Saturday, July 4, 2015

Addressing Depression from a Religious Point of View

I know depression is a concern to many people. Because I do research in this area, see patients, and am a man of faith I have a certain understanding of some of the misconceptions that exist regarding depression and faith. I have appended to these introductory comments a discourse I gave to a group of parents regarding depression. It was meant to open hearts to seeking help and to empathically approach depression from a stance of faith.

I was asked to talk to you tonight regarding the emotional well being of your children and will also touch briefly on physical health as it relates to the same. As you may know your children were asked what things would be helpful for their parents or leaders to talk to them about, or for their parents or leaders to understand. And a youth committee planned the topics for this evening. Several of the topics requested included: help our parents understand depression, talk about negative self image, talk about self esteem. In other words some of your children are concerned that they and their peers are feeling depressed or at the very least emotionally discouraged about some aspect of themselves. This was a large enough proportion of the youth that the stake presidency asked me to talk to you about this tonight. I was also planning to leave some time at the end for a brief question and answer session, so as I speak if you have a question come up, there will be a chance to respond to a few questions at the end.

A brief introduction to me and why I was asked. I am a fifth year PhD student in Clinical Psychology. One of my principal areas of expertise is depression. Most of my publications have been on depression or anxiety and how they affect the brain. I spend my days seeing patients who are depressed, and doing research on depression.

I want to begin first by discussing some basic information about depression, and then I want to put it into a gospel context and give you some direction about how you can best help your child or youth if they are facing an emotional challenge such as depression or poor self image.

Depression is more than having a bad day. It is a deep chasm. Major Depressive Disorder or MDD, which is what most people think of when they refer to depression, is a period of two or more weeks consecutively in which a person feels down or depressed most of the day nearly every day. Often this can manifest itself also as losing interest or pleasure from activities that normally are interesting or pleasurable. A concrete example of this may be the your son loves basketball, but suddenly tells you that he does not like it any more or that it is not any fun anymore, or that he wants to quit the team. This should be at the very least a sign that something is wrong and should spark some conversation about what is going on. This could simply be that they had a bad day, but you won’t know if you do not ask.

Other signs of depression include sudden loss of appetite, sudden increase in the amount they eat, or big changes in what food they eat. Sudden fluctuations in weight. Inability to sleep, or sleeping much more than is usual for them. I know teens like to sleep, but you know what is normal for you child, and any sudden change in sleep patterns is a warning sign. Another sign is difficulty concentrating or sustaining their attention. Also feelings of hopelessness or helplessness. They are more irritable, short tempered, or aggressive than usual. Difficulty controlling negative thoughts. And the symptoms that seem most scary to parents, feelings that life is not worth living or thoughts of suicide. Most people do not have all these symptoms, but a cluster of a few, which interfere with their ability to function well is what defines depression.

Depression can have a number of causes. Exhaustion. There are a lot of demands on our children to perform and be better and the best at something. When this is too frequent and is not accompanied by unconditional love and support then the stress can become overwhelming and lead to depression. Even if you feel like you demonstrate love and support, it is the perception of love and support that is most important. If your child is expressing that they do not feel like you are supporting them, ask them what support looks like to them or what you can do that would help them feel like they are being supported. And explain what it looks like to you. This frank discussion can be eye opening for both you and your child, and lead to a greater sense of support that can facilitate healing.

Another frequent cause of poor self image and depression in youth, particularly young women are social pressures. There are a lot of falsehoods perpetrated by society regarding how a woman should look. It is important to teach our daughters about good health, but good health is not measured by waist lines, bust sizes, and how much skin is shown off. A sense of self respect, respect for ones body, and the importance of making friends who accept you for who you are, will go a long ways in perpetuating good mental health. There is a reason that divine nature is one of the young women’s values. Knowledge that we are children of God created by him, and that this body whatever its measurements and proportions are, is a gift from our father in heaven, can bring identity and purpose into a youth’s life. We need to teach our children that physical attraction is not the only important quality to seek in others, either as friends, dates, or as spouses. These are lessons that need repeating.  If we teach them young, their expectations for perfection in image will be less, and they will be happier with themselves and others as they see them as more than just bodies, but minds and spirits. In a religious culture where we teach that striving for perfection is ideal, we run the risk of alienating our youth, if we fail to teach them to content themselves with the process of perfection rather than the product of perfection. This bridges both self image, and performance in their school and extracurricular activities. Perfection is the goal not our current state, and societies ideas of perfection are not God’s idea of perfection.

Another cause of depression can be familial or genetic. Depression and anxiety are highly heritable. However, there is no guarantee that if mom or dad are depressed that your children will be, but there is a greater risk of it happening. And the reverse is true as well, just because you have never been depressed does not mean your child will not ever face this challenge. As much as 25-30% of people are depressed at some point in their life. The most common age of onset of first episode of depression is between the ages  of 15-30. Young men tend to have their first depressive episode at younger ages, and women experience depression at twice the rate as men.

