Many in the LDS church (although I imagine this is a problem in other faiths) believe that if they are depressed, it must be due to their own personal unrighteousness. This is tragic, but understandable. We seem to have a strong need to attribute everything that happens to us to one cause or another. If we have been told that we will be happy if we keep the commandments, surely if we’re not happy it must be our fault. We must not BE enough, or not be doing enough. Can you grasp how many “sins of omission” there are? The list is endless for those in the church who are struggling with depression, no matter how many times someone quotes Mosiah 4:27.
This month (on Halloween!) I am speaking to the adults in my ward about depression. In a recent ward council meeting, the sentiment above was discussed as a big concern among the ward members, especially for women. I have been directed by the bishop and the relief society president to: 1-raise sensitivity about the problem of depression, 2-help people recognize depression, 3-empower them to do something about it, and 4-undermine the stigma surrounding depression and seeking mental health. That is a lot to cover in about 30 minutes, but it speaks to the tremendous need in the ward. Do you think there is a similar need across the church in general?
Some important stats about depression (from the American Foundation for Suicide Prevention):
- About 15% of the population is clinically depressed at some point in their lives.
- Depression affects one in ten men and one in four women.
- Two in five people in the U.S. believe depression is a sign of personal weakness.
- Less than half of people in the U.S. consider depression to be a health problem.
- About 10% of those struggling with depression also suffer from bipolar disorder, which combines depression with periods of mania, and has a high risk of suicide.
Many in the church are affected by depression. Many others are not very aware of the problem, or don’t know the difference between “feeling down” and depression. I have definitely had symptoms of depression, but not for longer than a few days. Most of us have bad days now and then. How do you know when you’re actually depressed?
According to the DSM IV-TR (of the American Psychiatric Association), you may be clinically depressed if you have 5 or more of the following symptoms, nearly every day for at least two weeks, along with a loss of daily functioning:
- Sad or irritable mood most of the day
- Less interest and/or pleasure in activities
- Weight gain (or loss), or a decreased appetite
- Sleeping too little or too much
- Feeling restless or agitated
- Fatigue
- Feeling worthless or a lot of guilt
- Having difficulty concentrating and making decisions
- Having recurring thoughts of suicide, with or without a plan
How can we recognize depression in others?
- Appearance: red swollen eyes, looking tired, changes in hygiene
- Mood: anxious, nervous, angry, irritable, depressed (duh)
- Sleep: too much or too little; frequent naps
- Energy: low
- Appetite & Weight: increase or decrease
- Cognitive: difficulty concentrating, poor memory, indecisive
Keep in mind that if you have a concern about symptoms of depression in yourself or others, you should see a professional. The information here is not meant to help you diagnose yourself, only to help you recognize when something may be a problem. Some of the biggest barriers to seeing a counselor are a lack of trust that it will be helpful, and concerns about paying for services. Talk to a friend or a church leader you trust about what your options are. There is also a lot of quality (and not so quality) self-help literature on depression.
Readers:
- What do you think are some of the causes of depression among members of the church?
- What do you think I should address to my ward this month about depression? What do they need to know?
- I am also giving a youth fireside (sans parents) with the bishop on the same topic. What do you think are the biggest concerns regarding youth and depression?
Wheat & Tares 
Once a year the Ensign tries to run an article on depression so that people will realize that it is normal, endemic and physical, not spiritual. LDS are more likely to get treatment for depression than some other groups, but you are right, this is still as significant problem in terms of awareness.
What I would do in an address on depression is focus on the fact that it is a physical ailment, so that “causes” are not so much causes for the most part, but manifestations.
That is, for the most part, people get depressed because they have a physical problem, not because they are obsessing about something or other. The obsession is a symptom, not a cause. Too often we focus on trying to avoid triggers as if they were causes instead of symptoms.
Not that there are not causes — loss of a job, death of a child, that sort of thing (and I’m not trying to be flippant, I’ve buried three children and been through unemployment). And not that physical exercise, improved sleep and eating patterns, and journal writing don’t help regardless of the type of depression.
But, for most, physical ailment depression, chasing symptoms won’t do much in terms of treating it.
1. What do you think are some of the causes of depression among members of the church?
I can only guess, but I am assuming that there is some actual research on this. I would think the stigma of committing a sin, particularly one that has habitual frequency, adds to depression, or causes depression.
2. What do you think I should address to my ward this month about depression? What do they need to know?
That it is alright to be depressed. That depression doesn’t say anything bad about you. That if you know people who are depressed, they don’t need your pity but just to continue being a good friend. Don’t make someone who is depressed a “project” to be fixed.
3. I am also giving a youth fireside (sans parents) with the bishop on the same topic. What do you think are the biggest concerns regarding youth and depression?
Same thing. It’s okay to be depressed.
1. – I think that the causes of depression among church members are the same among the general public – lack of exercise, stress, changes in family (ie: divorce, etc).
2. As far as what to address to the ward – I would have to agree with most of what you’ve said already. Depression is real. It isn’t a sign of weakness. However, I do think that there is a connection to our minds, bodies, and spirits. When we are feeling depressed, I really believe it helps to get on our knees and pray, study the scriptures, and get physical exercise.
Of course, it is hard to express these things without people thinking that their depression is a result of personal unrighteousness.
In my opinion (which isn’t worth all that much) depression is kind of a “plague” of our time, but we can get help.
3. I think that the youth would probably benefit from hearing similar things. I think that it would be good to remind them that if they feel depressed, they ought to avoid the temptation to turn to drugs or some other dangerous alternative – in other words, they need to be warned about “self-medication.”
I’m interested in seeing other resoponses, and I hope you post about the class(es) you teach. This is a very timely topic.
Did you see the video clip by Tim Gunn to gay youth making the rounds lately? Tim tells them (click for link): It gets better.
I think that’s what you should tell the youth, and everyone who is depressed. In the middle of it, it’s so hard to see that anything will ever change.
It gets better is part of a project.
There is a group feed somewhere, I need to find it.
I’m a big believer in the diathesis-stress model of depression, in that biology does indeed play a big role, but environmental stresses, events, etc. also contribute to it. I take the same approach to treatment.
“if you know people who are depressed, they don’t need your pity but just to continue being a good friend. Don’t make someone who is depressed a “project” to be fixed.”
