I’ve got Billy Idol’s song “Blue Highway” playing in my head. Sometimes a song will just come into my head for no apparent reason. But then I remembered. My first podcast guest appearance was just released. And the podcast is called “The Dream Highway,” hosted by Steve Pederson. Dream Highway, Blue Highway … I don’t know if you see the connection, but my subconscious mind obviously does.
Social distancing at its best 😉
Anyway, Steve Pederson is a “musician, author, speaker, entrepreneur and family man [who] hosts this weekly podcast that helps you up-level your life.” In the podcast he wants you to “be inspired by teaching and interviews with people whose lives have been transformed. Hear the stories that have enabled them to overcome crippling obstacles and have propelled them towards their destiny. It’s all about real people overcoming real odds to realize their dreams.”
My end of the audio sounds like it’s cutting in and out at first. I think that might be because I couldn’t find my headset and had to rely on my computer’s microphone. It does seem to clear up as you go through, so please don’t give up on me.
I’ve thought about creating a podcast, maybe in conjunction with my YouTube channel. But for now, I am looking to be a guest on other podcasts. Last month, I took a class from Nancy Juetten on how to be a dream podcast guest. From our comments, Nancy saw a similarity in topics we wanted to specialize in and suggested we connect. After a brief email exchange, he encouraged me to fill out the guest application. That gave me a chance to be specific regarding what I wanted to talk about. I had my one-sheet after going through Nancy’s one week course. Just having that done and refined has given me more confidence in approaching podcast hosts looking for guests.
This is the first, but it won’t be the last podcast I do. In fact, there is an episode for another podcast already recorded that will be posted some time in December, and I’m looking for more.
I’m doing this as a way to promote my book. It will take time to know how effective it is as a marketing tool. All I can say now it was a great experience.
Steve and I had a great rapport, and I think that comes through in the episode. Some things we discussed:
Writing a contest-winning book on a depressed brain
The relationship between shame, faith and depression
The chemical imbalance controversy
The difference between situational and clinical depression
Some science-based ways to alleviate depression
Signs you may want to get tested for clinical depression
Depression is not a lack of faith or character
Faith should allow you to be human
Faith should encourage you to be honest with yourself and with God
The best career path is one that fits your personality, you have talent for, and you love doing.
It was one of those conversations I was sad it had to end, and I hope Steve will have me again when it’s time to talk about my next book.
The Secret about Introverts
On knowing your personality, the Meyers-Briggs test was helpful for me. I am an INFP on the scale. The most helpful information was knowing I am introverted rather than extraverted. You might be surprised that I enjoyed talking for these episodes. Here’s something you might not know about introverts. We may appear to be quiet, shy, or wanting to fade into the background. We are usually not good at small talk. But if you get us talking about something we are passionate about, we can talk all day.
I am passionate about faith that promotes mental health rather than tears it down, and I can’t thank Steve enough for letting me talk about it. Next time, I’ll have an extra headset in case one gets lost again.
In my last post, I introduced my fourth principle for recovery: With the right help, you can live a happy and fulfilling life. For most depressed people, getting the right help begins with testing. I talked about standard testing for depression in the last post. If your depression is bad enough, you may need testing for more specific types. At my mother and sister’s suggestion, I got tested for clinical depression. At the time, I don’t think the standard tests I’ve read about would have caught it in my case, so I’m glad I took their advice.
Getting Tested for Clinical Depression Was Different
If
you are considering getting tested for clinical depression, I can tell you a few
things you probably won’t find online. I won’t give away too much. Part of the
effectiveness of the testing comes from going in fresh. But in many ways it was
not what I expected.
It Was Not Talk Therapy or Psycho-Therapy
It
did not involve talking about my emotions or childhood. It did not involve my
history, or how I’ve been feeling the last few weeks, or trying to determine if
there’s a particular reason for depression, or if it is just always there regardless
of any reason. Someone observing would not have thought it had anything to do with
depression. The psychologist (I say psychologist, but I don’t know exactly what
his title was) gave me various tasks to do and questions to answer. After each
task, he asked why I did it that way or why I concluded what I did.
