Tag Archive - depression

Depression: Discernment in Pastoral Caregiving

July 25, 2009 in Ministry-Theology, Therapy-Psychology with 4 Comments

Discernment
As we talk and think about the issue of depression in ministry one of the most important factors that we have in helping us determine what exactly we are dealing with is discernment.

the quality of being able to grasp and comprehend what is obscure

Discerning what type of help a person needs can be tricky. Should they see a therapist? A psychiatrist? Both? Is a recommendation for meds necessary? Are we dealing with depression, melancholy, burning out, etc? Maybe it’s all, maybe it’s some, maybe it’s none. But the act of discernment is a process and often involves multiple people helping one through their difficult journey.

In the book Depression and Hope: New Insights for Pastoral Counseling (which I mention quite a bit, is a great resource, and which I will reference and quote from heavily in this post), Howard W. Stone says:

Depression disturbs one’s most important relationships; for melancholics this may mean family members or close friends. For the mystic or hermit monk, and indeed for all faithful Christians, that most important relationship is with God. When people feel the absence of God, when they doubt, when religious ritual and service lose meaning, their experiences are very similar to the symptoms of depression.

Pastoral caregivers listen in a certain way to the words of those who are disconsolate, a way that is distinct from other helping professionals. To clergy and other professionals in ministry, despair, suffering, struggle, and adversity are laden with spiritual import, because reflection on the experience of melancholy and spiritual desolation can bring depth and meaning to those who are trying to be faithful to the call of Christ (Stone, 21).

When dealing with issues of such vital importance, you can see why discernment is key.  In fact, I would say that it’s quite rare for most people entering into ministry to have a decent understanding of mental health issues and the role of the pastor in pastoral caregiving.

In his book Stone talks about four experiences that “compare strongly to depression: the dark night of the soul, ‘accidie’, desolations, and Martin Luther’s understanding of ‘Anfechtungen’”. Fascinating stuff! Let me just mention them briefly here:

Continue Reading…

Depression: Christians and Medication

July 24, 2009 in Ministry-Theology, Therapy-Psychology with 10 Comments

“you may have questions about whether Christians should take this or that. You get in that state, I assure you, you will take rat dung.” Pastor Tommy Nelson on his depression

Why the Stigma?
Let me start this post by saying this. When it comes to the issue of taking medication for depression…there are some Christians who believe in it, and those that do not.

I believe in them. And I’m not trying to convince you otherwise. That will require circumstances, experiences convincing beyond my control.

I have worked long enough in the ministry and therapeutic setting to see the amazing and beneficial results that they have had in the lives of the co-workers, students and clients that I have journeyed through life with.

I believe God has given scientists/doctors/researchers amazing minds to create some medications that can help.

As one friend says, “If someone is diabetic, they are going to take insulin…aren’t they?”

Or I tell my friends, “If you have a heart condition, you are going to the cardiologist, right?”

So what’s the stigma around mental health and medications in the Christian life? I’m not completely sure. There is some disconnect it seems. Or rather than disconnect, there is some inconsistency in how we pick and choose what areas of our lives we seek help on, and what areas we think we should be able to pick ourselves up by our own bootstraps.

Continue Reading…

Depression: Hope Through Hospitality

July 23, 2009 in Ministry-Theology, Technology-Social Media, Therapy-Psychology with 4 Comments

The fourth and final video I shot for LifeChurch.tv on depression aired today and is titled Finding Hope. Monday’s video was An Anchor in the Journey-Exodus 17:1. Tuesday’s video was Depression-At the Movies continued. Wednesday’s video was Walking Through Depression.

As we end this week looking at depression I wanted to focus on the idea of hope, because without hope in our lives, it is very difficult to move forward, especially out of things like depression and anxiety. The theologian Jurgen Moltmann says:

Hope is a power in this life to begin life again, to be reborn in an affirmation of life from deep depression. At the same time, hope is a comfort in the world to come beyond death. These are not contradictions. The more hope gives strength in this life, the more comfort it gives in the life to come.

The great writer Parker Palmer (who I referenced in a couple of videos) says this about his own depression. In fact, I recommend his book Let Your Life Speak: Listening for the Voice of Vocation where he talks at length about the role of depression in his life.

I got tremendous help from a therapist at one point — in one of my depressions — who said to me, “Parker, you seem to keep treating this experience as if depression were the hand of an enemy trying to crush you. Would it be possible to re-image depression as the hand of a friend trying to press you down to ground on which it’s safe to stand?” Well, those words didn’t mean much to me immediately because when you’re there, you can’t hear that kind of counsel. But they grew on me, those words did.

