Our guests take a compassionate and knowledgeable approach to the topic of mental illness, discussing its medical, psychological and spiritual aspects as well as the challenges it poses for families. (Part 1 of 2)
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LaDonna Gatlin: Just imagine that you are asleep in the middle of the night and you just all of a sudden wake up out of a deep sleep because you hear a noise and you immediately sit up in bed and you think, "Oh, my goodness; there's a burglar in the house," just gripped with fear. Well, that is the way I felt all the time.
End of Teaser
John: Hm. Now that is a vivid description of one woman's experience with deep depression and anxiety. And you'll hear more of her story in a moment as we talk about various forms of mental illness and we learn how we can respond appropriate to some very difficult emotional issues. This is "Focus on the Family" with Focus president and author, Jim Daly. I'm John Fuller and Jim, this is a huge, huge problem affecting so many these days.
Jim: John, it is and I'm really thankful that we're addressing the issue today with experts, because in the Christian community particularly, mental illness can be misunderstood. It can be misdiagnosed. We don't know what to do with it. We want to apply our biblical understanding to things that are quite complicated. And today we want to talk about what that woman was talking about and that is, her fear, her anxiety and really how she found hope. I think it's also important to say that Focus on the Family and Lifeway research have partnered together to complete a study on mental illness and the church, which is actually releasing today and you can find out more on our web site.
John: Yeah, that study and it's very interesting insights will be at www.focusonthefamily.com/radio . And we have three gentlemen who have joined us. Our guests include Dr. Jared Pingleton. He's director of Focus on the Family's counseling department here and has 36 years of clinical experience as a psychologist and a pastor. Dr. Ricardo Whyte is a psychiatrist and is the director of Chemical Dependency Services at Loma Linda Behavioral Medicine Center at Loma Linda University and serves on our Physicians Resource Council, as does Dr. Don Graber, who just recently retired after more than 35 years as a psychiatrist in private practice or as a staff psychiatrist or as the medical director of a psychiatric hospital. So, these gentlemen have the goods, Jim.
Jim: Well, let me first say, welcome to all three of you. Thanks for bein' with us.
Panel: Thank you … thank you for having us.
Jim: Let's talk about some of the statistics right out of the gate here and have you respond to it. It seems that here in the U.S. at least—I know we air in Canada and other countries—but here in the U.S. it seems like so many people are experiencing anxiety and depression.
Let me give you some of the statistics: 1 in 4 adults is diagnosable for one or more of these disorders, just over 20 percent of children. That breaks my heart, 20 percent of children 13 to 18, either currently or at some point during their life--
Jim: --have had a seriously debilitating mental disorder. What is happening in the culture? Is it unique to a Western environment? Or is this normal to see this level of mental disorder within a society?
Ricardo: So first and foremost, I think there are definitely some factors in our culture that's contributing to depression. When you consider depression, of course, there are a number of etiologies and I think it's important to clarify right from the forefront, that to make the diagnosis of depression, first you're gonna rule out medical causes.
Jim: As a first step.
Ricardo: As a first step. And so, now once you've done that, now you're going to see if, by a certain criteria, if the person actually fits the criteria for let's say, depression. But from a societal standpoint, things like financial issues, that's gonna contribute to increasing a person's risk for depression. Things like feeling hopeless and as you consider the economic downturn and as you consider a number of the factors that are going on in society, I do believe it's contributing to us seeing more and more depression.
Jim: So, that environmental situation will definitely contribute. It's not necessarily biochemistry, although it can be that, right, Dr. Graber?
Don: Yeah, question you asked was whether it was unique to our culture and I think uh … I agree with Ricardo, that there are things that contribute to it in our culture. However, if you look at major psychiatric illnesses across various cultures and nations, the incidence tends to be fairly similar. So, the illnesses that we're talkin' about, if we're talkin' about serious mental illness, they're universal. They're in all countries and you know, whether we're talking ADHD or schizophrenia, uh … you're gonna find it everywhere.
Jim: Hm … let me introduce another audio clip, because I think it helps us to understand, as lay people uh … what we're talking about here. Um … this particular woman, we heard a bit of her story just a moment ago, uh … LaDonna Gatlin, she's the sister of the Gatlin brothers, I mean, a very successful band. Um … she's now a motivational speaker and has suffered with severe depression over the years and anxiety. Let's play a little more of her story right from her.
