Depression and Mental Health

The Not-So-Final Phase of My Recovery

I have not posted here for several months.  There has been what I consider a good reason:  I got a job teaching school.

 That’s a good thing.  I love teaching high school and I sorely missed it in the five years since I had to leave my last position due to family needs.  Though I substituted and did odd jobs, I never had the satisfaction of resuming my career and doing what I do best until this past September.  I am very happy with my position.  I love the kids and the coworkers.  The families have been great and the work has been fulfilling.  God is good!

 I am still battling depression.  Why? WHY?

 My pastor, my counselor, my psychiatrist, my friends and I had all agreed that when I got a good job I would be happy and the mental illness would be a thing of the past.  We were all wrong, for we were assuming that the aspects of depression I faced were based upon my attitude which in turn was based upon my circumstances.  As a matter of fact, my mental illness was, is, and always will be a result of physical causes within my body. 

 Don’t get me wrong:  I am better in many ways than I was even six months ago.  But as long as the chemical imbalance remains, my mind and emotions will continue to respond to situations in odd ways.  Let me describe a few of my personal observations, in the hope that someone else might gain understanding or even hope.

  •  For whatever reason, my memory is noticeably diminished; this makes teaching much harder than it used to be.  I am still struggling to remember a handful of student names.  Talk about frustration!
  •  I am extremely distractable, and find it difficult to concentrate.  Not only is it harder to grade papers, it is harder to stay on task for a 60-minute class, or even to follow my own lesson plans.
  • I fly through the day on an adrenaline rush—I am thrilled to be doing what I am doing!  But that leaves me exhausted physically and emotionally when the students leave and it’s time to start the 36-mile drive home.  Do you understand why I didn’t want to say that “I crash” at the end of the school day?  (And then I wake in the middle of the night, often to sleep no more.)
  •  Everything is new—the schedule, some of the classes, the policies and procedures, even the routines.  I had learned to cope with my limitations by living within a comfortable rut, but that’s no longer possible.
  •  The energy required to fulfill my duties no longer left me no choice but to eliminate a major source of stress in my life.  While I know I did the proper and necessary thing, in my weak moments I suffer from the temptation to feel guilt and regret.  The holidays have amplified this struggle.
  •  And one of the more difficult aspects of my position is that I am uncertain just how much I can and should say about my mental illness.  Those of you who have followed my journey know that I have been open and transparent, and that approach has been a blessing to me and to some others as well.  But as a professional educator, I must keep my students in mind; and I believe that my story is something that they need not hear, lest it cause confusion or distraction from the classroom ministry.  Some of the older students have found my blog, and, presumably, have read it; but none of them or their parents have commented on its contents.  My administrator and the school board knew my situation before they hired me; and my coworkers learned in October when I presented a seminar.  They have all been very understanding and, honestly, react to me as if I were “normal.”  I’m just not sure that my students in grades 7-? would be able to do the same, and I’m not about to put them to the test.  And the parents?    They pay the bills, and I fear that some would not trust their precious children to someone who has been unstable in the past.

 So I haven’t written in my blog.  I appreciate the patience of those who waited for a new post, and are ready to read this.  As time passes, I trust my energy levels will rise, my concentration will return, and my reputation at the school will allow me to write freely and frequently once more.  If you are a praying person, I would ask you to pray to that end.  Thank you.

 By the way:  I could write energetically about politics every day, but my counselors have advised me to stay positive.  God bless America—she needs it.

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Teachers Don’t Burn Out (and Other Lies)

Last week I presented a seminar to a teachers’ conference on the topic of burnout–which is often just another (more acceptable) name for depression.  I have included here the text of the handout I used.  I also included “Preacher’s Story” available elsewhere on this site.

Teachers Don’t Burn Out (and Other Lies)

Presented at NYACS Fall Conference Oct. 2013

Robert D. Bowker, ValleyHeightsChristianAcademy

 

“Burnout is not an official term or diagnosis in the field of mental illness….there is no agreement among scientists as to how we should define burnout.”   –Douglas Mental Health University Institute

“Teachers who feel a sense of accomplishment don’t burnout.”  –Maurice Elias

“You have a choice.  Stress leads to burnout; burnout leads to depression.  Next question.”  –quoted by Athlee Bowman

“Teacher burnout is a condition in which teachers remain as paid employees but stop functioning as professionals.”  –Martin Haberman in “An Antidote…”

  

 

True or False? 

In other words, do you agree with my conclusions based upon personal experience and research that I like?

_____ 1.  Burnout is a defined physical, emotional and psychological condition.

_____ 2.  Burnout is the greatest threat to teacher success and satisfaction today.

_____ 3.  The factors that may lead to burnout can be prevented or controlled.

_____ 4.  The factors that may lead to teacher burnout are primarily the school administrator’s fault.

_____ 5.  Behavioral and cognitive therapies are reasonable treatments for symptoms of burnout.

_____ 6.  Burnout is another name for depression.

_____ 7.  Time and place help to define both burnout and depression.

_____ 8.  Depression is quicker and easier to treat than burnout.

_____ 9.  .Spiritual Christians will suffer depression, but not for long.

_____ 10.  Depression is the result of sin.

 

1.  Burnout is a defined physical, emotional and psychological condition.  TRUE–though it is not recognized as a form of medical or mental illness.

Almost unanimously, burnout is said to be characterized by three aspects:

            a.  Physical and emotional fatigue  (with the pains, illnesses, irritability, inability to            concentrate, forgetfulness, changes in eating and sleeping patterns, and other factors that can          result from any severe exhaustion)

            b.  Depersonalization  (the withdrawal of the individual from interaction with others)

            c.  Reduced sense of personal accomplishment (loss of joy, satisfaction, motivation, and             hope)

Note that these aspects involve physical, social, and psychological factors.  Also note however, that there is a spiritual aspect as well—necessary for prevention or recovery from burnout or any other situation that may involve symptoms such as these.

 

2.  Burnout is the greatest threat to teacher success and satisfaction today.  FALSE.

Burnout poses a threat to any teacher who cares about students; but burnout itself is a response to the threat we call stress.

 

3.  The factors that may lead to burnout can be prevented or controlled.  FALSE. 

By definition, stress results from our inability to prevent or control aspects of our life.

