Medicatieprotocol behorend bij het onderzoek P-CGT +/- AD bij recidiverende depressie Inleiding In dit onderzoek wordt het effect van P-CGT plus doorgaan met antidepressiva (AD) vergeleken met enerzijds doorgaan met AD plus care as usual en anderzijds P-CGT plus afbouwen van AD Een eerste probleem is dat de farmacotherapiecondities in alle armen zoveel mogelijk uniform moet geb
Microsoft word - depression final.docMy Experience of Depression
2. What I experienced
3. Hospitalization & Help
13. The impartial observer
14. Spiritual growth
7. ECT – Electroconvulsive Therapy
INTRODUCTION: - Who this is for and what my message is.
These notes are intended as a short guide to anyone suffering from a severe clinical depressionand possibly contemplating suicide. You may have sought professional help and consulted adoctor, psychiatrist or psychologist. You may feel hopeless and helpless, convinced that you willnever recover. A psychiatrist may have admitted you for treatment to a hospital.
I have suffered debilitating depression for many years but now lead a fulfilled and purposeful lifewithout the scourge of suicidal depression. I hope that I can offer some comfort and help bysharing my experiences of depression and what helped me to survive and recover. My sincerewish is that I could encourage others to persevere in spite of the overwhelming feelings ofhopelessness and despair. It was an inspiration to me to know that others had suffered as I hadand yet they recovered to lead successful and productive lives.
Depression or mental illness does not have to be something that hangs over you, like a blackcloud, for the rest of your life. While you may not be cured of it, you can find ways to learn to cope.
These notes are to give you hope and to assure you that you, too, can get better.
Some Physical Signs
• Anxiety – rapid heartbeat, sweating and Feelings of being pathetic, useless or unwanted 2 WHAT I EXPERIENCED:
I felt too far gone and beyond help.
I felt helpless and at the mercy of others, as I was unable to make my own decisions and hadto rely on others to make them for me.
Unable to differentiate good decisions from bad ones. (I felt mentally disordered and keptthinking absurd thoughts which I had difficulty verbalizing. If I tried to express them, I feltembarrassed and stupid and it felt as if I only made things worse).
Frustrated and angry. (I hated being entirely dependant on those more sane, capable orcompetent family or friends who were often at a complete loss as to know what to do for me).
I felt utterly hopeless thinking that nothing and no-one would be able to help me.
Usually people have no idea how to offer you comfort and think if they can solve your problems
you will “snap” out of it. They often get highly indignant when you do not take their “sound”
advice. Try not to be hard on them. Even though they may not be experiencing your hell, it is
not easy living with a depressed person and can be frustrating and painful to see a loved one
suffering. (See section on GUILT)
Sometimes religious fanatics can push you over the edge by telling you that depression isGod’s punishment for your sins and your need for repentance! You may even be told thatdepression is “from the Devil.” This does not help. It can send you into a spiral of guilt aboutyour own participation in this evil state. Try to ignore them.
There are also some who haven’t been through a clinical depression themselves and make glibstatements with little compassion. They may be so terrified of their own dark side that they areafraid to come near you, almost as if they fear contamination. Often they live in denial of theirown negative thoughts. They are usually the ones who tell you to be positive and give youpositive thinking self-help books. These people think it’s your choice to be depressed and thatyou have no willpower to just ‘snap out of it’. They can also be afraid of their inability to copethemselves, especially if it’s their spouse or child who is depressed. Their relative’s illness maymake them angry as their sense of stability and security is threatened.
So when it comes to receiving comfort from others, you often receive it from unlikely sources,often from fellow sufferers. Family members may feel completely inadequate and helplessthemselves. They may also feel resentful and angry that they have to offer you so muchencouragement and that you are not there for them. Often they do not understand what you aregoing through and find it hard to have compassion for something so alien to them.
3. HOSPITALIZATION AND HELP:
If you are severely depressed you will probably be diagnosed with a chemical or clinical depressionand be prescribed anti-depressants and/or tranquilizers. You may also be admitted to a hospitalpsychiatric ward, a general hospital ward or even a specialized institution that caters for yourneeds.
