Stephen Education Series Depression Care

1
Stephen Education Series Depression Care

• Learning to Walk from the Darkness of Depression
  into the Dawn
• TE John Kuebler, Pastor of Congregational Care
  and Counseling
• RE Mark Hogan, Stephen Leader

2
Overview

• What is depression?
• Signs and symptoms
• Psychological and Physiological
• Transitions back--coming into the dawn
• Delivering Care

3
Facts

• It is estimated that 17 million Americans have
  suffered mild, moderate, or severe depression
  during their adult life. About 5 will experience
  severe depression.
• One in five women will experience moderate or
  severe depression.
• Women are nearly twice as likely to suffer
  depression than men.
• http//www.wrongdiagnosis.com/depression

4
Facts

• If a person suffers one major depressive episode,
  he or she has a 50 chance of a second episode.
  If the individual suffers two major depressive
  episodes, the chance of a third episode is
  75-80. If the person suffers three episodes,
  the likelihood of a fourth episode is 90-95.
  http//www.medicinenet.com/depression

5
Facts

• Children can experience depression.
• Adolescents who experience severe depression are
  likely to have further episodes of depression
  throughout life.
• There is an increase in depression awareness and
  therefore numbers in older adults (baby boomers)
  are higher with each generation.

6
Facts

• Postpartum depression (PPD), at various levels,
  is experienced by 1 out of 3 women.
• Medications can help the body to balance the
  imbalance, thus taking medications does not mean
  a lack of faith.

7
Have you

• Have you or someone close to you experienced the
  clouds of darkness and walked a path into
  depression and poured their tears upon your
  heart?
• Have you ever felt stuck in a situation, or
  muddled in your mind, or mired in your emotions?

8
Most

• Most all of us have struggled in various
  intensities with the black clouds of deep sadness
  or depression.
• Psalm 42 1-3, 11

9
Sadness or Depression

• Sadness (blues)
• Walk beyond disappointment moving to regretable
  circumstances expressed in unhappiness, being
  downcast, or grief
• --as one lives with and in a Genesis 3 world
  of brokenness while knowing and developing skills
  to live with the sad fact that something is wrong
  with everything. Nothing is a perfect as God
  intended.
• Nehemiah 22, Proverbs 1413

10
Sadness or Depression

• Depression (Deep Sadness)
• --one whose mind and emotions are very
  heavy, pressed down, and does not pop right back
  up is de-pressed. One who stays flat in mind,
  will, and emotions for a long period of time.

11
Definitions

• A depressive disorder is a syndrome (group of
  symptoms) that reflects a sad and/or irritable
  mood exceeding normal sadness or grief. More
  specifically, the sadness of depression is
  characterized by a greater intensity and duration
  and by more severe symptoms and functional
  disabilities than is normal.

12
Types of Depression

• Mild
• Moderate
• Severe

13
Types of Depression

• Physiological
• Psychological
• Spiritual

14
Manifestations of Depression

• Situation
• Psychological
• Spiritual

15
Situational Depression

• Pressed down by normative situations, a heavy
  heart.
• Hope (thinking) seems elusive, the heart is sick
• Proverbs 1312
• II Corinthians 18-9--Greek word Bareo
  (burdened) meaning pressed or weighted with
  hardships

16
Psychological Depression

• Psychology is the study of the mind as it relates
  to thoughts, will, feelings, and behaviors
  (choices)
• This type of depression is a state in which the
  heart is pressed down and unable to experience
  joy.

17
Psychological

• Those who suffer with psychological depression
  feel trapped underneath a pervasive canopy of
  sadness, grief, shame, leading to hopelessness.
  (The whole person is impacted mind (will), body
  (emotions), spirit (attitude and deep inner
  needs)
• Psalm 552, 4-8

18
Spiritual Depression

• Caused by disobedience to the Word of God (
  Jonah1) lack of trust in God leading, building
  to a sense of dread (Jonah 2) unresolved
  emotions such as anger and unwillingness to face
  the truth and apply the light of the gospel (deny
  or delusional thinking)
• Jonah 49, Genesis 45-7 (Cains anger),
  Proverbs 1012, Proverbs 1417, 29, Proverbs
  2224-25, Galatians 426

19
The Big Question

• Is depression the result of sin?

20
Is it a result of sin?

• No, it is not a result of sin, when you
• --Grieve over normal losses
• --Experience natural deterioration due to the
  passing of years--your biochemistry can change
• Hunt, June. (2008). Counseling through your
  Bible handbook Providing Biblical hope and
  practical help for everyday problems. Eugene, OR
  Harvest House Publishers.

