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Focus on the Family with Jim Daly

Shining a Light on Depression

Shining a Light on Depression

Drs. Gary Lovejoy and Greg Knopf clear up misconceptions about depression as they highlight its symptoms and explain how it can be treated.
Original Air Date: March 7, 2012

Teaser:

Woman: The depression was my pit that I was trapped in and I was longing for rescue, yet my rescue took over 6 years. And so, living a life of darkness and um … the lack of joy and I think more important for me, was the lack of hope.

End of Teaser

John: That woman there is describing a deep despair that she faced in the midst of untreated clinical depression.  This is “FOF,” with Focus president, Jim Daly. I’m John Fuller and depression affects a lot of people and women in particular.

Jim:  John, it does and I’ve read that as many as 1 in 4 women will experience depression at some point in her life.  And they are 70 percent more likely than men to be diagnosed with depression. We want to come alongside you if you’re feeling that way today.  If you’re in that spot where the world looks overwhelming and your circumstances look overwhelming, today’s program is for you.

John: You know, Jim, uh … as we were preparing for this broadcast, I was thinking about the … the familiarity that so many biblical characters probably had with depression. As you read through the Scriptures, time and again it seems this … these times of darkness just–

Jim:  Hm.

John: –descended on a lot of the people of biblical history.

Jim:  Uh … that’s true, John and you look at Psalms and when you start reading the Psalms, it is filled with those moments. David obviously had a sense of … of the depths of despair, as well as the mountain top of joy. And he probably is one of the characters that encapsulates what we’re talking about today.  Uh … and let’s get to it. Our guest today will shed some light on this issue of the valleys and depression.

John:  Hm.  Well, with us we have two guests. The first is Dr. Gary Lovejoy.  He’s a licensed counselor and then also, Dr. Gregory Knopf, who is a family practice physician.  And for over 30 years, these men have been helping hundreds of people work through depression and find wellness. And uh … they’re the co-authors of Light on the Fringe: Finding Hope in the Darkness of Depression.  And gentlemen, it’s great to have you here today.

Gary:  Well, it’s great to be here.

Greg:  It’s great to be here, John.

Jim: It is good to have you here.  Let’s start with this question of, what are the signs of depression?  And what’s the difference from just having a bad day or feeling what we used to say “bummed out?”

Greg:  Jim, that is the starting point, when people need to realize that the normal emotion of depression that we can all have, say your favorite football team loses the game at the last second, you know, you’re gonna be bummed out for a day or two. That’s normal to feel a feeling of depression and discouragement and sadness. But that’s temporary and transitory.  And even if a mom has a son who’s playing a baseball game and the pitch is thrown and he strikes out and the game is lost, that will resolve by the next game.

But what we’re talking about is something that is now going on for more than two weeks.  And those symptoms primarily can be divided up into issues of sleep. Um … and there’s eight of ’em in addition to feeling down, that medical personnel use to try to confirm the diagnosis.

And the first one is sleep and it’s generally not a problem of getting to sleep.  It’s a problem of staying asleep. They can get to sleep, but then they get … they wake up for no reason at 2 or 3 o’clock in the morning.

Jim: Uh-hm.

Greg: If patients tell me that, a light goes on in my head that says, “This person could be experiencing depression,” which actually can affect the neurotransmitters in the brain.  And then there’s a loss of interest in normal joy and pleasure of life.  “I don’t want to go to church.”  “I don’t want to be in my small group.”  “I don’t want to go hunting this year. I just want to chill out and “veg” out and … and sort of cocoon.”

Jim: Would that be kind of a pulling in then that–

Greg:  Absolutely.

Jim:  –you … you’re just more comfortable–

Greg:  Withdrawn.

Jim:  –being at home.

Greg:  I just … I … I want to avoid things, this … and leads into the condition called “Social Anxiety Disorder,” where people just sorta say, “I … you know, I don’t want to be around people.”

The next one is feeling guilty and it’s a false guilt in the sense that it’s inappropriate because it’s oftentimes related to, “I’m not measuring up.  I haven’t done what I should do and I could’ve done more and I didn’t.  And I’m disappointing God and I’m disappointing my family.”  And people begin to have these self-condemning ideas and thoughts that they can’t get away from.  Then probably the most prominent one is fatigue–

Jim:  Hm.