LaDonna Gatlin: Totally out of control and totally fearful, I mean, the word "fear" with a capital F. Everything just made me nervous. And now all of a sudden, what I had just always looked forward to and saw as my ministry and my career and my opportunity to stand in front of people and make a positive impact, hopefully, make a positive impact on their life and how to live a better life, more productive life and I begin to, you know, just go down into a shell. I didn't want to see anybody, just wanted to stay in the house. I was fearful of everything. Just imagine that you are asleep in the middle of the night and you just all of a sudden wake up out of, just a deep sleep, because you … you hear a noise and you immediately sit up in bed and you think, oh, my goodness; there's a burglar in the house, and just gripped with fear.
Well, that is the way I felt all the time. I can point back to now in hindsight is, that I think the hormone imbalance and the menopause triggered this. I will say, I have a family genetic predisposition to this. My mother is bipolar. Two of my three brothers are recovering alcoholics and drug addicts. And I have one brother to this day who still deals with mental illness and depression and sees a psychiatrist, as do I regularly and get, you know, the treatment that I need.
On November the 19th of 2008, I sat in my living room on a beautiful fall day and I took 31 Ambien and every prescription drug that I had from my psychiatrist and just thought, I want to go to sleep and I just want to end it all.
You know, after the 2008 drug overdose, I spent some time in the psychiatric unit. I walked into a psychiatric unit that next day. Over and over they asked me two questions. No. 1, "Why are you here?" And I had to answer, attempted suicide. And the second question was always, "And what do you do for a living?" And of course, I had to answer, I'm a motivational speaker (Laughing) And I mean, it was humorous.
After they asked me so many times, I thought, oh, my goodness. Here I am trying to stand up on a stage and tell other people how to be positive and I'm the one who took the pills, because it's an illness; it's a disease. It's no different than me being a motivational speaker and standin' on the stage and havin' a heart attack the next day.
End of Clip
Jim: There is a lot in that clip. But let's take a look at it. One of the things that I observe in that clip is, how do you become aware that you actually have a problem that you need help with? I mean, she did a good job there, uh … giving us the symptoms. How does a person who may not be that in touch with some of those things, how do you know that you're in trouble?
Ricardo: And that's why I really think it's important to understand the thoroughness of getting to the diagnosis. We throw around the terms "anxiety," "depression," and we need to understand that when we're talking about clinical depression, hopefully, your medical practitioners have responsibly ruled out medical etiologies, medical causes, so that it's not hyperthyroidism or hypothyroidism or a vitamin B-12 deficiency or what have you. Those things have been ruled out, so that we know that what we're actually dealing with is depression.
And then if you've got a good mental health practitioner, a good psychiatrist, they're actually now going to really try to identify what the cause of the depression is in that particular situation, because that can be multifactorial, as well.
Jared: I think another factor is, we all have blind spots and that makes it very difficult for us sometimes to be very observant about ourselves.
Don: Men particularly are a whole lot less likely to recognize depression than women in my 20 years in practice. I think three-fourths, if not nine-tenths of the clientele were females.
Jim: Because they recognize it in their lives.
Don: They recognized it and they weren't embarrassed to come in and ask for some help.
Ricardo: What I love about that case, though, was, a lot of times we want to trivialize it and we want to say, "Hey, get a more positive attitude." This is a motivational speaker! (Laughter)
Ricardo: You know, of all the people that would have a positive attitude, so this can have a biological etiology and biological cause.
Jim: And let's talk about that integration of the natural environment around us—science and then our biblical foundation—because I know [at] Focus on the Family, we're speaking to many, many Christians. How do we integrate that?
Some Christians, they're fearful of that. We don't want to embrace the fact that science can open up to us what's happening in the natural world. I mean, I think that is fair. And then how do we integrate that with a biblical orientation?
Jared: For me, Jim, it goes back to the Garden in Genesis 3. We've been suffering from shame ever since. And I think there's such a stigma in our culture particularly for mental health dynamics, problems, issues, that we're fearful to face the shame in ourselves, that we're somehow hurting, that we're somehow deficient, that we're somehow wanting or that there's some unresolved conflict, hurt or trauma in our life. And I think when we can help Christians be able to grasp their shame, it's humanizing. And I think that's why Jesus is such a powerful example, you know. The prophet personified Jesus to be a Man of Sorrows, familiar with suffering. He was acquainted with grief. He carried our pain. He felt our hurt and Hebrews says, He was in every way as we are, yet was without sin.
Jared: Therein lies hope.