The
only thing I recognized as “psychiatric” was the Rorschach inkblot test. You’ve
probably seen it on TV. They show an inkblot, and you tell them what it looks
like. On TV, they usually say a bat or a rabbit or something simple. My answers
were much more elaborate. In fact afterwards, I asked if I could get copies of
them, because I thought I saw scenes that could be used in a fantasy or sci-fi
story. Turns out they are copyrighted, a trade secret, or something like that. In
other words, they’re not available to the public.
It Takes More Time
With the standard question-and-answer tests I’ve seen, I can’t imagine them taking long. That kind of testing was made for something more general. It is one step in a process for your doctor to determine if you need treatment for depression or something else. The test I took was to look specifically for clinical depression. It took around two or maybe three hours. The time it takes for each person varies, because there is no time limit for the tasks. So if you took the kind of test you see online, and it only took a few minutes, that was not a test for clinical depression. There is a difference between situational depression, which usually does not take long to identify, and clinical depression.
Trust the Process
Like
I said, you might not see what the questions and tasks you’re given have to do with
depression. Clinical depression is not about how you feel or how you’ve been
feeling the last two weeks or more. It is a condition of the brain. One thing
about your brain. It is always with you no matter where you go, what you do,
what’s happening to you, or who you’re with. Your brain is unique. But if you
have clinical depression, it is there in your brain. And just like your brain,
it is always with you, no matter how you feel. Even if you don’t feel
depressed at this time in your life, you still could have clinical depression.
After
the process was over, I realized the tasks and questions the psychologist gave
were designed to give him a window into how my brain works. That is the only way
to detect clinical depression. Somehow, the psychologist has to see your brain
at work, how it processes information, and how it responds to various challenges
and stimuli. That’s why he asked me to explain my thought processes each step
of the way. Each answer gave him a little more data about how my brain worked.
Disorientation
When
it was over, I set a follow-up appointment to get the results. The psychologist
said I could bring someone in with me if I wanted. My sister was happy to do
it. She should have been, since she roped me into it in the first place. So she
was there when the psychologist gave me the news: “You tested high for
depression in every possible way.”
The
world stood still. It was so shocking I didn’t know how to respond. If he had said
anything else, like I tested moderate to severe in every possible way, or I tested
high in half the ways, I would not have been surprised. But high in every possible
way? How was that possible? I only felt mildly depressed. How could I
have tested high in every possible way? That would not have been the
case with one of those standard online tests. I’m not denigrating them. I’m
just saying diagnosing clinical depression as opposed to situational depression
is much more involved than that.
As
I adjusted to the shock, the next thing I felt was shame. Because I am a Christian.
What Will This Do to My Testimony?
I
had struggled mightily with depression in the past. But I always thought it was
in specific episodes. I was depressed in college. I was depressed during and
after my first year of Divinity School. I was depressed when I turned thirty,
and I was nowhere near where I was supposed to be in life. And each time, I said,
Jesus delivered me from it.
If
you are a Christian, you might have picked up the message that you should be
able to overcome depression by faith alone, because Christ is all sufficient. He
is all you need for peace of mind. You’ve heard others give that testimony. You
wanted it to be your testimony.
Do
you see the joy on my face? It’s because of Jesus.
Since
I found Jesus, I don’t get the blues.
I
can’t be depressed, because the joy of the Lord is my strength.
Too blessed to be depressed.
For me, all of that went away with my diagnosis. I wanted that testimony to show people what a difference Jesus made in my life. But I also learned long ago that in my relationship with God, honesty is much more important than having “the right testimony.” Honestly, as much as I wanted it, that was never my testimony. But there was still a part of me that thought it should be my testimony.
Here’s what you need to understand. Christ is all-sufficient when it comes to salvation, forgiveness of sins, and eternal life. When we get to heaven, we probably will never be depressed again. But when it comes to life on earth, we will sometimes need help from people, whether it’s warm bodies to carry things when you move, doctors and nurses to bring you back to health from sickness or injury, or mental health professionals to help you diagnose and treat mental illness. Christ is not at all offended if you need help from a professional, whether your illness is physical or mental.
