Lifting the Fog of Chronic Depression

By John D. Clague, Christian Science Committee on Publication for Oregon

@Glowimages
Model used for illustrative purposes only

I have a friend who suffers from SAD — seasonal affective disorder. The long periods of clouds and rain depress her so much that she feels she can no longer live in the northwest. She and her husband are actively looking to work and live in a sunny climate.

My friend is not alone in her depression. The Center for Disease control estimates that 1 in 10 adults in the U.S. suffer from depression.

Moments of temporarily feeling blue are not uncommon for most people at some point in their life. Chronic depression, however, goes far beyond temporary bouts to a persistent state of sadness without a cause or as a response to an event beyond what would be considered normal.

But feelings of sadness aren’t all that’s at stake.

The CDC also reports that

“Depression is a mental illness that can be costly and debilitating to sufferers. Depression can adversely affect the course and outcome of common chronic conditions, such as arthritis, asthma, cardiovascular disease, cancer, diabetes, and obesity. Depression also can result in increased work absenteeism, short-term disability, and decreased productivity.”

Left untreated this relationship between depression and other chronic illnesses can have serious consequences.

Even though a common treatment is to prescribe antidepressant medications, what’s interesting is that research is showing that except for the most severe cases, the active ingredients in the pills isn’t what makes the patient feel better. Rather, it’s the placebo effect, a belief that the treatment will help, which improves their outlook.

Researchers such as Irving Kirsch, Associate Director of the Placebo Studies Program at the Harvard Medical School, are finding that a key reason placebos work is that the recipient’s relationship with the person caring for them, or administering the drug, is therapeutic in and of itself. It doesn’t matter which drug they are given, whether a placebo or a bona fide antidepressant. Randomized clinical trials studying placebos are showing this to be true.

If antidepressants work through the placebo effect, and therapeutic relationships are a key factor in the effectiveness of placebos, then perhaps there are other relationships that can effectively treat depression without the ritual of pill-taking.

Carmen is a nurse practitioner who found herself in a deep depressive mental state after her son enlisted in the Army and was deployed to Iraq. She describes her journey on her website Naturally-Holistic.net. She eventually worked her way out of the depression, and without apology she claims that: “No matter how you look at it, there is a relationship between depression and spirituality.”

She makes four important points about how she emerged from her depression that have a direct connection to my practice of spirituality. Two of them are making the choice to be happy, and finding gratitude in every situation. The other two points, however, center on relationships.

She tells us to nurture important relationships, especially with God and to find “…something to love about every situation-even when it was really hard. Choose Love EVERY time.”

Not surprisingly, Carmen’s experience is backed up by research.

According to Dale A. Mathews, M.D:

“Studies have shown that religious people are less likely to become depressed and anxious than their nonreligious counterparts. Frequent churchgoing was shown to be associated with lower levels of anxiety and depression

Whether people are religious in the sense of being church-goers or simply individuals who embrace a spiritual relationship with a higher power, this premise seems to hold up. For example:

“…people who practiced prayer or meditation to reduce moderate to severe anxiety showed marked improvement after three months”

Research is important in learning what’s effective in treating depression. But personal experience is just as important in understanding these dynamics as I found with Carmen’s story.

I have a daily practice of reading the Bible. It helps me to maintain a spiritually-based “therapeutic relationship” with a higher Being, or God, that keeps me grounded on a meaningful purpose in life. One passage in the New Testament that I’ve found helpful says:

“… I am convinced that nothing can ever separate us from God’s love. Neither death nor life, neither angels nor demons, neither our fears for today nor our worries about tomorrow—not even the powers of hell can separate us from God’s love.”

Depression is very real and serious for those who suffer from this condition. It’s encouraging to know that there are options that don’t carry negative side effects, and which aren’t based on the trickery behind placebos.

Perhaps nurturing a relationship, spiritually, with a higher Being is the therapy that will lift the fog and let the light shine.

Health Apps, or an Inner Spiritual Sense?

By John D. Clague, Christian Science Committee on Publication for Oregon

@Glowimages

Simplifying our life seems to be getting more complicated. But never fear, there is an app for everything nowadays. Managing each aspect of the most intimate everyday details is being digitized through applications running on ever faster and smarter devices in astounding numbers.

