Depression Defined 

DEPRESSION OVERVIEW

Depression (major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks. 

Some forms of depression are slightly different, or they may develop under unique circumstances, such as: 

Persistent depressive disorder (also called dysthymia) is a depressed mood that lasts for at least two years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for two years to be considered persistent depressive disorder.

Postpartum depression is much more serious than the “baby blues” (relatively mild depressive and anxiety symptoms that typically clear within two weeks after delivery) that many women experience after giving birth. Women with postpartum depression experience full-blown major depression during pregnancy or after delivery (postpartum depression). The feelings of extreme sadness, anxiety, and exhaustion that accompany postpartum depression may make it difficult for these new mothers to complete daily care activities for themselves and/or for their babies.

Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations). The psychotic symptoms typically have a depressive “theme,” such as delusions of guilt, poverty, or illness.

Seasonal affective disorder is characterized by the onset of depression during the winter months, when there is less natural sunlight. This depression generally lifts during spring and summer. Winter depression, typically accompanied by social withdrawal, increased sleep, and weight gain, predictably returns every year in seasonal affective disorder.

Bipolar disorder is different from depression, but it is included in this list is because someone with bipolar disorder experiences episodes of extremely low moods that meet the criteria for major depression (called “bipolar depression”). But a person with bipolar disorder also experiences extreme high – euphoric or irritable – moods called “mania” or a less severe form called “hypomania.”

Examples of other types of depressive disorders newly added to the diagnostic classification of DSM-5 include disruptive mood dysregulation disorder (diagnosed in children and adolescents) and premenstrual dysphoric disorder (PMDD). 

 


 

Signs and Symptoms 

If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression: 

  • Persistent sad, anxious, or “empty” mood 
  • Feelings of hopelessness, or pessimism 
  • Irritability 
  • Feelings of guilt, worthlessness, or helplessness 
  • Loss of interest or pleasure in hobbies and activities 
  • Decreased energy or fatigue 
  • Moving or talking more slowly 
  • Feeling restless or having trouble sitting still 
  • Difficulty concentrating, remembering, or making decisions 
  • Difficulty sleeping, early-morning awakening, or oversleeping 
  • Appetite and/or weight changes 
  • Thoughts of death or suicide, or suicide attempts 
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment 

Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms while others may experience many. Several persistent symptoms in addition to low mood are required for a diagnosis of major depression, but people with only a few – but distressing – symptoms may benefit from treatment of their “subsyndromal” depression. The severity and frequency of symptoms and how long they last will vary depending on the individual and his or her particular illness. Symptoms may also vary depending on the stage of the illness. 

 


 

Risk Factors 

Depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. 

Depression can happen at any age, but often begins in adulthood. Depression is now recognized as occurring in children and adolescents, although it sometimes presents with more prominent irritability than low mood. Many chronic mood and anxiety disorders in adults begin as high levels of anxiety in children. 

Depression, especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. These conditions are often worse when depression is present. Sometimes medications taken for these physical illnesses may cause side effects that contribute to depression. A doctor experienced in treating these complicated illnesses can help work out the best treatment strategy. 

 

Risk factors include: 

Personal or family history of depression 
Major life changes, trauma, or stress 
Certain physical illnesses and medications 

 


 

Treatment and Therapies 

Depression, even the most severe cases, can be treated. The earlier that treatment can begin, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two. If these treatments do not reduce symptoms, electroconvulsive therapy (ECT) and other brain stimulation therapies may be options to explore. 

Quick Tip: No two people are affected the same way by depression and there is no "one-size-fits-all" for treatment. It may take some trial and error to find the treatment that works best for you. 

 

Medications 

 

Antidepressants are medicines that treat depression. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medicines before finding the one that improves your symptoms and has manageable side effects. A medication that has helped you or a close family member in the past will often be considered. 

Antidepressants take time – usually 2 to 4 weeks – to work, and often, symptoms such as sleep, appetite, and concentration problems improve before mood lifts, so it is important to give medication a chance before reaching a conclusion about its effectiveness. If you begin taking antidepressants, do not stop taking them without the help of a doctor. Sometimes people taking antidepressants feel better and then stop taking the medication on their own, and the depression returns. When you and your doctor have decided it is time to stop the medication, usually after a course of 6 to 12 months, the doctor will help you slowly and safely decrease your dose. Stopping them abruptly can cause withdrawal symptoms. 