So as we go out into the world, let me encourage you in how you might play a vital role in helping others through depression…through the dark times in their lives. There are many ways to do this, but let me leave you with one idea: HOSPITALITY.

“One way to build upon people’s strengths is to show them hospitality. The counseling session needs to be a place where counselees are welcomed, encouraged, and complimented for what they are doing well, not where their past wrongs or present pathology is dredged up….Showing hospitality has for centuries been one of the vital tasks of pastoral care (Depression and Hope: New Insights for Pastoral Counseling, 61).

Just as a therapist welcomes, as well as provides an encouraging environment where one’s strengths and possibilities for the future are opened up, those in the Church need to do the same.

My hope is that one day those suffering from depression will not just seek the safety within the therapist’s walls, but will find a safety within the walls of the Church.

Questions:

  1. Do you know anyone right now who is suffering from depression?
  2. What can you do to come alongside of them and show hospitality?
  3. What might hospitality look like for someone in the context of depression?

Disclaimer: This blog post is not to be a substitute for professional help or advice. Please consider seeking out professional help if you consider yourself to be at risk for depression.

Depression: Soren Kierkegaard on Actuality, Freedom and Possibility

July 22, 2009 in Ministry-Theology, Technology-Social Media, Therapy-Psychology with 1 Comment

Today, LifeChurch.tv posted the third of four videos that I shot with them on depression. Monday’s video was An Anchor in the Journey-Exodus 17:1. Tuesday’s video was Depression-At the Movies continued. Today’s video is Walking Through Depression. In today’s video I share about the prophet Elijah wanting to die, and actually asking God to take his life away.

Sometimes our depression becomes so severe that we just can’t even function. It evolves into an anguish that is difficult to cope with at times, and sometimes we wonder if we can move on. That is a difficult place to be, and it is not uncommon among humanity.

One of the things I have been reading a lot about recently is the issue of anxiety, and how anxiety lies between our knowledge of possibilities, and actuality. This is something that Kierkegaard talks a lot about, and I think he has some good things to say on the topic of depression.

kierkegaardKierkegaard is one of my favorite writers, thinkers, philosophers, theologians, and psychologists. Ever since reading Fear and Trembling when I was 22 he has continued to profoundly shape my life and thinking.

So it is not surprising that in the book Depression and Hope by Howard W. Stone, that it is Kierkegaard that has something to say to us on this issue. Let me quote at length the following passage from the book:

Soren Kierkegaard’s understanding of persons–for our purposes depressed persons–also helps us understand hope. In The Sickness Unto Death, he describes persons as possessors of actuality, freedom, and possibility. All three are a part of the authentic self, and a good relationship of all three is necessary for authentic existence. Actuality refers primarily to the past; it includes our context, our psychological predispositions, and choices we have previously made.

Freedom is what we have in the present. It is a finite freedom, exercised within the limits of our situation and abilities, our givens and past choices. Because of our actualities we cannot simply become whatever we want to be ‘if we try hard enough for it.’ We make choices, and act, from the range of options available to us.

Possibility addresses the future. It is what we can become as we use our freedom. In that respect our possibilities are not predetermined. We are not automatons. We can imagine, and within the givens of life we can become something new. Living as an authentic self, according to Kierkegaard, means looking beyond our immediate necessities or past liabilities. We anticipate the future with the awareness that we are free–however limited–to actualize whom we ought to become as faithful Christians and to take responsibility for shaping that future. Continue Reading…

Are You Experiencing Depression?

July 21, 2009 in Ministry-Theology, Technology-Social Media, Therapy-Psychology with 4 Comments

As I mentioned yesterday, I had the opportunity to share some thoughts around depression with LifeChurch.tv. The first video, An Anchor in the Journey-Exodus 17:1 appeared yesterday, and I posted a little more details on my blog, Depression: Getting Honest With Our Journey.

You can check out the second video, Depression: At the Movies continued.

Assessing Depression
There are a variety of factors and tools that one may use in assessing if someone has depression. In therapy, there are usually a few basic questions I ask to better assess what is going on. In my work as a Marriage and Family Therapist one of the main tools that we use is the DSM-IV (i.e. Diagnostic and Statistical Manual for Mental Disorders). Whether or not one believes in diagnosing individuals, some of the criteria they provide is very helpful in getting a sense of the symptoms that one is exhibiting.