This is GREAT advice, imho. Just continue being a friend, not trying to fix them.
If this post is still open on the 31st, I’ll let you know how it went.
Re: scriptures, the “psalm of Nephi” has some good stuff for dealing with depression, which I may address.
I’m not an expert, but in my experience I’ve found in life we have to redefine ourselves to ourselves. What made me who I am in high school is somewhat different from what makes me who I am as a stay at home mother of 3. I think my husband would say the same thing as a member of the corporate rat race. Staying home, especially, has been tough for me. My strengths are not young children 🙂
I find any kind of change or transition fine tunes how we know ourselves, and often there is a sense of loss or being without a solid foundation as we move through those transitions. Finding a space where we are comfortable with ourselves and our worth through all of life’s changes can be a challenge and in my experience can sometimes spiral into a lasting hopelessness or indescribable sense of loss.
My only thought to share would be to try not to become numb. Let yourself feel, even the uncomfortable emotions. Stay awake and as time goes by you will find the worth and defining moments you need to feel rooted again.
Thanks for the video… I wonder if the bishop would let me show that in the youth fireside. With 10 or so kids coming, there must be a chance that it could be important for one or more of them.
Great post. The only thing I can add is that it is not only (perhaps not even primarily) who think of depression as evidence of personal weakness. Due to what I call _the_ psychological fallacy most professionals in the field seem to be convinced that the depression of nearly all sufferers is self inflicted by virtue by poor thinking habits or inability to adjust, etc. The attitude is that anti-depressants, etc. are crutches for the weak minded.
The idea that genetic causes of depressive disorders including bipolar depression are fundamental in those who have life long cases of any degree of seriousness seems to be completely discounted even among trained psychiatrists.
[I have to say, by the way, that I think inline replies are a disturbing distraction from the ordinary flow of a blog like this]
Thanks for the comment Mark. Any professional that leaves out genetics, biology, or even just environment are missing out on key factors.
Re: inline comments – I’m not sure how I feel about the commenting. I like replying directly, but at the same time, I like having numbered comments when I am reading a blog or looking for the most recent comments>
This is such a big topic for me and my immediate family. Depression and manic behavior is rampant here. Before I was medicated and getting professional help I was told by visiting teacher and a bishop that my depression was something that I brought on myself. That if I had had enough “faith” it would go away. I actually became inactive for 2 years because it was so difficult. During that time I started getting help and slowly came back. I look back and I’m sad that they were so clueless to the real problem. It was only 6 years ago too.
My depression wasn’t brought on by a big problem like divorce or death, it just slowly came on me. I think it’s important to tell people that genetic factors attribute to depression and some are more prone to it.
Not an expert but a podcast I was listening to talked about how therapy (with a psychiatrist) can do more to overcome depression than mind altering drugs (anti-depressants).
My unprofessional & totally subjective thoughts on it are:
1. Lack of understanding the seriousness of sin, e.g., making sins far more serious than what they really are and not understanding how universal the love of Christ is. (There’s only 3 sins that are rated the worst that I know of, sin against the H.G., murder of innocent blood, and fornication. All others are pretty minor compared to those. – And fornication I think it much worse when the person has made a covenant to one person.)
Lack of close friends.
Difficult situations.
Mental illness caused by unhealthy living (e.g., poor diet, lack of exercise, lack of sun exposure).
Mental illness caused by genetics/environment (e.g., drugs use, poor living conditions – like poor air quality, etc.).
Belief that more is required of them than what truly is.
Lack of productive hobbies. (Spouse needs to let the other spouse out to do things.)
2. Exercise, good diet, positive hobbies, service, and healthy friendships would be the first thing to search out. Then a psychiatrist. Then mind altering drugs (depending on the severity). But above all else that I’ve mentioned is a deeper understanding of the atonement of Christ in our lives. I think most people don’t understand Christ well enough and should search and ponder what he has done for us.
3. Friendship, hardship is temporary, perspective, masturbation (is common and can be mastered with time), sins aren’t as bad as you believe and you can overcome, seek for guidance from parents/bishops/good role models and how bishops won’t judge your actions but will help you overcome your sin/hardship, seek Christ and charity in your life.
I think most professionals do credit genetics as contributing to a pre-disposition to depression. What seems to be missing is the idea that genetic influences can be so dominant as to cause a disorder that cannot be handled simply with adjustment skills, proper thinking habits and mental fortitude.
I don’t disagree of course with the proposition that all sorts of temporary and relatively mild depressions have what are essentially situational or mental causes, often (of course) with genetic pre-dispositions. Easy to treat using standard techniques, likely to be gone or mitigated in months. It is the “hard”, severe cases that I don’t think are appreciated very well, at least as to ultimate or dominant causation.
It might rather be evidence of an unusual degree of mental fortitude in addition to pharmacological treatment that some people manage to continue as functioning individuals at all. The problem is that there is no easy way for a third party to tell. It is like A causes B, therefore A is the only cause of B. QED.
Two professors at UVU recently ran some numbers at UVU Health Services and did a campus wide survey and found that the number one predictor of depression were feelings of needing to be perfect. In fact, they found that they could accurately predict likelihood of a formal depression diagnosis without using DSM criteria simply by using statistical analysis on answers given on the survey. Ethnicity, gender, etc, were not significant in their regression model.
This rings true to me. As a missionary I was very concerned with how my personal righteousness was affecting my work. I was, in a word, depressed. It wasn’t until nearly halfway through my mission when I told my mission president. He responded by telling me that my personal righteousness had nothing to do with the success I was seeing as a missionary, and that very honestly changed my life. The burden of perfectionism was removed from my shoulders and I finally started enjoying my mission.
I’ve also seen studies that indicate that depression may be tied to learned helplessness. Rats who have been subjected to electric shocks without an escape will give up. Even when they are presented with a way out later they will lie down and accept the shocks because they’ve learned that they cannot help themselves.
Genetics are important, but with depression climbing in such huge numbers (all over the world) I think that genetics as a significant contributor to most people’s depression is unlikely (unless we’re all designed to be depressed by default, which I find even more unlikely). Even contributing depression to an irregular flow of neurochemicals is hard to show (in fact, some recent research suggests that antidepressants don’t actually seem to work very well, if at all). So, yes, for some people there surely is a genetic component, but for most people that just doesn’t seem to be the case.
