Depression and Mental Health

Mental Illness Goes on Vacation

I wish!

But my mental illness didn’t go on vacation; it just accompanied me on mine. 

It joined me in the airports at Newark, Toronto, and especially Vancouver.  It spoke up just once during a bumpy spot in the air.  My depression is being held at bay, but the anxiety is fueled by the break from routine and the many unknowns around me but beyond my control. 

Things at home are beyond my control, too.  Relatives are staying at the house, but the dog bit a repairman.  There may need to be electrical work in our bedroom.  Dad Edwards is in the process of his chemo.  Short stories are awaiting the typing and rewriting process, which I can’t do on this notebook.  And of course, there is the whole job situation….

So in the meantime, I try to stay calm, appreciate the kiddos, and be a good father and poppa.  You don’t know how hard it can be until you have lived there.  And I hope you never have to live there.

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Therapy Pays Off

In addition to medication, supplements, and counseling, I have been writing these little posts and short stories as an outlet for my creativity.  My recovery has been slow, and I still have bad times and difficulties finding pleasure in God’s blessings.  People ask me if I am excited about my upcoming trip to visit my children and grandchildren; I am honest enough to say that I am glad I am going, but it has been many months since I have been truly excited about anything.

But last night I almost smiled.  I had a sense of accomplishment.  God led me to the mountaintop, and I got a glimpse of happiness.  My first attempt to self-publish one of the stories as an ebook was successful, and a dozen people had downloaded it before I even knew it was available.  It will be a few days before its final review is completed and it is added to the catalogs at Amazon and Barnes and Noble, but it has been officially published, and the goal of eventually publishing the collection of Stories from the Psych Ward has taken a giant leap from “Maybe” past “Someday” all the way to “I can get this done!”

Let me ask a few prayer requests:

  • Please pray that the story will make others aware of the reality (and pain) of mental illness;
  • Please pray that this free story will stir enough interest so that people will want to buy the collection;
  • Please pray as I write “The Preacher’s Story,” which will include a Gospel presentation;
  • Please pray as I edit and type the 5 stories that have piled up while I was formatting “Eva’s Story”;
  • Please pray for stability.  It is common for a depressive episode to follow a victory or success (just ask Elijah about that.)

In the meantime, you can download the published story here or by clicking on the image above and save it directly to your Nook or Kindle; or download the PDF version and read it on your PC.  (Sorry–the RTF version still has some kinks.)

Thank you for your support and your prayers.

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An Honest Obituary

You have probably heard the old joke about the man who went to a preacher to arrange a funeral for his brother.  “You must say that my brother was an angel,” he insisted.  The preacher protested that his brother had been notorious as a drunk, a womanizer, and probably the most wicked reprobate in town.  The brother offered $10,000 to the preacher, but only if he agreed to say that the man had been an angel.  The preacher accepted;  and at the funeral he fulfilled his obligation by saying, “This man was a terrible, evil sinner–but compared to his brother, he was an angel!”

We come from a society of pretty obituaries; we were all taught not to speak ill of the dead, and if we “don’t have nothing good to say, don’t say nothing at all.”  But one brave family placed an obituary in our local paper yesterday, and it was the most honest (and tragic) one I have ever seen.  If nothing else, it paints a pretty good picture of what mental illness can look like in the flesh.  As you read it, please remember that this is a man for whom Jesus lived and died; and there, but for the grace of God, go we all.

Dennis W. Trainor (1940 – 2012)

