This is an update to what I wrote in late 1997 about my personal experience with manic-depression.

Continuing where I left off…I was off medication and things were going fine until around late August or September, 2000. My husband started becoming concerned about me – he thought I was getting a little ‘active’ (for example I was sleeping less and talking very animatedly). Because he was concerned I called the psychiatrist I’d seen during my first illness. It had been about three years now since I’d last seen him, at which time he’d said that it was up to me to come in if it seemed like there was reason for concern; otherwise I didn’t need to.

I saw him regularly over the few months, according to when he had me come back. He suggested psychiatric medication one time but I declined. We discussed ways that might help me sleep. I talked to him in general about what was going on in my life. Looking back I do realize my thinking wasn’t entirely ‘normal’ during that time. In early December I was continuing to get worse and I became quite delusional. On December 6, various people talked to my husband on the phone about my condition. He took the next day off and took me to the psychiatrist himself in the morning.

When my psychiatrist saw me, he had a new concern as well as the Bipolar disorder. He thought I might well be having some sort of ongoing continual epileptic seizure activity, based on what he saw. The best description I can give is that I was shaking a lot, quite frequently and quite violently. From my point of view this wasn’t as involuntary as it probably appeared; it was part of my delusions that this was how I was supposed to be behaving. Anyway, he was very concerned because a period of continual epileptic seizures can cause brain damage. So he wanted me to have an EEG done. This a trace of brain activity which reveals whether someone is having epileptic seizures or not. It took a while to persuade me to have the EEG done (I was there for hours while they tried to persuade me).

It was a very difficult day for me in a variety of ways. (Not that it was easy for the people who were with me, either – in retrospect I can see that). As far as I was concerned, no-one on that day explained to me that they were concerned about me suffering brain damage if they didn’t intervene medically as soon as possible. I didn’t understand why I couldn’t just come back the next day for them to see whether I’d improved. But they said, if I didn’t have the EEG trace done they’d hospitalize me. I truly don’t understand why they didn’t explain the urgency to me. Despite being delusional I was aware enough to be in despair that basically the thing I had most hoped to avoid by having my own psychiatrist this time, happened again! In other words, I was in a situation just like the first time I was most ill, in which there was no-one present who was willing to try to get the key facts across to me, in a way I could hear, that day. My husband told me later that he thinks they did tell me but I was incapable of listening and/or understanding in the state I was in. Personally I don’t think I was and it made things much harder for me that day, that from my point of view, no-one would help me understand why they felt they had to intervene the way they did. Anyway, after a few hours my psychiatrist and his neurologist partner and my husband left me alone in his office to think about whether I’d have the EEG (which they happened to have the equipment to do in their shared office space) or whether I’d continue to refuse in which case they’d hospitalize me that day.

The sinking realization that I was quite possibly heading towards a situation where I’d be powerless again – just like my first hospitalization – had hit me earlier that morning, as my husband was driving me to the psychiatrist’s office. Once it occurred to me I sought reassurance from him that that wouldn’t happen, but he wouldn’t provide it. I can see why, in retrospect. And sure enough, a little later there I was in the office given the ultimatum, have an EEG or we’re hospitalizing you.

As I said, my husband, my psychiatrist and the neurologist had spent a while trying to persuade me to have the EEG, without success. Finally they gave up and left me alone. I suppose they thought they’d said all they could say. Although I still don’t understand why they didn’t try harder to convey the reason for the urgency, to me. I don’t even remember them telling me, once, why it was urgent. And I do remember the part of the day before I was medicated, quite clearly, in general.

I was very angry and upset about the ultimatum. It was hard not to focus on how unfair I felt that was. But nevertheless, when they left me alone, I did think about the situation I was in and tried to decide what to do, with all that was in me that day. I prayed and thought and I saw that unless I was willing to be hospitalized, I’d better have the EEG. (They probably thought I wasn’t capable of figuring anything out that day, but I was…) There was no way I wanted to be hospitalized. So that was that and although I wasn’t at all happy about it, I gave in and said I’d have the EEG. In preparation for it, the psychiatrist told me I needed to take Xanax so I’d be still enough to have a decent trace done (remember, I was shaking). I don’t honestly know if I could have totally stopped entirely but as I said, I know I had some control over the extent of my movements.

I took the Xanax and had the trace which evidently did show seizure activity. I was given more Xanax after the first dose; it was very sedating and I think it caused some short term memory loss too, so I have only a vague recollection of the 12-24 hours after I took it. I had a meeting at church the next morning – which was to do with managing my relationships with people at church. These, of course, had been significantly affected by my condition. Looking back I’m annoyed that I had that meeting that day. It would probably have been best not to have it in that partway sedated condition and when I was that delusional. But anyway, I don’t suppose that much matters now.

I was sent home after the EEG trace with anti-convulsant and and anti-psychotic medication. The anti-psychotic medication made me feel horrible and I begged to be off it; as a result, after a couple of days I was on the anti-convulsant medication only. It was a new medication called Trileptal, similar to Depakote. It so happens that anti-convulsants treat both Bipolar disorder and epilepsy, so I was given just the one medication to address both diagnoses. I was much better, relatively speaking, (i.e. no more activity related to seizures and way less delusions), in just a few days; I personally believe the drastic intervention had as much to do with it as the medication. No matter how delusional I was, it was clear to me I hadn’t wanted to end up powerless again. With rights and choices I took for granted, taken away, again! And so I know that – whether or not I had a complete understanding of how ill I was – on some level I had been decisively forced into the realization that all was not well. And not well was not how I wanted to be.