Do not panic! Many perfectly normal and healthy individuals have been through this and
there should be no stigma attached to it.
Do not label yourself insane! Many intelligent, gifted and highly capable individuals set their
standards very high and burnout at some point in their lives. This is just a temporary state.
You will get better!
At the moment you are not able to comprehend the prospect of being healthy again. But if you are
willing to be patient and slowly challenge false beliefs about yourself and your attitudes towards life
you will find healing. It is possible for you to return to normal life again and become a competent,
healthy and positive person. More importantly, however, you will learn to accept and forgive
yourself for your apparent mistakes and shortcomings.
Support and comfort
Loved ones: I’ve been lucky enough to have a loving and supportive family and a partner who
believed in me and supported me even at my worst. My friends too have cared and helped me
through the worst times.
Psychiatrists and psychologists: They can be wonderful lifesavers in a crisis. However, I must
stress that they can’t miraculously cure you. They can only facilitate your road to recovery. The
right anti-depressants, chosen specially to suit your needs, can also help you get better.
I know that when you are desperate you want to put your hopes into anything that seems like alifeline. You might hope that you will be cured instantly by these professionals. Sometimes this putsunrealistic expectations on them which they can’t live up to. If this happens and you lose faith inyour psychologist for example, you can spiral into a worse state of depression than before, feelingthat all avenues of help have failed you. BUT THIS IS IMPORTANT: It may feel as if everything has failed you because, as a society, we
are led to believe that humanity has an instant cure for everything. We have also been led to
believe that if a doctor can’t help you, the situation is hopeless. THIS IS NOT SO. I truly believe
that FAITH IN GOD can enable you to tap into the resources deep within you to help you to heal.
Unfortunately, you have to be patient as healing may be a slow process. Think of how many years
it has taken you to develop negative coping mechanisms, hiding behind a facade of coping while
all the time you have been dying inside. You may be in the habit, as I was, of condemning yourself
for past mistakes. You may be unable to forgive yourself for these and have an urge to hate and
punish yourself. (See notes about Therapy and medication). This is all part of the depression and
these feelings will lessen as the healing process begins.
BE VERY GENTLE with yourself at this time and allow yourself the space to heal.
Nurses: Many have been a crucial support to me and encouraged me tremendously. I’ve much
admiration and respect for them and, above all, gratitude for the many times they helped me.
Fellow patients: Be careful here. Do not try and solve their problems for them but offer sympathy
and love if you are able to. When you first arrive in a psychiatric ward, especially if it’s your first
time, you are filled with overwhelming feelings of humiliation, anger, despair, hopelessness and
fragmentation to name just a few powerful emotions. The last thing you are capable of doing is
communicating effectively with anyone. This is normal. No one expects you to feel any different. It
is quite natural for you just to sleep for a few days and speak only when necessary. You will
probably go into a state of numbness. Even though I didn’t speak at first, I slowly began to feel
comforted by the presence of fellow sufferers around me. Gradually I began talking and sharing my
feelings. Strangely enough, focusing my attention outside of myself, even though it was very
difficult, proved to be my saving grace.
However some patients may be delusional and/or make you feel uncomfortable. They may becomeaggressive or make offensive comments about you. Avoid them. You don’t have to respondaggressively or defend any of their accusations. Realize that they are probably worse off than you.
If they continue to bother you, tell the sister in charge.
Other things that helped:
Writing my deepest thoughts and feelings into a diary Reading books about depression and learning about others’ experiences, difficulties andeventual recovery. (These gave me hope that I would get better one day too) Sleeping (but not too much during the day) Listening to others with similar symptoms and realizing that I was not alone Speaking to someone who has been through it and recovered Forcing myself to exercise e.g. swimming or walking Doing something practical no matter how trivial Expressing myself creatively by writing or drawing (without thinking of the end result) Doing some of these things may feel like pushing a boulder uphill but you will have to force
yourself. It is sheer determination that will get you through. Persevere in spite of the odds.
DO NOT wait until you feel like being proactive, as this will not happen.