Greg:  –and just lack of energy.  And if somebody comes in to see me and their chief complaint is, “Doc, I’m tired. Do you think I could have Chronic Fatigue Syndrome?”  And I’ll check them for low thyroid and for, you know, uh … anemia and a whole variety of medical issues. But 60 percent of the time when people come in with that complaint, that the ending up diagnosis will actually be depression.  And as–

Jim:  Hm.

Greg:  –you treat that, their fatigue will then resolve and their energy will return.

Jim: So, 60 percent of the time.

Greg:  Sixty percent of the time, those are the clear statistics.

Jim:  Hm.  Dr. Lovejoy, uh … in addition to the things that are being expressed in terms of diagnoses, uh … depression in your book, Light on the Fringe, it talked about depression being an alarm system.

Gary:  Uh-hm.

Jim: I found that fascinating.  What … what did you mean by that?

Gary:  It is an alarm system.  Uh … many people who experience depression feel that sense of meaninglessness and purposelessness. And it’s … seems counterintuitive to them to think that depression itself has a purpose. You know, how …. how I can feel so bad and yet, maybe there is a good purpose.

And uh … the purpose of depression is, that it’s a signal.  It’s an emotional alarm system that tells us that something is wrong.  Something is missing, either within ourselves, which could be either physiologically or psychologically or more often, both.  Or it could have something to do with uh … something amiss in our relationships, particularly and … and in relationships.

Or it could have to … to do with our circumstances and oftentimes all three. But it is a signal and as a signal or as an alarm, it is protected in its primary function.  And in the same fashion the depression fulfills that it’s an emotional alarm system that says something is wrong that requires … that may be damaging you, has damaged you in the past, may continue to be damaging now, that if you don’t pay attention to it, it could wound you further.

And so, if you think of depression as an emotional alarm, as a signal, it is not the problem. Depression is not the problem. It is a signal to that there is a problem.

Jim:  Well, what …

Gary:  And as such, it’s your ally, not your enemy.

Jim: Right.  Uh … also, you mention in the book; you talk about this idea that depression is rooted in this idea that we’re … we’re seeking significance and meaning. Uh … that was intriguing to me, that a root of depression can be caused by a lack of significance. Talk to me about that.

Gary:  Well, um … a lot of people really struggle in general with the whole issue of significance.  Uh … they want to be specifically significant to another person. They feel unloved. They feel unimportant, that what they have to say is dismissed as uh … as unimportant.

And so, when they experience rejection from others, they then move into self-rejection. But this significance issue is … also has greater significance itself and that is, uh … it relates to spiritual issues, because many, many people who are depressed, feel that they are um … they actually believe in the myth that … that depression is a sign of spiritual deficiency, that somehow they failed God, that as Greg was saying, that they’re a disappointment to God.  In fact, I had one woman say to me, “I feel like I’m a stench in the nostrils of God.”

John: Hm.

Gary:  And they’re unaware that uh … as you were talking about, John, about depression in the Bible. In fact, depression is the most common disorder discussed in the Bible and they’re unaware of that.  In fact, if you stop and think about it, it’s not even preached very often.

Jim: Hm.  It … it seems to be a bit of a taboo in the Christian community and uh … all of us know people perhaps or are married to or we ourselves deal with some issues of depression.  Let’s talk about this gender differential, because it’s very intriguing to me and I’d like to know if you see in the research a rationale for it.  But women tend to experience depression uh … more often than men. Why?  And uh … help illuminate that for us.

Gary:  Women have certain stressors that uh … and I’m … I’m gonna talk about the environmental stressors now, that distinguish them from men.  Uh … let me first of all give men and then I’ll compare it.

For men, there are three basic things–financial reversals, where they feel that their own sense of ability to produce a living and so forth is effected and they have a fi … uh … they may lose a lot of money on the Stock Market.  Their retirements funds are gone. That’s been happening in … more recently lately.

