Unbreaking the Circle

“It is really rather foolish to so often feel we have to say something brilliant and enlightening to someone who is suffering. Job makes it clear that simple companionship is what suffering people often crave – not a course in philosophy.”

Kathryn Lindskoog, author and lecturer, Leadership magazine – 1985 “What Do You Say to Job?”

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“Not allowing a person who has experienced a great loss to walk alone is the greatest act of love that heals.”

Pesach Krauss, Why Me?

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“If there were no suffering, would there be compassion? If there were no discipline and hardship, would we ever learn patience and endurance? Construct a universe with no trouble in it and immediately you banish some of the finest qualities in the world.”

James Stewart

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“It is one of the most beautiful compensations of this life that no man can sincerely help another without helping himself.”

Ralph Waldo Emerson

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“Everybody can be great, because anybody can serve, you don’t have to have a college degree to serve. You don’t have to make your subject and your verb agree to serve. You don’t have to know about Plato and Aristotle to serve. You don’t have to know Einstein’s theory of relativity to serve. You don’t have to know the second law of thermodynamics in physics to serve. You only need a heart full of grace. A soul generated by love. ”

Martin Luther King, Jr.

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“On the street I saw a small girl cold and shivering in a thin dress, with little hope of a decent meal. I became angry and said to God, ‘Why did you permit this? Why don’t you do something about it?’ For a while God said nothing. That night He replied quite suddenly, ‘I certainly did do something about it, I made you.'”

Unknown

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“In whatever God does in the course of our lives, he gives us, through the experience, some power to help others.”

Elisabeth Elliot

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“At the center of the universe is a loving heart that continues to beat and that wants the best for every person. Anything we can do to help foster the intellect and spirit and emotional growth of our fellow human beings, that is our job.

Those of us who have this particular vision must continue against all odds. Life is for service.”

Fred Rogers

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“When we are certain that the way to accomplish our own wishes is to help others, we have no regrets.”

Sakyong Mipham

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“I needed clothes, and you clothed me.  I was sick and you came to see me.  I was in prison and you came to visit me …

And the King shall answer and say, ‘Truly I say to you, whatever you did for one of the least of these brothers and sisters of mine, you also did for me.'”

Matthew 25: 36 and 40
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The belfry pictured above is not associated with a church.  It stands, as you can see, in the midst of a cemetery.  This particular cemetery is in County Carlow, Ireland, near the village of Rathanna.

Again, we turn to our imagination and see what it might tell us about this little belfry, and the bell hanging in it.  When would the bell be rung, and why?  I would guess they would ring the bell either before or after a funeral or interment, or perhaps on certain special days when folks nearby would memorialize those laid to rest in that particular cemetery.  Why?  My thought would be that the ringing of the bell would signal a call to the living, to honor and lend aid to those who have suffered loss.  Hearing the bell ringing, knowing where the belfry stands, would thus, just as a church bell ringing on a Sunday morning serves as a call to sinners to come and worship, in this case call anyone available to come and give support to the family and friends of whomever has just passed away.

When you think about it in these terms, it’s really a wonderful idea, to put a bell tower in a graveyard!  I could also see where mounting belfries to the tops of hospitals, homeless shelters, and maybe even jails would also be a great innovation!  Anything that would call us out of our normal day to day routine, alerting us that some fellow human is suffering and in need of help, comfort, support, or our simple respectful presence, would thus be of high value.

Have you read some of the quotes above?   Perhaps you’ve got a pretty good idea of where I’m going with this post.

The idea actually came to me this morning as I was waiting for my grandson Jacob to awaken.  I was reading a psychiatric journal and came across an article summarizing several published research studies.  One of them caught my eye:  Researchers actually completed a study which showed, through “Functional MRI” evidence obtained while people provided physical contact support of others who were receiving electrical shocks, that giving this kind of support was very helpful to the “supporters”.  It was helpful in several ways:  1) It showed greater activity in the ventral striatum, a part of the brain which has long been known to be one of the main “reward centers” of the brain;  2) The MRIs also showed high activation in the septal region of the brain, another “pleasure center”;  3) As a result of the septal region activity, this also lowered activity in both sides of the amygdala, which registers pain and triggers fear reactions.   The study compared people who would sit beside and hold the arm of the person receiving the shocks, versus others who would sit across the table from them and simply squeeze a rubber “stress ball”.  The ball-squeezers received none of the benefits listed above.   (Inagaki TK and Eisenberger NI.  “Neural correlates of giving support to a loved one.”  Psychosomatic Medicine;  2011 Nov. 9;)

Therefore, this study affirms that when people are present with and hold others who are suffering, there are both internal rewards and a lessening of the fear and anxiety the person giving that support might otherwise be feeling.   This is remarkable!  Not only will we feel better when we give direct care and support to those who are going through pain or loss, but we will have less fearfulness and anxiety.  It should also be noted that it has long been established that frequent reductions in amygdala “fear-inducing” activity is associated with living longer.  Thus, being a “people-helper” can help you feel better, feel more at peace, and live a longer life.

When you remind yourself that God designed us this way, it is no wonder that, in my view, we were put on this earth primarily to help one another.  Bad things such as pain, suffering, and loss happen in life primarily to teach us to attend to those who suffer, so that they can later help us when we suffer.  When you then add in this new data that reaching out and lending our presence, time, hugs, and a listening ear to sufferers and strugglers, actually IS its own reward, it lets loose one more bat from the belfry of our mind … the one that falsely tells us that we won’t know what to say or do, or that the cost will be too high, or we’ll just be “in the way”, or an annoyance.  Being there for others in their time of need WILL help them, and it will help us.

Not that we need to be driven by selfish motives … May it never be!  We’re only seeing, though, that our Creator knew that for us to help to “unbreak the circle” while still here on earth would be a very helpful thing for us.  It’s just another reason to rejoice in the amazing symmetry of God’s world, of life, and of the power we have to do good by serving others!

So let’s celebrate and lend our aid!

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“Bridge Over Troubled Water”  (Paul Simon)

“When you’re weary, feeling small.  When tears are in your eyes I will dry them all.
I’m on your side, when times get rough and friends just can’t be found;  Like a bridge over troubled water, I will lay me down;  Like a bridge over troubled water, I will lay me down.

When you’re down and out, when you’re on the street, when evening falls so hard, I will comfort you.
I’ll take your part, when darkness comes, and pain is all around, like a bridge over troubled water, I will lay me down;  Like a bridge over troubled water, I will lay me down.

Sail on Silver Girl;  Sail on by.  Your time has come to shine.  All your dreams are on their way.
See how they shine.  If you need a friend, I’m sailing right behind.  Like a bridge over troubled water, I will ease your mind;  Like a bridge over troubled water I will ease your mind.”

Thanks!

Craig Meek, M.D.

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OK, let’s have some fun!

Now this is a glorious picture!  Just look at these bats madly rushing out of this church’s belfry!  What a fantastic shrink must have just moved into the belfry to do some bat-ousting!!!  Got ’em all out of there immediately!  I’ll bet all of that leftover guano smells PRETTY bad, though …

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A linguistics professor was lecturing his class one day.