Anyway, I was not happy with the way my psychiatrist handled that day or with subsequent visits and phone calls and follow-up. . In what turned out to be my last visit to him he had to ask me what medication I was on and what dose because he didn’t have access to my records. (Because the office was rearranging the records, so he said. But surely he could have retrieved mine first.) At one point during the visit he stood up behind his desk and said “Don’t play games with me young lady!”

I didn’t need that. (And, for what it’s worth, my husband would look back and agree in questioning his ability to treat me effectively). So, in January I decided I had to find someone else. This was all quite difficult because whatever my true motive, I know it must have appeared like resistance to appropriate medical treatment for my condition. I went with my husband to visit another psychiatrist who was recommended to me by a friend who is a doctor. That visit was a low point for me. He said he’d have to change my medication because the one I was on was simply too new. I felt it was working so this made no sense to me! And he said I’d have to see a neurologist as well as him because of my epilepsy diagnosis. I didn’t like the idea of that either and began to realize how the dual-diagnosis could complicate getting effective treatment. I didn’t want to change medication just because mine was ‘too new’, regardless of whether it worked or not. And I didn’t want to end up on two sets of medication, seeing two specialists, since the two conditions overlap quite a bit and are treatable with the same medications.

And he said unfair things in front of my husband (in my opinion), like “Are you just going to go from one psychiatrist to the next until you find one who agrees with you?” I don’t remember how I responded to that, if at all. Perhaps by then I’d realized there was no way I wanted to have him as my psychiatrist and so I’d given up saying much. It was a depressing, discouraging visit. However, he did say at the end – which turned out to be very helpful – “I know a psychiatrist who is board-certified in neurology, if you’re interested” and he gave me his phone number.

Having realized the complexity of being treated with a dual diagnosis I was quite interested to follow up on this. I did go see the other psychiatrist with my husband and it was a very different experience than with the psychiatrist who wanted to change my medication. This one was kind, calm and respectful and I felt he listened to me. We (my husband and I) both felt good about the visit with him and so I switched to him. To this day, he is my psychiatrist. Shortly after I started seeing him he suggested changing my medication to neurontin since I wasn’t particularly better and he had had good experience with that one. I wasn’t convinced about it but I reluctantly agreed to try it (and I’m still taking it as of today)

I’m not sure how long it was until I was ‘back to normal’ again. I think that I was still delusional to some extent, into the summer of 2001. Then, it seems to me I was getting much better as autumn got underway although maybe I was still somewhat on the ‘reactive’ side. From then on, I continued to improve and have been basically “normal” for a while now (I’m writing this in December 2002). Or, as “normal” as I ever am…maybe that would be a better way to put it!

One thing I am very glad about is that I started seeing a counselor soon after I was put back on medication in December 2000 – I think I started in January 2001. I don’t remember my exact reasons – it might have been because I wanted someone to help me communicate better with my husband – so I was looking for someone we could see together. When I’m ill that can be very hard…anyway, however it began, the counselor wanted to see me by myself, mostly (go figure!) He moved out of state earlier this year and I’ve been seeing the person to whom he handed over his practice, since then. Seeing a counselor has been extremely helpful to me. I really wish I’d had a counselor back in 2000 when I was getting ill. I’m hoping that if I have trouble again, my counselor will be able to be that person I needed and didn’t have – someone who will take time to communicate with me, listening to me and explaining things to me with patience and kindness. And perhaps that kind of help will enable me to avoid any more ‘crisis interventions’ which are very stressful, painful and difficult for me and those around me.

Until my second episode I was thinking of my psychiatrist as somewhat of a counselor – since I used to talk to him for longer than the customary 5-10 minutes medication check. But now that I know what it’s like to see a professional counselor, I wouldn’t go back to being without the help of someone who has that training and experience. I now have the more usual arrangement where I see the psychiatrist for meds checks (every three months, at present) and I see the counselor (every three weeks), to talk about how things are going.

I tried to get my records from my psychiatrist that I no longer see. He eventually (after I’d complained to the state regulatory board about him not sending them) sent a few things to my current psychiatrist but evidently he’d lost the EEG trace, which was what I most wanted! This is frustrating because now I can never get a second opinion about the epilepsy diagnosis that was based on the trace. The outward behavior which led to the test being done and then that diagnosis stopped within days of the test and hasn’t recurred. Maybe it doesn’t matter that I don’t have the EEG trace, since the medication I’m on for Bipolar disorder also treats epilepsy anyway. I still wish it hadn’t been lost, though. I would have liked to have a copy of it, at least.

So…that’s the update! At the end of what I wrote in 1997, I said I don’t know what the future holds. I still don’t. I do think I learned a lot during my first episode; perhaps I learned even more during my second. But I don’t know whether what I learned in combination with the treatment I’m receiving, will, or can, prevent further episodes. I don’t know but I can hope…and take one day at a time…

(This, of course, is allegorical)

The Party

You were so excited to be invited! At last…maybe this would lead to more friends…maybe this would open the door finally for you to be part of the “in-crowd” instead of the also-rans…there would be a lot of people here you wanted to meet – influential people, people you admired!

A little bit of a disappointment that you weren’t seated with anyone you knew ahead of time (not that there were many there – ha! That is to say, you recognized a lot of them but – they wouldn’t have known you from Adam…)

The wine flows freely and in the release and relief of finding that these people did laugh at your occasional, embarrassed, joke – you lose count and find yourself freer and freer in your comments…

But you begin to notice the laughter is dying down now and the looks of admiration are being replaced with looks of concern. One person – an older, wiser – kind and gentle even? – man says “It’s getting late…” Wow – you hadn’t realized the time!