You may be responsible for some of the things that lead up to your present clinical depression
BUT YOU ARE NOT RESPONSIBLE FOR THE ILLNESS ITSELF. Would you be responsible
for getting flu or diabetes? No. Depression is the same. It’s a chemical imbalance that some
people are more susceptible to through no fault of their own.
Live minute by minute, hour by hour, day by day. You just have to get through one day at atime.
You are responsible for looking after yourself and finding ways to overcome depression. Try to
be kind, gentle and love yourself. You do still have some control over your choices and
When you are able to confront those things that caused your depression, go for therapy or talkto others and read about your illness. Be prepared to change the things that are holding youback from realizing your full potential.
Do not try and solve problems or make big decisions until you feel better.
If you make a mistake or wrong decision try not to dwell on it but tell yourself you will reassess
it when you feel better and possibly some good may have come from it. You did the best you
could in the circumstances and often we can only see value in so called “mistakes” in time.
Remember that God uses ALL things for the good no matter how catastrophic an event may
seem at the time.
Do not compare yourself with others. What you are going through is of tremendous significance
– an important period of growth. Even though it seems pointless, or a waste of time and you
have a sense of futility about it all. The eminent scholar Proust said that the only periods of
growth in his life took place when he was deeply unhappy. Those were the moments that
made him one of the most profound philosophers of all time.
Remember that you are still a capable and intelligent person. No one has the right to make youdo things you do not feel comfortable with. You may be sick but that does not make you alesser person.
Your state of mind is temporary. You have not done anything wrong to deserve punishment.
Medication can really help but remember to take responsibility for the tablets you are on.
Especially if you have a bad reaction at first. Take medication according to a doctor’s orders.
BE VERY VIGILANT WITH MEDICATION. Try and remember what you take and the exact
dosage. Never just stop medication. If you feel it may be making you worse or you feel the
side effects are unbearable you have the right to stop, but it is essential to discuss it with you
doctor first and make him/her aware of your decision.
It is best to taper off medication unless informed otherwise by your doctor.
You have the right to refuse medication and electro-convulsive therapy. If you consent to it, a
consent form must be signed by you first. E.C.T can only be given with your consent.
Some of your thoughts may be out of control and you may be unable to “think yourself right.”This does not mean, however, that you are weak, lazy or stupid.
Remember the feelings of extreme humiliation will pass as you realize that, because your brain
chemistry is out of synch, messages are not being conducted efficiently. Therefore SOME OF
YOUR DISTURBED THOUGHTS ARE A RESULT OF A CHEMICAL IMBALANCE. NO
MATTER HOW CONVINCING THEY MAY SOUND TO YOU THEY ARE FALSE!
You have an illness that many have suffered and survived. Each time you go through it you
will find innovative ways to overcome it.
Try not to be angry with yourself but ACCEPT THE DEPRESSION AS PAINFUL AS IT IS. It is
hell and all you want to do is get on with your life and feel good, like everyone else seems to be
doing. Getting angry and fighting the depression will make it worse. So be patient and learn to
fight it in the right way: by accepting it and going through it, trusting and knowing it will come to
It is understandable that you feel angry and resentful and maybe envious of others but is notalright to take it out on others by making their lives miserable too. This will only serve toincrease any rifts there may already be and make others unwilling to help. Try to co-operate nomatter how hopeless things seem. Try not to blame others. It doesn’t help.
God intends us to depend on others in a healthy way. At the moment you may be feeling overdependant and that is alright for now. You are sick at this time now but it will not always be likethis. Depression is treatable and you will get better.
Accept help and comfort from others if they offer it. Remember that you are not weak, lazy orstupid. The very person who comforts you may well have been through it, or may go through itat some later point in her life. Nobody is immune.
There is so much more to you, so many more facets. This is just one of them that is takingprecedence at the moment, but will not last forever.
You will conquer the darkness and despair. Believe this, even though it feels impossible.
Sometimes you have to live through other people’s belief and faith. I know I had to.
All we can do is endure, do the best we can and survive this illness.
Do not expect miracles from therapists. They are there to facilitate self-awareness and healing. Ioften used to feel frustrated and angry with them, I wanted answers from them. At least I wantedthem to tell me what to do.