Almost everyone I know owns one of those ubiquitous smartphones or tablets. They seem to be able to do everything a computer can, and then some.

The technological wonder of these devices is surely one reason for their popularity. They can perform more commands per second than the computers in Apollo 8 by an order of magnitude in the thousands. They are cheaper and have far more memory. And you can easily carry them in your pocket.

And then the proliferation of software written specifically for mobile devices has a lot to do with their popularity.

Individual applications, or “apps”, exist for every conceivable function and service. And there are thousands of them. Apple has approved for download more than one million apps. Consumers have downloaded apps from their store more than 25 billion times. The Android download numbers are impressive too.

Managing health has not escaped this trend.

According to Research2Guidance, a global market research firm, nearly 247 million mobile phone users worldwide are expected to download a health app by the end of 2012. There are as many apps to manage health functions as there are health issues: losing weight, monitoring blood pressure or diabetes, exercising and so on.

There is even a proliferation of apps to assist physicians in making quick and accurate diagnoses and prescribing indicated treatments.

Are all these apps on our mobile devices the ultimate in making us healthier?

One person who might not think so is Dr. Marc Siegel, MD. Through a personal crisis he discovered a phenomenon he calls the inner pulse. It’s an awareness, or “sense”, about what’s happening with one’s body. He says it’s :

“… the fulcrum of a person’s life force, the place where the physical and the spiritual combine. It is the link between your body’s life force and your soul, tangible proof of your connection to a larger reality and of that reality’s strong presence in your body.”

“The inner pulse is more than just instinct and intuition.”… “Clearly, being aware of the inner pulse can change your life dramatically in a positive way.” (pg. 15)

Perhaps, though, the inner pulse, as Siegel describes it, goes beyond being aware of what’s lurking in our body. The inner pulse may not just tell us what condition the body is in, but may be able to affect health in a dramatically positive way, if we know how to access it.

Olympic skier Janine Shepherd tells the story of her remarkable return from a biking accident that left her paralyzed, yet she went on to a whole new life as a pilot. Told that she would never walk again, she asked, “Why me?” But at her lowest point she began to realize that it wasn’t just about her life. It was about life itself. She began to see that she was not her broken body. In the uncertainty of her circumstances, she found that she was free to explore life’s infinite possibilities. She felt she was responding to a spirit that was bigger than she was.

One day she looked up and saw an airplane flying overhead and said, “That’s it! If I can’t walk, I’ll fly.” She started by taking a flying lesson and went on to learn to walk again, to fly a plane and then to become a flight instructor.

Janine’s experience shows that there is an unmeasurable spirit that can bring out strength and ability far beyond what an app would be able to measure in the body. I call that God, and don’t ever want to underestimate the power it can have to restore a measure of health when human hope is gone.

The Bible says:

“There is a spirit in man, and the inspiration of the almighty gives them understanding… Whither shall I go from thy spirit? or whither shall I flee from thy presence? If I ascend up into heaven, thou art there: if I make my bed in hell, behold, thou art there. If I take the wings of the morning, and dwell in the uttermost parts of the sea; Even there shall thy hand lead me, and thy right hand shall hold me. (Job 32, Ps. 139)

Janine may know nothing about these Bible passages, but her life certainly embodies the energies of what I call a spiritual sense. I believe this spirit is available for everyone to tap into and receive an impulse like Janine did. Perhaps Dr. Siegel’s “inner pulse” is another way of naming this resource.

I haven’t yet found an app to make that link, but when I do, I will definitely let you know.

Health, More Than a Two-step?

By John D. Clague, Christian Science Committee on Publication for Oregon

As a father, I remember many times assembling toys for my children. Some of them were complicated and required carefully following the provided instructions. My mechanical intuition just wasn’t adequate.

In the end, when I patiently followed the steps for putting these toys together, I was happy and my kids were happy.

There are other areas in life, too, where following some steps brings about good results.

Sven Eberlein, a freelance writer and journalist in San Francisco has come up with what he calls 9 Simple Steps to Improve Your Health, all of which are supported by research. His list was published in Daily Good, News That Inspires.

© iStockphoto/ marrio31

Health is probably something most people are interested in. Some approach improving their physical health as a two-step process. One, go to the doctor. Two, do what the doctor says. Pretty simple.

Other people find this doesn’t always work for them.