Great Great Topic and Post!
I have a member of my family who suffers from depression and is on medication. Her opinion is that the more she speaks about it with those she knows well (not announcing it in Relief Society) the more accepted it will be.
It’s one of the benefits of the openess that has accompanied post-pardom depression, the more women that talk about it, the more likely others that suffer from it will be willing to seek help.
Very good post, Adam. I wanted to comment on one particular line, the first one:
“Many in the LDS church (although I imagine this is a problem in other faiths) believe that if they are depressed, it must be due to their own personal unrighteousness.’
This is pretty old world thinking, but like many things in the Church (and society), old thinking dies hard.
I think there is a big difference between a true clinical depression situation and a lot of what is called depression these days. In other words, some folks really have a problem which is chemical in nature and others use the word “depressed” when they mean sad. In this new self-absorbed world we live in, people compete for who can be the most “depressed” ignoring the fact that there is real clinical depression out there. Which needs to be treated like any medical condition. We have real world experience with that around here, and it is a real challenge for the person suffering and their family and loved ones.
In your discussion to the adults I hope you include the prevalence,symptoms,and indicators of Post Partum Depression(PPD). This is often overlooked in Mormon culture as we assume that the birth of a child is always a joyful time.
My PPD got worse with each child, so that by my last it was a deciding factor that having more was too much of a health risk to myself and my family.
I was extremely hesistant to discuss PPD with many people from the Church because they were so judgemental, mostly due to lack of education.
Also, medication is not a weakness if it helps control an illness. If you have diabetes would you refuse insulin because it’s a sign of weakness and you can “overcome” the disease if you fast and pray more? Depression is also disease.
It’s significant to mention PPD in a joint meeting because it was my husband who first noticed my symptoms and supported me in getting treatment.
1. Constant emphasis on worthiness creates feelings of guilt and inadequacy. Fear of admitting fault causes shame and self-deprecation. Emphasis on perfection and worthiness decreases likelihood of discussing personal struggles.
2. Lay out the statistics above! If you had 15% of the congregation stand to demonstrate how common this problem is, it could go a long way in helping people be more open and welcoming to discussion of the issue.
3. Youth will have an even harder time asking for help than adults will, because they have less privacy when it comes to medical issues. A child cannot go to a therapist on their own; their parents will be the one who determines which therapist to go to and whether or not it’s worth they money. Telling kids that it’s okay to ask for help is so important. Telling them that there is nothing wrong with them if they struggle with this problem is even more important.
Depression does not make you broken; it is permanent for some and temporary for others. If you had a broken arm, nobody would think of you as disobedient or unfaithful for going to get a plaster put on it. Likewise, depression is a medical condition. Only good comes from seeing a professional to treat it.
I agree that this is a big problem, even in the Church. In a recent conference talking about health issues in Utah, the number one medications paid for by Deseret Insurance (the health insurance arm of the Church, covering church employees, etc.) are anti-depressants. Utah is also among the highest per capita use of anti-depressants in the United States.
I haven’t seen any correlation to a specific factor. Is it something related to the Church? Is it related to having better health care? Is it something related to the genetic predisposition to people living in Utah? I don’t know.
On a purely anecdotal level, however, the Church has caused feelings of discouragement and inadequacy in my own life. Examples leading to this:
“I, the Lord, am bound when ye do what I say” implies that if we do what is “right”, the Lord is “forced” to give us blessings. Therefore, if we don’t have the blessings, there is something else we need to do. Faulty logic, but understandable.
The Church is also very demanding on our time if we truly do EVERYTHING recommended: daily scripture study, multiple prayers with and without family, home teaching, family home evening, callings throughout the week, social events on weekends, multiple meetings on Sundays, genealogy, making time for the temple, talking to our neighbors about missionary work, writing to the missionaries, etc. Add this to the burden of a job and a spouse and children and life and it can be overwhelming.
So, at least for me, the Church has at times been a factor in feelings of inadequacy. I am much better now, however. Instead of a relationship to the Church as an institution, my primary focus is on a relationship with God, with the Church merely one tool to help me in my primary focus. I am still active. I still hold a TR. But I don’t worry about all of the programs and minutiae any more. I go to what I helps me personally, but really don’t worry about missing things any more. I’m much happier and much more at peace.
There have been some very interesting comments made in regards to the cause, with a lot of people who seem to side to with either the biological or environmental camps of psychology. While I feel both can be necessary elements in the causation of depression I feel that neither is sufficient to explain it in it entirety, but that is my hermeneutic side coming out. I think there are some that are given depression as part of their life trial. In the psychology world we seem to think that all suffering is bad and should be ended, but we only have to look at Christ’s life or any of the prophets, ancient and modern to see that sometimes it is our lot to suffer. Now don’t get me wrong I am not trying to wax Stoic, and that nothign should be done to help; having watched both my wife and mother suffer with this I know that the suffering can be unbearable. But understanding that some suffering can be for our growth and is given to us to help us turn to the Savior, not because we are unrighteous or need to repent, but that is how a Father who sees the end from the beginning, knows how best to help us grow. Now again this is not sufficient to explain it, but is rather another possible reason.
2. There have been a lot of good things mentioned above, something I think that would be helpful is to discuss what I have heard called depression fallout, how spouses and kids can deal with a depressed family member, because its hard for them too. Its easy enough to remain a good friend, but let me tell you it is not fun seeing your spouse fall apart and being totally powerless to make them feel any better.
3. I would say same as above that I gave for #2
I’m not sure how I feel, either.
I just know I have a strange compulsion to keep commenting over and over
to see how small the boxes can get without messing up!
Well, I guess I got my answer! After a certain point, you can’t make any more inline comments, and have to start a new line. I hope I’ve solved the mystery for any of you who were wondering.
A friend has been experiencing severe depression for about 18 months now. She has an amazing career, lots of friends, and cool hobbies, but she is in her 50’s and has never been married or had children. She feels like a lot of her depression is related to these life circumstances. Breaking up with a serious boyfriend triggered this episode.
The interesting thing is that she has an identical twin sister who is married and has three kids. Her twin has also experienced several periods of severe depression in her life. Granted, they share the same family of origin, but you have to assume that there is a strong biological component.