There were many times that I felt therapy was a huge waste of time and money. Sometimes it is.
When you are about to jump over a cliff, it is hardly going to help analyzing what went wrongbeforehand. Sometimes when you are experiencing overwhelming feelings of pain, anger,hopelessness and confusion, the therapist seems to be just sitting opposite you, staring at you inyour dark void complacently.
This is when emergency steps need to be taken and a good psychiatrist should be there for crisismanagement.
At times a therapist can be a great help in putting things into perspective by giving you an objectivepoint of view. Sometimes allowing you to talk enables you to come to terms with your pain. Thereis no doubt that therapists have a very significant role to play in your healing and can be of greatassistance and comfort.
The problem arises when patients have preconceived notions that two or three sessions will do thetrick. Therapy is often a long-term commitment and one cannot expect to solve a complicated lifehistory in two or three sessions. It is also a large financial commitment to your mental health andshould be seen as such. Sadly many people cannot afford long term therapy but there are otheralternatives Lifeline
Psychiatric institutions sometimes offer free therapy.
Support groups Contact SADAG (South African Depression and Anxiety Group)
Social workers and community mental health teams
National department of health
Therapists have different approaches. You may be surprised at their observations, get angry withthem and perhaps just not agree. Remember that they do not have all the answers and are in theprocess of learning about themselves as well. Be willing to change, no matter how difficult, and bewilling to hear them out even if you think they may be wrong.
If you have given the therapist a chance and feel they have not got a full grasp of your predicamentyou should not feel guilty about looking around for another professional that may be moreexperienced in the field of your particular distress.
This is a difficult subject. What may help one person may be poison to another. Like therapy, it is aprocess of trial and error.
I have been on numerous different medications over the years. I am now on Cipralex which hasbeen working extremely well for 2 years. Prior to this I was on Prozac for about 5 years. It seemedto help me a great deal on a dose of one a day. When I was on 3 a day, I had a really unpleasantside effect that I called “Brain in a bottle”. It was a disconcerting sensation in my head thatunnerved me and made me doubt my ability to think properly.
Some of the anti-depressants have side effects and everyone reacts differently. Many people feel
in a dilemma about taking them, but I feel that they can be a great help provided they are taken
correctly and the right one is found. Sometimes people feel that the side effects are worse than
the depression and opt to go off them. There are no easy answers. One thing is for certain: YOU
take responsibility for your medication. Take the prescribed dose regularly to start with and should
you decide to come off the prescription, speak to your doctor first.
While medication may be a great help, unfortunately it is not a miracle cure. The greatest comfortfor me was knowing that there was help available. My psychiatrist explained that it was not my faultthat I felt the way I did. It was a result of my brain chemistry. This was a relief and helped me tostop blaming myself.
It is important to remember that the psychiatrist has a difficult job and of course they can be wrongat times. Their job is to try and get you right with medication alone. Occasionally this might helpbut usually it takes much more than medication.
The danger is that we can feel at the mercy of the “chemical imbalance” and stop trying to fight our
way out ourselves. The trick is to fight the right way. See notes about Responsibility and Help
7. ELECTROCONVULSIVE THERAPY: (E.C.T)
It is important to remember that there is no instant cure. I had a number of E.C.T treatments, someof which helped. For a period of 1½ weeks after the treatment I became quite elated and thenstarted to normalize. I still felt very scared and uncertain but not quite the same despair that I hadfelt before treatment. However I did not always feel any different after the course. One does have amemory loss but that did not bother me much. It is not a serious memory loss and I stillremembered the most important details.
It is important that you realize that E.C.T does not benefit everyone and that there is nothing wrongwith you if you do not respond to it. In my experience I would say that I had mostly positivebenefits. The side effects were memory loss, a headache afterwards and a bad effect on myeyesight. I am shortsighted but was more so after treatment. I had the therapy because I was in aplace where my illness was life threatening and I was willing to try anything. The side effectsseemed of little consequence to me.