Please Note: In some cases, children, teenagers, and young adults under 25 may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. This warning from the U.S. Food and Drug Administration (FDA) also says that patients of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment. 

If you are considering taking an antidepressant and you are pregnant, planning to become pregnant, or breastfeeding, talk to your doctor about any increased health risks to you or your unborn or nursing child. 

To find the latest information about antidepressants, talk to your doctor and visit www.fda.gov

You may have heard about an herbal medicine called St. John's wort. Although it is a top-selling botanical product, the FDA has not approved its use as an over-the-counter or prescription medicine for depression, and there are serious concerns about its safety (it should never be combined with a prescription antidepressant) and effectiveness. Do not use St. John’s wort before talking to your health care provider. Other natural products sold as dietary supplements, including omega-3 fatty acids and S-adenosylmethionine (SAMe), remain under study but have not yet been proven safe and effective for routine use. For more information on herbal and other complementary approaches and current research, please visit the National Center for Complementary and Integrative Health website. 

 

Psychotherapies 

 

Several types of psychotherapy (also called “talk therapy” or, in a less specific form, counseling) can help people with depression. Examples of evidence-based approaches specific to the treatment of depression include cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and problem-solving therapy. More information on psychotherapy is available on the NIMH website and in the NIMH publication Depression: What You Need to Know. 

 

Brain Stimulation Therapies 

 

If medications do not reduce the symptoms of depression, electroconvulsive therapy (ECT) may be an option to explore. Based on the latest research: 

  • ECT can provide relief for people with severe depression who have not been able to feel better with other treatments. 
  • Electroconvulsive therapy can be an effective treatment for depression. In some severe cases where a rapid response is necessary or medications cannot be used safely, ECT can even be a first-line intervention. 
  • Once strictly an inpatient procedure, today ECT is often performed on an outpatient basis. The treatment consists of a series of sessions, typically three times a week, for two to four weeks. 
  • ECT may cause some side effects, including confusion, disorientation, and memory loss. Usually these side effects are short-term, but sometimes memory problems can linger, especially for the months around the time of the treatment course. Advances in ECT devices and methods have made modern ECT safe and effective for the vast majority of patients. Talk to your doctor and make sure you understand the potential benefits and risks of the treatment before giving your informed consent to undergoing ECT. 
  • ECT is not painful, and you cannot feel the electrical impulses. Before ECT begins, a patient is put under brief anesthesia and given a muscle relaxant. Within one hour after the treatment session, which takes only a few minutes, the patient is awake and alert. 

Other more recently introduced types of brain stimulation therapies used to treat medicine-resistant depression include repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS). Other types of brain stimulation treatments are under study. You can learn more about these therapies on the NIMH Brain Stimulation Therapies webpage. 

If you think you may have depression, start by making an appointment to see your doctor or health care provider. This could be your primary care practitioner or a health provider who specializes in diagnosing and treating mental health conditions. Visit the NIMH Find Help for Mental Illnesses if you are unsure of where to start. 

 

Beyond Treatment: Things You Can Do 

Here are other tips that may help you or a loved one during treatment for depression: 

  • Try to be active and exercise. 
  • Set realistic goals for yourself. 
  • Try to spend time with other people and confide in a trusted friend or relative. 
  • Try not to isolate yourself, and let others help you. 
  • Expect your mood to improve gradually, not immediately. 
  • Postpone important decisions, such as getting married or divorced, or changing jobs until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation. 
  • Continue to educate yourself about depression. 

 


 

Join a Study 

What are Clinical Trials? 

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions, including depression. During clinical trials, some participants receive treatments under study that might be new drugs or new combinations of drugs, new surgical procedures or devices, or new ways to use existing treatments. Other participants (in the “control group”) receive a standard treatment, such as a medication already on the market, an inactive placebo medication, or no treatment. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individual participants may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future. 

Please Note: Decisions about whether to participate in a clinical trial, and which ones are best suited for a given individual, are best made in collaboration with your licensed health professional. 

 

How do I find a Clinical Trials at NIMH on Depression? 