You stand up, unsteadily and the change in equilibrium does no favors to your stomach which immediately starts churning and probably only a prelude to worse…

You reach out to lean on the pillar next to your table. But somehow, although it is a foundational pillar to the whole structure, instead of supporting your weight it begins to give…

It gives more, rumbling sounds begin, screams, shrieks, a lot of motion and commotion around you, people pushing…but you sink to the ground, unaware…

Waking Up

You open your eyes to the sound of a kind voice and see a kind face, someone who has brought you breakfast. As the memories flood back you start to say “Hey I had such a dream…”

and then you stop, arrested as you see tears in their eyes. “That – that wasn’t a dream. It’s happening again…Look…look, just eat this and the doctor will be along later. I’m sorry – I think we need to change your medication again…”

You look at the pill in her hand and start to say “Oh, I’m not sure that’s necessary” but even as the thoughts and words are forming her face begins to fragment and give way, metamorphosizing into Evil Incarnate…a talk man with evil eyes and a syringe in his hand…”

Hastily you say “sure I’ll take it”. And you do. (What other choice is there? Death? Insanity? The Evil of unending terror? Eternal incarcaration)

But you are being silly – of course – because it is only a hospital and this is only a nurse come to help you, the sick one, to “get better”. And you are. Very sick. Evidently. How could you have ever thought otherwise? But – it’s the illness isn’t it? Else you couldn’t have.

The Ashes

You sit up, dazed, as the dust begins to clear. You’re sitting in the open air now and the sun is just beginning to come up. It’s actually a beautiful morning but – the sunlight simply makes you squint and your headache worse. You feel – well, terrible.

There is no-one around. A catch of fear as the memory of last night floods back (well, most of it, perhaps ) remember – but, no you see nothing around you but rubble and dust. Thankfully because – well obviously you never meant to hurt a soul…it was an accident…how were you to know it would give?

But wait, some people are coming in the far distance.

When they arrive you begin to say “But – I was sure it would hold my weight…”

They are not listening though. As silently as they came, they turn around and walk away slowly, shaking their heads as they leave. They have not even talked but – they are clearly as one, in thought.

Does it hurt to die?

A thought that stings and brings a flash of anger – hey, it’s not as if I have leprosy!! But then…an insidious fear that steals into your heart – stealthily and yet comes with a vice-like grip – as the strengthening sunlight of the rising sun shines on your arm, is that – is that really just – white dust?

Sometimes, yes. I think it sometimes hurts to die. I wouldn’t know but – I suspect it hurts very much, sometimes.

[The last line of the Sacred Silence, 3/10/01] Perhaps a day is coming. I hope so. In fact I trust it is.

I was diagnosed as having Bipolar Disorder in 1996. Until that year I had had no mental health problems. In Mid-may we went away as a family and everything seemed fine. In the two weeks following Memorial Day I was sleeping gradually less and less and very excited about various things. I was enjoying life; I was “on a high”; I had no idea that anything might be wrong. By June 10 I had had two nights with only two or three hours sleep. On June 10 I was having extreme mood swings and major delusions in my thinking (I know this now but at the time I didn’t realize it). My husband Steve was becoming more and more aware that I was talking and behaving strangely and he finally called my Mom early in the morning on June 11. Steve had no idea what was wrong but my Mom was sure from the symptoms that I was manic. She is familiar with them since my Dad is Bipolar. She suggested Steve take me to the emergency room of a hospital with a psychiatric unit for diagnosis and treatment.

So we went to the emergency room at around 7 a.m. after making arrangements for someone to look after our children. I was diagnosed as being manic and it was recommended that I was admitted, which I agreed to. Soon after my admission I was forcibly taken to the “quiet room” (this is a room with no furniture, with a mat on the floor and two cameras to watch you, which is locked from the outside) because I grabbed another patient (I did this because I wanted to tell her something and she was going the other direction so I ran after her and grabbed hold of her). I didn’t know there was a “no touching rule” until then. In fact I don’t think that anything had been explained to me about the rules and procedures of the psychiatric unit, at that point. A psychiatry resident came and talked to me shortly after that, in the quiet room, with my husband still present. Then it was 1.00 p.m. and all guests had to leave, so all the hospital staff and my husband left me alone in the quiet room and three nurses came back and forced me to take some medication which I didn’t want to do – since they had given me a sheet when I was admitted that said I had the right to refuse medication – but in spite of this they told me they’d inject it with a syringe if I didn’t take it orally, so I took it, not having any choice. I still think they violated my patient rights by forcing me to take that medication and a few months later I wrote a letter to the doctor about this and about my general dissatisfaction with the way I was treated in the hospital.

After I was forcibly given the medication I was left alone in the quiet room for a little while which was actually a good time for me since I prayed and sang a worship song and felt very much assured that whatever was happening, God would take care of me. I wrote a poem about this day, especially my quiet room experience, a couple of months later.

Then a nurse brought me lunch and right after that I fell asleep and was not aware of being conscious again until the next morning. (Steve said I talked to him a little in the evening when he visited, and it is on my records that I talked to a nurse in the night but I don’t remember any of that, which is a known side effect of Ativan, one of the medications they had made me take).