21
Is it influence by sin?

• Could be if
• --suffer consequences of sinful choices and you
  choose to continue in those choices and refuse to
  change
• --dont take necessary steps for healing
  (seeking Biblical counseling, get medical help,
  spend time in the Word, seek relationships with
  other Christians)
• --hold on to self-pity, anger, or bitterness
  and refuse to forgive
• --use depression to manipulate others
• --continually choose to blame God for your
  unhappiness
• --choose to let others control you instead
  of obeying Christ
• Hunt, June. (2008). Counseling through your Bible
  handbook Providing Biblical hope and practical
  help for everyday problems. Eugene, OR Harvest
  House Publishers.

22
Symptoms

• Emotional
• Mental
• Spiritual
• Social
• Physical

23
Emotional Symptoms

• Lowered mood
• Pervasive depressed mood
• Lack of feelings
• Feelings of Anger
• Inability to find positives
• Apathy, unteachable, irritable, judgmental

24
Mental Symptoms

• Slow reaction time
• Repetition
• Mental listlessness
• Ambivalence
• Inability to make connections/memory loss

25
Spiritual Symptoms

• Hopelessness
• Emphasis of the negative
• Low self-esteem
• Feeling cut-off from God often because we have
  withdrawn from human relationships
• Unteachable--you cant really understand what
  Im going through (Self-Isolation)

26
Social Symptoms

• Loneliness
• Diminished pleasure in usual activities
• Risk taking (common in adolescent depression)
• Present but not engaging
• Closing off relationships (rejection of others)
• Isolation (to protect and block help)

27
Physical Symptoms

• Slowing down
• Insomnia/anxiousness/exhaustion
• Pain
• Weight transitions
• Physical change in face
• Weakened immune system

28
Continued recognition

• Mind--self-doubt, worry, rejection of objective
  truth, struggles with reasoning, listing to
  voices and message from the past
• Psalm 1424, 5

29
Continued recognition

• Emotions--acute anger, anxiety, suppressed pain,
  hopelessness, bitterness or avoidance of specific
  feelings
• Psalm 38 8, 10, 13-14
• Psalm 1023-4, 7, 9, 11
• Ezekiel 314

30
Continued recognition

• Will--apathy, unteachable, irritable, judgmental
• Proverb 223
• Body--sleep difficulties, weight shift
  (loss/gain), physical symptoms, headaches and
  pain

31
Causes of Depression

• Losses (actual, imagined, anticipated)
• Anniversaries/birthdays/holidays
• Unreleased anger
• Bitterness
• Feelings of shame (guilt)
• Failure and success
• Stress, Burnout
• Unresolved conflict/unresolved issues in life
• Change in meaning of lifes purpose (conversion)

32
Physical Causes of Depression

• Genetics--some studies show that deep depression
  can occur across generations (those with family
  members suffering from depression are two times
  more likely to develop depression)
• Stress of mother during pregnancy (new studies)
• Illness-- e.g. MS, TB, HIV/AIDS
• Pharmaceutical--oral contraception, combining
  medications
• Oversupply of serotonin

33
Serotonin and Depression

• Serotonin is a neurotransmitter (it impacts
  messages from one area of the brain to another)
• Serotonin is manufactured in the brain but 90 of
  it is in the digestive track and blood platelets
• Serotonin effects the heart, muscles, and
  endocrine system

34
Serotonin and Depression

• Cant measure the level of serotonin in the brain
  so we measure its presence in blood
• Stress and anxiety (drop in serotonin decrease in
  blood) but dont know if the drop in serotonin
  causes depression or depression causes the drop

35
Serotonin and Depression

• Synthetic serotonin treatment (Celexa, Lexapro,
  Prozac, Paxil)
• Tryptophan increases (tryptophan helps build
  serotonin)
• --diet (protein high vs. carbohydrate-high)
• Exercise (even 40 minutes raises mood)
• Sun (Vitamin D) especially older adults
• Gender
• --more women experience anxiety and mood
  disorders
• --more men experience impulse control
  disorder

36
Moving into the Dawn

• Seek out help from a friend, Stephen Minister,
  professional counselor, or CPC officer (2 Samuel
  229, Proverbs 15)
• Begin renewing your mind (1 Thess 516-26)--be
  joyful, pray, praise, be in the Word, be in
  fellowship
• Take off the masks and acknowledge the events
  and issues (Psalm 516, Proverbs 321-21)
• Develop new relational skills--vulnerability with
  accountability build intimacy (relationship)
• Bring your suffering into the redemptive process
  of others who suffer (2 Cor 13-11)
• Seek medical help and take medicine when needed
  (Ezekiel 4712)
• Make a list of Gods blessings in your life to
  keep perspective while suffering (Phillippians
  48, Romans 828)

37
Moving into the Dawn

• Keep a positive perspective by renewing of your
  mind. Martin Luther, Charles H. Spurgeon, and
  many other godly folks have struggled with
  depression. You are not alone. It is up to you.
  If you are lonely--choose relationship.