Ricardo: I back up to Genesis 1 and it's part of the reason why we cannot deny the environmental impact on these diseases. When you look at Genesis 1, what you see if God connecting humans vitally to five things, the first of which is spiritual. The next is community, then resources, a purpose and then weekly recreation—weekly rest.
Ricardo: So, these are core things that you're gonna see we need in order to have health.
Jim: We talked about depression in this case, which is the first of a few cases we're gonna talk about today and next time. But we talked about it from an environmental standpoint. I know my wife, whom I love, has been on this program. We've talked about her depression at times and the biochemical nature of her family. That can be one of the biggest contributors, right? You can come from a family that has a history of depression or anxiety. Talk about that and what family members need to do to be aware of that, especially Christians, that you don't simply brush it under the rug, Dr. Pingleton, as you said. You … you can't just ignore it. How do you come to grips with the fact that in this world, as Christians, we may have some deficiencies in our biochemical makeup?
Don: We aren't exempt as Christians in a fallen world. And I think depression not only runs in families, but it tends to be a recurrent condition, like so many medical conditions. In fact, most of the conditions we treat in medicine tend to be chronic or recurrent. Infections are one of the few things you can treat once, give them an antibiotic for a few weeks and cure it. For the most part, the other illnesses that we deal with can be pretty chronic and recurrent, so we need a high level of suspicion.
Ricardo: The operating theory right now regarding the cause of depression is, of course, serotonin deficiency. And I don't want to oversimplify it, because the other neurotransmitters are very important, as well. But we talk about a deficiency in serotonin. And so, sometimes our emphasis is on utilizing medications in order to increase the availability of the serotonin.
But I think a question we don't ask ourselves enough is, is our nutrition supporting producing the serotonin in the first place? And so, especially now if I know that a patient is at risk, shouldn't I pay attention to their nutrition, to make sure that they are getting those precursors to reduce the likelihood they might succumb to depression.
Jim: And that is something we have to do. We have to be at least self-aware enough to start that investigation with your physician to talk about these things. Let me give a different example. I remember (Chuckling) and this is a painful one for me to use, when I wrecked my Harley. (Laughter)
John: Very painful.
Jim: It's very painful.
Jim: Because it's interesting what you do when there's that physical injury. I remember sitting up very alert and awake. I'm sitting on the shoulder of the road. I've got a gash in my forearm and I looked at my feet and I know one of my feet is pointing at 5 o'clock, the other one's at noon.
Jim: So, I had a dislocated and broken left ankle. It's easy to recognize that kind of injury, to the point where if you're out there, you see it. You sit up and you take an inventory of your body to see what's hurting. Mental illness seems to be more difficult for us to recognize. We don't sit up one day and say, "Whoa, my leg is pointing the wrong direction." How do we become better, especially in the Christian community, not only to understand and accept it, but to really know that we've gotta be on the lookout for it in ourselves, in our family members? How do we get to that point where we can say, something's wrong?
Ricardo: For me, even in my patient care, it has become very helpful to look at the vital connections. Where am I spiritually? Where am I in my relationships? Where am I in my resources? Where am I in purpose? Where am I in recreation? Where am I in rest? And I think we need to really pay attention to function. You see, a condition is not really a disorder until it has a dysfunctional component.
Jim: A debilitating perhaps.
Ricardo: A debilitating uh--
Ricardo: --component. Some of that you can assess yourself, but other times, you need to respond to the feedback you're getting from others.
Jim: What would those symptoms look like? Let's say that there's somebody listening that may be right on the verge of depression or feeling anxiety. What will those things look like to the undiagnosed person?
Don: Yeah, low energy, loss of interest in things you used to enjoy, fatigue, low self-esteem.
Ricardo: Thoughts of suicide.
Jared: Loneliness, isolation, withdrawal.
Jared: Pulling into ourselves.
Ricardo: Impaired function at work, not as interested in doing the things that you enjoy.
Jim: And I would think when you're experiencing … is it any one of those? Or if you're experiencing a cluster of those should you be concerned?
Ricardo: Well, first of all, there are two that you absolutely need. One is the anhedonia. That's where you've lost interest in things you normally would enjoy. And of course, there is low mood--
Don: Depressed mood.
Ricardo: --the depressed mood. And then you need a certain number of symptoms that we listed for a certain amount of time, usually it lasting for at least two weeks for it to be a depressive mood disorder.
