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Reframe Your Goals

One of the biggest demotivators when we suffer from mental illness, particularly in depression and schizophrenia, is the loss of enjoyment and pleasure, also known as anhedonia. This leads to not wanting to engage in previously enjoyed activities.

This in turn leads to many other emotions such as boredom, loneliness, guilt and grief. Of course, these emotions also negatively impact your thoughts and physical symptoms.

When you don’t enjoy an activity, you stop doing it. When you stop doing things, you aren’t engaging in anything that will bring enjoyment. Bit of a catch-22, isn’t it?

It is really difficult to engage in an activity if you don’t receive any enjoyment from it. Unfortunately, though, when you suffer from mental illness, it can mean you don’t enjoy very many things at all! And when you don’t enjoy life, you feel there is no point to living.

Think about this short list of things that you may have enjoyed previously, but when depressed, find little or no enjoyment:

 

Activity: Eating

When you are well: Good appetite, enjoy your food, eating with others

When you are unwell: No appetite, everything tastes like cardboard, isolative

 

Activity: Church

When you are well: Enjoy worship, want to fellowship with other believers

When you are unwell: Perhaps feeling rejected by God, lack of emotion toward God, angry at God, isolative

 

Activity: Sport

When you are well: Energy to play and meet with others

When you are unwell: Lack of energy and motivation, isolative

 

Activity: General socialising

When you are well: Want connection with others, enjoy activities together

When you are unwell: Lack of energy and motivation, isolative

 

You know that you should be engaging in activities, but you feel that there is no point because you won’t enjoy it anyway. What can you do about it?

One suggestion that may work is to ‘reframe your goals’.

When you have anhedonia (loss of pleasure/enjoyment), having enjoyment as the end goal of an activity isn’t a good idea. You are setting yourself up for failure because it is likely you won’t enjoy it, or at least not very much.  This will just demotivate you to attempt other activities.

But when you ‘reframe’ or change the goal from enjoyment to something else, you have a much higher chance of engagement. Let’s explore this a little:

 

Activity: Eating

Usual goal: Satisfy hunger and enjoy food

Unsuccessful outcome: Not eating as not hungry and lacking taste

Reframed goal: To give your brain nutrition

Successful outcome: Eating small amounts of nutritious food to feed your brain

 

Activity: Church

Usual goal: To enjoy worship and connect with others

Unsuccessful outcome: Won’t go to church because won’t enjoy worship or connecting with others

Reframed goal: Worship God because He is worthy, irrespective of how I feel; I need connection (in spite of not wanting it)

Successful outcome: You attend church

 

Activity: Sport

Usual goal: To enjoy the sport and connection

Unsuccessful outcome: Won’t play sport because won’t enjoy it

Reframed goal: To increase my endorphins and have connection

Successful outcome: Play sport and have connection

 

Activity: Socialising

Usual goal: To enjoy it

Unsuccessful outcome: Won’t go because loss of pleasure

Reframed goal: Because I need connection

Successful outcome: Meet with friends/family

 

 

It is really important to understand that when you can engage in activities, as much as it is a huge effort to do so, a vast majority of the time you feel brighter afterwards (even if thoroughly exhausted).

The result of ‘doing’ has such a positive impact on your thoughts, emotions and physical reactions too. Let’s use the example of going out for coffee with a friend:

 

Thoughts – you have positive thoughts from the conversation; something else to think about; and it lessens your thoughts about loneliness

 

Emotions – you feel less lonely and more contented; you feel more motivated to do it again; you feel less guilt because you have been meaning to catch up with that friend for ages

 

Physical reactions – you have neurotransmitter boosts; you may sleep better due to feeling more contented; often your appetite increases a little too.

 

As you can see from the above example, there are so many positive outcomes to be gained from doing an activity – it’s not just about enjoyment.  Give ‘reframing your goals’ a try.  It may surprise you how it helps to motivate you to engage in some much needed activities.

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Asking For Help

Have you ever had family, friends or even acquaintances offer to help when you are unwell? Somehow, though, you struggle to come up with ideas, even though you know all too well that you could do with some help.

 

There can be many reasons why we don’t ask for help from others. Perhaps this list of reasons has been your experience:

 

  1. You don’t want to be a burden
  2. You just want to be left alone
  3. You feel guilty for needing help
  4. You are embarrassed
  5. You can’t think of ways others can help

 

Let’s briefly address these reasons:

 

  1. No one wants to be a burden – it can even seem a noble thought to have. However, you must remember that mental illness is doing all the ‘talking’ here.  Put the shoe on the other foot – if your family member/friend were unwell, you would be desperately wanting to help, just to be able to bring some relief to your loved one. In my experience, the family member/friend feels more burdened by not being able to do anything than by actually helping.

