All posts tagged Anxiety

Tuesday Tweets of the Week: 1.1.13

There is great value in saying something in a memorable, concise manner. Twitter has caused us to make this a near spiritual discipline. For my own growth (as a generally verbose individual… that’s a long way of saying “wordy”) and for the benefit of others, I highlight tweets each week that deliver a big message in a few words.

A movie preview tweet. timely passage of Scripture regarding the adoption blockage in Russia.

For those making New Year’s Resolutions.

And one because its funny (but you have to click the image link to get it).


7 Areas of Life Affected by Depression-Anxiety

This post is an excerpt from the study guide which accompanies the “Overcoming Depression-Anxiety: A Personal Responsibility Paradigm” seminar. This portion is one element from “STEP 2: ACKNOWLEDGE the breadth and impact of my sin.” To RSVP for this and other Summit counseling seminars visit

Depression-anxiety affects the world outside our mind (e.g., our physical body, relationships, and lifestyle) as it does the world inside our mind (e.g., thinking content and patterns). As you review the seven areas of life described below, understand these are merely offered as areas of examination. All of them may not be present, but they are often over-looked ways that depression-anxiety impact our lives.

1. Lack of Authenticity in Relationships

“How are you today?” can be a loaded question. Honesty requires a longer answer than the friend anticipated. Dishonesty reinforces the idea that “no one understands” and, thereby, leads to a deterioration in the quality of friendship. Honesty can make your emotions the center of the friendship more than is healthy. Dishonesty reinforces the belief that you’re a burden to others. One of the main topics of this seminar will be how to have healthy relationships when your emotions are unhealthy.

Where have you seen deterioration in your relationships?

2. Toll on Your Body

Depression-anxiety is hard on you. Emotions are not just emotional experiences. They are also physical experiences. Your entire body, not just your brain, is influenced by the experience of prolonged depression-anxiety.

“[Effects of anxiety and stress include] physical and emotional exhaustion, depression, heart disease, stroke, depletion of calcium from the bones, immune system vulnerability, immune disorders, cancer, gastrointestinal problems, eating problems, weight gain (especially around the abdomen), diabetes, pain, sleep disturbances, sexual and reproductive dysfunction, self-medication and unhealthy lifestyles, damage to the brain causing hippocampal atrophy, killing of brain cells, memory loss and diminished concentration… acceleration of the aging process (p. 166-167).” Archibald Hart in “Stress & Anxiety” Caring for People God’s Way

What physical symptoms of depression-anxiety have you experienced?

3. Decreased Attention Span

Emotions are hard to ignore. They tend to be front-and-center in our mind. This means that whatever else we may need to give our attention to has a competitor. Like the throbbing of an injured toe which distracts us even when we’re not walking on it, emotional pain makes everything harder to do even when the task has no direct-emotional-relevance.

When have you found it increasingly difficult to concentrate?

4. Interpretation of Events

Our emotional dispositions influence our cognitive interpretations. On a “good day” we hear things more optimistically than we do on a bad day. When our mood is stuck in a depressive-anxious state cynicism, suspicion, or pessimism begin to be the filter of all in-coming information. The result is our mood begins to spiral in on itself because it is so difficult for anything good to penetrate our interpretive shield.

What dispositions tend to most frequently distort your interpretation of events?

5. Lifestyle of Avoidance

Everything begins to feel like it requires “too much” of us, so we begin to avoid particular responsibilities or relationships as a misguided form of self-preservation. The isolation and lethargy that ensues allows depression-anxiety to barricade our life from any outside influences which would threaten its existence. Activities that would be satisfying and relationships that would be stimulating are construed as burdens (see point #4 above) and we are alone with our pain.

“By its very nature fear tells you to run rather than face whatever is causing it (p. 1).” Ed Welch in When I Am Afraid

Where have you noticed yourself avoiding people or responsibilities?

6. Lifestyle of Escape

This is avoidance-on-steroids. With escpe an individual begins to try to check out of life in general. Alcohol, drugs, prescription medication abuse, a fantasy world like pornography or video games, and ultimately suicide becomes ways to escape life. The longer we spend unplugged from life the easier it is to believe that we could never engage “the real world” (which becomes a purely negative phrase).

What habits have you begun or contemplated as a form of escape?

7. Less Enjoyment of Normal Pleasures

Depression-anxiety can make it feel like all the crayons in the box are grey. All the things that each brought unique pleasures, now feel “blah.” In many ways it is this loss or pleasure that is directly related to the loss of hope – the most painful aspect of depression-anxiety. It is one thing to be thirsty (i.e., sad), but it is another thing to be thirsty and discover that every beverage has lost its ability to quench thirst (i.e., bring joy).

What things that you once enjoyed have lost their ability to satisfy?

For the various counseling options available from this material visit

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Depression” post which address other facets of this subject.

20 Approaches to Battling Depression-Anxiety as Suffering

This post is an excerpt from the study guide which accompanies the “Overcoming Depression-Anxiety: A Suffering Paradigm” seminar. This portion is one element from “STEP 7: IDENTIFY GOALS that allow me to combat the impact of my suffering.” To RSVP for this and other Summit counseling seminars visit

One of the biggest challenges in identifying goals for combatting the effects of suffering is to be active without accepting false guilt. It is easy to think if there is something I “can do” to offset the impact of my suffering, then it is something I “should have been doing” all along.

The embedded deception in this kind of thinking is that the new strategy would have prevented the experience of depression-anxiety from ever occurring. If this were true, then you would be facing a sin-based experience of depression-anxiety rather than a suffering-based one.

The clearest example of this dynamic might be grief. Grief is clearly a form of suffering. But we are not powerlessly trapped in the experience of grief for a lifetime. There are things we can do to process the experience of grief and offset its impact. However, doing these things earlier would not have prevented our loved one from dying or our experience of grief at their death.

This is how we would encourage you to consider the strategies presented in this chapter. They are approaches to help alleviate the impact of depression-anxiety in your life. We present more strategies than you will be able to implement. Don’t get overwhelmed. Choose those that seem like the best fit for your experience. If you’re unsure which ones those may be, consult with the friends, pastor, or counselor with whom we’ve encouraged you to walk through this material.

