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Wanting to Help

This may seem like a strange way to start, but your commitment to the person who has depression will be tested if the illness is serious and extends for a long time.

It is not unusual for the husband or wife of a depressed person to seek a divorce. Although it’s impossible to judge such a situation, I wonder if at least some of these divorces occur because the non-depressed spouse just couldn’t keep on wanting to help for long enough. Their lives were turning out to be much different than they had planned. The person he married was replaced by someone much different. He or she began to believe he had made a mistake in the marriage and stopped really wanting to help.

A member of our ward whose wife has fought an often-disabling chronic illness for many years once spoke to me about our shared experience. He said, “Our wives will get us into the Celestial Kingdom. Without them, we might not make it.”

When someone in your family has a serious problem with depression, your life changes from what you expected it would be to what the Lord, in His infinite wisdom, wants your life to be.

Why does He do that? Because He loves you. Why does your loved one have to suffer like this? Because He loves your loved one too.

It is not wise to compare our mortal path with those that others walk, although the temptation is great. We look at the wide array of experiences in the lives of righteous people and wonder where, within that incredible variety, there is a common thread, a shared direction that could ever make it possible for each to return to his Heavenly Father.

At times, when we weaken, we may look at the lives of others and think, “Everything always works out well for them. They don’t seem to be suffering like my family and I are.” The answer is, of course, that you don’t truly know the experiences of those people. You don’t know their secret demons. You don’t fully know their past and you certainly don’t know their future. You may be sure, however, that they will be tested and tried in all the ways that Heavenly Father knows are necessary for them. Your particular test may be different than those of others, but everyone gets tested.

In a general conference address, then-Elder Boyd K. Packer said of our varied paths:

A wise friend who suffered enormous health trials often repeated, “This life is the test, not the reward.” Some people believe, at least subconsciously, that if you pay your tithing and live the commandments and do what is right, nothing bad will happen to you. These people become very uneasy with the idea that someone can do all these things and have serious, even life-threatening difficulties. Although we can certainly bring on a wide range of problems through our failure to live the commandments, some trials will happen in spite of all we are doing right.

Peter wrote, “Beloved, think it not strange concerning the fiery trial which is to try you, as though some strange thing happened unto you.” (1 Peter 4:12)

Look at the life of Joseph Smith, who was greatly beloved of the Lord and who obeyed despite enormous trials. Did Heavenly Father spare Joseph from Liberty Jail because he paid his tithing? Did he avoid being beaten and tarred because he faithfully offered heartfelt prayers? It would have been so easy for Carthage not to have occurred, but it did despite the fact that Joseph received and followed heavenly guidance all his adult life.

Have either you or I earned better treatment than Joseph Smith through our greater faith and obedience? If we are someday to sit down with Joseph and Moses and Peter and Nephi and Alma and Mormon and Moroni in the Celestial Kingdom, will we feel like we really belong in that company if we have not spent some time on a rocky road? Eternal life is not for wimps.

Success in this life consists not in avoiding any trials and tests, but in responding well to them when they come. Our mortal lives are a place and time of testing, not the ultimate reward that comes from righteous living and overcoming all things with faith.

When you think about really wanting to help a family member or friend with depression, you need to remember that this mortal life is the tiniest slice of eternal life. Our lives go back farther than we can possibly imagine prior to our mortal birth and they will extend forever after our bodies die.

Despite the brevity of this earth life, what we do here is vital, essential, determinative of the kind of life we will enjoy after we leave this earth. The depressed person who can bring you much despair will leave their illness with their mortal body. Their greatest test in this life may be their depression and, if they endure that test to the best of their abilities, they may have, through the Atonement of Christ, have done all that is necessary to enter the Celestial Kingdom.

Your greatest test, the one you get graded on, may be how you respond to the depressed man or woman or teenager or child that you love. The person that causes you so much frustration and anguish and tears may, in fact, be Heavenly Father’s way of providing you an opportunity for your greatest blessing. Some of our most important rewards come heavily disguised. You may have passed all the quizzes and mid-terms of mortality only to be given a final opportunity to show your Savior how much you love Him by helping one of his terribly lost sheep.

That’s why you want to help this person.