And then um … uh … there are difficulties with vocational identity, where they fail to get a job promotion, especially if they’re passed over by younger men or they hate their careers and they’re only about halfway through and they … they see no end to it and they’re … they’re miserable.

Or uh … the third is failing physical powers. For example, the classic 50-year-old guy goes out and tries to play basketball and … and commands his body to do the same thing a 20-year … when he was 20-years-old and he pulls ligaments and muscles and wonders what happened.

Jim: That’s a little–

Gary:  And he gets–

Jim:  –too close to home–

Gary:  –depressed.

Jim: –here. (Laughter)

John:  Never … never happens around her.  (Laughter)

Gary:  Because one thing that ties all these together for men and that is, anything that’s … deals with a sense of adequacy–

Jim:  Hm.

Gary:  –and competence.  Uh … for a woman on the other hand, it’s attacks … uh … anything that is a[n] attack on their sense of femininity. It may be a mastectomy, a hysterectomy. It may be their sense of their attractiveness.  We live in the society where it’s a cult of beauty. And uh … I remember hearing a story just recently on the … on the radio, where they were having a … a beauty pageant, believe it or not between uh … little girls from ages 7 to 12.

And uh … they announced the winner of the pageant and the … the mother of the runner-up became hysterical and … melt down, began accusing the sponsors of corruption and so forth. And her little girl began to cry and says, “Mommy, does this mean I’m not pretty?”

Jim: Hm.

Gary:  And if you look at the women in television, they’re … news anchors, news reporters, they’re all beautiful and they’re young.  Men can vary in attractiveness, but women don’t, not in [the] public eye.  And it gives a message to women, that beauty has an inordinate effect and uh … on their life. And if they’re not, then they think, “Oh, my life is gonna be a failure.”

The second thing is uh … feelings of loss or abandonment by important men in their life, starting with their fathers and then graduating to boyfriends, husbands and even male friends. Uh … and then thirdly, that has an effect is any trouble in the home.  Even though there are many women now who the past 20 years have moved out into the world and … and have careers of their own and so forth, still domestic issues still are more likely to arouse depression in women than in men.

The common thread between these three is issues of security, a feeling of love and security. And … and oftentimes, when I have a couple come in and they are having struggles, he will say something like, “Well, you know, I never really measure up. She’s never happy with uh … whatever I say or do. She’s always criticizing me and I’m just uh … tired of it.”  And that’s his view of the problem.  What is he talking about?  Feelings of inadequacy, I don’t measure up in her eyes.

And then I ask … I turned to her and I said, “Well, how do you see the problem?” And she’ll say, “Well, he comes home and he doesn’t hardly pay any attention to me.  He goes right to the computer or right to the television and “vegges” out and … and I feel so alone and I …”  And she’ll say things like uh … uh … “And I just wonder if he even loves me anymore. He doesn’t show me the affection that he used to,” and so forth.

And I’ll turn to her and I’ll say, “Sounds to me like you’re feeling very, very lonely and abandoned.” And when I say that, more often than not, tears start rolling down her eyes.  And so, here you have two people, one who feels inadequate and therefore, he feels angry that he feels inadequate. And the other one who feels deeply … the woman who is feeling deeply depressed, because she feels her security is wrapped … uh … being pulled from underneath her and her husband’s about ready to leave her or doesn’t care about her anymore and she feels unloved and disrespected.

Jim: So …

Gary:  So, that … those are powerful differences.

Jim: Yeah and so much of what you’re talking about as we do shows here at FOF, you’re really talking about communication.

Gary:  Yeah.

Jim: And uh … you know, the male and the female knowing how to uh … meet each other’s needs in a deeper and deeper way.  Uh … but …

Gary:  Could … can I–

Jim: Yeah, but … yeah.

Gary:  –make a comment about that? It’s really interesting.  An author was … put it uh … when a man comes home from work, he’s looking for a report, that they give uh … uh … a report of the day.

Jim:   … something.

Gary:  And if there’s a problem–

Jim: Yeah.

Gary:  –to solve, he’ll solve it, even if she’s not asking for that and she usually isn’t. But on the other hand, a woman is looking for rapport–one letter difference, but all the difference in the world.  She’s looking for connectedness, closeness, intimacy.  That’s what she’s looking for.