If you believe that you need an approach to anxiety-depression that calls you take more personal responsibility for your emotional state, then we would encourage you to consult chapter six in the corresponding study that addresses these same emotions from a sin paradigm (; note – link not active until after the live presentation).

Your goal at the end of this chapter, and possibly in conjunction with chapter six of the corresponding study, is to identify the most impactful things you could do in your struggle with depression-anxiety. We want to help you break the sense of powerlessness to which it is so easy to succumb.

Several of these approaches were adapted from a larger list found in Ed Welch’s book in Depression, A Stubborn Darkness (page 231ff; bold text only).

Note: Each is described more fully in the study guide that accompanies this presentation.

  1. Talk to Yourself Instead of Listening to Yourself
  2. Stop Saying, “It Won’t Work”
  3. Allow for Contributive Causes and Contributive Remedies
  4. Medication
  5. Identify Areas Where Your Choices Matter
  6. Engage Relationships
  7. Ask People to Pray for Goals More than Relief
  8. Be Willing to Be Challenged
  9. Serve Others
  10. Forgive
  11. Shield Against a Depressed-Anxious Identity
  12. Worship
  13. Realize This Is a Battle and You Must Fight
  14. Let Go of “Should”
  15. Question Your Interpretations
  16. Look for the Good in People and Situations
  17. Read a Good Book on Suffering
  18. Be Willing to Sacrifice the Pseudo-Comforts of Depression-Anxiety
  19. Don’t Confuse Boredom with Depression or Uncertainty with Anxiety
  20. Spiritual Life – Less May Be More

Date: Saturday September 27
Time: 4:00 to 7:30 pm
Location: The Summit Church, Brier Creek South Venue
Address: 2415-107 Presidential Drive; Durham, NC 27703
Cost: Free

For the various counseling options available from this material visit

6 Steps to Wise Decision Making About Psychotropic Medications

This post is an excerpt from the study guide which accompanies the “Overcoming Depression-Anxiety: A Suffering Paradigm” seminar. This portion is one element from “Appendix A.” To RSVP for this and other Summit counseling seminars visit

Let’s begin this discussion by placing the question in the correct category – whether an individual chooses to use psychotropic medication in their struggle with mental illness is a wisdom decision, not a moral decision. If someone is thinking, “Would it be bad for me to consider medication? Is it a sign of weak faith? Am I taking a short-cut in my walk with God?” then they are asking important questions (the potential use of medication) but they are placing them in the wrong category (morality instead of wisdom).[1]

Better questions would be:

  • How do I determine if medication would be a good fit for me and my struggle?
  • What types of relief should I expect medication to provide and what responsibilities would I still bear?
  • How would I determine if the relief I’m receiving warrants the side effects I may experience?
  • How do I determine the initial duration of time I should be on medication?

In order to answer these kinds of questions, I would recommend a six step process. This process will, in most cases, take six months or more to complete. But it often takes many months for doctors and patients to arrive at the most effective medication option, so this process does not elongate the normal duration of finding satisfactory medical treatment.

Having an intentional process is much more effective than making reactionary choices when the emotional pain (getting on medication) or unpleasant side effects (getting off medication) push you to “just want to do something different.” With a process in place, it is much more likely that what is done will provide the necessary information to make important decisions about the continuation or cessation of medication.

Preface: This six step process assumes that the individual considering medication is not a threat to themselves, a threat to others, and is capable of fulfilling basic life responsibilities related to their personal care, family, school, and work. If this is not the case, then a more prompt medical intervention or residential care would be warranted.

If you are unsure how well you or a friend is functioning, then begin with a medical consultation or counseling relationship. If you would like more time with your doctor than a diagnostic and prescription visit, then ask the receptionist if you can schedule an extended time with your physician for consultation on your symptoms and options.

Step One – Assess Life and Struggle

Most struggles known as mental illness do not have a body-fluid test (i.e., blood, saliva, or urine) to verify their presence. We do not know a “normal range” for neurotransmitters like we do for cholesterol. The activity of the brain is too dynamic to make this kind of simple number test easy to obtain. Gaining neurological fluid samples would be highly intrusive and more traumatic than the information would be beneficial. Brain scans are not currently cost effective for this kind of medical screening and cannot yet give us the neurotransmitter differentiation we would need.

For these reasons, the diagnosis for whether a mental illness has a biological cause is currently a diagnosis-by-elimination in most cases. However, an important part of this initial assessment should be a visit to your primary care physician. In this visit you should:

  • Clearly describe the struggles / symptoms that you are experiencing.
  • Describe when each struggle / symptom began.
  • Describe the current severity of each struggle / symptom and how it developed.

As you prepare for this medical visit, it would be important to also consider:

  • What important life events, transitions, or stressors occurred around the time your struggle began?
  • What is the level of life-interference you are experiencing as a result of your struggle?
  • What lifestyle of relational changes would significantly impact the struggle that you’re facing?

Step Two – Make Needed Non-Medical Changes

Medication will never make us healthier than our current choices allow. Our lifestyle is the “ceiling” for our mental health; we will never be sustainable happier than our beliefs and choices allow. Medication can correct some biological causes and diminish the impact of environmental causes to our struggles. But medication cannot raise our “mental health potential” above what our lifestyle allows.

Too often we want medication to make-over our unhealthy life choices in the same way we expect a multi-vitamin to transform our unhealthy diet. We assume that the first step towards feeling better is receiving a diagnosis and prescription. This may be the case, and there is no shame if it is, but it need not be our guiding assumption.

Look at the lifestyle, beliefs, and relational changes that your assessment in step one would require. If there are choices that you could make to reduce the intensity of your struggle, are you willing to make them? Undoubtedly these changes will be hard, or you would have already done so. But they are essential if you want to use medication wisely.