C. Kyriacou in 2001 listed 10 of the main sources of teacher stress:

  • pupils who lack motivation
  • maintaining discipline
  • time pressures and workload
  • coping with change
  • be evaluated by others
  • dealings with colleagues
  • self-esteem and status issues
  • administration and management
  • role conflict and ambiguity
  • poor working conditions

 

In most cases, the teacher has few resources to prevent or control these issues.  However, the teacher at the outset does have the power to determine how she or he will respond to the stresses.  Palliative techniques focus on reducing the feelings of stress in the individual.

 

4.  The factors that may lead to teacher burnout are primarily the school administrator’s fault.  TRUE. 

Well, maybe responsibility is a better word than fault.  In an ideal world, the administrator would be the person with the power to change the things that we cannot.

 

5.  Behavioral and cognitive therapies are reasonable treatments for symptoms of burnout.

TRUE.

While the terms sound worldly and unspiritual, the concepts that they describe are profitable spiritual exercises and steps of obedience and growth.

Whether we call them palliative, behavioral, cognitive, or some other kind of treatment, the fact is that the way we respond to stress under normal conditions is determined by our choices.  Do we think on the things of Philippians 4:8?  Do we focus on the fruit of the Spirit, or are we overcome by the works of the flesh?  Do we rejoice in the Psalms, or do we wallow in the first 11 chapters of Ecclesiastes?  Do we worship, or do we worry?  Have we made moderation and contentment our watchwords?

If (for whatever reason) wrong thought patterns, speech patterns, or behavior patterns have started affecting our lives and ministries, we can apply techniques of prayer, meditation, praise, singing psalms, hymns, and spiritual songs, etc.  These therapies will not change our circumstances, but they will change the way we view our circumstances.

Examples of behavioral therapies:

  • change in diet, especially to add vitamin D
  • increased physical activity
  • discussion group/relationship building
  • set and keep a simple schedule and routine
  • become actively involved in a hobby
  • breathing exercises and other stress relief mechanisms
  • seek and maintain regular counseling

Other examples of cognitive therapies:

  • trust God, read His word, pray–even if it is only a few minutes or a few words
  • list negative influences in your life, and deal with them appropriately
  • confess sin and forgive yourself–aloud if necessary
  • acknowledge and permit yourself to experience your disappointments and griefs
  • list encouraging words and practice them on yourself and others
  • memorize and quote or write appropriate Scriptures
  • list 5 goals for the future, and determine what it would take to make them come true
  • accept your illness and call it an illness
  • eliminate terminal words from your vocabulary:  can’t, won’t, always, never, impossible, etc.

 

It behooves us to pause and look at five stages of burnout, as defined  by Jesse Lyn Hanley, M.D.

Driven—the pre-burnout stage, when tremendous things are accomplished—not motivated by plan or purpose, but by the adrenalin rush triggered by pressure.  While this looks great to the casual observer, the driven individual is becoming dependent upon adrenalin (the “fight or flight” hormone).  Unless interrupted at this point, there is the very real danger of adrenaline addition and adrenal fatigue.  NOTE:  both of these are physical, hormonal imbalances that affect the body and mind.

Draggin’—the physical fatigue from adrenalin overload results in weakened determination and self-control.  Diet and sleep habits begin to be affected. 

Losing It.—Physical and emotional fatigue are having an effect on the social aspects of life.  Anger, hypersensitivity, and complaining are constant companions when you have to be around others.  On the whole, it’s easier to stay away from everyone else.

Hitting the Wall—the body and mind are wearing down, resulting in aches and pains, outbursts of emotion, and forgetfulness.  The teacher who has “hit the wall” knows that she is no longer effective in the classroom, but can’t do anything about it—and frankly, doesn’t want to try.

Burned Out—Serious illnesses and accidents are common.  The teacher at this stage will often self-medicate or will stop taking necessary prescriptions.  The pervasive sense of uselessness, despair, and unworthiness leads to serious consideration of leaving the job, the profession, the family, or worse.

 

6.  Burnout is another name for depression.  TRUE.

It is my contention (and my experience) that when one reaches stage 5 of burnout as defined above, there is no distinction between it and depression.

 

7.  Time and place help to define both burnout and depression.  FALSE.

 

Various “experts” try to use duration or workplace setting to distinguish between these conditions, but their conclusions are contradictory and occasionally nonsensical.

John Rosales tells of a “Survive and Thrive” Mini-Sabbatical Intervention Program for suffering teachers.  The program begins with a retreat and “…After the first year, most [of the burned-out teachers] are back in their classrooms.”  Nicholas Provenzano assigns the most frequent burnouts to the end of the school year, lasting about two months.  Another writer (Douglas) contends if the symptoms are intense and last more than two weeks, then the sufferer has depression, not burnout.  Tim LaHaye describes how his own serious depression lasted only a few days.  He also documents the claim that the tendency toward depression increases over the years, and especially past age 50; Clandfield cites a study indicating that burnout is greater when the teachers are much younger.

As for the matter of location, Elias contends that “…Teacher burnout is most often an organizational problem….”  Leiter and Durup write that “…Burnout is primarily a social construct…” as opposed to the personal nature of depression; and that they illustrate by referring to how sufferers word their complaints:  teachers with burnout might say something to the effect that their job makes them feel sad, while those who are depressed express sadness without reference to the job.  Other writers (e.g. Brennfleck and Brennfleck) apparently believe strongly that burnout is specific to the job–suggesting that a primary solution to burnout is changing workplaces or even careers.  I have not encountered any professionals who have suggested that changing location would in any way help someone who is depressed.

 

8.  Depression is quicker and easier to treat than burnout.  FALSE.

“If the problem is depression, particularly of the endogenous type, effective relief may be only weeks away through appropriate medication.  Burnout may require many months or even years of adjustment for effective recovery.”  –Hart

My experience is that experts in depression may discount burnout (since, after all, it is not a mental illness) and assign quick and easy solutions for it.  Those who study burnout may, in their rush to differentiate it from depression, may make claims like the one above: depression may require medication, but burnout never does. [This is especially true in religious articles such as Bowman, Wiedis, Amimo, Vess, etc. etc.  I suspect there is an ulterior motive behind this phenomenon.] If, however, both conditions share the clinical cause of a hormonal imbalance, and both require physical, social, and emotional/psychological/spiritual treatment, then I do not see how one is easier to deal with than the other.