 

  1. Once again, mental illness takes a hold of your thoughts and makes you want to isolate. It is wise to remember that illness and isolation are inseparable –  isolation means illness, illness means isolation. We need to allow others to help us, even if only in small ways, to help break the chains of isolation.

 

  1. Guilt is an emotion that comes to the fore a lot with mental illness. You can have guilt over lots of things from not being able to earn an income to not spending time with family. But the negative cycle of guilt only makes you feel worse. There is no need to feel guilt from others helping you. Remember, they want to help, and it allows them to feel useful, even in some small way.

 

  1. When you let embarrassment rule the situation, you are denying yourself the opportunity to feel loved and supported. And once again, you also deny others the opportunity to reach out to you.

 

  1. Even if you want others to help you, the brain fog and lack of energy and motivation make it difficult to come up with ideas. Often you are just too tired to even think. Once again, these symptoms of mental illness are the very things stopping you from asking for and accepting help.

 

Whether you can relate to one or all of these reasons, it doesn’t negate your responsibility as a part of your recovery to accept or even ask for help.

 

Some of the simplest things can be so impacting. Perhaps you could write a list (or ask someone to help you write a list!) of practical things that others can do when you are unwell. Here are some suggestions:

 

  • Prepare a nutritious meal – not onerous as they are already cooking
  • Give you a lift (e.g. to appointments or church)
  • Pick up some groceries for you (remember you need to feed your brain for recovery, so suggest simple yet nutritious items like almonds, walnuts, fruit/veggies – these don’t need any preparation!)
  • Pop in for short visits – when you are unwell you probably wouldn’t want a lengthy visit, but you still need interaction from others. Educate your family and friends that just a quick visit is fine.

 

These suggestions aren’t necessarily time consuming or difficult to do, yet they can positively impact your recovery, whilst at the same time benefiting the other person. Asking someone to help you in a way that uses their strengths and interests will be energising to the other person also.

 

It is important to remember that God expects His children to help others, so don’t deny others the opportunity to be obedient to His word. I will leave you with some verses from that perspective that might release you to ask for help:

 

Philippians 2:4  Let each of you look not only to his own interests, but also to the interests of others.

 

Hebrews 13:16 Do not neglect to do good and to share what you have, for such sacrifices are pleasing to God.

 

Matthew 5:16   In the same way, let your light shine before others, that they may see your good deeds and glorify your Father in heaven.

 

John 15:12       My command is this: Love each other as I have loved you.

 

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Recovering from Depression

(Excerpt from full article entitled, “Be Sure of Your Healing”, as seen in the September issue of Faith Filled Family Magazine, page 10, https://indd.adobe.com/view/e1112bc6-09e6-4f19-abb7-46fc27b3db84)

As a mental health nurse, I see the devastating effects that depression has on the person and their family. For those who haven’t experienced it themselves nor known anyone diagnosed, it is often misunderstood, sometimes even ridiculed and written off as ‘all in the mind’. Sadly, this misunderstanding can even come from those closest to the person, with hurtful and unhelpful comments along the way. 

With depression, the person may feel hopeless and helpless, fearing they may never escape the darkness; they may feel like a burden to their family and friends; they feel out of control and overwhelmed with life; the energy is drained from their bodies; quality sleep eludes them; their body may be racked with pain; eating becomes either a mood-enhancer causing over-indulgence, or a chore; the thoughts run wild, like a recording playing over and over and over in their mind; negative self-evaluations pervade their mindset leading to thoughts of being unworthy of love, of being pathetic and unable to cope with life.

Most people believe that medications are the main form of treatment. Research tells us, though, that a combination of treatments has been found to be the quickest and most effective for sustaining remission from depression.(1) Of course, medications play an important role, but most don’t find them exclusively effective. (2)

In order to work out a combination of treatments, it is worth a closer look at the ‘biopsychosocial’ model.  This model can be understood easily when broken down into three easier parts: biological, psychological and social. Current mental health science says that a majority of emotional problems stem from these three interrelated areas, and are therefore effective to use as a basis for combination treatment.(3)

BIOLOGICAL

Your physical body is a precious gift and looking after it physically is a way to honor God (1 Corinthians 6:19-20).

When we consider biological treatments, we need to include medications, exercise, nutrition and sleep, as well as treating other medical conditions that are contributing to depression, for example, pain management.

