This is especially true of youths. “Adults look depressed, but if a depressed child walks into a room, you would not notice a thing,” explained Dr. Donald McKnew of NIMH (National Institute of Mental Health) in an interview with Awake! “That’s why childhood depression went unrecognized for so long. But as soon as you talk to them about it, they will pour out their depression.”
Yet, the 1980’s have seen significant advances in understanding and treating depression. The mysteries of brain chemistry are being unraveled. Tests have been developed to identify certain types of depression. The fight has been augmented by the use of antidepressant medications and nutrients such as certain amino acids. Additionally, short-term talk therapies have been effectively used. According to NIMH scientists, between 80 and 90 percent of all victims can be helped substantially with appropriate treatment.
But what causes this disabling emotional disorder?
[Chart on page 4]
The Spectrum of Depression
Simple Blues Major Depression
Mood
Sadness, normal grief Overwhelming hopelessness
Self-pity, discouragement Feeling of worthlessness
Self-blame and guilt Destructive guilt and self-blame
Able to find some pleasure Find no pleasure, no longer care
Thinking
Remorse or regret Thoughts of suicide
Hard to concentrate
Duration
Brief duration (few days) Prolonged duration (two weeks or more)
Physical Symptoms
Normal functioning Constant fatigue; unexplained aches
Slight physical problems Changes in eating and sleeping habits
(temporary) Inability to sit still, pacing,
handwringing
Slowed speech or body motions

Part 26

 
26.  Depression: All in One’s Head?

THE MAN became depressed as soon as he began to restore his 200-year-old home. He slept badly and found sustained mental effort unusually difficult. His family wondered whether the house was haunted! He noticed that his worst symptoms, which included abdominal pain, followed periods spent removing old paint from interior woodwork. A doctor discovered that poisoning from the lead in the layers of old paint he was scraping caused his depression.
Yes, at times, even toxic materials are to blame for depression. In fact, you may be surprised to learn that depression can be triggered by a number of physical causes.
Several years ago researchers carefully examined 100 persons who were admitted to a city hospital with psychiatric problems, including depression. In 46 of these cases, the emotional symptoms were found to be directly related to physical illnesses. According to the report in the American Journal of Psychiatry, when these physical ills were treated, 28 “evidenced dramatic and rapid clearing of their psychiatric symptoms,” and 18 were “substantially improved.”
The role of physical illness in depression, however, is complex. The experience of many doctors is that a depressed patient may also have a physical illness that is not responsible for his depression but that becomes the focal point in his mind. Yet, the underlying depression often must be addressed and treated.
Though some physical illnesses can cause or intensify emotional disorders, psychiatric symptoms can also develop as a reaction to a previously existing illness. For instance, after major surgery, especially of the heart, recovering patients almost always get depressed. When they recover, the depression usually lifts. The strain on the body from a serious illness may also cause the disorder. In addition, an allergic reaction to certain foods or other substances can cause severe depression in some persons.
Heredity may also be a factor in whether one develops certain types of depression. Earlier this year, researchers announced the discovery of an inherited genetic defect that is believed to predispose some persons to manic depression.
Additionally, some medical experts say that from 10 to 20 percent of new mothers experience a full-blown clinical depression. Researchers do not agree, however, whether the hormonal changes associated with childbirth or the emotional strains of motherhood bring on the disorder. Recent findings also indicate that premenstrual syndrome and the taking of birth-control pills tend to cause depression in some women.
Current research has also revealed that some people appear to have seasonal mood cycles, referred to as Seasonal Affective Disorder. Such ones feel very depressed during the fall and winter. They slow down and generally oversleep, withdraw from friends and family, and experience changes in appetite and food preference. But come spring and summer, they are elated, active, and energetic, and they generally function well. Some have been successfully treated with the regulated use of artificial lighting.
So depression is not always ‘in the head.’ Therefore, if a depressed mood lingers, having a complete medical examination is vital. But what if no physical reason can be found?
[Box on page 6]
Some Physical Causes of Depression
Medical research has associated the following things with the development of depression in some people:
Toxic metals and chemicals: lead, mercury, aluminum, carbon monoxide, and some insecticides
Nutrient deficiencies: certain vitamins and some essential minerals
Infectious diseases: tuberculosis, mononucleosis, viral pneumonia, hepatitis, and influenza
Endocrine-system diseases: thyroid disease, Cushing’s disease, hypoglycemia, and diabetes mellitus
Central-nervous-system diseases: multiple sclerosis and Parkinson’s disease
“Recreational” drugs: PCP, marijuana, amphetamines, cocaine, heroin, and methadone
Prescription drugs: barbiturates, anticonvulsants, corticosteroids, and hormones. Some medications that treat high blood pressure, arthritis, cardiovascular problems, and some mental disorders
(Certainly, not all such medicines will cause depression, and even when there is a danger, it usually involves a small percentage of those who use the drug under the proper medical supervision.)

Part 27

 
27.  The Psychological Roots

“I’VE done every test, and nothing shows up,” the kindly doctor told Elizabeth. “I believe you are severely depressed and for good reason.”
Elizabeth, who felt that her problem was a physical illness, began to wonder if the doctor was correct. She reflected on her daily struggle for the past few years with her unruly, and often uncontrollable, six-year-old son, who was later diagnosed as having an attention-deficit disorder. “The day-in, day-out stress and anxiety that never let up took an enormous toll on my emotions,” confided Elizabeth. “I had reached the point where I felt hopeless and suicidal.”
Many depressed persons, like Elizabeth, have faced an exceptional amount of emotional strain. In fact, a landmark study by British researchers George Brown and Tirril Harris found that depressed women had a rate of “major difficulties,” such as bad housing or a strained family relationship, that was over three times greater than that of nondepressed women. These difficulties had caused “considerable and often unremitting distress” for at least two years. Severe life experiences, such as the death of a close relative or friend, a severe illness or accident, shockingly bad news, or the loss of a job, also were four times more common among the depressed women!
Yet, Brown and Harris found that adversity alone does not cause the depression. Much depended on the mental response and emotional vulnerability of the individual.
“Everything Seemed Hopeless”
For instance, Sarah, a hardworking wife and the mother of three young children, wrenched her back in a job-related accident. Her doctor said that she would have to curtail much of her physical activity because of a ruptured disk. “I thought my whole world had come to an end. I had always been an active, athletic person who played sports with my kids. I pondered this loss and felt things would never get better. Soon I lost all joy of living. Everything seemed hopeless,” confessed Sarah.
Her reaction to the accident led to thoughts of hopelessness concerning her life as a whole, and this bred the depression. As Brown and Harris, in their book Social Origins of Depression, state: “It [the provoking incident, such as Sarah’s accident] may lead to thoughts about the hopelessness of one’s life in general. It is such generalization of hopelessness that we believe forms the central core of a depressive disorder.”
But what makes many people feel unable to repair the damage of a painful loss, causing them to fall into major depression? Why was Sarah, for example, vulnerable to such a negative train of thought?
‘I’m Unworthy’
“I’ve always lacked confidence in myself,” explained Sarah. “My self-esteem was very low, and I felt unworthy of any attention.” The painful feelings associated with one’s lacking self-worth are often the critical factor. “Because of the pain of the heart there is a stricken spirit,” states Proverbs 15:13. The Bible recognizes that a depressed spirit can be the result, not of external pressures alone, but of inward misgivings. What can cause low self-esteem?
Some of our thought patterns are shaped by our upbringing. “As a child, I was never praised by my parents,” confided Sarah. “I cannot ever remember receiving a compliment until after I was married. Consequently, I sought approval from others. I have this terrible fear of people’s disapproval.”
Sarah’s intense need of approval is a common element with many who become seriously depressed. Research has revealed that such persons tend to build their self-esteem on the love and approval received from others, rather than on their own achievements. They may estimate their own worth by the extent that they are likable or significant to someone else. “Loss of such support,” reports one team of researchers, “will lead to a fall in self-esteem and this contributes significantly to the onset of depression.”
Perfectionism
An exaggerated concern about gaining the approval of others often expresses itself in an unusual way. Sarah explains: “I strove to do everything just right so that I could get the approval that I didn’t get as a child. On my secular job, I did everything just so. I had to have the ‘perfect’ family. I had this image that I had to live up to.” When she had her accident, however, all seemed hopeless. She adds: “I believed I was keeping the family going and feared that if I couldn’t function, they would fail and then people would say, ‘She is a bad mother and wife.’”
Sarah’s thinking led to major depression. Research about the personalities of depressed persons reveals that her case is not unique. Margaret, who also suffered from severe depression, admitted: “I worried about what others thought of me. I was a perfectionistic, clock-watching, organized worrier.” Setting unrealistically high goals or being overly conscientious, and yet failing to live up to expectations, is at the root of many depressions. Ecclesiastes 7:16 warns: “Do not become righteous overmuch, nor show yourself excessively wise. Why should you cause desolation to yourself?” Trying to show yourself nearly “perfect” to others can lead to emotional and physical desolation. The frustrations can also lead to a destructive type of self-blame.
“I Can’t Do Anything Right”
Self-blame can be a positive reaction. For instance, a person may be robbed because of walking alone in a dangerous neighborhood. He may blame himself for putting himself into such a situation, resolving to change and thereby avoid a similar problem later. But a person could go further and blame himself for the type of person he is by saying: ‘I’m just a careless person who is unable to stay out of trouble.’ This type of self-blame faults one’s character and undermines self-esteem.
An example of such destructive self-blame occurred with 32-year-old Maria. For six months she harbored resentment toward her older sister because of a misunderstanding. One evening she lambasted her sister over the phone. Their mother, upon finding out what Maria had done, called and strongly reprimanded her.
“I got mad at my mother, but I was even more upset with myself, for I learned how much I had hurt my sister,” explained Maria. Shortly afterward she yelled at her nine-year-old son, who was misbehaving. The boy, who became very upset, later said to her: “Mommy, you sounded like you wanted to kill me!”
Maria was crushed. She reported: “I felt that I was a terrible person. I thought, ‘I can’t do anything right!’ That’s all I could think about. Then the deep depression really began.” Her self-blame proved destructive.
Does all of this mean that everyone with major depression has low self-esteem? Of course not. The causes are complex and varied. Even when the result is what the Bible calls ‘pain of heart,’ there are many emotions that cause this, including unresolved anger, resentment, guilt—real or exaggerated—and unsettled conflicts with others. (Proverbs 15:13) All of these can lead to a stricken spirit, or depression.
When Sarah realized that her thinking was at the root of much of her depression, at first she was crushed. “But then I felt a measure of relief,” she confided, “because I realized that if my thinking caused it, then my thinking could also fix it.” Sarah said this thought was exciting to her, explaining: “I realized that when I changed the way I was thinking about certain things, this could affect my life from here on for good.”
Sarah made the necessary changes, and her depression lifted. Maria, Margaret, and Elizabeth likewise won their fight. What changes did they make?
[Blurb on page 10]
‘When I realized that my thinking caused my depression, this gave me some relief and comfort because I believed then I could also fix it.’
[Box on page 8, 9]
Childhood Depression: “I Wish I Weren’t Alive”
An interview with Dr. Donald McKnew of the National Institute of Mental Health, who has researched this subject for 20 years.
Awake!: How prevalent do you consider this problem to be?
McKnew: A recent New Zealand study of a thousand children found that by the age of nine, some 10 percent of the children had already experienced a depressive episode. And we get the impression that 10 to 15 percent of schoolchildren have mood disorders. A smaller number suffer from severe depression.
Awake!: How can you tell if children are severely depressed?
McKnew: One of the key symptoms is that they find no pleasure in anything. They don’t want to go out and play or be with their friends. They’re not interested in the family. You see loss of concentration; they can’t keep their mind even on television programs, much less their homework. You see a feeling of worthlessness, a personal sense of guilt. They’ll go around saying they think they’re no good or nobody likes them. Either they can’t sleep or they oversleep; they lose their appetite or they overeat. Plus you hear suicidal ideas such as, “I wish I weren’t alive.” If you see a conglomeration of these symptoms, and it’s lasted for a week or two, then you’re talking about a seriously depressed child.
Awake!: What are the key triggers of childhood depression?
McKnew: When you get down to the specific factors in any given child’s life, the major thing is probably a loss. While this usually means a parental loss, it could include friends, close relatives, or even a pet. Second to losses I would put depreciation and rejection. We see an awful lot of children who are maligned and made to feel they’re small or insignificant by their parents. At times a child is made a scapegoat. He is blamed for anything that goes wrong in the family whether he is at fault or not. Hence, he feels unworthy. Another factor is a mood disorder in a parent.
Awake!: The book Why Isn’t Johnny Crying?, which you coauthored, states that some children who are depressed engage in drug and alcohol abuse or even delinquent behavior. Why is this?
McKnew: We believe they’re trying to hide the depression, even from themselves. Their way of dealing with it often is to stay busy with other things, like stealing cars, taking dope, or drinking. These are ways of disguising how badly they feel. In fact, trying to hide their depression is one of the clearest ways that children differ from adults.
Awake!: How can you tell when it is depression and not a child just misbehaving?
McKnew: By talking with these children, getting them to open up, you will often find the depression. And if the depression is properly treated, their behavior improves. Though something else was showing up on the surface, the depression was still there underneath all the time.
Awake!: How can you get a depressed child to open up?
McKnew: First of all, choose a quiet time and place. Then ask specific questions like, ‘Is something bothering you?’ ‘Have you been feeling sad or blue?’ ‘Are you upset?’ If there has been a loss, you could ask, depending on the circumstances, ‘Do you miss Grandma as much as I do?’ Give the child a chance to ventilate his feelings.
Awake!: What would you tell severely depressed children to do?
McKnew: Tell their parents about it. This business of detection is a serious one because generally only the children know they’re depressed. Parents and teachers usually don’t see it. I have seen adolescents who have gone to their parents and said, “I am depressed, I need help,” and they’ve gotten it.
Awake!: How can a parent help a depressed child?
McKnew: If the depression seems to be debilitating, then it’s not something to be handled at home, any more than is pneumonia. A debilitating depression must be taken to a professional because there may be a need for medication. We use medication in well over half of our cases, even with children down to five years of age. We also try to readjust the child’s thinking. And by these means the depression is eminently treatable.
Awake!: If it’s not a debilitating illness, what can a parent do?
McKnew: Take an honest look at yourself and your family. Has there been some serious loss that needs to be talked about and dealt with? When losses occur, don’t belittle a child’s sadness. Allow him the freedom to work through his grief. Give a depressed child special amounts of attention, praise, and emotional support. Spend extra time with him alone. Your warm involvement is the best form of treatment.