I think for my friend, she can assume that being married with kids wouldn’t fix it.
One of the nice things about the twin thing is my friend can try medications that were helpful to her sister, and they can compare which dosages worked best. Having an exact replica of yourself who can tell you about the side effects they experienced with certain medications would be great. Also, knowing that her sister has gotten better and experiences years of feeling good is motivating.
I’ve never seen someone try so hard to get over their depression. She’s exercising a couple of times a day, seeing a therapist, taking meds, and trying to force herself to make contact with friends daily, forcing herself to keep to a routine of getting out even when she wants to stay in bed. She’s doing yoga and meditating, and eating healthy. She even tried attending an out-patient retreat. Some days are better, but still the depression persists. It’s given me a real empathy for how difficult depression can be.
If I’m going to make a comment, I like being able to refer back to the comment number.
Adam
Your post is timely. You must also gear your responses toward your audience skillfully. There is still a lot of misconception about what the systemic causes of depression are. Many refuse treatment. This boggles my mind.If someone had leukemia, they would have no trouble seeking treatment They would take pills and undergo chemotherapy. If you had Diabetes, you would not only loose weight and watch your diet, but you would also take a pill to control it. But for some reason, people will refuse and people look down on you if you admit that you need something to control your brain chemistry. This is something that one has no control over, sure, you can exercise, and eat right, loose weight, etc,
But for crying at loud, if one needs medication for depression please man/woman/ up and take it. Take the medication and hold your head up high. Take the medication and get yourself appropriate therapy. Tell everyone else to please keep their mouths shut and mind their own business.
We can actually change the amount of nesting. It’s currently set to 5 deep (as you found out), but we can do things differently.
Also, you don’t always have to reply to the deepest nested comment. As I have done, I replied to the 4th nest of comments, since the 5th can’t go further. But I could’ve also replied to the 3rd, 2nd, or topmost level.
This is a bit like Inception, without the limbo.
I was actually a little surprised to find out this is still a big problem, even in a “liberal” ward like mine. The RS pres and the bishop assured me that it is rampant. Die Hard indeed.
I agree with you, clinical depression is different from the “blues” or “I’m feeling a little depressed today.” Maybe it’s on a spectrum, but I’ve certainly felt most of the symptoms of depression, but the severe times were never longer than a day or two.
There is also dysthymia, which is less severe but lasts for years, kind of a “somewhat depressed” mood most of the time, on most days of the year, for a few years.
I agree, sometimes mind altering drugs are good – after seriously trying other remedies first, like your friend has. Our bodies aren’t perfect and sometimes we gotta do what we gotta do. Diet seems to be a big factor in a lot of illnesses. Sometimes extreme diets can be helpful, like raw vegan. Not for everyone though, not for me for sure!
Some people like to try natural remedies first. Like diabetes (type II, I believe), no reason to take pills if you’re willing to change your diet, sometimes extreme diet. It’s important to get to the root cause. Sometimes meds can obscure the root causes. That’s why many of us choose to try everything else first and use meds last. Medication does have a vital role in our world but not for everything (some would argue not even for all types cancer).
For the youth fireside:
First: it’s okay and normal to be depressed.
Second: But you don’t have to stay that way.
One question though: are the parents specifically not allowed to attend the “sans parents” fireside? I wouldn’t let my kids attend if that was the case.
I don’t have a lot of experience with depression. I think the longest I’ve been able to maintain a funk is about 3-5 days, and that only after a major breakup or some other outlook-altering event.
I agree that we need to overcome the stigma of depression and allow people to get the help they need. I think teen depression specifically is very worrisome as teens seem to have more ups & downs as their hormones shift and fewer strategies and resources to deal with depression. I would think that very young missionaries (and likewise young soldiers) might be especially vulnerable to depression given that their brains and bodies are not yet done changing and they are placed in trying circumstances. Coping can be extremely difficult for them I would imagine.
I adopted an eating clean lifestyle with Vitamin B supplementation and feel way more energy, less need for sleep. A friend who is a primary care doc has seen some miracles with Vitamin B. Exercise outdoors is a huge mood lifter for me too. The outside part is important.
In any case, seeing someone really grapple with depression has made me appreciate my brain chemistry. Nobody in my family has depression, although frankly if you looked at their lives in light of the gospel, some of them should be freaking miserable! It’s a huge gift that positive brain chemistry.
My wife gets a magazine that talks about clean eating… you’ve enjoyed it?
The bishop told me it would just be the two of us, with the youth over 12. I can see some parents being reluctant, though many kids won’t talk in front of their parents. It’s a trade off I guess.
This is helpful – I will include PPD. Some women develop depression during pregnancy, and feel better afterward as well…
I think my ward is a little “streets ahead” on this issue, with so many young families, professors, and students, but the lack of education and fear of stigma is still a big problem…
I agree – a constant focus on worthiness will result in a constant stream of people who feel ashamed and depressed. It doesn’t turn out that way for everyone, but there is a significant amount who feel like they can never do or be enough to please God or “be” worthy.
Some of the comments I have read here are examples of what you are up against. There is sadness, temporary depression and chronic depression. There are biological, environmental, and situational factors. There are both mental and physical symptoms – and sometimes only the physical symptoms (unexplained, chronic aching or pain, fatigue, among others) may manifest, and life may be fine otherwise.
I have suffered from episodes of depression for 20 years now. From ages 12-21 I was unaware that’s what it was, and so would get overwhelmed and just think I was lazy or inadequate or weak, unworthy, etc (no legitimate reasons for any of it). At 21 with the help of a counselor, we figured it out, but the particular medication we tried didn’t work, so I gave up and tried the “faith and repentance” route.
As I had children, during and after pregnancy, the episodes got worse but for the most part, with diet and excercise and good churchy thoughts I was able to function. During the good times, I could think clearly, I had faith and hope and energy and motivtion, etc. During the down times, my brain was a fog, I would overly focus (obsess) on different things, I would feel constantly tired, achy, sick, etc, and while I still clung to my faith, I lost hope. I could barely function, care for my family, my home, etc. It got so bad, when I stopped being able to distinguish the “false thoughts” as I called them (discouraging, obsessive, paranoid thoughts, etc) from the true ones, I spoke to my doctor again. She suggested a different type of medication, and when we found the right dose it was as if the fog had been lifted, and the sun was shining once again. The last 10 years, even the good times, all seem as if I were under oppressive clouds, sometimes raining, sometimes not.
