The unrelenting sadness
and hopelessness that characterized my experience with depression is something I will
never forget. In the grips of depression I often felt paralyzed, not possessing the
strength to rise from bed or even to open my eyes in the morning. I felt completely alone,
unable to make contact with anyone, not even Almighty God. I lost interest in life and the
things that make life special. I became reclusive and withdrawn, not wanting to be with
friends I alternated between insomnia and exhaustion. I couldn't concentrate. And always,
I felt inexplicably sad. Nothing made me happy. Most frightening of all, I made intricate
preparations for my death. (1)
This year, 17 million Americans will suffer from depressive
illness. In 1988 the General Accounting Office estimated that up to half of the homeless
suffer from chronic psychiatric disorders -- many also addicted to alcohol and drugs. (2)
While severe forms of psychosis are readily recognized, depressive disorders, which are
more subtle, can be overlooked as factors that prevent program participants from moving
forward in recovery.
People with a depressive illnesses cannot simply "pull
themselves together" and get better. Without treatment, their symptoms can last for
weeks, months, or years. Depressive disorders include; major depression, dysthymia (a less
severe type of depression), and bipolar disorder, formerly called manic-depression. People
with bipolar disorders have alternating cycles of depression and elation (or mania). In
the depressed cycle, they experience many of the symptoms of depression; persistent
sadness, feelings of hopelessness, pessimism, insomnia, fatigue, thoughts of death or
suicide, difficulty concentrating, headaches and digestive disorders. Symptoms of the
manic cycle include; inappropriate elation or irritability, grandiose notions, increased
talking, disconnected and racing thoughts, markedly increased energy, poor judgment and
inappropriate social behavior.
While often inherited, depressive disorders occur in people with
no family history of problems. Genetic, psychological, and environmental factors all
contribute to the onset of a depressive disorder. A serious loss, chronic illness,
difficult relationship, financial problem, and unwelcome change in life patterns (like
becoming homeless) also trigger depressive episodes. The root cause of these illnesses is
usually physiological, having too little or too much of certain neuro-chemicals,
especially the compound called serotonin.
Specific Suggestions for Helping Residents with Depressive
- Evaluation from a Medical Professional - This is
important because certain medications and health problems cause symptoms of depression.
- Get the Proper Treatment - This usually involves a
combination of antidepressant medications and psychotherapy.
- Monitor Their Medications - Though not habit-forming,
antidepressant drugs must be carefully monitored. People suffering from depressive
disorders often forget their medications or stop them taking without consent of a doctor.
For bipolar disorder or chronic major depression, medication may have to become part of
- Provide emotional support -- Provide lots of
understanding, patience, and encouragement. Be a good listener and remind them that they
will feel eventually better. Don't expect them to take on a lot responsibility or make too
many decisions until after the depression has lifted. Watch for remarks about suicide and
report them to their therapists.
- Engage Them in Constructive Activities - This could
include taking walks and participating in activities such as hobbies, sports, and
spiritual activities. While they need diversion and company, too many demands can increase
their feelings of failure.
People can recover from depressive illnesses, if they get the
right help. Here's how one person describes his own recovery:
I am able to maintain my sanity through prayer, studying the
Word, honest sharing with close friends, the support of both a counselor and a pastor,
regular exercise, good eating habits, and an antidepressant drug which boosts my serotonin
levels. None of these things by themselves was enough, in my case, to create balance in my
emotional life. But taken as a package, they have each played a part in the restoration of
my sanity and in making me a strong and productive part of the body of Christ. (3)
Much of the information in this article came from "Plain Talk
About Depression" NIH Publication No. 94-3561 by Marilyn Sargent, Office of
Scientific Information, National Institute of Mental Health National Institutes of Health
Printed 1994. It is found at the NIMH WWW site http://www.nimh.nih.gov/.
D/ART/Public Inquiries National Institute of Mental Health Room
7C-02 5600 Fishers Lane Rockville, MD 20857 1-800-421-4211
National Alliance for the Mentally Ill 200 North Glebe Road, Suite
1015 Arlington, VA 22203-3754 (703) 524-7600; 1-800-950-NAMI
National Depressive an Manic Depressive Association 730 N.
Franklin, Suite 501 Chicago, IL 60601 (312) 642-0049; 1-800-826-3632
National Foundation for Depressive Illness, Inc. P.O. Box 2257 New
York, NY 10016 (212) 268-4260; 1-800-248-4344
National Mental Health Association 1021 Prince Street Alexandria,
VA 22314-2971 (703) 685-7722; 1-800-969-6642
(1) Missionary Charlie Lehardy's
experience with depression as shared in STEPS magazine, quarterly journal of
the National Association for Christian Recovery
(2) A Nation in Denial, Alice Baum and Donald Burnes,
Westview Press, Boulder, CO, 1933