Part 28

 
28.  Winning the Fight Against Depression

“BY SKILLFUL direction you will carry on your war,” states Proverbs 24:6. Skill, not just good intentions, is needed to win a battle. Certainly, if depressed, you do not want inadvertently to cause yourself to feel worse. For instance, a 1984 study of depressed persons found that some tried to cope with their depression by ‘taking anger out on other people, reducing tension by drinking more, eating more, and taking more tranquilizing drugs.’ The result: “more depression and physical symptoms.”
Some depressed persons fail to seek skillful direction because of their fear of being viewed as mentally weak. Yet, major depression is a sign neither of mental weakness nor of spiritual failure. Research indicates that this severe disorder may exist when there is a certain chemical malfunction in the brain. Since a physical illness may cause this, if you have been severely depressed for longer than two weeks, a medical examination may be advisable. If no physical illness is found to be contributing to the problem, often the disorder can be improved by adjusting the thinking pattern along with some help from appropriate medication or nutrients. Winning the fight against depression does not mean that you will never have a depressed mood again. Sadness is a part of life. Yet, skillfully directing your blows will help you deal with depression better.
A doctor will often prescribe antidepressants. These are drugs designed to clear up the chemical imbalance. Elizabeth, mentioned earlier, used these, and within weeks her mood began to improve. “Still, I had to cultivate a positive attitude to work along with the drugs,” she said. “With the ‘push’ from the medicine, I was determined to get well. I also maintained a daily exercise program.”
However, the use of antidepressants is not always successful. There are also troublesome side effects for some. And even if the chemical malfunction is corrected, unless one’s thinking is corrected, the depression may return. Much relief, however, can come by being willing to . . .
Open Up Your Feelings
Sarah deeply resented the one-sided load of family responsibilities that she carried, as well as the pressures of a secular job. (See page 7.) “But I just stuffed my feelings inside me,” explained Sarah. “Then one night when I felt so hopeless, I phoned my younger sister, and for the first time in my life, I began to pour out my feelings. This was a turning point, as that call brought such relief.”
So, if depressed, seek out an empathetic person in whom you can confide. This one may be a marriage mate, close friend, relative, minister, doctor, or trained counselor. One of the essentials in defeating depression, according to a study reported in the Journal of Marriage and the Family, is “having a support helper available with whom to share the tribulations of life.”
Putting your feelings into words is a healing process that prevents your mind from trying to deny the reality of the problem or loss and, hence, leaving this unresolved. But open up your real feelings. Don’t allow a sense of false pride, wanting to have an undaunted-by-adversity appearance, to inhibit you. “Anxious care in the heart of a man is what will cause it to bow down, but the good word is what makes it rejoice,” states Proverbs 12:25. Yet, only by opening up can others begin to understand your “anxious care” and thus give that “good word” of encouragement.
“I just wanted sympathy when I called my sister, but I got a lot more,” recalled Sarah. “She helped me to see where my thinking was wrong. She told me that I was putting too much responsibility on myself. Though at first I didn’t want to hear this, when I began to apply her counsel, I could sense that a huge load began to be lifted.” How true are the words of Proverbs 27:9: “Oil and incense are what make the heart rejoice, also the sweetness of one’s companion due to the counsel of the soul.”
There is sweetness in having a friend or a mate who talks frankly and helps you to put things in proper perspective. This may help you to focus on just one problem at a time. So rather than becoming defensive, cherish such “skillful direction.” You may need someone who, after several conversations, can offer some short-term goals that will indicate steps you can take to change or modify your situation so as to reduce or eliminate the source of the emotional strain.
Fighting depression often requires contending with feelings of low self-esteem. How can these be skillfully resisted?
Fighting Low Self-Esteem
For instance, Maria, as the preceding article shows, became depressed after conflicts within her family. She concluded: ‘I am a terrible person and can’t do anything right.’ This was wrong. If she had just analyzed her conclusions, she could have challenged these by reasoning: ‘I do some things right and some wrong, just like other people. I made a couple of mistakes, and I need to work on being more thoughtful, but let’s not blow this all out of proportion.’ Such reasoning would have left her self-esteem intact.
So often that overly critical inner voice that condemns us is wrong! Some typical distorted thoughts that breed depression are listed in the accompanying box. Learn to recognize such erroneous thoughts and mentally challenge their validity.
Another victim of low self-esteem was Jean, a 37-year-old single parent. “I was under strain trying to rear two boys. But when I saw other single parents get married, I thought, ‘Something must be wrong with me,’” she explained. “By dwelling on just negatives, these snowballed, and I ended up hospitalized for depression.”
“After leaving the hospital,” Jean continued, “I read in the Awake! of September 8, 1981, a list of ‘Thoughts That Can Incline One to Depression.’ Each night I read that list. Some of the wrong thoughts were, ‘My value as a person depends on what others think of me,’ ‘I should never feel hurt; I should always be happy and serene,’ ‘I should be the perfect parent.’ I tended to be a perfectionist, so as soon as I would think that way, I’d pray to Jehovah to help me stop. I learned that negative thinking leads to low self-esteem, for all you see is the trouble in your life and not the good that God has given you. By forcing myself to avoid certain incorrect thoughts, I got over my depression.” Do some of your thoughts need to be challenged or rejected?
Is It My Fault?
Although Alexander was very depressed, he managed to teach a school class. (See page 3.) When some of his pupils failed a very important reading test, he became suicidal. “He felt that he had failed,” reported Esther, his wife. “I told him it was not his fault. You can’t have 100-percent success.” Yet, his overwhelming guilt closed his mind and led him to suicide. Often, exaggerated guilt is caused by assuming an unrealistic responsibility for the behavior of other people.
Even in the case of a child, a parent can strongly influence his life but not absolutely control it. If something does not go as well as you had planned, ask yourself: Did I face unforeseen occurrences beyond my control? (Ecclesiastes 9:11) Did I do all I reasonably could within the limits of my physical, mental, and emotional resources? Were my expectations just too high? Do I need to learn to be more reasonable and modest?—Philippians 4:5.
But what if you do make a serious mistake, and it is your fault? Will continuing to beat yourself mentally change the mistake? Is not God willing to forgive you, even “in a large way,” if you are genuinely repentant? (Isaiah 55:7) If God will “not for all time keep finding fault,” should you sentence yourself to a lifetime of mental suffering over such wrongdoing? (Psalm 103:8-14) Not constant sadness but taking positive steps to ‘right the wrong’ is what will please Jehovah God and also ease your depression.—2 Corinthians 7:8-11.
‘Forget the Things Behind’
Some of our emotional problems may be rooted in the past, especially if we were victims of unjust treatment. Be willing to forgive and forget. ‘Forgetting is not easy!’ you may be thinking. True, but it is better than destroying the rest of your life by dwelling on what cannot be undone.
“Forgetting the things behind and stretching forward to the things ahead,” wrote the apostle Paul, “I am pursuing down toward the goal for the prize.” (Philippians 3:13, 14) Paul did not dwell on the wrong course he had pursued in Judaism, including even approving of murder. (Acts 8:1) No, he concentrated his energies on qualifying for the future prize of eternal life. Maria also learned not to dwell on the past. At one time she blamed her mother for the way she had reared her. Her mother had stressed excellence and physical beauty; hence, Maria was a perfectionist and tended to be jealous of her attractive sister.
“This underlying jealousy was the root of the conflicts, but I blamed my family for the way I acted. Then I came to the point where I thought, ‘Really, what difference does it make whose fault it was?’ Maybe I have some bad traits because of the way Mother raised me, but the point is to do something about it! Don’t continue to act that way.” This realization helped Maria make the needed mental adjustments to win her fight against depression.—Proverbs 14:30.
Your Real Value
All factors considered, successfully fighting depression requires having a balanced view of your own worth. “I would say to every one of you,” wrote the apostle Paul, “not to estimate himself above his real value, but to make a sober rating of himself.” (Romans 12:3, Charles B. Williams) False pride, ignoring our limitations, and perfectionism are all an overestimate of ourselves. These tendencies must be resisted. Yet, avoid going to the other extreme.
Jesus Christ stressed the individual worth of each of his disciples by saying: “Five sparrows sell for two coins of small value, do they not? Yet not one of them goes forgotten before God. But even the hairs of your heads are all numbered. Have no fear; you are worth more than many sparrows.” (Luke 12:6, 7) We are of such worth to God that he takes note of even the minutest detail about us. He knows things about us that we do not know ourselves because he deeply cares about each of us.—1 Peter 5:7.
Recognizing the personal interest God had in her helped Sarah to improve her feelings of self-worth. “I always felt awe for the Creator, but then I came to realize that he cared about me as a person. No matter what my children do, no matter what my husband does, regardless of how my mom and dad raised me, I realized I had a personal friendship with Jehovah. Then my self-esteem really began to grow.”
Since God considers his servants precious, our worth does not rest on approval by another human. Of course, rejection is unpleasant. But when we use another’s approval or disapproval as the yardstick by which to measure our own worth, we are making ourselves vulnerable to depression. King David, a man after God’s own heart, was on one occasion called a “good-for-nothing man,” literally, a “man of worthlessness.” Yet, David realized that the name-caller had a problem, and he did not view the remark as a final judgment of his own worth. In fact, as people often do, Shimei later apologized. Even if someone justly criticizes you, recognize it as directed against a specific thing you did, not your worth as a person.—2 Samuel 16:7; 19:18, 19.
Sarah’s personal study of the Bible and Bible-based literature and attending the meetings of Jehovah’s Witnesses helped her lay the foundation for a relationship with God. “But my changed attitude about prayer was the biggest help,” recalled Sarah. “I used to think that we only prayed to God about big things and should not bother him with insignificant problems. Now I feel I can talk to him about anything. If I’m nervous about making a decision, I ask him to help me be calm and reasonable. I draw even closer as I see him responding to my prayers and helping me get through each day and each trying circumstance.”—1 John 5:14; Philippians 4:7.
Indeed, the assurance that God has a personal interest in you, understands your limitations, and will give you the strength to tackle each day is the key in the fight against depression. Yet, at times, regardless of what you do, the depression lingers.
‘Hour-by-Hour’ Endurance
“I have tried everything, including nutritional supplements and antidepressants,” bemoans Eileen, a 47-year-old mother who has struggled with major depression for years. “I have learned to adjust wrong thinking, and this has helped me to be a more reasonable person. But the depression remains.”
The fact that depression persists does not mean that you are not fighting it skillfully. Doctors do not know all the answers to treating the disorder. In some situations the depression is a side effect of some medicines taken to treat a serious illness. Thus, the use of such medicines is a trade-off because of the benefit they may be in treating some other medical problem.
Of course, pouring out your feelings to another understanding person helps. Yet, no other human can really know the depth of your agony. However, God knows and will help. “Jehovah has provided strength to keep trying,” revealed Eileen. “He has not let me give up, and he has given me hope.”
With God’s help, emotional support from others, and your own efforts, you will not be overwhelmed so that you give up. In time you can adjust to the depression, just as you would to any chronic illness. Endurance is not easy, but it is possible! Jean, whose severe depression persisted, said: “We didn’t even take it day by day. It was more like hour by hour.” With both Eileen and Jean, the hope promised in the Bible kept them going. What is that hope?
A Precious Hope
The Bible speaks of a time in the near future when God “will wipe out every tear from [mankind’s] eyes, and death will be no more, neither will mourning nor outcry nor pain be anymore. The former things have passed away.” (Revelation 21:3, 4) God’s Kingdom will then bring about the complete physical and mental healing of all its earthly subjects.—Psalm 37:10, 11, 29.
Not only will physical pain be removed but painful distress and affliction of the heart will disappear too. Jehovah promises: “The former things will not be called to mind, neither will they come up into the heart. But exult, you people, and be joyful forever in what I am creating.” (Isaiah 65:17, 18) What a relief it will be to mankind to be relieved of the burdens of the past and to awaken each day with crystal-clear minds, eager to tackle the day’s activity! No longer will humans be hampered by the haze of a depressed mood.
With ‘no more death, mourning, or outcry,’ gone will be the sense of tragic losses and daily emotional strains that now lead to depression. Since loving-kindness, trueness, and peace will permeate dealings that people have with one another, bitter conflicts will cease. (Psalm 85:10, 11) As the effects of sin are removed, what great joy to be able finally to measure up perfectly to God’s standard of righteousness and have full peace within!
This exciting prospect is a great incentive to keep fighting, no matter how intense depression becomes. For in God’s new world, perfected humans will have gained an absolute victory over depression. What good news that is!
[Footnotes]
Awake! does not endorse or promote any form of treatment but provides current information to be helpful. See “Attacking Major Depression—Professional Treatments” in our October 22, 1981, issue. To overcome the simple blues, which are quite different from major depression, see “How Can I Get Rid of the Blues?” in our October 8, 1982, issue.
The confidant of a depressed person must not only avoid judgmental statements that would add to that one’s feelings of guilt and worthlessness but also not be unrealistically optimistic. Our next issue will have information on how others can help depressed ones.
[Box on page 13]
Distorted Thinking Patterns
All-or-nothing thinking: You see things in black-and-white categories. If your performance falls short of perfection, you see yourself as a total failure.
Overgeneralization: You see a single negative event as a never-ending pattern of defeat. For instance, after an argument with a friend, you may conclude: ‘I’m losing all my friends. Nothing turns out right for me.’
Disqualifying the positive: You reject positive experiences by insisting that they “don’t count” or, “I’m not worthy of such.” By dwelling on a single negative detail, your whole view darkens.
Jumping to conclusions: You arbitrarily conclude that someone doesn’t like you, and you don’t bother to check this out. Or you are absolutely convinced that things will always turn out badly.
Magnification or minimization: You exaggerate the importance of things (such as your own mistake or someone else’s achievement) or play down things until they appear tiny (your own desirable qualities or the other fellow’s imperfections). You make nightmarish disasters out of commonplace negative events.
Personalization: You see yourself as the cause of some negative external event that, in fact, you were not primarily responsible for.
Based on Feeling Good—The New Mood Therapy, by David D. Burns, M.D.
[Picture on page 12]
Pouring out your feelings to an empathetic confidant can be a healing process and provide great relief
[Picture on page 15]
God considers even little sparrows of worth, so of what greater worth God considers us