As you identify these changes, assess the areas of sleep, diet, and exercise. Sleep is vital to the replenishing of the brain. Diet is the beginning of brain chemistry – our body can only create neurotransmitters from the nutrition we provide it. Exercise, particularly cardiovascular, has many benefits for countering the biological stress response (a primary contributor to poor mental health). Your first “prescription” should be eight hours of sleep, a balanced diet high in antioxidants, and cardiovascular exercise for at least thirty minutes three days a week.[2]

A key indicator of whether we are using psychotropic medication wisely is whether we are (a) using medication as a tool to assist us in making needed lifestyle and relational changes, or (b) using medication as an alternative to having to make these changes. “Option A” is wise. “Option B” results in over-medication or feeling like “medication didn’t work either” as we continually try to compensate medically for our volitional neglect of our mental health.

Step Three – Determine the Non-Medicated Base-Line for Your Mood and Life Functioning

This is an important, and often neglected, step. Any medication is going to have side effects. The most frequent reason people stop taking psychotropic medications, other than cost, is because of their side effects.

If we are not careful, we will merely want to feel better than we do “now.” Initially “now” will be how we feel without medication. Later “now” will be how we feel with medication’s side effects. In order to avoid this unending cycle, we need to have a baseline of how we feel when we live optimally off of medication.

One of the reasons postulated for why placebos often have as beneficial an effect as psychotropic medication is the absence of side effects. Those who take a placebo get all the benefits of hope (doing something they expect to improve their life) without any unpleasant side effects. Getting the baseline measurement of how life goes when you simply practice “good mental hygiene” is an important way to account for this effect.

“As I practice medicine these days, my first question when a patient comes with a new problem is not what new disease he has. Now I wonder what side effects he is having and which drug is causing it (p. 191).” Charles Hodges, M.D. in Good Mood Bad Mood

There is another often over-looked benefit of step three. Frequently people get serious about living more healthily at the same time life has gotten hard enough to begin taking medication. This introduces two interventions (medication and new life practices), maybe three or four (often people also begin counseling or being more open with friends who offer care and support), at the same time. It becomes very difficult to discern which intervention accounts for their improvements.

Writing out your answers to these questions will help you discern if you need to move on to step four and make the needed assessment in step five.

  • What were the struggles that initially made me think I might benefit from medication?
  • How intense were these struggles and how did they manifest themselves?
  • What changes did I make in my lifestyle and relationships to alleviate these struggles?
  • How effective was I at being able to make the needed changes?
  • How much relief did the lifestyle and relational changes provide for my struggles?
  • How do I anticipate medication would assist me in being more effective at these changes?

Step Four – Begin a Medication Trial

If your struggles persist to a degree that is impairing your day-to-day functioning, then you should seek out a physician or psychiatrist for advisement about medical options. As you have this conversation, consider asking your physician the following questions:

  • What are the different medication options available for the struggle I’m facing?
  • What does each medication do that impacts this struggle?
  • What are the most common side effects for each medication?
  • How long does it take this medication before it is in full effect?
  • If I chose to come off this medication, what is the process for doing so?
  • What have been the most common affirmations and complaints of other patients on this medication?

These questions should help you work with your doctor to determine which medication would be best for you. Remember, you have a voice in this process and should seek to be an informed consumer with your medical treatment; in the same way you would for any other product or service you purchase.

In this consultation you also want to decide upon the initial period of time for which you will remain on the medication (unless you experience a significant side effect from the medication). In determining this length of time, you would want to consider:

  • Your physician or psychiatrist will make recommendations based upon additional factors not considered in this article
  • A minimum of at least twice the length of time it takes the medication to reach its full effect
  • Significant life stressors that would predictably arise during this trial period (e.g., planning a wedding)
  • How long it would take to make and solidify changes that were difficult to make without medication (see step three)

Once you determine this set period of time, your goal is to continue implementing the changes you began in step three while monitoring (a) the level of progress in your area of struggle and (b) any side effects from the medication.

Step Five – Assess Level of Progress Against the Medication Side Effects

Near the end of the trial period, you want to return to the life assessment questions you answered at the end of step three. Compare how you are able to enjoy and engage life at this point with your answers then. The questions you want to ask are:

  • What benefits have you seen while you were on medication?
  • What side effects have you experienced?
  • Is there reason to believe your continued improvement is contingent upon your continued use of medication?
  • Are the side effects of medication worth the benefit it provides?

The more specific you were in your answers at the end of step three, the easier it will be to evaluate your experience at the end of step five. At this point, try to be neither pro-medication nor anti-medication. Your goal is to live as full and enjoyable a life as possible. It is neither better nor worse if medication is or is not part of that optimal life.

Step Six – Determine Whether to Remain on Medication

At this point in the process there are several options available to you; this is more than a yes-no decision. But any option should be decided in consultation with your prescribing physician or psychiatrist. You can decide to:

  • Remain on medication because the effects are beneficial and the side effects are minimal or worth it.
  • Opt to stage off of your medication because the benefits were minimal or the side effects worse than the benefits.
  • Stage off medication to see if the progress you made can be maintained without medication; knowing you are free to resume the medication if not without any sense of failure.
  • Opt to try a different medication for another set period of time based on what you learned from the initial experience.

Regardless of what you choose, by following this process you can have the assurance that you are making an informed decision about what is the best choice for you.

For the various counseling options available from this material visit


[1] For more on understanding the choice about psychotropic medications as a wisdom issue, I would recommend the lecture “Understanding Psychiatric Treatments” by Michael Emlet, MD at the 2011 CCEF conference on “Psychiatric Disorders” which can be found at

[2] Additional guidance on this kind of “life hygiene” can be found at

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Mental Illness and Medication” post which address other facets of this subject.

Who and Where Is God in My Depression-Anxiety?

This post is an excerpt from the study guide which accompanies the “Overcoming Depression-Anxiety: A Suffering Paradigm” seminar. This portion is one element from “STEP 6: LEARN MY GOSPEL STORY by which God gives meaning to my experience..” To RSVP for this and other Summit counseling seminars visit

There are many God-questions that arise in the midst of depression-anxiety. It is nearly impossible to persistently battle for hope and peace without asking questions directed to or about God. The things discussed below should not be new. They are meant to be crystallizations of what you’ve been learning. Allow these truths about God to become cemented in your story; they should increasingly feel like “givens” as opposed to “possibilities.”