I am thankful for modern medicine, it has helped me. Some may be helped by a therapist (my sessions were pointless, I was doing all the things they suggested) good nutrition and excercise are key (but if you can barely get out of bed, you need extra help).
I believe in the Atonement, I know He will heal me one day, and I will no longer rely on medication, etc, but that may not happen in this life.
so, to answer your questions –
1) genetic (homonal, too, for many women), environmental (food, chemicals, etc), situational (possibly loss or transgressions by self or others).
2) ETB’s article “do not despair” has some great suggestions, even though it is from a time when medication was less accepted (#11 suggests enduring Satan’s depressive spirit and eventually it will leave you) So I would add seeking counsel with friends or loved ones, a doctor, both primary care and if needed a therapist, but not to be discouraged if these things don’t work right away, they take time, and medicine is a perfectly acceptable option, but not a magic pill… though it can help you take steps to get your life in order if that is what you need to do.
3. Sadness is a part of life, but if it interferes with a teen’s ability to function, and seems to persist, he or she should seek advice. Drugs and alcohol (and immorality) will not make the problems/ feelings go away, but will make them worse.
Man is that he might have joy – the joy will be more sweet after the trials, just hold on, it is worth it.
Someone described clean eating is “If it tastes good, you need to spit it out.” I disagree but I happen to love fish, fruits and vegetables. The less I eat junk, the less I crave it. The hardest thing is spending more time in food preparation. Oh, when I mentioned Vitamin B I was referring to treating people who complain of low energy/chronic fatigue, not a serious case of depression.
My wife had a class in psychology where a graduate student lectured once per week as a teaching assistant. He told the class that psychological maladies only occurred because people were out of tune with the Holy Ghost. Of course, the teacher corrected him, but it’s crazy how common this idea is.
We have plenty of depression in my family — my sibling, my wife’s siblings, several of our kids (maybe it’s my fault…).
I think it’s great that you have a bishop who is concerned about this. Of course your time is limited, so you’ll need to provide enough to allow people to nibble and get them to want to learn more.
We had a therapist do a session at a local women’s conference in our stake. He included the value of talk therapy and medication and talked about how each worked and why.
Clearly breaking the stigma is key.
Why so much in the church? I dont’ know that there is more or not, but rather than blaming our focus on worthiness, which is part of who we are, it might help to talk about how to juxtapose worthiness expectations with the reality of who we are. That’s what emotionally healthy people learn to do over time.
With the youth: when I was bishop we never had parents attend youth firesides with their kids except once in a blue moon and for special topics. In fact adult leaders who attended sat in an adjacent room and were not allowed to speak unless spoken to. All in the name of encouraging the youth to speak freely.
We eat mostly vegan (we cheat with eggs & honey, usually we eat mostly raw up to dinner time). You need B-12, you can only get it from vitamins (you have to be careful of the vitamins since you have to have a certain type of B-12 that the body can assimilate) or meat. I’m not much for vitamins so meat it is. My wife got me into it. I read a nutrition book and other books and thought, yeah, vegan diet is pretty good, with a little meat.
We’re never sick unless we start eating lots of sugary foods (vacation/going out), hard to avoid when people bring to your house and when wherever you go there’s tons of it everywhere (of course, this usually doesn’t affect us to badly). A caveat on the sickness. When we were in UT living along the Wasatch front we would get sick much more often, of course we lived in a basement apartment…so I don’t know if that had anything to do with it, or if it was just the horrid air pollution up there.
My 3 year old has never had ear aches. I think this may be since we don’t eat flour everyday, and when we do its whole wheat. We also don’t eat dairy products. I don’t think raw dairy is that bad for you but the kind you buy at the store is pretty bad since it doesn’t have all the live beneficial organisms that raw dairy has.
Jon
Your attitude is exactly why people who suffer from depression do so silently.
One needs to be careful with natural remedies especially if they have another illness that is the underlying cause of their depression. Hence, that is why I stated that if you don’t agree with a person who is taking medication to help themselves then one should keep their mouths shut because your doing this person a great disservice. If you are not a medical professional then you have no right to tell me not to take the medication. And or there is something wrong with me if I do.
Also, thinking like yours keeps people sicker longer. I’ve had chemotherapy. And I would never tell anyone not to as you are suggesting, And I’m sorry but your advice to diabetics, which I’m not is also ludicrous and dangerous. And I will not comment further
AH, that’s helpful informations, Andrew!
Me, too, Rebecca. I’m liking this nesting thing better now that I’m getting used to it — but I wonder if we can put numbers on the comments as well.
At least the main comments, if not the nested ones.
@Adam F
There is something else you should consider as well and that is the cultural aspect to it. I remember reading Namsi ( I believe that’s what it is called. ) which showed clearly how different cultures deal with or for that matter refuse to deal with topics of mental illness, you may want to take that into consideration in your talk.
I applaud you in your effort.
Also, it’s harder to follow a discussion on a post, isn’t it? To find it again, you have to scroll around instead of just going to the end of the thread.
You can never be sure if you’ve read all the comments, unless you pay really close attention…
Whoa. *Feels contempt*
THAT’s crazy.
Thanks – cultural impact is big, so this is a good reminder. Even among a single ward, there can be quite a mix of cultures. I know that many white men, for example, often “don’t want to talk about it.” Actually, I think that’s even the name of a book about men for dealing with depression.
I once took “Milk Thistle” for my liver, which may have helped… but I’ve never seen any research or even first-hand anecdotal evidence on natural remedies or herbs, etc.
Actually the placebo effect in many cases, even with medications plays a powerful role, in some studies the placebo effect has more influence on the outcome (e.g. relief from depression) than the actual substance of the drug. Placebo includes not just belief in the medicine, but in the doctor (hence the white coats they wear), in the doctor-patient relationship, etc. All of this is important, even just for a pill.
Thanks for sharing that SarahJane. Personal stories help a lot. My bishop is actually going to start off with a story of a family member who struggled with depression. Hopefully that sets things up well.
Sarah jane
You are spot on in your approach. You can do everything right, (eating, exercise, etc)however if your brain chemistry is not right, its’ not right. You were right to go to your doctor and get the help you need.