Even though Eberlein’s approach has more steps, it does more than help us stay healthier.  It can enrich our lives in other ways as well.

Several of his steps stand out to me. They are:

Laugh to your heart’s delight.

“Laughter might be one of the only things in life that can be done outside of moderation and still reap the benefits,” muses Dr. Michael Miller, director of the Center for Preventive Cardiology at the University of Maryland Medical Center.

Age artfully

Research shows that seniors engaged in activities like singing, creative writing, or painting are healthier and happier than those who aren’t.

Work with friends

Israeli researchers found that people who get along with their co-workers in a friendly and supportive work environment live longer.

Chat with the neighbors

A 50-year study centered around Roseto, Penn., a close-knit community of Italian-Americans, showed the lowest rates of heart disease in the nation until the town became more “suburbanized” in the 1960s.

Hope like your life depends on it

We know enough about anxiety and depression to drag us down for several lifetimes, but a truly uplifting new study by Harvard’s School of Public Health gives reasons to rejoice. “Happy and optimistic people with a purpose in life tend to have a reduced risk of cardiovascular disease,” says researcher Julia K. Boehm.

This is an expansive list of steps for improving your health. But I’m wondering if it’s complete.  Could there be a spiritual step to a healthy life?

Journalist Richard Schiffman writes that “…regular prayer and meditation has been shown in numerous scientific studies to be an important factor in living longer and staying healthy.”

This seems like a nice complement to the list above. Even though Schiffman has found recent research to support prayer as a path to health, this is not a new idea.

In the nineteenth century, health researcher and theologian, Mary Baker Eddy, made these same observations. Beyond demonstrating that prayer has a health benefit, she showed that prayer in and of itself could be approached through a reasoned process, beginning with a premise and reaching conclusion. Through this process she found the elements of prayer that heal consistently.

For a complex issue like health, going beyond the two-step to include more of the emotional and spiritual elements may be a way to a happier, healthier life.

First published on OregonLive.

Giving as Thanks Aids Health

By John D. Clague, Christian Science Committee on Publication for Oregon.

Thanksgiving is my favorite holiday, probably because it’s a time to especially acknowledge the gratitude I feel for all the good in my life.

A dictionary might define this term, thanksgiving, as “an act of giving thanks”, but I think it means more than that. It goes beyond uttering words of thanks to expressing it in concrete ways. It’s more action oriented and isn’t focused on me. Rather, my gratitude should impel action.

There are many examples of people selflessly helping others. I think immediately of incidents like:

Hundreds of boat owners and ferry pilots converging on the Manhattan shoreline to evacuate stranded New Yorkers after the World Trade Center towers collapsed.

People in my community working at food banks and soup kitchens for the homeless.

Victor Frankl observing fellow prisoners of war coping through simple acts of sharing and encouragement.

©iStockphoto/guvendemir

These are people engaging in helping acts with no expectation of anything in return.

Why do we do it if there’s no expectation of reciprocal acts of kindness or money?

As a Christian, I might see The Golden Rule as a motivator out of obedience. And for those of other faith traditions, such as Hinduism, Buddhism, Taoism, Zoroastrianism, and Judaism there are similar guiding principles. But is this really what motivates adherents of any tradition to act for the benefit of others?

In examining my own impulses along this line I feel moved to do for others because I’m grateful for the good in my life which I feel comes from God. Perhaps giving to others as an expression of gratitude is the Divine working in the lives of others.

This could be why an unexpected result appears for the giver: it’s good for your health.

Stephen G. Post, PhD. has been researching this notion that helping others is actually beneficial to the helper. In his report It’s Good to be Good: 2011 Fifth Annual Scientific Report on Health, Happiness and Helping Others, Post makes these observations.

“My working hypothesis is that one of the healthiest things a person can do is to step back from self-preoccupation and self-worry, as well as from hostile and bitter emotions; there is no more obvious way of doing this than focusing attention on helping others.

“There is solid evidence to support the perennial hypothesis that benevolent emotions, attitudes, and actions centered on the good of others contribute to the giver’s happiness, health, and even longevity. Although genuine benevolence must be chiefly motivated by concern for others, it has the side effect of nourishing the giver.”

Linda P. Fried, M.D., director of the Center on Aging and Health at Johns Hopkins found that : “Older adults who volunteer in troubled urban schools not only improve the educational experience of children, but realize meaningful improvements in their own mental and physical health.”