Part 29

 
29.  Defeating Depression—How Others Can Help

IT WAS the third time within just a few days that Ann had phoned long distance for no apparent reason. Her mother, Kay, noticed that her voice seemed lifeless. “It was like a voice of depression,” explained Kay. “Though she didn’t complain, the tone of her voice was saying out loud, ‘I need help!’” Kay’s heart raced as she sensed trouble.
“I told my daughter that I would be there the next day!” recalls Kay. “Ann started crying, muttered ‘OK,’ and then hung up.” Upon arriving, the mother was shocked to learn that Ann had revealed to her friends that she felt totally hopeless and worthless. She had even seriously talked about suicide! Nevertheless, the support Kay gave during her five-day visit helped her daughter recover. It was the turning point. “This taught me a lesson about listening,” reflected the mother. “She could have killed herself, and how awful we would have felt if we had not helped in her time of need.”
Help from others can often mean the difference between life and death to a severely depressed person. Would you have been as alert as Kay? Since each year a hundred million persons worldwide develop a severe depression, the chances are that someone who is your friend or relative may be affected. But helping someone who is severely depressed can be exasperating.
Dr. Leonard Cammer in his book Up From Depression tells of one mother who was at her wit’s end with a depressed son. As she and her son conferred with the doctor, she bemoaned: “He just moves away from us and acts as if we’re not there. He knows we love him. Why does he have to hurt us this way? You don’t know what I’ve been going through, Doctor.” Dr. Cammer remarks: “If only she knew the suffering he has been going through! . . . The depressed person senses that he is a burden to the family. But he is a burden to himself too, because he is helpless to rectify his condition and is ashamed and humiliated by it. His only recourse then is to drift farther away.” The mother’s lack of sensitivity made the situation worse. To help, therefore, the first essential is . . .
Empathy
Empathy, or “fellow feeling,” is an effort to identify emotionally with another. (1 Peter 3:8) Realize that the depressed person really hurts. His distress is real and not feigned. “Weep with people who weep,” advised the apostle Paul. (Romans 12:15) In other words, try to understand the pain the depressed one feels.
Though you cannot know exactly what he feels, you can show a genuine interest in wanting to know. Encourage that one to talk, and when he vents his feelings, try to see things through his eyes, putting yourself in his place. Avoid judgmental statements such as, ‘You shouldn’t feel like that’ or, ‘That’s the wrong attitude.’ The depressed person’s emotions are especially fragile, and such critical comments only make him feel worse about himself. Usually his self-esteem has evaporated.
Rebuilding Self-Esteem
To restore his self-esteem, you must appeal to the person’s reason. Ever so gently, help him see that his low assessment of himself is incorrect. But simply giving him a stirring speech, telling him that he is ‘a great person,’ is not the answer. “He that is removing a garment on a cold day is as vinegar upon alkali and as a singer with songs upon a gloomy heart,” observes Proverbs 25:20. Such shallow efforts leave a depressed one emotionally cold and irritated, since they rarely address the reasons why that one feels worthless.
For instance, a depressed person may say: ‘I feel that I’m just no good and that I’ll never be worth anything.’ You could in a nonchallenging manner ask: ‘Can you tell me why you feel that way?’ As he begins to explain, listen carefully. Such close attention assures him that what he is saying is worth while. As he opens up, you will be able to ask further questions to help him identify and correct the reasonings that can cause depression.
Use simple, direct questions, not in a scolding way, but in an effort to get the person to reason. (See box, page 13.) If you see that the person is doing things that are contributing to his problem, then in a nonaccusing way, you could kindly ask: ‘Is what you’re doing up to this point helping you? Do you need to do something different?’ Getting him to offer suggestions may restore some of his self-confidence.
A depressed person tends to ignore all his good qualities; so focus his attention on his personal assets and capabilities. She may have a knack with plants or be a good cook. He may have reared happy, stable children. Look for areas where the depressed one has succeeded and draw these to his attention. You may even have him write down some of these to review later. It helps also when that one can use his talent to help you.
For instance, Maria, who was an excellent seamstress, became severely depressed. One of her friends asked: “Would you like to help me pick out some fabric and a pattern? I want to make a suit.” Maria offered to make it for her. “Oh, would you?” responded her friend. Later, she warmly thanked Maria for the suit and by mail told her of all the fine compliments she had received on it. “This increased my confidence and brightened my days,” said Maria. “I later found out that she had gone through a depression and knew this task would be a big help. It was. She did more for me than I did for her.”
So help depressed ones to develop a few specific short-term goals that are within their ability and circumstances. These may be simple household duties, a handicraft project, or even wholesome words. As one severely depressed woman said: “I would try each day to say something upbuilding to either my family or a friend.” Reaching these small goals builds self-esteem.
When It’s Your Spouse
The first assumption of many whose mates become severely depressed is that they are somehow responsible for the other’s low mood. This produces guilt that, in turn, creates friction. Yet, depression is not necessarily a sign that one has had a bad marriage.
After studying the lives of 40 depressed women, Myrna Weissman and Eugene Paykel in their book The Depressed Woman concluded: “Not all the depressed women had poor marriages prior to their illnesses. We found a number of marriages where free and easy communications, mutual sensitivity to each other’s needs, . . . had existed prior to the depression. The illness put considerable strain on the relationship.”—Italics ours.
Sometimes, however, though not always causing the depression, a strained or detached relationship with a mate can create an environment that makes depression much more likely. Some factors that induce depression are listed in the box on page 15. One husband whose depressed wife became suicidal admitted: “I was not serious about watching over her emotional and spiritual needs. To me she was a roommate rather than a wife. I was too busy helping others to give the reassurance and warmth she wanted and needed. I had to work at communication as well as sharing myself and my life with her.” Are there areas that you might see in your family that need improvement? But what else will help a spouse?
□ Patience, Patience, Patience! Because a depressed person is in emotional pain, he or she may lash out at a mate. Victoria, who suffered major depression, confessed: “I hated myself and felt miserable. I’m sure that my husband and kids would have liked to lock me in the closet and throw away the key. Yet, I heard hundreds of times, ‘We love you; we know you don’t mean it’ or, ‘You’re just tired.’” Yes, realize that the person will say many things that he doesn’t mean. Even Job, a man of faith, admitted that because of his vexation “my own words have been wild talk.” (Job 6:3) Having the insight to know that you are not the target will enable you to respond with mild, kindly replies that will usually defuse the situation. (Proverbs 15:1; 19:11) Don’t expect a spouse to get well overnight.
□ Give Spiritual and Emotional Support. Many depressed persons have found that the meetings of Jehovah’s Witnesses provided the spiritual encouragement to endure. (Hebrews 10:25) But Irene, whose depression lasted 18 months, admitted: “One evening before the meeting, I cried because I could hardly bear to think of facing everyone.” She added: “But my husband encouraged me, and after saying a prayer, our family did go. Though I had to fight back tears during the meeting, I was so thankful to Jehovah God for giving me the strength to be there.”
In addition to the spiritual help, a depressed mate needs the reassurance that he or she has your emotional support. Irene describes how her husband did this: “At home after the children were asleep, my husband and I would talk, and sometimes I would cry for close to an hour. His supportive understanding was so helpful. He prayed with me, listened to me, or gave me a shoulder to cry on—whatever I needed at the time.” Since a Christian is concerned about pleasing his or her spouse, frequently reassure the depressed one that he or she is doing this.—1 Corinthians 7:33, 34.
□ Provide Physical Help. Household chores and care of the children may suddenly seem overwhelming to a depressed wife. The husband (as well as the children) can help with cleaning and cooking. Try to avoid asking her what to do, as this can add pressure. “My husband, Bob, didn’t let anyone pile anything on me at that time. He was sort of a buffer,” explained Elizabeth, a mother who became severely depressed. “All I really had to concentrate on was just getting better.” She added: “The doctor not only prescribed medication but also told me to exercise every day. Bob encouraged me to follow the doctor’s orders. We walked every day.” A well-planned outing with the depressed one also helps. All of this takes much initiative on the part of the husband.
Help From Others
“A true companion is loving all the time, and is a brother that is born for when there is distress,” states Proverbs 17:17. The genuineness of a friendship is evident during a time of distress, such as depression. How can a friend help?
“When I was depressed, a friend wrote to me several times and always included encouraging Scriptures,” reported Maria. “I would read the letter over and over, crying as I read it. Such letters were like gold to me.” Encouraging letters, cards, and phone calls are deeply appreciated. Warm visits also help. “If no one comes, it reinforces the idea that we’re all alone,” adds Elizabeth. “Pray with the person, tell some upbuilding experiences, even cook a meal and bring it over as a family. One friend made me a box of little odds and ends. Unwrapping each item provided such a pleasant surprise.”
Of course, when it comes to things like running errands and doing housework for a depressed person, be discerning. Listen to him. Don’t insist on doing something if he does not want it done. At times, knowing that someone is doing work that he should be doing may add guilt. The depressed one may prefer that it be left undone.
The elders, or spiritual shepherds, in the congregations of Jehovah’s Witnesses have also provided invaluable help. Irene explains: “I talked with a couple of the elders about my problem. (My husband came along for support.) This was a big step and helped me a great deal. I found that these men really do care.” By carefully listening and by being well prepared, these men will be able to “speak consolingly to the depressed souls.”—1 Thessalonians 5:14; Proverbs 12:18.
Knowing when to seek professional help is vital—in fact, it may save a life! At times the condition becomes so severe that arrangements should be made to see that the depressed one gets needed professional care. Don’t count on the depressed one to decide. Often it means making the necessary appointment for him. You can reassure him by saying: ‘I’m sure your illness is not serious, but it should be checked to relieve everyone’s doubts. Though I love you very much, I’m not a doctor.’ Be kind but firm!
Helping a friend or mate defeat depression is not an easy task, but perseverance may be lifesaving. Often, your caring makes the difference. For instance, Margaret, when she reached her deepest low, told her husband that she wanted to give up and die. He warmly said: “I’ll help you not to give up.” Overwhelmed to see his care, Margaret explained: “I knew then I could go on.” She did and eventually defeated her depression.
[Footnotes]
See “Winning the Fight Against Depression” in our October 22 issue of this year.
See “An Educated Tongue—‘To Encourage the Weary’” in the June 1, 1982, issue of our companion magazine, The Watchtower.
[Box on page 13]
Reasoning in a Way That Builds Self-Esteem
One woman, whose marriage was shattered by her husband’s infidelity, became depressed and suicidal. She later confided to a skilled counselor: “Without Raymond, I am nothing . . . I can’t be happy without Raymond.”
The counselor asked: “Have you found yourself happy when you are with Raymond?” Her reply: “No, we fight all the time and I feel worse.” He continued: “You say you are nothing without Raymond. Before you met Raymond, did you feel you were nothing?”
“No, I felt I was somebody,” blurted the depressed woman. The counselor then replied: “If you were somebody before you knew Raymond, why do you need him to be somebody now?” Discussing this case in his book Cognitive Therapy and the Emotional Disorders, Dr. Aaron Beck stated: “In a subsequent interview, she stated that the point that really struck home was: How could she be ‘nothing’ without Raymond—when she had lived happily and was an adequate person before she ever knew him?” She overcame her depression.
[Box on page 15]
Could Your Home Environment Cause Depression?
□ Is self-esteem undermined by thoughtless comments such as ‘Why aren’t you a better wife?’ ‘I love you in spite of the kind of person you are,’ or ‘Why are you always so thoughtless?’
□ Is guilt repeatedly provoked by making the spouse always feel responsible, regardless of the facts?
□ Does the atmosphere in the home discourage the open show of emotions, making whoever displays such seem to be a weakling?
□ Is one made to feel that he or she must be nearly perfect to measure up to the expectations of a spouse?
□ Is open and direct communication blocked?
[Pictures on page 16]
One depressed person said that ‘letters from a friend were like gold’

Part 30

 
30.  Why Do I Get So Depressed?

● MELANIE had always lived up to her mother’s ideal of the perfect child—until she turned seventeen. Then she withdrew from school activities, stopped accepting invitations to parties and didn’t even seem to care when her grades dropped from A’s to C’s. Her parents noted her sullen mood and at mealtimes would gently inquire what was wrong. Melanie would stomp away from the table, saying, “Leave me alone! There’s nothing wrong.”
● Mark, at fourteen, was impulsive and hostile, with an explosive temper. At school he was fidgety and disruptive. When frustrated or angry, he would race across the desert on a motorcycle or shoot down steep hills on his skateboard. His parents and teachers dismissed his rambunctious behavior as childishness.
You may be surprised to know that both Melanie and Mark suffered from depression. While widespread depression among adults is common knowledge, only recently have experts conceded that young people, too, get depressed. It can happen to you.
A Common Emotion
A survey conducted by the National Institute of Mental Health claims that about one out of every five youths may be suffering from the symptoms of depression. Youthful suicides in many nations have been described as a recent epidemic. Depression is the most common ingredient in juvenile suicides. Perhaps you know of some of your friends who got the blues and attempted to take their own life. But you probably do not need statistics to know that depression can touch your life. Why, almost everyone is struck with the blues at times for a few hours, days—or even weeks. This is just a part of life. However, during their teen years many youths are especially prone to the blues. Why?
These years are probably some of the most difficult you’ll ever have to cope with. The internal pressures created by reaching puberty can bring great anxieties and mood swings. You find yourself caught in a transition period—no longer a child but not quite an adult. Beset with new and often conflicting expectations from your parents, teachers or friends, you feel like a failure when at times you cannot measure up. To make matters worse, because of inexperience you are unfamiliar with life’s ups and downs. No wonder that some get painfully depressed.
Are My Blues Normal?
There are, nevertheless, different degrees of depression. A young person could be demoralized by some upsetting event: failing a school test, the death of a loved one, not getting a job or losing one, as well as other stressful situations. Usually, with changing circumstances, these blues fade in a relatively short time.
However, if the depressed mood lingers and the person has a general negative feeling along with feelings of worthlessness, anxiety and anger, this can develop into low-grade chronic depression. The symptoms vary considerably. One young person may have anxiety attacks. Another may be tired all the time, have no appetite, experience trouble in sleeping or may lose weight. Sometimes even a series of accidents may be a warning. Note the box on page 23. If you answer “Yes” to most of the questions, chances are that your depression has become chronic. Recognizing this type of depression is vital for, if it is not dealt with, it will progress to major depression, a serious disorder that usually requires professional help.
Some young persons mask depression by totally different behavior: by an endless round of parties, by sexual promiscuity, by vandalism or by heavy drinking. “I don’t really know why I have to be going out all the time,” confessed one fourteen-year-old boy. “I just know if I’m by myself, alone, I realize how bad I feel.” It is just as the Bible described: “Even in laughter the heart may be in pain; and grief is what rejoicing ends up in.” (Proverbs 14:13) So a pleasure binge may indicate that a person has real problems.
Is There a Physical Problem?
Marie had just started college and found herself in an emotional tailspin during the first few months. She had trouble in sleeping. She lost interest in food, in her studies and in her friends. Fortunately, a discerning college counselor referred her to a physician for a medical checkup. The cause of her problem? Iron-deficiency anemia. With proper treatment her spirits rose and her energy returned.
Yes, there is at times a biological basis for depression. Infections, glandular or hormonal disorders, malignancies, hypoglycemia and blood problems—these can all trigger depression. Are you a junk-food addict? Deficiencies caused by such an unbalanced diet can cause depression. So can certain medications or allergic reactions.
However, usually juvenile depression can be traced to another cause.
“I Have Never Done Anything Right”
Donald felt that he had to excel in school to be regarded as worth while. His parents were scientists and he felt that they expected much from him. However, his girl friend accepted him regardless of his mediocre academic achievements. But then their relationship became punctuated by quarrels. He became depressed and suicidal. “I have never done anything right. I have always let everybody down,” bemoaned Donald to a therapist.
That a sense of failure can kindle depression is evident from the case of a Bible character named Epaphroditus. During the first century this faithful Christian was sent by his home congregation on a special mission to assist the imprisoned apostle Paul. But when he reached Paul he soon fell sick and Paul ended up caring for him. The Bible says that after his recovery Epaphroditus became “depressed” because the congregation had heard of his illness. You can imagine how he felt: ‘I’ve been a real failure! They were all counting on me and I fizzled out.’ Apparently he overlooked all the good he performed before he got sick. A similar sense of failure can make you depressed.—Philippians 2:25-30.
Additionally, the type of entertainment you choose can affect how you view disappointments and may enhance feelings of failure. Discover magazine cites psychotherapist Margery Fridstein, who in Chicago’s juvenile “suicide belt” has treated many depressed young persons. According to her, television dramas, with swift, superficial and happy endings, are a disservice to young people. She stated: “Kids don’t like to read books—they’d rather watch television and see the story end quickly—and so they don’t know how to deal with long-term frustration. They don’t have the built-in patience, when something bad happens all of a sudden, to tolerate it.” By expecting problems to be solved easily or by comparing yourself to a carefree TV character who “never gets depressed,” you can create feelings of inadequacy. Also, movies, TV programs and literature that highlight depressing themes will often create within you a similar mood.
So there are many things that can bring the blues. You could probably list more, such as not having a close friend and feeling that no one cares, excessive guilt about some personal weakness, the breakup of an intimate relationship, even the teasing from schoolmates. Knowing the causes can be helpful when you feel down, because you can analyze what could be wrong. Yet, as helpful as all of this is, the matter of real concern to you is, ‘What positive steps can I take to offset a depressed mood?’ Some suggestions that have proved effective will be discussed in a future issue of Awake!
[Footnotes]
See the article “Attacking Major Depression—Professional Treatments” in the Awake! of October 22, 1981.
[Box on page 23]
Is It Low-Grade Chronic Depression?
1. As a young person are you tired most of the time even when you have had enough sleep?
2. Are you constantly restless?
3. Have you lost interest in almost everything—in school, in family and in friends?
4. Are you unable to make decisions, even relatively minor ones?
5. Are you continually angry or resentful?
6. Do you have many bouts of anxiety, feeling that something terrible is going to happen?
7. Are you a chronic complainer?
8. Are you self-destructive?
9. Are you overly critical of yourself, often feeling very inferior or inadequate?
10. Do you spend an unusually large amount of time daydreaming?
11. Do you constantly have “up weeks” and “down weeks” with large mood swings?
(Based partially on The Book of Hope by Helen DeRosis and Victoria Pellegrino.)

