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Sisters, here is a copy of my lesson on “Overcoming Depression” that some sisters asked me to post. I have tried to include almost everything I said. I must say the cognitive therapy, or positive self talk, has proven to be an amazing tool in my own life in the last couple of weeks. I have found that I am constantly questioning the rationality of negative thoughts and fears I have about trying new things, and going out on a limb. I see it as a huge source of strength for personal change and self development.
Carolyn
“(Wo)men are that they might have joy” - displayed at front of lesson.
Introduce topic:
What is Depression
Everyone feels sad about events that occur in life. We use the word 'depressed' sometimes to talk about a fleeting feeling of disappointment or frustration, but clinical depression occurs when such feelings are out of proportion to any external causes. It is an illness in which a person experiences a marked change in their mood and in the way they view themselves and the world. Depression presents itself in many ways. Sometimes sadness is not the major feature. Many depressed people feel numbness, or a decrease in ability to feel pleasure.
Types of Depression
Major Depression: combination of symptoms which interfere with the ability to work, sleep, eat and enjoy once-pleasurable activities. Often lasts for months.
Dysthymia: less severe, involves long-term, chronic symptoms that do not disable, but keep you from functioning a "full steam" or from feeling good. Sometimes people with Dysthymia also experience major depressive episodes.
Bi-polar Disorder: involves cycles of elation and mania(affects thinking judgment and social behaviour) followed by depression.
PostPartum Depression: mild moodiness and blues are very common after having a baby, but when symptoms are more than mild or last more than a few days, help should be sought.
Symptoms
1. Feeling sad (down in the dumps, discouraged) 1+2 for more than 2
weeks +3 others=D
2. Loss of interest in life ( decreased ability to feel pleasure)
3. Disturbed sleeping patterns (most common physical symptom of depression)
4. Abnormalities in appetite
5. Changes in sexual desire
6. Feeling tired all the time (exhausted for no reason)
7. Trouble concentrating, thinking, remembering or deciding
8. Feelings of agitation
9. Feelings of irritability and resentment
10. Feelings of discouragement and pessimism
11. Feeling worthless or guilty
12. Feelings of inadequacy
13. Brooding about the past (going over and over wrongs in the past,
both real and imagined)
14. Crying more than usual
15. Feeling extremely needy
16. Suffering from physical complaints with no medical explanation
(often constipation, diarrhea, headaches, backaches, heaviness in the chest,
tingling, rapid heartbeat)
17. Increased use of alcohol
18. Feelings of hopelessness
19. Recurrent thoughts of death or suicide
20. Delusions and hallucinations. You can see from this that depression
is a continuum.
We all experience some of these feelings occasionally This is one end of the continuum. Move along the continuum, and the symptoms increase in severity, frequency and duration.
Depression is like any other illness. It may be an illness we strive to overcome for a large part of our lives in some cases. It can be a life-threatening illness. It can have very harmful effects on our spirituality. It can stop us from feeling the spirit. It can make us wonder if Heavenly Father really cares about us. Of course he does, but to a really depressed person, everything is black It can be a hole so deep they cannot even see the light above them. The person who wants to commit suicide does so because he or she cannot see any other options.
The first principle of the gospel is Faith in the Lord Jesus Christ. In Numbers, Moses told the Israelites that all they had to do be saved from the bites of the fiery snakebites was to look at the brass snake Moses held up. This true event symbolises the fact that we today need to look to Jesus Christ to live. He is the way, the truth and the life. He has told us to be happy. Our purpose is to have joy. To some this seems impossible. Everything seems so bleak. Read 1 Nephi 3:7. Sisters, I testify to you that He has provided the way for each one of us to be happy.
There are many people who can help us in a journey away from depression - Church leaders, prophets in scriptures and in modern times, professionals who can help us change thought processes, doctors who can help us in case of physiological problems that could cause depression.