Perhaps a good example of this is the Catholic nun who volunteered in our local jail for many years. She devoted her life to helping those in trouble with the law to better themselves through various programs. Last time I checked she was well over 90 years old and still going strong!

Robert A. Barnett says that “We consistently find that volunteering and helping behavior is associated with a reduced risk of mortality. We see this over and over again in prospective studies that control for other variables, such as baseline health and gender.”

Thinking about this more deeply, what if more of us worked harder to love and help out our fellow women and men? I mean really approach them with compassion, forgiveness, and a longing for their well-being impelled by gratitude for all the good in our lives. Might it make us feel better? Perhaps we would live in healthier, more connected communities.

The implications are profound. I make it an axiom that I can never be harmed by helping others. Now, I see it actually helps my health, too.

First published on OregonLive.

Does the health care system know best?

Americans are an independent lot. It’s rooted in the very fabric of this country. We are accustomed to having a choice and making our own decisions. That’s what we expect in our homegrown version of democracy.

We can choose virtually any product or service we want. Any size, shape, color, or model. Except when it comes to our health care.

It seems to me from much of what I’ve read that the patient-doctor relationship is mostly unbalanced. The doctor tells the patient what’s wrong, and what needs to happen to fix it. Our health care system forces doctors to quickly address the offending symptoms and move on.

In the United States more is spent per patient on health care than in any other developed country in the world.

For all the wonders of our nation, its unparalleled standard of living and freedom of choice, does this ensure that we are the healthiest country with the longest lifespan?

The United States came in at 37th place in the World Health Organization’s assessment of overall health outcomes of all nations in 2010. According to the CIA World Factbook, the U.S. currently ranks 50th for life expectancy. In 1950 we ranked 5th for women and 10th for men.

According to Gallup Polls, “Americans’ evaluations of healthcare coverage…show that much less than a majority of Americans are positive in their overall evaluations of coverage and cost of their healthcare.”

@ iStockphoto/Tom Hahn

Could it be that people are not satisfied because they don’t have much voice in their health care? Are their care expectations being met?

Shannon Brownlee makes the point in her book Overtreated. Why Too Much Medicine is Making Us Sicker and Poorer, that:

Strengthening the patient’s role in choosing a particular treatment or test is an important aspect of moving toward more efficient care. (pg.. 297)

A health care system allowing a more responsive patient-doctor relationship could provide for more effective two-way communication. The doctor could better understand the underlying causes of the patient’s symptoms and the patient could actually choose treatment options that fit better within his or her values.

Emerging aids to facilitate this process are decision tools that help patients make their own choices about health care. As Brownlee points out:

“…informing patients better, will very likely decrease overutilization rates:…clinical trials show that the use of decision aids leads to a decline in demand for surgery ——- about 25 percent overall.” (pg. 298)

Fewer tests and invasive procedures would lower costs and reduce the risk of adverse consequences.

This appears to be a central theme in shifting our health care delivery system. In her paper Emerging Patient-Driven Health Care Models Melanie Swan makes the observation that “The growing presence of patient-driven health care models may be central to the evolving health ecosystem. Individuals are starting to better manage their health.”

Within those models can be included all manner of alternative and integrative care. The whole patient needs to be attended to, including mental, emotional, physical, and spiritual needs.

In the late 1800s spiritual healer Mary Baker Eddy introduced a form of health care that puts the patient’s needs at the center of their care. She explains in her major work, Science and Health:

“Give sick people credit for sometimes knowing more than their doctors. Always support their trust in the power of Mind to sustain the body. Never tell the sick that they have more courage than strength. Tell them rather, that their strength is in proportion to their courage.” (pg. 417)

Patient-centered health care starts with our thoughts, whether they’re using a decision aid regarding the conventional health care paradigm, or addressing the connection between thinking and bodily health. Certainly better decision-making in a medical system is a good thing.

Is it reasonable to conclude that spending more time discovering the patient’s mental state and behaviors determined by their thoughts, and encouraging and strengthening the healthier thoughts, could be the basis for improved health?

Originally published on OregonLive

John Clague is a retired sheriff’s office captain, father of two grown sons, and husband. He now works with the media to ensure accurate representation of Christian Science.