9.  Spiritual Christians will suffer depression, but not for long.  FALSE.

This denies the fact that true burnout and clinical depression are physical in cause and nature.  Many people wish to believe the statement, however, because their underlying belief is that

10.  Depression is the result of sin.  TRUE–AND FALSE.

Depression is a result of the sin of Adam, just like any other illness.  An individual’s depression may or may not be the result of sin in the life of the sufferer.

This is just my opinion based upon the appearance of the research, and my own personal experience:  but the feeling seems to be pervasive that though Christians can suffer burnout due to circumstances beyond their control truly spiritual people do not get depressed.  Here’s how Brennfleck and Brennfleck paint the picture:

 

You can’t get out of bed in the morning, and always feel tired no matter how much sleep you’ve had.  During the day, you feel unmotivated, bored, and perhaps depressed at work.  You feel overwhelmed and like you have lost control over things at work (and at home).  You have lost interest in the things that you used to find exciting.  You find yourself being more irritable or angry.  You are experiencing more physical aches, pains, headaches, stomach problems, or chest pains and find yourself sick more often than before.  When you are at home, you feel anxious, angry, and disconnected from your family members.  If several of these symptoms describe you, you likely are experiencing job burnout.

[Notice–not depression but burnout, though the description is textbook perfect for depression itself.]

 

Since my own struggles with mental illness began, I have spoken to numerous church groups and pastors’ meetings.  At every one, I have had Christian brothers and sisters confide in me that they too had struggled or were struggling with depression, but that they were afraid to tell anyone because “Spiritual Christians don’t get depressed.”  Every pastor has told me that mental illness is a genuine and serious problem among their members–yet they still hesitate to discuss the topic publicly–presumably because of the long-held prejudice that if believers would just trust and pray, they wouldn’t suffer from depression.  There is an ancient Greek word that expresses my reaction to that ignorant way of thinking:

 

Hogwash!

 

 

Works Cited

 

Amimo, Catherine A.  “Are You Experiencing Teacher Burnout?  A Synthesis of Research Reveals Conventional Prevention and Spiritual Healing.”  Education Research Journal. November 2012. <http://resjournals.com/ERJ/Pdf/ 2012/Nov/Amimo.pdf>.

 

 “An Antidote to Teacher Burnout:  Building the Learning Relationship.”  <http://straightpaths.typepad.com/straight_paths_through_cr/2013/02/an-antidote-to-teacher-burnout-building-the-learning-relationship.html>.

 

 “An Apple a Day:  Avoiding Teacher Burnout.” <http://www.beliefnet.com/Inspiration/  Christian-Inspiration/2003/09/An-Apple-A-Day-Avoiding-Teacher-Burnout.aspx#>.

 

Bowman, Athlee.  “How to Manage Stress—Advice for Christian Women on

Managing Stress and Beating Burnout.”  Just Between Us. <http://justbetweenus. org/ pages/ page.asp?page_id=124173>.

 

Brennfleck, Kevin, and Brennfleck, Kay Marie.  “Are You Burned Out on Your Job?”  ChristianCareerCenter.com.  <http://www.christiancareercenter.com/advice-and-resources/career-and-calling-articles/burned-out-on-the-job>.

 

Clandfield, Lindsay.  “Debate:  Are You Suffering from Burnout?”  OneStopEnglish.  2013.  <www.onestopenglish.com/support/mehodology/debates/are-you-suffering-from-burnout>

 

“Depression or Burn-out?” Mental Health A-Z.  <www.douglas.qc.ca/info/depression-or-burn-out.>

 

Elias, Maurice.  “Teacher Burnout:  What Are the Warning Signs?”  Edutopia.  May 12, 2012. <http://www.edutopia.org/blog/teacher-burnout-warning-signs-maurice-elias.>

 

Hanley, Jesse Lynn, M.D.  cited in “Five Ways to Bring Yourself Back from Burnout.”  Oprah.com.  November 2011.  <www.oprah.com/spirit/What-to-Do-When-Youre-Burned-Out-Consequences-of -Stress>

 

Hart, Archibald D.  “Depressed, Stressed and Burned out:  What’s Going on in My Life?”

Enrichment Journal.  2013.  ,<http://enrichmentjournal. ag.org/ 200603/ 200603_020_burnout.cfm>..

 

Kyriacou, C.  cited in “Coping with Teacher Burnout.”  Center for the Advancement of Mental Health Practices in Schools.  <http://www.schoolmentalhealth.org/

Resources/Educ/CAMHPS/Coping%20with%20teacher%20burnout.pdf>.

 

LaHaye, Tim.  How to Win Over Depression.  Revised Edition.  Grand Rapids:  Zondervan, 1996.

 

Leiter, Michael P., and Durup, Josette.  “The Discriminant Validity of Burnout and Depression:  A Confirmatory Factor Analytic Study.”  Anxiety, Stress and Coping.  1994.

 

Mesar, Tania.  “Teacher Burn Out—3 Crucial Strategies to Get Beyond It.”  Articlesbase.com.  <http://www.articlesbase.com/education-articles/teacher-burn-out-3-crucial-strategies-to-get-beyond-it-784190.html>.

 

Provenzano, Nicholas.  “Teacher Burnout:  Four Warning Signs.”  Teacher Leadership.  May 22, 2013.  <www.edutopia.org/blog/teacher-burnout-four-warning-signs-nicholas-provenzano>

 

Rosales, John.  “Surviving Teacher Burnout.”  NEA Today.  June 7, 2011.  <neatoday.org/2011/06/07/surviving-teacher-burnout/>

 

Vess, Daniel R.  “Are You Suffering from Spiritual Burnout?”<http://www.forumterrace.

com/Questions/Burnout.html>.

 

Wiedis, Dave.  “Ten Rules to Avoid Ministry Burnout.” ChurchLeaders.com. <http://www.churchleaders.com/pastors/pastor-how-to/150219-ten-rules-to-avoid-ministry-burnout.html>                                                                            

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The News Depresses Me

All my life I have been a “news junkie”.  People still ask me what I have heard about various stories.  I have become used to the network TV news reporting stories that I had seen several days earlier–or leaving out the most important part of the story.  I still cringe when I hear Rush L. or Sean H. rant about a story that would have been very different if only they had done a little more reading and research.