Getting Reoriented
The
psychologist explained clinical depression is a condition of the brain. It
means my brain does not produce enough natural antidepressants, like serotonin,
dopamine, and norepinephrine. It’s a natural condition and nothing to be
ashamed of. A diabetic has a pancreas that can’t produce insulin. There is no
shame in that. It says nothing about that person’s faith or lack thereof. If my
brain doesn’t produce normal levels of “happy chemicals” (as I call them), I shouldn’t
be ashamed of that either. It can happen to anyone, regardless of what kind of
faith they have.
Just
like there is treatment for diabetes, there is treatment for clinical
depression. That usually starts with antidepressant (AD) medication and
counseling. Counseling, I had no problem with. But I had some resistance to medication.
***DISCLAIMER:
In the medical field, the effectiveness of AD medication is being seriously
questioned. Just keep in mind, any psychotropic drug affects each person differently.
My experience might be the same as yours, and it might be totally different. You
should never take one without a recommendation from a doctor or mental health professional.
And you need to pay attention to how it affects your thoughts and emotions,
especially in the first few days or weeks. Before you start taking AD
medication, be sure you know what to do if your condition doesn’t improve or
gets worse.***
With
that disclaimer, I’ll tell you why I took it, and why I’m glad I did.
Okay,
but remember, I had just tested high for depression in every possible way. The diagnosis
of clinical depression meant I had been living with depression my whole life
and did not even know it. If that is not severe depression, what is? If my
diagnosis had not been so extreme, I would not have even considered it. I would
more likely have accepted counseling and tried doubling down on faith
confessions, positive thinking, motivational messages, and meditating on
scripture. I’m not saying those things were not effective for me. They kept me
going in some of my worst and darkest moments. But I had been doing all that for
almost two decades, and I still tested high in every possible way. That realization
took down most of my resistance.
There
was also the comparison with the diabetic. He/she needs to take insulin, because
their body can’t produce it. If my brain doesn’t make normal levels of “happy
chemicals,” taking medication for that is no different.
She Is So Much Nicer Now
This
was also where having my sister there was helpful. She knew some things I didn’t.
For example, she knew of a relative who had recently started AD medication. “She
is so much nicer now,” I said. Oh, and another who was moody and had a volatile
temper. “That was depression?” I had never made that connection before with him
or myself.
In
the past, I had chalked up my own moodiness to “artistic temperament.” But it had
never occurred to me that was a sign of depression. This is one way you can
be depressed and not know it. You know some of the signs, but not all of them.
Like here, I knew I was moody and temperamental, but I didn’t connect that with
depression. And seeing how much nicer that one relative was with medication, I thought
maybe it wouldn’t be a bad thing for me.
Perfectly Timed for College
The
psychologist also told me clinical depression usually gets its worst between
late-teens and early-twenties. Bang! That was totally true for me. At first,
that was connected to a crisis of faith. But even after that crisis was resolved,
I still had this malaise I couldn’t shake. It was so hard for me to get
motivated for anything back then. I thought it was the work of the devil.
Finally, I realized, it was the work of my chemically imbalanced brain.
Furthermore,
whenever I had a crisis of faith, depression always accompanied it. So how do
you know if this is the situational depression of a dark night of the soul, or
clinical depression felt more intensely because you’re wondering, “What the
hell is God doing to me?” You don’t without getting tested.
What about “Artistic Temperament”?
I
wanted to be a writer. Let’s face it. Some of the greatest writers and artists
in history were very moody and temperamental. I can’t diagnose them, but it’s
likely most of them had clinical depression or similar mental illness. But is
that where their genius came from? Was depression the muse that inspired their
work that we still celebrate today? What if they could have taken AD medication
so as not to be tormented with those dark thoughts and emotions anymore? Would that
have made them less creative?
Many
times, depression compelled me to write something. It was therapy before I began
therapy. If I lose that, will I lose some of my creativity or my urge to write?
Can I really be an artist without the temperament?
The
psychologist’s answer was, in effect, yes, I could. Since I started AD
medication, I’ve been able to go back to some of those dark places when I needed
to without being caught up in the darkness myself. I can write about the
insanity I experienced without re-experiencing it. And I still feel the urge to
write, even when I don’t feel depressed. In fact, the most depressing thing for
me is to go a few days without writing. That’s when I really get moody and temperamental.