Let us now look at the MANY positive actions we can take to get out of and stay out of depression. Caution: If there is a medical cause for our depression, NOTHING will fix it but medical treatment. Some of the following suggestions will help mild depression, but will be of no use in major depression. If you experience severe symptoms, please speak to someone who can help you. (Refer Community info)
First we will look at the help available to us from professionals. The following is by a sister who wrote an article about her journey from depression called "Learning to Love Myself" in the Ensign. This is what she said of her experience with LDS Social Services: "Turning to professional help was far from easy, but it was one of the best things I have ever done. After only a few sessions, I began an adventure that has encompassed three years of study and hard work, sprinkled with encouragement and inspiration from my Father in Heaven. It has been a quest that I expect will last a life-time: discovering and taking charge of myself." (Louise Brown)
Cognitive Therapy (Self-Talk) - illustration of triangle - thoughts, feelings, actions
1. Our thoughts determine how we feel
Read story by Dr Reitman: You're the last one to squeeze aboard a crowded elevator, but as you begin the slow descent, you realise someone behind you wishes you had waited for the next one. Whoever is back there is digging a blunt object very firmly and painfully into the small of your back. You are too embarrassed to make a scene, so you just stand there thinking "I can't believe this! Who is that inconsiderate moron back there?" Finally the elevator touches down on the ground floor and you step off, whirling around quickly to deliver the dirtiest look you can muster. And there stands a white-haired, sweet-faced blind lady, tottering out of the elevator on her cane. Almost instantly, your feelings change to shame and sadness, and you offer her your arm."
Cognitive therapists work on changing your thoughts and therefore feelings - this strategy is very successful in treating depression, phobias, anxieties. Clients will often be asked to keep a journal, and fill out charts rating their emotions and intensities at different times through the day, and to describe what they were doing at the time they felt these feelings.
If we work on thoughts we can change our feelings. Many depressed people are plagued by the following faulty thoughts: Exaggerating "I just can't get myself to do any work around the house - my whole marriage is falling apart." A wild over-estimation of problems. Jumping to conclusions. Ignoring the Positive: "Sure the dinner party went all right, but I burnt the toast." You only remember the negative events, or view positive events in a negative way. Personalising: "Everybody at the meeting kept looking at me because I'm gaining weight". You think everything revolves around you. Overgeneralising:"Nobody likes me...I'm losing ALL my friends... Nothing ever turns out right." Faulty thoughts are 'automatic' - they leap into your mind unbidden.
The object of cognitive therapy is to "put your life and your problems in REALISTIC perspective". You are looking for the true facts of the case.
Beneath the faulty thoughts are core beliefs we have, such as "I'm worthless."
QUOTE: Marvin J Ashton
There is a natural, probably a mortal, tendency to compare ourselves with others. Unfortunately, when we make these comparisons, we tend to compare our weakest attributes with someone else's strongest.
For example, a woman who feels unschooled in the gospel may take particular note of a woman in her ward who teaches the Gospel Doctrine class and seems to have every scripture at her fingertips. Obviously these kinds of comparisons are destructive and only reinforce the fear that somehow we don't measure up and therefore we must not be as worthy as the next person.
We need to come to terms with our desire to reach perfection and with our frustration when our accomplishments or behaviors are less than perfect. I feel that one of the great myths we would do well to dispel is that we've come to earth to perfect ourselves, and nothing short of that will do. If I understand the teachings of the prophets of this dispensation correctly, we will not become perfect in this life, though we can make significant strides toward that goal.
To overcome these negative beliefs, we must constantly ask ourselves "What is the evidence of this belief or thought?" Look at the facts. "What is the evidence that I am worthless? What facts are there that show I have strengths?"
You might draw two columns, one headed, Recurrent Negative Thought, and one headed Fact-Based Answers. For example, the recurrent negative thought might be " I am worthless." The evidence might be " My children love me, I am an adequate cook, I am a reasonable Sunday School teacher, I have never caused a car accident, etc etc etc."