“In English”, he said, “A double negative forms a positive.  In some languages, though, such as Russian, a double negative is still a negative.  However, there is no language wherein a double positive can form a negative.”

A loud voice from the back of the room piped up, “Yeah, right!”

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Now these young ladies are doing the world a HUGE favor by holding up the leaning Tower of Pisa in Italy!  Just like the young boy who still, to the best of my knowledge, has one of his fingers plugging that little hole in the dike, holding back the sea from drowning Holland, these two heroines will be sacrificing their lives for a while, at least until some others volunteer to take their places.  Let’s all give it up for servants of the world like these young people!

By the way, did you know that the leaning Tower of Pisa is actually a free-standing bell tower?  That’s right!  It serves as the bell tower for the Cathedral of Pisa, pictured above to the left of the tower.  So this tower is actually a leaning belfry!!!  And I thought bats were a problem!

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Newlyweds …

Husband:  Sweetheart, am I the only man you’ve ever loved?

Wife:  Of course you are, dear.  But why do all of you men keep asking me the same silly question?!?

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For all of us Doomsday Count-downers:


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And now for some more belfry humor:

After Quasimodo‘s death, Bishop Thomas of the cathedral of Notre Dame sent word through the streets of Paris that a new bell ringer was needed. The bishop decided that he would conduct the interviews personally and went up into the belfry to begin the screening process.

After observing while several applicants demonstrated their skills, he decided to call it a day.

Just then a lone, armless man approached him and announced that he was there to apply for the bell ringer’s job.

Bishop Thomas was incredulous. “You have no arms!”

”No matter,” said the man, “observe!” He then began striking the bells with his face, producing a beautiful melody on the carillon. The bishop listened in astonishment, convinced that he had finally found a suitable replacement for Quasimodo. Suddenly, while rushing forward to strike a bell, the armless man tripped and plunged headlong out of the belfry window to his death in the street below.

The stunned bishop immediately rushed down the stairways. When he reached the street, a crowd had gathered around the fallen figure, drawn by the beautiful music they had heard only moments before. As they silently parted to let the bishop through, one of them asked, “Bishop, who was this man?”

“I don’t know his name,” the bishop sadly replied, “but his face rings a bell.”

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Have a great day, and an even better week!  And please, try to do something good this week that you’ve been meaning to do for a while.  It will help your self-esteem, and that alone will make the world a better place!

Craig Meek, M.D.

On Self-Esteem …

Believe it or not, this is actually a belfry.  It’s a, uhhh … “belfry on the side”, so to speak.   This church is known as “The Church of San Martin Caballero”, and is located in a little village along the old Camino Real road in the coffee-growing region of Veracruz, Mexico.    Not exactly sure what happened here, but I would imagine that this little bell “tower” was added on sometime after the church had been built.

We’re left to use our imagination, as this church was built in 1776 (for some reason, that year rings a bell for me …), and there are no records, oral or written, that exist that might explain this odd, sideways belfry!   However, several clues really lead me to believe the belfry was added after the church was originally finished.

First, the stone used to support the tower is different from the stone used in the original wall of the church.  Second, if you look at the front facade of the church

 you see a completely different look than what is seen from the little belfry.  Even the roof tiles don’t really match those of the rest of the building.

Why is any of this important?  Well, probably none of it is important, but I think there may be a lesson for us about self-esteem.  Thus, we’ll just think about it for a while and as the days and weeks go by maybe we’ll come up with an answer.

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So, what exactly is “self-esteem”?

When I look up the definition for “esteem”, I see “regard” and “value”, both noun and verb.  When you tag on the “self” prefix, I would thus conclude this is the quality or amount (positive or negative) of value we attribute to ourselves, or if a verb, the positive or negative value we assign to ourselves as we think about ourselves and our place or importance in the world.

We hear so often that our culture has a self-esteem crisis.  I believe it.   If you’ll harken back to our discussion about depression, perhaps the greatest contributor to depression (recall that depression is the 4th leading cause of disability in the WORLD!) from our own internal stuff (non-biological) is poor self-esteem.  If I believe I am not worth very much, am not very competent, am ugly, am dumb, am hated by God, or perhaps already condemned, my attitude and my choices will reflect that view.  I will tend to hold a very pessimistic view of life and my chances for having a good one.  I will not hold much hope for things turning around.  And, if by some chance things begin to go right for me, I’ll be momentarily glad … until I remember that I’m certain to “blow it” sooner or later.   It makes for a very grim, cloudy, grey world.

How does a poor self-esteem happen?  In my view, the kinds of unhealthy competition that our society so readily fosters, with adults being so caught up in their own emotional struggles that they can’t figure out that it’s long overdue to change the messages we give little children, is the primary cause.  All of us remember the subtle but powerful beliefs we absorbed as kids.  Some were very young when they came.  Most of us were relatively healthy until we got to early adolescence (Middle School!!!).  A few lucky ones were in high school or college before they had it beaten into them that they were really not very competent, attractive, popular, or smart all along.  Regardless, our “chew ’em up and spit ’em out!” culture got to almost all of us.  From cutest baby contests to gold stars at day care to Christmas plays to spelling bees to who got picked first (or last!) for kickball to who sat alone at lunch every day to who had their lunch money stolen time and again to who always had their name misspelled, mispronounced, or worse, mocked in caricatures.   All of these and a thousand other little competitions all combined to tell us exactly who we were, who we are, and how high or low a value we hold in society, in life.  Even worse, some of us had our “value” beaten into or out of us by angry parents, stepparents, or other adults.  If we happened to be one of the very large portion of kids who also inherited a physiology that made us very anxious and nervous in many social situations (read, “school”), well, life was and has been a very difficult river to navigate.  No wonder, when all is said and done, that so many, many of us choose to numb that life with alcohol and drugs, and that we’ve had so many Judy Garlands, Norma Jean Mortensons (aka Marilyn Monroe), Janis Joplins, Jimi Hendrixes, Kurt Cobains, Michael Jacksons, Amy Winehouses, Heath Ledgers, Whitney Houstons.  So incredibly sad.

Is there any hope?  I believe there is … but as usual, it is an individual thing to improve it.  So how do you do that?

Improving self-esteem has been the subject of many, many books, magazine and journal articles, radio shows, documentaries, etc.  Many!  I really think many of us have at least one bat that is fluttering around in our belfry screeching all the wrong things about improving our own self-esteem!  Almost all of the stuff I’ve seen about building a healthy self-esteem is just so much crap!  Sorry, but to affirm every little thing that little Susie or little Johnny does will NOT have a positive impact on their self-esteem later on in life.  In fact, I’m not sure we as parents or adults can “hug”, “applaud”, or “affirm” our kids’ self-esteem enough to make a real difference.  We certainly can hurt their self-esteem if we don’t do those things!  But, ultimately the main jobs of parents, teachers, coaches, and adult role models of all flavors is to make sure kids are safe, that they know right from wrong, that they know where boundaries are and that there ARE consequences for crossing them.  Then, as they enter adolescence and gain the capability to understand why things are right and wrong, safe and unsafe, that we’re there to explain things, including the shades of gray, and that we’re there to listen to their thoughts and ideas, their struggles and breakthroughs.

