Men get depressed

She's never called it depression before. I know it's taken me years to say it.

Last week she said he's depressed and I nodded because my soul gets stretched like that too. Depressed husbands make themselves push through. They twist their heart darkness into any other possible shape. They call it frustration or they label themselves "the melancholy type" or they just constrict to the necessary, hiding in bed but barely sleeping. They don't say "I'm depressed" very often.

Some have such rigorous self standards that they face a mountain of daily disappointment. Some wrestle with inadequacy bred into their bones and they doubt every urge or idea. Doubt paralyses them, and risking new notions fills them with terror. Fear that they cannot admit or perhaps cannot see.

Grace is the only solution. But depression conceals grace because it is born of self-criticism and failure. Failure to be what we long for, failure to see another's love for us.

So we talk about counselling and 'strategies' for self-care and the last thing he needs is strategies. He's all strategied up and he's worn out because it's another way to 'do the right thing' and be a good husband or father or person. His fear is of giving his all to God and finding nothing left for himself. That God would steal his soul if he offered it.

Someone else fears that God has nothing good to do through him. The fear robs him of passion and motivation. It leaves him misunderstood, dissatisfied and frustrated with himself. Another friend thinks others don't really like him and that man's wife reflects that she's 'a bit of an annoying person'.

It maddens me, this blindness. That we measure ourselves along such human scales, and our inadequacies become an obsession. Arrogance and pride can be about our achievements. But self- criticism is a type of pride too.

I see us all carrying self-critical burdens and they sap the life from us. God wants us to be free of this. Maybe freedom would come from seeing them more clearly and being willing to give them up. Willing to stop defining ourselves with them. To stop letting our imperfections be the barrier to God using us.

Let's turn the measuring around. Stop applying it to ourselves. Put it up against God, measure the life of Jesus. Start looking for achievement and adequacy where we're guaranteed to find it. Give up the flurry to be good enough. Accept ourselves, not to excuse failures but to stop the distracting internal war.

God is not stealing our souls, he's renewing them. We'll never find ourselves empty or soul-bereft trusting him. He's doing more than we can imagine in us (and through us), if we'll let him.

*NB. I write this, not knowing your particular experience of depression or self-criticism. Please forgive me if this does not ring true for you. I'm just reflecting on some things I've been thinking lately. This is not an exhaustive treatise on depression.

Caring

She's living at the house he bought. After the divorce. After winning a hundred thousand on a carelessly bought scratchie. He's had the house since half the money was in the till at the pub.

She's glad to have a place to stay. And doing her the favour eases the jagged edged fact that she is his carer. Not his carer on a welfare form. His carer on the watch for when he starts to be distracted with his own thoughts. Looking for his words to lose their distinct flavour. They can become like mist in the headlights.

He says there's nothing wrong. He lives it, too. If ignoring it were therapeutic, he'd be well. But he's not. He sifts everything he hears to capture words that make him better. But they don't. He careens, rather than slips into madness.

She came home to find the windows nailed shut and the back door couldn't open. He'd left the hunting knife on the table. The police had pulled him roughly out the door, with his arms clasped behind him. He hunted for explanation but it slipped away. She was saddened that he didn't notice his own incoherence. He thought it made sense.

She slept. It felt like days. Repaying the debt of pacing, interrupted nights. She tells me of retreating to her room. That she saw his eyes peering out from the darkness. That he waited for her to sleep and then he walked back and forth, all night. Wry, she laughs. His mad thoughts are funny. They are funny and timid and sad and broken.

Somehow she can shiver at his paranoid preparations and giggle at his oddness. Her steadiness is epic.

Family without burden is enticing. But it spoils us for the true beauty of care for a broken brother. Perfection has been smashed so that love can be glued patiently together. Built piece after piece, sturdily, secured one by one. It's a heroic, humble construction.

Joining Emily,

Healing



"I'm waiting on God for healing. Don't you do that?"

I wasn't sure how to respond. There was hesitation in her eyes after I answered.

So I'm sitting here thinking about healing and waiting and what we mean when we say such things. I realise I have never thought I needed healing. I don't have a serious illness, and I assume that's what healing is for. I pray for people with pain or with cancer, for friends after accidents and babies with congenital problems. And I prayed for this questioner, today.

Are the medications and therapies we give her the answers to my prayer (and hers)? Is it what she is waiting for? Would it be more obviously the work of God if it seemed more impossible or miraculous? Is waiting on God an active or a passive process?

We each speak a language of faith, and the words can be vague. There are a range of dialects. Because I understand her words in my own way, I cannot meet her with clarity. I cannot answer in a way that engenders trust. I became just another doctor whose faith is suspicious and doubting about the glorious, miraculous healing of God. I really want to taste her uncompromising hope, and I fear that I have bound God into my own rational, scientific paradigm. Have I forgotten that His possibility and scope far transcend my conception of Him?