Part 31

 
31.  What if It’s More Than Just the Blues?

VIVIENNE and Marie never knew each other, but each knew the meaning of despair. Both 14 years old, they had totally different backgrounds. Vivienne—a “perfect” young lady with caring parents. Marie—at times a raging terror, her fury fed by bickering parents who eventually were divorced. But both girls fought a life-or-death struggle with a disorder said to cause “more suffering than any other disease”—severe depression.
Before learning the outcome of their struggle, you need to understand the dramatic difference between the everyday blues and major depression, the disorder that has “killed” thousands of young people earth wide and has made millions of others wish they were dead.
Deadly Depression
You probably have had “down” days—everyone does. Sometimes one may even go through what doctors may call chronic low-grade depression. But major depression is different. “I constantly felt as if I were ‘dead’ inside,” explained Marie. “I was just existing without any emotions. I had a feeling of constant dread.” Vivienne similarly described her “no escape” situation in a letter to a friend: ‘The funny thing is that even after crying, the pressure is there afterward, all the time; it doesn’t really matter what I do. It’s strange living with no relief for so long.’
Yes, the gloomy mood is unrelenting. And this may continue for months. See the box in this article for some of the symptoms—both emotional and physical. It should not surprise you to know that this type of depression is the most common ingredient in youthful suicides—now considered a “hidden epidemic” in many countries. In the United States only accidents and homicide take more young lives.
Deep-rooted Causes
Francine Klagsbrun wrote in her book Too Young To Die—Youth and Suicide: “At the root of many emotionally caused depressions lies a profound sense of loss, of someone or something that has been deeply loved.” Thus the loss of a parent through death or divorce, the loss of a job or career, or even of one’s physical health, could be at the root of depression.
A most poignant loss to a young person is the loss of love, the feeling of being unwanted and uncared for. “When my mother left us I felt betrayed and alone,” revealed Marie. “My world suddenly seemed upside down.” A therapist recognized Vivienne’s emotional hurt and asked: “What would you like from the family?” Her terse reply: “Understanding.”
You can just imagine the bewilderment and pain some youths feel when faced with awesome family problems such as divorce, alcoholism, incest, wife beating, child abuse or simple rejection by a parent who is swallowed up in his or her own problems. To the child, it is a “day of distress.” How true the Bible proverb: “Have you shown yourself discouraged in the day of distress? Your power will be scanty”! (Proverbs 24:10) Yes, the power to offset depression becomes very small, especially since the young person may even blame himself for the unfortunate conditions.
“How Can You Kill Nothing?”
“I am worthless. I am of no use to anyone,” wrote Vivienne. “What good [is it] to kill myself? How can you kill nothing?” Why did she feel that way? She confessed to her diary: “I have the constant feeling that I’m big and clumsy and sort of dense beside someone [a friend] who is small, precise, brilliant and absolutely perfect.” The advertising and entertainment media encourage destructive comparisons by glorifying physical attractiveness, sexuality and academic achievements.
Also, one’s own weaknesses add to feelings of low self-esteem. You may do something that you know is wrong and feel as did King David of ancient Israel, who bemoaned: “There is no peace in my bones on account of my sin. For my own errors have passed over my head; like a heavy load they are too heavy for me. . . . All day long I have walked about sad.” (Psalm 38:3-6) Frankly, such a remorseful attitude is commendable. It shows that you haven’t become calloused to right standards. Yet, if you change your course, God will freely forgive.
However, some try to cover over feelings of guilt or worthlessness by running away from home, practicing sexual promiscuity or engaging in heavy drinking. Marie resorted to injecting herself with heroin. She said: “I had plenty of self-confidence—until the drug wore off.” And when it did, she was faced with extreme . . .
Hopelessness
The most persistent emotion connected with major depression—and the deadliest—is a deep sense of hopelessness. Vivienne could not fight any longer. In despair this 14-year-old hanged herself! Writing in Vivienne—The Life and Suicide of an Adolescent Girl, Professor John E. Mack observed: “Vivienne’s inability to foresee that her depression would ever lift, that she had any hope of ultimately obtaining relief from her pain, is an important element in her decision to kill herself.”
Those affected with major depression feel as if they will never get better, that there is no tomorrow. It is the hopelessness that, according to experts, often leads to suicidal behavior. Yet Marie, whose life had become a living nightmare, eventually found something that helped pull her shattered existence together.
You Will Get Over It!
“The thoughts of suicide definitely came into my mind,” confessed Marie. “But I realized that as long as I didn’t kill myself there was always hope.” Her hope had been somewhat nurtured by Bible instruction she had received as a child. Sadly, she failed to follow such teaching as a way of life. Nevertheless, she knew that God was willing to help her if she sincerely turned to him. So she saw alternatives to a bleak situation.
Unfortunately, when confronted with despair many young persons cannot even visualize alternatives or the possibility of a favorable outcome. So what can help you to keep your hope up?
Talk to Someone About It
“Anxious care in the heart of a man is what will cause it to bow down, but the good word is what makes it rejoice.” (Proverbs 12:25) A “good word” from an understanding person can make all the difference in the world. No human can read your heart, so pour it out to someone you trust and who can help straighten out your thoughts.
‘But I’ve already tried that,’ you may say, ‘and all I get is a look-on-the-bright-side-of-life lecture.’ True, not everyone is a skillful counselor. The Bible says: “When there is no skillful direction, the people fall; but there is salvation in the multitude of counselors.” (Proverbs 11:14) So don’t give up because of an inept counselor. Seek out a skilled one. How?
Marie, in one of her bleakest moments, poured out her heart to God. “I begged him to please send someone to help me,” admitted Marie. “As I approached Jehovah I could feel a calmness setting in. I knew there was still hope.” Her fervent prayer was answered as one of Jehovah’s Witnesses stopped by her house that day. A study of the Bible was started. She began to attend the meetings of Jehovah’s Witnesses. There she met many skillful counselors who were more than willing to help.
Even if your prayers for help are not answered in just this way, God can give you the strength to endure. The Bible says: “God is faithful, and he will not let you be tempted beyond what you can bear . . . He will also make the way out in order for you to be able to endure it.” However, effort on your part is needed.—1 Corinthians 10:13.
“Over the years I had put up such a pretext that no one really knew how depressed I was,” revealed Marie. “But then I confided in one of the older women in the congregation. She was so understanding! She had gone through some of the same experiences I had. So I was encouraged to realize that other people have gone through things like this and have come out just fine.”
No, Marie’s depression did not clear up immediately. But gradually she began to cope with her emotions as she deepened her relationship with God through her study of the Bible and association with fellow Christians.
Vivienne apparently had no such faith. “I really want to believe in something, but like many others, I don’t know what,” she bemoaned before her death. “I never could pray. You can tell when a prayer doesn’t get through.”
Don’t make the same mistake. If you are severely depressed, pray to God. Seek out skillful counselors and bare your feelings. Let their “good word” lift your spirits. Jehovah’s Witnesses are especially willing to help you. Let them assist you in developing a friendship with God so that you may sense the realization of this heartwarming promise: “The peace of God that excels all thought will guard your hearts and your mental powers by means of Christ Jesus.”—Philippians 4:7.
[Footnotes]
See “Why Do I Get So Depressed?” in the August 22, 1982, Awake!
[Blurb on page 12]
Severe depression is the most common ingredient in youthful suicides, which have become an epidemic in some countries
[Blurb on page 15]
A personal friendship with God can help you to cope with major depression
[Box on page 13]
Could It Be Major Depression?
Anyone may suffer temporarily from one or more of the following symptoms without having a serious problem. However, if several symptoms persist, or if any is severe enough that it interferes with your normal activities, you may have (1) a physical illness and need a thorough examination by a doctor or (2) a serious mental disorder—major depression.
● Nothing Gives You Pleasure. You can’t find pleasure in activities once enjoyed. You feel unreal, as if in a fog and just going through the motions of living.
● Total Worthlessness. You feel as if your life has nothing important to contribute and is totally useless. You may feel full of guilt.
● Drastic Change of Mood. If once outgoing, you may become withdrawn or vice versa. You may often cry.
● Total Hopelessness. You feel that things are bad, there’s nothing you can do about them, and conditions will never get better.
● Wish You Were Dead. The anguish is so great that you frequently feel that you would be better off dead.
● Cannot Concentrate. You go over and over certain thoughts or reading material without comprehension.
● Change in Eating or Bowel Habits. Loss of appetite or overeating. Intermittent constipation or diarrhea.
● Sleeping Habits Change. Poor or excessive sleep. You may frequently have nightmares.
● Aches and Pains. Headaches, cramps and pains in the abdomen and chest. You may constantly feel tired for no good reason.
[Picture on page 14]
Talking to others and pouring out your heart is one of the best ways to cope with severe depression

Part 32

32.  Is It All in the Mind?

THE medical doctor listened intently as the depressed woman described her symptoms—constant headaches, irritability, constipation, loss of appetite, insomnia and incessant tiredness. She would burst into tears and, at times, wanted to die. “It’s all in your head,” said the doctor. “Until you find yourself, there is nothing I can do. I strongly urge you to see a psychiatrist.”
Though well meaning, this doctor reflected a common view. Yet, like this woman suffering major depression, many are crushed when someone tells them that their agony is a result solely of their own thinking. True, our thoughts can affect our body—for good or for bad. Yet there is also increasing evidence that a sick body can affect our thinking processes.
But before considering this evidence we need to realize that the term “depression” covers a wide range of emotions (see box).
How Can You Tell?
“In the kind of depression that results from, let’s say, the death of someone in the family, there is some relief from it,” reported Dr. Nathan S. Kline, director, Rockland Research Institute Department of Mental Hygiene of New York State, in a recent interview with an Awake! staff writer. “If there’s a good meal, beautiful moon or something else, there’s some relief. In major depression, there is no relief. You could win money or be elected president; it doesn’t bring any particular pleasure. The future looks hopeless.”
What are the symptoms of manic depression? Dr. Ronald Fieve, professor of Clinical Psychiatry at Columbia University College of Physicians and Surgeons, told Awake!: “There must be a history of the high that comes out of the blue. The person has an abnormal state of optimism where he is overactive, overtalkative, sleeping less and has an enormous amount of energy that he’s never had before. This sudden change may last from two weeks to usually one or two months. Then the person switches to a severe depression.”
Many scientists now feel that specific chemical changes in the brain accompany some forms of severe depression and may bring it about. (The accompanying diagrams explain.) The process is complex and regarding it scientists disagree. But what can cause such a chemical mix-up? Many different factors.
The Disease/Depression Connection
“Depression can stem from clear-cut—or, more accurately, clearly defined—organic problems,” states medical writer Lawrence Galton. “It includes infections such as hepatitis, mononucleosis, and influenza; hormonal (glandular) disorders such as those of the thyroid, parathyroid, and adrenal glands; malignancies, deficiency states, anemias, and other blood problems.”—You May Not Need a Psychiatrist (1979).
For instance, one woman had been treated for 15 years for severe, sometimes suicidal, depression. She received antidepressant drugs and even electroshock therapy, but nothing gave her lasting relief. Finally, it was discovered that a diseased parathyroid gland was the problem. When this was successfully treated, she improved. Her basic problem had been physical.
Stress
Nervous exhaustion caused by stress can likewise produce depression. Among such stressful situations the following are listed by specialists: ‘a bad marriage, unrelieved slum living, an unkind boss, chronic warfare,’ and trying to follow a daily routine “that is clearly beyond one’s mental, emotional, and physical resources.” An environment void of love, wherein one feels lonely, dejected and hopeless, can also bring depression. Many persons find themselves in such situations.
A specific stressful event such as a death or a divorce can cause major depression. Yet one recent study found that, out of 185 clinically depressed individuals, only one fourth had a discernible stressful event preceding their depression. Psychiatrist Dr. Fieve feels that the stressful life event “is simply the tip of the iceberg.”
Comparing a depressed person to a car that breaks down while climbing a steep hill, Dr. Kline says this of his belief: “Now, in one sense it was the fact that you went up the hill. On the other hand, if the engine was in good condition, you would not have had the trouble. So the environmental stress may precipitate the breakdown, but there has to be the biological deficiency, or engine weakness, to begin with.”
However, is it possible that the mind itself can create this chemical imbalance without there having been some prior physical defect?
The Role of the Mind
There is sound evidence that many persons are relieved even of major depression by having their thinking adjusted by trained counselors. This would indicate that in some types of major depression the thinking of the person or what he puts into his mind, not some physical defect, plays the vital role.
Recent research has shown that the way we think can affect our brain chemistry. For instance, in a 1979 study some patients who had just had their wisdom teeth extracted were given injections of a salt solution, a placebo, and were told that this would ease the pain. Despite the fact that this injection had no pain-killing ability, reportedly one third “soon found that their pain was dramatically subsiding.” It was felt that naturally occurring brain “pain-killer” chemicals (endorphins) were put to work by the person’s thoughts. This was verified when another drug was given that blocks the effects of the brain’s natural “pain killers.” The pain returned.
The power of the mind to respond to love has been seen in numerous cases. Conversely, anger, hatred, jealousy and other negative emotions also have been found to produce biochemical changes in the body.
The Bible recognizes the important role of our inner feelings and attitudes. It states: “The spirit [the inner feelings and thoughts] of a man can put up with his malady [disease]; but as for a stricken spirit, who can bear it?” (Prov. 18:14) If the “spirit of a man” is “stricken” by faulty thinking (discussed on pages 8-10); if it is crushed by jealousy, resentment or a bad conscience, then the bad situation becomes unbearable. Major depression may follow.
Also, if a person feeds his mind on depressing thoughts—perhaps through television, motion pictures or pornographic literature—this will color his moods and breed depression. Especially if a person regularly spends much time in front of a TV set, this can adversely affect his outlook. But for other persons something else might be at the root of the problem.
Other Possible Causes
“The brain is much more sensitive than other organs to changes in [blood] plasma concentrations of certain nutrients,” stated two Massachusetts Institute of Technology researchers. In Nutrition and the Brain (Vol. 3, 1979), these doctors, Wortman and Wortman, published material that shows the effect of what we eat on our mood and how certain nutritional deficiencies can alter the chemical balance in the brain and produce depression.
Even when regularly eating balanced meals—keeping “junk food” to a minimum—one may still have nutritional deficiencies leading to depression. Some medications, oral contraceptives, such strains on the body as pregnancy, pollution and exceptional stress—all can create nutritional deficiencies.
Allergy to certain foods or to chemical fumes and the hormonal changes in women have brought on depression. Also, one study of 1,100 patients treated for hypoglycemia (low blood sugar) found that 77 percent of these complained of depression.
So there are many causes of depression besides just having a wrong attitude. A seriously depressed person may suffer from any one of a combination of factors. An individual’s heredity and childhood experiences also play a role. All these influences can affect how one responds to a stressful event or environment.
While trying to understand the possible causes of depression is helpful, an even more persistent question of sufferers is: What can I do to overcome it?
[Footnotes]
Designations used in the box below are based, in part, on Diagnostic & Statistical Manual of Mental Disorders (3rd edition, 1980).
[Box/Pictures on page 4]
THE VARIED FACES OF DEPRESSION
Demoralization and Grief
A low feeling because of some upsetting event such as a death, divorce, loss of job, medical problems or other stressful situation.
Low-Grade Chronic Depression (Depressive Neurosis)
The “blues” continue. There is a general negative feeling and dissatisfaction. One feels fatigued and loses interest in family and friends. Often there are feelings of worthlessness, anxiety and anger.
Major Depression
“You feel like you are in the pits of the earth,” said one sufferer. There is no relief. Sleeping habits change; there is loss of appetite. The person feels full of guilt and may wish he were dead. Overwhelming feelings of dread, anxiety and lack of ability to concentrate. This may in some cases alternate with periods of normal behavior.
Manic Depression
Periods of high elation—wild spending sprees, working around the clock, constant action—followed by deep depression.
[Box/Diagram on page 5]
Our thoughts flow from one nerve cell to the next in the form of electrochemical impulses. A proper mood depends on their undistorted flow. The ends of the nerves do not touch. The nerve impulse stimulates the production of chemical neurotransmitters that bridge the gap and our thought continues undistorted. The chemical balance in this area called the synapse is vital.
[Diagram]
(For fully formatted text, see publication)
nerve impulse
nerve cell
nerve cell
synapse
nerve impulse
chemical neurotransmitters
synapse
receptors
nerve impulses continue undistorted
[Box/Diagrams on page 5]
WHAT MAY GO WRONG
An abundance of certain neurotransmitters distorts nerve impulse, causing overstimulation, perhaps producing mania.
[Diagram]
(For fully formatted text, see publication)
nerve impulse
chemical neurotransmitters
nerve impulse distorted
Low levels of certain neurotransmitters distort nerve impulse, perhaps resulting in depression.
[Diagram]
(For fully formatted text, see publication)
nerve impulse
chemical neurotransmitters
nerve impulse distorted

