Sunday, August 10, 2014

Initial Reactions to the Return of Major Depressive Disorder

Please note - this article is about major depressive disorder, which is different from the most common form of depression, which has a variety of different causes, and is a normally an isolated, one-off episode.

Do Not Blame Ourselves

A reaction we may have to major depressive disorder’s return is to blame ourselves for its return, asking ourselves questions like, “What have I done to cause this relapse?”

When depression was forcing its way back into my life in 2010, I kept going through this issue, wondering if I was doing too much, not exercising enough, and so on. Here’s such an entry from my diary:

3.11.10 – Here I am, making lists again.
I believe the primary cause of what I’m going through now is a combination of the following:
1. Was not eating properly for a few months due to throat problems, and lost 6kgs
2. Add to that getting sick repeatedly throughout winter, perhaps seven illnesses in a row...
3. As a result of getting sick so many times, I did not exercise regularly.
4. Pushed myself way too hard practising the the piano.
5. Though of course, it could be my damaged, epilepsy ridden brain simply misfiring, with no rhyme or reason at all.

However, major depressive disorder, which is also known as recurrent depression, is called that because it re-occurs, and does not need anything to trigger it. Instead, it is a malfunction of the brain and nervous system, and new episodes may trigger from time to time, as sufferers can have several episodes during their life. We can have months, years, or decades free of it before it triggers again.

Succumbing to another episode of major depressive disorder in 2010 was none of my doing, it was simply another episode caused by the disorder. And it followed the same pattern it took back in 1989 - 1994. Therefore must not blame ourselves or feel guilty when it returns. We are not a failure. We cannot prevent such episodes, but by responding to them correctly, for example by trusting entirely in God, keeping our eyes fixed upon Jesus, using Dr Claires Weekes techniques of facing, acceptance, learning to live with it, and letting time pass; medication, counseling, exercising, etc, we can reduce the severity and duration of the episode.

Do Not Feel Guilt if Previously Dealt with Fears Return

When I suffered an emotional/mental collapse during my first major depressive episode in Dec 1989, a fearful thought/doubt entered my mind that became an obsessive fearful thought, which terrorized me night and day, week after week, for months. I received significant relief when the fear was addressed by my counselor, but it continued to plague me until the end of that depressive episode. After I recovered, it popped up a few times but was easily dispatched. So to all intents and purposes, it had been dealt with.

Several months after the onset of this new depressive episode which began in 2010, I suffered another emotional/mental collapse, and that same fear, which had previously been dealt with, resurrected, and with almost as much power as it had back in 1989-94.

One reaction to the return of previously dealt with fears is to feel guilty, to think we have regressed to falling prey to those fears again, perhaps even thinking our walk with the Lord is going backwards. However, we have to remind ourselves that the only reason these fears have returned is because of depression. For when we are depressed, our mind typically loses its flexibility and resilience. If we were not depressed we would have got rid of the fears with ease.

So we must must not feel guilt if any previously dealt with fears return, but remember that those fearful thoughts will reduce in severity and duration as we recover from this depressive episode.

However, we may need to receive prayerful/Biblical counseling or therapy to help us deal with and overcome those fears. At the very least, we need to speak to someone wise to help us see the true perspective about what we fear, and learn to see things as they see them.

“There is now no condemnation for those who are in Christ Jesus,” Romans 8:1

Maintain Hope

Regardless of how bad a new major depressive episode becomes, we must NOT lose hope. We need to keep reminding ourselves that we recovered from it last time, and we will recover from it this time.

We need to remember that our hope in Jesus gives us the strength we need to persevere and endure whatever trials come our way. ‘We continually remember before our God and Father your work produced by faith, your labor prompted by love, and your endurance inspired by hope in our Lord Jesus Christ.’ 1 Thessalonians 1:3

Set Realistic Recovery Goals

We also need to set ourselves realistic goals for recovery if we enter a new episode of recurrent depression. Unrealistic goals create time pressure, which only makes things worse. It took me five years to recover from a major depressive episode last time, so when I was diagnosed with it again in 2010, I mentally set aside five years to recover from it again. That means five years of doing less, of reduced responsibilities, of never feeling guilty for not doing as much as I was before the onset of this depressive episode. And Jesus understands exactly what we are going through, and is there to comfort and strengthen us.

‘For we do not have a high priest who is unable to empathize with our weaknesses, but we have one who has been tempted in every way, just as we are—yet he did not sin.’ Hebrews 4:15






10 comments:

  1. Wow, nothing triggers the disorder, it just returns. May it never come back to you Peter and I hope you are feeling well.
    Hugs,
    Mary

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    1. Hi Mary,
      Lovely to hear from you :)
      I'm three years into this second major depressive disorder episode, but are well on the road to recovery. The 'bad' days can still be horrendously bad though. I'm so glad Jesus is holding my hand and guiding me through this.
      God bless
      Peter

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  2. dear Peter, thank you so much for saying this is not my fault. I have suffered with anxiety/depression my whole life (I now realize). It is so hard to explain to people how it feels, especially to other Christians when they give well intentioned advice as to why they don't get depressed or have anxiety. I know God is using this to keep me close to Him but some days are so hard. I cannot thank you enough for writing this blog. I recommend it to everyone I know who has fallen into depression or anxiety. Clinical depression/anxiety run very strongly in my family and is no more my fault than having a physical illness would be. Sometimes, I wish it were something physical which could be seen, then people would understand. I read this blog all the time and it comforts me tremendously. Your suffering has not been in vain. You have helped many many people, and I thank you for it and pray for you. Denise