Doctors at NIMH are dedicated to mental health research, including clinical trials of possible new treatments as well as studies to understand the causes and effects of depression. The studies take place at the NIH Clinical Center in Bethesda, Maryland and require regular visits. After the initial phone interview, you will come to an appointment at the clinic and meet with one of our clinicians. Find NIMH studies currently recruiting participants with depression by visiting Join a Research Study: Depression. 

 

How Do I Find a Clinical Trial Near Me? 

To search for a clinical trial near you, you can visit ClinicalTrials.gov. This is a searchable registry and results database of federally and privately supported clinical trials conducted in the United States and around the world (search: depression). ClinicalTrials.gov gives you information about a trial's purpose, who may participate, locations, and contact information for more details. This information should be used in conjunction with advice from health professionals.

 

Reference: https://www.nimh.nih.gov/health/topics/depression/index.shtml#part_145398

Bart Millard Talks About the Magic of Music in I Can Only Imagine 

Bart Millard, MercyMePARADE, M.B. ROBERTS, FEBRUARY 9, 2018

MercyMe singer Bart Millard hit it big with I Can Only Imagine, a song that dominated Christian radio in 2001, then crossed over to become a major hit on Adult Contemporary and Top 40 charts. 

In his new book, I Can Only Imagine, which will hit the big screen as a movie starring Broadway actor J. Michael Finley as Millard, and also features Dennis Quaid, Madeline Carroll, Cloris Leachman and Trace Adkins, in March 2018, Millard tells the story behind the song of his abusive father who found God and reconciled with his family before he died of cancer. 

Read on for an excerpt from the book where Millard shares how music put the magic in his life. 

Starting in my middle school years, next to Jesus and the church, I had five best friends: music, Mammaw Millard, Mammaw Lindsey, Kent, and Shannon. While all five had already been in my life for many years, there was something about the journey into my teen years, dealing with my dad, and my newfound faith that brought a deepening relationship with each of these blessings. These four people’s presence in my life, combined with my love of music, kept me grounded and growing even in the most difficult days. 

The Magic of Music 

For me, music has always been a pleasure, a protector, and my passion. The words my favorite artists sang gave me strength and courage and inspiration and motivation to keep going, to keep living, and to believe something better was around the corner. Music gave me hope when I felt hopeless. Love when I felt unloved. A reason to embrace life when I was dying inside. If a song moved me, then I felt I was alive for a reason. Later I came to the truth of knowing these blessings were all gifts from the Lord. Music was simply the conduit for them to reach my heart.

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Connection and Compassion for a Happy New Year 

Connection and Compassion for a Happy New Year

by Lara Schuster Effland, LCSW

A client expressed relief about the coming New Year and the fresh chapter that it brings, seeing it as a promise of new beginnings and better things to come. 

At the same time, she resists the idea of reflecting on the past year and the mistakes and struggles endured. In this moment, I ask her to take a breath and congratulate herself on all she has accomplished, both through the joy and the suffering. She sighs with ease and remembers the work we have done to cultivate self-compassion as a core value. 

Loving-Kindness 

This conversation is representative of an important value I hold for myself, as well as for my clients: the practice of loving-kindness. You may be familiar with this idea; it has, along with mindfulness, traveled west from its Eastern roots to work its way firmly into our therapeutic approach to healing and developing a positive sense of self. 

Loving-kindness is the intention of embracing yourself and others with a nonjudgmental, compassionate, and kind approach. The practice begins with ourselves to build a strong foundation of internal confidence and compassion, and then we can extend loving-kindness to others. As the flight attendants say before take-off, “In the case of an emergency, when your oxygen mask drops, place it over your own nose and mouth before attempting to assist others.” 

The research we’ve done in our center and that done by others continues to prove that the most powerful tool for healing is connection and compassion. Through the practice of loving-kindness we can intentionally cultivate this sense of connection. Research has shown that if you practice loving-kindness on a weekly basis it can increase a positive sense of connection to others and the world around you. 

How to Practice 

To cultivate a practice of loving-kindness, you find four or five phrases that you can comfortably relate to. The phrases consist of “May I be _______.” Here are four common phrases: 

“May I be happy.” 
“May I be at peace.” 
“May I be healthy and well.” 
“May I live a life with ease.” 