38
Delivering Care

• Be patient
• Be accepting
• Initiate conversation
• Encourage expression of feelings
• Take things seriously and listen
• Discourage self-defeating behaviors
• Provide physical support
• Instill hope
• Use scripture and God assurances

39
Warning Signals

• Feeling of unhappiness intensify
• Severe withdrawal
• Suicidal ideas or intent
• Distortion of reality
• Depression permeates total life
• Depression has become a way of life
• Inability to identify depression focal point

40
Warning Signals

• Masked signs (host of physical complaints without
  physical cause)
• Obliteration of feelings from language
• Uses manipulation of events or others to remain
  in depression

41
When to refer to a doctor?

• 1st thing is always have a medical check up
• Suicidal thoughts
• Depression has interfered with work, family
  activities, or interaction for more than a brief
  period of time
• 4 or more characteristics of depression have
  exhibited beyond a 10 day period
• Any of the warning signals exhibited

42
How can you help a depressed person?Hunt, June.
(2008). Counseling through your Bible handbook
Providing Biblical hope and practical help for
everyday problems. Eugene, OR Harvest House
Publishers.

• Learn all you can about depression--read books,
  watch videos, attend seminars (Proverbs 2312)
• If suicide is a concern, ask, Are you thinking
  about hurting yourself or taking your life?
  (Proverbs 1821)
• Take all suicides and self-injury threats
  seriously. 15 of those who are depressed
  ultimately kill themselves. (Proverbs 184)
• Be an accountability partners and say, I am with
  you in this, and I wont abandon you.
  (Ecclesiastes 49)
• Initiate dialogue regularly throw frequent phone
  calls and intentional contact. (Proverbs 1621)
• Listen and hear the persons pain. Listening
  affirms the persons value. (James 119)
• Talk about depression. Talking helps remove the
  stigma of depression. (Proverbs 2511)
• Verbally encourage the person sincerely and
  often. (I Thessalonians 511)

43
How can you help a depressed person?Hunt, June.
(2008). Counseling through your Bible handbook
Providing Biblical hope and practical help for
everyday problems. Eugene, OR Harvest House
Publishers.

• Realize the power of touch, such as a hand on the
  should or appropriate hugs and kisses. (1 Peter
  514)
• Play inspirational Praise music to lift spirits.
  Music is therapeutic. (Ephesians 519)
• Bring laughter into the persons life--through
  fun notes and cards, videos, movies, and people.
  (Proverbs 17 22)
• Provide nutritional therapy. (Ezekiel 4712)
• Help the person set small, daily goals that
  require minimum effort, and check on his/her
  progress regularly. (Proverbs 134)
• Enlist help from other family and friends. Be
  specific about concerns. (Galatians 62)
• We may never understand it all, but we know this
• Though he brings grief, he will
  show compassion,
• so great is his unfailing love.
  For he does not
• willingly bring affliction or
  grief to the children of men.
• 
  Lamentations 332-33

44
C-O-N-Q-U-E-RHunt, June. (2008). Counseling
through your Bible handbook Providing Biblical
hope and practical help for everyday problems.
Eugene, OR Harvest House Publishers.

• C Confront any loss in your life, allowing
  yourself to grieve and be healed.
• O Offer your heart to God for cleansing and
  confess your sins.
• N Nurture thoughts that focus on Gods great love
  for you.
• Q Quit negative thinking and negative self-talk.
• U Understand Gods eternal purpose for allowing
  personal loss and heartache.
• E Exchange your hurt and anger for thanksgiving,
  and give thanks even when you dont feel
  thankful.
• R Remember that God is sovereign over your life,
  and He promises hope for your future.

45
The Only Promise that Remains

• When the ground beneath you starts a-shakin'
  (shakin)
• And you forget the place we came from (came from)
• When you're lost and lookin' for you're way home
• You're way home to me
• I'll come out and find you
• When the world around you starts a-movin'
  (movin)
• And you should wonder if I still love you (love
  you)
• If you feel the darkness comin', risin' inside
• I'll make a light to guide you back home
• And after all the sky has fallin' down
• And after all the water's washed away
• My love's the only promise that remains
• When your doubts have got you thinkin'
• Nothing's ever really sacred, sacred,
• And you're afraid you might believe in...
• Believe in me
• And I'll give you a reason

• Cuz the world around us keeps on movin' (movin)
• And there's no doubt that I still love you (love
  you)
• So when you feel the darkness comin', risin'
  inside
• I'll make a light to guide you back home
• And after all the sky has fallin' down
• And after all the water's washed away
• My love's the only promise that remains
• My love's the only promise that remains
• My love's the only promise that remains
• And after all the sky has fallin' down
• (After all the sky has fallin' down)
• And after all the water's washed away
• (After all the water's washed away)
• My love's the only promise that remains, remains.
• Lyrics Justin Timberlake
• From Duets Reba McIntire with Justin Timberlake

46
QUESTIONS?