Given good boundaries, safety, and enough of food and shelter, in a world that can be trusted, all of us were able to, and still are able to, give ourselves good, healthy, positive self-esteem.  How?  Well, it won’t come through others patting us on the back 5,000 times and telling us how great and how valued we are.  That’s all well and good, but ultimately where truth veers away from all the pop psychology out there is in the following, and this is very important, so listen up:  

I AM THE ONLY PERSON ON THE EARTH WHO CAN IMPROVE MY SELF-ESTEEM!!!

Did you get that?  Hope so.  Life, through the cooperation of many other people, has given us all the message that we just aren’t worth very much.  The reverse message must come from ourselves.  Reading or reciting written affirmations might help a little, but it won’t get us over the hump.  Real change in our self-esteem follows the “Missouri Rule”.  Our self-esteem says to us, “Show me.”  Plain and simple.  Prove to me that you are competent; that you can truly accomplish something.  And then it simply stands and waits.  It doesn’t give up, it doesn’t get impatient, but it doesn’t give us any “gimme’s”, either.  There is no other way around it … we must step up and do something good, something positive, to get the needle on our self-esteem meter to budge.

And what kinds of things are we talking about?  Really, doing just about anything can move that needle, so long as whatever we’re doing is healthy, important, makes a difference in the world, or makes a positive difference in us.  The way I put it to my patients is this:  making any real progress toward any kind of goal that is truly yours!  This is what makes for a better self-esteem!  So, anything from brushing our teeth more consistently, to eating  a little less, to walking a few times a week, to calling a relative we’ve been meaning to, to going to bed earlier, to studying a bit instead of playing an extra 15 minutes on a video game, to washing the dishes instead of leaving them “for tomorrow” for the 8th day in a row.  Anything can work, so long as afterward we know we’ve done something that is toward the good side of the ledger.  Doing things for ourselves can also help, if we typically do only for others.  Recharging our own batteries could be something we have long neglected because we told ourselves all along we weren’t worth it.

You know, this leads me to another truth:  We humans don’t make good hypocrites.  Oh, now don’t misunderstand me here!   We all can be hypocritical at times!  But one part or the other of us will be lying.  We either won’t really believe in the value we say we believe in, or our actions won’t truly reflect what we believe.  But we can’t say one thing and do another and believe them both!!!  Never happened.  Now what I mean here is, I try to get myself and many folks with whom I work to give themselves a voice.  To speak up for themselves.  Why?  Because if they do often enough, the value in which they hold themselves will HAVE to increase.  If you speak up for yourself, even though you don’t think you’re worth it, or you think you’ll offend someone, or put someone out and they’ll dislike you more, and you keep on doing so, sooner or later you’ll either begin to feel that you ARE worth speaking up for, or you’ll quit speaking up.  The two cannot co-exist.  And my belief and hope is that we all, whenever we are legitimately being unfairly treated, or are right about our views or our needs but they aren’t being attended to, will keep on speaking up for ourselves and not give up, EVEN if we have great doubts about ourselves or our voice.  If we do, I’m confident the amount and the way we esteem ourselves will inevitably grow!  It must.  And it will!

I urge you to try it out.  Treat yourself as important (not any more important than anyone else, but no less so), and your beliefs about yourself will have no choice but to improve.   And even if you have no belfry, and everyone else around you does, you won’t feel the need to build one, especially if all you can do is build a cheap one on the side!

Until next time!

Craig Meek, M.D.

 

“The wolf shall dwell with the lamb … ” Isaiah 11:6

 This belfry is located on the beautiful campus of Radford University.  It sits atop a small, older building at this 100 year old school in the New River Valley of western Virginia.  It’s a bit of an odd bird on the campus, as nearly all other buildings are of brick and stone, much larger, more impressive, and more imposing.  Just going by appearances, this clapboard-sided building and its aging belfry stand out like a sore thumb, in my opinion.

I took this picture while my family and I were touring the campus following our daughter’s dance audition.  My cell phone camera did not do this belfry any favors, as you can see, and I’m obviously no photographer.  But, in my mind this illustrates something interesting:  this building, surrounded as it is by much larger buildings that are considerably more appealing and more impressive to the eye, still stands.  It offers little to the overall ‘feel’ of the campus, yet it stands.  It could have slunk away long ago in shame over its diminutive size and odd look, but it stands.  It is not defeated, and you get the sense that it will never let itself feel in any way inferior.  It is “who” and what it is, and is perfectly okay with that.  It is NOT in competition with any of the other gorgeous buildings nearby.  It knows its role, and plays it well.  It knows that what is on its inside is a heckuva lot more important than what it looks like on the outer surface, and it agrees with me that any building with a belfry is in the cool club anyway!

So let’s return to where we left off when last we met.  Competition.  Today I want to talk about how I would distinguish between healthy, or “positive”, competition, and the destructive, “negative” types of competition.

First off, the title of this post comes from a passage from the Old Testament of the Bible that is very often misquoted.  Most times you will see or hear it as, “And the lion shall lie down with the lamb.”  Isaiah 11:6 actually reads:  “The wolf shall dwell with the lamb, and the leopard shall lie down with the young goat, and the calf and the lion and the fattened calf together; and a little child shall lead them.”  This is a picture of how things shall be in the new Kingdom that God will establish in the next age on the earth.  Do you deduce anything from this verse?  Do wolves and lambs, or leopards and goats, or calves and lions, or little children and wolves, leopards, or lions, cohabit in our world peacefully?

This is obviously a world in which competition, as well as the food chain, have been rendered obsolete.  This is “The Ideal”.  Utopia.  Heaven.  God’s Magnum Opus.  No more tears.  No more war.  No more pain.  No more sickness.  No more competition.  No more, “Thrill of Victory, and the Agony of Defeat.”  God’s peaceable kingdom.

In that day, all will know that they are perfectly ‘OK’.  All will know that they are perfectly loved as they are, and there will be no more perceived need to puff myself up, or put others down.  No longer will anyone need to be in control, to demand respect, to cast aspersion through gossip or social scheming, or to keep up with the Joneses.

Can we get there now?  Well, given that we are all indelibly flawed and fallible human beings, and given that we are all on a long journey through life hoping to better and better learn to depend on one another, to love one another, to help one another, to not fear or worry but to trust in God and safe people around us, but also knowing that we will likely never completely get there this side of the grave, it’s doubtful.  But, that is not to say that we can’t achieve progress.

Real progress, however, can only happen beginning with me and with you.  I know … sounds corny, but it’s truth.  Each of us can, a little at a time, grow closer and closer to the knowledge that we are OK.  Completely, just as we are, with all of our mistakes, all of the things we do selfishly or with hurtful attitudes.  We are still OK.  We are loved by our Creator.  No matter what.  Believe that … I mean really KNOW that truth … and then there will be nothing anyone can say to you, think about you, or do to you that can take your peace away.   Believe that, and there will be much less need for worry or fretfulness.  And once we know we are OK, then we can live the serenity prayer we looked at a couple of weeks ago.  Loving ourselves, our Creator, and one another will be easy.