51yeqm7b52l_bo2204203200_pisitb-sticker-arrow-clicktopright35-76_aa240_sh20_ou01_As a pastor, leader, or volunteer in the Church you most likely will not look at the criteria in the DSM-IV, but it’s important to have a baseline of criteria that one’s symptoms can be measured against. A book that I have found really helpful is Depression and Hope: New Insights for Pastoral Counseling by Howard W. Stone. In this great book Stone says the following:

Criteria for Depression

Depression, or melancholia, is known in psychiatric terminology as major depression to distinguish it from the normal low periods that many people go through. The psychiatric diagnostic criteria for major depression lists nine symptoms, as follows:

  1. Depressed mood, sadness, irritability part of each day, nearly every day
  2. Diminished pleasure or interest in daily activities
  3. Considerable weight loss or gain, change in appetite
  4. Significant change in sleeping patterns (The most common result is early waking.)
  5. Marked increase or decrease in movement (Most commonly the person physically slows down.)
  6. Fatigue and loss of energy
  7. Feelings of worthlessness or guilt (The feelings are beyond the scope of how people would usually feel.)
  8. Difficulty in concentration
  9. Ideas of suicide or death

To be diagnosed with major depression according to the American Psychiatric Association criteria, persons must exhibit at least five symptoms for a minimum of two weeks, and have either depressed mood or diminished pleasure or interest on most days for at least part of the day (APA 1994). These criteria are a good basis for determining if someone really is depressed. The certainly are not exhaustive but signal that a person’s story may be one of melancholia. (pp. 65-66)

Have you, or are you experiencing any of these symptoms? Have you sought out help for them? Continue Reading…

Depression: Getting Honest With Our Journey

July 20, 2009 in Ministry-Theology, Technology-Social Media, Therapy-Psychology with 2 Comments

Untitled
[image by Church Online]

This week I have had the opportunity to share some thoughts around depression with LifeChurch.tv. You can watch the 4:34 minute video, An Anchor in the Journey-Exodus 17:1 as I talk about the importance of seeing our lives as a journey, and the experiences we will come up across during the journey…such as depression.

Whether you are struggling with depression yourself, or just know someone who is, I hope that you can resonate with the video and the post below.

I remember where I was at the exact moment I read the words below by Rob Bell in his book Velvet Elvis: Repainting the Christian Faith. I was sitting on our couch in Pasadena, CA and as I read each word the resonance grew deeper and deeper within me until I finally felt like I was hit by a ton of breaks…but at least understood. At least there was some pastor out there I thought, this one in Michigan, who put words to my feelings and thoughts in ways that I was not able to at the time. Bell says,

Once again I am going to give you some numbers, and I hesitate to do so, but it is part of the story and it helps to explain the rest. Two years into it, there were around 10,000 people coming to the three gatherings on Sundays.

In the middle of all this growth and chaos was me, superpastor. I was doing weddings and funerals and giving spiritual direction and going to meetings and teaching and dealing with crises and visiting people in prison and at the hospital–the pace and the workload were unreal.

I can’t begin to describe what it was like because it was happening so fast. One minute you have these ideas about how it could be and the next minute you are leading this exploding church/event/monster. All of a sudden there are all of these people who know who you are and want something from you and think you’re a big deal, and you are the same person you’ve always been. Everything has changed and yet it hasn’t. It’s hard to explain, but I found myself asking, “Where is the training manual?”

Continue Reading…

Dealing with issues around depression, anxiety, etc…

July 19, 2009 in Marriage-Family, Technology-Social Media, Therapy-Psychology with 2 Comments

This last week I had the opportunity to drive up to LifeChurch.tv to film 4 video vignettes on the movie Henry Poole is Here. Without sharing too much in this post, the movie does a great job of really capturing some of the more human experiences we go through during difficult times in our lives. So I shot 4 videos, each about 3-5 minutes long dealing with different thoughts on topics such as depression, anxiety/angst, etc.

If you haven’t seen the movie, I really recommend it. Even better yet, check out LifeChurch.tv’s new sermon series, “At the Movies”, with plenty of opportunities this week for you to view online.

So each day this week (Monday-Thursday) you will see a new video vignette from me over at LifeChurch.tv Facebook page, and you will have the opportunity to interact, comment, ask questions, etc. I hope that what I have to share will be of encouragement to you, and I hope that I can point you towards some great resources as well.