I am still waiting through TV news stories of Nelson Mandela’s slow recovery to see if the networks will cover the IRS, NSA, Benghazi, or State Department scandals.  They don’t.

I am sick of people who measure economic recovery by the rise in the stock market, or the number of people who leave the unemployment rolls (often because their assistance is exhausted, they have taken part-time, minimum wage jobs, or they have claimed early retirement or disability).

I am confused when my unemployment is cut 10.7% to save money while the First Family spends millions of dollars per day on trips to Africa, Europe, and Ireland, among other places.

I am angered when covert operations are called transparent and private communications have been improperly accessed by the NSA, who then passed them to the
Attorney General, who claims to have destroyed them without reading them. 

How is it possible that an IRS supervisor in DC admits to asking that Tea Party tax exempt requests be routed to her, and yet the media insist on quoting political hacks who claim that the targeting was done by a handful of disgruntled and delusional low-level employees?

I could go on, but I need to stop with one more item.  I may have to give up my news intake before my depression takes me down that dark and dangerous road again.  But here’s a story and quote from our President, reported yesterday (emphasis added):

In an interview that’s been heavily promoted by the White House and Obama aides, the president acknowledged that a program which collects massive amounts of data on telephone calls made in or through the U.S. could theoretically be used to invade individuals’ privacy, even potentially yielding conclusions about callers’ health conditions.

“All of that is true. Except for the fact that for the government, under the program right now, to do that, it would be illegal.”

As if that has ever stopped them before.  With popular confidence in the credibility of the federal government at such a low point, I can think of fewer things that the President could have said that would be more idiotic or less reassuring than that.

My struggle has come down to this:  how do I find the balance between being an informed citizen and a biblical Christian?  After all, Paul said in Philippians 4:8,

Finally, brethren, whatsoever things are true, whatsoever things are honest, whatsoever things are just, whatsoever things are pure, whatsoever things are lovely, whatsoever things are of good report; if there be any virtue, and if there be any praise, think on these things.

Somehow, that description doesn’t fit the news.
Read more: http://www.politico.com/story/2013/06/obama-im-not-dick-cheney-92925.html#ixzz2Wf1NRDbo

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Sympathy

I am saddened and express my heart-felt condolences to the Rick Warren family on the loss of their son this week. While suicide is generally considered an act of the will, for a person with mental illness it can be more of an accidental death; though well-meaning (but misinformed) friends, family, and church-goers may not understand it.

Imagine with me, if you will, a father who knows that his son’s car is acting up. Its acceleration is erratic and unpredictable, and it seems potentially unsafe. All that the son knows is that he needs the car to get to work. His father takes the car to his local mechanic, who can’t find the problem, but says he doesn’t think it’s serious. The car is then taken to the dealer, who says that the problem is familiar, and that certain fuel additives and intentional changes in driving habits can make the problem less noticeable. All the son knows is that he needs the car to get to work. Dad takes responsibility for seeing that the additives are used and reminds his son to drive carefully. Mom doesn’t know anything about cars, but she knows how important working and having money is to her son, and does her best to be supportive as he pursues his career goals. After all, the only way to slow him down would be to lock him in his room, which goes against her love for him and her desire to see him happy. When the car breaks down and the son dies, the blame game starts.

Dad blames himself, sensing that there must have been something more that he could have done to get the car fixed. Mom feels that somehow she should have raised her son differently, as if it’s her fault that he became obsessive about work, regardless of the risks. Friends and acquaintances are shocked, knowing that the car was faulty, but still never expecting it would lead to this outcome.

Depression is a faulty car; the need to drive it is mental illness; the unnecessary death that results is suicide–not necessarily a selfish act of the will, but the sad outcome of the mental illness.
(I understand that people kill themselves for many reasons; but this young man was not trying to make a statement or to strike back at a perceived insult or injury–this situation, as reported, was not in that category.)

Mental illness is real; its potential deadly consequences can become tragically real; and when all is said and done, all we can do is pray for the family and friends. Pray for comfort, and pray for understanding–and pray for the young man or woman that you know is driving that defective car down the rough road of life.

Prayer first is better than sympathy later.

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I’m Sorry. No–Wait–I’m Not.

One common aspect of depression is that sufferers tend to adopt and accept the blame for things that they are not responsible for.  This manner of thinking can become ingrained to the point that it is called neurotic guilt.  It may have several causes, but ultimately is rooted in a sense of failure carried by the sufferer.

I am sorry that I have not blogged recently.  No, I’m not.  I have set a goal for myself to write at least two blogs per week, which is a reasonable goal.  No, it’s not a reasonable goal for me, because once I have set it, the goal becomes a law that I must obey or violate.  When I violate it, I feel guilty, regardless of the reason for the failure.  So my expectations are self-imposed and do not take into account various factors that may interfere.  And I am learning not to impose guilt on myself when it is a result of my own unreasonable expectations or outside interference, but I’m not doing very well in overcoming this wrong thinking.  Sorry.

Five weeks ago I woke up with a pinched nerve in my back, which prevented me from moving freely or even standing for more that a minute or two.  Despite 3 series of oral steroids and a nerve-block shot (epidural), the pain is still only slightly less and is only controlled by vicodin around the clock.  In the meantime, I have not been able to spend time at the library (my primary writing spot) and even find it counterproductive to try to sit at my desk and work.  Darlene had signed us up for a cruise and I refused to let her down, so we rented a wheelchair, bought a walking stick, and had a very nice time.

Needless to say, I have not been able to blog for a while, and it might be a while before I can do it again regularly.  To those of you who have come to expect something from me, I’m sorry.  But my inability to write without pain is not my fault, so I’m not sorry.  I’m not going to set a goal for when I can return to this forum, but with your prayers and my doctor’s help I trust that it will be soon.  Until then, I will miss you, Gentle Readers, but I refuse to feel guilty about it.  (At least I will try not to feel guilty.)  

Yours in Christ,

RD Bowker

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At the Corner of Body and Soul

At the risk of sounding self-centered, I’m going to let you, My Gentle Readers, into another corner of my personal life.  There’s a commercial on television that says, “Depression hurts.”  I can testify just as sincerely that “Hurts depress.”