Near to Those Who are Anxious-Depressed

There is a danger in reading our Bibles in search for God’s answer to depression-anxiety. It begins to make God feel like an absentee father; as if all he offers us is a letter in the mail. A letter would mean both that God cared and that he was far away. This would be both encouraging and disheartening; God’s words would seem sincere but powerless. This is why we must pay careful attention to the thing God most repeats and we most overlook when he speaks about depression-anxiety.

“Anxiety-disordered individuals are often so focused on trying to control their circumstances and avoiding some potential catastrophe that they begin to perceive God as punitive, perfectionistic, and authoritative (p. 109).” Matthew Stanford in Grace for the Afflicted

Read I Peter 5:6-9 and Philippians 4:5-9. The most neglected aspect of both of these passages is the nearness of God. We come to these passages seeking God’s “answer” for depression-anxiety. As we search for principles and practical steps, we miss that the first and main thing God offers is himself. When we doubt or rush past God’s presence, we begin to expect knowledge to accomplish what only relationship can provide. Yes, God does offer us strategies and truths to combat depression-anxiety, but these are not the first and most important things he offers.

  • Question: Where do you see God in relation to your experience of depression-anxiety? How can you remind yourself of his actual location when your fear / despair feels closer than God?

Inside Your Experience of Depression-Anxiety

Our concept of being “near” does not capture how close God is. If God were merely “next to” us in our suffering, then we would simply feel less alone. That would be nice, but less than transformative. God is actually “in” us as we suffer. There is nothing that occurs in our soul that does not immediately register with him even before we can bring it to him in prayer. God does not begin his response to our suffering when we pray; as is if we had to alert him before he would move. God is experiencing our suffering as we do, so our prayer only alerts us to his presence and activity.

Read Romans 8:23-30. Notice that God can put our suffering into words better than we can. Why? God is so “with” us that he is “in” us. Our groans make sense to him because he experiences them with us. Actually, they make more sense to him than they do to us because he knows their origin (past), expression (present), and redemption (future). In spite of his knowing the future resolution of our anxiety-depression, notice that God does not grow impatient with our sense of being overwhelmed by them in the present (v. 26).

  • Question: How would your prayers change if you remembered you didn’t have to explain your experience to God?

Capable of Transforming Suffering

We often think that transformation requires elimination. That is true when a water droplet is transformed to vapor; the droplet no longer exists. But God’s transformation of suffering is usually much more like the change in our memories of a loved one during grief. These memories transform from experiences of pain to precious treasures (that may still evoke sadness). This side of heaven God’s transformation of our suffering will not be Utopia. This helps us remember that the presence of pain does not mean the absence of God’s redemptive work in our suffering.

Read Hebrews 11:13-16. Notice this awkward interlude in the midst of Hebrews 11, a chapter commonly referred to as the “Hall of Faith.” We would say that God worked mightily in the life of each of these individuals. They are the upper-echelon heroes of the Bible. But also notice that the cliff notes-highlights we read from their life are not the same as their experience of these events. Their experience of following God by faith is much more similar to your experiencing of trusting God in the midst of depression-anxiety than you might have thought.

  • Question: What evidences can you already see of God using your experience of depression-anxiety? What are the incomplete aspects of that redemption with which you’ll have to trust God like those in Hebrews 11?

For the various counseling options available from this material visit

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Depression” post which address other facets of this subject.

Differentiating Mourning from Wallowing in Depression-Anxiety

This post is an excerpt from the study guide which accompanies the “Overcoming Depression-Anxiety: A Suffering Paradigm” seminar. This portion is one element from “STEP 5: MOURN the wrongness of what happened and receive God’s comfort..” To RSVP for this and other Summit counseling seminars visit

There are many things that unhealthy wallowing and healthy mourning have in common. It can be easier to confuse one from the other than many people think. The person who thinks he is “working through” his pain may be wallowing in self-pity. Those who try to rouse their friend out of self-pity may be rushing them through legitimate mourning.

Unfortunately, there is no emotional litmus test to verify the difference in these two experiences. However, we can (a) clarify what wallowing and mourning share in common, so we are less prone to assume the overlapping experiences necessarily indicate their counterpart. We can also (b) identify distinguishing marks between wallowing and morning so that we know what to look for in order to rightly identify the emotional experience.

Let’s begin by considering the similarities of mourning and wallowing.

  • Both are triggered by an undesired life circumstance.
  • Both exist on the unpleasant end of the emotional spectrum.
  • Both feel justified and logical in light of the triggering experience.
  • Neither feels like we are “doing” them but that they are “happening” to us.
  • Both involve a high degree of mental repetition.
  • Both are seeking to make sense of life in light of the unpleasant experience.
  • Both begin to shape the way you interpret the events and people around you.
  • Both shape the way you anticipate and prepare for the future.
  • Both change the way that you remember past events.

What do you gain from this bulleted list? A realization that none of these criteria are able to distinguish mourning from wallowing. Each criterion is true for both. It is as if you were asked to distinguish a square from a rectangle. You could say, “It has four sides and each corner formed a ninety degree angle.” This is true for both a square and a rectangle, so it does not help you differentiate the two shapes.

Why take the time to draw these parallels? Often people believe some of these symptoms always indicate either healthy mourning or unhealthy wallowing. When you have these experiences all you know is that you’re hurting. It is not clear whether this pain is part of a healthy or unhealthy process; contributing to a redemptive or destructive story line.

This should give you freedom to consider the criteria that follows. Never will our emotions or motives be as pure as we would like. Your goal at this point is not that you “mourn perfectly” but that your experience be increasingly free from qualities that are indicative of wallowing.

Wallowing Fears Hope but Mourning Trusts Hope.

How much do you find yourself arguing with those who want to encourage you even before they make their point; maybe even before you have the opportunity to talk with them? This is an indicator that you’ve begun to fear hope. You are bracing against being “up” again because you fear falling “down” afterwards.

When we give into this temptation then anxie or depressed become the only “safe” ways to feel. Anything that is pleasant is immediately labeled untrustworthy. When this shift from mourning to wallowing is made, our “common sense” barricades us against the progress we desire.