Church Online at LifeChurch.tv is a great ministry, and I really appreciate the opportunity they have given me to talk about such important life issues, especially in such a great online venue where the interaction among people is so authentic and real.

So please let me know if I can be of any help this week as I post videos, interact with content, and point you towards resources on the topics of depression, anxiety, fear, anger, etc.

When Should I Go See a Therapist?

July 1, 2009 in Marriage-Family with 6 Comments

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[image by Ted Percival]


This is a great question and was actually brought to my attention by a comments thread over on Facebook. In fact, one can Google this question and you will find a variety of answers, ranging from very specific things, to a more broad and general feeling of “feeling down” or “depressed.”

There is a not a right or wrong answer here, so let me just suggest a few reasons why you might want to go see a therapist.

  1. A general feeling of needing to talk with someone about some various things going on in your life.  These things can be serious (“I feel like taking my own life.” To more general, “I have just been feeling off…not sleeping…and wanted to talk with someone about this.”).


  2. You are looking for an unbiased, non-judging, caring person to listen to you.  In therapy speak, we might refer to this as unconditional positive regard. A lot of people feel like they can’t find this acceptance with friends, family, or their church, so therapy is often a good place to start. Now I’m not saying that all therapist will practice this, but I think really good ones do.


  3. Someone in your circle of influence (friends, family, co-workers) notices that there are some things in your life that are concerning to them, or that they feel like you might need someone to talk to about them.  So often people end up in therapy due to the suggestion and encouragement of others.


  4. Because you want to grow.  Therapy is not all about working on issues of depression, anxiety, fear, etc., but can be a great environment for personal growth (spiritual, emotional, physical, psychological).  There aren’t many places in your life where you can be in an environment that helps you grow , but a therapist is able to get a different perspective and help foster this growth with their experience, knowledge and tools.


  5. You are experiencing some minor or major life transitions.  Divorce.  Marriage.  Pregnancy.  Death.  College.  Career.  Etc.  These transitions and others often bring out new feelings, challenges, fears, etc. in a person, and it’s helpful to have a guide along that journey.


  6. You have no one else to talk to.  This could literally mean you can’t think of anyone to talk to, or there isn’t anyone who would really understand what it is you are going through.


  7. You are wanting anonymity as you seek help and work through the issue.  Therapy operates under very specific ethical guidelines regarding confidentiality, etc., and this may be important to you as you seek help, rather than going to your pastor, family member or friend.


  8. You are more specifically able to identify what it is you are struggling with, and you want a professional to help you.  This could be depression, anxiety, bi-polar, ADHD, fear, adultery, abuse of any kind, etc.


  9. Many of us don’t take the opportunity to explore the deeper meanings in our own life, or to wrestle with key issues of identity.  We often live on the surface, and never get beyond the things in life that just make us feel good and comfortable.  Seeing a therapist is a great opportunity to really find out who you are, and to be known.


  10. You have seen the positive benefits of therapy in the lives of those around you.  So you want to give it a try yourself.


  11. You might not have any reason, but simply the curiousity of the positive ways it could benefit your life are appealing to you.


  12. You are looking for some hope in your life.

Okay, those are just 12 reasons for when I think it would be beneficial for someone to go see a therapist. I’m sure there are more, but this is where you help me out.

What reasons are there for going to see a therapist?

Did any of the above reasons resonate with you?

Depression, Burnout & Ministry: Showing Hospitality

February 13, 2009 in Ministry-Theology, Therapy-Psychology with 0 Comments

This is my 8th and final post in my series on Depression, Burnout & Ministry. There are lots of things I wish I would have written about in this series, and lots more that has been left unsaid. Hopefully this will be an ongoing topic because it is an issue that is so prevalent among us, but often ignored.

What I hope that these 8 posts accomplish is bringing to light the reality that depression is all around us, and it knows no boundaries. It does not matter if you are a Christian or non-Christian. It doesn’t matter if your spiritual life is going well, or not so well. It doesn’t matter if you are male or female, young or old. Depression is real and affects many, many people.

That being said, one of my hopes is that we interact with those suffering from depression in loving, compassionate and non-judgmental ways.

There are many ways to do this, but let me leave you with one idea: HOSPITALITY.

“One way to build upon people’s strengths is to show them hospitality. The counseling session needs to be a place where counselees are welcomed, encouraged, and complimented for what they are doing well, not where their past wrongs or present pathology is dredged up….Showing hospitality has for centuries been one of the vital tasks of pastoral care (Depression and Hope: New Insights for Pastoral Counseling, 61).