And what does all of that have to do with the idea of competition?  It has everything to do with it.  Starting with a solid foundation of “OK-ness”, no longer must any form of day-to-day human competition cause us fear.  Now, I’m not speaking of military warfare or dealing with burglars or muggers.  Perfectly normal to feel fear in those situations.  But in any other typical form of ‘competition’ – academics, business, clothing, social, sports-related, etc., etc. – fear of “losing” does not any longer have to be a part of one’s normal experience.

Healthy vs. unhealthy thus becomes, not the actual competition itself, but all about my own attitude.   Healthy competition is anything that causes me to strive to be my very best, to give my best effort, to play fairly, to examine my strengths and weaknesses, and to build on those.  It leads me toward greater and greater teamwork, to become more interdependent with others, to not fear sharing things I’ve learned with others in order to help them.  Healthy competition can result in some “pain” if I “lose”, but not the kind of pain that leads me to want to get back at the winner, or to beat myself up, or to be ashamed of myself.  Rather, this is the kind of pain that can still enjoy the experience, love and have fun with the “winners”, but then look at ways I can, with God’s help and assuming that we believe it’s our Creator’s will that we even be involved in this particular competition, improve myself and further improve my mental health and attitude.

Unhealthy competition is, likewise, mostly about my own mindset and approach.  If I believe that winning the pretty girl’s approval, or getting her to go out on a date with me, or catching the eye and attention of that very cute and popular guy, is all-important for me if I am to be “worthy” or valuable, then this is not healthy.  If “winning” makes me feel better about myself, but losing makes me feel there is something terribly wrong with me, that’s not healthy.  If winning makes me laugh at my opponent, or losing makes me hate or resent the winner, that isn’t healthy.

Two different women who worked at two different women’s domestic violence shelters here in central Kentucky have each told me that when the Kentucky Wildcats men’s basketball team loses a game, they have notably higher rates of women being admitted into the shelters within hours afterward.  Something is horribly wrong and unhealthy when competition, not even involving me personally, becomes so important that I get angry enough to lose all control when I lose.  We’ve all seen reports of fatal fights and brawls following NFL and college football games, and during and after soccer games in Europe and elsewhere.  We’ve all seen MANY cases of violence and murder involving “competition” between men and women, when one someone leaves another someone, and finds a new mate elsewhere.  The jealousy and anger we can feel about competition is boundless … IF, again, we base our worth and self-esteem on coming out ahead vs. losing.

So, in conclusion, we again see the truth that being healthy people, especially in any situation in which we are vying with others, involves first and foremost our own attitude.  Knowledge that we are not more or less valuable or worthy, no more or less loved, no more or less OK, whether we win or we lose, must be the foundation.  Then, taking the attitude that I am only ever going to measure myself against myself, against my own self’s very best, in preparation, practice, effort, and resilience.  I can look to others for inspiration, for tips and wisdom as to how to do things better, but never to let myself fall into the trap that when, not if, someone out there does things “better” than I that therefore I simply don’t measure up; that I am a loser.  Hogwash.  Please, let us all move from that kind of mindset, day by day, toward the truth that, just as in Special Olympics, we can and should all strive to win, but also to be brave, to give our best, and to celebrate all participants when the results are announced!

Thoughts?

Craig Meek, M.D.

“Let me win … but if I cannot win, let me be brave in the attempt.” (the motto of Special Olympics)

Competition is to self-esteem as sugar is to teeth.”

Alfie Kohn, 1987, in No Contest:  The Case Against Competition

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“If it doesn’t matter who wins or loses, then why do they keep score?”

Vince Lombardi, Hall of Fame football coach

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Pictured here is the Church of St. Martin in Landshut, a city in the Bavarian region of Germany.  It boasts the tallest brick bell tower in the world, and is also the 3rd oldest brick belfry anywhere.  The top of the belfry stands 428 feet (130.6 meters) above the street below.  As you can see, it needed to be very tall in order to compete with all the other skyscraper buildings in Landshut and the surrounding countryside … ummm, NOT!

So, given that it is so “out of place” tall in that area, why build it so high?  I don’t know, but it was not just one person’s idea … the church took 110 years to build (including 55 years just to build the bell tower!), and was supervised by FIVE different architects, the last being the only one still living when the building was finally completed and dedicated in 1500 A.D.  Therefore, this required many people over multiple generations all being dedicated to building this almost ridiculously tall church tower.  Again, I wonder, why?!?  Why so tall?  Surely the priests there were aware of what happened when the good folks of Babel tried to build a tower that would reach all the way to “heaven”, back in ancient times.  It didn’t work, and they were all scattered to the winds, “Babelling” about things no one else could understand!

So, again I ask, why?  What compelled these people to want to build such a tall bell tower as part of their church?  It’s far out of proportion to the height and size of the main part of the church.  Were they attempting to compete with someone?  And if so, with whom?  Were the guys in the next town over trying to build a 425-foot tall belfry, and so the Landshuttians believed it their duty to outdo them?  Maybe.  Or were they trying to have the title of “Tallest Church in Christendom, and Everywhere Else, Too!” so they could hang a big sign outside, all lit up during the tourist season?  Perhaps.  One has to wonder if maybe they were thinking God would be more pleased with them (than those other rival churches who were so lazy and cheap that they only designed 250 foot tall bell towers) if they “thought big” (and tall)!

In any case, it seems clear to me that their mindset had to have featured at least some degree of competitiveness.  They may have had no idea how the finished height of the tower would have compared to other towers in the world, but they surely knew that it would be the tallest of any in that part of the country.  Was this fact important to the various architects and those who commissioned the project in the first place?  We can’t say with certainty, but it would be difficult to persuade me that it wasn’t.

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I wanted to write a couple of posts about the whole topic of ‘competition’.  Once again, I’ve picked a topic about which entire books have been penned, and so obviously I will be merely hitting what I hope will be the highlights (as opposed to the lowlights!).  I believe that “competitive” drives are in many ways dyed into the fabric of our being very early in life, to such a degree that we are only rarely aware of them and how they influence us.  For example, why should I care whether the aspects of competition I choose to write about will be ‘highlights’ or ‘lowlights’?  Because, I guess, I’m competing for your favor and for you to agree with me, in the final analysis, and this motivation colors how I think and make choices.  Further, though, I believe that these competitive drives are in many cases very “un-mentally-healthy”.  My goal is to explore this, to show myself and you all in what ways competition affects us in detrimental ways, but also to see if there are ways in which some competitive thinking and motivation are actually good and beneficial.  I hope to keep an open mind about this.  I don’t think that will be hard to do, though, as I happen to find this area of human functioning to be extremely fascinating.  At least part of the reason for that fascination is that we rarely examine the ways we are wired to compete, in so many ways and in so many settings, and for so many reasons.