I wish you continue health and I’m glad you had the support you needed.
St johns’ wart is another natural remedy that is suppose to help. But people who have autoimmune diseases should not take it because it can exacerbate the disease, so use caution.
Now that you mention that, I have seen that around… I’ll have to read into more of this stuff, as I’m sure many of my clients have or are taking some form of herbal remedies.
Adam
Please also stress the importance of a physical check up from a doctor, specifically an endocrinologist. Had my doctor not noticed my thyroid not functioning correctly, I would still be in distress.
I’m sure as as doctor (therapist)you are aware of the literature that shows how the thyroid, supports brain chemistry.
I’m not a PhD yet for a while, just still at a Master’s level, but will be some day! As for brain chemistry, unfortunately my training in that area is limited. I would try to get the client to a medical doctor for sure. I knew a therapist who required all of his clients to get a physical as a prerequisite to having therapy. There are often things that the physician can catch that the therapist cannot or has no business trying to manage.
On the whole, I like what you said. The main point of contention I have with what you stated is this. Having an exact replica of yourself who can tell you about the side effects would be great.
This does not ring true to me. She may have a twin, but they each have their own separate body with their own brain chemistry. Just because the dose and medication works for her sister, does not necessarily mean that it will work for her.
I had to go to my doctors office and get my blood checked to make sure I was at the right levels and then there was a waiting period to let the medication get to the right levels in your blood stream.
I don’t really buy this argument. Being a good person and following the commandments as best we can is an ultimate benefit to us and those around us. How we feel about things is simply a choice, so we have the power to chose to ignore whatever we want.
If you understand the gospel and its purpose, then you can put the “constant focus on worthiness” in proper perspective.
The main message is try your best, we all fall short and to repent and try harder. Perfection may be the ultimate goal at some point, but obtaining is is a lifelong (and perhaps beyond) journey.
I don’t see how you can blame the Church if some folks don’t get the message right.
“How we feel about things is simply a choice”
Agree to disagree? This is putting the blame back on the person doing the feeling. Emotions are often not a choice, in my experience. I should also add that what happens between people and between people and institutions is really a key that people leave out. They want to blame the church (as you said) or blame the individual (as you imply should be done sometimes) when the real problem is something gets lost in the middle.
If some folks don’t get the message right, I agree, it may be “their fault” as you imply. However, when something like this is a widespread problem that many suffer from, what good does it do to blame them, when there could be a systemic problem? Perhaps we’re not connecting on what a “constant focus on worthiness” means. Maybe it means something different for different people. For some it is great, for some a challenge, which can be good, but for a significant amount (a minority, perhaps, but IDK) it is crushing.
You just need to let go of your yearning for totality, BiV! 😉
You might want to, but you can’t read ’em all!
I suffered from intense depression for much of my late teens and just about all of my twenties. It was a deep dark depression that made it difficult for me to do anything at times. It would come in waves. I remember feeling so angry when I would be in a Sunday school lesson and people would talk about how being a faithful believing Latter Day Saint would make you happy. I certainly was trying to do that and I darn sure wasn’t happy. I thought it must’ve been my fault. I must be doing something wrong.
Anyway, I decided to take charge of my life and do something about my problem. I got some counselling briefly. I think I saw the counsellor a total of 3 times. I changed my diet. Getting the right amount of essential fatty acids can do a lot for depression. Countries that have fish as a major part of their diets have lower depression rates. I make sure I get plenty of healthy fats in my diet. I eat no processed foods and I eat fish twice a week. I get out in the sun as much as I can and I exercise every morning. I haven’t been depressed in years.
Thanks for sharing that, Lovelyn. This goes out to everyone who has shared personal stories here, including you – is it alright if I read some of these comments in the my lesson in my ward? It would be nice to have some LDS voices, as I can’t really open up discussion from the congregation due to time constraints.
Adam
Can I also suggest something else that has helped me tremendously? I know this sounds ridiculous, but I really think pet therapy works wonders. My doctor suggested to me last November.
I’m actually not allowed to have pets(dogs) in my apartment but because my doctor wrote up a note, my landlord couldn’t refuse. I rescued Beau(shetland Sheepdog/Collie) last December and I can’t tell you how much he has helped me.
Since I’ve had Beau, I’ve lost 56 lbs, because I walk him 4x a day, and because dogs are social in nature he is forcing me to be social. Everyone loves him(including me) He makes it easy for me to interact with people because he becomes the focus. Last Tuesday, I had an anxiety attack last Tuesday, and Beau came and sat in my lap and cuddled with me and then he was like,” momma lets’ go out for a walk,” and felt better after-wards.
Everyone says, I did a good deed by taking him home, but he has already repaid me in words and ways that I can not express. Can you tell that I love him? (not in the least)
That is what I would use to illustrate the difference between a symptom and a cause. The cause is not being told to be worthy. The symptom of depression is compulsive attention to the thought of not being worthy — but it would have a different flavor with different inputs.
Excellent example of the difference between causes and symptoms.
Well, we can agree to disagree. But I think there is a big difference between feelings and emotions. An emotion might be a momentary reaction to a situation not necessarily controllable which may last for a moment or linger, but, to me, a feeling can be a conscious reaction determined over a longer period of time. I am not willing to assign “blame” nor did I use the word “fault here.” I think those words are problematic.
But, for folks not to take responsibility for how they feel about something is giving up their agency to some degree. i can’t see who anyone else can be responsible for another’s feelings. i do admit, this is a highly complex issue.
but
Hmm. Nearly 100% of my great grandfather’s descendants have or had depression (manic, or bipolar- whatever you want to call it). My father and his kids are the only members of the church out of that group. So if it is fair to make in-group comparisons then I have this to say:
A depressed person without the gospel in their lives is better off than they would be without the gospel in their lives. My dad, as a member of the church, was able to make positive life choices, and be reasonably stable to a far greater extent than other members of his family. Attempting to live the gospel helped to mitigate the symptoms of his depression.
A depressed person with the gospel in their lives is still a depressed person. My dad went for years without treatment. When he finally did get treatment the change was drastic, not just for him personally, but for the whole family.