The day I was admitted was the day I was most ill. I was not having hallucinations but I was interpreting the outside world very differently from other people. I was very preoccupied with my own thoughts. I believed that God had singled me out for some very special purpose and was trying to figure that out. And everything I saw and heard that day had a deeper meaning and significance that I was also trying to figure out. All this figuring out took a lot of time, especially since I kept changing my mind or finding that my current “theory” needed some modification! When the social worker asked me some standard questions in the emergency room, I thought that these questions were “in code”, that they had a deeper meaning than their apparent literal one. So I answered them accordingly and proved myself in her eyes to be definitely manic. I suppose that is the proof but the sad thing is that when you get into psychiatric hospital people ask you such strange questions and treat you in such unusual ways that it is very confusing and I believe it encourages people to stay in their own unreal world and to wonder why the professionals are treating them so strangely and so disrespectfully. It is very disorientating to go in five hours from being in one’s normal environment to having one’s life controlled by people who will not answer your questions and have no interest in hearing that they are not acting in accordance with the little information they did give you – the patient rights sheet. Patients in psychiatric units are treated in ways that would be unthinkable anywhere else in our society. The staff probably assume that they are too ill to know the difference; well, that’s simply not true. Having a mental disorder does not take away a person’s ability to perceive whether they are being treated with kindness and respect as a human being, or as something less, that must be forcibly subdued and controlled, that will respond only to medication. Of course it saves a lot of time and money to handle patients this way. But I am convinced that it is not right and sets people up for future problems in accepting their diagnosis and finding the appropriate balance between taking personal responsibility for their wellness and seeking help and treatment as needed.

In any case, one of the questions the social worker asked me (which is known to them as “serial 7s”) was “What is 100 minus 7?” I heard the question and interpreted it to be a symbolic question about absolute truth and said something like “You tell me what it is and that’s what I think it is”. I think I could have given the answer 93 but it didn’t occur to me that that is what she was looking for! I wanted to convey to her the concept “I am on your side – I affirm your answer to the question” To answer the question assertively without hearing what she had to say would have implied that I was not interested in her perception of the world. I wanted to see what she thought the answer was and then agree with her – I was being “sensitive” to her way of looking at the world. I had “reasons” for everything I said but to the other people in the room my answers were silly; I was out of touch with reality. By the time I was in the quiet room I was thinking that maybe my current view of the world needed some major adjustments. I stopped looking for the deeper significance and tried to relate to people normally. What really hurt was that then it was too late. They weren’t listening. They didn’t bother to try to give me an answer when I said “Why must Steve leave at 1 O’clock? Why do you have a rule like that? I need him to be here with me!” And then they left the room and the three nurses came back with the medication that they gave me no choice about taking. I was very upset when I realized that I was absolutely powerless in the hands of these people, as they told me to take the medication. But in the same moment, I also realized that if I really believed that God was in control, then I could relax because He knew what was happening and had chosen to allow it in my life. In fact I realized that all morning I had been trying to figure out and do what was right – and that’s not easy when you think everything has a hidden meaning and you’re not sure what it is! And now I had no choice – well, hey, this was easy! I knew what to do! I didn’t like it but I believed that God had allowed me to get into this situation and decided to trust that whatever consequences ensued from me taking this, it was part of God’s plan for me. I really did think this at the time and it did reassure me. Then I was further assured that God was going to look after me, as I prayed and sang alone in the quiet room, as I mentioned already.

The next morning I woke up in a regular room in the psychiatric unit (I had been transferred from the quiet room at some point – I may have been “awake” when I moved but didn’t remember moving). I was feeling generally happy and went around trying to be nice to all the other patients. I immediately became best friends with one person and wondered why no-one else wanted to talk to me. I later realized that I had probably been on a unit with one other manic patient and the rest were there for depression! I attended a group session that morning in which we were asked to write down three goals for the day. I think this question was aimed more at the depressed patients since it posed no challenge for me – except that of limiting my goals to three, perhaps! At one point a patient said something and all the patients laughed but the nurse in charge didn’t. There was a definite sense of “us and them” in the room. Later I hugged my “friend” and got in trouble because of the “no touching” rule but I didn’t care. She drew me a picture and I told her some of my theories. I asked the staff for some colored pencils and found they had the person’s name on who I had grabbed the day before. So I gave them to her hoping that it would make up a little for what I had done the day before. I don’t know if it did or not. I have to wonder why they initially assigned me to a two person room with her. It seems like a crazy thing to do to put a manic person in with a depressed one – they are guaranteed to drive each other nuts! After my quiet room experience I found myself in a private room. I suppose they had reconsidered whether I should be sharing a room.

I had decided during my quiet room time alone the day before that I would agree to whatever the doctors said and not try to resist anything (that this was what God wanted me to do). Late that morning I met with the resident from the day before and a psychiatrist, with Steve and my Mom (who had flown in to help) present too. I could see for myself that my symptoms were symptoms of mania but I was not yet convinced that I was Bipolar rather than merely having the same symptoms by coincidence! But I kept this to myself. It’s noted on my medical records that I cried as I agreed with the diagnosis. It’s not an easy thing to agree to. That was one of the most humbling moments of my life.

The doctors decided that I could go home since I had Steve and my Mom to look after me. I was very pleased because I was expecting to be in the hospital for a while. I was a little bit disappointed to be going home after I hadn’t even had a chance to get to know anyone, but mostly I was pleased, especially because the rest of my immediate family were arriving from England in a few days (for a visit planned months earlier). I’m sure it was hard for them to see me in the state I was in and I was pleased to have an opportunity go back eight months later, in February, and see them again in a more “normal” state. The doctors wanted to start me on daily lithium medication but there was a possibility I was pregnant and so they gave me haldol (haloperidol) to start with.