You’ll notice there are two quotes above.  The first is the post title, which is the motto adopted by Special Olympics.  I love Special Olympics!  It plays a large and important role in the lives of a bunch of folks with whom I work, and whom I have come to love and cherish.  And, I love their motto.  It was not until I became a Special Olympics volunteer a few years ago that I learned of this motto.  Had you asked me to guess what their motto might be before that time, I would have responded it must be something along the lines of “When the Great Scorer comes to mark against your name, He writes not that you won or lost, but how you played the game.” (Grantland Rice, famous American sportswriter).  I would have guessed that the highest hopes of founder Eunice Kennedy Shriver and others who worked to make Special Olympics work and grow were that it would be all about the joy of participating in physical activity and the fun of imitating competitions held in the actual Olympics.  While it is about those goals, the motto clearly indicates it is first and foremost about striving to win.  There is no doubt that it is a real competition.  This was an eye-opener for me.  But (and I heartily encourage all of you to look for ways you might be able to become a Special Olympics volunteer!) I came to more fully embrace the motto when I actually saw S.O. in action!  In S.O., winning IS important.  But bravely taking part is JUST as important, and you will see that in the way organizers treat both the athletes who win events and competitions and those who don’t.  It is equal, except in the color of the medals or ribbons.  That is AFTER the competitions end, though.  Before and during, the goal for all athletes is to WIN their event.  It ends up being, in my view, a very healthy balance of the highest teaching and motivation, to draw out one’s very best in the preparation and participation, and of the highest adulation and celebration for both ‘winners’ and participants.  It keeps the word ‘win’, but jettisons the term ‘lose’.

In the other two quotes, by Alfie Kohn and Vince Lombardi, you can see the stark contrast between those who view competition as always harmful, and those who build their whole philosophy around it.  As in so many things, I can see some virtue in both sides of this debate.  What I want to do is to discuss a few areas in which we instill competitive “instincts” in children, and see if we can then spot ways in which those instincts play themselves out in adolescence and adulthood.  And we’ll see what we will find.

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Obviously, our culture is built around competition.  In nearly every conceivable way, we compete.  We compete for jobs.  Politicians compete to be elected.  Capitalists compete for business, for market share, and for profits.  We compete for dates and for mates.  We compete in sports, in livestock shows and pie-baking contests at the fair, in decorating our homes for the holidays, in amassing the most and bestest ‘toys’, in just about everything you can think of.  We spend so much energy in our lives either trying to “keep up” or come out ahead.  From “Cutest Baby Contests” to beauty pageants to Little League to our entire educational system, almost everything in childhood ends up being a competition.  Perhaps the most pervasive competition in childhood occurs during early adolescence:  the ‘middle school’ years.  Competing to be in the most favorable social circles occurs at a fever pitch in these years, and most of the time no one wins.  Sure, some kids DO end up getting into, and staying in, the popular, cool, hip, awesome cliques, but at what cost?  How much of their soul did they give up to do so?  And then there are all of those who don’t.  I likely don’t need to go into much detail here.  All of us have seen either first-hand or close by how cruel kids are to one another and to themselves at that age.  In my experience, self-esteem gets murdered by this process.  This is why I’ve been in favor, for several years now, of banning middle school!  Make all kids be home-schooled from age 11 to 15, then return to high school.  I’m being somewhat facetious here, but I do wonder if it might not be an idea with merit.

In Alfie Kohn’s book he speaks about being on a talk show in the early 1970s which featured an interview with a 7 year old tennis star and his parents.  The boy had been playing tennis when he was 2, and by the age of 7 was regularly winning competitions throughout the country.  Someone in the audience asked the boy how he felt when he lost … his reply:  “Ashamed”, and hung his head.  This anecdote makes its point.  Not that all children are so driven to win and thus avoid shame.  But it is doubtful that this young child was born with this drive to win so strongly.  This kind of drive was instilled in him.  The feeling of being ashamed to ever lose was instilled in him.  Not necessarily by his parents;  there may have been coaches, grandparents, sponsors, tournament organizers, or others.  But, certainly the drive didn’t come from other children.  Adults were the authors of it.  Sad.  This and so many similar cases stand as witnesses against our unhealthy obsession with winning in everything, but also our false belief that “losing” (or anything other than winning) is somehow a bad thing.

When we think of competition, we first think of sports.  But really, sports and the incredible degree to which we (worldwide, not just in the U.S.) are consumed with them are only an outflowing of our philosophy of life.  Rivalry with others begins in childhood, as kids absorb the lessons their parents teach them, often indirectly.  Because we adults spend so much of our time and energy talking negatively about others, the message to our kids is clear.  They hear us, and learn.  If others (our boss, our coworkers, people at church, the checkout clerk at the store, the guy who pulled out in front of us on the road, our relatives, our neighbors, etc., etc.) treat us unfairly or disrespectfully, it’s ok to comfort ourselves by painting them in a bad light at home, on the phone with our friends, or in a variety of ways.  The message is that we are therefore better than that other person in some way (by the logic that he or she is worse than I), and that it’s a “good thing” to be better than someone else.  We even directly address this message to our children by pointing out the ways in which other children behave, speak, dress, groom, etc.  We do this in order to either give our children a “model” to aspire toward (the message being that “you” aren’t as “good” as that child, but you should be), or more commonly, an example of how not to behave, speak, dress, or groom themselves (the message being that “you” are “better than” that child and you’d better keep it that way!).

The bottom line is that we are competitive people in so many ways that most of the time we are completely unaware of it.  When it’s negative competition, that is, when the outcome is linked with being “superior” as a human being if we win, and being “less than” or “shamefully weak or bad” as a human being if we lose, no one really wins, as that superior feeling is purely based on falsehood.  It’s a house built on sand, and will only fill us with complacency and arrogance.

On the other hand, when being competitive is positive, the complete opposite occurs.  By this I mean, when being in a positive and uplifting competition of some sort causes me to strive to be and to do my very best, but not in order to “show the other guy up”, or to prove my worth as a person, then all can benefit.  And as with Special Olympics, when the outcome is that the winner is praised, and the non-winners are celebrated, it’s all good.

Now, some will argue that the “positive competition” I’m speaking of here is what is wrong with, particularly, America in this day and age.  They believe that this is the “soccer mom” complex in which “no child is left behind”, everyone gets a trophy, no one “fails”.  That’s not exactly what I’m speaking of.  I really think that it comes down to two things:  what are the real goals of a particular competition, and how are the winners and those who don’t win treated after the competition ends.

We’ll expand on those ideas in the next post.  Thanks for reading and, I hope, thinking along with me.

Craig Meek, M.D.

“There must be some kind of way out of here”, said the Joker to the Thief …

“There’s too much confusion; I can’t get no relief.
Businessmen, they drink my wine, come and dig my earth.
None of them along the line know what any of it is worth!”
 
“No reason to get excited,” the Thief, he kindly spoke.
“There are many here among us who feel that life is but a joke.
But you and I, we’ve been through that, and this is not our fate.
So let us not talk falsely now; the hour is getting late.”

Bob Dylan, 1967

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This belfry, which sits atop the Chambre de Commerce et d’Industrie in Lille, France, has a certain appeal to me.  It has a very strong feel to it, and I love the understated elegance of the gold rim around the clock.  Very nice lines.  Nice mix of stone and brickwork.  Unfortunately, it has a little bit of a smug aura around it, too, but perhaps that is just my subconscious ‘read’ of the French in general.  I doubt any self-respecting bats would reside herein.  Unless there were free pastries delivered “tous les matins” (every morning)!  THAT would be a different story altogether.