Complete the phrase with anything you want more of in your life. Then sit in a quiet place, close your eyes, and repeat each phrase to yourself, either silently or out loud. I prefer to say each phrase split between the in-breath and out-breathe. As I breathe in, I say, “May I,” and as I breathe out, “be happy.” After I finish the phrases for myself, I replace “I” with anyone I would like to extend loving-kindness to—family, friends, those I’m in conflict with, or the world at large. I go through each phrase for as long as it feels comfortable for me that day. At first, it may feel foreign and forced, but give it time and soon enough this will start to feel more genuine, and a sense of connection will build. 

Happy New Year, and may you all feel a sense of ease, peace, and happiness. 

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Lara Schuster Effland, LCSW, is the Vice President of the Mood and Anxiety Program and Residential Services at Insight Behavioral Health Centers of Chicago. Ms. Effland clinically specializes and trains others in dialectical behavior therapy, mindfulness-based therapies, exposure and response prevention, and trauma treatment.

Kay Warren on Depression, Grief, and Hope 

Kay Warren on Depression, Grief, and Hope

Choosing joy "even if my worst nightmare came true" 

Interview by Amy Simpson

Kay Warren is intimately familiar with depression. This cofounder of Saddleback Church, wife of senior pastor Rick Warren, beloved Christian communicator, and advocate for people in need knows what darkness looks like. Through her own lifelong emotional battle, parenting a child in tremendous pain, and losing a son to suicide, depression has left deep marks on her soul. Yet she chooses joy—the kind of joy that can live right alongside sorrow. TCW talked with her about her experiences and what she's learning. 

How has depression affected you and your family? 

Depression has been a part of our family's life since our son Matthew was very young. He was clinically depressed at seven. We moved from the place where he was born and where his friends were, just across town. It wasn't that far, but it was far enough that he didn't get to keep playing with those kids. He started coming home from school pretty subdued and quiet, and I'd ask, 

"Who did you play with today?" 

He would say, "Oh, nobody." 

And I'd ask, "Did anything happen?" 

"No." 

When he started saying, "I'm sad," I attributed it at first to the fact that we had moved and he was just having a hard time dealing with that. It continued and began to affect his schoolwork, and he lost interest in playing with his own toys, playing with his siblings. He just was different. 

Eventually I knew we were dealing with something beyond the normal sadness from a transition. There was something very deep going on in this little boy, and I didn't know what to do. I didn't even realize children could be depressed. It wasn't long until he began to experience panic attacks. He couldn't stand up in front of his classmates at school. He couldn't play sports because he couldn't take the pressure of performing. Then he was diagnosed with ADHD. The initials just kept stacking up. By 12 he was diagnosed with early-onset bipolar disorder. Then it was obsessive-compulsive disorder and major depressive disorder. Depression was ever-present. And then—just a year-and-a-half before he passed away—finally the diagnosis that made it all come together and make sense was borderline personality disorder. Almost all of his life, Matthew struggled with very intense depression. 

You know, if you live with a depressed person, it's catching. Our whole family struggled with watching him suffer, feeling the sadness for his suffering. I think we all had a little bit of depression ourselves because his suffering was so intense.

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Stress, depression and the holidays: Tips for coping 

Stress, depression and the holidays: Tips for coping

Stress and depression can ruin your holidays and hurt your health. Being realistic, planning ahead and seeking support can help ward off stress and depression. 

By Mayo Clinic Staff 

The holiday season often brings unwelcome guests — stress and depression. And it's no wonder. The holidays present a dizzying array of demands — parties, shopping, baking, cleaning and entertaining, to name just a few. 

But with some practical tips, you can minimize the stress that accompanies the holidays. You may even end up enjoying the holidays more than you thought you would. 

Tips to prevent holiday stress and depression 

When stress is at its peak, it's hard to stop and regroup. Try to prevent stress and depression in the first place, especially if the holidays have taken an emotional toll on you in the past. 

1. Acknowledge your feelings. 

If someone close to you has recently died or you can't be with loved ones, realize that it's normal to feel sadness and grief. It's OK to take time to cry or express your feelings. You can't force yourself to be happy just because it's the holiday season. 