Jim: Let's dig into anxiety a little bit. We've touched extensively here on depression. But anxiety oftentimes we use humor to describe it, you know, the phobias. And they're very real for some people though, these fears. Those of us that don't have those fears struggle to understand why would you be afraid of a spider, really? You could crush it. But it's almost crippling fear to where a person can't operate. Describe what's happening and why a person has that fear?
Jared: I think the major reason for anxiety disorders being so more prominent in our culture--that also has a factor back to the issues of depression--is the ways in which we do not manage stress well. Stress, we know depletes many vital hormones. Physiologically it causes depressive feelings. But moreover, it does, like the lady described in the vignette, grip our hearts with fear. And this is again, I think it's intensified in our culture, but it's universal to be fearful. I think fear activates our sense of helplessness, that we are creatures. We're not in control.
John: Where does that fear, though, become a phobia? Because even just yesterday, Jim, here at Focus on the Family, up on the third floor talking to somebody and for those who have visited our campus, there's kind of a "main street" we call it and the balcony that overlooks that hallway. This person took a few steps back and--
Jim: From the balcony.
John: --yeah, she said I'm afraid of heights.
John: And I thought, well, you'd have to work to kinda go over the rail here. (Laughter) So, there are common fears, but we're talkin' about something deeper than that, right?
Ricardo: Again, it becomes an issue of function, you know. It's one thing to be a little afraid of the balcony, but you can still take that picture with your spouse. You know, you're still able to function at the end of the day. That the problem is when the fear is keeping you from actually working.
Because of my fear of poverty, I work very hard actually. So, it's actually something that I can actually use to my advantage. But a lot of times when we talk about stress, there's a good stress. There's a point …
Jim: Good in what way?
Ricardo: Well, it will focus you.
Ricardo: It will actually drive you. There's actually a sense that you're doing something good and it's actually called "you stress."
Don: And up to a certain point, anxiety helps us function at a higher level. But there's a clear point at which the anxiety goes beyond that point, we then become less functional.
Jim: Let me ask this question with the few minutes we have remaining today and let's come back next time and we'll pick up on the topic. But with the wars that we've had in Iraq and Afghanistan, here in Colorado Springs, John, we have Fort Carson and other military institutions. And soldiers are really struggling with PTSD. Talk about that. I believe it's in the anxiety category. Talk about what that truly is, the fact that it's not just those that go to war that can suffer from this. It's a trauma when you see something horrific occur. But what's happening in the mind when a man or a woman experiences PTSD?
Ricardo: With post-traumatic stress disorder, a person has been brought to a point of being so overwhelmed, they're fearing for their life. They may have had a loss of limb. This is just the most unimaginable thing has happened to this person.
And in a certain percentage of people, they go on to have a syndrome of re-experiencing that trauma or needing to avoid that trauma or having nightmares and flashbacks. So, it's not just war-related. It's any trauma where a person feels just overwhelming fear and loss.
Ricardo: And that's an important point in that, sometimes with the military personnel I take care of, one of the things I notice is, after you've had that trauma, after you've come back to work, an important part of recovering would be kind of avoiding that particular trauma.
But what you find is, they actually want to go back into contract work, where you're doing that work or becoming a police officer or a first responder. And what that does is, it re-exposes you to that line of trauma. So, what you love ends up in some ways kinda retraumatizing you.
Jared: One of the things that's crucial in treatment of post-traumatic stress disorder is, giving the victim that has experienced that trauma, a safe opportunity to re-experience the trauma without the negative--
Jared: --consequences. Because what happens even biochemically, is the adrenal gland is stimulated, such that the victim is prepared to either take fight or take flight.
Jared: And so, there's this intense biophysiological reaction that occurs within us. And it doesn't just only occur in battlefield situations. I had the privilege of being involved in the first Vietnam combat veteran treatment unit in America on my post-doc residency in dealing with PTSD, back in the early '80s. And what we found from those men is the same thing we find from rape victims, victims of physical violence, automobile or motorcycle accidents, to where those "re-experiencings" make us feel that helplessness, that feeling of being out of control. And that's where counseling and psychotherapy can really help the person understand the trauma in a different way.
Jim: I want to address something that I think is very important here, because mental disorders can be so misunderstood in our culture. There's a myth that personality weakness or character flaws cause the mental health problems. People, in other words with mental health problems can somehow out of it if they just tried hard enough, you know, if they just picked themselves up by their boot straps, they'd be able to overcome it. That's not the case. We don't understand depression and these other things to the degree that it's that simple. It's very complex and uh … those people that don't struggle with these issues, I think, find it hard to understand the hurdles and the obstacles. And just saying, "Pray harder," isn't enough and we've gotta be careful as Christians not to make that journey more difficult.