Chenango Forks: Dennis W. Trainor of Chenango Forks, NY (2/23/40-7/10/12) decided to end his life in the place he loved best: his home and sanctuary in the Chenango Forks wood. Born in the Bronx, he spent his early years negotiating difficult circumstances with defiance, energy, and determination: jumping off the docks into the river, visiting Edgewater and smelling the vibrant life there, catching trains and riding the length of Manhattan Island, sleeping on rooftops and trying to find ways to survive. He was always proud to be a Bronx native; one of the family residences on Bruckner Boulevard was razed to make way for the Triboro Bridge. He spent too many of his teen and young adult years bouncing from institution to institution, struggling with his addictions and mental health issues. Sometime in the 1970s, his brother Frank convinced him to try living in Binghamton. After many therapeutic interventions and 12-step meetings, Dennis found life-long sobriety in August 1980. In 1982, he moved to a remarkable retreat and safe place in the woods overlooking the Tioughnioga River. He loved living there; he could listen to and feed the birds, cut firewood with an old-fashioned handsaw, try to find ways to live with his many ghosts, demons, hopes, and his firm moral and spiritual code. Dennis was a bundle of complexity and contradictions: incredibly smart yet often irrational, he was a charming and charismatic child-like spirit who could quickly turn angry and afraid. He possessed a searing intensity and determination yet often couldn’t complete the simplest tasks. He felt that he had a very limited capacity to “be in the world,” as he would say; he characterized himself as a hermit, a cowboy, a spiritual seeker, a rebel, a recluse—but never as a comfortable member of society. No amount of rational conversation or pleas could change his beliefs. He was doggedly determined to live his life on his own terms in the best ways that he could. He lived alone since 1996, although he had a close, long-time friend who tried to help him and care for him, as well as relatives, neighbors, and others with whom he developed superficial but deeply important relationships. Although he depended on minimal social services for his very basic needs, he never wanted to feel indebted to any person, agency, or government. So despite his meager resources, he paid enormous interest to clear an old loan for an aborted semester at BCC circa 1980. Because he knew that cigarettes were destroying his health, he quit smoking forever in 1997. In fact, other than a very rare round of antibiotics and occasional OTC pain-relievers, he shunned all medications. If he had accepted help and used prescription anti-depressants or other medications to help him cope with his mental and emotional illnesses, he might still be alive. But he chose his path carefully and deliberately. He saved enough money to pre-pay for his final arrangements because he did not want to burden us with those details of his death. Dennis loved so much about his life: the full moon, the changing seasons, the river, the birds and rabbits and deer and hawks. Yet he carried on a relentless battle against the flying squirrels who reside in the attic and the rodents who pilfer bird feed. Dennis adored 50s bebop and rock, classic cowboy movies and TV shows; he also venerated series such as The Sopranos and Deadwood. He tilted at too many windmills for too long, and he refused to concede a defeat that would have been enormous if he had lived to the point where he could no longer care for himself. Because he wanted a simple, unencumbered life and wanted to live as frugally as possible, he gave up car ownership many years ago; he rode his bicycle to the Forks—in all weather–for his newspapers, milk, bread, and his mail. For several years until shortly before his death, he depended on the BC County Rural service to take him to a grocery store so he could buy what he needed to survive. Dennis so appreciated the lifeline that the BC Country dispatchers and drivers provided. He came to see them as friends and he valued his interactions with them. When the powers that be decided that BC County routes would be almost eliminated (not “cost-efficient” to provide essential services to the most needy among us), Dennis was shaken and scared because one of his few safety nets had been severed. We will never know why he chose to end his life when he did; we know that a constellation of forces contributed. But he would want folks to know that he did all that he could to live and die on his terms. He often quoted the Bible – “let the dead bury the dead”— so he did not want us to mourn him or memorialize him publically. We hope that he would understand why we are publishing this obituary as a way of honoring and remembering him. Dennis was predeceased by his parents John Trainor (1959) and Helen Trainor (2/19/12), his cherished sister Patty (2/25/97) all of the Bronx, his brother Frank (12/18/11) of Pennsylvania, and his dog Willie. He is survived by his long-time close friend Susan Y Williams of Eastham, MA and formerly of Binghamton and Chenango Forks, by his dear sister Mary Bianco of Holbrook, NY, his sister Joan Meehan of Endicott, NY and many nieces and nephews, all of whom will miss him dearly. Special thanks and deep gratitude to Dennis’ neighbors, Jim and Joyce Thomas, and to the people who helped him survive as long and well as he did, especially the dispatchers and drivers of BC Country. Thanks to the first responders, especially the State Police investigators, and to Tim and Donna of DuMunn Funeral Home, who helped us through these horrible first days. In lieu of flowers, consider donating to the Southern Tier Independence Center, the Broome County Country bus service, or a mental health or suicide-prevention organization. If you cannot contribute, please take time to look up at a full-moon or take a walk in the woods or provide a helping hand to someone who needs it. To forward condolences please visit www.demunnfh.com. Arrangements for the family are directed by the DeMunn Funeral Home.
Published in Binghamton Press & Sun-Bulletin on July 15, 2012

 

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Motivation

I was wondering today why it is so hard to shower and shave.  I know, I know–it’s not hard for most people, but for the severely depressed, it is a classic symptom of the illness.  One writer attributes it to the fact that the sufferer doesn’t want to be around people, and so has no reason to get presentable.  But that doesn’t explain my own situation, for I know I am going to the bank and the library–so why is it so hard to shower and shave?