I wonder, though, do bats enjoy french pastry?

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Moving on, can anyone guess as to why I chose the lyrics from “All Along The Watchtower”, copied above?  If you guessed, “probably no reason at all, it’s just a song you like”, then you are VERY close!  But, there is a pertinent reason.

When last we met, we talked about depression.  We said a lot of very depressing things about depression, and I am anxious to leave that tone behind.  I want to think a bit about how someone dealing with or suffering from depression can actually find a way out; how they might find the light at the end of the long, lonely, black tunnel.

So, if a person is mired in depression, no matter the cause, what can be done?  As we established, depression is a global disease impacting every area of a person’s life.  True, the “hub” of the disease lies in the brain, but everything about us filters its way through the brain in some ways.  Now, I decided that I was not going to try to piece together what scientists think they know about the brain and depression.  I strongly doubt that it matters much to any of you, or even to me for that matter, whether the left frontal or right frontal lobes are more involved in the symptoms of depression; whether the hippocampus, the limbic system, the right temporal or parietal lobes are involved, or none of those brain regions.  I would guess that what matters most is:  how can I help others who may find themselves trapped on the inside of depression?

The very first thing to realize and remember is this:  it takes a village.

As we’ve said, depression is, by its very nature, a disease that first of all kills off the host’s (that is, the person afflicted by it) ability to do the things that could overcome it.  Depression saps one’s energy, motivation, interest, concentration, and decisiveness.  Depressed people are literally stuck in the mud, and often cannot even decide IF they ought to call someone for help or not.  And if the thought goes through their mind, the negative thinking and belief systems that almost always accompany depression will tell them that no one cares enough about them to help, or that they’ll just end up being a burden, as they may believe they have been to those around them throughout their entire lives!  Even when they finally decide they need help, and there might be some obscure soul out there who may be willing and able to help, their energy stores are drained down to the bone, and nothing gets done.  And we have not really addressed to any degree those who have what is called, “anxious depression.”  Anxiety mixed with depression can often be much worse than the slightly more common “vegetative” type.   Folks with serious anxiety on top of their depressed moods, minds, and bodies, are often even more reluctant to reach out to others, fearing those others, or fearing the bodily discomfort and social embarrassment (humiliation?) that will certainly (they tell themselves) result if they actually open up to someone.

The bottom line is that when we encounter someone who is depressed, the very first thing they need is someone who is willing:  Willing to give of your time.  Willing to listen.  Willing to not give them all sorts of advice.  Willing, at first, to respect their privacy, but with time to gently nudge them into opening up.  Willing to restrain your urge to rush in with 5 different solutions.  Willing to just be present until the problem is laid out.  Willing to do whatever it takes to “be trustworthy”.  Depressives, no matter their flavor, have an extremely hard time trusting others.  It’s not out of conceit.  It comes from a feeling of having been beaten down, and a strong reluctance to be around anyone they suspect may beat them down even further.   So, first establish that you come in peace, and keep establishing that.  Then, when once you have won their trust, and heard their story, and given them privacy, the time will then come to softly introduce the thought of going “outside” for help.

Help may start anywhere.  If I had strong faith in any of society’s “helping places” out there, I would heartily recommend that place first and foremost.  I do not.  One thing I do know about our “people-helping infrastructure” is that it is highly individual-dependent.  In other words, it depends on the quality of the specific person you will find if you walk in a door or call a phone number, as to whether you will find help there.  So, if you know of a pastor or priest who is very serene and understanding of true mental health problems and is willing to help, then take your friend there.  If you know that the local mental health treatment center has a good reputation for having kind staff, and good, caring therapists and psychiatrists or psychiatric nurse practitioners, then go there.  If your friend has a primary care doctor whom she or he trusts, then start there, and accompany the friend to the appointment.  Again, recall that they will have a strong, “built-in” drive NOT to burden others.  Unless gently pushed, they might not open up about what they’re going through.  Your presence will help.  If possible, I would try to find a good person in all three settings.  Not just anyone.  It might not be possible to find a good, “human” professional in any of those settings (physical health care, mental health care, spiritual care) in your area.  But keep trying, please.  You might be surprised, as might your friend.

Of course, in my view depression must be addressed on several fronts.  Even though I have already stated previously that there is no such thing as a “chemical imbalance” when it comes to depression and other mental illness, it is nevertheless true that the brain is a biological organ, and it may very well be necessary, in order to “jump start” the depressed sufferer, to begin a course of medicine.  There are some pretty good and pretty safe medicines, and medicine combinations, nowadays, and they should get better as more and more research is done.  But medicine can never be the total solution.  If so, there is no solution at all.  If a person relies solely on medicine, and does not try to improve the way they think, or their relationship with their Creator, or their social life, or their physical health, then just as one of the quotes at the beginning of my last post stated, as soon as the medicine stops, or stops working, it all goes back to ground zero.

Medicine can, though, BEGIN the process of improving neurons’ functionality, and thus giving a person just a bit of “juice” to get moving forward.  It can begin to give a bit of hope.  It can help reduce what I call “emotional reactivity” (how and how intensely we react to emotions such as sadness, frustration, fear, anger):  angry irritability which often accompanies depression, frequent tearfulness, anxiety, agitation/restlessness, etc.  It can lift the overall mood and functioning of a person out of the deeper depths of the pit, and put a ‘floor’ under them so that they won’t sink back down into the darkness, where hopelessness and suicide may lurk.  But, medicine can and will never be the full recipe.

Again, help from others is necessary for almost all sufferers in the beginning phases of recovery.  To provide a listening ear.  To be a voice of unconditional acceptance to them.  To support, share some humor, to be a companion, even if it’s just for a few minutes or an hour every week or two.  Once you or a helping professional establishes rapport and trust, and once the person’s energy and motivation is lifted off the dungeon floor a few feet, then perhaps they can begin to look at the “action steps” that they will need to consider in order to reach full recovery.  They will need to consider some kind of exercise program.  Doesn’t have to be like training for the Olympics.  Doesn’t have to be P90X, MMA, or Zumba.  Walking is great.  And if walking is not possible due to physical health limitations, then some kind of stretching routine, or a very simplified yoga format can be very helpful.  Research studies have shown, though, that regular exercise can be as effective in depression as any single medicine or psychotherapy.  [  http://www.psychosomaticmedicine.org/content/69/7/587.abstract  ];  [  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC474733/  ]  Put them all together, though, and it gets much, much better.

In tandem with exercise is sleep, hygiene, and nutrition.  In short, good self-care.  Now here’s the rub:  most persons with depression have a lot of self-loathing, or at the least, apathy about themselves.  It is extremely difficult to help such folks to expend the energy it takes to form new, better habits of daily routine … but it’s important, and it feels good once those habits start to develop.