If in the evidence of Fact-Based Answers column you find another negative thing, look for the evidence of that as well. For instance, if the reason you think you are worthless is because your mother always told you, then ask yourself "Well, what is the evidence of the truth of what she said?" The evidence might be that you accomplished many things as a child, that she said that as a reflection of her own poor self esteem, or you might say to yourself - Because someone tells me something does that make it true? By constantly challenging the negative beliefs you have about yourself, gradually, you will break down these beliefs. It might seem logical at first, but difficult to really believe in your heart. However, as you go through the evidence-finding process over and over, day in, day out, it will eventually sink in.
You might keep a calendar with a timetable jotting down the things you accomplish through the day, with a rating of how well you think you did the task.
The following is from a Social Services Conference. As you listen, see if you can pick out some faulty thinking.
LDS Depression (from LDS Social Services Ogden Area Staff Conference April 15, 1975) - according to the author, Dr Daniel Christenson, the most common depression among the LDS. Things which may lead LDS people to be depressed:
1. LDS people, it seems, are not really encouraged to express feelings unless they are warm, loving, and kind. These feelings are acceptable. "Let us oft speak kind words to each other" etc. If you blow up, you feel guilty. This can make you depressed. If you hold it in, resentment grows. This resentment leads to depression. Solution: find the correct way to express negative emotions.
2. Having a husband busy at meetings and with callings. Being left alone to cope with family problems, children and the whole household. Not feeling supported. She may be resentful about him being away, and then feel guilty about that resentment.
3. The fallacy that if you are living your religion you would never get depressed or have emotional problems. This leads to self-doubt, what am I doing wrong? Worries about the feelings she is experiencing - leads to depression.
4. Wives of bishops and stake presidents may have an extra problem in that they may not feel they can talk to their bishop about these matters because he is their husband.
5. Many people who have problems they wish they could discuss with someone are afraid, because they think "What will they think of me? Will they think I am unworthy? Will I be released? Who else will find out if I do confide in them?"
6. Superwoman complex. We must do everything we are asked all the time, and do it better than anyone has ever done it before. We never say no. We do much more than our share, even to the point of neglecting our family and personal relationships. When things break down at home, we wonder why the Lord would let this happen to us when we are doing everything we can to serve at Church???? We think it must be because we are not spiritual enough. We blame ourselves. We may feel angry. Then we feel guilty about feeling angry. NOTE: This situations are not in harmony with living the gospel. Obviously we just misunderstand some concepts. These problems arise not from doctrines, but from faulty thinking which is a part of the way we interpret the gospel.
COGNITIVE THERAPY MAY NOT CURE DEPRESSION - IT TEACHES SKILLS TO COPE. REMEMBER: TEACH YOUR CHILDREN TO HAVE POSITIVE CORE BELIEFS ABOUT THEMSELVES. TELL THEM THEY ARE GOOD, CLEVER AND KIND. IF YOU TELL THEM NEGATIVE THINGS ABOUT THEMSELVES OVER AND OVER YOU ARE INSTILLING NEGATIVE CORE BELIEFS WHICH WILL LEAD TO LOW SELF ESTEEM AND DEPRESSION
Medical Therapy
Serotonin is an important chemical in our brain for emotional well-being. If our serotonin system is faulty, Serotonin is sent from nerve to nerve. Each nerve has receptors that pick up serotonin. Anti-depressants work by making more serotonin available for the receptors. Interestingly, if we get depressed , our serotonin levels may decrease, which will make us more depressed for longer. Anti-depressant medication can be very useful in short-term depressions, and medication levels may need a lot of adjustment at first. Lithium is the general medication for bipolar disorder. Low-functioning thyroid, or hypothyroidism can lead to depression, and thyroid drugs are prescribed. Medication for depression is like medication for other physical illnesses. If the body is lacking, it needs help.
Read personal experience: I have depression. For many years I have struggled with the fact that maybe I'm not a good person, or I've done something wrong, or I'm lazy. This comes from the statements of people who say "all you need to do is serve someone else", "all you need to do is repent", "maybe you should be trying harder".