After I finished (because most days I do manage to accomplish the task), I was wondering why I had no motivation–no energy or impulse to get up and do something–and it came to me that the word motivation might have two distinct but related meanings:

  1. The energy to move; and
  2. The reason to move…

So I got out my dictionary.  It turns out that motivation always refers to that which initiates or causes motion–whether a logical argument, or a simple desire or emotion.  I decided that the emotion of depression was conflicting with the logic of cleanliness, and now I know why it is so hard to do.  But will my new understanding make a difference?  Only time will tell.

But while I was on the topic, I pondered the motivation that leads people to make decisions for Christ.  We all know from the Scriptures that we have sinfully offended the Holy God, and that we owe him a debt and should repent and allow Him to adopt us into His family in order to inherit the blessings of this life and all eternity.  But we also know that our estrangement from God causes the emotions of fear, regret, guilt, loneliness, desire for love, and gratitude for the sacrifice of Jesus Christ that allows us to establish a personal relationship with Him. 

So is the true motivation for salvation a logical conclusion reached in the brain, or an impulse having its root in the heart? 

Ask Paul on the Damascus Road.  Ask Thomas in the upper room.  Ask Moses at the burning bush.  Ask Peter at the lakeside.  And then maybe we will have a logical understanding of the emotions of spiritual conversion.

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Unjoyment and Uncouragement

Why is light given to a man whose way is hid, and whom God hath hedged in? For my sighing cometh before I eat, and my roarings are poured out like the waters.  (Job 3:23-24)

I return to the topic of my depression–not as an expert, but as a sufferer.  My remarks are anecdotal, but true as I understand and can convey them.

I choose the word sufferer on purpose.  Until one has been through a bout of severe clinical depression, he cannot fully understand all its ramifications.  In my case, it produces terrible physical pain; every arthritic joint hurts more than normal, and I get sharp pains in my chest, accompanied by a feeling of pressure as if a wide band were wrapped around my rib cage and being slowly tightened.  My heart, liver, stomach, lungs, etc. have checked out fine–it is the pain of depression.

My mind wants to dwell on the struggles in and around me, but I seek out ways to retreat into safe and peaceful states of mind.  Unfortunately, because of the energy it takes NOT to think about things, my brain operates at low efficiency and I find it very difficult to concentrate.  I am easily distracted and frustrated.  I cannot enjoy the things that once brought me pleasure, because my brain is in a constant battle for balance.  Did you ever try to read a book, or play golf, or talk to your grandchildren, while you were standing on one foot with a pebble in your shoe?  It can be done, but not well and not for long.

The quote above is from the 3rd chapter of Job, in which he curses his life.  After sitting in silence for 7 days, he describes his suffering in dramatic and powerful images.  He does not curse God, but neither does he praise or glorify Him.  Job is too low for that.

Then his “friends” try to “help” him.  They spend the next 34 chapters or so trying to assess the blame for his tragedies, to analyze his responses, and to accuse him of impiety.  I’m sure that they thought that they were helping him by telling him to confess, repent, and rejoice evermore.  They operated under the assumption that he had forgotten God’s love, mercy, grace, and goodness; and they believed that if they just argued him into a right state of mind that his problems would be solved.

But no amount of talking would bring back Job’s family or possessions, and no amount of talking would take the pain from his soul.  Depression is a disease that needs God’s healing touch; preaching and motivational posters are no substitute.  Job told his companions before they even started that it didn’t make any sense to hand a lamp to a lost man–all it would do is to enable him to better see the unfamiliar surroundings in which God had imprisoned him.  Their well-intentioned words merely made his misery more apparent.

So how are my friends supposed to help me?  Don’t try to fix me–just sit quietly with me, pray, and wait for God to do His healing work.  He will, and I am told that I will be better off for the suffering I have experienced.  One day, some day.