Attaining the Celestial Kingdom

How do you get to the Celestial Kingdom? I think that we all understand the big picture answer to that question. We receive the saving ordinances of the Gospel, obey the commandments, repent when we fall short and endure to the end.

Moving beyond those vital, but general requirements, how do you get to the Celestial Kingdom? What do you do when you get up in the morning if you want to reach that goal? What do you say to your depressed loved one when they tell you he feels horrible, when he says he doesn’t feel like talking to you at all, or when he wants to die? How can you help him? What do you do right now? If you turn to the right, will that get you closer to your Celestial goal, or should you turn to the left?

On this level, you don’t really know precisely what is necessary to reach the Celestial Kingdom. Is sickness necessary? Is deep discouragement necessary? Is desperation necessary? How many prayers are required? At times, we feel that heaven is close, but it never seems like a short jump for us to arrive there. Mostly, our road seems very long and very hard and doubts may arise in our minds about where that road will really lead.

“Charity suffereth long.” (1 Corinthians 13:4)

In Alma 7:19, Alma prophetically tells the people of Gideon, “For I perceive that ye are in the paths of righteousness; I perceive that ye are in the path which leads to the kingdom of God.” On occasion, we will receive that reassurance from the Spirit for our lives and those occasions are wonderful, but much of the time, most of the time, we must rely upon our faith in Christ and His Atonement. We must be on our own personal, sometimes strange path and we must take steps forward. That next step must be on our path. We can’t take a giant leap over to some other path that looks more pleasant.

If this is the path the Lord has given us, we cannot choose another way to reach the Kingdom of God. If this is the path the Lord has given us, we can be certain that if we faithfully follow that path, it will lead us to the Kingdom of God.

We have a completely trustworthy Heavenly Father and Savior. Their work is to “bring to pass the immortality and eternal life” of you and me and they are very good at their work. (Moses 1:39)

Our only reliable roadmap requires us to depend upon “the merits, and mercy, and grace of the Holy Messiah, who layeth down his life according to the flesh, and taketh it again by the power of the Spirit, that he may bring to pass the resurrection of the dead, being the first that should rise.” (2 Nephi 2:8) There is no alternative. If you try to use your mortal wit and strength alone, you will fail. You must absolutely and completely rely upon the Savior and the path He places you on.

We remember the story of Jonah. The Lord had a path for Jonah to follow. “Arise, go to Nineveh, that great city, and cry against it; for their wickedness is come up before me.” (Jonah 1:2)

Jonah thought he saw a much better path, an easier path and he started toward Tarshish. Jonah’s Plan B did not get him to Tarshish.

After a brief, but intense period of solitary contemplation, Jonah received another opportunity. “And the word of the LORD came unto Jonah the second time, saying, Arise, go unto Nineveh, that great city, and preach unto it the preaching that I bid thee. So Jonah arose, and went unto Nineveh, according to the word of the LORD.” (Jonah 3:1-3)

In Nephi 2:27, Lehi tells us what our choice is, “Wherefore, men are free according to the flesh; and all things are given them which are expedient unto man. And they are free to choose liberty and eternal life, through the great Mediator of all men, or to choose captivity and death, according to the captivity and power of the devil.”

You will note that Lehi doesn’t say that we are free to choose our trials or those of our family members. The One who knows the way to the Celestial Kingdom knows what trials will change us enough to allow Him to take us there. We need to be careful about running away from those vital trials. We need to keep on wanting to help.

Understanding Depression

One of the great challenges for a depressed person is simply for people to understand what is going on in his or her mind.

Well-meaning family and friends who have never dealt with depression suggest a wide range of solutions that are way off the mark. If they felt blue for a few days, then felt better, they weren’t really depressed and whatever remedy worked for them won’t work for someone who suffers from this illness.

For longer than I care to remember, I was one of those well-meaning people in dealing with G.G.’s depression. I had lots of great solutions. Unfortunately, they were for the wrong problems.

Following is a collection of things I learned by making mistakes in dealing with a depressed wife.

One of the most difficult challenges for a faithful member of the Church who is depressed is that it is very difficult for him to feel the Spirit. A wonderful conference talk, a tremendous testimony meeting, a great temple session, a beautiful priesthood blessing where the Spirit was touching everyone can leave the depressed person untouched and unmoved.