I was given a general anaesthetic, muscle relaxants and oxygen, and then a brief electricalstimulation to the scalp. The treatment only lasts a few minutes and I came around soonafterwards. (Nothing like the old fashioned treatment depicted in the movie One Flew over theCuckoo’s Nest).
My psychiatrist was with me in the room as well as the anesthetist and a trained sister. It wascomforting to have someone holding my hand, as the experience can be anxiety provoking. Theonly minimal pain I experienced was in the administration of injections, which was brief.
It is important that you ask your doctor any questions you might have about the procedure. He/sheis there to help and reassure you.
NB: A consent form must be signed by you after the treatment has been fully explained.
Depression can occur in episodes over a period of years not necessarily through any fault of yourown. You can experience great extremes of emotion and long for the day when you are able tofunction on an even keel. You dread the terrible lows and the fear may stop you fulfilling yourdreams, doing anything new or taking on any responsibilities. It can become debilitating andfrustrating and you feel as if you will never reach your full potential.
I remember the devastating anger and disappointment I felt when, after surviving my first episode, Istarted to experience a second depression. After the first experience I vowed that I never wantedto go through it again and if I did I would end my life. I tried unsuccessfully.
I continued to battle with bouts of depression over a 10 year period and was in and out of hospital.
This time I no longer battled as much with depression as with Obsessive Compulsive Disorder(OCD) which seemed to control my mind and had a frightening life of its own. I became trapped bymy obsessional thoughts and annoyed myself with my checking rituals. Self-condemning voiceswere strong and debilitating and I had zero confidence in myself.
I would say that my slow healing was a result of a number of things. Most important are myhusband, family and my faith. I no longer fear the depression or O.C.D like I used to and it nolonger has a hold on me. I can quite honestly say that I have not suffered from severe depressionfor over 6 years. This is not to say that I do not have bad days like everyone else but I certainlynever consider suicide. I mostly enjoy life and if I do have a bad day I try not to dwell on it orcondemn myself for mistakes. I try to forgive myself quickly and move on. I have also realized thatmy attitude affects the outcome of events.
However, it takes a long time to break old thought patterns and it is something that you will befaced with every day. Throughout your life you will be challenged to re-evaluate fixed mindsets.
I also realized that even though it was difficult for me I could chose to listen to the positive
voices instead of the negative. Some people have to work harder at being positive and believing
It is wonderfully liberating when you are able to challenge the misconceptions about yourself and
break free from the “victim” role. The worst thing about mental illness is that you do not have the
strength to fight against the false truths that you tell yourself, the lies that develop into paranoia,
neurosis, a crippling of the spirit and a longing for death.
For a long time I felt guilt which only served to worsen my situation. The guilt was overwhelming. Ifelt guilty about my illness and blamed myself for being weak. I felt guilty mostly about the peoplewho loved me and only wanted me to get better and be happy. My partner had endured so muchand stuck by me through the worst. He had tried hard to help me and was feeling frustrated andangry at times. I felt that I had let him and my family down. Guilt can be terribly debilitating anddestructive and there is no easy answer as to how to work through it and let it go.
In some instances, it is a very necessary emotion. It brings us to repentance and a sincere wish torestore that which is broken. However when it is examined out of perspective, serving only todestroy us, it becomes negative.
Clinical depression is regarded as a physiological illness by the medical profession. Being in a
depressed state is an awful place to be but you are not completely at the mercy of the chemical
imbalance. There are still things you CAN do.
When it comes to guilt remember that at the moment, while you are depressed, you are unable tosee things in perspective. Even small things seem to be disproportionately huge and your mind candistort issues and feelings. As you recover though, the disproportionate thoughts and feelings willdiminish to their correct perspective.
Keep in mind that the people who love you chose to believe in you and support you. As I got betterI was able to give back to those who had helped me most. Don’t fret about it when you are notfeeling well. It might help, however, if you can tell your loved ones how you feel and ask them toforgive you for any perceived wrongs.
Many people who suffer from depression are perfectionists or have a certain belief about howthings should be. They also have high expectations of others and themselves. When life andpeople fail to measure up they succumb to feelings of despair. This makes them feel like victims.