There is a definite (though not completely understood) relationship between the workings of emotion and intellect with the physical body.  In my case, I have a hormone imbalance that predisposed my mind to depressive and even suicidal thoughts.  In searching for the root of that imbalance, doctors have discovered that I have Graves Disease, which in itself disposes my mind to depressive thoughts, even while it acts on the thyroid to cause anxiety (or, in some cases, mania).  Now I have a herniated disk in my lower back, pinching a nerve and interfering with virtually all physical activity.  It also interferes with my sleeping and contributes to a depressive predisposition.

I cannot meet my home or church obligations, and my inability to work leaves me with ethical considerations regarding my unemployment benefits.  My wife had signed us up for a cruise to celebrate our 35th wedding anniversary, which could be less than optimal if I have to attend on crutches or in a wheelchair (and we didn’t purchase the insurance, so we can’t cancel or reschedule without losing beaucoup bucks).

When Darlene gets home from work, I have little or nothing to talk about, because my day has centered around my pain and little else.  This leaves the burden of conversation (as well as my chores) on her, at a time when her work situation is hectic and almost oppressive, and she could benefit from being able to put her own aches and pains aside.  Tomorrow is a “respite day” for us, but we have relatively few options for getting away for some “us” time.  The church has graciously stepped in to provide some meals because she is so busy and I am unable to stand long enough to prepare dinner.

I am not looking for pity.  Many people in my support group have far more serious problems than I have.  There are medications to take the edge off the pain and to reduce the swelling while I await the next step.  I have a loving and understanding wife, and 3 children and grandchildren who are all involved and concerned.  My church family is helping to carry the burden.  I am truly blessed.

But next time you hear that mental illness is all in somebody’s head, don’t you believe it.  It pollutes the soul and contaminates the body.  It dominates the mind as well as the physical aspects of life.  My intellect may tell me that happiness is a choice, but my body laughs at that assertion.

Gentle Reader, if you have gotten this far, please stay with me for one more minute, for there IS a positive side to all this.  For there is more to me than body and soul; there is also spirit.  And while happiness may or may not be a choice, the fact is that faith is a gift from God.  I have the spiritual foundation of Jesus Christ, Who never changes.  I have the guarantee of full recovery in a land where the body will be glorified and my soul will know all things.  God’s love for me and caring for me never waver, even when I crash at the corner of Body and Soul.

I have a request for you today.  If your time and energy are limited, please don’t pray for me; I have lots of brothers and sisters praying for me.  Rather, think of someone else in your family, your church, your circle of acquaintances, who suffers from mental illness; and ask God to guide them through their mental morass and their physical minefield.  Ask that they may find a listening ear, and an appropriate medical treatment.

And pray that the Lord will protect you and the rest of your family from this accident of life that could be waiting just around the corner.

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Mental Illness and Gun Confiscation

At this point, I have not been able to find the actual wording of New York’s new law or the federal government’s proposals; but I have some questions based on the information that I have found.

In general, the concept is that if a person is mentally ill, and a health care professional believes that he poses a threat to himself or others, the doctor must refer the matter to a supervisor, who will determine whether or not the threat is serious.  If he determines that it is a real threat, he is obligated to notify the appropriate police authorities, who will confiscate the patient’s guns.

  • Apparently, the NY law specifies only threats that mention using a gun illegally.  Will this be expanded to include all terroristic threats, which can be verbal, nonverbal, written, or even implied by body language?  If my doctor thinks I’m pointing a finger at him like a gun, can that result in my guns being taken?  (Or maybe they should amputate the finger?)
  • How are the doctor or supervisor supposed to investigate the threat to know whether it is serious?  Once they report to the police, do the police have to conduct their own investigation?
  • Will police need a search warrant to enter my house and take my guns?  Will the doctor’s word be enough evidence to obtain one?
  • Will there be a trial or other hearing to which I could appeal and potentially get my guns back?
  • How long will the report–even a false one–remain on file?
  • What if the guns in the home belong to someone else, like my wife or mother?  Are the police justified in confiscating them?
  • What if I make a threat to use a friend’s gun that is not stored in my home?  Can officials take it away from my friend?
  • What if I say I intend to buy a gun legally and then use it illegally?  Can it be confiscated from the seller?  (Remember, I don’t need a background check to buy from a family member.)
  • From what I can tell, doctor-patient privileges or HIPAA requirements do not apply in cases like this, even though they apply if my underaged daughter gets an abortion.  So what happens if my daughter has an abortion, and then suffers such guilt and remorse that she threatens to shoot herself with my gun?  Does that mean that the police can take my gun away, but they can’t tell me why?

When I was at my lowest, my thoughts of suicide never involved any of my guns–they always involved my car.  I wonder if the police will pay off the loan after they take that away from me.

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Mental Illness: Public Functionality, Private Incapacity

As I learn more about my own mental illness, I understand more about why people find this affliction difficult to understand in others.  Let me illustrate with a story.

Suppose I were expected to stand up in public to promote an enterprise or a meeting.  Many influential people whom I admire (and fear a little) are watching and listening; I want to–I NEED to–make a good impression.  However, backstage on the way to the platform, I have fallen and twisted my ankle.  I can hardly put any weight on it, and certainly cannot walk on it without excruciating pain.  So what do I do?

I walk across the platform without a limp or a grimace.  I endure the pain with a smile on my face and hope and pray I don’t fall over or pass out.  I make my presentation from behind the lectern, and I am not as energetic as I would have been otherwise, but I conduct myself and my business in a positive and professional (if not exciting) manner.  When finished, I smile and wave and make the long trip behind the curtains without letting anyone see the agony I am feeling.  When I get backstage I collapse and need to be helped to my car, into my house, and straight into bed.  I feel guilty that my audience got my best effort, but my family only gets a suffering shell of myself; so I won’t let anyone help me or make a fuss over me.  My wife is understanding and quietly provides for me and helps me from a loving distance; one of my children pouts when I can’t take him to the ball game, and complains that I always put my family last.  The sting of that attack only makes the ankle hurt worse.

If I try to get up and take the trash out, I may damage the leg even more; if I don’t, the guilt hangs around like a song I heard and can’t get out of my head.

And that’s what my mental illness is like.