The nature of depression often causes the depressed person to blame himself for his spiritual isolation. He believes he is a bad person and must have done something very wrong because he couldn’t feel the spirit. Depression is not a moral failure.

It is difficult for depressed people and for those close to them to accept that their illness interferes with the delicate spiritual receptors that allow other faithful Saints to feel the promptings of the Holy Ghost. Anyone can damage those receptors by violating commandments relating to improper substances, the law of chastity, bad movies or websites. An innocent, righteous person can suffer from a mental illness that also damages those receptors.

Depression changes the way that the victim perceives reality. It injects different emotions and overtones into a situation than others experience. When a depressed person tells you that he sees an event or a situation in a much different way than you do, he is not confused or foolish or lying or dramatizing. He is describing what he sees and feels. The difference between the depressed person’s view and yours is caused by the disease. If depressed people said that they saw and felt things the same way that you do, they would be lying.

Someone who has always enjoyed good mental health finds it difficult to comprehend that the way we see and feel and remember experiences is the result of a complex series of minute chemical reactions and processes that are occurring at lighting speed in the brain. If those chemical processes are in balance, a person may see a sacrament service as an enjoyable, uplifting experience with friends in the ward. If those chemical processes are not working properly, the same person may see the same sacrament service as an unending condemnation of his numerous failings and deficiencies and the people there as threatening and uncomprehending.

To make this point clear, those chemical processes are part of our mortal bodies – not our spirits. We have each known spiritual giants trapped in bodies that manifest a wide range of physical limitations and illnesses. With the right spiritual eyes, we will see other spiritual giants trapped in bodies that manifest a wide range of mental and emotional limitations and illnesses. Each of these bodies houses a spirit that came from heavenly parents.

Our bodies are made of the elements of this fallen earth. None of our bodies work perfectly; otherwise we wouldn’t die. Each of us has a variety of problems that originate with our bodies. Those that we call healthy have problems that manifest themselves late in our mortal lives. Some of us, including those who are depressed, have very serious problems that originate with our bodies and often show themselves much earlier.

One of the symptoms of severe depression is thoughts of suicide. When these thoughts arise, a faithful Latter-day Saint is particularly afflicted. We know that suicide is wrong, but it keeps coming to the depressed person’s mind and it appears to be a way to end the intense and unremitting pain of depression.

You must not ignore suicidal statements. Ever.

Depression is a life-threatening illness. The way it takes a life is via suicide.

There is no reliable formula for what you should say when your loved one is suicidal, but you need to talk to him and keep on talking to him for a long time. The Spirit will help you. You must be prepared to take the depressed person to the emergency room or to a psychiatric hospital for his own safety if you have any sense whatsoever that he may take action on suicidal thoughts. The Spirit will help you there, too, but when in doubt, go to the hospital.

Depressed Teens

Depressed teenagers present some unique challenges. The first is discovering that the problem exists. Teenage years often include an emotional roller coaster, even for healthy kids, so parents can easily overlook the signs of depression.

Because some teenagers have poor impulse control, unrecognized depression can lead to drug or alcohol abuse or dangerous driving. Suicide is a significant risk. When I was bishop of a family ward several years ago, one of my Deacons committed suicide. In retrospect, warning signs were present, but neither I nor anyone else took action. This terrible event was a tragedy for the family, the members of the ward, and the boy’s classmates.

To a greater extent than adults, teenagers are unwilling to acknowledge that they are feeling depressed. They may not really understand what is happening to them. Following are a few signs that may indicate that your teenager is suffering from depression. Someone can be depressed without showing all of these signs:

Since most teenagers desperately want to fit in and not be “different,” it can be very difficult to persuade them to acknowledge that they have a problem or accept professional help. It is possible that the bishop, a trusted Young Men or Young Women advisor or Sunday School teacher can speak to a teenager about his problems more effectively than parents can.

Professional Help

There are two classes of professional help that an adult or teenager suffering from depression will need:

Sometimes the same person performs both of these roles, but usually this is not the case. There are not enough good psychiatrists and therapists. Your first experience with a psychiatrist or therapist may not be a positive one and you may need to make a change. It’s not easy, but you must keep trying.