2. Reach out. 

If you feel lonely or isolated, seek out community, religious or other social events. They can offer support and companionship. Volunteering your time to help others also is a good way to lift your spirits and broaden your friendships. 

3. Be realistic. 

The holidays don't have to be perfect or just like last year. As families change and grow, traditions and rituals often change as well. Choose a few to hold on to, and be open to creating new ones. For example, if your adult children can't come to your house, find new ways to celebrate together, such as sharing pictures, emails or videos. 

4. Set aside differences. 

Try to accept family members and friends as they are, even if they don't live up to all of your expectations. Set aside grievances until a more appropriate time for discussion. And be understanding if others get upset or distressed when something goes awry. Chances are they're feeling the effects of holiday stress and depression, too. 

5. Stick to a budget.

Before you go gift and food shopping, decide how much money you can afford to spend. Then stick to your budget. Don't try to buy happiness with an avalanche of gifts. 

Try these alternatives: 

Donate to a charity in someone's name. 
Give homemade gifts. 
Start a family gift exchange. 

6. Plan ahead. 

Set aside specific days for shopping, baking, visiting friends and other activities. Plan your menus and then make your shopping list. That'll help prevent last-minute scrambling to buy forgotten ingredients. And make sure to line up help for party prep and cleanup. 

7. Learn to say no. 

Saying yes when you should say no can leave you feeling resentful and overwhelmed. Friends and colleagues will understand if you can't participate in every project or activity. If it's not possible to say no when your boss asks you to work overtime, try to remove something else from your agenda to make up for the lost time. 

8. Don't abandon healthy habits. 

Don't let the holidays become a free-for-all. Overindulgence only adds to your stress and guilt. 

Try these suggestions: 

Have a healthy snack before holiday parties so that you don't go overboard on sweets, cheese or drinks. 
Get plenty of sleep. 
Incorporate regular physical activity into each day. 

9. Take a breather. 

Make some time for yourself. Spending just 15 minutes alone, without distractions, may refresh you enough to handle everything you need to do. Find something that reduces stress by clearing your mind, slowing your breathing and restoring inner calm. 

Some options may include: 

Taking a walk at night and stargazing. 
Listening to soothing music. 
Getting a massage. 
Reading a book. 

10. Seek professional help if you need it. 

Despite your best efforts, you may find yourself feeling persistently sad or anxious, plagued by physical complaints, unable to sleep, irritable and hopeless, and unable to face routine chores. If these feelings last for a while, talk to your doctor or a mental health professional. 

Don't let the holidays become something you dread. Instead, take steps to prevent the stress and depression that can descend during the holidays. Learn to recognize your holiday triggers, such as financial pressures or personal demands, so you can combat them before they lead to a meltdown. With a little planning and some positive thinking, you can find peace and joy during the holidays.

Reference

Addressing Depression and Suicide in Your Church 

The best time to deal with a crisis is before it hits. 

Amy Simpson | posted April 17, 2013 

There's a lot in the news about depression and suicide these days, since the April 6 news of Matthew Warren's death brought it into the public eye. But although depression may be the most well-known and widely understood mental illness, it's still mostly hidden within the church—and this is a big problem. Just because we don't discuss it much doesn't mean it's gone. Ten percent of American adults suffer from depression, and more than 38,000 people die by suicide each year. Plenty of the people represented by these statistics will be sitting in church next Sunday morning. 

Most church leaders are very aware of the challenges depression and other mental illnesses present within the context of ministry. Some have experienced the devastating concussion of a suicide within their congregation, or close to it. But when it comes to mental-health problems, people in ministry can feel as lost, intimidated, and fearful as most others. In my book Troubled Minds: Mental Health and the Church's Mission, I cite results of a survey I conducted through Leadership Journal, BuildingChurchLeaders.com, and other publications for people in Christian ministry. Among the 500 leaders who responded, 16 percent indicated they feel "not equipped at all" to minister to people with mental illness. Another 53 percent feel "somewhat equipped." Only 30 percent feel at least "competent." 

When a mental-health crisis hits, it shouldn't catch you off guard. The best time to address depression and suicide is before someone needs crisis intervention. 

Here are some steps you can take. 

• First, understand that depression is a disease; it's not a failure of the will or a triumph of self-indulgence, and people can't just "get over it." It's not simply a spiritual problem requiring a spiritual solution. Your basic understanding will affect the way you react when you realize someone in your church is suffering. 