Also, because my siblings and I saw the positive effect treatment had on my dad we have all been proactive about seeking treatment when it is needed. The positive effects of seeking treatment quickly cannot be overstated. My dad will be on pills for the rest of his life- in large part because he spent so much of his life without it. Most of us kids have only needed medicine for a few weeks at a time.
I am largely able to manage it through lifestyle- something I attribute to early intervention.
ahem: A depressed person with the gospel in their lives is better off than they would be without the gospel in their lives.
Sorry, I did not read all of the posts & freely admit this may have been said, but….
One of the biggest concerns in mental health is “stress.”
My approach to treating is tripartite. In treating (depression) I try to address 1) the biochemical or genetic aspect. We are different. We respond differently to stress. The most prudent approach for this aspect is medicine. Find the right one(s). There is no “moral fault” in one’s genes.
2) Situational aspects. There are situations in life that produce stress. Some we can change. Some we can’t. This is where I encourage patients to change what they can (move, get a new job, change their major,etc.) and work on developing coping skills when they cannot change something.
3) And this is where I think many treatment professionals fall short; Personal choice. When we make bad decisions; when we go against our personal values, we feel stress that can manifest itself in (depression). The options are to validate the value set (some expectations are tyrannical) or to “be obedient” to them. I encourage patients to honestly examine if they are living the standards they should be living. Many times the “perfection” standard is the problem, being unrealistic. Sometimes it is a moral flaw. But, they must discover those things for themselves.
When you’ve got those 3 “in balance,” “good” mental health is typically the result.
Another sorry.
I have never found anyone who was less depressed by being disobedient to true principles and doctrines that they had internalized to be their own values.
I have to say that I think the term “mind altering drugs” is more than a little pejorative when applied to a medication as benign as a typical anti-depressant. “Mood altering”, perhaps.
However, anyone who _really_ needs anti-depressant or anti-bipolar medication doesn’t need it so they can feel better about themselves or have an artificially elevated mood. They need it to remedy a fundamental and severe chemical deficiency of often unknown origin. I would say in general that anyone whose brain hasn’t practically ground to a halt in the absence of treatment has yet to experience what the most severe cases of depressive disorders are like.
There are individuals who if they cease medication and go about their ordinary lives with ordinary habits and behaviors will become incapacitated within ninety days. Without modern pharmacology such individuals would be basketcases, and no amount of positive thinking, diet, or exercise can change that, even if all are helpful on the margins.
If he/she has a proper understanding of the gospel, absolutely.
A serious vitamin B deficiency can cause a serious case of depression. A simple blood test can rule that out though.
This time of year the days are getting shorter and therefore there’s less sunlight. I have trouble with SAD and using a Verilux light box
really makes a difference in my energy level.
I have depression, my dad did and so did his mother, as do cousins of mine–it is genetic much like diabetes or needing eyeglasses.
I also take antidepressant meds. year round.
The B vitamins, the natural alternatives,
no sugar, and what I ate made no difference.
I always PMS and then it got worse after childbirth and became full blown depression.
Progesterone also did nothing for me.Nor did
exercise or praying or positive thinking. This is a chemical thing in the brain.
I generally agree with Jeff here, although the term “feeling” is a bit ambiguous. One symptom of untreated severe/clinical depression is the inability to “feel” a variety of emotions with any degree of intensity. But that does not mean that such individuals do not have strong, experience driven “feelings” about a variety of subjects. The problem is that they don’t “feel” their feelings very well. In other words, feelings without (or with very little) internal perception of emotion.
This is a semantic debate, but in general I would say that a feeling without a subject is perhaps not best referred to as a “feeling” at all but rather an “emotion”. In Adam Smith’s day they used the term “sentiment” instead. An emotion, on the other hand, is a sensation, that can be entirely context free. One can suddenly experience various emotions without any obvious causation, mental or otherwise. But most “feelings”, like all “sentiments” have an object, i.e. they are about something.
Any doctor who doesn’t do a thyroid test when presented with a serious case of depression probably isn’t doing his job.
I was in fast and testimony meeting once when someone got up and quoted her grandfather to the effect that anyone with serious depression must be in a state of iniquity.
Too many people (mis)interpret Moroni 10:22 that way, unfortunately. A implies B does not mean A is the only cause of B, let alone that B = C, where A is “lack of hope”, B is “despair”, and C is “depression”, in this case.
I’m not sure what you intend by that distinction. I think my dad (and many of us kids) have fallen into all of the misunderstandings of the gospel mentioned here in this post (trying for perfection, believing that sin caused our depression, etc. ). While those things certainly didn’t help, we would have found similar pitfalls if we were LDS or not. However, we weren’t drinking away our problems, or doing drugs. We made ourselves get out of bed and go to church functions. We had home and visiting teachers who visited our homes, making us clean up our living spaces and actually talk to someone. We had callings and people who depended on us for them so we couldn’t just let it fall to the wayside. Everytime we moved someone checked in on us.
Just going through the motions of being publicly mormon can be highly beneficial in counteracting the effects of the kind of depression we deal with in my family. I mean I look at my cousins and see where they are- jail, drug addicts, long strings of terrible relationships, homeless, unemployed, kids taken away by the state- simply going through the motion of being Mormon, even with the imperfect understanding of the gospel, helped keep me and all of my siblings away from all that. That’s nothing to shake a stick at.
Well, it’s understandable to feel depression if you feel guilt over “unrighteousness” or the consequences thereof.
What is sad is that many members who seem to have little if any issues nevertheless have embraced the “Dark Side”. There’s always a dark cloud behind every silver lining for them. They blame themselves for their ill feelings.
Part of it comes from the pontificating, self-righteous, get-up-on-thy-high-horse attitude that many members, leaders, and even some GAs exhibit. Verily, you’d think by the way they talk they pass not ill wind and their bodily excrement is fit for human consumption! From them, it’s never your leaders, bosses, teachers, spouses, parents, etc that have any fault. It’s ALL YOUR FAULT. YOU ARE NOT GOOD ENOUGH. YOU WILL NEVER BE GOOD ENOUGH.
Raise up impressionable children with this damnable condescention, rarely if ever praise them or give them positive strokes, and never admit that you’re human also and sooner or later you either get a rebel that tells you to shove the Church where the sun shineth naught OR a timid, pathetic soul would meekly extends her bowls and pleads, “please, sir, may I have some more?”