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A Community in Need

Just a quick note on why and how I ended up hospitalized for mental illness:

When my depression became severe, I knew I needed help; my family knew I needed help; and because of the medical aspects of the disease, my doctor should have known I needed help.  (But that’s another story altogether.)

I was too far down to seek outside help, so when my doctor didn’t come through, I gave up—but my family didn’t.  They used the resources available to them to try to find help for the mentally ill in the Greater Binghamton area.  My wife and daughter are both health care professionals, so their resources were far better than the average.

What they found was that the normal wait to get an appointment to see a psychiatrist or counselor in the area was measured in weeks and months, not days.  When they explained my situation to the various offices they contacted, the common response was, “Go to the crisis center.  They can evaluate the patient and get an earlier appointment.”

So I went to the crisis center, expecting to be evaluated and then sent home with an appointment to see a mental health specialist.  Instead, I was kept overnight as an out-patient, and then admitted to the mental health ward of the hospital, where I remained for a week.  During that time, I saw two different doctors (once each) and a nurse practitioner (three or four times).  I had three meetings with a psychotherapist.  All in all, the in-patient treatment was a good jumpstart toward recovery.

However, as I understood it, it would be vital to follow up with further care immediately upon discharge from the hospital.  The professionals at the hospital would line me up with appointments and resources to keep my recovery on track.  It was suggested that I should receive counseling or group therapy sessions a couple of times per week at first, to be decreased as appropriate.

You can imagine my surprise, then, when I was given my discharge papers showing my first mental health appointment being scheduled for two weeks down the road.  When I protested that such late follow-up contradicted what I had been led to expect I would need, I heard the same old story:  there are few mental health specialists in the area; a lot of established patients who fill their schedules; and it takes weeks or months for a new patient to get in.  The appointment for two weeks in the future was the earliest that even the hospital could arrange for me.  (The option of group therapy has never been brought up again.)

Once I had a professional who had agreed to see me, my family and their contacts were able to get my appointment moved up to within a few days, and my treatment has been ongoing regularly since then.  But my experience highlights a real need in the community:        

  • With two major health care provider networks in the community, there is only one crisis center for mentally ill patients;
  • The psychiatric center itself has a waiting list, and only the most severe patients can get in;
  • The hospital’s unit is staffed in part by traveling doctors, who spend a few days in Binghamton and then move on and are not available to follow up with patients;
  • Some of the hospital beds were taken up by people involuntarily committed by the justice system after alcohol-related incidents;  in one case I witnessed, the “patient” openly admitted that he was just biding his time until he could get legal discharge and go get his next drink;
  • Insurance companies dictate the length of medically-necessary hospitalizations, and the hospital staff has only limited ability to extend a patient’s stay;
  • If there are other resources available to sufferers of mental illness, that information is not being given to patients prior to admission or upon discharge.         

I am not criticizing the crisis center, the hospital, or any of those good people who helped get me started on the road to recovery.  I AM grieved that the community which was recently reported as the most depressing city in America does not have enough resources available to meet the needs.  I don’t have the answer, or even any reasonable suggestions toward solving the problem—but maybe somebody else does.  I hope that between our existing hospitals, private providers, colleges, and other community groups we can accomplish two things:

    1. To make more mental health resources available; and
    2. To publicize the ones that exist already.

My blog posts have connected me with dozens of fellow sufferers.  May each one find the help they need to achieve recovery—despite the apparent shortages and shortcomings in our community’s mental health services.

Addendum:  As a result of a friend reading this post and contacting some of her acquaintances, I was sent a document listing services available to those suffering from mental health issues.  I include that document as a link:

BC Counseling 111711

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Strength in Numbers, Large and Small

When I entered the mental health unit of the local hospital, I was alone.  My wife and daughter came to see me, and my mother called on the phone, but I was alone.  Twenty-one hours a day I was surrounded by strangers—the majority of whom were mentally ill!  My walls of self-defense and self-reliance were firmly in place, and for a day all I did was watch the others in silence.