I force myself to be functional in public, because I have made commitments I feel I must keep.  I am looking for work, and know I will have to put on a good front if I hope to be hired.  So I push through the pain and despair with a smile on my face and the appearance of normalcy.  When I get off the public stage, I collapse and retreat into the agony and the guilt.  No amount of prayer takes away the pain.  I push people away because I don’t want to hurt them, and I don’t want them to hurt me.  In reality, I look to the doctors and counselors to help heal my crushed spirit, but family and friends sometimes don’t understand why I won’t accept their version of help.

Mondays are the hardest days of the week, because I have used all my mental energy and discipline to be functional in church on Sunday; I have nothing left to give until my emotional batteries recharge a bit.

After months of recovery, medical treatment, therapy, and the rest, I should be better now, right? 

One more illustration:  a person with mental illness is like a flooded house.  The waters may retreat, and you may clean it up and make it pretty again; but the insulation is still wet, the mold is still growing, the wires are still being corroded, the lost items can never be replaced–and you always live with the fear that the flood waters may return. 

My ankle is not twisted, but my brain is.  And, in reality, the two are not as different as I once thought.

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Mental Illness’s Mixed Messages

I have not written about my mental illness for a while–oh, it hasn’t gone away, but it has just made itself difficult to express.  Here are a few random observations:

  • Disappointment and criticism have a devastating effect on my emotional and physical state; but my sensitivity to my own failings makes it hard to accept praise or encouragement.  It is almost impossible for me to go into my old business–not because people despise me, but because they are so enthusiastic and happy to see me.
  • As lonely and in need of friends as I am, I avoid seeing or calling people I know and that I know care about me.  When someone says, “It’s been so long…” my mind goes into guilt mode; but the longer I avoid people to escape the stress and guilt, the more guilty I feel. 
  • Our (unheated) back porch has been my sanctuary for the past several months–a place where I could get away from things that attack me at home, and where I could take my mind off things with jigsaw puzzles, Wii, satellite radio, and the occasional video.  With colder weather coming, I need to convert my study upstairs into my “winter sanctuary” but I have no hope that it will serve the purpose; so both places have become symbols of despair.
  • My bitterness toward some people contributed to my breakdown, and part of my therapy is to become strong enough to clear the air.  At the same time, the offenses were real and not perceived; and confrontation could be more destructive than restorative.  It may be difficult for me to speak the truth in love; but for some people it would be even more difficult to hear the truth and believe it was spoken in love.  And the cycle–and the downward spiral–would continue. 
  • Do I need to forgive someone whose greatest offense is bringing unnecessary stress into my life?  Or do I just need to learn to cope with it?  Are they at fault for stressing me?  Am I at fault for being stressed?  Am I at fault for being stressed at being stressed?  I have heard it said that a phobia is the fear of being afraid of something; is mental illness the stress at being stressed and the guilt at feeling guilty?
  • I wish some people were heretics, because the Bible says I could reject them after a couple of warnings; but my challenges are not heretics.  They are just difficult or toxic people.
  • Family members have generously paid so that I could join a gym and get my hunting license.  Now, if only I had the energy and motivation to take advantage of either of these great opportunities….  I know I would feel better for doing them, if only I could do them.

Lord, help me to be more loving and forgiving.  Help me to bear all things and endure all things.  And help me to enjoy some things.  Amen and Amen.

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Mental Illness Is a Long Dark Ride Part 2

I recently finished reading a book on depression.  The Christian author contends that Injury + Anger x Self-Pity = Depression, and his solution is to confess the self-pity and praise God; confess the anger and praise God; and praise God in the injury.  That solution may work for people who are discouraged or disappointed, but by the time someone gets to severe depression, it is difficult or impossible even to read the book, let alone stir up the will power to follow his steps.  I know that asking God for help is a genuine key to success in this area, but on its face it reminds me of the old Bob Newhart routine where, as a psychologist, his answer to every fear, phobia, anxiety, and compulsive or paranoid behavior was “Stop it!”  He didn’t have a lot of success.

(I have started reading a book on the wounds, burnout, and depression suffered by Christian workers.  At least it better identifies the characteristics of the mental illness called clinical depression.  Book report later if I can get through the reading.)

The mental processes of the severely depressed are radically different from those of the healthy Christian individual, at least in my case.  For many years (since I came to know the Lord at age 16) it has not been any issue at all to resist certain temptations:  smoking, drinking alcohol, blatantly violating laws, etc.  My wife has been a help to me in keeping me accountable, but these are areas that were basically non-issues.  (Purity in thought and action was and is a genuine struggle, but that’s another matter.)  The fact is, things that had long ago ceased to tempt me are once again on the table for consideration; I think that the distractability, emotional instability, and erosion of self-control have given my diabolical enemy an open door to tempt and test me.

So as I drove down to South Carolina and back, I noticed every sign for cut-rate cigarettes and cigars (if they had advertised pipe smoking it might have been too much for me to resist), and I had to make a conscious decision each time to drive on by.  Choices that were once automatic without any consideration whatsoever had to be made over and over again.  Ditto for every liquor store and fireworks outlet I passed.  (I know, fireworks are a fairly harmless issue, but they are illegal in NYS, so unless I wanted to shoot them off in my car or along the road, why would I consider buying them?  But I did think about it.  Every time I saw a sign.)  A damnable lie from a TV comedy kept going through my head: “During the war, we all had stress, but we didn’t take pills–that’s what booze is for.”  I know that alcohol is not the answer to my problems, but I had to know that all over again every time I saw a sign.

For the same reason that it is hard to get out of bed or into the shower, it is hard to resist temptation; but I am making that effort a priority.  As important as the next step is, I have little mental energy left to battle my self-pity or anger. All I can do is be willing, and let God empower the restoration work.

And that’s today’s scenic view of my long, dark ride through the valley called depression.

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Mental Illness Is a Long, Dark Ride

I have recently returned from a solo trip to South Carolina and back.  When an unavoidable family crisis prevented Darlene from going to her niece’s wedding and a brief vacation get-away, I had to go alone.  (I truly considered not going, but I had committed to performing the service, so I could not back out.)  In days to come, I will write about some of my other experiences, but for now let me focus on just a couple of aspects.

(I have clinical depression.  In the past I have been suicidal, but not for several months–but my feelings of despair and helplessness have been increasing.  Now I discover that the generic medicine I was given after getting out of the hospital has been pulled off the market by the FDA for being “ineffective”.  I will talk to my doctor about switching to the name brand product, which apparently does work.)