These are not true statements. I finally realized that listening to people (bishops, friends, etc.) tell me this was just making me more depressed because I would go out and do service, and it didn't help. I would push myself to the point of exhaustion to do things I simply was not physically or mentally able to do because of my depression. One of the members of a list that I am on for depression is a former bishop. He was depressed while he was a bishop. Now I don't think anyone could say that he wasn't serving enough, that he was being lazy or that he needed to repent of something. He in fact was asked to hold a training session for the bishops and high councilors in his stake to help them better understand what depression is.
My medical doctor is a bishop. He knows that medication is called for. Depression is an illness just like diabetes or asthma. I hope someday that stereotypes will be broken so people with depression can talk about it. And especially so when they go to their bishops, or their relief society presidents, visiting teachers, etc., advice won't be given that is more detrimental to the person.
These are two ways of coping with depression by getting help from professionals. Let's look at some things we can do ourselves. Remember they will not all work for everyone, and severe depression needs professional help.
Live the Gospel as best we can, and "strive diligently to retain the influence of the spirit". Paul wrote in Galatians: "the fruit of the Spirit is love, joy, peace, longsuffering, gentleness, goodness, faith, meekness, temperance." (Gal 5:22-23) "For me, the most important insight in overcoming depression was this. When I hve the Lord's Spirit with me, I have greater joy in my heart whatever drudgeries and difficulties life amy bring.
And praying faithfully - on good days and bad - is a key to making the blessings of the Spirit a more consistent part of my life." Alma 26:27 (Ammon said while on his mission) And when our hearts were depressed, and we were about to turn back, behold, the Lord comforted us, and said: go amongst thy brethren, the Lamanites, and bear with patience thine afflictions, and I will give unto you success".
Read sister's experience:
"I can relate to what Br Stevenson said about the things he's been through. We have a lot of weaknesses. I've had a lot of things happen to me. I have struggled with a lot of depression and anxiety in my life, and sometimes it has been so bad, I have not wanted to live, and have had thoughts of suicide. I have had to really work with these, and have had to fight myself. I know my weaknesses were given to me so I can help others. I know they're a test I have to go through. When I got my calling as Homemaking Leader I was very worried about it. I didn't think I was smart enough to do it. I cried about it and prayed about it because I didn't understand why I had these feelings of anxiety. I was worried I would not be able to do a good job. I had been going to doctors and taking medication for a long time. I don't have to anymore. I haven't for about three years. When I started going back to Church, and doing what I was supposed to do, I just did not understand why I still had these feelings of anxiety. I went to Bishop, and he gave me a blessing. In it, he told me to help my sisters, and put myself into my calling, and it would help me forget some of my weaknesses. I went home that night and prayed. I couldn't sleep, so I thought about it a lot, and decided I would put all I had in my calling and my friends, and I would work as hard as I could, and Jesus helped me. Then I became Second Counsellor in Relief Society, and I was even busier. I love hleping and caring for others. I love giving of myself to help others. It helps me, and I hope it helps them."
In ALL our efforts to overcome depression, prayer is our greatest ally. If we struggle with a negative core belief about ourselves, we can ask Heavenly Father - am I worthless? Am I worthy? Are you pleased with me?
Service:
President Kimball said "We find ourselves when we lose ourselves in the service of others."
Read personal experience
A few years back, while living in dark wet Oregon, I went through some severe personal challenges including severe family trauma that included one child going to prison (which was one thing in life that was waaaaaay harder than losing a child in death) and another brutally raped by a family friend that was well trusted and loved and I had just finished 6 years of school with big student loans and no job and my husband not working and no operational vehicle. What added to our difficulty was a ward that was not loving or supportive, in fact, they were cruel many many times..... Needless to say, I was depressed, seriously. I cried all the time for several months, I stayed in bed most of the day. I didn't bathe often, I didn't dress most days. I guilted my other children and yelled at them, I invited each of them several times to pack their stuff and leave (the youngest was in kindergarten). Occasionally I would get a job interview. On those days I would get up and shower, get dressed and put on makeup and after I came home discouraged I still had a better day. Finally after many months I got a job in another state (New Mexico) with the Indian Health Service and they were paying the cost of moving us and gave me a small advance on my salary. New Mexico is in the sun and out on an isolated reservation where there were 900 members in the branch but only 70 at church on any given Sunday. They waited for white people to come an run the branch for them, and we had to be responsible for providing the church programs for all the children. So needless to say between having to drive 100 miles to grocery shop, run all the church programs and work full time we were pretty busy. After a few months I took stock of myself and realized I was happy again. After spending a lot of time thinking about this I believe my recovery was mostly 2 things. The sun - Looking back I realize that I had some level of depression for all those years we lived in the grey world, and I hadn't even realized it until I was no longer depressed. But the most important thing was being anxiously engaged in a good cause. This is a basic principle of the gospel and is so simple but it is so hard to do. I hope this helps.