So if you are a creative or artistic type, I can tell you taking AD medication
has not dampened my creativity one bit. In fact, now I have so many ideas, there
aren’t enough hours in a day for me to write them all.
One More Tip No One Told Me
So
I had the results of the test. I had the beginnings of a plan for recovery. I accepted
the diagnosis and agreed to medication. The psychologist recommended a pastoral
counselor for me, because I knew I would need help with some of the theological
issues I still had. I left with a copy of the report, and my sister and I sat
down in a coffee shop to talk more about the implications of all this.
One
thing I remember from the conversation was the relationship between depression
and anxiety. In addition to depression, I seemed to be more anxious than people
around me. My sister said that depression and anxiety were located close to
each other in the brain. If you have issues with one, it’s common to have
issues with the other. That reminds me of Chris Cornell. He took Ativan for anxiety,
but in some of his interviews he also talked about depression. The good news is
if you treat one effectively, it often helps the other. That has been true of
me, and I wish it had been true for Cornell.
Overall,
after adjusting to the shock, it was one of the most enlightening days of my
life. My recovery began that day. But there was one thing I wish someone had told
me. Don’t read the results of your test. Normally, I’m the type of
person who would say, “If you have the test, read it. The more information you
have about your condition, the better.” This is an exception. That report was
the most depressing thing about myself I have ever read.
You
don’t need to read it to know what you need to. Ask the psychologist who tested
you about the results, what they mean, and what kind of treatment you need. Don’t
throw it away. Keep a copy of it in case you need to make a disability claim. But
don’t read it unless for some reason you absolutely have to.
Life after AD Medication
Back
in college, I had this voice in my head that was so negative and so condemning,
it felt like it came straight out of the pit of Hell. I could cast it out in
Jesus’ name. Temporarily. But anytime I failed, or my prayers weren’t answered,
the voice returned. And in some ways, I felt I deserved it, because I still
didn’t have enough faith (whatever that means). In the Word of Faith, they tell
you that voice is a demon or the Devil. And then, it changed from the Devil to
Jesus, beating me up for not having “enough faith” to get what I prayed for.
Fortunately,
I did learn not to associate that voice with either one of them. I had an
incredible Epiphany that drove it away for a couple of years. But eventually,
it came back. After a few days on medication, that voice went away for me. I
don’t know if there really are such things as demons or Satan, but I do know
this. If a pill can make it go away, it’s not a demon. For that matter, it’s
not Jesus either. It’s a mental illness.
Here’s
another thing that happened. I used to think I had ups and downs like everyone
else. I could be happy or sad, stressed or at peace, friendly or misanthropic. But
even when I was happy, there was this underlying sadness I couldn’t get rid of.
I never felt like I belonged anywhere, even among friends. I thought it was
normal, because that was how my brain worked. When I started AD medication, those
feelings finally went away. From that, I learned that however your brain works,
you will think it’s normal because everything about your experience is processed
through your brain. If your brain is naturally tilted toward depression, it
will color all your experience with that brush. That was why I didn’t recognize
it as depression except when it got really bad.
Takeaways
That
leads into my fifth principle for recovery: Never believe a chemically
imbalanced brain, even if it is your own. I will dive into that in my next
post. Until then, here are your takeaways.
Situational depression is much
easier to recognize than clinical depression. Situational depression is about
how you feel. Clinical depression is a medical condition.
Because they are different, the
testing for each is different.
Testing for depression is only one
part of a process to determine if you need treatment for depression or
something else.
If your family and friends think
you are sad or depressed even when you don’t, you should seriously consider
testing for clinical depression.
Sadness and lack of motivation are
not the only signs of depression. Anger, moodiness, and a quick, extreme temper
are also signs.
Like any medical condition,
clinical depression has nothing to do with faith or the lack thereof. Don’t believe
anyone who tells you faith should be all you need to treat it.
AD medication is normally for severe
or clinical depression. Research has not confirmed effectiveness for less
severe kinds of depression.
If you have severe depression, it’s
no sin to try AD medication.
Like other psychotropic drugs, AD
medications affect everyone differently. Before you take it, make sure you know
what to do if your depression gets worse after taking it.