  1. I can force myself (with God’s help) to do what needs to be done.  Based on the many kind comments about the wedding ceremony, I am pleased to conclude that no one could tell how desperately lonely and lost I felt.  I was able to pack up my own things for the return trip.  (Darlene had to pack in the turmoil of the unexpected crisis that prevented her from going.)  I was able to keep the car on the road and avoid rear-ending anyone, even though the distract-ability that accompanies my anxiety makes any drive an adventure.  By God’s grace, I went; I performed my duties; and I returned safely.  It’s not how I would have chosen it, but I can do it when necessary.  Now we will see how my mind reacts to the victorious completion of the task–that is when Satan often attacks us (and not just the depressed or mentally ill).
  2. We are to love our neighbor as we love ourselves; that means we have to have an appropriate appreciation for the person God made each of us to be.  We need to love ourselves without conceit, arrogance, grandiosity, or self-centeredness–some struggle with avoiding the excesses of self-love, others struggle even to achieve an appropriate and healthy self-esteem.  I have been reading I Corinthians 13 and meditating on my own lack of the attributes of love.  But where do I start?  Do I ask God to help me love Him more?  Do I ask him to give me healing through loving others better?  Or do I need to plead that He will enable me to love myself more?  I can pray for all three, but I sense that that leaves my prayers a bit unfocused, and less than “fervent and effectual”.  This is the point where a Christian counselor might be able to take me further than my otherwise helpful secular counselor can do.  I have picked up three Christian books that may help me with this.

I will stop rambling for today.  My writing seems to me to be narcissistic and self-serving.  I am not sure that it will benefit anyone else; but maybe if I am able to come back with an answer to the problem of #2, I will have accomplished something.  After all, I can force myself (with God’s help) to do what needs to be done.

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Eeyore

As I was doing some reading this morning, I discovered a cross-curricular phenomenon:  the Winnie-the-Pooh-as-psychology industry.

Just go to your favorite search engine and type in some combination of the words depression, Milne, Eeyore, ADHD, Pooh–and you will soon find dozens of sites that take all the fun out of A. A. Milne’s classic children’s stories.  The internet experts go so far as to diagnose not only Pooh, Piglet, Eeyore, and Tigger, but even Christopher Robin, Rabbit and Owl.  It seems there is no one “normal” in the 100 Acre Wood.

Obviously, with my experiences, I focused my research on Eeyore:

The old grey donkey, Eeyore stood by himself in a thistly corner of the Forest, his front feet well apart, his head on one side, and thought about things. Sometimes he thought sadly to himself, “Why?” and sometimes he thought, “Wherefore?” and sometimes he thought, “Inasmuch as which?” and sometimes he didn’t quite know what he was thinking about.
A. A. Milne From book Winnie the Pooh

“Good morning, Eeyore,” said Pooh.
“Good morning, Pooh Bear,” said Eeyore gloomily. “If it is a good morning, which I doubt,” said he.
“Why, what’s the matter?”
“Nothing, Pooh Bear, nothing. We can’t all, and some of us don’t. That’s all there is to it.”
“Can’t all what?” said Pooh, rubbing his nose.
“Gaiety. Song-and-dance. Here we go round the mulberry bush.”
A. A. Milne From book Winnie the Pooh

One can’t complain. I have my friends. Someone spoke to me only yesterday.
Eeyore
From Winnie the Pooh by A. A. Milne

 So what is the consensus of the experts?  Our favorite disfigured donkey is either

  • Realistic
  • Fatalistic
  • Stoic
  • Exhibiting a Melancholy Personality
  • Mildly depressed
  • Suffering from Dysthemia
  • A victim of Limbic System ADHD

(Some of the above diagnoses overlap; others contradict. )

Here’s my conclusion:  Eeyore is an interesting fictional character, consistent in portrayal, and with his complete “case file” written and on hand.  If the “experts” cannot agree on a diagnosis for him, what hope do any of us real, inconsistent, and incomplete humans have?

Seeking treatment, taking medication, following prescribed therapy, and all the rest are steps of faith, which may be in short supply for the mentally ill.  Pray for those around you who suffer, that they will get proper early diagnosis and treatment, so that they can focus their limited faith in the Almighty, and not have to waste it on doctors.

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My Book

Thank you for your prayers yesterday. I finished Stories From the Psych Ward and uploaded it just before Midnight. It is now for sale in all ebook formats at Smashwords for a whopping $0.99! After review, it will be sent to the major distributors. It contains 16 stories–11 never published on the blog. As an English teacher, I am particularly proud of “Lee’s Story”; as a Christian, I am proud of “Preacher’s Story,” which includes the Gospel. See https://www.smashwords.com/books/view/215699 for purchase details.

Why am I charging for it?  I am unemployed, and every little bit helps; and the workman is worthy of his hire. 

So why am I charging so little?  Until I am an established and recognized author, I need to do everything I can to get my writing into people’s hands.  As I write and publish more, I will raise the prices based on value and what the market will bear.  (I originally priced this at $1.99, but felt bad when it  turned out to be only 40-50 pages, so I dropped the price this morning.  If you are the one person who bought it at $1.99, let me know and I will give you credit toward the next book.)

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To Lose One’s Mind

An icebreaker exercise used with middle schoolers to get them talking and appreciating their blessings is the old question, “If you had to lose one of your senses, which one would you choose to do without?”  Thankfully, most of our teens never had to really make that decision.

But our older generation is facing a similar situation, without the element of choice thrown in.  All those of a certain age would concede that, to one extent or another, we are losing our minds.

The ravages of Alzheimer’s Disease are well-documented and tragic.  One of the saddest stories about Ronald Reagan in his diseased years came from a former aide and friend who visited him in his office at home.  The former President did not know his friend, and was reading a picture book about horses.  Upside down.  Unfortunately, the conditions behind that story are being played out in homes and facilities across our country.

When my father was suffering with cancer in 2008, he went through some episodes that left him convinced that Jimmy Carter was President.  Every time he woke up, he wanted to know where he was, what had happened, and what the doctor had said;  every time he fell asleep, he lost his memory.  Eventually, he regained his strength and memory and had a few more good months before his body shut down and the Lord took him Home.