• Get some basic education, and learn to watch for symptoms of depression and warning signs that someone is considering suicide. Consider yourself at the front lines of mental-health care. One quarter of people who seek treatment for mental disorders go first to a member of the clergy. This is higher than the percentage of people who go to either psychiatrists or general medical doctors. 

• If you believe someone is in immediate danger or presents an immediate threat to someone else, call the police. This is not the time for second-guessing or trying to address the problem yourself.

• Acknowledge your own fears about depression and other mental illness, and take them before God. Many of our most natural reactions to mental-health problems are based in fear—either fear of the suffering person, fear that we are getting in over our heads, or fear that acknowledging someone else's mood disorder means we have to acknowledge the possibility that depression can strike anyone—including ourselves. Most of these fears are irrational. Ask God to make you a bold and wise person and to remove fears that are not based in reality. 

• Wrestle with your theology of suffering and how it relates to mental illness. Recognize how depression and other mental illness fits within Christian teaching on the effects of original sin, the presence of sickness in our world, God's unconditional love, redemption in this life, and complete healing in the next. Come to peace with the questions you can't answer and the overriding hope you can offer through Christ's love, his purpose for all people, and his coming renewal of all creation. There is no need for you to have all the answers, but you must face these questions and rest in God's truth, or your own uncertainty will leave drowning people without a lifeline. 

• Assemble a library of resources you can share with struggling people and their families. Include books, a list of helpful websites, pamphlets, a list of local counselors, and contact information for your local branch of the National Alliance on Mental Illness (NAMI), where individuals and families can find support groups and education. 

• Before you need it, create a network with local mental-health professionals. Get to know the Christian counselors in your area; you may have some in your own congregation. Be sure your network includes professionals from across a spectrum of specializations—not just depression, but also anxiety disorders, eating disorders, Autism Spectrum disorders, psychotic disorders, and others. 

• Work with your local NAMI chapter to host faith-based training for your church and the community. 

• Consider Mental Health First Aid training for you and perhaps your entire church staff. This course will help you understand the basics of various types of mental illness and how to respond. 

• On a regular basis, consult with a mental-health professional or consultant. You can discuss ways to interact with and support people suffering from depression and other conditions. If you can't afford to pay for this consultation on your own, pool resources with a few other church leaders to share the cost of consultation and meet together with that person once a month.

• If someone in your church is in treatment for depression or another mental illness, request that he or she sign a consent form allowing you to consult with the relevant professional. If you do receive that consent, ask the mental-health professional specifically how you and your church can support the person's treatment and ongoing pursuit of health. Be sure you keep all discussion strictly confidential. 

• With your church, acknowledge mental-health awareness month in May. Use it as an excuse to discuss mental health in sermons, classes, and Bible study groups. People in your church probably need to hear pastors and other leaders discuss mental health for two reasons: to normalize the experience for people who feel marginalized and ashamed, and to help address theological questions about mental and emotional suffering. 

• Don't forget the families of suffering people! Loved ones need support too; living with and caring for someone with depression or another mental illness can be extremely challenging. Check in with them, ask them what they need, and be prepared to do what you can to help. 

• Recognize the likelihood that someone suffering from depression or another mental illness is suffering a spiritual crisis as well, particularly the first time symptoms take hold. Even while a person is receiving treatment, spiritual nurture is critical. Ask if you can pray with the person or listen or just sit nearby for a while. Assure the person that God has not abandoned him or her (Romans 8:35-38), and don't deviate from this message. 

When you signed up for church leadership, you may not have realized you were signing up for mental-health intervention. But ready or not, many suffering people walk through the doors of your church each week, and faithful ministry in the name of Christ does not allow us to simply ignore problems like depression and suicide. In partnership with mental-health professionals, you can play an important role in helping hurting people—and now is the time to prepare.

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How to create a stress-reducing playlist 

by Jenni Rook, MT-BC, LCPC (Anxiety.org)

In my years as a music therapist, I've heard so many people describe music as a magical and mysterious force that somehow impacts our brains, bodies, and emotions. I've heard beautiful stories about the ways music helps children learn or brings an adult with dementia back into a coherent state, if only for a moment. "It brings people together," "It's universal," and some even say, "It feeds the soul." At this point, I always smile and reply, "Do you want to know why?" 