Some Latter-day Saints are very opposed to psychiatrists and psychologists on principle. I’m not certain exactly what principle, especially what gospel principle, they may be applying. Christian Scientists may believe that all illness has a spiritual basis and doctors are unnecessary. That belief is not part of the revealed gospel. If someone breaks a leg, you would never tell him to get a priesthood blessing, think nice thoughts and exert their in lieu of taking him to a doctor to get the broken bone properly set. The admonition to “pray like everything depends on God and work like everything depends on you” applies to mental illness as well. The “work” includes taking the sick person to medical professionals who can help.

In order to obtain medication for the illness, a depressed person will need a physician who can prescribe that medication. The good news about medication for depression is that it has improved immensely over the past 25 years. The bad news is that it’s not perfect yet.

One of the challenges for the doctor is selecting the right medication from a wide range of possibilities. Inevitably, even for the most skilled physician, there is an element of trial and error involved in selecting medications. The first medicine may not work and the patient may need to try another. In some cases, a combination of two or more medications is needed. Praying for your doctor, asking that he or she be guided when treating your loved one, is always an excellent practice.

Trying out different medications is very difficult for the depressed person. He sees a ray of hope, only to have that hope dashed when the medication doesn’t work. Some types of medication take time to reach their full potential, so the patient may have to take the pills for two to four weeks before discovering that they aren’t working. One of your jobs is to keep the depressed person going back to their doctor if the prescribed medicine is not doing the job.

Medications to treat depression are powerful drugs that can have negative side effects for certain people. Sometimes the medication may seem to be working for the depression, but the patient can’t tolerate the side effects. A trip back to the doctor is necessary. A different drug in the same general group of drugs may provide the benefits without the side effects. In some cases, a second drug may control the side effects.

An entirely separate challenge can arise when the medication does work. Sometimes a depressed person feels great and believes that a permanent healing has taken place. He believes he doesn’t need the medicine any more. In a matter of days, he can crash and the up-and-down emotional whipsaw he experience can be even worse than depression alone was. You have to make sure the patient keeps on taking the pills until the doctor tells him differently. Going off some medications must be done in a particular manner to avoid a crash.

A person who has been depressed for an extended period of time may also need a therapist, someone who can spend time talking to the depressed person. Depressed people usually develop habitual ways of thinking, coping mechanisms, during their depression to help them get through their days and weeks. These habits may interfere with their recovery, even if the medication is working.

One of the ways a good therapist can help is by identifying those patterns of thinking and leading the patient to different, healthier ways of dealing with problems. Negative habits are often hard to eliminate, so one visit to a therapist will probably not be enough.

Although there are fine therapists of all faiths, in our experience, a good LDS therapist is very helpful. During the course of therapy, the fundamental beliefs and values of a patient are involved. An active LDS therapist may be able to understand how the gospel affects the lives and decisions of LDS patients more easily than one who is not familiar with our beliefs.

Unfortunately, good LDS therapists are difficult or impossible to find in some regions. LDS Social Services can help you locate either an LDS therapist or a non-LDS therapist who works well with LDS patients.

Medical Expenses

Cost can be an issue with these medical treatments. Under the health insurance laws of many states, treatment for mental illness may be limited. An annual limitation on the number of visits to a therapist that will be covered is common. You will want to become familiar with the mental illness coverage under your health insurance.

If you receive health insurance through your employer, you will need to be careful if you change jobs. A gap in insurance coverage may result in a waiting period before pre-existing medical conditions, including mental illness, will be covered under your new insurance. Under some circumstances, it may be financially advisable to utilize COBRA coverage under your prior employer insurance plan for a period of time until the new insurance becomes effective. Check with whoever in your company handles employee insurance benefits for details.

Sometimes people will avoid obtaining needed medical treatment for depression due to financial considerations. Without health insurance and sometimes even with health insurance, medical costs can be large. Avoiding or terminating treatment for serious depression due to financial constraints is a bad idea. Remember that depression is a potentially fatal disease.