Just as a therapist welcomes, as well as provides an encouraging environment where one’s strengths and possibilities for the future are opened up, those in the Church need to do the same.

My hope is that one day those suffering from depression will not just seek the safety within the therapist’s walls, but will find a safety within the walls of the Church.

Questions:

  1. Do you know anyone right now who is suffering from depression?
  2. What can you do to come alongside of them and show hospitality?
  3. What might hospitality look like for someone in the context of depression?

Previous Posts in the Depression, Burnout & Ministry Series
Depression, Burnout & Ministry: Deciding to Get Honest About Our Journeys
Depression, Burnout & Ministry: Anne Jackson Interview, Part 1
Depression, Burnout & Ministry: Anne Jackson Interview, Part2
Depression, Burnout & Ministry: Assessment
Depression, Burnout & Ministry: Christians and Medications
Depression, Burnout & Ministry: Discernment in Pastoral Caregiving
Depression, Burnout & Ministry: Soren Kierkegaard on Actuality, Freedom and Possibility

Disclaimer: This blog post is not to be a substitute for professional help or advice. Please consider seeking out professional help if you consider yourself to be at risk for depression.

Depression, Burnout & Ministry: Soren Kierkegaard on Actuality, Freedom and Possibility

February 12, 2009 in Ministry-Theology, Therapy-Psychology with 1 Comment

kierkegaardOne of my favorite writers, thinkers, philosophers, theologians, psychologists is Soren Kierkegaard. Ever since reading Fear and Trembling when I was 22 he has continued to profoundly shape my life and thinking.

So it is not surprising that in the book Depression and Hope by Howard W. Stone, that it is Kierkegaard that has something to say to us on this issue. Let me quote at length the following passage from the book:

Soren Kierkegaard’s understanding of persons–for our purposes depressed persons–also helps us understand hope. In The Sickness Unto Death, he describes persons as possessors of actuality, freedom, and possibility. All three are a part of the authentic self, and a good relationship of all three is necessary for authentic existence. Actuality refers primarily to the past; it includes our context, our psychological predispositions, and choices we have previously made.

Freedom is what we have in the present. It is a finite freedom, exercised within the limits of our situation and abilities, our givens and past choices. Because of our actualities we cannot simply become whatever we want to be ‘if we try hard enough for it.’ We make choices, and act, from the range of options available to us.

Possibility addresses the future. It is what we can become as we use our freedom. In that respect our possibilities are not predetermined. We are not automatons. We can imagine, and within the givens of life we can become something new. Living as an authentic self, according to Kierkegaard, means looking beyond our immediate necessities or past liabilities. We anticipate the future with the awareness that we are free–however limited–to actualize whom we ought to become as faithful Christians and to take responsibility for shaping that future.

In short, faithful Christian living requires recognition of givens from the past and exercise of finite freedom in the present, so that positive future possibilities can be imagined and brought into existence. Those who are depressed, viewed from Kierkegaards’ understanding of persons, allow their actuality (past) to limit and dominate their possibility (future) by not exercising their finite freedom in the present. So the anguish of depression comes not only from dwelling on negative past but also from the loss of a positive future. Unfortunately, much counseling offered to the depressed focuses on actuality, on the past. It is a grave error. The purpose of the minister giving care to the depressed is to engender a hope that recognizes actuality but also steps directly into the future by exercising freedom in the present, by taking action.

The good news is that there are care and counseling methods that can engender future hope in melancholic individuals. Methods especially useful for enlivening hope include searching for exceptions, reframing, focusing on people’s strengths, and creating future goals as a way to move away from preoccupation with the past (47-48).

Questions:

  1. How does Kierkegaard’s understanding of people fit into your understanding of people?
  2. Does your theology compliment Kierkegaard’s understanding of people, or contrast with it?
  3. How do you understand both our limits and freedom as people, and our ability those parameters offer to treat depression?

Previous Posts in the Depression, Burnout & Ministry Series
Depression, Burnout & Ministry: Deciding to Get Honest About Our Journeys
Depression, Burnout & Ministry: Anne Jackson Interview, Part 1
Depression, Burnout & Ministry: Anne Jackson Interview, Part2
Depression, Burnout & Ministry: Assessment
Depression, Burnout & Ministry: Christians and Medications
Depression, Burnout & Ministry: Discernment in Pastoral Caregiving

Disclaimer: This blog post is not to be a substitute for professional help or advice. Please consider seeking out professional help if you consider yourself to be at risk for depression.
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