But I want her to take her medication, because she has been crippled, imprisoned and gagged without it. I am responsible to engage her in this treatment and not give her a reason to doubt it. Then I find myself with deeper ties to her than I had supposed. She is my sister, and that counts. It matters if she thinks I'm her sister, too.

There is another quiet question in the room... Is she the one who sees God clearly? Is her psychosis actually ecstatic communion with God?

I know that Jesus healed a psychotic man and his mind became clear. This tells me clarity is better than psychosis. But are religious delusions really delusions or are they just a breaking through of an intense, consuming meeting with God into someone's life? If Peter described the transfiguration to me in a moment of excitement, would I think he had been hallucinating and that he was unwell?

I need to wrestle with these questions. I need to know that God is working in the rational and explainable and that he also labours in the mysterious and transcendent. Paradoxically, I can trust in medication that is the work of human hands and therapy guided by human minds, while also putting my faith in the inexplicable divine touch to bring healing.

In the midst of madness or surrounded by sanity, Jesus is present and is not overwhelmed. He knows and understands, even if I am still puzzled.

What do you think?

Is she playing with my mind?

Is she playing with my mind?

Desperation. It drips from him. Only to be sopped and dried by lasting reassurance that he's loved. Where can he find it?

He's stuck at the question about a game, this playing. Urges me to see the proof and decide. Why does my opinion matter? Especially when others have already gently (even roughly) laid this possibility in him.

He trawls an ocean of emotion in the wake of her messages. Rocked, pulled under, lost. Washed up on unfamiliar sand expanses. He has no map, no compass and nothing to steer.

No wonder that he sees her as malevolently controlling. That he suspects her motives, her actions and her ability to control him. He is consumed by her.

Reassurance is impossible, brief at best. Can he even hear me through the confusion?

I long to tell him - no human exerts this God-like control over another. He has been tricked into powerlessness. He is blind and lost. She is much more inert, broken and confused than he imagines. She is washed ashore on her own forsaken place, adrift from him, yet seeking. Desperate, too.

Know that we are like grass, every one of us. That we are all desperate, lost and blind.

THIS IS NOT A CONSPIRACY. A game. To be played by another.

We all need someone to find us, to heal our blindness, to love us out of our desperate confusion.

Jesus traveled through all the towns and villages of that area, teaching in the synagogues and announcing the Good News about the Kingdom. And he healed every kind of disease and illness. When he saw the crowds, he had compassion on them because they were confused and helpless, like sheep without a shepherd. (Matthew 9:35-36)

'Is she playing with my mind?' at Circumstantial.

Denial

I've written a post about having a child with a mental illness. You might be interested to check it out, over at Circumstantial.

When I consider how I would respond to the news of a child of mine having a major mental illness, I am ashamed. I realise how perfect I hope my children's lives will be and how unrealistic this is.

 'togetherness' at three

because the glint of mischief in his eye matches the hesitant smile in hers.

Heart-soft

I hate disappointing people.

Most of us do. I don't want to be the one who couldn't deliver what was needed. Sometimes efficiency, big picture decisions and 'the way things are done' trump really being there for someone. And I let people down. I have to say no to what a distressed person is asking me because my job only goes so far. I can't stretch it any further.

I cannot clearly express my failure to a colleague. He thinks I'm being too precious, his teasing, mildly facetious 'You're too worthy," just makes my cheeks redden. I am trapped in this 'feeling sorry for...' and unable to do what is being pleaded for.

But I don't want to be the one who hardens my spirit, so that I can escape this not being enough. Inadequacy or helplessness can give birth to heart hardening. It's so easy to reflect..."If I can't fix it then that problem is not a real one, or worthy of my effort." And the next step is to dismiss and ignore, to avoid painful dilemmas.

And for some stories in an acute mental health ward, being in there is not enough. It will not bring solace or rescue. It will not heal a soul scarred by abuse, repeated abandonings or self-loathing scored deep. That sort of healing comes slowly, a winding, wearing journey, needing companions who walk patiently alongside.

I disappointed her. She ran away because I did not give her one request, the one I could not grant. She couldn't hear anything else I said because I abandoned her again. Yes, I know I'm just a page in a story written long, but my wish was to be different. Sadly, I do not have armour or a thoroughbred, and gallant rescues are beyond me.

But as I write, I see that I will be hurt by not rescuing, by disappointing. The hurt comes of not protecting with hardness. Not becoming blase or cynical. I can avoid disappointing by never getting close and never really listening. Safe, to some degree efficient, but lifeless.