Proverbs 13:12 says, “Hope deferred makes the heart sick.” Those who struggle with depression-anxiety often succumb to believing the solution is to stop hoping. That is the equivalent of a cancer patient concluding, “If chemo leaves me feeling weak, then quitting chemo will make me feel strong.” This result is making the depressive-anxious experience chronic.

Wallowing Resents Joy but Mourning Longs for Joy.

Resentment has a way of flipping our values. If we were made fun of because of struggles in school, then the resulting resentment can cause us to downplay formal education in favor of “good ol’ common sense.” Similarly, if we were ridiculed for being poor, then there is a tendency to think that people who have nice things are bad (i.e., dishonest, condescending, etc…). A virtue (education) or asset (wealth) begins to be viewed as a vice because of our resentment.

The same thing happens when our depression-anxiety begins to make us feel rejected or deficient. We can begin to view a blessing (joy) as a vice (something we resent, fear, and resist). We begin to identify with our misery to such a degree that we don’t want to be like “those people” who “think they are better than we are” even though there is no rivalry and we know it would be better to have joy. But it feels like we would be “betraying our team.”

Mourning is sad, but it hasn’t quit desiring joy; neither has it removed joy from the category of “desirable virtue.” This requires emotional strength. It is hard to continue wanting a good thing you do not have and are not sure you will be able to obtain. It is easier, although unhealthy, to turn your back on the good thing as a cruel joke faked by people who are, in some way, against you.

Wallowing Is Skeptical Towards Faith but Mourning Listens to Faith.

Who or what you are willing to listen to says a great deal about you. When mourning gives way to wallowing hearing words of faith – from Scripture or a friend – begin to be heard through a filter of mistrust or cynicism.

Consider for a moment how you listen to a news program that does not share your political views or a telemarketer who is telling about a life-changing product. Compare this to how you hear statements of faith in the midst of your depressed-anxious experience.

The more you instinctively hear these messages with skepticism the more mourning has given way to wallowing. Your initial goal should not necessarily be to fully embrace the messages of faith you’re hearing. You can begin much smaller; just hear these messages neutrally and know they’re intended for your good. Even if this initially causes you to feel sad, it is a step towards transforming wallowing into mourning.

Wallowing Resists Being Strong but Mourning Embraces Strength.

Both mourning and wallowing are exhausting. Mourning results in the exhaustion of a marathon runner – someone who realizes their journey is a mark of strength. Wallowing results in the exhaustion of prey acquiescing to a predator – someone who is giving up.

Either way the exhaustion is real. The marathon runner and the gazelle succumbing to a lion are both legitimately tired. The question is whether you view where you are as hopeless or as evidence of God’s continuing ability and willingness to sustain you. You have relied on God’s grace to this point – willingly or reluctantly – and that same grace is available for whatever journey lies ahead.

Do not confuse the metaphor of running with the need to rush. If that were the case, then we would not be at the mid-point of a nine step journey. Neither should you begin to view God as a cruel track coach. The things you learn in this experience are not necessarily “God trying to teach you a lesson” (in the harsh connotation of that phrase). Too often we view every lesson we learn in suffering as God’s purpose statement for that experience; this causes us to mistrust our source of strength during these times.

Wallowing Avoids Being Known but Mourning Invites Community.

Most of the points above focus on the intrapersonal differences between mourning and wallowing – those things going on inside of us. This final point looks at an interpersonal difference – how we relate to others differently.

When shame turns mourning into wallowing we resist allowing others to know us well. We become slippery – able to answer people’s questions without allowing them to really know us. With time, we begin to cynically disbelieve that others care or are able to understand.

The reality is that we limit how much we can be cared for by others with how much we make ourselves known to them. If we are 50% known, then we will (at best) be able to receive 50% of the care they offer. Shame convinces us that “if they really knew” they would not mean what they said or do what they did. The result is a corruption of each act of kindness or word of encouragement offered to us.

Using these criteria, how would you describe your current response to the experience of depression-anxiety: mourning or wallowing? Which criteria gave you the most insight about your response?

For the various counseling options available from this material visit

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Depression” post which address other facets of this subject.

12 Ways Depression-Anxiety Impacts Family and Relationships

This post is an excerpt from the study guide which accompanies the “Overcoming Depression-Anxiety: A Suffering Paradigm” seminar. This portion is one element from “STEP 3: UNDERSTAND the Impact of My Suffering.” To RSVP for this and other Summit counseling seminars visit

The first two areas of impact we examined were how the experience of depression-anxiety impacts you. Now we are going to examine how your experience of depression-anxiety impacts those around you. You happen to those around you as much as they happen to you. Overcoming depression-anxiety will have social implications and it is good for us to begin considering those now.

This is a point where it is easy for many people to lapse into self-pity and shame. But considering how your emotions impact others is vital to godly change. The best response is effort towards progress rather than an emotional apology. If confession is needed, that will be covered in step five of the sin-based counterpart to this study. For now your objective remains to understand the impact of your depression-anxiety so that you can be equipped to battle it most effectively.

In her book Troubled Minds: Mental Illness and the Church’s Mission, Amy Simpson lists twelve ways that family and friend are affected when their loved one experiences significant mental illness (p. 60-80; bold text only). As you read these, ask yourself two questions: (1) when may these be present in my relationships, and (2) how can I minimize their effect? But do not allow these to distract you from your pursuit of hope and peace; which is the best thing you can do for those who care about you.

1. Special Rules: When one person does less others must do more or suffer the consequences. When one person becomes emotionally fragile those around him/her learn the “rules” to keep things “normal.” Whenever certain subjects or activities become “off limits” they become life rules people must follow to stay in good relationship. When some things are “not public knowledge” this creates an artificial social system. All of these are ways that depression-anxiety can create special rules for those around you.

2. Resource Monopoly: Therapy, medication, hospitalization, and missed work all cost money, time, and attention. They may be a very good investment, but they still consume resources. Other family members will do without certain things because of this investment. If you are a parent, the most costly of these resources is attention. Make sure you set aside time to invest your attention in your children. It will bless you and is vital to their healthy development.