Music Affects the Brain 

Music is magical, it's true, but it's not all smoke and mirrors. Behind the mystical healing powers of music are scientific reasons for why it holds such an influence over our minds. Music is really a combination of many different elements, such as pitch, tempo, and dynamics. How fast, slow, or loud the music, the differently it impacts our brains. When these elements work in combination, we see dramatic changes in physiology and behavior. The effects of music have been documented by scientists for years, and despite its mysteries, one thing is certain: listening to music activates our entire brains, creating the potential for us to use music to improve the way we think, behave, and feel. 

What is Music Therapy? 

This is where music therapy comes in. Music therapists work with individuals of all ages to help them communicate, process difficult experiences, and improve motor or cognitive functioning. A music therapy session is an interactive music-making experience where the client uses musical instruments (including the voice) in either an exploratory manner or through a more personalized exercise designed by the therapist to address a specific issue. According to the American Music Therapy Association (AMTA), music therapy can have profound effects, and has helped many people since it became an established profession in the 1950s. 

Create Your Own Therapeutic Playlist 

When you play music as you're cleaning the house or listen to an energetic song during your morning workout, you could be using music therapeutically without even realizing it. However, by thoughtfully creating a selection of music, you can use a playlist to combat stress, achieve relaxation, increase motivation, and evoke positive emotions. 

To start the process, address your current emotional state. Is it anxious, restless, or sad? How would you like to feel instead? With that goal in mind, know that it's important to bring yourself there gradually through a progression of music that first empathizes with your current mood and then slowly delivers you to your desired emotional state. 

Here are some guidelines for creating your own therapeutic playlist: 

1. Use Familiar Music 

Start with your own music collection. Your previous associations with pieces of music determine the manner in which you will respond to them. Memories, especially emotional memories, are stimulated by music and can take us back in time in an instant. You already have labeled certain music as happy, sad, energizing, disturbing, and so on. Trust yourself and how you believe songs will make you feel. Once you identify what it is about music that makes you feel a certain way, you might want to supplement your current collection by finding new music that contains similar characteristics (choral voices or emphasized percussion). Place pieces of music into different categories according to your common moods like, sluggish, depressed, nervous, tired, anxious, stressed, and so on. 

2. Use Music You Enjoy 

There is no sense in using that awful music your mother/child/brother/friend makes you listen to. If you can't stand it, don't use it. You know what you like and should be able to find enough variety within your preferred music to match different moods. 

3. Find Music That Speaks to You 

A friend of mine once said, "Music is the ultimate form of empathy." As humans, we are constantly striving to be understood. This could explain why we tend to enjoy music that we find relatable or music that speaks to us in some way. Songs can validate our feelings and actually provide comfort when they match our mood. For instance, listening to sad music actually causes our brains to produce the same neurochemical that is released when we cry. This chemical, prolactin, helps to elicit feelings of comfort, meaning that listening to a sad song when we are feeling down not only provides empathy, it is causing our brains to start to try to make us feel better!  

4. Match Your Mood 

Think about how you feel right now. How fast are you moving (inside and out): is your heart racing? Are you feeling sluggish? Are you feeling heavy? How fast are you breathing? Before trying to change your mood with music, you will need to match it. This is easier done when you can consider different musical elements: 

Tempo. This one is easy. Pick a piece of music that matches your heartbeat, your breathing and how fast you feel you are moving. 
Volume. Are you feeling loud or soft? If you are overstimulated and feel like you need to turn everything off, first find the music that matches your current state. It might be loud and chaotic. Perhaps you are lacking energy and motivation, and things around you are quiet. Find a song with soft lyrics and instruments. Keep in mind that soft and slow do not always go together, and neither do loud and fast. 
Harmony and Timbre. Musical instrumentation and background vocals are often written to blend nicely with a melody to add layers of sound in a tonal structure. Some music actually uses instruments and tight harmonies that create a feeling of tension or dissonance. Think about your perceived level of stress and how tense you might feel. Also think about the instruments that appeal to you in the moment. The timbre of an instrument refers to the way it sounds. Do you feel like a distorted electric guitar or a clean piano? Do the deep, heavy sounds of a cello match your mood or are you feeling lighter like a flute or a high-pitched voice? 