You do not have to read the results
of your test. Just follow the advice of the one who tested you, and you’ll be
on your way to recovery.
Grace
and Peace to you.
P.S. I’ve talked about how my sister and mother encouraged me to get tested. You might be wondering about my father. He recently confessed to me that he thought I had problems with depression too, but he did not know how to talk to me about it. So it’s official. Everyone in my family knew I was depressed before I did (see Takeaway #4). But that in a nutshell is why I’m writing these posts and why I wrote my book Dark Nights of the Soul: Reflections on Faith and the Depressed Brain. I’m sharing what my clinical depression looked like as best I can, in the hopes that A) someone undiagnosed will see themselves in it and be prompted to get help, or B) someone who cares for a depressed person can use it to help share their concerns.
My
fourth principle for recovery from depression says, “With the right help,
you can live a happy and fulfilling life.”
Getting
the right help first requires proper diagnosis. If you think you are depressed,
your doctor can help with screening to see if you need therapy.
***Disclaimer:
I am not a doctor or licensed therapist. Any advice I’m offering is based on research
and personal experience. Unlike WebMD articles, it has not been vetted by
professionals.***
I
think the way I can be most helpful is not as a professional but as a bridge
between the professional and layperson. I am a layperson myself but with personal
experience of clinical depression and treatment for it. If you think my
experience might inform you, keep reading.
Should I Get Tested?
The
American Psychiatric Association (APA) has a list of symptoms of major
depression. You could look at that, but these two questions might make it
simpler:
During the past month, have you
been bothered by feeling down, depressed, or hopeless?
During the past month, have you
been bothered by loss of interest or pleasure in doing things?
If
you answer “yes” or “some” to one or both of these, it’s a good idea to talk to
your doctor about being tested for depression. Information about how they test
is available online. However, I don’t think you should look into testing beforehand
more than this. If your doctor wants to ask more questions, I think it’s best not
to prepare for it ahead of time. Just answer the questions honestly and leave
the diagnosis to the professionals.
Is It Depression or Something Else?
First,
however, your doctor will probably want to eliminate any physical causes of
your symptoms. There are a number of conditions with symptoms similar to
depression, including
Hypo- or hyper-active thyroid. If
your thyroid gland is too active not active enough
Nutritional deficiencies,
especially vitamin-D or calcium
Certain types of cancer or tumors
Hormone imbalances
Anemia
Cushing’s disease (a disorder of
the adrenal gland)
Head trauma
Multiple Sclerosis (MS)
Stroke
Syphilis
Certain medications, e.g.,
corticosteroids
Withdrawal from certain medications
(for example, steroids, amphetamines, OTC appetite suppressants, or
anti-depressant medications)
Some of these you probably already know if they apply to you. Others you will probably have to be tested for. Consult your doctor about which tests are appropriate for you. The most common physical causes of depression have to do with the brain and nervous system, thyroid and endocrine system, or sometimes a nutritional deficiency such as Vitamin-D or calcium.
And
here’s a couple of tidbits I learned from personal experience. Many types of
depression are related to a serotonin deficiency. So is Irritable Bowel
Syndrome. So if you have IBS, chances are you will be depressed too. Also, if
you recently had heart surgery, many post-op patients experience depression.
Depression Testing
If
your depression is not related to any physical causes like the ones listed
above, the doctor should screen you for depression. This will involve answering
some questions that may make you uncomfortable. But as usual, you should answer
your doctor honestly if you want an accurate diagnosis. Doctor-patient
confidentiality is there for a reason.
There
are several testing options your doctor can choose from. I’m not going to
explain them because, unlike when you were in school, I think it’s best to go
into these tests without “preparing” for them. Your doctor needs honest
answers, not the ones you scripted beforehand. If further treatment is needed,
he/she can advise you on the next steps.
Self/Online Testing
There
are tests available online, including one called “3 Minute Depression Test.” Tests
like these are convenient, private (unless you’re being hacked), and often free.
That can be a good place to start. However, that is hardly enough for a
diagnosis of major depression or any of the possible physical causes. Getting
the right help will involve seeing a doctor at some point. And after that, you’ll
probably need to see a therapist or counselor for a while. I don’t see how any
self test can tell you if you need it. But if the results prompt you to talk to
your doctor, then it’s served a purpose.