Jim:  Let’s talk about the young mom, because I  uh … see in the research that young moms who decide to stay at home, can tend to have the … the onset of depression.  It might be they’ve given up a career and … and whatever.  But talk to that and some of those periods in a woman’s life particularly where depression is a little closer to the heart than at other times. Uh … is it being a young mom at home one of those moments?

Gary:  Oh, absolutely and I’ll … I’ll let Greg address the postpartum issues, that … ’cause there are some biological issues involved there that can occur, but absolutely, because when a … a … in fact, depression peaks oftentimes early on when a … a … you have a young mother with young children in the home.

And part of the reason for that is, maybe em … embodied in uh … in a client I recently had.  It was … really showed a lot of the risk factors that are involved. She was a … a young mother. She was 28-years-old. She already had three children, one 4, one 2 and one 2 months of age.

Jim: Uh-hm.

Gary:  She felt desperately lonely.  She felt overwhelmed by her tasks. She looked absolutely like she had been through World War III.  She was exhausted.  And fatigue is a major factor, as Greg was talking about earlier.

And her friends, most of her friends didn’t have children. Some of ’em weren’t even married, so they couldn’t relate to her problems.  So, she began distancing from them and withdrawing from then. And then her husband didn’t help matters any, because he worked long hours and he came home and he was exhausted. And so, he’d go and sit down in front of the television and ve … “veg” out, basically uh … oblivious of crying children and so forth.  And all the efforts of childcare fell on her.

And she resented that and uh … and I asked her, has she ever asked him to do more?  And she said, “Well, I feel guilty.” I said, “What do you feel guilty about?”  And she says, “Well, I feel guilty, ’cause he already works long hours and he’s tired and … and I don’t want to ask him to do more.” But she resented it at the same time, because her expectations were that he would help, that it would be a joint venture, that he would uh … help change diapers, take care of the kids and give her a break.  And she’s–

Jim: So what does–

Gary:  –lost for time.

Jim: –a couple do?

Gary:  Pardon?

Jim: What does a couple do?

Gary:  Well, a couple has to utilize their resources. First of all, a husband has to recognize how his wife is starving for adult conversation and adult companionship. She’s been working with little kids all day, talking kid language. She needs that. So, they need to … have times where they go out and … and develop their alone time together. Oftentimes that’s one of the first things that gets sacrificed.  And marriages are not gonna remain strong unless you have the nurturing time to devote to it. It takes effort and energy to … uh … be placed into that marriage.

Jim: Dr. Knopf, as a medical physician, uh … talk about postpartum, because that’s in the news. Often you hear these horrific stories of women who have done things to their children. Uh … what is postpartum?  And how does it manifest itself?

Greg: After having a baby is a very high-risk time and sometimes it’s described as the “Baby Blues.”  And the mother will cry for days at a time and uh … it has to do with this incredible hormonal flux that occurs after now no longer having the baby inside the womb.  And that’s to some degree again, it’s a continuum.  Some of that is pretty normal, but at … sometimes it can be extreme.

I believe that there is a connection now that appears to be a real issue and that is, if some people have severe postpartum depression, it can be one of the first signs of a bipolar disorder which was unrecognized before.  So that, now a woman can … can actually become … lose touch with reality and believe that her children are somehow evil and she must get rid of them. And that would be the extreme.  And fortunately, it’s not that common, but there is a continuum and it has to do with that hormonal flux.

Jim: Hm.

Gary: I might just add with that, that in terms of postpartum depression, if a woman has a history of mood disorders, she’s two to three times more likely to develop depression during or after her pregnancy. And often when they’ve had a postpartum depression, they increase their risk for a depression later on by about 70 percent.

Jim: And in that context, what can a woman do who finds herself self-diagnosing perhaps a postpartum?  What should she do as a next step?

Greg: She should see her physician and talk about the treatment options and say, um … you know, “Is what I’m experiencing, is this normal?  Or should we uh … engage in some sort of therapy, some protection?”  Involve the family and support those issues.