5. Consider Music Without Lyrics 

Song lyrics leave a little less up to the imagination because someone else's story is being told. When lyrics are included in a piece of music, more of our brains are used to process these lyrics. They might also stimulate more memories. If you are using music for the purpose of trying to relax, you want to allow your mind to wander without consciously focusing on the music. This is more challenging when lyrics are involved. Consider choosing instrumental music or a song where the lyrics reflect the way you are feeling. 

6. Order Your List to Help You Reach an Intended Mood 

As noted earlier, consider your goal. Do you want to feel energetic, happy, relaxed, or optimistic after listening to your playlist? With your intended mood in mind, think of how you might organize the songs to bring you from your current emotional state to your desired. For example, if you started with an up-tempo piece of music that matched your initial state of high anxiety, find something a little slower for your next song. If you are trying to move toward a more relaxed state, select a piece of music that is slightly slower for your third song. The third piece should also have less instrumentation or vocals. The idea is to decrease the amount of stimulation in the music so that your playlist can facilitate a gradual transition while allowing you time to adjust to the music. Select songs that are at least three minutes long and make sure your playlist contains at least thirty minutes of music. You want to give your body plenty of time to experience your current emotion and adjust physiologically with the music. 

Trust Your Musical Intuition 

If you've ever listened to music and were moved to tears or motivated to run an extra mile because of it, you already understand that music can have an extreme impact on emotions. When intended, music can provide comfort during difficult times and also promote relaxation. You might be thinking that music is more complicated than you originally thought. It is! Although there is much to consider when using music therapeutically, humans have a particular knack for choosing music that soothes and heals them, without having to think too much about the technical aspects. Trust the way you feel, and if you think you might need more assistance with this process, consult a board-certified music therapist.

Bible Verses about Anxiety and Worry 

by Candy Arrington, CBN

 

Years ago, a catchy little tune filled the airwaves, an island beat punctuated the lyrics, “Don’t worry; be happy.” While these words are easy to sing, they are more difficult to practice. World events, natural disasters, political uncertainties, financial difficulties, and fear often crowd our thoughts and feed anxiety. 

Does Worry Accomplish Anything? 

Many of us waste lots of time worrying about what might happen, but never does. Or we have the mistaken idea that worry somehow prevents what we fear from happening. Here's what the Bible says: 

"Can all your worries add a single moment to your life?" (Matthew 6:27 NLT) 

"Therefore do not worry about tomorrow, for tomorrow will worry about itself." (Matthew 6:34 NIV) 

"But make up your mind not to worry ahead of time about how to stand up for yourselves." (Luke 21:14 NIRV) 

Fear and Worry – Unhappy Twins 

Fear is often the wind that fans the flames or worry. Like hand-holding twins, fear drags worry into our thoughts and actions, encouraging us to do some things and preventing us from doing others. Scripture provides insights into banishing fears and calming worry. 

"I sought the Lord, and he answered me; he delivered me from all my fears." (Psalm 34:4 NIV) 

"When I am afraid, I trust in you." (Psalm 56:3 NET) 

"I am leaving you with a gift—peace of mind and heart. And the peace I give is a gift the world cannot give. So don't be troubled or afraid." (John 14:27 NLT) 

Trusting God Instead of Worrying 

"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 NIV) 

"If God is for us, who can be against us?" (Romans 8:31 NIV) 

"Now faith is confidence in what we hope for and assurance about what we do not see." (Hebrews 11:1 NIV) 

"Turn your worries over to the Lord. He will keep you going. He will never let godly people be shaken." (Psalm 55:22 NIRV) 

Don't Worry, God Provides 

"I tell you not to worry about your life. Don’t worry about having something to eat, drink, or wear. Isn’t life more than food or clothing? Look at the birds in the sky! They don’t plant or harvest. They don’t even store grain in barns. Yet your Father in heaven takes care of them. Aren’t you worth more than birds?" (Matthew 6:25-26CEV) 

"You will keep in perfect peace those whose minds are steadfast, because they trust in you." (Isaiah 26:3 NIV) 

Can God change your life? 

God has made it possible for you to know Him and experience an amazing change in your own life.