1Kings 19:4, 13-14  But he himself went a day’s journey into the wilderness, and came and sat down under a juniper tree: and he requested for himself that he might die; and said, It is enough; now, O LORD, take away my life; for I am not better than my fathers…. (13)  And it was so, when Elijah heard it, that he wrapped his face in his mantle, and went out, and stood in the entering in of the cave. And, behold, there came a voice unto him, and said, What doest thou here, Elijah?  (14)  And he said, I have been very jealous for the LORD God of hosts: because the children of Israel have forsaken thy covenant, thrown down thine altars, and slain thy prophets with the sword; and I, even I only, am left; and they seek my life, to take it away.

After my second “Community Meeting,” I realized that I was not alone by myself; everyone else there was alone too.  Despair has a way of isolating us; we feel solitary and useless, as Elijah did.  But when I saw that the other people alone around me understood what I was feeling, then I began to bond with them—our community  became like a modern-day colony of emotional lepers, thrown together by circumstances, but united in the common cause of survival. 

            The most traumatic experience of my hospitalization came when the staff told me that I would have to leave my community and move to another floor.  I had a meltdown, and retreated far within the cave of my pain and self-pity.  I felt more alone and abandoned than I had ever felt before.  I wouldn’t eat, I didn’t want to see anyone, and I certainly didn’t want anyone to see me. 

            But as I stepped out of the elevator on my new floor, my face wet with tears, all my possessions in two paper bags, who should step out of the adjacent elevator but my daughter Elizabeth and my friend Tim.  Inwardly I cursed God for letting them see me this way.  But He knew what he was doing.

Ecclesiastes 4:9-12  Two are better than one, because they have a good reward for their toil.  (10)  For if they fall, one will lift up his fellow. But woe to him who is alone when he falls and has not another to lift him up!  (11)  Again, if two lie together, they keep warm, but how can one keep warm alone?  (12)  And though a man might prevail against one who is alone, two will withstand him–a threefold cord is not quickly broken.

They helped me through the next hour, and they have helped me through many hours since then.  My wife Darlene, my son Jeremy, my friend Lee, Pastor Dan—these and a few others have made a point to check on me, hold me up when I need it, and leave me alone (nearby) when I need to decompress.  My daughter Jennifer even flew in from northern Canada to help in my recovery.

            People in numbers still overwhelm me and I tend to withdraw; but with one or two at my side, I can stand on my wobbly legs and work on making my way back to the land of strength and health.

Matthew 18:19-20  Again I say unto you, That if two of you shall agree on earth as touching any thing that they shall ask, it shall be done for them of my Father which is in heaven.  (20)  For where two or three are gathered together in my name, there am I in the midst of them.

I have taken great comfort in the story of Elijah referred to above.  The prophet had a tremendous victory, followed by a severe bout with depression and suicidal thoughts.  But he never forgot God, and God never forgot him.  When Elijah was ready, the Lord told him to join up with Elisha and to continue his ministry with this faithful man at his side; that was what he (and I) needed—God and a friend.  Then, almost as an afterthought, the voice from Heaven told him,

Yet I have left me seven thousand in Israel, all the knees which have not bowed unto Baal, and every mouth which hath not kissed him.  ( I Kings 19:18)

God had an army held in reserve for the day when they would be needed!  What a comfort and encouragement!

            I am not alone.  I am blessed to know that so many people are thinking about me, praying for me, struggling along with me, pulling for me—and it is wonderful to know that there is an entire fleet of ambulances (figuratively speaking) ready to rush to my aid.  But for now, the ambulances can stand by on alert–what I need personally is a walker or a pair of crutches to lean on as I take that next step. 

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Mental Illness Goes to Church

Since my depression had become severe, I had not been in church a lot.  Before I was hospitalized, I had a problem with all crowds, but especially with people I knew and cared about.

  • I was easily distracted, and couldn’t follow the pastor’s message;
  • I tended to get angry toward the people that I felt were distracting me or detracting from the service;
  • I saw (or imagined) ulterior motives in what people said or did, and distrusted them more and more;
  • I assumed that everyone in church was as big a hypocrite as I felt I was.

After my stay in the mental health unit of the local hospital, my anxieties were actually multiplied!  After all, I had been diagnosed as “mentally ill,” and

  • “Everybody knows” that mental illness is a spiritual problem, resulting from sin in one’s life—and depression just represents a lack of faith in God;
  • “Everybody knows” that seeking secular help for a “spiritual problem” is definitely NOT appropriate for a church leader;
  • “Everybody knows” that mental illness is a disqualifying position—it kept Thomas Eagleton off the Democratic ticket in 1972, and certainly ought to keep Bob Bowker out of ministry in 2012.

