When I awoke on October 6, 2006, it was a morning like any other. We had just returned home from a two week trip to the Midwest to visit children, siblings and take in the wedding of my wife Betty’s nephew. All seemed well, although I had said to Betty “I think I am getting depressed, but I do not know what to do about it.” I naively hoped that I was ready to resume my work as Pastor of Congregational Life and Outreach at Visalia Christian Reformed Church. It was Thursday. The only thing I had that was pressing was a wedding on Saturday. Being part of a staff ministry and not being the senior pastor meant that I was not scheduled to preach on Sunday. This I thought would be a relaxing weekend punctuated with the joy of an especially heartwarming wedding of two believers in Jesus Christ. But Thursday and Friday went by with a sluggish kind of pace and I had a feeling that something was not right. Just what, I did not know or did not want to know. You see, what I was going to find out very soon was that I had slipped back into a seventh depression. Perhaps I was just in denial, or the cursed feelings of depression had not yet totally hit me. By Saturday they had. Although I was playing a minor role, the wedding details already in the morning were beginning to overwhelm me as if I had never officiated at a wedding before in my life. I had been a pastor for 37 years and the number of weddings at which I had officiated was substantial—so to feel this threatened and nervous was not normal for me.
I gradually had to admit the old “dark cloud” that Abraham Lincoln used to talk about had come back. I have come to hate it when I have to admit to myself, to Betty, the family, and to those close to me that I’m depressed. I mean clinically depressed. I’m not talking about having a bad hair day, or having the blues, or suffering from some anxiety associated with a particular event that has happened or is about to happen. No, I’m talking about complete dis-ease. Dis-ease with oneself, dis-ease with all one’s relationships, dis-ease with life, and dis-ease with God. I’m talking about what William Styron described as the indescribable:
If the pain were readily describable most of the countless sufferers from this ancient affliction would have been able to confidently depict for their friends and loved ones (even their physicians) some of the actual dimensions of their torment, and perhaps elicit a comprehension that has been generally lacking; such incomprehension has usually been due not to failure of sympathy but to the basic inability of healthy people to imagine a form of torment so alien to everyday experience.
Depression is never easy. It is an ugly time for the afflicted and for all the significant others affected. Lillian Grissen aptly writes: “The depressed person does not live at the bottom of the sea; he lies beneath the bottom.” When I hear about people who take their own lives because they were depressed, it does not surprise me but it deeply saddens me. How is it possible that in a day when we can communicate with gadgets in outer space, we still cannot figure out something to prevent these troubled souls from taking matters into their own hands? In a world where we all walk around with cell phones by which we can call or text each other, find out the latest news, weather, sports, and get directions to a store’s location, how is it possible for a young mother of five to become so despondent that she drowns her own children in her bathtub? How is it possible that a depressed person, as happened in our town, shot and killed a much loved Mormon bishop? How can a depressed person in Aurora, Colorado, go to a theater and open fire on a crowd, killing twelve and wounding many more? Astonishingly, as I am writing these words, the news is filled with the tragic account of a shooting in a Newtown, CT. elementary school taking the lives of 20 children and 7 adults. The shooter also took his own life. Again much speculation is taking place regarding the mental health of the shooter and the appropriate role of guns in our society.
Yes, depression is indescribable. In an article in Christianity Today, Christine A. Scheller quotes Kay Redfield Jamison, Johns Hopkins University professor of psychiatry in an attempt to describe the indescribable:
From the time I woke up in the morning until the time I went to bed at night, I was unbearably miserable and seemingly incapable of any kind of joy or enthusiasm. Everything—every thought, word, movement—was an effort. Everything that once was sparkling was now flat. . . . The wretched, convoluted, and pathetically confused mass of gray worked only well enough to torment me with a dreary litany of my inadequacies and shortcomings in character, and to taunt me with the total, desperate hopelessness of it all. . . . Death and its kin were constant companions.
My first personal brush with depression came in Riverside, California. In the same year that I turned 40, 1984, I became totally lethargic, unable to concentrate, felt worthless, incompetent, and struggled mightily to get my pastoral responsibilities done. I thought it would fade away but it continued for several months. I spoke with a hospital chaplain, (whom I had met along the way) at Voorman’s Psychiatric Medical Center about my situation and he arranged for me to meet with a psychiatrist.
The psychiatrist asked me a number of questions: “What do you do for pleasure?” “Any hobbies, outside of ministry interests?”
I could not think of anything.
“How is your marriage, family life, ministry life? Anything stressing you out there?”
I could not think of anything.
“Well,” he said, “you are obviously very angry with someone.”
I could not think of anyone.
“You are angry with yourself.”
“I am not aware of being angry with myself,” I said.
“You are beating up on yourself,” came the all too quick response.
“You are telling yourself that you are no good, worthless, incompetent, and a piece of s_____.” That got a little closer to home than I was prepared for and I had to admit that I did not think very well of myself. He said, “You have to get your own cup filled first. You cannot minister to others, if you do not have anything in your cup to minister from.” That made sense. Thankfully my time was up. That was enough for one hour. We parted with him saying, “You do not need to see me again unless you want to. You can find any number of good psychiatrists right there in Riverside, if you want to.” I went home with plenty of meat to chew on. But I did nothing except to tell Betty about it, and she right away thought that the idea of filling my own cup was right on target. I thought about it but started feeling better so never went any farther with filling my cup.