Part 33

 
33.  How You Can Fight Depression

“IF YOU could get all the people who are depressed just to exercise,” said Armand DiMele of the DiMele Center for Psychotherapy, “three-quarters of them would find their mood lifted.” Others agree when it pertains to a person’s having the “blues” and not major depression. Proper rest and sleep also are vital.
Some mildly depressed persons are helped by setting aside some time for activities they especially enjoy. One woman who loves to make clothes said: “It’s hard to be depressed when you’re being creative.” At times, all that is needed is a change of pace—perhaps eating in a restaurant one evening or a short vacation.
Pouring out one’s heart to a trusted friend is a big help. But, be careful of your associates—either in person or through the TV/movie screen. Avoid like the plague gloomy complainers and shows that can corrupt a person’s morals or defile his conscience.—Prov. 17:17; 1 Cor. 15:33.
Yet, what if the depressed mood lingers?
Is It Your Food?
Take a careful look at your diet. The chief probation officer in Cuyahoga Falls, Ohio, Barbara Reed, explained to an Awake! staff writer that many of the offenders assigned to her office complained of depression. She examined their diet. Many lived on “junk food” and ate no breakfast, and some went for weeks without eating green vegetables. A better diet—regular balanced meals—and exercise helped many to have an improved mood. “One depressed 20-year-old with a deep lack of self-worth, arrested for criminal damage, lived on ‘junk food,”’ reported Mrs. Reed. But with an improved diet and proper counseling his depressed mood lifted and his behavior improved.
Authorities disagree as to whether a person’s diet causes depression. Even with the finest of food some still get depressed. Others are not helped by an improved diet. Each person is different, and some are more sensitive to substances like sugar and caffeine than others. But eating balanced meals, coupled with moderation when it comes to consuming such things as pies, pastry, chocolate, candy and soda pop will often pay dividends for depressed persons.
Because severe depression could be a symptom of physical disorders it is also important to get a complete medical checkup.
Are You Thinking Correctly?
While not all cases of depression result from a wrong outlook, a recent 10-year study showed that depressed persons often interpret situations incorrectly. “The depressed person feels sad and lonely because he erroneously thinks he is inadequate and deserted,” explains researcher and psychiatrist A. T. Beck. The Bible also shows that how you feel at heart can color your thinking about external matters. It states: “All the days of the afflicted one are bad; but the one that is good at heart [in a cheerful frame of mind] has a feast constantly.” Whether a person has ‘all bad days’ or ‘every day like a feast’ depends in large measure on his frame of mind.—Prov. 15:15.
So depressed individuals must work hard to correct their thinking and guard what they ponder on. This can be far easier to say than to do! Some damaging thoughts common to many depressed persons are listed in the box. Each one is faulty. When these come into mind, quickly dismiss them. Dwelling on them will lead to low self-esteem and deeper depression.
Excessive guilt feelings usually accompany depression. But realize that everyone makes mistakes. “If errors were what you watch, O Jah, O Jehovah,” said the psalmist, “who could stand?” Nobody! Yet genuine forgiveness for our blunders and sins can be found with Jehovah God.—Ps. 130:3, 4.
The Value of Accomplishment
Grieved over her husband’s death and disappointed with others’ unfulfilled promises to repair her home, one widow became deeply depressed. But then she thought, ‘The repairs couldn’t be that hard.’ She got busy and soon retiled her kitchen floor. Though it was not a perfect job, she was pleased. Her self-esteem soared; her depression melted away.
Not everyone could do this, but one research study showed that while some severely depressed patients felt that they could not accomplish certain tasks, they actually performed these as well as the nondepressed participants.
The accomplishments a depressed one could reach out for might involve more than just housework. For instance, they might include cheering up someone by a visit or a phone call, or doing something nice for one’s family.
One depressed Christian woman visited a young woman who had just been viciously beaten, raped and stabbed. The Christian, though depressed, tried hard each week to visit and comfort her. The result? “Gradually I no longer felt depressed,” reported the Christian. “Trying to encourage her in time made me forget my own problems.” She found true what Jesus said: “There is more happiness in giving than there is in receiving.”—Acts 20:35.
“Be Angry Without Doing Wrong”
Another factor in depression is coping with anger, says psychologist DiMele. “What usually happens is that a person feels anger toward some person, probably for some seemingly irrational reason. Yet the person believes the anger is not good because he’s been taught ‘Anger is bad.’ So you start blaming yourself for feeling angry and you get angry at yourself. This, combined with a sense of helplessness, brings depression.”
However, to vent anger uncontrollably on others not only is dangerous but, as studies have shown, does not relieve the depression either. The Bible cautions: “Be angry without doing wrong; let not the sun go down on your wrath [or, “with you in a provoked state”].” (Eph. 4:26, The Bible in Basic English; compare New World Translation.) By being willing, not afraid, to express their feelings and being candid but kind, depressed ones can communicate their feelings in a way that promotes peace. Especially is such open communication vital between marriage mates.
However, something excels all these suggestions. Because the suicide rate among depressives is 25 times as great as it is among the general population, this can make the difference between life and death. What is it?
Prayer and a Relationship with God
“The only thing that kept me from pulling the trigger and ending it all,” confessed one mother suffering with major depression, “was the relationship I had with God. I had the gun in my hand, and at that moment Jehovah God really helped me to put it away.” Yes, this woman found strength “beyond what is normal” to endure until her condition responded to medical treatment. She had developed real faith through her study of the Bible and attendance at Christian meetings where she found real friends. This faith saved her life.—2 Cor. 4:7, 8; Phil. 4:13.
One of the ways that God helps is by providing his Word, the Bible, which shows how to make one’s family life better; how to get along with others; how to avoid conduct that can create anxiety and guilt; and how to choose worthwhile works and goals in life. Following this information can help relieve many stressful situations that bring depression.—Col. 3:5-14, 18-21; 1 Tim. 6:9, 10, 17-19.
Even with strong faith one who is suffering from depression may have doubts, perhaps feeling that God has abandoned him. But never stop praying! “I prayed daily—five and six times intensely,” said one mother who was so depressed that she could barely get out of bed for months. “I begged and begged for help. I pleaded that Jehovah God would give me the proper direction to find a doctor that knew what was wrong and could help me. I prayed for strength just to keep going and keep things straight enough so I wouldn’t do any more damage to my family.” Such persistence paid off. She endured until appropriate medication relieved her major depression.
“Prevent It”
“The most important advice I can give is, ‘Prevent it,”’ said one sufferer. But how? There are no easy or sure answers. Some authorities suggest:
1. Don’t build your sense of worth on love, money, social position, power or drugs. The failure of these could be devastating if you do.
2. Set realistic expectations. Aim to do the best you can, but not to be a perfectionist.
3. Recognize the early symptoms (anxiety, panic, inability to concentrate). Check to see if your daily schedule is reasonable. If not, adjust it. Learn to say “No” when necessary.
However, millions of persons, despite many personal pressures, have found one of the greatest helps in preventing depression to be the gaining of an accurate knowledge of the will and purposes of “the Father of tender mercies and the God of all comfort.”—2 Cor. 1:3.
[Footnotes]
A future issue of Awake! will describe various modes of treatment that helped people who had major depression.
[Box on page 8]
THOUGHTS THAT CAN INCLINE ONE TO DEPRESSION
□ In order to be happy, I have to be successful in whatever I undertake. If I’m not on top, I’m a flop.
□ To be happy, I must be accepted by all people at all times.
□ My value as a person depends on what others think of me.
□ I can’t live without love. If my spouse (sweetheart, parent, child) doesn’t love me, I’m worthless.
□ If somebody disagrees with me, it means he doesn’t like me.
□ I should be the perfect friend, parent, teacher, student, spouse.
□ I should be able to endure any hardship with a calm disposition.
□ I should be able to find a quick solution to every problem.
□ I should never feel hurt; I should always be happy and serene.
□ I should never be tired or get sick, but always be at peak efficiency.
Based, in part, on “Cognitive Therapy and the Emotional Disorders,” by A. T. Beck, M.D.

Part 34

 
34.  How Others Can Help

IT IS vital for others to show empathy to the depressed—to put themselves in the other person’s place. What this means was demonstrated in the following case. The depressed father, after lashing out at his wife, sobbed: “I don’t mean to be this way!” He was deeply moved by his wife’s simple, understanding reply: “I know you don’t, honey.”
Dr. Ari Kiev, a clinical associate professor of psychiatry, warned: “When families see the depression as a result of willfulness, an unwillingness to fight it off, then that tends to increase the patient’s frustration. . . . And one would see suicidal acts.” However, he adds: “People could ride out the depression better if they and their families accepted it as an illness that runs a self-limited course and eventually will pass.” Such advice is good for both family and friends.
“Speak Consolingly”
Some who suffered major depression were asked what comments from others helped the most. They said: “I understand,” “We love you,” “I know you’ll soon be your old self again,” “You look a lot better today” and “I don’t know exactly how you feel, but we’re behind you.” One mother wrote: “Just to hear my children say, ‘We need you,’ was like a shot in the arm.” But she added: “Undue criticism to a person already depressed is like a bullet of death.” How practical the Bible’s inspired counsel! It urges: “Speak consolingly to the depressed souls, support the weak, be long-suffering toward all.”—1 Thess. 5:14.
What did others say that hurt? Some of the replies were: “I’m sorry for you,” “She just wants attention” and “Don’t pity yourself; there are other people sicker than you are who don’t cry and complain.” Just imagine how these remarks made these persons feel! “There exists the one speaking thoughtlessly as with the stabs of a sword, but the tongue of the wise ones is a healing.” (Prov. 12:18) It is not that persons intended to hurt or ‘stab’ the depressives, but often they simply did not think before they spoke.
“The depressed person is already angry with himself, so don’t add to his guilt by constantly correcting what he does,” advises a psychologist who has worked with mentally disturbed individuals for over 20 years. “Rather than tell him, ‘Why don’t you just shake it off,’ perhaps you could say, ‘It seems to be a real problem for you, and I don’t fully understand it, but I would like to understand what you’re feeling. I would like to help.’ Be sincerely interested. A person can tell if you are not.”
Look for opportunities to give genuine praise. Be specific: “Look what a good job you did rearing your children,” “You have a real knack for making others comfortable,” and so forth. Help the person to restore his self-esteem. But above all else . . .
Be a Good Listener
Usually, a depressed person has much to say but often feels unworthy to express it. He may feel that nobody really is interested in hearing about his problems or feelings. Said one 27-year-old woman who suffered for several years with bouts of depression: “I needed someone to listen, not someone to lecture me and make me feel that I was being this way on purpose. My problems were real!”
This young woman, who wanted to die, added: “I had a couple of friends that I could really pour my heart out to. Even though I couldn’t fully understand my own feelings, this conversation really helped.” So let the depressed person “unload” his feelings. There is no need to judge everything he says. He may make some statements that seem extreme. Often, he really does not mean what he says. However, if you are a good listener and gain the person’s confidence, it may be that by gentle reasoning, step by step, you can correct his thinking.—Matt. 7:1.
“Support the Weak”
“Friends help; others pity” is an old saying. Certainly genuine friends and family members whose circumstances allow will take steps to support those who are close to them and are depressed. Within the congregations of Jehovah’s Witnesses are spiritually qualified men who often have been of much help to depressed persons. Depressives are invited to seek their empathetic, loving aid. One sufferer confessed: “I was not too proud to call for help.”—Jas. 5:14, 15.
Depending on circumstances, there are many things that persons can do. If the sufferer cannot sleep, stay up with him. If he will not eat, do not pressure him, but tempt him with small amounts of nutritious food, deliciously prepared. If he will not exercise, then take him out for a walk, or engage with him in some form of vigorous physical activity. Helping the sufferer in such ways may not be easy.
One bighearted woman has assisted several severe depressives. One of these whom she invited to live with her until she improved was having a hard time. Very warmly, Doreen said to this young woman: “Put your coat, hat and boots on.” But she responded: “I don’t want to go for a walk.” “I told her kindly, but firmly, ‘Yes, you’re going. Put them on,”’ explained Doreen. “She did. We walked for four miles. When we returned she was tired, but she felt better. Nobody believes how helpful strenuous exercise is until you make them do it. Then they see it.”
Support may also mean helping the seriously depressed person to find proper professional help. With major depression, one may need help from persons especially trained in dealing with the sickness. There is a variety of treatment currently available.
Other helpful acts reported by depressives were: “Don’t invite so many visitors over; prevent others from making unnecessary noise—like loud music.” “Short visits of honest concern from others are nice.” “My family watched over me, calling me regularly on the phone, taking me out, even helping me to get dressed at times.”
Often it is simply being close at hand and showing love. One previously depressed woman related what got her through nine months of being “trapped in a terrible nightmare.” At one point she sobbed to her husband: “I can’t stand it anymore! I’m not getting better. I’m going down the drain!” He tenderly replied: “If you go down the drain, I’m going right down there with you!” Reflecting on this, the woman said: “Simply put—he was always there for me.”
Yes, genuine support, coupled with consoling words, and a listening ear are the finest assistance others can give to “depressed souls.”