However, as we saw in LDS Depression, trying to do too much for others
can have the opposite effect. "Other women's capacities may be different
from mine, but I have learned to compare myself only with myself.
And I have learned the hard way that there is a difference between having
a healthy challenge and being hopelessly overloaded. Recognizing my limitations
has helped me be more creative with the energy I have.”
(Louise Brown, Ensign)
Take Time to Play Relax.
Enjoy. Find pleasure. (Do Pleasure Activity)
Think of three things right now that bring you pleasure - real things that you can do e.g.. look at the start, read a book, paint your nails, drink freshly squeezed juice, brush your hair, dance in your lounge room, eat a special treat. When you have your three, make a mental note of when the last time was that you did them. Make sure you do one thing every day just for the sake of pleasure.
Try to live on day at a time. Don't worry about next week's problems before they arise . Decide what you will accomplish today, and praise yourself when you accomplish realistic goals.
Try to learn to love yourself This involves changing our core beliefs about ourselves. Once we have weighed up the evidence about ourselves, and pushed ourselves to replace our negative beliefs about ourselves with realistic ones, and have focussed on our strengths, we will have higher self esteem.
Repent
Once we have realistically appraised our core beliefs, we have a more honest picture of who we are. If there really are sins that are dragging us down, or serious transgression in our past which we have sorted out, we can go through the process of repentance, and the Atonement take care of it. Once we have repented of it, we need to push ourselves to let it go, and not punish ourselves over it anymore.
Set realistic expectations. We have heard about this already in the Marvin J Ashton quote.
"Adjusting my expectations to a reasonable level was truly liberating. It dramatically changed my relationship to my Father in Heaven and to the gospel. Formerly I had pictured God as a stern, finger-shaking personage who was impossible to please. I had been taught that he loved me, but since I didn't feel lovable I had built a barrier between us that made his love for me seem academic and meaningless. I was so overwhelmed by my distorted view of gospel "demands" and by my own lack of perfection that I could find little joy, comfort, or strength in the gospel - that which should have been my greatest resource. As I re-experienced the gospel from my new vantage point, the meaning and purpose of life unfolded to me with a clarity, unity, and beauty that I had never before imagined. For the first time in my life, that stern-finger-shaking personage was gone - and God was my Friend. He had a smile on his face and had abundant approval and encouragement for me." (Louise Brown, Ensign)
Try not to depend on others for approval "I came to realize that disapproval is an inevitable part of life: because each of us is different someone will invariably disagree with almost anything we do. This frame of mind helped me focus on MY own reasons for my choices and on seeking confirmation from my Father in Heaven. It helped liberate me from needing the approval of all those other people." (Louise Brown, Ensign)
Nutrition
Some foods increase depression, particularly refined sugar and refined flours. Some research has been done, and is available about how our diet can make us depressed. Some foods increase reportedly increase seretonin levels naturally, thus creating the effect of a natural anti-depressant. The book "Naturally Slim and Powerful - the Natural way to boost serotonin without drugs" by Dr Phillip LIpetz discusses this as length. If PMS causes depression symptoms, Evening Primrose Oil may help. The herb St John's Wort has been proven to help many with depression. (Some research shows it can bring on pre-existing cardiac problems) I received several letters from sisters who had had wonderful personal experiences with it.