3. Confusion: With depression-anxiety there are no bruises, scars, or broken bones; there is not a rash, skin discoloration, or bumps. There is nothing that makes it obvious that something is wrong. This is as confusing to others as it is frustrating to you. Children are especially prone to self-incriminating interpretations of your down mood as being their fault; they need something that “makes sense” of what is occurring in their world. You can love others well by listening for and patiently correcting their confused guilt-interpretations of your emotions.

4. Anxiety: Confusion (previous point) breeds anxiety. This is true for you. If you do not understand what causes your emotional fluctuations that feels unpredictable and stressful. Alleviating this stress is the reason for the amount of assessment work you’re asked to do in this study. The same is true for your family and friends. When you can tell they are confused by your mood changes, acknowledge that you are confused as well. This can let them know they are not “missing something” that is obvious to you and should be to them.

5. Guilt: The quickest way to control and make sense of something emotional is to take responsibility for it (whether it is accurate or healthy or not). The answer to the question, “What can I do to help?” can easily be misconstrued as an answer for the question, “What should I be doing so you would not feel this way?” The former seeks to provide support and gives grace; the latter assumes responsibility and assumes guilt. When this mistake is made it makes your unpleasant mood a tarnish on their clean conscience. Your sadness is perceived as their deficiency. Saying, “You haven’t done anything to make me feel this way,” can be important.

6. Maladjustment: This is particularly true for children. When mom or dad is more internally focused on themselves than externally focused on their children, the children have to adjust to this culture change. It will be the “normal” that they know and from which they form their relational instincts. Spouses also adjust as they accommodate their social and home expectations to the possibilities allowed and environment created by their spouse’s emotions. The best way to account for this factor is to fully engage with pursuit of healthy emotions and demonstrate awareness of when your mood is affecting others in an unhealthy way.

7. Role Reversal: Children can become caregivers or emotional supporters, spouses can become parents, and friendships can become one-way relationships when depression-anxiety dominates our life. These reverse what is healthy for each of these relationships. Resist this most intensely with your children. Kids should be allowed to be kids and not asked to carry the emotional load of their parents. With spouse or friends, overtly acknowledge if there is a role change, which can be helpful, but also keep them informed of the steps you are taking to make this arrangement short-term. Allowing these role reversals to become long-term is what accounts for the “special rules” described in the first item on this list.

8. Instability: When your emotions change the plans of others you introduce instability into their lives. They become less able to prepare for future events and implement reliable patterns for managing basic life tasks and interests. Beyond sensitivity to others, you begin to teach them that your emotions are the top priority and final arbiter of schedules and decisions. Following through on commitments is not just about preventing the passivity that is hospitable for depression-anxiety, but also about loving others well by limiting the instability in their lives.

9. Medications: How to make wise decisions about the use of medication is covered in Appendix A. But, as you likely know, finding the “right” medication is hard. How to identify which medication will be most effective for a given individual’s depression-anxiety can be difficult. In this effort, family and friends’ view of medication and doctors can be affected. Some may grow cynical when results are not as immediate. Others may grow overly-reliant on the role of doctors-medicine for healthy emotions. The resource is intended to balance these expectations.

10. Grief and Loss: People who love you will experience sorrow as you struggle. This is right and good (Romans 12:15). It can feel awkward or guilt-provoking when your emotions have this kind of influence on others. But when you see this influence simply say, “Thank you… Thank you for caring about me enough that what happens in my life impacts you. I want you to know that my emotions are not your responsibility, but it is comforting to know that I am not alone in this experience.” Affirm their character while releasing their sense of responsibility.

11. Shame: Unfortunately, there is still a social stigma associated with depression-anxiety. It can make other’s knowledge of what you’re experiencing feel like a secret. Secrets create a sense of separation and, with that separation, shame. We face a cultural battle to corporately understand depression-anxiety better so that this stigma can be removed. The removal of every stigma happens when courageous individuals will talk openly about their experience and use it to educate others. This seminar is intended to help you, and thereby strengthen the entire church, in this process.

12. Spiritual Crisis: Depression-anxiety generates many God-questions; for you and those who love you. We will explore these in great detail in chapters four through six. Share what you learn with those who love you. This will help reinforce what you are learning and help them process the corresponding questions they are also asking.

Read I Samuel 1:3-8. It might be easy to conclude from this section that family and friends are innocent by-standers affected by your emotions. That is not always true. Often our “support network” can be less than helpful. Look at the example of Elkannah (v. 8). His “support” revealed that he clearly did not understand. Hannah’s sorrow made him uncomfortable and he wanted her to feel better. But God would have to comfort Hannah in spite of his words instead of through them. Part of the comfort we take from Scripture is the examples of how God was faithful even when his people were clumsy with one another.

Read Galatians 6:1-5. Notice the different ways that God describes how relationships should work when one person needs other to bear their burdens. First, notice that you should go to those who are more mature in their faith (v. 1a). Second, notice that these individuals are instructed to know their own limits (v. 1b). Third, notice how you are providing them an opportunity to fulfill the law of Christ (v. 2). Fourth, notice that even those who are spiritually mature are prone to the same struggles (v. 3). Finally, notice that, while this person comes alongside you for encouragement, each of you maintain responsibility for your own lives and struggles (v. 5).

For the various counseling options available from this material visit

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Depression” post which address other facets of this subject.

6 Changes in Lifestyle that Add to the Impact of Depression-Anxiety

This post is an excerpt from the study guide which accompanies the “Overcoming Depression-Anxiety: A Suffering Paradigm” seminar. This portion is one element from “STEP 3: UNDERSTAND the Impact of My Suffering.” To RSVP for this and other Summit counseling seminars visit

Depression-anxiety is not an awkward house guest who stays for a few hours and then goes home. You quickly begin to realize that depression-anxiety wants to live with you. It begins to arrange the structures of your life as if it “owned the place.” It is moving furniture, hanging pictures, and putting its favorite foods in your refrigerator. Unless you are willing to de-accommodate these changes, depression-anxiety will remain in your home as long as you allow (passivity towards these changes is permission).

We will examine six ways depression-anxiety makes itself at home in your life.