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    1. Dear Denise
      Thank you for your comment, and for letting me know how the blog has been so helpful. I am greatly encouraged that the Lord is using my writings.
      And I know what you mean about wishing depression was something physical, I've wished that myself at times too.
      God bless you heaps,
      Peter

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  3. It bothers me to see someone write that God thinks the only way to keep someone (and therefore, me, very possibly) close to Him is only by keeping him/her perpetually depressed. Which raises the question of if we are ever happy, then should we feel guilty or start anticipating that the happiness means we've strayed from God and to expect to be hit with depression? I'm almost afraid that if and when I feel any kind of happiness, that I'm somehow sinful and to expect the rug to be pulled from under my feet because God will want to test me with crippling depression...

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    1. Dear Anonymous,

      Please be assured that God keeps no one perpetually depressed to draw them/keep them close to Him. Please recall the scripture - "Every good and perfect gift is from above, coming down from the Father of the heavenly lights." James 1:17.

      However, we can also be encouraged that God does use for good everything that happens in the lives of His children. "And we know that in all things God works for the good of those who love him, who have been called according to his purpose." Romans 8:28. So if we do become depressed, He will use it for good. Just like He will also use the better times for good.

      And to answer your question, if you are experiencing a time of happiness, no, do not fear that you have strayed from God or expect depression. That's a deception of the enemy, trying to rob us of our joy, by whispering lies in our ears that because we are happy, God's going to steal it away and replace it with depression.

      If you are not already receiving Christian counselling, may I please encourage you to receive counselling from a Christian counsellor/therapist/minister, and mention these fears that you have. Through Biblical teaching, and prayer, they help you to be set free from these fears completely.

      Hang in there, and please place your hope firmly in Jesus,
      God bless
      Peter

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  4. Thank you for the assurance, Peter. I have always had the image of a Christian life as being thrown one trial after another, never being allowed to be happy for very long, a belief I am trying to modify, as I realize that is a lie from the Enemy to discourage people from committing their lives to Jesus. Not to say that Christians won't face hardships and trials because I know we will, but I know, as you say, our suffering will be used for good. Maybe non-Christians will face less problems in their lifetime than those who are living for Jesus, but I know the price is steep. There are many days I want to "run away" from God because I don't think He cares but I'm hanging on. And since God keeps his promises, I can be reassured that He will be faithful to me too as I go through this darkness.

    And yes, I am in the progress of seeking counseling.

    Peter, can I ask you, do you find it a challenge to be feel joyful, despite the return of your depression and the fact that it's been so long now? I know we are instructed to be joyful no matter our circumstances but boy, it is SO difficult.

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    1. Dear Anonymous,

      Thanks for writing. I am encouraged to hear that you are seeking counselling. It will be a wonderful thing to see you set free from the fears that God will take away your joy. Here is a verse that my minister shared with me when I shared a similar doubt with him. "God's gifts and his call are irrevocable." - Romans 11:29. Joy is one of God's gifts, and therefore He will never take it back from us. (Satan uses deception and trickery to try to make us focus on fear instead of God's gifts.)

      To answer your question, over the past five years it has been a challenge to feel God's joy, especially during the blackest of the bad days, which sometimes tempt me to despair. However, I know these times are temporary, so I fix my eyes on Jesus, keep busy, and wait for them to pass. And they always do. Also, the joy of knowing Christ, of having Him always with me, of His salvation, are always close at hand. Sometimes I just need to remind myself of these wondrous truths. And though I often feel the blackness of depression, yet at the same time, I feel His presence and know He's with me, and I praise & worship Him, regardless of how I feel.

      God bless
      Peter

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  5. hi Peter,
    I admire your faith and walk with God...may God continue to bless you and help you touch more lives...
    like you i suffer from depression and in remission...i was diagnosed as having Major Depression, Dysthymia and had several bouts of depression since my 20's...i am 44 now...my parents also both have depression, it just runs in the family...and like you it is mainly Jesus who keeps me "alive" physically and spiritually...i had suicidal ideation in my 20's in a bout of major depression but i read that the soul never rest when you die by suicide so this scared me so i chose depression over biological death...also just thinking of how my family will take my "death" make me have second thoughts about ending my life...i hold on to that little faith i have...through the years it is only God after all who can help...i took antidepressants too and read many self-help books, psychology and spiritual books as counseling is not very available in my country that time nor can i afford it...I still have some bouts of depression as i think it is also related to PMS...i also suffer from panic attacks but usually now it is low grade anxiety...but i am so much better now...i offer to God also all the burdens of this disease...i also pray for healing and deliverance always...yes, it's true...this disease does not disappear overnight and one needs preventive maintenance so to speak...if only people know it is only God who can ultimately heal...one needs to desire it and have faith...

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    1. Dear Anonymous,

      Thanks for sharing your journey with depression, and sharing how Jesus has kept you safe in Him through the ordeal. Thank you for choosing life over suicide, you have definitely made the correct choice, for it robs us of what God has in store for us, and truly destroys the lives of our family and loved ones. That's wonderful news that you are so much better now.

      May the Lord continue to sustain you and lift you up, and bring you to wholeness.

      God bless
      Peter

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