While I think setting high standards is a good thing, perfectionism is another ball game.
Perfectionism can be stifling, restrictive and uncreative. Coping with life often means being able toaccept the downs, mistakes and disappointments as soon as you can and then moving forward.
There are times when you can become overwhelmed by emotions and that is normal. But trying tocontrol everybody and everything only leads to frustration. I believe in doing things to the best ofyour ability. You should not feel you have to conform to some “ideal” imposed by society or religionthat really is not attainable.
I discovered that pride can be the biggest handicap in one’s healing. It stops us from trying orthinking anything new in case we make a fool of ourselves. It keeps telling us how weak and stupidwe are and that we should have the strength to overcome depression without the help of others. Itmakes us feel pathetic, humiliated and fearful of sharing our true feelings with someone we trust. Ittells us that we should always be self-sufficient and never dependent on others, always try to proveourselves and never to be needy or vulnerable.
I found it incredibly liberating when I stopped caring so much about what other people thought ofme. I stopped being afraid of making a fool of myself. This is not to say that we can just say and doas we please. Rather it’s about being true to ourselves. This may mean accepting that our frailtiesare as much a part of ourselves as our strengths. I believe in always respecting others but not inalways trying to please others at the expense of my own sanity.
Perhaps being true to ourselves also means challenging our fears and preconceived beliefs andovercoming negative thoughts so that we are free to fulfill God’s will for us. It also could meanacknowledging our faults, trying our best to overcome them but accepting that we can never beperfect.
Pride gets in the way of our growth and, like perfectionism, can be very destructive. I have begun
to challenge my fixed ideas of what constitutes weakness. Many of my previous beliefs seem to be
turned upside down. Think about how much your pride hinders your growth. Keep in mind that
the “embarrassing and senseless” thoughts are common to many people with mental illness even if
you feel all alone in experiencing them. Our pride keeps us trapped in an unbearable humiliation as
we imagine people laughing, jeering and discussing our “idiotic neurosis” and “pathetically weird
The road to recovery can be very bumpy at times. I remember having feelings of extreme anxietyand doubt about my happiness. Terrified that it would not last, I felt that I had to hold onto itdesperately. I had ridiculous thoughts and felt stupid and inferior to others. But I remembered thatmany of the most influential and creative people in history were plagued with neuroses of variouskinds. It’s almost as if this was the sacrifice that they had to pay for their genius. Perhaps it’s partof the package of having an overactive imagination.
The unconscious cannot be kept in neatly labeled boxes. It is unpredictable, all encompassing andmysterious. So I began to accept the other side of the coin. Instead of feeling fear and rejection ofmy depression, I tried to accept it. This acceptance did not happen overnight. I fought it for a longtime. Strangely enough when I began to befriend it, as unwelcome as it was, I began to fear it lessand less. It began to have less power in my life.
Part of me did not want to let go of the depression because I had associated it with my creativity. Ibegan to realize that I could be creative without having to be miserable. I began to associate joywith my creativity. However I did not trust my happiness and feared that if I did anything wrong, itwould desert me. This of course did strangle my peace of mind.
Slowly, I came to realize that happiness is an elusive thing and binding it, or trying to hold onto it,only serves to destroy it. I stopped paying so much attention to my moods and thoughts and justbusied myself by doing things, no matter how trivial. I stopped paying so much attention to “beinghappy” and tried to just BE and accept where I was.
Now accepting the depression as a part of my life, I’ve just learnt to go with it. This does not meanthat I indulge in it for weeks. Rather, I allow myself to feel down for a few days when it comes andjust try to keep busy until it passes. I no longer get trapped in the downward spiral of fear that thesuicidal depression will come back for good. Now I simply trust that I will come through it.
Sometimes it is important to give yourself some tough love and be firm. Tell yourself suicide is notan option, that you must stop indulging in depression for weeks on end and find ways to overcomeit.
Here is a poem by William Blake that expresses, so well, what happens when we try and hold ontohappiness.