When I was a bishop, I was always happy to use fast offering funds to help treat all serious illness, including mental illness, when the family was unable to cover all the costs from their own resources. If payment for treatment is a problem, go see your bishop. When the members of the Church make their fast offering contributions, they expect that those contributions will be used to help other members who are in need of them. Fast offering assistance is never treated as a loan that must be paid back, but you can always make generous fast offering contributions when your financial condition improves.

Trusting in the Lord

“O Lord, I have trusted in thee, and I will trust in thee forever.” (2 Nephi 4:34)

At its worst, depression can make it seem as if your family member, the person you knew, has died. The spark that motivated him and made him unique disappears behind a thick suffocating blanket of darkness.

At these times, the depressed person needs a Savior. At these times, you need a Savior. Whatever Christ touches lives. If He touches your heart, it will live. If He touches the heart of your depressed loved one, it will live as well. If you reach your hand up, you will find that His hand is there, has always been there, for you to grasp. If you hold tight to that hand, it will lift you up.

“Then saith he to the man, Stretch forth thine hand. And he stretched it forth; and it was restored whole.” (Matthew 12:13)

In your darkest hours, He is the only light, but He is a never-failing light. If you do not rely upon Him, trust Him, turn your fears and doubts and anguish over to Him with a sure knowledge that He can bear them, that He has borne them, you, too will begin to sink. Even if you are not depressed, you will begin to sink in despair, in hopeless pessimism that the spouse, the child, the friend you care so much about will never be able to change, to extricate himself from the deep and dark pit into which his illness has trapped him. One of Christ’s primary missions is freeing those held captive by all the forms of darkness that are endemic in mortality.

“Behold, he changed their hearts; yea, he awakened them out of a deep sleep, and they awoke unto God. Behold, they were in the midst of darkness; nevertheless, their souls were illuminated by the light of the everlasting word.” (Alma 5:7)

It is difficult, sometimes impossible, for someone suffering the worst of depression, to muster the hope that allows him to reach out for the Savior. In such times, your faith, your focus on Jesus Christ, must be strong enough for two. Your prayers must be strong enough for two.

The Lord understands all things, including every thought and feeling of one who is depressed.

The great Healer can mend all things, including anyone who is depressed. You cannot do so. No mortal force or capability can mend all things, but your Savior can. You must be willing at times to turn all things over to the Savior. You cannot bear all things, but He can.

After many of your prayers for healing seem not to be answered, you will be tempted to give them up. Charity suffereth long. Charity doesn’t give up, doesn’t fade, doesn’t pull back from abiding with someone during the darkest days of the soul because it is the pure love of Christ – His greatest power. It is a power that He is willing to share with you. His infinite love came from infinite suffering for the pains and infirmities and sicknesses of your loved one and for the pains and anguish that you feel so deeply. He has descended below all things so He can lift us up from below. His atoning sacrifice and love are stronger than any sickness, any sin, any problem, any challenge.

“I will encircle thee in the arms of my love.” (D&C 6:20)

It is true that not all prayers for healing are answered at the times and in the ways that we ask. But if the man or woman or teenager or child is in the arms of the Savior, he will be saved in the eternal ways that are more important than anything that occurs in this mortal life. Your belief must be strong enough that you can prayerfully place them in those arms through your faith in and entreaties to the Lord.

By doing so, you are not abandoning your loved one or ceasing to do whatever you are capable of accomplishing with your own best efforts. You are adding His infinite powers to your mortal capabilities in order to nurture and comfort and save the person you love. One of His greatest titles is Savior because He can save anyone.

What can I say of myself after spending 25 years of my marriage at the side of a wonderful, but severely depressed woman? I am changed for the better. I am changed in ways that I don’t believe ever would have occurred without the terribly difficult experiences I shared. I have come to know God through our shared suffering. Although I am certainly far from perfect, I am a committed follower of Jesus Christ because more times than I could ever count, I have felt His redeeming love supporting and strengthening me. Because He has never given up on G.G. or me, my love for Him has grown deeper and I know that I must follow Him.

However long and hard the road that leads me back to my heavenly home, every step that I take is worth it. A time will come when I will look back on that road with clearer eyes and realize that it was it was a golden pathway and that one of Heavenly Father’s greatest blessings was when He gave me the opportunity to walk that road with my Savior.