When you first introduce these topics to a depressed person, you’ll usually get either mild agreement (the needle will barely move a notch or two, but it still moves) or a blank stare.  If you were to peel off the surface shell, though, you’d likely see that this is when they start to recoil at this concept of ‘self-care’.  One of their false beliefs often is that their purpose in life is to tend to the needs of all others around them first, and then … that’s it.  Nothing for them.  They were often brought up to believe that their greatest satisfaction in life ought to be to make everyone else around them happy.  Period.  What a sham.   Now, it’s important to emphasize that self-care is NOT about being selfish or self-centered.  It’s about taking care of themselves so that they can be better able to do those things that they were TRULY purposed to do in life … to be children of God.  To care for others as others care for them.  To give and to receive.  To wallow in the joyful grace of our Maker.

Beyond exercise and physical self-care, there is therapy, also known as psychotherapy.  This is the process whereby a trained professional helps another person to change some things about themselves.  These things are typically the way that person feels, thinks, chooses, and acts.  The best forms (among many) for depression are cognitive, or cognitive-behavioral, therapy, and supportive therapy.  In my way of thinking, cognitive therapy is the best out there, but with supportive features built in.  This is the type of therapy aimed at identifying the negative, counter-productive, and just plain false, ways of thinking, beliefs, and self-talk that all of us engage in at one time or another.  The vast majority of us practice false thinking and negative self-talk most of the time.  But, we are either not aware of it, or too comfortable to change.  However, depression is sort of the end result of such mental patterns, and in order for a person to recover they simply must also look at at least a few of their negative belief patterns.  I hope to devote a future post to cognitive therapy and false thinking, but I warn you:  whole books have been written about the subject;  I shan’t be doing that!  Just the highlights, I promise!

There are many other treatments available for depression now:  meditation and mindfulness training, acupuncture, bright light therapy (especially during the fall and winter months for those afflicted with seasonal depression), and the newest form:  transcranial magnetic stimulation.  For those especially severely depressed, to the point of almost total shutdown, there is also a surgical treatment called deep brain stimulation, and the modern version of electroshock therapy:  electroconvulsive therapy (ECT).   All of these treatments have been helpful to at least a few folks out there, so they are “on the table”.

To review then, as stated above, recovering from depression is a process, a journey, and the “dump truck” method (starting 3 or 4 modalities all at once) will not work.  You’ll lose them.  Start quietly, where they are, with two ears and eyes open, and mouth almost completely shut.  Listen.  Keep secrets.  Accept.  Be trustworthy.  As trust comes, then introduce the idea of going outward to seek help from professional sources.  Depending on how severely depressed they are, medicine may be necessary up front to give their energy a boost.  Once things begin to show some improvement, then the other areas will have a chance for success.

One thing I have long believed, though I’ve not often seen, is that for a person who has major depression to fully recover, they have to find a way to be in your shoes:  to give to another what you have given them.  To “pay it forward”.  There is a concept out there in mental health lore known as the “wounded healer”.  I am a strong believer in this power.  Basically, this is when someone who has been wounded by pain of some sort – abuse, trauma, serious loss, injustice, oppression, depression, etc. – develops the special ability to connect with others similarly afflicted.  This “healer” is therefore gifted;  they can identify, connect with, and listen to, others who are also wounded, in ways that you and I perhaps cannot.  I believe that those recovering from depression often can have this gift.  And if, by some chance, they find a way or an opportunity to help someone else with depression, they come full circle.  And the clean, soft, quiet, knowing smile and nod of the head will be all the evidence you’ll need, once you see it.

Craig Meek, M.D.

Depression … even the word itself is a real downer.

“But with the slow menace of a glacier, depression came on. No one had any measure of its progress; no one had any plan for stopping it. Everyone tried to get out of its way. ”
Frances Perkins

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“Depression can seem worse than terminal cancer, because most cancer patients feel loved and they have hope and self-esteem.” 
David D. Burns

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“I didn’t know my mother had it. I think a lot of women don’t know their mothers had it; that’s the sad thing about depression. You know, you don’t function anymore. You shut down. You feel like you are in a void.
Marie Osmond

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“I start to think there really is no cure for depression, that happiness is an ongoing battle, and I wonder if it isn’t one I’ll have to fight for as long as I live. I wonder if it’s worth it.”                                                                                        Elizabeth Wurtzel

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“Noble deeds and hot baths are the best cures for depression.”                                                                                                               Dodie Smith

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Recovering from the suicide of a loved one, you need all the help you can get, so I very much recommend a meditation program. The whole picture of how to recover from this has to do with body, mind, and spirit. That’s applicable to any kind of depression.”
Judy Collins

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“Since I was 16, I’ve felt a black cloud hangs over me. Since then, I have taken pills for depression.”                     Amy Winehouse

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“The other thing is that if you rely solely on medication to manage depression or anxiety, for example, you have done nothing to train the mind, so that when you come off the medication, you are just as vulnerable to a relapse as though you had never taken the medication.”
Daniel Goleman

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“The Bluebird of Happiness long absent from his life, Ned is visited by the Chicken of Depression.”                        Gary Larson

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Here is a belfry that is actually separate from its church.  It’s located in the Philippines.  Sort of plain.  Cloudy day.  Not very ornate.  Lonely.  You might even call it a “depressed belfry.”  Even the bats that live inside don’t feel like doing much of anything.  Sad.

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I listed a number of quotes above, obviously all having something to do with depression.   Depression, or “major depression“, as we shrinks like to say, is one of the most complex illnesses known to humandom.  It is most definitely an illness.  It is a disease.  It can strike anyone.  Over 20% of adults in the entire world will suffer from a bout of major depression at some point in their lives.  It is the #1 cause of disability worldwide, measured in Years Lived with Disability (YLD), according to the World Health Organization, and the 4th leading cause of disability burden by “Disability-Adjusted Life Years” (DALYs):  The sum of years of potential life lost due to premature mortality and the years of productive life lost due to disability.  By 2020, the WHO estimates it will move up from #4 to #2 in DALYs, behind only heart disease.

Depression is a killer.  It is a taker of life, both literally and figuratively.  It is unforgiving.  It is merciless.  It has no conscience.  It gives no quarter.  It is a seemingly impenetrable web that engulfs those who fall prey to it, a web that others on the outside very often have to hack their way through to rescue those trapped inside.

In short, depression sucks.

But, there is reason for hope.  For you, for me, for anyone ensnared in the sticky web of depression.  Let’s talk about it.

First, what is depression?  Well, depends on whom you ask.  If you look it up in the DSM-IV (that is, “Diagnostic and Statistical Manual, 4th edition”, published by the American Psychiatric Association), you’ll see a list of symptoms that must be present over at least a 2-week period of time:  there must be either “depressed” (excessively sad, tearful, or empty) mood most of the day almost every day, or the loss or marked decrease in any interest or ability to experience pleasure in any normal activities;  Beyond those, there must also be at least 4 of:  significant weight loss or gain, insomnia or hypersomnia nearly every day, observable motor agitation OR retardation, fatigue or loss of energy, feelings of worthlessness or excessive guilt, diminished ability to think, concentrate, or make decisions, and either frequent thoughts about death or suicidality in some form (thought, planning, or action).  Also, the symptoms cause distinct distress to the person suffering from them, they can’t be caused by alcohol or drug abuse, or by some medication or general medical condition, and they can’t co-occur with bereavement (although, obviously some people with depression at times suffer the loss of someone close to them, which only worsens it all).