1. Unhealthy Lifestyle Accommodations: Withdrawal from friends, erratic sleeping patterns, eating for comfort rather than nutrition, avoiding things that feel like “too much work,” neglecting interests that usually energize you, and similar changes make your life a hospitable home for depression-anxiety. If you leave your door open and have a big bowl of mixed nuts in your living room, don’t be surprised if you’re living with squirrels. If you allow these changes to persist, don’t be surprised if you’re living with depression-anxiety.

2. Changes in Role or Identity: Being anxious-depressed can change the way we see ourselves, and, thereby, how we relate to other people. We can begin to take on pejorative titles like “sick,” “crazy,” or “broken.” These become sources of shame or entitlement; we begin to hide or expect things from others in a way that creates an imbalance that is unconducive for healthy relationships. The result is that healthy friendships grow distant and we are left with enabling or shaming friendships that feed our depression-anxiety.

3. Living in Response to Emotions: We begin to measure our day on the basis of a single variable – how do I feel? Further we begin to make choices on the basis of a single variable – will this make me feel better… quickly? When this happens our mood begins to dominate our thinking and cloud our decision making. No longer are we considering what a “full life” would be; instead we begin to live for relief. Whether we are abusing a substance or not, we are beginning to think like an addict.

4. Loss of Hope for Change: A primary measure of the severity of depression-anxiety can be revealed by the question, “How much hope do you have that things can be better?” The fading of hope is the measure of severity. Hope is the difference between a challenging season of life and experiencing depression-anxiety. Hope does not make us immune to unpleasant emotions, but it does buffer us against despair. If you want to know the difference between “normal sadness and worry” and significant depression-anxiety, it is when hope begins to fade.

5. Passivity Towards Change: “It doesn’t matter what I do, so I might as well do nothing,” is the cynical response to the loss of hope. Passivity is the behavioral expression of the absence of hope. The result is an atrophy of the will. In the same way that physical passivity results in muscle atrophy, growing passive towards the things that upset you results in an atrophy of the will.

 6. Loss of a Sense of Time: In the absence of goals and short-term memory loss (common features of depression-anxiety), the loss of a sense of time. The longing for what is “next” is key to our sense of time and memory. When we surrender our ambition and hope to depression-anxiety we forfeit what connects tomorrow to today and allows “this task” to take on meaning as it contributes to something “we want and believe is possible.” The result is that every moment begins to float in an abyss of meaninglessness.

Read Lamentations 3:1-48. Often when we think of this passage we start with the “happy part” that begins in verse 21. Take your time and walk with Jeremiah, the author of Lamentations, as he traces the challenges which create a great sense of felt-need to cling to hope (v. 1-20). Note how much detail Scripture gives to “understanding the impact of his suffering.” Now read the way that Jeremiah fought to take every thought captive (2 Corinthians 10:5) in the second half of this chapter. Allow this to both dispel any sense of whining you may feel as you seek to understand the impact of your suffering, and to strengthen the notion that God intends to care for people with hard emotional battles like yours through his Word.

For the various counseling options available from this material visit

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Depression” post which address other facets of this subject.

7 Factors that Contribute to the Impact of Depression-Anxiety

This post is an excerpt from the study guide which accompanies the “Overcoming Depression-Anxiety: A Suffering Paradigm” seminar. This portion is one element from “STEP 3: UNDERSTAND the Impact of My Suffering.” To RSVP for this and other Summit counseling seminars visit

No two experiences of depression-anxiety are the same. This is partly because every person is unique. But the differences in experience go beyond personality and life history. It is not just that each individual who experiences depression-anxiety is unique, which is true, but also that each anxious-depressive experience is itself unique. In this section, we want to examine many of the factors that account for this.

As you assess these factors in your life, avoid two temptations. First, as we’ve already said, do not allow them to overwhelm you. Nothing you will read is more true because you read it. You are only acknowledging the reality that already existed. Second, do not minimize your experience because someone else’s experience may involve more factors. You are equipping yourself or your journey; not racing anyone else in their journey.

1. Cause of Depression-Anxiety: There is no one-cause for depression-anxiety. Most of the debates about whether depression-anxiety is a caused by a chemical imbalance, bad choices, relational wounds, weak faith, or other factors over simplify the experience. The answer is, “Yes, all of these can cause depression-anxiety.” The question is, “Which of these is the leading contributor to your experience?” To help you make this assessment see The point here is that the type of cause-trigger for your depression-anxiety will contribute to the degree and type of impact it has on your life.In the resource link above we help you assess the difference between biological, environmental, and volitional causes for depression-anxiety and develop an approach for the wise utilization of medication based upon the leading contributor to your anxious-depressive experience.

2. Duration of Depression-Anxiety: We can endure anything for “a little while.” But when a little while continues and we are unsure when it will end, we begin to lose hope and this compounds our emotional experience. The longer we struggle with anything, the more we begin to view it as inevitable and embrace it as part of our identity.

“The longer we struggle with a problem, the more likely we are to define ourselves by that problem (divorced, addicted, depressed, co-dependent, ADD). We come to believe that our problem is who we are. But while these labels may describe particular ways we struggle as sinners [or sufferers] in a fallen world, they are not our identity! If we allow them to define us, we will live trapped within their boundaries. This is no way for a child of God to live (p. 260)!” Paul Tripp in Instruments in the Redeemer’s Hand

3. Number of Occurrences of Depression-Anxiety: A struggle can be “long” by virtue of its duration or its repetition. “Not again” can be as painful as “How much longer?” When your experience of depression-anxiety returns after seasons of relative dormancy, you can begin to feel like “times of peace” are merely “seasons of waiting” for pain to return. When the return of depression-anxiety is unpredictable, the recurrence impact factor is even greater. It can be hard to rely on God’s grace as new each morning (Lamentations 3:21-26) when you are relying upon that grace for a struggle you’ve already faced.

4. Number of Attempts to Overcome Depression-Anxiety: More difficult than mere recurrence is having to refight a battle you believed you had already won… or, at least, withstood. It feels like being required to retake a class you thought you passed, but found out a semester later you failed on a technicality. It feels like being required to pay a bill twice because the clerk wasn’t paying attention the first time. When depression-anxiety recurs after we thought we had overcome, it takes away any sense of “final-ultimate victory” over this experience. We begin to fear depression-anxiety’s fiercest forms in its milder expressions; as if every thunderstorm was going to have hurricane level impact.