Unfortunately, about a year later, the same thing came back, only this time more intense. So I went to a psychologist in Riverside who talked with me and gave me a test. His observations were very similar to the first doctor I saw. He also thought I could benefit from the reading of John Bradshaw’s book On the Family. Bradshaw’s book had by this time become a highly regarded book on the nature of functional and dysfunctional families. He said he wanted me to see a psychiatrist to determine if I needed to be on medication. I did and the psychiatrist’s conclusion was that in addition to medication I should make filling my own life with good things a much higher priority. This was the beginning of a long journey which I am still on today.
Depression is baffling. To the concerned family member or friend, sometimes even therapists, depression appears to be something about which one can do something. This may be true in some situations. It certainly is not true when the cause comes from within the person. Archibald Hart explains in his book Dark Clouds–Silver Linings that, broadly speaking, there are three major categories of depression. I find these distinctions helpful in understanding depression. “First, there are endogenous depressions. These come from within the body. They are generally understood to be caused by biochemical disturbances in the brain, the hormonal system, or the nervous system. Some are the direct cause of disease or infection.” In a different book, Counseling the Depressed, Dr. Hart cites a “Special Report on Depression Research” from the National Institute of Mental Health:
This report emphasizes that at a fundamental level, all behavioral responses to our world are dependent on electrical and neurochemical transmission in the brain. Nerve impulses trigger the release of neurotransmitters, or special chemical messengers. Every nerve pathway has special synapses and the purpose of the neurotransmitter is to help the nerve signal jump across this gap.
This is the kind of depression I primarily experienced and am describing. Because of endogenous causes, depressed people often speak about a dullness of mind or a frozen brain without an ability to focus or concentrate. It is a brain that is largely out of control. What one can do easily normally, suddenly becomes a mountainous and gigantic task. I could stand at the closet for five minutes trying to decide what to wear. While this may be normal for some, believe me, it does not normally take this long for me. Dr. Hart continues:
The second group of depressions is known as exogenous depressions [meaning “from without”]. These are reactions to what is going on externally, the depressions we experience in day-to-day living. They are psychological in nature. . . .
The third group of depressions I call the neurotic depressions. These differ from reactive depressions in that they’re responses to the stresses and anxieties of life that have built up over a long period. They happen when we don’t grieve our losses in a healthy way.
In Dark Clouds; Silver Linings, Hart adds the following regarding endogenous depression: “We don’t fully understand everything about how the brains chemistry can be disturbed, but these depressions respond so well to antidepressant medication that it is generally accepted that that they have a biochemical basis.” If a depression can have a biochemical basis, then it becomes clear to me that it is not helpful to say to a depressed person, “you should exercise more regularly, read your Bible more faithfully, pray more fervently, stop dwelling on your depression, think more positively, and take the focus off of yourself, and then, perhaps, the Lord would bring you victory.” This does not mean that any one of these alone or all of them together could not help anyone at anytime in their life. But to focus on self-help exercises alone for a biologically based depression is simply devaluing the suffering that is taking place. It is cruel and flows from ignorance regarding depression. I can assure you it is not the best way to win the friendship of depressed people. They resent it and well they should. Imagine saying to a person suffering with cancer: “forget taking those chemical treatments or radiation treatments, if you would just adopt a positive attitude or eliminate certain negative and self-defeating thinking patterns you would get better.” Yet unfortunately things like this are said to people with depression. Not because of malice but of misunderstanding.
Clinically depressed people are not able to get themselves out of their depression. And this may be baffling to those who come alongside of the depressed person. Why can you not just snap out of it? Why can you not just make one right decision and then another and another and gradually simply walk out of your pit? Indeed this “advice” baffles depressed people and increases their pain. They feel like they should be able to get out of their depression. They ask: if everybody else can why can’t I? This begins a cycle of guilt and shame.
Since I am not getting better, I must not be trying hard enough, and if I am not trying hard enough, I am lazy. And if I am lazy, that makes me guilty of sin. And if I am guilty of sin and cannot get well, that must mean I am not confessing my sin properly before God, or perhaps I may have sinned beyond the bounds of his grace, perhaps like Judas. One can become increasingly convinced that she has committed the unpardonable sin against the Holy Spirit. My mother often struggled with this thought. This cycle of inability, guilt and shame, worthlessness and hopelessness can, if not carefully treated and monitored, lead to suicide. I know from experience that it is only the gentle but firm hands of God that have held me back. Only his faithfulness and unconditional love saved me from doing what others have done. I can only believe that God in his grace and justice will deal with them in a gracious and just manner. Gracious because God will deal with them in light of his gift of eternal life for all sinners who believe in Jesus; just because God will deal with them as he does with all Christians in light of having judged or punished our sins when Jesus died on the cross for our sins. “He did it to demonstrate his justice at the present time, so as to be just and the one who justifies those who have faith in Jesus” (Romans 3: 26).