Enuf hyperbole for everyone?
I wish people would study a little about neural interaction, and the chemicals involved. Calling SSRI’s “mind altering drugs” is distorting how they work. If the serotonin cycle is out of whack in you, then you need them.
“Natural” solutions don’t always work, or they have side affects. St. John’s Wort just made me sleepy, probably interacting with the Paxil I take. Pantothenic Acid helps, but just a tiny bit. Ginko did help alertness, but not my mood, and it thins the blood. Vitamin D helps a little, and I would recommend it for SAD, which hits the Northwest & Wasatch front hard. But, it’s not a cure all.
Also, diabetes was thought to be a lack of will in those who have it. Until they discovered insulin, & how it works. Oops. Being sincere didn’t keep people who thought diabetes was just a question of mental will from being wrong.
Starfoxy: Your family sounds like some of my extended family members.
Very well said.
Okay yeah, I think in that sense I would define what you call a “feeling” as a schema, worldview, attitude, etc.
What I mean by “blame” or “fault” is really only attribution. When one says “it’s up to them because they have agency” that means one is attributing the cause onto that person. My point is that there is more to agency than the individual, which is also the post I did a while back. There is also collective agency, and proxy agency – i.e. no one is fully agentic for everything in their lives. We have to rely on others and on systems.
While not speaking specifically on the topic of depression, I generally think the idea that more personal righteousness/obedience = more happiness is problematic in many ways. Mostly, though, it’s a result of comparing ourselves against some “favor line.”
This “favor line” basically suggests that the more we “do,” the more God “loves” us. And, when we fail (as we all do) we usually take that to mean that God no longer loves us or, if we believe He still does, then our unworthiness decreases His love. Some GC talks in the past have actually perpetuated this belief.
I’ve linked to an article in my name which contains a chapter from a book of a non-member, but one who, I feel, has a fantastic grasp on the issue of the “favor line” and God’s love.
It’s my belief, ultimately, that tapping into God’s love (which is always there) is what will ameliorate the depression we may feel. Performance based righteousness will never get us there.
While not speaking specifically on the topic of depression, I generally think the idea that more personal righteousness/obedience = more happiness is problematic in many ways. Mostly, though, it’s a result of comparing ourselves against some “favor line.”
This “favor line” basically suggests that the more we “do,” the more God “loves” us. And, when we fail (as we all do) we usually take that to mean that God no longer loves us or, if we believe He still does, then our unworthiness decreases His love. Some GC talks in the past have perpetuated this belief.
I’ve linked to an article in my name which contains a chapter from a book of a non-member, but one who, I feel, has a fantastic grasp on the issue of the “favor line” and God’s love.
It’s my belief, ultimately, that tapping into God’s love (which is always there) is what will ameliorate the depression we may feel. Performance based righteousness will never get us there.
I think the causes of depression are the same whether within the church or without. I have a number of people close to me who suffer with this illness and a couple within my family as well.
I think there are many factors that can contribute, but there is usually always a trigger. Something that tips the balance and sends you tumbling into that abyss. Often the feelings of being totally overwhelmed are the precursor. In my experience, feeling that everything is out of control was the overwhelming sign that things were not right.
I don’t know that factors within the church make that better or worse. It could happen regardless of the circumstances. Medication can help restore balance and reduce that feeling of things spiralling out of control to allow people to feel some measure of ‘normal’.
But I do know that the number of people here in Oz with depression is increasing steadily as well and its an issue we all have to deal with given its prevalence.
Depression is caused by many things physical.
Many things physical, such as lack of exercise, overeating, addictions, etc. can be caused by sin, the subtle as well as the sensational. Sometimes it’s part of being in a fallen world. Obedience helps us get closer to God, including obedience to prayer, fasting, and temple worship. These things can help us combat physical problems or spiritual problems. We can be lifted above the din of depressions very many times with sincerely turning to the Lord. Sometimes we need extra help if our brains are too wired for depression or anxiety (my malady). All I know is that close I am to God, the less my anxiety impacts me.
Tell them your Grandmother Fisher was among the greatest of women and mothers and she battled depression for 40 years of her life including multiple series of electroshock therapy. Nothing to do about obedience or the lack thereof, absolutely nothing. Her son and her bishop says so! What an honor it was for me to ask her the questions to renew her recommend. She insisted that I ask them because it was her privilege to answer them faithfully.
1. I’ve been diagnosed as bipolar II.
What I’ve experienced is that when I got into a negative thought pattern, those thoughts were validated by the ideas taught at church. I clearly wasn’t perfect. I clearly could be doing more. Therefore, I was an evil person, not worth anything and probably didn’t deserve to live because I was hurting my family by being so depressed and not able to serve them the way a good Mormon wife and mother would. I was caught in black and white thinking.
See the trap?
And then, you get the talks about how sin makes you depressed, and since everyone sins, I clearly deserved to be depressed. And it makes it extremely difficult to get out of that hole and feel like I deserved help.
And it was ridiculous, because my sins were tiny and small. Never sins that should make me feel that way. I was sick. My brain wasn’t working right.
So, I think there are genetic factors (depression and bipolar disorders run in my family) and then there are probably people who aren’t happy because they are committing grievous sins that go against what they know, and then there are probably people who are happy committing those sins and then there are people who get a lot of joy from trying to live they way the church wants them to live. For me, I constantly have to reframe the perfection message I get at church.
By the way, I’m doing a lot better now. When I got some help in the way of therapy and some drugs (still working that part out) and finally got to the point when I could accept that God loves me, just as I am now, I have healed in amazing ways. It took 9 years to get there though.
2. I would focus on some of the biological factors, etc that have been mentioned. I would also say that there is hope and that we don’t need to be perfect or even try for perfection–that God loves us and accepts us and that we are enough. If we know that and believe it down to our core, than our behavior will flow naturally from that knowledge. We will be transformed.
3. I would make sure they know about suicide hotlines that are confidential. I also love the idea that it gets better.
Thanks for the comment Claudia. I think there needs to be a clear distinction for “feeling bad because of sin” and “feeling depressed.” We have been told (and it makes sense) that doing bad will make you feel bad. (Obviously, what constitutes “bad” is different from person to person, but that’s another post.) However, people seem to interpret that to include things like clinical depression.