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by Dr. Bill Gaultiere
Executive Director of New Hope

"I've been depressed since I was nine years old," Veronica lamented (not her real name). "My mother was depressed when I was a child. It seemed she was in a bad mood all the time. I never knew if I'd get a smile or a slap.

"My depression took a severe turn for the worse a few years ago when I had a nervous breakdown at work. At first I fought against going to the hospital and taking medication, but then it came together for me: `This is a biological illness. It's not my fault. I don't care what anybody thinks. I want to be happy again. I'm going to get help.'

"I did get help. I got the medical and therapeutic help I needed and I started improving. I was getting my life back. I could sleep peacefully. Food didn't taste like cardboard anymore. I could concentrate. I could smile again!"

Veronica is not alone. Depression is the most common complaint heard in doctor's offices today. One in five women and one in ten men will at some time in their lives be diagnosed with clinical depression. Many more people become depressed at one time or another in their lives, but aren't diagnosed. Some people are just too embarrassed to admit that they are depressed. They may think that it's weak or bad or sinful to feel depressed and therefore try to deny their feelings. Others have asked for help and been disappointed and so they've gone into hiding. And still others are so depressed that they can't seem to muster up the energy to get the help they need; they don't have any hope that they could ever feel better anyway.

Those who are depressed need to feel better. Depression is serious. Left untreated it is not only painful, but can be disabling and even life threatening when it leads to a suicide attempt. Those who are depressed can feel better. There is hope. Depression can be treated. Like Veronica, those who are depressed can smile again, they can find the pep in their step, they can feel love and peace and joy in their hearts.

Symptoms of Depression:
As with any psychological or relational problem the first step to getting help is diagnosis. You need to accept that you have a problem and understand the nature of your struggle before you can get help. People who are depressed have negative feelings and perceptions about themselves, their life, and their future. They say or think things like:
• "It doesn't matter. Why try to do that? It won't work for me anyway."
• "I feel empty inside."
• "Nobody really cares about me."
• "I'm a loser. I just keep messing things up."
• "I don't care anyway."
• "I'm caught in a long, black tunnel, and there is no light at the end."
• "It's like I'm trying to walk in mud. I can hardly put one foot in front of the other."

People who are depressed also struggle with some of the following symptoms:
• Lethargy, fatigue, general slowing down
• Loss of appetite or weight gain
• Insomnia or sleeping too much
• Neglect of responsibilities
• Lack of concern for personal appearance and hygiene
• Poor memory
• Difficulty concentrating
• Irritability over minor things
• Sudden tearfulness
• Inability to find pleasure in relationships, hobbies, or other activities
• Headaches, backaches, and other aches and pains

Reactive or Biological Depression?
Not all depressions are the same. The key distinction is identifying whether the depression is reactive or biological. Veronica's depression was biological. She had a family history of depression, had been depressed a long time, and her functioning was severely impaired by her depression. She was not only emotionally depressed she was physically and biochemically depressed. She responded well to medication and supportive therapy and has an active and full life today, volunteering some of her free time to help other people who are depressed.

A reactive depression is different than a biological depression. It is a short-term response to a stressful or painful life event. If you've had a loved one die, been fired from your job, experienced a health problem, or been hurt or disappointed in a relationship, then you probably feel depressed. This is a normal and healthy response. When dealing with these emotional heartaches we need a season to grieve. Talking about our sadness with a friend or in a support group helps us to heal. We need to be listened to. We need comfort. If, in this way, we grieve and get support with a reactive depression then in time we will feel better.

If you don't get help when you start to feel depressed then your problem may become more serious. Reactive depressions can become acutely overwhelming or chronic and disabling if you don't get the help you need when you're hurting. How does this happen? Consider Steve's story (not his real name). When he was a six years old his parents divorced. His father moved out of state and remarried, and then Steve only saw him sporadically throughout his childhood. His mother remarried when he was a teenager, but he was reticent to let this man fill the role of step father.