Part 35

 
35.  Attacking Major Depression—Professional Treatments

“Awake!” is not endorsing or promoting any of the popular modes of treatment. We are simply reporting some of the recognized professional approaches. These attack a severe mental disorder that is far more intense than the “blues” that occasionally affect all of us.
THE patient’s depression was crippling. He couldn’t work and was in and out of psychiatric hospitals. Realizing that all other treatments had failed, neurosurgeon Keith Langford performed an operation, opening the man’s head and placing on his brain a battery-operated “pacemaker.” Reportedly, without damaging the brain or altering the thinking process, this “pacemaker” emits a rhythmic electrical pulse that alleviates depression.
It worked! The man regained his positive attitude and returned to work. “You saved my life,” he told the doctor. “Now I can live a normal life.”
This man had more than the normal blues. He was among the eight million Americans who yearly seek professional help for major depression—a disorder that creates intense feelings of guilt, helplessness and hopelessness. Usually, there are disturbances in appetite and sleep, constant fatigue, crying spells and inability to derive any pleasure from life.
Very few cases require radical treatment with a “pacemaker.” Usually, however, with major depression some form of help from trained professionals is suggested. Studies indicate that in some lands as many as one out of every four women and 10 percent of the men will suffer such an episode at some point.
What treatments are available? There are a variety. Some are poles apart in their approach; yet others overlap. Why is this?
Some researchers feel that severe depressions are caused by a physical defect in the body (even if precipitated by some stressful event)—a biochemical imbalance in the brain—and therefore medication is considered vital in correcting this imbalance. Others argue that the disorder results from faulty thinking and that the mind creates the imbalance and can thereby rectify it. These believe that the mind needs correction by “talk therapy,” psychotherapy. There is some truth in each approach, yet neither has the full answer.
Mind and Body Involved
This issue is difficult to resolve because of the close interworking of the mind and the body. Each has decided effects on the other.
Mental disorders are very complex and every patient is different. Therefore a doctor who is acquainted with the patient usually can make recommendations as to which approach is best for the patient. If the patient is not satisfied, perhaps the doctor can assist him in seeking other specialists. The following material may be helpful in aiding both patient and doctor to realize that several treatments are available. No one form of treatment cures all cases of major depression. It is recognized, too, that within each field of treatment there is often a wide range of practitioners. For instance, in psychotherapy 130 different approaches are reported. Moreover, those using the nutritional approach may vary from prominent researchers who have behind them decades of study to some who have become “weekend experts” after attending a two-day seminar.
Talk Out Depression
When major depression is diagnosed, one recommendation is psychotherapy—or “talk therapy.” Since a depressed person usually has greatly disturbed ideas, many have been aided by their talking to a therapist. Such professionals may include psychiatrists, psychologists, social workers and others with specialized training. However, some have found help by talking with a lovingly concerned minister.
Armand DiMele, director of the Center for Psychotherapy, observes: “The depressed person is protecting himself by shutting down his mind and body and not allowing any stimulation. For example, when someone suffers a loss such as a death, he may go into a depression rather than face the loss.” The job of the counselor is to help the sufferer to face the feelings and anxiety that come from such a loss. DiMele continues: “If the therapist sitting with him can really nurture him through and tell him what to anticipate in body sensations, then the person gradually realizes he can cope with the emotion, and the depression lifts.”
Submerged feelings, such as anger, resentment and guilt, have often bred depression. For instance, a psychologist employed by the New York State Mental Health Department treated a 58-year-old woman suffering from severe depression. She felt that God had abandoned her and that everyone was talking against her. As this expert of 20 years’ experience began to talk with her in a kindly way each week, he noticed that in discussions about her family she never mentioned her mother, with whom she was now living. He probed. In time she revealed that she felt that her mother, by her neglect, was responsible for her beloved father’s recent death. Gradually the counselor helped her to overcome this resentment, and her depression melted away.
Since guilt is often a major symptom of depression, psychologists will endeavor to eliminate it along with the patient’s feelings of worthlessness. One woman became severely depressed when her child turned rebellious. “I was never really a proper mother, was I?” she cried to the psychiatrist. “That’s why she’s gone wrong.” The doctor helped her to see all the good she had done for the child. The guilt then vanished—and so did her depression.
However, the treatment of most cases is unsuccessful, according to Dr. Ronald Fieve. He reports in his book Moodswing—The Third Revolution in Psychiatry that not infrequently, after weeks, months and years of working with a moderate or severe depressive, helping him to analyze his behavior, “very little happened.”
There is also a danger here for persons who are endeavoring to live by high moral standards. Some therapists go too far, justifying attitudes that the Bible disapproves. This is done to alleviate the patient’s guilt. True, a person should neither be overwhelmed with guilt nor feel “condemned by God” if improper feelings enter his mind. Yet, rather than reasoning that such erroneous thoughts are not wrong, as some therapists would say, those who highly value the Bible’s counsel prefer to correct such ideas or dismiss them. So they have to weigh seriously (or have help to weigh) counsel offered by a therapist. Potential problems may be avoided if the patient, or a companion, explains to the therapist the importance of the patient’s religious beliefs.—Gal. 5:16, 19-21; Jas. 1:14, 15.
Authorities in the field differ as to intensive psychotherapy’s effectiveness. One of the reasons for this is that many doctors feel that the chemical imbalance present in severe moodswings cannot always be corrected by psychotherapy. They advocate the use of . . .
Antidepressant Medication
“I used to think that people could overcome any mood by just setting their mind to it, but now I don’t believe it,” confessed one housewife who previously slumped into a major depression. “At times I would drop to the floor and just sob for no real reason.” She finally contacted a doctor who had an answer that helped her.
After listening to her symptoms of major depression, the doctor said: “First off, let me explain that you have a physical illness. I have some medication that I feel will help.” He prescribed a tricyclic antidepressant. He believed this would offset a suspected chemical imbalance in her brain and relieve the depression. “Nothing improved for a while,” but then, she said, “in six months I was like a new person, completely off the drug.”
There are over 20 antidepressants and also lithium available. These are not “pep pills” (amphetamines) or tranquilizers, which immediately either stimulate or calm the nervous system and can be addictive. Rather than hinder certain impulses that produce anxiety, as do tranquilizers, these antidepressants (tricyclics and monoamine oxidase inhibitors, MAO for short) apparently modify the levels of certain neurotransmitters in the “pleasure center” of the brain and this is believed to make it easier for pleasurable impulses to be transmitted from one nerve cell to the next. So these drugs possibly treat a chemical imbalance within the brain.
According to Dr. Ronald Fieve, director of Fieve Lithium Clinic in New York city, “lithium treats the manic phase of bipolar manic-depression and serves well as a preventative for this disorder and sometimes helps recurrent major depression.” He reported that in a 20-year period, over 6,000 patients given lithium in a dozen countries were carefully studied. Of those suffering from manic depression, 70 to 80 percent were successfully treated.
Of course, there can be unpleasant side effects with all these drugs. Frequently, several drugs are tested until the “right one” is found. The MAO inhibitors can cause a lethal reaction if combined with certain foods, such as aged cheeses, beer, wines and chicken livers. So all drugs must be used under the careful supervision of a well-informed doctor.
“[Drug therapy] is not, however, a magic solution to all of a patient’s problems,” writes Dr. Nathan Kline of New York city, in his book From Sad to Glad. This pioneer in the use of antidepressants continues: “What it does do is correct a particular kind of functional breakdown, so that the patient can address problems with capacities restored.”
Nutritional Approach
That a deficiency in what you eat can cause mental disorders, including major depression, was established over 65 years ago. A killer disease, pellagra, was then raging in many countries and sweeping away 10,000 Americans each year. The first manifestations of the disease were usually mental disorders—predominantly depression.
In trying to get to the root of the problem, Dr. Joseph Goldberger put some healthy persons on the same diet that he found was being provided for some mental patients—meals consisting mainly of cornmeal, grits, cornstarch and other corn products, and a tiny amount of vegetables. He waited. Seven of the 11 participants developed the depression and came down with pellagra! The doctor then added to their diet brewer’s yeast, lean meat and milk. All quickly recovered. A nutritional deficiency had been responsible for their depression.
Corn, the bulk of the diet of the poorer people in that area, lacks almost totally a vital amino acid—tryptophan. This led to a shortage of some of the B vitamin complex.
Scientists have found that other nutritional deficiencies cause such symptoms as depression, nervous irritability, fatigue and personality changes. Much research has linked vitamins, especially B-complex, with the conversion of amino acids, such as tryptophan, into neurotransmitters, which carry our thought impulses between nerve cells. A shortage of certain neurotransmitters has been associated with some types of depression.
“Putting the patient in the optimum nutritional balance is the first thing to do,” explains Dr. David Hawkins, founding president of the Academy of Orthomolecular Psychiatry. But even when a nutritional deficiency is discovered, correctional supplements do not always relieve the depression.
For instance, one severely depressed patient had read a book about mega-vitamin therapy and was taking large doses of several vitamins to find relief, but without any noticeable effect. A doctor using the nutritional approach carefully examined the patient’s diet. He found that her one meal a day consisted of a hamburger and French fries, with a little lettuce and tomato. She drank 25 to 30 cups of coffee a day. Adding a variety of vegetables, fruits and nuts to her diet, and restricting her intake of coffee, reportedly brought a complete recovery in a few months.
Even some of those doctors who use the nutritional approach will use drugs and electroshock therapy too. This is because the nutritional approach often is slow, and the patient, especially if suicidal, may need immediate relief.
Doctors advocating the nutritional approach primarily use substances normally present in the body and thereby avoid the dangerous side effects of psychotropic drugs. The American Journal of Psychiatry (May 1980) reported how a naturally occurring amino acid, tyrosine, was administered to a 30-year-old woman who had suffered for several years with major depression and had reacted adversely to antidepressant medication. She “improved markedly after two weeks of tyrosine therapy.” As a test to see whether the improvement really had some psychological basis, she was given a similar looking placebo. Within a week her depression returned! When the amino acid was reinstituted, her depression was “again completely alleviated.”
Research trials have indicated that another amino acid, tryptophan, is just as effective as some antidepressant drugs, with none of the side effects. While not all trials have been successful, Dr. J. H. Growden said in summary: “It seems likely that a group of patients exist whose mood disorders do improve clinically after tryptophan is administered, either alone or in combination with more conventional therapies.”
However, a pioneer in nutritional research, Dr. Allen Cott, warns: “A doctor is always necessary to work out the correct formula. One shouldn’t go around swallowing vitamins by the handful. If a person loads himself down with B6 he depletes his bodily store of magnesium. . . . Only an experienced physician can make sure that correcting one vitamin deficiency does not create another.” So nutritionists usually recommend several supplements, including vitamins, minerals, trace elements, enzymes and amino acids. Also, it is recognized that if a supplement is used in massive doses it acts on the body as a drug.
Psychiatrist H. M. Ross, who uses vitamins and diet in his daily practice and reportedly has treated hundreds of cases of severe depression successfully, states: “Vitamins are not the sole answer to many psychiatric problems.” Echoing this balanced opinion is popular spokesman for those using this approach, Dr. Carlton Fredericks, who admits: “As psychiatrist and psychologist have become obsessed with the concept that mental disease is purely mental, so must the orthomolecular practitioner resist the temptation to place overemphasis on a single biochemical approach to emotional and mental disorders.”
A Careful Self-Search
Though help can often be found through professional treatment, the solution is usually no “one shot cure.” It is crucial that a depressed person do some honest self-searching. One 35-year-old depressed woman found that she had to make several adjustments besides those in her eating habits in order to find lasting relief eventually. She explains: “Antidepressants will not solve all your problems. You must recognize and face your fears and anxieties and change your way of thinking.”
Yes, every form of therapy has its limits. Not one of them can in itself make you a new person. Medication and vitamins may level your moods, but they cannot put your family life in order. “If you require ‘perfect’ performance on the job, ‘just right’ friends, expensive and numerous material possessions,” warns DiMele, “you may be setting yourself up for a lifelong periodic depression.”
So while there is a variety of professional treatments for major depression, never forget that a sound effort on the part of the depressed one must go along with all of them. Only then will one conquer major depression.
[Footnotes]
A discussion of how the application of Bible principles has helped many to overcome depression appeared in the September 8, 1981, Awake! article, “How You Can Fight Depression.”
See “Is It All in the Mind?” in Awake! of September 8, 1981.
B1, B3 (niacin), B6, B12, pantothenic acid, biotin, folic acid and C are listed by a team of scientists in Nutrition and the Brain (1979, edited by Wortman and Wortman of the Massachusetts Institute of Technology).
[Blurb on page 27]
Mental disorders are very complex and every patient is different. Therefore a doctor who is acquainted with the patient usually can make recommendations as to which approach is best
[Box/Picture on page 23]
There is a close interplay between the mind and the body. Our thoughts can affect our body and can produce a chemical imbalance in the brain, leading to depression. Our body, because of deficiencies, disease or physical defects, can also affect our mind and contribute to depression