One weekend I was feeling horrible. I was saying scary things and thinking even scarier things like “I do not know why I’m still alive.” “I’m not getting any better.” “It seems like my best way out of this predicament is death.” I was desperate and hopeless. I could not appreciate reminders that I had a wonderful wife, family, friends and otherwise good health. It seemed best to Betty and the family that I should be hospitalized. Betty and Pastor Vink took me to the emergency room. I cannot remember very well what all took place in the emergency room. Someone gave me a shot and stuffed me in what seemed to me like a chamber in which I would slide back and forth. I thought they were going to kill me. I have asked Betty about this contraption, but she has no idea what I am talking about. Perhaps this was a product of hallucination. After consultation with a social worker, Betty, and my daughter, I was transferred to a mental hospital in Fresno. Never in my wildest dreams, did I expect to end up in a mental hospital. I knew that my mother had gone to Pine Rest Christian Hospital in Grand Rapids, Michigan, several times in her life, but I never thought that I would hear the door slam behind and realize that I was prisoner. It was frightening to me but also emotionally draining for Betty and our children.
In the Fresno hospital, I received numerous visits by a variety of physicians, social workers, and counselors. My medicine prescriptions were changed several times and I felt somewhat better. The hospital could only keep me for 72 hours and then if I wanted more care I could voluntarily commit myself. One counselor said, “You need to find a new way of handling stress,” implying, I thought, that my problem was a simple matter of proper skills and that some kind of behavioral change could make me better. Such an understanding, I think, completely oversimplifies what depression is, particularly one with a biological component. One psychologist came in and started berating us for being in a mental hospital. Perhaps he thought we wanted to be there. In his speech he argued against the use of medication for depression because, he said, drugs are ineffective. He described us as the clowns, black sheep, and morons in our family. I had never thought of myself in those terms. I started talking to some other patients to see what they thought of him, but they did not want to say much. One said, “You had better be careful or you will be in here for a long time.” Being a preacher, I knew the trouble you could get into by saying the wrong thing. I thought the psychologist was guilty of verbal abuse. But was I in any kind of condition to make that judgment? After three days, they said I could go home. I remember that Betty was very uncomfortable with me coming home, but I was unwilling to commit myself to further treatment. Now as I look back I wonder why I did not use this opportunity for greater treatment? Was it concern for the cost? Was it the stigma of being in a mental hospital? Did I actually think that I could go home and with outpatient professional care I would get well?
I had several visits from pastors of the church and friends. They were much appreciated. I remember a meeting of Betty, Becky, and Sarah (my wife and two daughters) and me with a psychologist. But I cannot remember specifically what was said or planned.
The first couple of days at home went okay. Towards the end of the week, I was having serious problems with the regular symptoms of depression. I think it was Thursday night that Betty asked Rev. Herm Minnema to come over to talk with me. He did, and everything he said made sense and was supportive, but I was not feeling any better. I truly appreciated his time and presence with me and his prayer. By Friday I called 911. The operator asked if I thought I might do myself harm, to which I said I really did not know. A police officer came to the door and wanted to talk with me. He asked how I was feeling and other questions to see if I could be at home or if I needed to go to the hospital again. I thought I would be okay. So he left. My neighbor also came over to check and I told her I would be okay. But my feelings started to get more intense. It was not long and a police car, an ambulance, and a fire truck were parked in front of the house. A police officer came in the house and ushered me to his car. Off to Kaweah Hospital I went again. After that initial procedure, which I cannot figure out to this day, I was transferred to our local Kaweah Delta Mental Hospital. Since it was the weekend, very little in the area of therapy occurred. I remember walking down the hall thinking that all the people I met were in a ghost like dimension. I would talk to them but I could not tell if they were real. It was horrible. A social worker took me aside and I asked, “What is going on with me?” He said, “You were hallucinating.” I never want to do that again.
This time Betty asked the staff to recommend a psychiatrist. They suggested one. He felt I was completely over-medicated and that some medications were actually fighting with each other. He changed the medical package. This time we also decided to stay for two weeks and at the end of that time I started to feel somewhat better. During this hospitalization, I had visits from the family and fellow church members. During all my episodes of depression, I had tremendous family support and that of friends. They were always an integral part of my healing. Pastor Vink also stopped by. He had seen me many times throughout this whole episode, because of our mutual ministry at church, and had assured me that nothing could separate me from the love of God in Christ Jesus. He repeated it: “Nothing.” I am thankful for his non-judgmental support. Again it was time to go home but this time I gradually became better so that I went back to work at church almost immediately.
On reflection, this was way too soon. I felt good and actually started a new church program called Celebrate Recovery in the fall of 2006. But gradually the symptoms of depression were coming back. I was completely frustrated. I had to drop out of Celebrate Recovery, which made me sad for the volunteers and for this program that was showing a great deal of potential.
Excerpted from This Poison Called Depression by Larry E. Van Essen (InspiringVoices, 2013). Used by permission of the author and publisher.