John:  Uh … you know, as you’re speaking, Greg, I’m thinking about the door that was opened for my wife to depression. You know, Gary, you mentioned that postpartum depression can lead to depression later on. And after our third child, Dena was really struggling. And I remember being in the office with … with her physician and … and he said, “I think we might want to consider some medications.” And she just looked at her in shock.  She had the “baby blues,” but she couldn’t believe that he [sic] would suggest medication.  And uh … she actually did try some things out a little bit there and then went off them. But it came roaring back.  Uh … talk to how common that is and what a couple should be looking out for.

Greg:  I describe it, John, this way.  If you were to walk into your home on a winter evening and it was 50 degrees in the house, you would go, “Something is wrong. Either the furnace is no longer working or somebody left all the doors and windows open.”

And our brains must have enough of the neurotransmitters, primarily serotonin and norepinephrine functioning for us to have a normal mood and normal thinking processes.  Now if you are experiencing extreme stress, then it’s like the windows were left open and now you’ve got to shut those windows and crank up the heat again. And one of the ways to do that is … medication simply helps your body conserve what is already made.  It does not become addictive in any way when we’re talking about antidepressants. And so, I think some people have the fear that if I take this medication, I’m somehow gonna change my personality or it’s somehow like taking an addictive drug. And antidepressants are not addicting.

Jim: Hm.  And to show you how common it is, I think in both John and I, in our families, I think Jean along with Dena has suffered depression from time to time. In her case, there is a family history there.  And uh–

Greg:  Uh-hm.

Jim:  –in fact, one of her brothers committed suicide.  And that … that was a very difficult time for the entire family obviously, but it was a wake-up call for Jean. The difficulty there though, the struggle, I think particularly for Christians and perhaps Christian women more so, is this idea that um … being a Christian, if I have this situation, I … I should be able to expect the Lord’ll take care of it. And they can and I can say that Jean has given me permission to talk about this.  Uh … they want to push medication away because it … it kind of uh … defeats them in their faith. Does that make sense?

Gary:  It … it’s interesting that people even tell them when they’re depressed, “Well, if you just had more trust and faith in God, if you prayed more and read more uh … the Bible, that … that He would heal you and then He’d do this.” I had a woman who practically had calloused knees from praying and her Bible was dark from fingering the passages. And yet, her depression persisted and she thought, “My, I must really be repulsive to God, ’cause I’ve done it all. I’ve done everything and then, I … I still … I’m struggling with depression.”

I think there’s a lot of stigma uh … attached to a … certain stereotypes of depression, that somehow it has to do with a lack of trust and faith in God. And if I only just exercised it more, that it would go away. But the thing is, uh … as you were talking about the … the characters in Scripture, uh … whether it was … it’s Moses, Elijah, Jonah, Jeremiah, Job, Peter and Paul, they all experienced depression.

But God did not respond to them as unfaithful.  Didn’t even respond to the … He responded with compassion and care and mercy, but He did not respond to them this way, “You’re not being My faithful servant.” He never did that. You go back and you read the stories.  It’s remarkable how God dealt with their irrational thinking.  He corrected their misconcepts and He also dealt with them with great compassion, but He never once reproved them saying, “Well, you don’t have enough trust and faith.”

In fact, uh … you know, when we were talking about the biological and the environmental factors, sometimes we think of it this way.  The genetic factors and biological factors are the gun and the environment pulls the trigger. That loads the gun and this pulls the trigger.

Jim:  Hm.

Gary: And uh … and so, the two are intimately connected. And so, sometimes it’s just issues.  That’s why it’s an alarm system. It’s pointing out issues that need attention, maybe that have been neglected, maybe they don’t want to look at them. I always … my clients who come into my office, I always salute them for the courage for them to come in and face some of the darkest parts of their lives and deal with some of the issues that maybe ha … is still hurting them, but they have ne … they’re for the first time tak … turning around and taking a look at the skeletons in their closet. And I salute the courage to do that.  It’s not easy.

Gary:  Our desire is that people recognize that God wants us to see ourselves in our fullness and as a whole person, recognize the vulnerabilities of our body and the genetics that we have, recognize our family systems and the stresses that we’ve come about, recognize the spiritual dynamics that may have had uh … influenced us in our false concepts of God. And now as we understand that, to understand God and appreciate Him in a new way.