They had me see the resident again three days later as an outpatient, then a week after that I went to a psychiatrist in private practice that they had recommended. Steve and I weren’t entirely happy with her because she referred to DSM-IV (the standard reference book about mental health disorders) during my visit – we thought, surely she should have known everything about something as standard as Bipolar! Between that and my next visit my father who was visiting us happened to meet someone at my church who is a psychiatrist. I asked if he would be my psychiatrist and he is, to this day. I saw him every three weeks through the summer. He was respectful of my wish to avoid medication if at all possible. By the time I went to see him I knew I was not pregnant and had stopped taking haldol. He said he was an advocate of taking as few medications as necessary and did not push me strongly to take anything at that time.

For a while after I was sent home from the hospital it seemed that I was getting better but I did have a “relapse” in early September; Steve took me to see my psychiatrist the day after it was clear that I was significantly worse again (having a lot of delusions again, emotionally very unstable). A week after that I did agree to take Depakote since I could see for myself that I was overreacting and emotionally not very stable. I started on 125 mg a day and stayed on that although my psychiatrist pointed out that that was a very low dose and said I could take more if I wanted (actually Steve’s view is that he said I should take more and I refused). In any case I didn’t take more and my psychiatrist didn’t pursue the matter further.. In mid-December he said I was clinically stable at my visit. I was very pleased to hear this! I asked about stopping the Depakote but he and Steve wanted me to continue through February since we had a big vacation planned for that month. In fact I stopped on January 3 without telling them. By the way, I don’t recommend that anyone stop medication without the knowledge and consent of their doctor, even though I did. Nevertheless I would encourage anyone who wants to try cutting down or stopping their medication to discuss it with their doctor. I would hope that a doctor would be flexible enough to allow this if a patient’s condition is stable and as long as there is no risk of harm to the person (meaning that they have friends or relatives who would notice if they had a relapse and help them to get help). By the time I did see my psychiatrist again, which was after our vacation, he said it was OK for me to stay off the medication unless I got worse.

I have not taken any medication since then and so far I have not had another episode. I don’t know what the future holds; I would like to stay medication-free but will take medication if I get ill, of course and I realize that further episodes would suggest that I start taking daily medication. I will update this page according to my ongoing state of health!

Introduction

I believe that God wants us to trust Him with the parts of our lives over which we have no control and to make responsible choices in the parts where we have control. The believers in the New Testament churches underwent a lot of suffering, so there is much written there about how to understand and handle suffering. I do believe that emotional pain is a form of suffering which is partly under our control and that God calls us to have a certain attitude about suffering and to respond to it in righteous rather than sinful ways (the strength and power to do this comes from Him, not us).

Suffering

First of all, we need to remember that Jesus warned his disciples to expect trouble in their lives:

“I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world.” (John 16:33)

Paul tells us in the following passage how he suffered in some unspecified way and God did not take away his suffering although he asked Him repeatedly:

To keep me from becoming conceited because of these surpassingly great revelations, there was given me a thorn in my flesh, a messenger of Satan, to torment me. Three times I pleaded with the Lord to take it away from me. But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” (2 Corinthians 12:7-9)

God allowed Job to suffer although Job had done nothing wrong:

Then the LORD said to Satan, “Have you considered my servant Job? There is no one on earth like him; he is blameless and upright, a man who fears God and shuns evil.” “Does Job fear God for nothing?” Satan replied. “Have you not put a hedge around him and his household and everything he has? You have blessed the work of his hands, so that his flocks and herds are spread throughout the land. But stretch out your hand and strike everything he has, and he will surely curse you to your face.” The LORD said to Satan, “Very well, then, everything he has is in your hands, but on the man himself do not lay a finger.” (Job 1:8-12)

Jeremiah suffered emotionally and cried out to God about his “incurable wound” (emotional):

Why is my pain unending and my wound grievous and incurable? (Jeremiah 15:18)

and even God’s beloved Son Jesus had to suffer and die on the Cross:

Although [Jesus] was a son, he learned obedience from what he suffered (Hebrews 5:8)

Finally, Peter tells his readers not to be surprised by suffering, implying that it is part of the Christian life:

Dear friends, do not be surprised at the painful trial you are suffering, as though something strange were happening to you. (1 Peter 4:12)

First, then, we need to accept that this life generally includes suffering of one sort or another.

It helps us to endure suffering if we can see what the end result will be, like Job could, who wrote:

But [God] knows the way that I take;
when he has tested me,
I will come forth as gold. (Job 23:10)

According to James and Paul, what God works in us through suffering is so important that we can rejoice about our suffering:

Consider it pure joy, my brothers, whenever you face trials of many kinds, because you know that the testing of your faith develops perseverance. Perseverance must finish its work so that you may be mature and complete, not lacking anything. (James 1:2-4)

Not only so, but we also rejoice in our sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope. (Romans 5:3-4)

Considering our suffering to be “pure joy” doesn’t mean that we must pretend that it does not hurt. It means that although we are in pain we recognize by faith that God is using it to achieve something good in our lives – and the lives of others too, perhaps. God can and will bring something good out of it, as Paul affirms:

And we know that all things work together for good to those who love God (Romans 8:28)