He who binds to himself a joyDoes the winged life destroy;But he who kisses the joy as it fliesLives in eternity’s sun rise 13. THE IMPARTIAL OBSERVER:
Through reading a book called BRAINLOCK by J.Schwartz I discovered a very helpful technique. I
interpreted it in my own way. Whenever I start condemning myself for something, I imagine I am
telling another person about it. That person is myself: a just, reasonable, loving and positive part of
myself. I ask this person for her opinion. This helps me to access this side of myself that is never
allowed to speak when I get into a depressed, anxious or obsessional state. I ask this side of
myself if I am being too hard on myself. The answer usually is “Yes”.
14. SPIRITUAL GROWTH: From a Christian point of view.
So many of us get stuck in the Old Testament view of God as being punishing, jealous and testing.
Reading the Old Testament really challenges my faith and some of God’s dealings with peopleseem unfair, bizarre, unreasonable and even cruel. We can get so stuck trying to make sense ofthe Old Testament’s version of God that we forget the wonderful news of the New Testament aboutGod’s new covenant.
God in Jesus reveals Himself as a God of infinite compassion who loves His people and wants
them healed. A revelation that transformed my understanding of God is this: if God is within each
of us, it makes sense that GOD SUFFERS WITH US.
Understanding this puts a new perspective on our understanding of God. No longer is He a Godwatching us from a distance, judging and punishing us. But He is a God who goes through all ourtrials with us. Remember this and let it etch itself into your heart. It will make your cross easier tobear. Remember Christ has gone before you with His cross and goes with you now.
God is not punishing you. It is not God’s intention that you suffer, even though it feels that way.
God may be preparing you for something. Try not to have regrets about things you have donewrong in this life or opportunities you think you may have lost. Try not to have regrets over thedays you are missing while sick. This life is very significant but I think it’s only a small part of thewhole. The world does not understand the importance or depth of your suffering because the worldis equipped only for the temporary and short-lived. I think that suffering, in some mysterious way,transforms us and prepares us for eternity.
Right now you may be suffering self-hatred, loathing and despair. You may feel the desire to
flagellate yourself. You may even feel the desire to make yourself bleed to know you are alive, to
give yourself more pain than you can bear and to finally terminate existence. It is alright to feel
these things. But to continue this way is to sin against yourself and God. Try to cherish yourself as
God does. You are precious to God. Ask for God’s forgiveness and for the gift of grace to show
mercy to yourself and to others who have sinned against you.
Remember Christ’s words “My grace is sufficient for you, for my strength is made perfect in
weakness” 2 Corinthians 12:9
If you feel that others have lost hope in your recovery (as I felt at times) remember you cannot
begin to comprehend God’s tremendous powers of healing and restoration. Also remember that
we can beg God on bended knee for relief. It will be given but NOT always immediately.
Sometimes the illness has a course to run, and we have to be patient and endure, much like
someone would endure a physical illness or a handicap. God can and will heal us, but in my case
the full course had to be run. I still have to work on negative thoughts on a daily basis. And
sometimes I still have to challenge dysfunctional thought patterns and attitudes that threaten to
It helps me to remember that Jesus went through a time when he felt God was not with him: “My God, My God, why have you forsaken me?” Matthew 27:46.
The cry of desolation from Jesus reflects a real feeling of being abandoned by his father. At thismoment of utter and profound despair he felt all alone with no comfort. I know I often felt so alonetoo. I also know that I’ve felt separate and fragmented, desperately needed people but not beenable to be around anyone. I’ve been unable to receive comfort from others, unable to feel love foranyone or myself, unable to comfort or show mercy to myself. I’ve felt numb and tormented in myfrightful cell.
When you walk through the valley of darkness you cannot see how far you have come or whereyou are going. It feels like you are walking in circles, or that you are playing some horrible boardgame and keep having to go back to the start. That is what the darkness of depression is like. Yoursoul may be in a place of darkness, but your spirit still lives even if it is small, scared orsuppressed.
The light will be waiting for you. So try hard to access the gentle, accepting voice within yourself.
For me it was hard because the condemning voice was so powerful and overwhelming. The loving
and forgiving voice is your strength not weakness. Do not be fooled by the so-called
successes of others. What this world regards as “success” is not the same as God’s victory. You
are fighting an eternal battle within.