And that’s why we’re so excited of the ministry of FOF, because you are able to come alongside people as they call and ask for help in these areas, to sort of say, “What can I do to find resources that will enable me to understand the love of God in a deeper way, so that I am not trapped.”

I tell people that the most toxic environment that they can experience is that they feel trapped.  I can’t move here.  No one will accept me there.  I can’t go that way.  I am stuck.  God not only listens; He is actively engaged in your freedom and in your release from being in the bondage of this emotional turmoil that you’re in, that is affecting your body, your soul and your spirit.

Jim: Can I ask you to pray for those who are suffering from depression?  Will you do that for us now?

Gary: I’d be honored.

Jim:  Let’s do that.

Gary: Loving Father, as we come into Your presence, we never need an appointment. So, Father, You know the devastation that depression can cause on the hearts and lives of people, that causes them to be withdrawn and to doubt you and to live a life of lack of hope and hopelessness.

So, Father, would You companion and come alongside those who are hurting and give them uh … the courage to take the next step, to break free and to find hope and to find help, because we are never closer to You than when we acknowledge our need for You. And each one of us needs You and thank You that You will meet us in our time of need and that You will give us the hope and the healing that can only come from You, for You are the Great Physician.

So, Father, we thank You for the God that You are, Who listens and responds actively and intentionally in our behalf.  In Jesus’ name, amen.

Jim: Amen.  Dr. Knopf, Dr. Lovejoy, author of the book, Light on the Fringe: Finding Hope in the Darkness of Depression, thank you for being with us here at FOF.

Gary: Thank you so much.

Greg:  Well, thank you.

John:  And as I mentioned earlier, we’ve dealt with depression in my own family and I’ve really appreciated the encouragement and uh … the practical advice that you’ve offered us today.

You know, here at FOF, we want to come alongside you if you’re journeying through depression.  And a couple of resources that might help get out of that depression include a book by both of our guests here. It’s called Light on the Fringe and then Dr. Knopf has written Demystifying Depression for Christians

We also have some additional conversations with them about medication and its important in treating depression and then one about the impact of low self-worth on depression.  And then, uh … we do have audio downloads and CDs.  We have links to a couple of other broadcasts that we’ve had.  Recently we featured Sheila Walsh on this program, talking about her journey through a very deep depression.  And uh … not too long ago, we talked with Jerusha Clark about postpartum depression. So, a lot of good resources in print and audio form and you can find details about all of this at
www.focusonthefamily.com/radio.

Now perhaps today’s discussion has really resonated with you because you or someone you love is in the midst of a dark depression. Please know that we’re here for you and we have caring Christian counselors who can talk with you and direct you to somebody locally to offer ongoing assistance.  That’s as easy as a phone call during business hours to connect with our counseling department: 1-800, the letter A and the word FAMILY; 800-232-6459.

By the way, last year we fielded 66,000 calls for counseling help. And you can make that possible when you pray for and donate to this ministry.  Your gift of $28 today provides one struggling family with help. And of course, we’ll accept a gift of any amount.  After you’ve met the obligations of your local church, please do reach out; help us to continue coming alongside those who are hurting and uh … often need this ministry most, but can’t always afford to support it.

Our program today was provided by FOF and on behalf of Jim Daly, Dr. Juli Slattery and the entire team here, thanks for listening in. I’m John Fuller, inviting you back tomorrow, when we’ll talk about pregnancy, the joys and the challenges and once again, turn our hearts toward home.

Today's Guests

Cover image of the book "Walking on Water When You Feel Like You're Drowning"

Walking on Water When You Feel Like You're Drowning: Finding Hope in Life's Darkest Moments

Tommy Nelson's book offers a truly biblical approach to healing emotional distress that focuses on a holistic cure integrating the mind, body, and spirit.

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Accepting Your Imperfect Life

Amy Carroll shares how her perfectionism led to her being discontent in her marriage for over a decade, how she learned to find value in who Christ is, not in what she does, and practical ways everyone can accept the messiness of marriage and of life.