Part 36

 
36.  How Dangerous Really Are Drugs?

By “Awake!” correspondent in Canada
ALL drugs are potentially dangerous. A drug is any substance that by its chemical nature alters the structure or function of a living organism. It is this “altering” effect that constitutes a definite danger.
The drugs here being discussed are substances that have some effect on the mood, perception and consciousness. According to this definition, a number of things in common use, such as coffee, some tea, cola drinks and alcoholic beverages, although not thought of as drugs in themselves, actually do contain drugs. The drug in the first three is caffeine and, obviously, in the latter is ethyl alcohol. Moderate use of these drinks is not harmful, and may even possess some nutritional or health value. Wine, for example, is specifically recommended in the Bible for health reasons. At 1 Timothy 5:23 it states: “Use a little wine for the sake of your stomach and your frequent cases of sickness.”
But the use of drugs can cause serious problems. The accompanying chart shows what some of these are.
Of course, some drugs are used for healing purposes, or to reduce pain due to illness or surgery. Are there abuses in such medical use of drugs? Certainly. For example, not only is there the overmedication that results from the indiscriminate prescribing of tranquilizers and antibiotics by some doctors, but there is also the overuse by individuals of nonprescription drugs such as aspirin and sleeping pills. And that, too, is harmful and dangerous. But that is something that we will discuss in a later issue of Awake!
Generally, however, the use of drugs in medicine is not the same as drug use by individuals where the purpose and motivation are very different. The results to the recipient are also usually very different.
Just look at what happens to those who abuse drugs for whatever reason. Note carefully what even short-term abuse will bring about. Ask yourself, Are not the dangers to health and life real ones? Consider just a few examples:
AMPHETAMINES: Short-term use results in reduced appetite, increased heart rate and raised blood pressure. Long-term, heavier doses result in restlessness, irritation, malnutrition, increased susceptibility to infections, high blood pressure, a sense of power and superiority, unusual delusions and hallucinations, paranoia, and so forth. Not a pretty list, is it?
BARBITURATES: Short-term effects are slurred speech, staggering, a “high” feeling, and, in large doses, unconsciousness and fatal depression of the respiratory system. Harmless?
COCAINE: Short-term effects are much like those from amphetamines. Long-term, heavier doses bring on bizarre, erratic and violent behavior, paranoid psychosis, and sometimes an irresistible and maddening sensation that something is crawling under the skin.
OPIUM, HEROIN AND CODEINE (the latter used in many cough medicines found in drugstores): Short-term effects of opiates like these include a state of “contentment,” detachment, nausea and vomiting. An acute overdose adversely affects the respiratory function, with danger of death. Does nonmedical use of these sound safe to you?
TRANQUILIZERS: Adverse effects are reduced alertness, slurred speech, dizziness, depression, possible impairment of muscle coordination, urinary retention, low blood pressure, and so forth.
LSD: Effects are usually rapid pulse, distortion of perception, anxiety or panic, feelings of unusual power or importance.
PCP: Effects noted often are shallow respiration, increased blood pressure, muscular incoordination, numbness of the extremities. With larger doses: nausea, vomiting, blurred vision, loss of balance, delusions, confusion, hallucinations, coma, uncontrollable rage, suicidal and homicidal tendencies, death.
Frightening? Yes, and yet the list is by no means complete. Under the influence of these drugs people often lose their lives. In the book Mind Drugs, there is related the account of one young girl who, after taking LSD, jumped to her death on a rocky beach because the ocean below appeared to her as a silky scarf. Then there were the youths who wanted to ‘become one’ with the traffic on a busy thoroughfare. And there was the student who had to be restrained from leaping from an apartment window because he wanted to use his new ability to fly. Long is the list that tells of those who committed suicide or perpetrated terrible crimes after using PCP or LSD.
Imagine its power: an eyedropperful of LSD would be enough to produce a drug experience for 10,000 people. “By weight it is about three million times as potent as crude marijuana,” says the book Mind Drugs.
In addition to the direct effect of the chemicals themselves, many drugs are administered by unsterilized hypodermic needles, adding the dangers of tetanus, phlebitis, hepatitis and inflammation of the lining of the heart and its valves. Sooner or later, too, if a person becomes addicted or dependent, he will find himself in the company of criminal elements and in dangerous neighborhoods as he seeks out sources of his drugs. All of these pose a threat to health and life.
What are your chances of survival on the highways these days with so many under the adverse influences of drugs? Would you be at ease if you knew that coming at you at night from the opposite direction on a highway was a young girl who, due to recurrent effects of a drug she once took, now sees 1,000 pairs of headlights ahead of her, resulting in her not knowing for sure which are your real ones and which are the illusions? In her case, the headlights trigger the recurrence of the drug effect.
And are you at ease on the highway knowing that one of the effects of marijuana is the impairment of the ability to judge distance and time? that coordination is slowed down and that ability to make decisions is affected? What would that mean to you and your family when you are on a busy highway with many cars passing one another? Dangerous? No doubt about it!
Imagine, too, on a job, the danger to persons other than the drug takers. Think of the threat to life from having people afflicted by dizziness, loss of control, blurred vision and hallucinations working on fast-moving machinery and equipment, operating cranes lifting heavy objects overhead, or handling dangerous liquids and explosives. They truly constitute a threat to their own lives and to those of fellow workers. Do people have a right thus to endanger the lives of others? This relatively new safety problem is of serious concern to employers and medical officers at large plants. No wonder some job applications inquire as to the applicant’s previous use of drugs, if any!
There are those who would argue that they are doing better work now that they have used drugs to sharpen their awareness and creativity. But the facts argue otherwise. Take the case of a man who had been a successful international lawyer. For months after his experience with LSD he simply wandered about in the desert pondering his “experience” and its meaning.
A doctor’s report to executives on problems due to the increase of marijuana smoking pointed out that its use has “an adverse effect on performance of high-level jobs. The user is frequently lethargic, lacks motivation, is prone to error, has trouble remembering important details, and cannot think practically about the future.” How can a person’s brain be really aided by something that interferes with perception?
In another case a doctor tells of a transformation in a formerly bright student, studying for his law degree and his Ph.D. The changes came with marijuana use.
In time, thinking became unclear, concentration on schoolwork became more and more difficult and there were problems in his ability to finish work. Later, hostile reactions showed up and there was suspicion of others. The student and two companions were killed a short time later when the small plane he was piloting crashed.
As for cocaine, a report in Psychology Today said that it “gives an often deceptive feeling of improved intellectual and physical capacity.” It added: “The euphoria and confidence induced by cocaine can make the user attribute to the drug effects that have nothing to do with it, and cause him to overestimate the changes it does produce.” Even though amphetamines, since they are stimulants, seem to improve performance of simple tasks, “they do not improve performance on more complex tasks,” explained the same magazine.
The situation with drug use seems to be that the user thinks he is better than ever, but he really is not. The fact of life that must also be appreciated in this matter is that no drug is able in some magical way to develop a talent or an ability that was not there at the start.
Of real concern these days to medical men and many parents is the result of parental drug taking on the unborn. The route for nourishment to a baby is the mother’s bloodstream. Thus the many things a mother eats, drinks or otherwise puts into her body eventually show up in the baby.
Who can forget the tragic results to the unborn in the case of the mothers who took thalidomide as a sleeping pill? Babies were born with malformed limbs or arms and legs missing. There are also cases reported where an infant of a drug-taking mother was born with withdrawal symptoms, and where the baby of an alcoholic mother was born an alcoholic. Now, also, tranquilizers are thought to pose dangers to the young.
No wonder more and more warnings are issued to pregnant women and those who plan pregnancies about the risks involved with drugs, smoking, even aspirin, tea and coffee. Dr. Conrad Schwarz, head of the psychiatric department at St. Paul’s Hospital in Vancouver, said that scientific results have shown that “in pregnancies, the active ingredient in marijuana passes through the placenta to the fetus,” and that “the ingredient also passes through breast milk.”
Add to that the adverse consequences to the kidneys, brain and liver in barbiturate abuse and the inhaling of fumes from various solvents. What a poor start in life drug-taking women give their children!
One of the almost certain results of starting on drugs is the eventual taking of other drugs. Thus, it is not uncommon to find that heroin users are also users of marijuana, that some who take amphetamines to get “high” later take a depressant to bring them “down,” resorting to such drugs as tranquilizers or alcohol. The risk of mixing these drugs can be seen in this explanation:
The effect you desire from one drug, such as a depressant like a tranquilizer, may be canceled out by a stimulant taken at approximately the same time. For example, if one drinks six cups or more of caffeine-containing coffee the “benefit” of a tranquilizer will be nullified. On the other hand, the taking of two drugs of the same kind, such as two depressants or two stimulants, will heighten the effect—but not just a doubling of the effect. And here is where one encounters a very real danger. It is said that one alcoholic beverage plus one barbiturate can have the force of five or six alcoholic drinks. Or, as one pamphlet from a provincial ministry of health put it: “If you weigh 150 lbs., seven drinks in a couple of hours will probably make you intoxicated. If you have taken a cold capsule or some cough medicine as well, you may be unconscious. If you have also taken a barbiturate, you may find yourself in the emergency ward, or perhaps in the morgue.”
What about those who are not drug addicts but who are merely ‘taking what the doctor ordered’? They, too, must be careful and informed. You may be taking tranquilizers or perhaps have had one dose of a cough medicine purchased at the local pharmacy. Either of these mixed with one beer can have the impact of three or four drinks. One who is taking medication for blood pressure, heart problems, diabetes, epilepsy or allergies, should always ask a doctor or a pharmacist about whether any drug preparation he is to take is dangerous with coffee, tea, or alcoholic beverages. Also, tell your doctor or pharmacist what other drugs you are already taking when you have another prescribed or are buying one from your local druggist. Don’t become a statistic in the files of fatalities from drug mixing!
Drugs alter bodily functions designed to continue life. Any interference with or altering of the body chemistry can be dangerous and even death-dealing. Drugs will cause some unbalance in your organism. Their careful use as a prescribed medicine may have the beneficial effect of counteracting some chemical imbalance, but continued experimental, recreational or nonmedical use of drugs is playing Russian roulette with your life. And, if doing so, you are, in the case of those who are working and driving, or in the case of expectant mothers, putting the lives of other persons, including innocent babies, in jeopardy. Is that love of neighbor? Really, is there any valid reason for the current bumper crop of drug abuse?
[Blurb on page 12]
An eyedropperful of LSD would be enough to produce a drug experience for 10,000 people
[Blurb on page 12]
Marijuana users are considered to be a hazard on the highway and on the job
[Blurb on page 13]
Cocaine “gives an often deceptive feeling of improved intellectual and physical capacity”
[Blurb on page 14]
One alcoholic beverage plus one barbiturate can have the force of five or six drinks
[Blurb on page 14]
Continued experimental, recreational use of drugs is playing Russian roulette with your life
[Chart on page 10, 11]
ALCOHOL (Ethyl)
EXAMPLES Beer
Whisky
Wine
MEDICAL CLASSIFICATIONS Central nervous system depressant.
AND USES Used to sedate, promote sleep.
Dilates the blood vessels.
Energy source.
Aid to digestion.
SHORT-TERM EFFECTS Initial relaxation.
Loss of inhibitions.
Impaired coordination.
Slowing down of reflexes and mental
processes.
Attitude changes, increased risk-taking
to point of bad judgment.
LONG-TERM EFFECTS Regular, heavy use adds to chances of
cancer of the gastrointestinal tract,
cirrhosis of the liver, gastritis, heart
disease and pancreatitis.
MAJOR DANGERS Possibility of physical and psychological
dependence.
Social and personal deterioration.
Permanent damage to brain, kidneys and
liver.
ASA (Acetylsalicylic acid)
EXAMPLES Alka-Seltzer
Anacin
Aspirin
Bufferin
Dristan
Frosst 222
Templeton TRC
MEDICAL CLASSIFICATIONS Central nervous system depressant.
AND USES Used for fever, headaches, inflammation,
muscular pain and neuralgia.
SHORT-TERM EFFECTS Reduces fever, inflammation and pain.
Stomach upsets and possible gastric
bleeding.
LONG-TERM EFFECTS Enhances the effect of anticoagulants,
making patients bleed more easily.
Possible side effects are asthma, hives
and irritation and bleeding of
gastrointestinal tract.
MAJOR DANGERS To be avoided if you have blood clotting
abnormalities, ulcers and bleeding
problems, nasal infection, sinus
disease, asthma or allergic conditions
of the nose or sinuses.
CAFFEINE
EXAMPLES Cocoa
Coffee
Cola drinks
Tea
Wake-up pills
MEDICAL CLASSIFICATIONS Central nervous system stimulant.
AND USES Sometimes as mild stimulant.
Acts on kidneys to produce diuresis.
Stimulates cardiac muscle.
SHORT-TERM EFFECTS Greater alertness and increased
sleeplessness.
Involuntary hand tremors.
LONG-TERM EFFECTS Regular, heavy use increases caffeine
dependence (withdrawal symptoms include
irritability, restlessness and
headache).
Also, insomnia, anxiety, stomach and
duodenal ulceration.
MAJOR DANGERS Suspected as cause of heart disease,
bladder cancer and birth defects.
HALLUCINOGENS
EXAMPLES DET; DMT;
LBJ; LSD;
MDA; STP;
Hashish
Marijuana
MEDICAL CLASSIFICATIONS Central nervous system stimulant and/or
AND USES depressant.
No medical use.
SHORT-TERM EFFECTS Reduced appetite; increased energy and
postponement of fatigue; increased heart
rate and blood pressure; dilation of
pupils.
A “high” feeling.
Distortions of perception in colors,
shapes, sizes and distances.
Impairs memory, logical thinking and
ability to perform complex tasks.
LONG-TERM EFFECTS Psychological dependence possible.
Apathy, loss of drive and interest in
continuing activity.
Prolonged anxiety and depression.
Illusions.
Marijuana smoke, due to high-tar content,
carries risk of lung cancer, chronic
bronchitis.
MAJOR DANGERS Bizarre mental effects.
Irreversible personality changes.
Suicidal or homicidal inclinations.
“Flashbacks” may occur even after drug
discontinued.
NARCOTICS (Opiate analgesics)
EXAMPLES Codeine
Demerol
Heroin
Methadone
Morphine
MEDICAL CLASSIFICATIONS Central nervous system depressant.
AND USES Used to relieve pain.
SHORT-TERM EFFECTS Relief from pain; produces a state of
contentment; sometimes nausea and
vomiting.
LONG-TERM EFFECTS Rapid development of tolerance and
physical and psychological dependence.
MAJOR DANGERS Very strong physical and psychological
dependence.
Addictive.
General physical deterioration.
Death from overdose due to respiratory
depression.
NICOTINE (Tobacco)
EXAMPLES Chewing tobacco
Cigarettes
Cigars
Pipe tobacco
Snuff
MEDICAL CLASSIFICATIONS Central nervous system depressant and/or
AND USES stimulant.
No medical use.
SHORT-TERM EFFECTS Increases pulse rate; raises blood
pressure; lowers skin temperature;
raises acid levels in the stomach; first
stimulates, then lowers activity in
brain and nervous system; reduces
appetite and physical endurance.
LONG-TERM EFFECTS Damage to blood vessels in heart and
brain.
Shortness of breath, cough.
Increased respiratory infections.
Chronic bronchitis
Emphysema.
Risk of cancer of bladder, esophagus,
kidneys, larynx, lungs, mouth and
pancreas.
Stomach ulcers.
MAJOR DANGERS With habitual use, cancer of larynx,
lungs and mouth; irritative breathing
syndrome, chronic bronchitis, and
pulmonary emphysema.
Damage to the heart, blood vessels.
Impaired vision.
SEDATIVES AND HYPNOTICS
EXAMPLES Barbiturates
Amytal
Nembutal
Seconal
Tuinal
MEDICAL CLASSIFICATIONS Central nervous system depressant.
AND USES Used in treating insomnia, anxiety,
tension and epilepsy, and in treatment of
mental disorders.
SHORT-TERM EFFECTS SMALL DOSES can relieve anxiety and
tension, bringing calmness and
relaxation of muscles.
LARGER DOSES result in intoxicated
feeling, slurred speech, staggering,
unconsciousness.
ACUTE OVERDOSE can be fatal.
LONG-TERM EFFECTS Rapid development of tolerance and
dependence.
Normal sleep not produced.
MAJOR DANGERS With continual use, high psychological
dependence.
Dangers due to faulty judgment and
coordination.
Possible brain and kidney damage.
Death from overdose or in combination
with alcohol.
SOLVENTS (Deliriants)
EXAMPLES Airplane glue
Dry cleaner fluid
Gasoline
Lighter fuels
Nail polish remover
Paint thinners
Plastic cement
MEDICAL CLASSIFICATIONS Central nervous system depressant.
AND USES No medical use.
SHORT-TERM EFFECTS Extreme excitement; disorientation and
confusion slurred speech and dizziness;
distortions of perception and vision;
auditory hallucinations; loss of
muscular control.
Larger doses result in sleepiness and
unconsciousness and even death due to
heart failure.
LONG-TERM EFFECTS Dependence may develop, craving and
habituation.
Extensive use may bring about kidney and
liver damage.
MAJOR DANGERS Psychological dependence liability.
Potential irreversible damage to the
brain, liver and kidneys.
Accidental death due to choking or
suffocation.
STIMULANTS
EXAMPLES Amphetamines
Benzedrine
Cocaine
Coca leaves
Dexedrine
Methedrine
Phenmetrazine
PMA
TMA
MEDICAL CLASSIFICATIONS Stimulant to central nervous system.
AND USES Relieves mild depression and fatigue.
SHORT-TERM EFFECTS Reduces appetite; increases energy,
deters fatigue; increases alertness;
induces faster breathing; increases
heart rate and blood pressure, risking
rupture of blood vessels or heart
failure.
With LARGER DOSES, talkativeness,
restlessness, paranoia, panic, delusions
of grandeur.
LONG-TERM EFFECTS Malnutrition; increasingly subject to
infections; rapid development of
psychological dependence.
MAJOR DANGERS High blood pressure or heart attacks;
brain damage, malnutrition, exhaustion,
pneumonia.
Coma and death.
TRANQUILIZERS (Minor)
EXAMPLES Equanil
Librium
Miltown
Valium
Vivol
MEDICAL CLASSIFICATIONS Central nervous system depressant.
AND USES
SHORT-TERM EFFECTS Relaxes muscles; calms hyperactivity,
stress and anxiety; lowers emotional
responses to external stimuli.
Reduces alertness; gives short-term
relief from anxiety.
With LARGER DOSES, potential adverse
effect on muscle coordination.
Dizziness, drowsiness, lowered blood
pressure and/or fainting possible.
LONG-TERM EFFECTS Danger of physical dependence.
Similar to sedative hypnotics.
MAJOR DANGERS Dangerous with alcohol.
Produces depression, mental sluggishness,
slurred speech.