But what’s the excuse for a middle-aged man like me who doesn’t have Alzheimer’s or cancer?  Why does mental illness strike and rob of us our most precious sense–our sense of mind?  Why am I suddenly so distractable?  Is there such a thing as late-onset ADD?  And why can’t my memory hold onto things like it used to?

When I was principal of a small Christian school in PA, I knew every parent’s name, kids, address, and account balance.  Now, when I go into my most recent place of employment, I can’t call my co-workers by name unless they have their name tags on.  The distant past is like a tapestry–the pictures and story are there, but are sometimes hard to make out or to see how one part of the picture relates to the rest.  The recent past is like the back of a poorly-made tapestry–threads and knots, an unruly mass of color and texture, but without apparent meaning.  (A recent article I read–somewhere–talked about how depression changes the brain and makes it harder for memory linkages to form or be renewed; it also talked about actual brain shrinkage, if I remember right.)  UPDATE:  I found the article.

But perhaps as bad as losing my memory is the frustration that comes with the realization that I am not what I once was.  I have been looking for a file containing vital documents necessary for a job search.  I know where the file was in August of 2010; I know where it was in January of 2011.  Today, I have no idea where I might have put it for safekeeping; and in the past week I have spent at least 8 hours looking for it.  I have scanned every document in the filing cabinet at least 4 times; I have searched every box in my study, closet, and garage more times than that.  I have looked on every bookcase, shelf, and cabinet we own.  All the documents can be replaced; but that’s beside the point:  I have spent two full days in utter despair and helplessness over my failure to remember and locate the file. 

I spent several years without my sense of smell; my eyesight and hearing are not what they once were; the food goes by too fast to relish the taste; and the sense of feeling is too intense in my joints and not intense enough in other places.  But none of these changes  or deteriorations can compare to the heartbreak of losing my mind.

I am not looking for pity, but I would value your prayers.  And if I have helped anyone to better understand the ravages of mental illness or senility, then my time spent has been worth while.

 

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When Mental Illness Doesn’t Get the Help It Needs

There’s a tragic story in the NY Daily News that points out a problem faced by individuals and families everywhere:  the consequences of untreated mental illness.  I have written before about the difficulty of obtaining adequate treatment in our area, and have received divergent responses.  Those who are involved at the entry level/diagnosis/referral end of the spectrum tell me there is a drastic lack of follow-up resources and options;  those on the treatment end tend to tell me that the services are available.  While I am only a sufferer and not an expert in the field of mental illness, I wish you would indulge me as I make a few observations.

  1. People who are mentally ill may not seek out or accept help.  I required an intervention to get me to the crisis center, even though I knew I had become a danger to myself.  The processing into the system is complicated, difficult and stressful, and I would not have made it through the process if not for my wife and daughter.  Once I was through with the hospitalization, the medications helped me out of bed in the morning, but they couldn’t get me to my counseling sessions through the Prospect Mountain construction traffic.  I had to force myself to go–and my guess is that not every sufferer is strong enough to make it to follow-up meetings.
  2. Sufferers may have an unrealistic sense of their own illness or the necessity of the treatments offered to them.  I have had several times when I thought I was better, only to put myself in situations I could not handle.  There is an aspect of my treatment that I am convinced is quackery and ineffective; and I have had to trust someone else’s wisdom, and force myself to do what I don’t believe in if I want my recovery plan to continue.  There have been many suggestions from my therapist that I have not even considered, because my mind is closed to those ideas–rightly or wrongly, I don’t know.  I often think that I can do it on my own, when reality (in the form of my wife) tells me I can’t.  I think a lot of my fellow sufferers who truly want to get better still have the mistaken idea that healing will come on its own with time (and perhaps some pills).
  3. In-patient treatment requires not only financial considerations, but availability of beds, and, sometimes, legal action.  In the case of the young man in the news article, a judge could have committed him to an in-patient facility on earlier occasions, but almost certainly the patient would not have wanted it, and the level of his acting out may not have made him a priority for the limited space.  The concept of “preventive” admission for a short-term stay still leaves the issue of follow-up to be considered (or ignored).  Mental illness is like a back injury:  if serious, it requires drastic measures in the hospital, and then months of follow-up therapy both in and out of the hospital.  Mental illness is different, though, because the sufferers can still walk around and be a threat to themselves or others, and it may be difficult for them or for the justice system to know when the hospital admission is an absolute necessity.
  4. Short-term treatments are helpful for patients like me, to point us in the direction of recovery.  For others, though, they are no more than minor inconveniences.  I met fellow sufferers who were just waiting to get discharged so that they could throw themselves back into their self-destructive behavior.  One patient, knowing that the stay was temporary, continued to conduct his illicit business by phone daily, and returned to it apparently unaffected by the services offered during the short-term stay.  By the way–my experience was that the various meetings, seminars, and sessions during the week I was there were only offered, but not required.  There were fellow sufferers I saw at meals, but at no other time.  While that may have caused some to have a longer stay, others were discharged on schedule.
  5. And one last note for today:  there are some issues–serious, life-dominating, family-destroying issues–that are not addressed or even acknowledged during the short term stay.  I asked my therapist about this, for the issues came up often in group meetings, but the leaders quickly changed the subject as if they had been instructed not to go there.  My therapist first suggested that it was out of confidentiality and that the topics would be covered in private counseling sessions.  When I countered that to my knowledge (based on my experience and inquiries with others)  such had not been the case, her second thought was that some topics are so complex that they take years of therapy to work through, and there would be no sense in trying to deal with them during the typical six-day stay.  I do not doubt her assessment at all; but I wonder how many sufferers are going to follow up for years to deal with issues apparently not considered a problem during their short-term jump start on recovery.

My therapist emphasizes the importance of spiritual–and specifically Christian–components to recovery from mental illness.  I fully agree and pray that some day I will find the miraculous healing of Christ for my troubled mind.  In the meantime, I can only pray for strength for myself and for fellow sufferers to cry out, “God, be merciful to me, a sinner, and give me my daily bread; for Yours is the Kingdom and the power; and I can do this one thing today through Christ who strengthens me.”  I know it’s not much of a prayer, but it’s what I can handle.  I am a Christian and I am sick; but He is Christ, and He is the Healer–in His time.

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