I have suffered with depression most of my life it seems. At 15 I was struggling and my mom took me in thinking that it was Mono. They could never detect any mono though. Finally, at 18 and tons of medical problems later. (and too many Dr.'s saying it was all in my head) they diagnosed me with Chronic Fatigue. I am tired and depressed on a daily basis. I have tried many "drugs" lots of praying and trying to live close to our heavenly Father to be in tune with my body, etc. With two small children this is a chore, I catch myself yelling and getting frustrated with everyone. My husband who is about as sympathetic as a ROCK, has made it harder on me and so I try harder which makes me more depressed and tired and more frustrated with myself. The answer for me has been to figure what is the most important each day; sometimes it's playing with my kids or watching a movie with them, while I rest. Other days it's laundry, dishes. etc. That is how I go through my week by doing what has to be done and enjoying it. I have found though that St. john's wart is for me, It's natural, cheap (Costco brand is best for me) and really helps my mood swings. If I faithfully take it every morning and every night....I am a nice, fun person. Just ask my husband or mother!!! Depression is a real thing, it is something we need to overcome on a daily basis with the lord's help. We also need to be sympathetic to people who have it. It's not something they've chosen for themselves. It's in our genes. Really, who in their right mind would want to hate themselves everyday?? This letter also shows that it is important to check out other possible physical sources of depression.
Exercise
I do have a problem with depression. It is so hard to overcome. I don't think I have actually overcome it, it is a daily struggle. I take medication sometimes, but most of the time I just try to overcome it myself. I really hit a low though a few months ago. I couldn't quit crying. I woke up one morning and started crying over nothing, and didn't stop for three days. I couldn't go to work, because I couldn't talk I was crying so hard, and I went to the doctor, and they couldn't do anything for me either. They sent me to a psychiatrist. I went, not really happy about being there, but I went. It did help me, and I have been going to him ever since. It is good to talk about things and learn things and try to overcome things.
I just made a huge life style change to try to overcome depression. I dragged myself off of the couch, even though I think I was a permanent fixture on it!!! I got up and started exercising, (gotta lose those extra pounds) and that made me feel good. Now when I start crying or feeling down for no reason, I get up and go for a walk or do breathing exercises. It helps.
When you exercise, it makes endorphins release in your brain, and it is like a natural drug to battle depression. It is hard to explain depression, but it is like you don't know where you are, who you are, or what you are doing and why. I have had situations where I felt like I was in a hole, and I couldn't crawl out. it is an awful feeling. I hate it, and I think it will always be a trouble to me, but I just wake up every morning, and force myself out of bed and tell myself I am going to be happy. Like I said, I will always be battling this thing, but hopefully I can make it and be able to overcome it in the next life. And don't ever tell someone that has depression that everything will be okay. That makes it worse, because I get angry with myself because I don't want to feel this way, but I do, and I can't do anything about it. I try to overcome the feelings of despair and sadness, but sometimes they overcome me. Someone just has to be patient and understanding and just listen at times.
Community Resources
Show and discuss leaflets from local Community Health Centre.
Bear testimony of how much Our Father in Heaven loves us, and how He wants us to succeed, and to be happy, and to return and live with him. Encourage sisters to support each other, and provide a stronger network of friendship.
Finish by reading quote by George Q. Cannon on the Worth of Souls:
Now, this is the truth. We humble people, we who feel ourselves sometimes
so worthless, so good-for-nothing, we are not so worthless as we think.
There is not one of us but what God's love has been expended upon. There
is not one of us that He has not cared for and caressed. There is not one
of us that He has not desired to save and that He has not devised means
to save. There is not one of us that He has not given His angels charge
concerning. We may be insignificant and contemptible in our own eyes and
in the eyes of others, but the truth remains that we are the children of
God and that He has actually given His angels -- invisible beings of power
and might -- charge concerning us, and they watch over us and have us in
their keeping. (_Gospel Truth_, 1:2)