Part 37

 
37.  Mental Depression Afflicts Millions—Why?

THE symptoms may not seem overly serious at first. Perhaps a person suffers from fatigue, stomach cramps or chest pains. He may find himself waking up at wee hours of the morning for no apparent reason; or the trouble may be difficulty in getting to sleep. Possibly a change in appetite has led to weight loss; or maybe the problem is overweight due to a sudden splurge of eating.
Who of us has not experienced some of these symptoms? They may indicate a number of simple physical ailments. But what if they persist and an examination by a physician reveals that there is nothing wrong physically? In such a case is the ailment merely imaginary? Not necessarily.
Fatigue, physical pains and change in eating or sleeping habits can constitute what doctors call “the somatic mask of depression.” What is depression? Why does it afflict people?
The Earmarks of Depression
Everyone feels ‘down in the dumps’ on occasion. This should not cause alarm, for off days of this type are not what doctors mean when they speak of depression. During an interview recorded in U.S. News & World Report, a leading psychiatrist, Dr. Bertram S. Brown, explained the significance of the term: “Clinically, we mean something more serious when we speak of depression. In the intermediate stage, victims feel a lack of energy and interest in life that hangs on for a few days or a few weeks and affects their life functions.”
A depressed person finds it difficult to perform even the most routine tasks, such as getting dressed, brushing teeth, preparing breakfast and making routine decisions. “The third level, where no one can doubt that you’re dealing with depression,” continues Dr. Brown, “is when somebody literally sits in a corner—almost paralyzed—looking into space.”
And usually depression has another characteristic symptom. Commenting on findings by Dr. Aaron Beck, an article in the New York Times Magazine stated:
“Beck did find, as he reports in his book: ‘Depression: Causes and Treatment,’ that the dreams [of depressed persons] repeated, night after night, constant themes of inferiority, of unattractiveness, deprivation, incompetence. . . . Beck noticed these gloomy sleeping fantasies were matched by an equally negative way of thinking during the day. For example, a depressed woman whose friend was late for an appointment became convinced that the friend no longer cared for her, that no one liked her, and that in fact she was unlikable.
“Beck postulated that almost all the thoughts of depressed patients are ruled by what he calls ‘the cognitive triad of depression’—negative views of the world, themselves and the future. He found that depression-prone people exaggerated minor obstacles into impossible barriers, considered themselves stupid or hopelessly incompetent and saw the future as only full of more painful failures.”
Doctors often speak of depression as either “acute” or “chronic.” Acute depression sets in from some external cause, such as the death of a loved one, divorce or some other severe loss. Depending on the seriousness of the cause, acute depression may last weeks or even months; but then it disappears. On the other hand, in chronic cases the crippling effects of depression persist month after month.
Another type of sufferer is the “manic-depressive.” This person seesaws between a “manic” (from manikos, Greek for “mad”) state and one of depression. During a manic state, the individual becomes overactive, impulsive, often disorderly in speech and thinking. Then follows a “normal” period, after which he plunges into depression. Some remain in the manic state most of the time, with only brief low periods. Others are just the opposite, remaining depressed most of the time. And there are those who, for the most part, remain on an even keel except for brief ups and downs.
“Common Cold of Mental Disturbances”
How widespread is serious depression? According to Dr. Nathan S. Kline of the New York State Department of Mental Hygiene, “it has been estimated that 15 per cent of the adult population of the United States has some degree of depression which is serious enough to be in need of treatment. This amounts to about 20 million people, which makes it not only the most frequent psychological disorder but also one of the most common of all serious medical conditions.” Depression is so widespread that it has been called “the common cold of mental disturbances.”
Studies report that women outstrip men in suffering from depression by a ratio of about 2 to 1, though some claim that this is because women are more willing to admit that they are depressed. Depression afflicts all races and every social and economic level. While the malady is most common between the ages of sixty and seventy, it strikes all age groups and has been rising among persons in their twenties.
Why do so many millions of persons suffer from depression?
Human Society a Factor
Much study has gone into uncovering the root causes of mental depression. Flaws in human society constitute one main source of the problem.
Illustrating an aspect of this are comments by Dr. John Schwab, of the University of Florida College of Medicine: “We’re in an era of change right now. Old values such as the old work ethic are being rejected and people are caught in an ideological vacuum. Kids see that the fruits of four hundred years of scientific progress may be more bitter than sweet—but they don’t know what to put in its place, and consequently there is a sense of futility.” Because of this, many disillusioned youngsters seek “escape” through drugs and other means. “The search for highs among the young,” observes Dr. Schwab, “is often only a flight from the lows.”
Also contributing to the rise in depression is “supermobility.” Families that keep changing their places of residence, hopping about from house to house and city to city, do not stay in one place long enough to build solid relationships with other people. A psychiatrist at the Massachusetts Mental Health Center wrote: “Psychiatrists around Boston have been aware for some time of what is called ‘the Route 128 syndrome’ or in Florida ‘the Cape Kennedy syndrome.’ It is found in young families who have moved too much, and its components are a husband too centered in his career, a depressed wife and troubled children.”
Sometimes depression results when a person reaches a “plateau” in his life after many years of painstaking labor. A hard-driving business executive may finally achieve the top position in his company, only to realize that he no longer has a goal in life. Housewives in their forties and fifties often suffer from what psychiatrists call “empty nest syndrome.” By this time their children usually have grown up, their husbands are at work for most of each day and they must face lonely hours in houses devoid of people.
What about the feelings of inferiority that often accompany depression? Here too the responsibility may rest with human society. How so? Because it is often at a tender age that children are made to feel unattractive. Their peers may ridicule them if they are unable to do what the majority consider the “in” thing. If a youngster tends to be clumsy and uncoordinated, schoolmates and playmates can influence the child to believe that he “can’t do anything right.” Children of this type often combine the generalization: “I am weak,” with the value judgment: “It’s disgusting to be weak.” Such youths are likely candidates for depression.
Biological Factors
During recent years considerable research has gone on to show that in many cases depression may be due to faulty chemical activity in the brain. Throughout the brain are scattered “biogenic amines.” These chemical compounds are especially concentrated in the “limbic system,” a part of the cerebrum that has much to do with emotions. Scientists have connected three of these amines—dopamine, norepinephrine and serotonin—with the transmission of impulses from one brain cell to another.
Interestingly, experiments with both animals and humans have shown that depression results from taking drugs that reduce the level of amines. On the other hand, experimental animals showed notable liveliness when their amine level was increased. Notes the New York Times Magazine:
“An international research team of British and American scientists in 1968 added new circumstantial evidence to support the amine theory when they found that the brains of patients who had committed suicide seemed to show some evidence of reduced amine levels. And a recent study of manic-depressives added further support: The urine of manic-depressive patients during their manic period showed increased excretion of norepinephrine, and the exact opposite after they had shifted to the normal phase or the depressed phase.”
Do you have symptoms of depression? What can you do to cope with melancholy feelings? These questions are discussed in the following article.
[Blurb on page 6]
Mental depression is “one of the most common of all serious medical conditions.” It afflicts all races and every social and economic level.
[Blurb on page 7]
“Depression may be due to faulty chemical activity in the brain.”

Part 38

 
38.  What Can You Do About Being Depressed?

DEPRESSION presents serious problems for millions of persons today. Does it affect you or persons you love? What can you do, either for yourself or for others, to ease the crushing burden of depression?
Likely you will find it helpful to discuss your distressing circumstances with someone close to you. Seeing a difficult experience through the eyes of another can aid you to develop a more realistic outlook. Often this alone will bring a measure of relief from depression.
At times the reason why individuals become depressed is frustration at daily tasks that are repetitious and boring. Does that describe your situation? If so, some simple changes in the order of your regular routine may help. For instance, tackling the more unpleasant tasks earlier each day will leave later hours for activities that afford greater enjoyment. Another thing you can do from time to time is to seek out a change of pace. Something as simple as taking a walk, a brief period of exercise, or getting away to an area of different surroundings for a weekend or vacation can do much to chase away the “blues.”
One thing that depressed persons must strive to overcome is the temptation to withdraw from other people and “vegetate” in a pool of despair. Keeping busy at some helpful service, a hobby, or other type of activity will help grief-stricken persons to keep their mind off unpleasant circumstances.
When Feeling Worthless and Guilty
What about the feelings of incompetence, worthlessness and guilt that frequently accompany depression? Could it be that worldly standards of “success” have led you to believe that somehow you do not measure up to others? It will be worth while to consider the Scriptural view of this matter. The Bible assures that what the world considers popular, flashy and appealing “does not originate with the Father [God], but originates with the world.” (1 John 2:15, 16) The Scriptures also make it plain that everyone has positive qualities that can serve for the benefit of others. Concerning the correct attitude for Christians, the apostle Paul writes:
“For the body, indeed, is not one member, but many. If the foot should say: ‘Because I am not a hand, I am no part of the body,’ it is not for this reason no part of the body. And if the ear should say: ‘Because I am not an eye, I am no part of the body,’ it is not for this reason no part of the body. If the whole body were an eye, where would the sense of hearing be? If it were all hearing, where would the smelling be? But now God has set the members in the body, each one of them, just as he pleased. The eye cannot say to the hand: ‘I have no need of you’; or, again, the head cannot say to the feet: ‘I have no need of you.’ But much rather is it the case that the members of the body which seem to be weaker are necessary.”—1 Cor. 12:14-18, 21, 22.
Regarding a tendency to do things wrong, the Scriptures place all humans on the same level. “All have sinned and fall short of the glory of God.” (Rom. 3:23) The Scriptural term “sin” means “to miss the mark” in the sense of failing to reflect perfectly the qualities of God’s personality. This tendency spread to all mankind from the first human pair, Adam and Eve. (Rom. 5:12) If one misses when shooting at a target, it matters little whether the error is due to shooting above, below or on either side of it. It is reckoned that one simply missed the mark. So likewise your own inherited weaknesses do not in God’s eyes put you on a lower level than fellow humans.
As to the comfort gained from talking to a trusted friend, King David, who underwent numerous hardships, said concerning the Creator: “Jehovah is near to those that are broken at heart; and those who are crushed in spirit he saves.” (Ps. 34: 18) Approaching God in prayer during times of distress is especially helpful. Do you do that regularly?—1 Thess. 5:17.
What can relatives and friends do to assist depressed individuals? Persons who wish to help should avoid blurting out things such as: “Oh, why don’t you snap out of it!” Much more helpful is heeding the Scriptural advice: “Speak consolingly to the depressed souls.” (1 Thess. 5:14) A way to do that is to notice things that they do well and give commendation. When persons have totally lost confidence in themselves, some have helped by giving them simple tasks that they obviously can perform. Then they provide more difficult things to do, gradually rebuilding the depressed person’s self-confidence. Might you be able to help someone in this way?
But what if suggestions such as these do not bring much improvement? What other types of treatment are there?
Treatments Some Have Tried
Treating the mentally depressed has run the gamut from kindness to horrors. Today when doctors fail to aid a person to a better frame of mind through psychotherapy, they may resort to “shock therapies.” This procedure dates back to the early 1930’s. Manfred Sakel pioneered insulin-induced shock in psychotherapy back in 1933. Two years later a Budapest psychiatrist, Van Meduna, used Metrazol to produce epileptic-like convulsions. In many cases these shock treatments relieved symptoms of severe depression for a period of time. However, to be most effective insulin shock had to last 30 to 50 hours and the patient required costly attention. Metrazol shock resulted in a high incidence of fatalities and fractures.
These treatments have been largely replaced by “electroshock therapy” (EST), also called “electroconvulsive therapy” (ECT). This procedure, which is still popular, involves applying electric currents to the brain, which causes the body to convulse. Usually a drug is given in advance so that the patient does not feel anything. However, a confused state of mind follows electroshock therapy; and, on occasion, it has brought about amnesia that lasted for weeks, as well as permanent brain damage. Moreover, as noted in the book The History of Psychiatry: “Shock treatments effect only a relief of symptoms. They do not reach the basic psychological disturbance underlying the illness.”
Another way of treating depression is psychosurgery. This involves cutting certain nerve fibers that connect the frontal lobes of the brain with the thalamus. If successful, this operation may bring about relaxing of tension and anxiety. However, it has caused some patients to lose contact with their past and to become passive and lead an almost vegetative existence. And once performed, psychosurgery cannot be reversed.
Because of the frequent failure of earlier methods of treatment, some doctors have begun viewing depression from an entirely different direction. What does this involve?
Coping with Defective Body Chemistry
In an effort to treat depression from the standpoint of body chemistry, scientists have developed certain “antidepressant drugs.” These are not sedatives that induce dependence. With very rare exceptions persons can discontinue or restart antidepressant medications without adverse effects.
How do these special drugs fight depression? Scientists have noted that chemical substances called “biogenic amines” are highly concentrated in the part of the brain that controls moods. “In depressed individuals,” explains Dr. Nathan Kline, “there is fairly good evidence that certain ‘biogenic amines’ are either not produced in sufficient quantity or are destroyed much too rapidly.” A group of drugs called “monamine oxidase inhibitors” (MAOI’s, for short) has been developed to retard the breakdown of amines that appear to be needed to maintain a pleasant mood. One medication, lithium carbonate, has been quite effective in leveling off the alternate highs and lows of manic depressives.
Concerning the merits of antidepressant drugs, Dr. Kline writes: “Certainly, when extensive psychotherapy has proved to be ineffective in relieving symptoms, there are strong reasons for trying antidepressant medication. One school of thought, increasing all the time, is that medication ought to be tried first. In many cases this proves to be all that is needed. Medication not infrequently is helpful in combination with psychotherapy. After all, a depressed person is not the world’s best subject for intensive psychotherapy.”
However, there are many people, perhaps 40 percent of depressives, that do not respond to these drugs. Too, the medications have unpleasant side effects and can be dangerous if not used under the careful oversight of a doctor.
With regard to proper functioning of the brain, a reasonable safety measure would be to make sure that your body receives proper nutrition. After citing evidence that mental depression results when there are deficiencies in vitamins and other nutritional elements, biochemist Roger J. Williams observed in his book Nutrition Against Disease: “The safest assumption we can make is that every essential nutrient is needed by brain cells and that the inadequate supply of any one will cause trouble.” Of course, this is not to suggest that a person simply stuff himself with a random assortment of vitamin capsules. Requirements for optimum nutrition often vary from person to person. It would be wise to seek out expert advice as to any deficiencies of this type that you should correct. However, this is an approach to depression that is often overlooked but sometimes successful.
The Permanent Cure for Depression
If you suffer from depression, perhaps one of the suggestions mentioned above, or a combination of several of them, will afford a measure of relief. However, a permanent cure for all depressive illnesses is now at hand. What is this?
As noted earlier, the basic reason why the human body is defective and subject to various diseases, including depression, is that all humans inherit sin. According to the Scriptures, the removal of inherited sin through the ransom sacrifice of Jesus Christ will eventually lead to disappearance of all diseases that afflict mankind.—Isa. 33:24; Col. 1:14; Rev. 21: 1-5.
The Scriptures assure, too, that all unpleasant aspects of human society will disappear when God’s heavenly Kingdom government replaces human political governments with divine rule of the earth. (Dan. 2:34, 44) Bible prophecy schedules this cleansing of the earth for the present generation.—Matt. 24:3-8, 14, 32-34.
Even now, before complete fulfillment of these sure promises, the Bible can help to uproot deep-seated depression. How so? Because persons who live according to Bible principles can offer one of the most important elements in treating any mental disturbance.
According to the Scriptures, persons practicing true Christianity heed the advice: “Clothe yourselves with the tender affections of compassion, kindness, lowliness of mind, mildness, and long-suffering. . . . But, besides all these things, clothe yourselves with love, for it is a perfect bond of union.” (Col. 3:12-14) Depressives will surely profit from association with persons who live according to such principles. A chairman of the Mental Health Research Fund in London said: “By far the most significant discovery of mental science is the power of love to protect and restore the mind.”
Time and again Jehovah’s Witnesses have noted the effectiveness of Bible knowledge and application of its principles in lifting people out of depression. For example, a woman from the western United States writes: “I was in a very low mental state, depressed, and had entertained thoughts of suicide. I turned to Jehovah’s Witnesses and began studying the Bible seriously. It was like God answering my prayer. My depressions and loneliness disappeared and a new hope grew in me, namely, to serve Jehovah. Today I am happy as one of Jehovah’s Witnesses, knowing that there is a real reason to live and that my children can have a hope for a better life. I thank Jehovah for his loving-kindness.”
Would you like to know more about how God will soon replace this depressing system of things with a new one of peace and happiness? This information, along with sound principles for happy everyday living, is found in the Bible. Would you enjoy getting better acquainted with the Word of God? Jehovah’s Witnesses will be glad to help you to do so.

Last Part, thanks for reading this and I do hope this has been a help, and if you have any comment then do let me know, Re: Jeff

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