Steve was still depressed about losing his father when I met him in his thirties. He had never grieved. Dad told him on the phone that "Big boys don't cry." His mom was hurt and bitter about the divorce herself and she just got upset whenever Steve tried to talk about it, so he didn't feel safe sharing with her. Tragically, he spent 25 years "pulling himself up by his bootstraps," denying his pain and his needs for support, and trying to be strong and independent. His strategy worked pretty well at work, but not in his relationships. He wouldn't let anyone close to him. He was lonely, withdrawn, and burdened with depression and low self-esteem. When I met him he was having trouble getting out of bed to go into the office. His depression had become physical. Fortunately, he finally did get the help he needed by taking an anti-depressant and entering therapy, where he worked through his unresolved grief over losing his dad and his family unit and took some important steps to turn his life around.

Steps to Get Help for Depression
If you're depressed you can get help like Veronica and Steve did, but you need to work at it. Change isn't easy, but is possible. You can get help for your depression by working through the following eight steps. Start by focusing on the one or two steps that you most need to implement.
1. Get medical help. Consult with your doctor or a psychiatrist to see if you need anti-depressant medication. If you're depression is biologically based, or you have a severe and unresolved reactive depression, then you need medication. Don't fight it get the help you need.
2. Talk to trustworthy people. Talk to your friends, get involved in a local church, find a support group, or consult with a pastor or therapist. Don't stay isolated. You need other people in your life to feel care, joy, and meaning.
3. Grieve your losses. Usually, people who are depressed are emotionally blocked in some way. They have "ungrieved grief." Past losses need to be grieved, whether the death of a loved one, the loss of a job, a relational disappointment, childhood injuries, or some other loss. Jesus described this process succinctly in his beatitude, "Blessed are those who mourn, for they shall be comforted." (Matthew 5:4). Indeed, to share your sadness with a trusted confidante and to receive comfort is the blessing that in due time will heal a reactive depression.
4. Mobilize your anger to take better care of yourself. If you're depressed then you probably have a problem with repressed anger. You may have been violated, criticized, or hurt in the past and accepted a judgment that you are of little value or are "eligible" to be mistreated. The pain of these past injuries then gets perpetuated if you misdirect your anger inward as self-criticism or let it stagnate in a pool of resentment. Instead, you need to mobilize your anger to take care of yourself. What does it mean to mobilize your anger? To mobilize your anger is to get in touch with the anger by feeling it and then harness the energy in that anger and focus it in helpful ways. Let me offer some very brief examples.
   • Talk through the situation with the person who hurt you to improve your relationship today.
   • Write a letter you don't send or talk about the problem with a trusted confidante.
   • With the person who wounded you and in situations similar to that with others, be sure to set boundaries of protection or limits on what you will and won't do.
   • Work on being proactive in meeting your needs by asking for what you need in your relationships and by doing things that you enjoy.
   • Finally, let go of your anger by entrusting justice to God. Tell God how you feel and ask him to deal with the person who wronged you and ask him to help you to forgive.
   
   As the Apostle Paul taught us, "Instead, speaking the truth in love, we will in all things grow up.... In your anger do not sin. Do not let the sun go down while you are still angry" (Eph 4:15,26). Dealing with your anger in this manner will help to lift your depression.
   
5. Think positively. People who are depressed struggle with negative thinking. Low self-esteem, guilt, and hopelessness besiege them. Don't give in to negativity. Discipline yourself to think positive thoughts about yourself, your life, and your future. Meditate on Bible verses that remind you of God's love for you, like Romans 8:1: "There is now no condemnation for those who are in Christ Jesus." (For more encouraging verses see my article, "God's Love, Our Christmas Gift.")
6. Do something positive today. Do something good for yourself even if you don't feel like it. Take a bubble bath while listening to your favorite music. Go for a walk with a friend on the beach or at a park. Write a letter to a friend. Smile to a stranger. Even "little" things like these can make a big difference in how you feel.
7. Pray or write a psalm to God. Powerful, positive, healing possibilities await us when we pray to God about our hurts and concerns. When we go a step further and write our prayers out, like David did in the Psalms, we tap into even greater potential help. In many of his psalms David models a simple, effective format for praying and writing out your concerns. Simply talk to God honestly about what you're experiencing, ask him for what you need, and then remind yourself of God's goodness and past provision for you as you wait on him.
8. Help someone else who is need. Jesus promised, "It is more blessed to give than to receive" (Acts 20:35b). Helping others helps us. Veronica's story at the top of this article illustrates this point. We all need to be needed, to feel significant and to know that we are making a difference. When we help someone we experience the joy of connecting and we learn and grow even as we help.