We all know that these things help us to feel better. These improvements don’t just occur for vague, unidentifiable reasons. They happen due to biochemical changes that take place and tangibly improve your mood.(4)

Medications help change your biochemistry and play a role in recovery. While they aren’t the sole answer, they can help lift your symptoms enough that you are able to work on the other things that are required for recovery and maintenance.  They can lift you out of that dark pit, so that you can at least start moving forward. 

In recent years, there has been much research and information shared in regard to nutrition and mental health. You may have noticed more news reports, documentaries and articles on the topic. Even on Facebook you may have seen this topic pop up in your newsfeed.

It has been said for many years that ‘You are what you eat’. More than ever this is being proven, with the research pointing to your gut health as a key factor.

Simply put, research has found that there is a link between our brains (mental processes and emotions) and our gut (intestinal functions).(5) In other words, they ‘talk’ to each other.  Think about a time when you were feeling excited.  Did you get butterflies in your stomach? Or when you were anxious, did you feel nauseas or experience diarrhea or reflux? The emotion is happening in the emotional centre of your brain (amygdala), yet those responses are in your gut.

It stands to reason then, that if your gut is healthy, it contributes to better mental health.(6) But how do you improve your gut health?

Research tells us that improving gut health is two-fold – increasing gut friendly (anti-inflammatory) foods in your diet and limiting or removing foods that aren’t gut friendly (inflammatory).(7)

PSYCHOLOGICAL

There is a well-known verse from Philippians 4:8 that gives a great pattern for us to follow with our thoughts, “And now, dear brothers and sisters, one final thing. Fix your thoughts on what is true, and honorable, and right, and pure, and lovely, and admirable. Think about things that are excellent and worthy of praise” (NLT). Of course, this is much easier said than done, especially when depression overwhelms.

However, there are things that you can do to help lift your mood and therefore help you model this kind of thinking.

Psychological treatments include formal therapies (such as cognitive behavioral therapy), gratitude journals, music, building self-esteem, kindness, prayer, meditation, controlled breathing, and relaxation (to name a few).

One of the key things as Christians is our connection with God through prayer. There have been studies done on how prayer affects our wellbeing, both physically and mentally.  One study found that practices such as prayer actually thickens the brain cortex which is thought to be a protective factor for depression.(8)

SOCIAL

The Bible has many verses that talk about our relationships with others.  It speaks of who to connect with and how we should manage those relationships. All areas of our life are covered, from marriage and families, to friendships and business partners, to enemies and strangers. Obviously, we are designed for connection!

When someone suffers from depression though, connections can fall by the wayside.  The person may not have the energy to connect; they may not feel worthy to connect; they lack the motivation to connect. Sometimes bridges have been burnt, so to speak, and some connections have been irreparably severed. But this social isolation from family, friends and support networks only compounds the problems with depression.

In the biopsychosocial model, the ‘social’ not only relates to relationships but also to environmental circumstances.(3) Avenues for treatment of both of these include social connections/supports (eg family, friends, clubs, church, professionals-doctors etc) and working on issues such as unemployment, housing, transport – many things contribute to one’s social situation and need to be considered to assist recovery.

A key factor to consider for recovering from depression is social supports. There are many ways this can be done, but as Christians, we have a great support network provided to us through the church. In Hebrews 10:25 it says, “And let us not neglect our meeting together, as some people do, but encourage one another, especially now that the day of his return is drawing near.” While we have viewed these three areas individually, it is important to keep in mind that there is a lot of overlap. When you work on one area, the other areas tend to improve also. Just like medications alter your biochemistry, so too do these other treatments. By using a combination of treatments, you can improve your mental health quicker and with longer lasting effect.

You can check out Shauna’s website and book at https://www.shaunagallagherauthor.com/

References:

  1. Medscape: https://emedicine.medscape.com/article/286759-treatment
  2. PubMed Health: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0087089/
  3. Psychology Today: https://www.psychologytoday.com/au/blog/think-well/201605/why-the-best-therapy-is-biopsychosocial-process
  4. Healthline: https://www.healthline.com/health/depression/exercise#1
  5. Psych Scene: https://psychscenehub.com/psychinsights/the-simplified-guide-to-the-gut-brain-axis/
  6. Harvard Health Publishing: https://www.health.harvard.edu/diseases-and-conditions/the-gut-brain-connection
  7. Harvard Health Publishing: https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation
  8. Mental Health Social Support: http://www.mhss.net.au/research-and-statistics