There is a call to soft-heartedness that hears pain spoken, and does not shut it out. There's a call to see needs and not be able to meet them. To be broken by that failure, but to see that hope lies in rescue way beyond what I can do.

At Holy Experience, Ann has written about her trip to Guatemala with Compassion. I encourage you to read these posts - Sept 9, Sept 10, Sept 11, Sept 14, Sept 15. She has captured the call to soft-heartedness lyrically.

Linked with Emily and Ann

Moods

Some mornings I get out of bed, and unpacking the dishwasher is an empowering, focussing task. I notice the day blossom into being. I participate in the emerging freshness and looking out the window strikes fascination with the way the light is shafting through the trees, unique to today.

Other days, the effort to drag myself out from between the sheets, is surpassed only by the work of prying open my eyes. At that point I wonder if there is any energy left in my body to continue with today. Over the next hour I gather whatever pulse I can find within and drag myself tardily on. (Emphasis on tardy - I am punctuality impaired).

What makes the difference?

How can our moods be so capricious, unpredictable and erratic? Mine depend on tricky combination of sleep, hormones, hunger, caffeine, the moods and behaviour of those around me, my current self-estmation, the state of the house and the direction of the prevailing wind. And I'm a reasonably even-tempered person.

I've had mood disorders on my mind this week. I am trying to understand a little of what someone experiences when their moods are wildly mercurial. When a low mood drains the colour out of everything and thinking drowns slowly in hopelessness, death and failure. When great moods bring creativity, productivity, optimism and possibility unbounded. When this tips into grandiosity, invincibility, irritability and thought disorder.

My moods are prosaic and pedestrian in comparison. Yet they seek to rule my behaviour and responses, creeping into consciousness after I have over-reacted or failed to listen. Moods are so much a part of us that it is impossible to live without reference to them.

Moods are a gift, as well as sometimes burdening us. Have you felt the buzz of possibility and inspiration that pulls you into action and opens your eyes to brightness, colour and enchantment? This is God-given excitement and creativity, a taste of the morning and evening of the first seven days.

I stop at naming depression as a gift, but perhaps it reflects the sin-destroyed desolation of Calvary.

Jesus said in Gethsemane, "My soul is crushed with grief to the point of death." (Matt 26:38). Can it teach us of Jesus' broken-hearted torture? Can we better know deep joy having tasted of despair? Perhaps we need the consolation of this balace to accept the existence of wretchedness.

Sometimes I see the perplexed, helpless, listless faces of the melacholically depressed, and cannot understand a reason for such agony.

And yet I thank God for moods, for minds that experience them, for the light and contrast they bring to our lives. For those who have experienced mood disorder, high or low, what is your response?

Family as Safe Harbour

We all build internal sea walls to keep at bay the sadnesses of life and the often overwhelming forces within our minds. In whatever way we do this - through love, work, family, faith, friends, denial, alcohol, drugs or medication - we build these walls stone by stone, over a lifetime. One of the most difficult problems is to construct these barriers of such a height and strength that one has a true harbour, a sanctuary away from crippling turmoil and pain, but yet low enough and permeable enough, to let in fresh seawater that will fend off the inevitable inclination towards brackishness.

(p214-5. An Unquiet Mind, Kay Redfield Jamison.)

Sea walls, slowly constructed to guide and protect. The image is starting thought-streams, since I read An Unquiet Mind, this week. It's a memoir of having bipolar disorder (manic-depressive disorder) written by a professor of psychiatry. (worth reading, too).

Guiding and protecting structures are part of shaping a family or community. As parents we face the same tension, that Jamison describes internally.

Building walls that provide a 'safe harbour' for our children, without stagnation or suffocation.

I want the walls to be high, the protection absolute. I fight my anxiety to allow the sea to flow with some freedom through our family. But I need to bite back my fear, because this flow brings growth and developing independence. It's ironic that an experiential learner like me, struggles to see our children learn through grazed knees, bruised hearts and mistaken ideas. I forget the triumph of succeeding in a new endeavour - pure gold to developing souls.

linked to reflections on parenting at holy experience

What voices do you listen to?

We all have voices in our heads. Some people have truly disturbing ones. The kind that confuse, terrify and lead them into strange stories, mind-constructed. Stories where people implant microchips in heads to surreptitiously communicate. Where bodies are taken over, right down to special control of a particular organ's function. Some illnesses mean we cannot even trust our own thoughts completely.

But even the non-psychotic among us experience conversations in our minds. (I'm reassuring myself that its not just me...) We talk to ourselves about all sorts of things, but often the comments that stand out are self-criticism. 'I'm not good enough.' 'I wish I hadn't done that.' 'I'm so embarrassing.' 'I'm such a *(insert favourite insult)*.' 'I am bad/hopeless/worthless.' Or absolute statements beginning in feelings of loneliness or confusion - 'No one cares.' 'No one understands.'