Remember: the fire that does not destroy will purify.
(A helpful book to understand the purpose of suffering is Where is God when it hurts? by Philip
BOOKS ON DEPRESSION from the Msunduzi Municipal Library
1. How to heal depression, Bloomfield, H.H
2. You can feel good again: good news about depression, Carlson, F
3. Dealing with depression naturally, Samuel, S
4. Look for rainbows : for the sad, the lonely, the depressed and the despairing, Gibson,
5. Open the window : healing ideas for the lonely and depressed, Gibson, J
6. Why am I up, why am I down? Understanding bipolar disorder, Granet, R
7. The private life of the brain, Greenfields, S
8. Beating the blues: self help for depression, McConville, B
9. Coping with depression and elation, McKeon, P
10. Happiness is a choice: a manual of the symptoms, causes and cures of depression,
11. Depression, Mitchell,R
12. Depression matters, Musikanth, S
13. Breaking the bonds: Understanding depression, finding freedom, Rowe, D
14. Beating depression, Rush, J
15. Depressed? Here is a way out, Smith, H
16. Overcoming depression, Stanway, A
17. A mood apart: a thinkers guide to emotion and its disorders, Whybrow, P.C
18. The wisdom of depression: a guide to understanding and curing depression using natural
Other books - Msunduzi Municipal Library
1. Mind power, Kehoe, J
2. Life’s not fair but God is good, Schuller, R
3. Living through the Meantime: learning to break the patterns of the past and begin the healing
4. Finding your own North Star: How to claim the life you were meant to live, Beck, M
5. How to know God: The soul’s journey into the mystery of mysteries, Chopra, D
6. Soul Stories, Zukav, G
7. Seat of the soul, Zukav, G
8. How to succeed at being yourself: Finding the confidence to fulfil your destiny, Meyer, J
9. Chicken soup for the soul: 101 stories to open the heart and rekindle the spirit, Canfield, J
10.Nothing is impossible with God, Kulhman, K
11. Applications for living, Walsch, N.D
12. Lord I need a miracle, Hinn, B
13. Coversations with God, Walsch, N.D
List of books I have read: - Recommended reading with *
1. *Terror by night : Hope shining in dark places, David Walker
2. *A brilliant madness – living with Manic Depressive Illness, Patty Duke and Gloria Hochman
3. Released from bondage- true stories, Dr Neil Anderson
4. Living without depression and manic depression - A work book for maintaining mood
5. Breaking the bonds – understanding depression, finding freedom, Dorothy Rowe
6. Lost and found, Mike Lipkin
7. Depression : Lifting the cloud, Dr Christine Read
8. *Where is God when it hurts?, Philip Yancey
9. *Darkness visible, William STYRON
10. **Brainlock - Free yourself from Obsessive-Compulsive Behavior, Jeffrey M. Schwartz, M.D.
11. *The boy who couldn’t stop washing, The experience and treatment of Obsessive-
12. *An unquiet mind – A Memoir of moods and madness, Kay Redfield Jamison
Job and the mystery of suffering, Richard Rohr
Play the ball where the monkey drops it, Why we suffer and how we can cope. Gregory Knox Jones
Swamplands of the soul,
Struggles with sanity, by Esje Du Toit. Everyday coping skills – suicide, hospitalisation,
certification, recognize symptoms, diet, treatments & support groups.
SADAG Speaking books, Educational & instructional tools aimed at low level literacy population.
Look at SADAG website.
A Life Interrupted, Stephanie Redelinghuys (Biography of an artist who suffered from Bipolar disorder. It’s a
tribute written by her mother)
I have life – Alison’s journey as told to Marianne Thamm
“The courage which allowed her to move beyond severe physical and emotional trauma and to turn
a devastating experience into something lifeaffirming and strong, is an inspiration to people
Veronika decides to die, Paulo Coelho
Courage to change, One day at a time in Al Anon Al Anon Family group headquarters. Inc. New
The road less traveled,
Seven things that steal your joy, Joyce Meyer
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