“Considering suffering pure joy” also does not mean that we have to put a smile on our face when we are crying inside or that we do not need comfort and support at times. The pain is real, even if we know that it is for a good purpose. And it certainly is OK to express our pain to God (see “Be Honest”, below). Peter reassures us that the suffering will not last long:

And the God of all grace, who called you to his eternal glory in Christ, after you have suffered a little while, will himself restore you and make you strong, firm and steadfast. To him be the power for ever and ever. Amen. (1 Peter 5:10-11)

Paul tells us that our suffering will be minor compared to the glory we will experience in eternity:

I consider that our present sufferings are not worth comparing with the glory that will be revealed in us. (Romans 8:18)

So, as the author of Hebrews says, let’s persevere, even in the midst of suffering, and not become discouraged:

Therefore, since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles, and let us run with perseverance the race marked out for us. Let us fix our eyes on Jesus, the author and perfecter of our faith, who for the joy set before him endured the cross, scorning its shame, and sat down at the right hand of the throne of God. Consider him who endured such opposition from sinful men, so that you will not grow weary and lose heart. (Hebrews 12:1-3)

Be Honest

It’s important to be honest with ourselves and with God about the pain. It’s OK to be in pain and to admit it. Life is painful sometimes. And it’s OK to cry out to God about it too. Even Jesus did that:

During the days of Jesus’ life on earth, he offered up prayers and petitions with loud cries and tears to the one who could save him from death, and he was heard because of his reverent submission. (Hebrews 5:7)

At the ninth hour Jesus cried out in a loud voice, “Eloi, Eloi, lama sabachthani?”–which means, “My God, my God, why have you forsaken me ?” (Mark 6:34)

The Psalms provide us with wonderful reassurance that we can tell God all about the pain we are in. Here is one example:

O LORD, do not rebuke me in your anger
or discipline me in your wrath.
Be merciful to me, LORD, for I am faint;

O LORD, heal me, for my bones are in agony.

My soul is in anguish.
How long, O LORD, how long?
Turn, O LORD, and deliver me;
save me because of your unfailing love.

No one remembers you when he is dead.
Who praises you from the grave?
I am worn out from groaning;
all night long I flood my bed with weeping
and drench my couch with tears. (Psalm 6:1-6)

David encourages us to pour out our hearts to God in another Psalm:

Trust in [God] at all times, O people;
pour out your hearts to him,

for God is our refuge. (Psalm 62:8)

God knows how we feel anyway, so we may as well be open about it when we talk to Him in prayer. It’s important for us to admit how much we need His comfort and reassurance that He loves us.

Self-Pity

There is a difference between being honest about pain and self-pity. We need to be careful to distinguish between the two. If we get so wrapped up in our own pain that all we can do is think about ourselves and our problems, then we have forgotten God’s power and promises and provision for us. As Paul learned, there is no need for self-pity because no matter what our circumstances are, God always provides us with the strength we need:

I have learned the secret of being content in any and every situation, whether well fed or hungry, whether living in plenty or in want. I can do everything through him who gives me strength. (Philippians 4:12-13)

We need to allow our pain to draw us into deeper dependence on God instead of withdrawing and shutting Him out. We need to see Him right in the midst of the pain, ready and willing to comfort us and sustain us. We need to bring our needs to Him instead of looking for help from other people or turning to substances or things which make us feel better in the short term but which are really substitutes for God, that keep us from being what He wants us to be.

Anger and Forgiveness

There are some Christians who justify something they refer to as “righteous anger”; but James warns us about man’s anger:

My dear brothers, take note of this: Everyone should be quick to listen, slow to speak and slow to become angry, for man’s anger does not bring about the righteous life that God desires. (James 1:19-20)

Ephesians 4:26 (quoted from Psalm 4:4) tells us “in your anger do not sin” but I personally have not found a way to continue to be angry without sinning. My anger seems always to be a self-defense mechanism, a way to deal with my own pain by blaming someone else. Well, that’s the plan but it doesn’t actually make me feel better; usually if I react in anger then I regret my actions later.

What works for me is to realize that my anger is an attempt to deal with pain and to ask God to help me to resist the temptation to deal with my pain that way. Instead I want to learn to let go of the anger and forgive the person, if it was a person who hurt me; and to take the pain directly to God. Even if a person deliberately has hurt me, God has allowed that and so it is better for me to go to God and express my frustration to Him rather than focus all my anger on the person. I’m not saying that we should never confront a person who hurt us; I believe in going to someone and trying to talk things through, when appropriate. But not while I’m still angry; that just escalates the situation. Only after I have prayed and given the anger to God and asked Him to help me respectfully tell the other person that they upset/offended me.

I haven’t been in a situation where I have been seriously abused. I know that it is hard to forgive in those circumstances. It may take a long time and it may need to be revisited if something triggers memories of the abuse all over again. Nevertheless it ought to be our goal, as Christians, because as Jesus said:

If you do not forgive men their sins, your Father will not forgive your sins. (Matthew 6:15)

I don’t believe this means that God will cast us off if we are having a hard time forgiving someone but it does mean that we ought to have forgiveness as our goal. Forgiving someone does not mean that you are excusing what they did; and it may not be appropriate for you to tell them you forgive them; sometimes it’s better to avoid all contact with those who have abused us. But it does mean letting go of the anger and asking God to change your heart concerning that person so that you no longer have thoughts of wanting to harm them in return for how they hurt you.