You may have noticed that there were no laboratory data or physical exam findings listed.  There are also no X-ray or other imaging criteria in the list.  This is what is called a “phenomenological” method of making a diagnosis:  you look for certain symptoms, certain observations of the person involved occurring over a specified time period, and if there is no other possible cause that would better explain it, then the person has the diagnosis.  This is the way the majority of psychiatric illnesses are diagnosed.  Eventually, there may be more direct and specific ways to diagnose mental illness, but until scientists come up with one of those wonderful wands that Dr. McCoy (from Star Trek’s starship Enterprise) would wave over sick folks and instantly detect the correct diagnosis and the needed cure, we’re stuck trying to read the human brain/mind by what and how the overall person is doing on the outside.

So, what I’ve listed so far is the “textbook” version of depression.  A simple search engine exploration will give anyone that info.  But I’d like to go a little deeper … make this discussion just a little more human.  

What is true about depression that you might not commonly find in books?

Let’s first look at the causes of depression.  And, first among firsts, is the fact that there are many “causes”, many risk factors, many ingredients, many flavors.  It might be helpful to think of depression as the ultimate “human illness”.  This is because it embodies more than any other disease I know of, the mantra that we spoke of recently:  that in humans every sphere of our existence – physical, mental, emotional, social, spiritual – impacts, and is impacted by, every other sphere.    As such, every one of those spheres plays a role in the origins of depression, and every sphere is affected by it.

Are there genetic causes?  Yes, in a sense.  Just this past May researchers were able to isolate a segment of one arm of the number 3 chromosome that is solidly linked to familial depression (  http://www.ft.com/cms/s/2/01a23ec2-7f13-11e0-b239-00144feabdc0.html#axzz1lSQfFHg6  ).  In all over 100 gene loci have been associated with depression that so often runs in families.  But, it is also true that not everyone who has one of these gene structures in his or her DNA makeup will automatically and without fail end up with an episode of depression.   Just a matter of raising the risk to a relative degree.

Are there environmental or social causes?  Of course there are.  Many.  Probably innumerable.  As many different traumas, frustrations, disappointments, losses, relational conflicts, patterns of abuse, patterns of neglect, and almost every other negative human experience you can imagine … for each and every one of them there has certainly been at least one of our fellow humans who has become depressed as a result.

There are cognitive, or mental, causes, too.  Actually, this category fits more as an all-around factor:  if, as for many of us, one’s thinking and beliefs are skewed, then once any other causes or risk factors are present depression can more quickly gain a foothold, and will be much more severe, lasting, difficult to treat and to recover from.  It can also serve as a sole cause of its own.  It is definitely possible to “think” yourself into depressive illness.  When we later talk about cognitive therapy, getting back to what we spoke about in the very first post – debunking myths and dispelling false beliefs and notions about life – we’ll see just how powerful our minds can be, for good and for ill, in our lives.

Are there spiritual causes?  No doubt.  So MANY of us are highly vulnerable to the prevailing winds when it comes to measuring our lives’ worth and relative success or failure.  And when I overlay the template of how God may or may not feel about my life’s virtue thus far, any guilt I feel for both real and imagined sins, whether of commission or omission, can become both seed and fertilizer for sprouting and supporting depression.  We’ll talk much more about this when we address the whole issue of how sick we are as a culture in terms of how competitive we insist on being in every possible way.  In addition, sadly, many of those in ministry can often make “spiritual” depression worse when they dismiss depression as an actual illness, or accuse sufferers of simply having too weak or feeble a faith in their Lord.   Friends and family, unfortunately, at times do the same with hasty criticisms uttered in frustration.  Statements such as, “just get over it”, or “why don’t you get up and do something?”, or “you’ve just got to trust in God, and everything will be fine”, well-meaning though they may be, typically serve only to make the depressed person feel greater guilt, less hope.  Trying to talk someone out of depression, especially with misguided appeals to greater faith, greater effort, can be like trying to fill up the Grand Canyon with a shovel.  There are sources and methods of giving someone spiritual help, though, and we’ll look at those soon.

Physical causes?  Sure.  Chronic pain.  Aging, and losing one’s agility, ability, mobility, and memory.  Chronic illness, and all the uncertainty, discomfort, hassle, expense, and treatments it can entail, can wear us down and lead to depression.  Earlier it was noted that if a medicine or medical illness causes a syndrome that seems to mimic depression, you can’t really call it “depression”.  Well, that may be, but in so many of those cases the longterm effects of such a syndrome (such as depression-like symptoms during a bout of hypothyroidism, or the depression-like effects of taking interferon for treatment of Hepatitis C virus) actually take on a life of their own, and the individual unfortunately ends up having both diseases.

You know, it occurs to me that the last sentence in the previous paragraph sums up an awful lot of truth about depression.  As a couple of the quotes above indicate, depression often has a very subtle approach; an insidious development.  It can strike anyone at almost anytime from any angle, but its “strike” is most often at the speed of a snail, soft and silent.  Most folks I’ve come to know have told me they didn’t really see the depression coming beforehand, didn’t realize what was happening to them until it had fully taken hold, but once it took hold it truly did seem to become a “life of its own”, taking complete control of their lives.

And the control is definitely complete.  One of the more frequent descriptions I hear from depressed patients is that it’s like being in a deep, dark pit, from which there is no escape.   “A black hole.”  “Like a thousand pound blanket lying on me, constantly.”  “I feel completely paralyzed.”  “Life is just all gray, always.”  Against such an enemy, can there be any hope of victory?

From years of experience, I can say firmly and with conviction, yes.

However, overcoming depression is never easy.  If we grant that it can be caused by any or all of the physical, cognitive, emotional, social, and spiritual parts of us, and if we grant that, regardless of cause, it most certainly impacts every one of those spheres, then it stands to reason that it must be addressed in every one of those arenas.  And, it can be.  It takes large effort, in some cases huge effort, and typically much of the early efforts must come from others, rather than from the patient.  Why?  Well, as we’ve established, the very nature of the illness known as depression is that it takes away the ability to motivate oneself to do any of the things that could help to eliminate that depression.  That’s why we can say with full conviction, “Depression sucks!”  But, if the sufferer will merely allow someone else to help them get out of the house to come into contact with a helper somewhere, then help can begin.  That help may take many shapes and forms, it won’t be quick, but it can and will genuinely save lives.

There is reason for good hope.  More discussion coming.

At this point I want to give thanks to the many, many human beings who have sat next to me, and have trusted me enough to honor me with their stories, their experiences, with recounts of what helped them, and what did not.  They have let me try to play a small role in their journey toward recovery, and I have learned so very much from them.  Almost all of what I know about overcoming depression I have learned, not from textbooks, drug reps, lectures, journals, or science, but from them.  I am humbled, and grateful.

Craig Meek, M.D.