I started back to church slowly:  a Senior Saints Bible study; an evening service where I slipped in late and left early; and then, after I went public with my condition, I taught an adult Sunday School class.  I am sure that no two people share exactly the same experiences, but here are my observations.  Please remember, I’m not thinking completely straight, so be kind in your reactions.

1.  People were far more welcoming and understanding than I expected.  Many people touched my arm or the back of my hand in a gesture of encouragement.  What a pleasant surprise—my stay on the psych ward was not a stigma to these caring people!

2.  Several people were eager to share their own stories of their struggles with—and sometimes victories over—depression.  I learned that many are suffering along with me today.

3.  A few people seemed uncomfortable around me.  Some were unnaturally friendly, and one or two, it seemed to me, went out of their way to ignore me.  I’m sorry I made them feel uneasy, but I can’t help it that I am sick, and I don’t regret going public with it.  They will have to sort out their feelings about it all, even as I work to sort out my own.

4.  I’m sure some wondered how I could teach Sunday School, but couldn’t sit through the morning service.  The answer involves the safety that comes from structure.  When I am teaching, I can control the topic, the pace, the direction of any discussion, and even who I call on (if I choose take any questions or comments at all).  The classroom has always been a “safe” place for me—just like the hospital was safe, and areas of my home have been made safe, so that I can avoid those things that might inflame my fragile mental and emotional state.  Having a ministry in a safe setting was good therapy for me.  On the other hand, sitting in a service where my safety is gone, someone else is in control, and every aspect from the songs to the prayers to the message are designed to impress my soul and elicit a response—well, right now that is a recipe for anxiety and the fear that I may cry for no obvious reason, or perhaps even speak out inappropriately.  My teeth chatter and I get chest pains, and I don’t need that right now.

–Question:  was it hypocritical of me to teach the Bible when I don’t have my mental and emotional state under full control?  No.  I have seldom been as real and authentic in my approach to the Scriptures or my students as I was on Sunday.

5.  I will end my observations with a request:  if my mental illness and I visit your church, please don’t ask me how I’m doing.  I don’t know how I’m doing.  My mental state changes from day to day—from moment to moment.  I don’t know how to answer you, and I’m not sure you want an answer; after all, “How are you doing?” has become a routine and rhetorical greeting.  On the other hand, those who truly made me feel welcome were those who just smiled and said, “It’s good to see you.”

Considering where I was not long ago, I could honestly answer, “Thank you.  It’s good to be seen.”

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Now You Know

My friends and family know that I have dealt for some time with depression and anxiety.  I have a hormonal imbalance that contributes to the situation, and I have been on and off medications as needed to help me deal with the physical and emotional effects.  Recently, the disappointments and pressures of various situations hit me hard, and a side effect of the medicine made my response progressively worse.  With the support of my family, I checked into the hospital and spent a week on the psych ward.  I am currently at home on disability, adjusting to new medicines and receiving therapy to improve my ability to cope with this disease called mental illness.  I ask for your prayers and your understanding as the Lord, the doctors, and I travel what could be a long path to full recovery.

And yes, this blog is therapy–a way to reach people without being around too many people until I am able to handle it.  Your “hits” on the site and your comments–positive or negative–affirm to me that I still have something that people are willing to listen to.

Some day soon I will begin publishing some character sketches–fictionalized snapshots inspired by people I met in the hospital.  Watch for them in the “Readers’ Corner” and know that each character is me, and that each situation is real.

To all my fellow sufferers, let me remind you what the prophet Jeremiah said in Lamentations 3:19-21 (freely paraphrased):  If God knows and remembers all my struggles (and He does), then even when I am overwhelmed by the knowledge of them and sink to the lowest pit of despair, I know He is still there, and that gives me hope.

This morning for the first time in a very long time, I woke up and I had a sense of His pulse in the hand He holds me in.  There is hope.

Even when the ship of my life
Has crashed on the rocks of hopelessness,
And there is nothing left
But the rocks and the waves,
He is the rock
And He controls the waves.

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