Jared: The thing that to me, is so encouraging about this issue, Jim is, God never white washes or God never, you know, makes a case for having to be perfect. Scripture is filled with examples of people who struggle with major mental illness. And to me, the encouraging thing where there is help and hope and healing in Scripture is, that God is not impressed or intimidated by our pathology or our problems. There are many, many examples throughout the Scripture, where people struggled with suicidality. For example, Elijah and Jonah, they were both acutely suicidal and God helped them--
Jared: --at their point of need. Many people in Scripture struggle with severe mood swings, you know, like David, Moses, where they're struggling with intense emotional conflict. And yet, God never in any way puts them down, criticizes them or makes a negative judgment about them. The message of hope in the Scripture is compassion and healing.
Don: An important point to make about suicidality is, that there's recent evidence that bipolar patients that are on lithium carbonate for instance, are at about 20 to 28 times less likely to commit suicide. Suicidality can really go away with an appropriate medication given to many patients.
One of my four favorite words I think are, "This too will pass." I always tell depressed patients, whether they're bipolar, major clinical depression, whatever. I always tell them this will pass. This won't last forever. But we can and should do everything we can to alleviate it as soon as we can.
Jim: And it's possible that you, someone listening right now is living with that. And if you are, I want you to know, we're here to help you here at Focus on the Family. Jared, that's what you do. You head up the counseling department right here at FOF. And we would want to encourage you to contact us to get that initial step of help that we can provide. And don't be ashamed. If you're in that dark place, and you know it, call us. Let us stand with you. Let us work together with you to get you to a better place. I think the Lord would smile if you can take that first step, and there's no shame in it. Make the call. Get in touch with us. Let our counseling team talk with you. And I know all of us believe that that is a good step, if you're living in that place.
Let me just say here in offering kudos to the counseling team, I am so encouraged at how God is changing literally tens of thousands of lives and giving people hope, many for the first time, as they contact us with all kinds of family issues. Of course, we're praying with them, and if they need additional help, we're able to refer them to over 3,000-3,500 counselors throughout the country that are on our database. When you give to Focus on the Family, you are literally throwing a lifeline out to help families stay together to mend that brokenness. So, I invite you to call us today and make a monthly gift to support the work at Focus on the Family
Now as we close today, I want to emphasize how critical the health of the family is. The family should be a safe place where people can be themselves, not have that anxiety that they're not measuring up, but having feelings of depression or whatever it might be can certainly block that feeling of acceptance. Gentlemen, let's come back next time and talk more about mood disorders and hear a couple of more testimonies from people who have struggled through this, and I believe we'll give hope to those who are hurting. Dr. Pingleton, Dr. Graber, Dr. Whyte, thanks for being with us. Let's come back and continue the discussion.
Panel: Thank you, thank you for having us
John: What an important topic and next time we'll talk about mood disorders and we'll hear a couple more recorded stories from folks who have persevered through their diagnosis. And at our website, you'll see a lot of follow-up resources. We have links, articles and some additional helps for you. Please spend some time at www.focusonthefamily.com/radio to get the help you need. I think it'll be worth your while.
And as Jim said, call us at 800, the letter A and the word FAMILY, 800-232-6459. Our program was provided by Focus on the Family and made possible by generous listeners like you. On behalf of Jim Daly and the entire team, thanks for listening. I'm John Fuller, inviting you back next time as we continue talking with our panel about mental illness and offer more trusted advice to help you and your family thrive.
Jared PingletonView Bio
Don GraberView Bio
Dr. Don Graber retired in 2013 following a professional career that spanned more than 35 years. He worked as a psychiatrist in private practice, as a staff psychiatrist and as the medical director of a psychiatric hospital. Dr. Graber continues to serve in his field as a member of Focus on the Family's Physicians Resource Council.
Ricardo WhyteView Bio
Dr. Ricardo Whyte is the Director of Chemical Dependency Services at Loma Linda Behavioral Medicine Center of Loma Linda University. He also serves as the Medical Director of the Outpatient Psychiatry Service of the Loma Linda University Psychiatry Department at the Behavioral Health Institute, and on Focus on the Family's Physicians Resource Council. Dr. Whyte and his wife, Florence, have one child, a daughter named Alexi.