Fear And Worry

God wants us to trust Him so much that we can bring all our fears and worries to Him and leave them with Him, confident that He will take care of us. As Paul wrote:

Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus. (Philippians 4:6-7)

John explains how the love of God can drive out our fears:

There is no fear in love. But perfect love drives out fear, because fear has to do with punishment. The one who fears is not made perfect in love. (1 John 4:18)

We need not be worried or afraid, according to these verses; all we need to do is to talk to God and believe that He is in control and will take care of us. If we are worrying then in effect we are allowing ourselves to think that God is incapable of, or doesn’t want to help us. Of course, neither of those are true, according to the Bible.

Guilt

John tells us that once we confess our sins to God He totally forgives us and cleanses us from them:

If we confess our sins, [God] is faithful and just and will forgive us our sins and purify us from all unrighteousness. (1 John 1:9)

Any lingering feelings of guilt we have after we have confessed are “false guilt” and are not from God. If we have confessed all wrongdoing that God has brought to our attention, we need to believe Him that there is no longer a reason to feel guilty. If we think we must feel guilty for a while because we “deserve to” then in effect we are saying that Jesus’ death was not sufficient; we are dishonoring Him. Yet it was enough; because of His death we now have the righteousness of Jesus Christ and are holy and blameless in love before God, as these verses tell us:

God made him who had no sin to be sin for us, so that in him we might become the righteousness of God. (2 Corinthians 5:21)

For [God] chose us in [Jesus] before the creation of the world to be holy and blameless in his sight in love (Ephesians 1:4)

Since we have this standing before God in Jesus and through faith in Him, and once we have confessed any sin we know about to Him, we can reject any lingering guilty feelings and approach God in prayer with confidence:

Let us then approach the throne of grace with confidence, so that we may receive mercy and find grace to help us in our time of need. (Hebrews 4:16)

In [Jesus] and through faith in him we may approach God with freedom and confidence. (Ephesians 3:12)

What We Think About

Let’s be careful what we think about. Paul explains here what we ought to think about:

Finally, brothers, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable–if anything is excellent or praiseworthy–think about such things. (Philippians 4:8)

We ought to be aware of whether we are telling ourselves things that are unhelpful and in fact untrue such as “I’ll never feel better” or “Everything is hopeless”. If that is what we are saying to ourselves all day, no wonder we feel bad. Rather than let such thoughts go through our mind unhindered, we should be testing every thought against Scripture. Paul wrote this to the Corinthians about how he dealt with each of his thoughts:

We demolish arguments and every pretension that sets itself up against the knowledge of God, and we take captive every thought to make it obedient to Christ. (2 Corinthians 10:5)

In Ephesians 6 Paul wrote about the spiritual “armor” God has given us. Two pieces which help to protect our thoughts are the helmet of salvation and the belt of truth. Putting these on means trusting that God really has forgiven us our sins and reconciled us to Him and also filling our minds with what is true. Some very important truths we need to know are who we are in Christ and what amazing things God has done for us. A good place to start is the “Who Am I” list of Bible verses (this is on Neil Anderson’s web site; the URL is http://www.ficm.org/whoami.htm). When we notice that we are thinking negative thoughts we can remind ourselves of these encouraging truths instead. I’ve found that memorizing Scripture is a very effective way to address unhelpful thought patterns.

It’s OK To Be Weak

Paul wrote here about learning to delight in his weaknesses because he discovered God’s power was perfected in weakness:

To keep me from becoming conceited because of these surpassingly great revelations, there was given me a thorn in my flesh, a messenger of Satan, to torment me. Three times I pleaded with the Lord to take it away from me. But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me. That is why, for Christ’s sake, I delight in weaknesses, in insults, in hardships, in persecutions, in difficulties. For when I am weak, then I am strong. (2 Corinthians 12:7-10)

Let your weaknesses be opportunities for God’s strength to be manifest in you. Remember that we can do all things through Christ who strengthens us (Philippians 4:13). It’s also good to let other Christians help you. Don’t go to those who don’t understand depression but do choose one or two caring Christians who you can share your struggles with, who will pray for you and ask you how things are going. Paul and James encourage Christians to pray for each another and bear each others’ burdens:

Carry each other’s burdens, and in this way you will fulfill the law of Christ. (Galatians 6:2)

Therefore confess your sins to each other and pray for each other so that you may be healed. The prayer of a righteous man is powerful and effective. (James 5:16)

Being Thankful

Paul wrote this wonderful advice to the Thessalonians (1 Thess 5:19).

Be joyful always; pray continually; give thanks in all circumstances, for this is God’s will for you in Christ Jesus. (1 Thessalonians 5:18)

It’s important to remind ourselves of specific things we are thankful to God for; that will have a very significant effect on how we are feeling.

Praise And Worship

It’s important for me to keep my eyes and thoughts fixed on Jesus and heavenly things rather than on myself and my problems:

Let us fix our eyes on Jesus, the author and perfecter of our faith, who for the joy set before him endured the cross, scorning its shame, and sat down at the right hand of the throne of God. (Hebrews 12:2)

Therefore, holy brothers, who share in the heavenly calling, fix your thoughts on Jesus, the apostle and high priest whom we confess. (Hebrews 3:1)

Set your minds on things above, not on earthly things. (Colossians 3:2)

One of the most effective ways for me to get my perspective back and fix my eyes on Jesus again is to listen to worship music or read Bible passages in praise of God. When I do look at Jesus instead of me, the view is so much better! I can’t really overstate what a difference it makes in my outlook when I take time to praise God.