5. Reaction of Friends and Family: Many people are uncomfortable with the unpleasant emotions of others. If they do not know what to say or do to “make things better,” they avoid the person who makes then uncomfortable. Other people do not understand that depression-anxiety can often be a persistent, recurring struggle, so they get upset with the person they perceive as “attention hungry.” If you have lost friends or have strained relationships because of these dynamics, this adds to the impact of your suffering.“Friendship is very important for those with poor mental health, but it is very hard to be a true friend to someone in such a condition (p. 33).” Kathryn Greene-McCreight in Darkness Is My Only Companion

“[Testimony] The most profound sentence uttered by my spiritual director, when I was in the midst of my depression, was, ‘I am not afraid of your despair!…’ It is uncomfortable for many caregivers to enter the dark night of the soul with those who traverse the path of despair. [Advice] Walk with the despairing person and listen, rather than attempting through words to coerce the person to walk a different path (p. 26).” Robert Albers, William Meller, and Steven Thurber in Ministry with Persons with Mental Illness and Their Families

6. Losses Associated with Depression-Anxiety: You can lose more than relationships. We can lose confidence, jobs, money, opportunities, and many other things. When this happens the experience of grief – denial, anger, sadness, and identity confusion – can be added to the experience of depression-anxiety.

7. Interpretation of Depression-Anxiety Experience: The content of these interpretations will be the focus of chapters four and six. But you will be more equipped to resist the content of unhealthy interpretations of your depressive-anxious experience if you are able to identify the common patterns they take. In his book Christians Get Depressed Too David Murray addresses nine unhealthy thinking patterns (pg. 36-43, bold text only).

  1. False Extremes – Various forms of all-or-nothing, black or white thinking.
  2. False Generalizations – Assuming an unpleasant experience will become the new normal for life.
  3. False Filters – Ignoring, “filtering out,” any positive experience that does not fit with our down mood.
  4. False Transformations – Changing our perspective on positive experiences to make them seem bad.
  5. False Mind Reading – Assuming negative opinions about ourselves in the minds and mouths of others.
  6. False Fortune-Telling – Living as if our negative expectations of the future are true.
  7. False Feeling-Based Reasoning – Treating your negative feelings and assessments as if they were facts.
  8. False “Should’s” – Giving moral weight to expectations that are either unrealistic or not moral matters.
  9. False Responsibility – Taking responsibility for events or other people over which you have no control.

Read Philippians 4:8-9. As you look at the kinds of thinking Paul says we must discipline our mind to engage, do not think of this list as “types of content.” Yes, Paul is addressing the content of our thinking. But following his instruction will also correct the “pattern of our thinking.” The nine patterns above are corrected as we follow Paul’s instruction. Also notice that Paul talks about living these things out in community (v. 9). The most effective way to learn these new patterns is to associate with people who think this way and imitate their life (e.g., I Corinthians 11:1).

For the various counseling options available from this material visit

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Depression” post which address other facets of this subject.

Depression-Anxiety Daily Symptom Chart

This post is an excerpt from the study guide which accompanies the “Overcoming Depression-Anxiety: A Suffering Paradigm” seminar. This portion is one tool from “ACKNOWLEDGE the Specific History and Realness of My Suffering.” To RSVP for this and other Summit counseling seminars visit

Identifying the types of anxiety-depression with which you struggle is an essential step towards gaining a clear understanding of the intensity and duration of your struggle. (Note: This is referencing the depression-anxiety evaluation in a previous post.) It is odd that we are not always accurate in our perception of the frequency and intensity of our struggle.

  • We may have intense periodic struggles that we continually brace against so we feel they are “always present.”
  • We may have several different anxiety-depression struggles that we lump together and give them a single name.
  • We may have adjusted to low-grade, background depression-anxiety struggle that we don’t “count” anymore.
  • We may intentionally try to ignore milder symptoms until they arrest our attention in peak moments.

If we are going to be effective in overcoming our experience of anxiety-depression, we will need to be accurate in our assessment of when it occurs and the fluctuation in its intensity. It is an unwise general who goes to war against an adversary he does not know well.

Inductive Bible Study: Go to an on-line Bible study tool (for instance and search for passages that include words like “before” and “after.” Notice how much attention the Bible gives to describing when one event occurs in relation to another. Then search for words like “great” and “more” or “less.” Notice how much attention the Bible gives to the intensity of various experiences. Chances are you will not read every passage listed – they are too many – but you should get a sense of how much God cares about the kind of details you are discovering with this exercise.

The tool below is intended to help you track the frequency and intensity of various symptoms of depression-anxiety across a month. The top row demarks one column for each day of the month. Rows along the side give places to track each symptom. If your counselor or friend wants you to track a symptom that is not included a row is provided at the bottom for you to track this.

As you record this information here are several patterns to look for:

  • Look for symptoms that cluster together – occur or peak at the same time.
  • Look for symptoms that occur before or after a significant event (e.g., tragedy, visit from stressful relative, payday, etc…). When something upsetting or exciting occurs mark the day of the month with a symbol and write what occurred on the back of this page next to that symbol.
  • Look for symptoms that occur before or after other symptoms. For instance, what symptoms occur in the days before you experience a panic attack?
  • Look for similarities in the pattern of your emotions across weeks or months. This may indicate biological rhythms (e.g. menstrual cycle) or logistical rhythms (e.g., work week, shift work schedule, child custody schedule, etc…).

More will be assessed about the story behind (chapter four of this study) and the motive for (chapter three of personal responsibility counterpart to this suffering study) in latter portions of your study. At this point in the process you are merely trying to become more self-aware of the fluctuations in frequency and intensity or our various depression-anxiety experiences.

To download this resource: DEP_ANX Daily Symptom Chart_2.0

For the various counseling options available from this material visit

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Anxiety” post which address other facets of this subject.

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Depression” post which address other facets of this subject.