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Everyone feels blue now and then, and certain life events can leave you feeling down for quite a while.  How do you know if you’re just sad or if it has crossed the line into clinical depression? One simple evaluation tool is whether you can identify something in particular that is evoking the sad feelings.  Clearly if you have lost a loved one, sadness and grief are normal and  appropriate feelings.  Has there been a conflict, a disappointment, a betrayal that is bringing on the sad feelings?  With just sadness, the affected person can generally  still feel joy about other events in life.

Depression on the other hand tends to be more non specific and although it may feel a lot like sadness, it is usually harder to identify a specific trigger.  It is often described by more of a feeling of numbness and it is usually all encompassing.  There is little energy, motivation, or ability to enjoy previously enjoyable activities.  The depressed person cannot just “snap out of it”

The DSM IV identifies some specific characteristics of depression that must be present for a 2 week period and represent a change from previous functioning.  At least one of the symptoms must be diether depressed mood, or loss of interest or pleasure.

•Depressed mood most of the day, nearly every day. An individual may express feeling sad or empty, or others may observe it (ex: appears tearful). Children and adolescents may exhibit irritability.

•Markedly diminished interest or pleasure in all, or most, daily activities most of the day, nearly every day

•Significant weight changes (ex: a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day

•Insomnia or hypersomnia  nearly every day.

•Psychomotor agitation or retardation nearly every day.

•Fatigue or loss of energy nearly every day.

•Feelings of worthlessness or excessive or inappropriate guilt nearly every day.

•Indecisiveness or diminished ability to think or concentrate nearly every day.

•Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

Many depressed people don’t recognize that their depression is an illness.  The brain is an organ just like any other organ in our body and it can become ill.  However because the symptoms of depression are so emotional in nature, people often feel embarassed to ask for help or think they should be able to get over it.  I have noticed that Christians sometimes feel like they are letting God down if they are depressed as if this is a failure of faith on their part.

If you are feeling depressed, it is important to get help.  Psychotherapy and medication together have the best results in helping depression.

If you are fairly certain that what you are feeling is sadness, it is still important to reach out for additional support as you walk through it.

Here’s an interesting article that correlates faith, or spirituality with increased mental health and faster healing from traumatic brain injuries.  It discusses that having faith led to higher functioning both mentally and physically from those suffering from traumatic brain injuriies.  The connection people of faith had to their faith communities also led to greater emotional healing.

Interesting that science is discovering what the Bible has instructed us from the beginning.  Living in right relationship with our Creator and participating with others in this walk help us live better lives.  For anyone struggling with physical injuries, or the associated depression, relational problems, or PTSD this is worth noting.

Click here for the link to paste and read the article.

Steven R. Tracy’s “Mending the Soul”  is a great resource for those recovering from any kind of abuse.   The book provides an overview of abuse from both the Biblical and scientific perspectives.  The book is divided into three sections:  The Nature of Abuse, The Effects of Abuse, and The Healing Path.   Steven Tracy is  a professor of theology and  his wife Celestia is a family therapist, and together they have started Mending the Soul Ministries.  The Ministry trains facilitators to run abuse recovery groups in local churches.  Both the book and the ministry are well worth looking into if you are seeking help from abuse you may have suffered in your past or the effects including anxiety, depression, relationship , marriage or self esteem problems.

Seeking help for yourself and starting counseling can be easy to put off.  It takes work to find the right counselor and taking an honest look at your life can be hard work as well.  However the benefits are typically great as growth occurs, relationships improve and emotional symptoms are shed and the cost of not addressing problems these problems is great. Listed below are some common reasons people don’t seek counseling.
•“My problems aren’t THAT big.”
•“I don’t want to start looking at things because I don’t know what else is there.”
•“I’m not crazy.”
•“What will people think?”
•“I don’t want to be weak.”
•“I don’t have time.”
•“I can tough it out.”
•“Sounds like too much work.”
•“My problem is unique and no one can help me.”
•“It sounds like work—why would I want to do that?”

So how do you find a counselor?  One of the best ways is to talk to others who have been in counseling and who have had a satisfying experience.  There are also many referral lists that exist based on specific issues.  Try googling the specific problem you want to address and you will probably find links to specific therapists.  Organizations your trust can also be a good resource in finding a counselor.    Focus on the Family maintains a national counselor referral list,  EMDR Therapy Network has a national listing of therapists trained in EMDR, and  your local church or pastor can also be a good resource.

When you get to the point of making that first phone call, it’s a good idea to have a list of questions to ask.  Therapists are used to fielding questions about the work they do and many will give a complimentary phone or 30 minute session to help you decide if they are the right therapist for you.  I generally tell clients that once you start counseling with someone it is reasonable to expect from the beginning that you are getting new insights or help in your situation that you didn’t think of before.

(10 reasons people avoid counseling is borrowed from my good friend and skilled therapist Kay Simmeth  www.kaysimmethlmft.com)

Hold Me Tight by Sue Johnson is a great tool for couples to have and to work through on their own or in conjunction with marriage counseling.  Sue Johnson is the developer or Emotionally Focused Therapy which is a highly effective research based approach to marriage counseling and therapy.  Emotionally Focused Therapy (EFT) addresses the bond or connection that exists between couples.  Many conflicts, misunderstandings, or standoffs that couples get stuck in are really about how secure the attachment or bond is between the couple.  In Hold Me Tight,  Sue Johnson introduces 7 concepts and practical suggested exercises or conversations couples can have around these concepts and about their relationship.  These include recognizing the patterns a couple repetitively gets stuck in,  revisiting conflicts,  learning to engage and be emotionally responsive to each other, and forgiving old injuries.  I have found EFT to be highly effective in marriage counseling as the research indiciates, and this book is a helpful tool for couples to work through.

A recent article in the NY Times interviewing Francine Shapiro the founder of EMDR discusses  the evidence that exists for the effectiveness of EMDR.

Click here for the link to the followup article to the one above again interviewing Dr. Francine Shapiro and giving a great and easy to follow explanation on how and why EMDR works and the supporting research for it.

EMDR is fast becoming known throughout the helping communities as a quick and effective treatment for PTSD.  This is great news for the many who suffer from the effects of traumatic events in their lives and also for the many military veterans who have recently returned from tours of duty and are needing help.