Our Personal Relationship With God

Each of us is unique in the exact way God planned us to be. His goal for Christians is not that we all become exactly the same but that we become more faithful, unique, representatives of Jesus. We might actually become more different from one another as God sets us free from our fears of “not fitting in” and enables us to do what He’s called and gifted us to do rather than what we think will make us accepted by others.

Since we are unique, our relationship with God is also. We need to find our own way of deepening our relationship with God. If the way we pray is not working, we should try something else until we find a way in which we are able to communicate with God. We also should not automatically believe everything other Christians say; rather, as Paul wrote: “Test everything. Hold on to the good.” (1 Thessalonians 5:20)

Our uniqueness gives each of us a slightly different perspective and furthermore, sin messes up our understanding of God. So none of us has “all the answers”, as Paul knew. In 1 Cor 13 he wrote that, in this life, we only “know in part” (verse 9) and we see “but a poor reflection as in a mirror”. What is important is that in spite of our imperfect knowledge, we keep seeking to get to know God better and to become more like Jesus.

Back to “For Christians In Pain”

• Christians And Compassion
• God And Our Emotional Healing

About God

• God Is Kind, Gentle And Sensitive
• God Cares About Our Pain
• God Is Always Listening
• God Values Us Highly
• God Has Promised That Things Will Get Better

How Shall We Live?

• Introduction
• Suffering
• Be Honest
• Self Pity
• Anger And Forgiveness
• Fear And Worry
• Guilt
• What We Think About
• Being Thankful
• Praise And Worship
• Our Personal Relationship With God

Further Reading

Introduction

Note: this is written for Christians, but anyone is welcome to read it, of course.

This page is about us and God, not about psychiatrists, therapy and/or medications. I’m not commenting here on whether they do or don’t work; my purpose is to encourage Christians to seek God in the midst of depression and other pain, whatever else they are doing to deal with the pain.

Christians And Compassion

I am concerned by the lack of compassion shown by many “Christians” towards those in pain. Such Christians fail to understand the depth and reality of emotional pain and what it does to people. They quote Bible verses, thinking that they are showing “love”; whereas true love is shown by taking the time to listen to someone in pain and cry with them, comfort them and pray with them and for them. It’s better not to say anything than to say something which sounds like you are minimizing a person’s pain.

Christians ought to be as sensitive as Jesus. These words written by Isaiah describe how gently Jesus treats those of us who could be described as a “bruised reed” or a “smoldering wick”:

A bruised reed he will not break, and a smoldering wick he will not snuff out. (Isaiah 42:3, also quoted in Matthew 12:20)

God And Our Emotional Healing

Having said that, I do believe that the Bible has much comfort and hope to offer those in pain. But a “band-aid” approach of trying to cover up our pain with Scriptures will not work. We need to ask God to show us the truth that will set us free. We need Him to reveal to us our misconceptions about Him which keep us from fully trusting Him and letting Him have control of every area of our lives. We need to learn how to depend on His strength and not our own. We need to believe what He has promised and learn to walk in faith, based on those promises. God is not primarily concerned with our outward behavior (although He does care very much about how we treat other people). He wants to deal with our hearts, to change us within. No matter how secure our defenses against other people may be, God is already inside those walls which we have built to keep other people from seeing who we really are. So we may as well accept that He knows all our sins and weaknesses already and loves us anyway, and has called us into relationship with Him despite all of those things. It is very comforting, once we get used to it, that we can never surprise God by the extent of our sin or failure, since He already knows and accepted us and loves us anyway.

I divided my thoughts into a section about God and a section about what our response ought to be, given our relationship to Him (to get to these sections, click on one of the next two titles).

About God

How Shall We Live?

Further Reading

“The Inner Voice Of Love” by Henri Nouwen has been helpful to me; it is his notes written to himself as he was recovering from an emotional breakdown. In it he writes about how God’s love sets us free to love others in an appropriate way. I like everything I have read by Henri Nouwen, yet this book has been especially meaningful to me. I also like Larry Crabb’s books. In “Inside Out” he talks about the need for us to be honest about the pain and suffering we do encounter in this world, and that we must let it drive us to God instead of looking for comfort from the world or by denying the pain. I also like “Connecting” very much, which explains that we can help each other to heal and grow in Christ by connecting with one another and allowing God’s Spirit to minister through us to others.

I have listened to many of the call-in shows of the people who run the New Life Clinics (their URL is http://www.newlife.com/) and read some of their books. I find their advice very helpful, especially their comments about the need for Christians to have healthy relationships with other Christians and to go through a sort of “grieving” process over all the major disappointments in our lives such as being let down by people who have significant roles in our lives and when our dreams that don’t come true. The names of these authors are Henry Cloud, John Townsend, Steven Arterburn and Paul Meier.

I have heard good things about “When God Doesn’t Make Sense” by James Dobson and “Where Is God When It Hurts” by Philip Yancey. I have read other books by them and appreciated them but not those specific books.

If you want to read something funny which will take your mind off the pain for a little while, my favorite humorous Christian book (and in my view there are too few humorous Christian books around, making this even more special) is “The Sacred Diary Of Adrian Plass aged 37 ¾” by Adrian Plass. This is a British book; it is supposed to be in print in the US by Zondervan, or you could order it online from a British bookstore such as Blackwell’s. (Make sure you get the original; there is also a sequel with the same title except he is now aged 45 ½ – that is good too but read the original first!)

Much of what I have learned about practical ways to deal with situations in daily life in a Christlike way comes from Mary Whelchel, who has a ministry named The Christian Working Woman (the URL is http://www.christianworkingwoman.org/).