On paper (or screen) most will read as exaggerations or even as ridiculous statements. Until you reach the one that has power in your mind-paradigm. Most people will have one. That you've practiced for many years. It will give rise to a sense of being overwhelmed or anxious, even depressed. These internal voices can be extremely powerful, and we may not even notice.

When we're stressed, the commentary gets louder, sometimes driving people to despair. Psychologists and therapists can help us to monitor and change the inner dialogue. We can learn to think more positively, to challenge irrational thoughts or self-statements. The rise of CBT, and more recently, positive psychology has seen more challenges to these early, slowly and carefully nurtured messages. That is a good thing.

But they are still based in the concept that our inner voices are ultimately trustworthy. If we just change them to positive messages, we'll be OK. For lots of people, changing their thinking like this is enough to help lift depression or manage anxiety. It can be empowering to realise that our thoughts and feelings are receptive to efforts to change them.

But what happens if we do all we can to change our internal messages, but life is still a struggle. What if we just can't seem to budge our instinctive negative thoughts? Do those inner voices win, and we concede that since they've been so sticky, they must be right? I've seen people do just that.

In that situation (and I would say in most situations), we are crying out for someone who's trustworthy words can trump the critical inner voices. But where do we find it? So often the people around us try to give us a more realistic appraisal and we don't listen, or we don't believe what they are saying.

I find it hard to give up my deep trust in my self-criticism, partly because it is a comfortable bit of my brain furniture, but mainly because it's hard to admit that my own brain has 'gone rogue'.

I don't have an easy answer. But this is what I'm thinking... I'd like to be so soaked in God's words that the instinctive dialogue in my mind involves him. When I'm stressed, or feeling inadequate, or struggling with anxiety, overwhelmed by depression, I'd like to listen to my inner voices saying things like...

"I will never fail you. I will never abandon you." (Heb 13:5b)

"The Lord is merciful and compassionate, slow to get angry and filled with unfailing love."
(Psalm 145:8-9)

"The faithful love of the Lord never ends! His mercies never cease." (Lamentations 3:22)

What would you like to hear?

That woman wrote my textbook!

I went out to a talk last Friday night, by Nancy McWilliams. She had been in NZ for the College of Psychiatrists annual conference and came to Sydney for a few days either side of the main event.

The chance to see her was something I couldn't pass up. And it was worth going. She was interesting, thoughtful and I could understand most of what she was talking about.

In general, she talked about Affect (emotion) Theory and psychotherapy.

A couple of interesting ideas she talked about...

She divided people with depression into 2 subsets, those whose primary need is for healthy attachment and those who focus on negative self-evaluation (I am bad/not-good-enough). The 2 groups respond differently to particular treatments. The first group are responsive to, (and vulnerable to), the therapeutic relationship. The second group are often perfectionistic in their expectations of themselves, and are less responsive to the relationship with the therapist. Instead they may respond to challenge to their ideas of being bad, expressed at the right time.

She told a funny story of a perfectionistic, depressed man she was treating, who started improving after she said to him " I'm not disputing that you're and a**hole, I'm just pointing out you're no worse than the rest of us miserable suckers."

It made me think of how easily we sink into this type of thinking - that we are no good, and that we are worse than other people. We forget one of the freeing things about our human sinfulness... that all humans share in it. Not that being sinful frees us, rather that sinfulness and failure being universal means we are freed from self-absorption. Focus on ourselves as uniquely sinful is just as self-obsessed as thinking we are special because we don't sin.

Secondly, she talked about some research she had done into altruistic people. She studied people who were involved in altruistic, serving endeavours and discovered among them a high degree of perfectionism, too. Most of them did not, however, get depressed and she theorised that by living out their principles of serving others, these people were satisfying their own high self-expectations to the point where they did not become discouraged or feel like a failure.

Two of them did get depressed, however, both when they had young children and were not able to continue their 'serving' to the degree to which they had become accustomed. Suddenly I thought of all the mums I know, or whose blogs I read who struggle with just these feelings. What a twisted place the world is to have tricked us into thinking that raising children is not serving enough, not doing enough, not significant enough. Perfectionism is such an enemy of grace and it is definitely not the same as being made perfect.

May God help us to know who we are and where we stand, because we know him. May he rescue us from self-evaluation based in perfectionism which perpetuates the lie that we can be perfect in our own strength.

Mental Health Reform Needed

In vain I have looked for the icon to post a video here. My minimal technical knowledge is bamboozled for today...

Anyway, watch this video from GetUp starring Patrick McGorry. Health reform needs to include mental health reform in Australia.