The last cause I want to briefly discuss is that when a youth makes a mistake they can feel a great burden. If that burden is left unrelieved it can fester into guilt and depression. I left this for last because I do not want you to have the mistaken idea that if your child is depressed or has a poor self image, or if they are anxious that they have done something wrong. Sin can lead to despair, but not all despair is the product of sin. If you discover your child has made a mistake. Be careful not to dwell in the mire, but direct them on how to get out. Tell them that hope lies in the atonement of Jesus Christ. Trust me they are probably beating themselves up more and are creating more guilt that you can produce with any lecture you can contrive. Give them hope, give them love, give them direction, do not give them guilt.

This brings us squarely into the spiritual aspect of emotional distress. Depression is often accompanied by a sense of helplessness, hopelessness, or negative thoughts about one’s self. Again, I reiterate that we can teach our children to find hope in Christ, to find comfort in prayer and the scriptures. It is through daily devotional activities that we avail ourselves of the spirit. That spirit can comfort, teach, and guide us. Whether we are a depressed teen or a scared parent of that teen. Through our faithful obedience to gospel principles we are given a portion of the spirit to comfort us and guide us. This does not mean we will not struggle, but rather often it means our burdens will seem lighter as we yolk ourselves to the Lord.

A talk I recommend everybody reads is by Elder Jeffery R. Holland from October 2013 General Conference called “Like a Broken Vessel.” In this talk he discusses his own struggle with depression. As a young father he felt overwhelmed. He had overloaded his life with too many obligations and sunk into despair. He found hope in Christ.

Elder Holland also taught us about other great men who struggled with depression: Abraham Lincoln, Winston Churchill, and the Prophet George Albert Smith struggled with numerous bouts of depression. If a righteous upright man like the prophet can be subject to emotional distress like depression, then who are we to expect that we or our children will escape it. It is not something that everybody will experience, but as I said before as many as one in four will experience depression at some point in their life.

We can see other examples in the scriptures: Elijah in despair asked God to take his life in 1 kings 19:4, Job who suffered grave circumstances and the loss of everything he had, was very depressed, but still maintaining hope in Christ.

My advice to you if you or your children face this obstacle is this. To start with openly talk to your children. Discuss their schooling and extra curricular activities. Ask them if they feel they are struggling to keep up. Sometimes it is necessary to cut something out so they do not burn out. If you discover they are depressed, or anxious to a degree that interferes with their ability to function on a daily basis, do not be afraid to seek help. Elder Holland in the talk I mentioned teaches us that just as God expects us to seek medical help for appendicitis, we are expected to seek out reputable people with certified training, professional skills, and good values to treat  our mental illnesses as well. There are a number of effective therapies, and medications that can help in treating depression. For depression, medications and therapies are roughly equal in efficacy and strength. The best results usually come with combined medication and psychotherapy. Therapy; however, continues to be helpful after it ends, whereas medications once they are stopped are no longer effective, and side effects are always a possibility with medications. Two common types of therapy are Cognitive Behavioral Therapy (CBT) which looks at the relationship between thoughts, behaviors, and emotions and teaches structured ways to challenge negative thoughts and rationally work through difficulties. Another is Acceptance and Commitment Therapy (ACT), which does many of the things CBT does, but works form the framework of encouraging an individual to live in congruence with their values and beliefs, and to commit to action that moves them towards their values. If your child is a worrier or has difficulty with self image to the point that it interferes with their daily functioning therapy can also be very beneficial for many of the same reason that it helps with depression.

Exercise is also another critical component to good mental health. When the body is healthy and happy, it is easier for the mind to be as well. When we exercise it releases a number of beneficial chemicals into the brain that elevate mood. It also causes the body to metabolize and break down chemicals produced when we are under stress. Exercise is almost as effective at treating depression as other treatments, and should be a component of treatment. Aerobic exercise or exercise that gets your heart pumping will help alleviate stress and depression. Depression; however, can make it difficult to motivate one’s self. This is one of the critical role that family can play in the life of someone trying to overcome anxiety and depression. To motivate and keep on track doing the actions that maintain good mental and physical health. If your youth is not depressed, but is feeling a bit down, or if they are feeling a bit overwhelmed and stressed, exercise is a great and immediate way to alleviate stress and tension and elevate mood.

I want to stress that not all treatments help every person equally. It is important to work with your doctors to find the right balance for your child to overcome their emotional challenges.

Maintaining good physical and emotional health is necessary to be able to serve an effective full time mission. As we prepare our youth to serve or as we prepare them for life in general it is important to stress good habits of eating, exercise, and taking the time to care for themselves physically and mentally. If they do not take time to be well, the will take time to be sick. Prevention and maintenance is always the best policy. Healing and repair always takes more time and is more costly financially, physically, and emotionally. As your children maintain good healthful habits it will be easier for them to act in confidence and have a healthier perception of themselves. When our bodies are not well maintained we are more likely to suffer emotional consequences, as our mental health is inextricably connected to our physical health.

Lastly you must rely on the spirit to guide you. Be worthy of it’s guidance and you will know how to best help your children in critical moments. Teach your children to rely on the spirit and they will be guided in the critical moments.

At this point I want to bear my testimony to you that Christ is our hope. He is our Savior. He has all power to heal and lift. In the name of Jesus Christ Amen.

Other Good Posts
How do I Work Towards a More Balanced Life 
You Have Your Hands Full: Children and Family Values

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