I
think this sums up the standard advice on getting tested. However, this kind of
screening is about situational depression, not clinical depression. We need to
think of that as something separate from standard screening for depression.
Testing for Clinical Depression
The
questions in most screenings are about how you have been feeling recently. Getting
tested for clinical depression is different. When I got tested, the therapist did
not ask anything about how I was feeling. The test involved going through
different tasks and explaining why I did it this way. So it is about how your
brain responds to different puzzles and challenges. This makes sense, because clinical
depression is not about how you are feeling at the moment or in the past few
weeks. It is about how your brain works. This is why clinical depression is
harder to detect than situational depression. It requires a trained professional
test for it.
When
I was diagnosed, I only felt mildly depressed. It seemed odd to me that my
mother and sister were pushing me to get tested. There were times in my life
when I had much worse depression, so why are they bringing it up now? I would
have said at the time that I was mildly depressed. And why not? I was in
my early thirties, unemployed, and never had a girlfriend. Who wouldn’t be at
least a little depressed? I didn’t think depression was something that needed
to be addressed before finding a job. But my sister said to me, “I have always
experienced you as being depressed.”
That
got my attention. She has known me for a long time. She knew things about me no
one else did. The same is true of my mom. If they are seeing something, maybe I
should at least look into it. Since I was unemployed, my mom agreed to pay for
it. The testing took about two or three hours, which is another reason why I don’t
think a three minute test is enough for diagnosis. I’m not saying don’t use that
tool if you suspect you are depressed. Just remember it is only one step in the
process of being diagnosed.
Wouldn’t You Know If You Are Depressed?
Not
necessarily. Remember I said I only felt mildly depressed when I got
tested? Here is how the therapist summed up the results. “You tested high
for depression in every possible way.”
What?
High in every way? How is that possible?
I only felt mildly depressed. On a scale of one to ten, I was at a two, maybe three. And still, I tested high in every possible way. This was probably the greatest shock of my life. And it’s how I learned the difference between situational depression and clinical depression. The therapist explained to me that the brain naturally produces antidepressant chemicals like serotonin, dopamine, and norepinephrine. When it doesn’t get enough of these chemicals, you have clinical depression. While situational depression is about how you feel over a period of a few weeks or sometimes months, clinical depression is a condition of the brain. No matter how you feel—happy, sad, hopeless, confident, angry, peaceful—it is always with you.
While
you may think you have highs and lows like everyone else, your lows are lower
because of your brain chemistry. While situational depression is usually triggered
by something that got you down, with clinical depression, you can be depressed
even when you know you have no reason to be. Again, that is because of your
brain chemistry. It’s not your fault, and it is treatable.
It’s important to note not everyone who is depressed is clinically depressed. While some experts question a definition of depression that is based on brain chemistry, I still believe it was a major factor in my case. It was hard to take in at first. But once I accepted it, the path to recovery became much clearer.
Next Post: Getting Treatment
So
I had my diagnosis, clinical depression. The next step was to get treatment. That
usually means medication and counseling. I’ll talk about that in more detail in
the next post.
To
sum up so far,
Getting help for depression will most likely involve your doctor and a counselor. Understand they each have different roles to play.
Your doctor can test for various physical illnesses that could be behind your depression symptoms. Treating anything that comes up from that might clear up your depression.
Your doctor can screen you for depression and tell you if the tests indicate a need for further treatment. He/she cannot give professional counseling but may be able to recommend a counselor to you.
Only a trained mental health professional can test specifically for clinical depression. If your doctor (or mother or sister) recommends testing for it, take his/her advice, even if you don’t think depression is that serious a problem for you at the moment.
A mental health professional cannot test for physical illnesses. That’s something for your doctor.
Your doctor might recommend counseling. However, you don’t need a doctor’s order to get counseling. If you feel like you need it, you are probably right.
Even if you don’t feel like you need counseling or testing, but people close to you who have your best interests at heart think you do, consider that they may be right. I didn’t get tested for clinical depression because I felt like I needed it. I got tested because my mother and sister thought I needed it.
David Anderson 