Daily Blog
A brand new study, published in Nature Medicine, suggests that transcranial direct current stimulation (tDCS) can be used, safely and effectively, for depression, by patients at-home.
TCDS is a type of noninvasive brain stimulation that uses electrodes to send a weak current which activates key portions of the brain while participants wear a cap or band across the forehead.
Currently, the method is only used experimentally in some countries and, always, at a clinic.
Now, the study.
Researchers at UT Health Houston, the Institute of Psychiatry, King’s College London, and the University of London gave one group of depressed participants a device using active tDCS and the other group, an inactive tDCS device.
In other words, the device providing brain stimulation was real for one group; fake for the other group. Participants had no way of telling whether they were getting active or inactive treatment.
Well, turns out that the real deal turned out to be much more effective.
Patients who received genuine tDCS were 300% more likely to report significant improvement in their symptoms of depression than patients who got the sham tDCS.
Here’s another interesting part about the study.
All participants (in the experimental group and control group) were currently on antidepressants for at least 6 weeks when they began treatment.
At first glance, one might object, “Well, it’s the antidepressants that were helping,” but keep in mind that these patients came into this study, depressed, despite the antidepressants.
In other words, they weren’t feeling the benefits that millions of others (including myself) get from antidepressants.
Thus, this study’s results suggest tCDS might be an effective treatment for those who can’t get relief from antidepressants.
The more options, the better.
And in case you were wondering about side effects, they were remarkably mild.
At week 10, reports of skin redness ((active = 54 (63.5%); sham = 15 (18.5%), P < 0.001), skin irritation ((active = 6 (6.9%); sham = 0 (0%), P = 0.03) and trouble concentrating ((active = 12 (14.1%); sham = 3 (3.7%), P = 0.03) were greater in the active treatment arm relative to the sham treatment arm. There were no differences in headache, neck pain, scalp pain, itching, burning sensation, sleepiness or acute mood changes between treatment arms. Two participants in the active group described developing ‘burns’ at the left anode site.
Read more on the study here.
Now, of course there are a lot of steps to getting this approved and actually available to patients at home. And those steps will look very different, country by country.
But thank the Lord for scientists who continue to look for ways to treat this disease.
If you’re depressed, or struggle with any aspect of mental health…
For readers from the United States….
Find a psychiatrist here.
Find a therapist here.
For readers, internationally, seek help from a local resource.
For salvation, Christ and Christ alone.
[Photo: By Yokoi and Sumiyoshi. 2015 – https://npepjournal.biomedcentral.com/articles/10.1186/s40810-015-0012-x, CC BY 4.0, Link].
Paul Miller, in his book A Praying Life:
“An interviewer once asked Edith Schaeffer… ‘Who is the greatest Christian woman alive today?’ She replied, ‘We don’t know here name. She is dying of cancer somewhere in a hospital in Indian.”
No matter where you are, no matter what you feel you have or haven’t done for Christ, remember, that Christ doesn’t measure us the way the world or the church measures us.
He measures us through what his eyes see, not the “failures” the world sees, or the worst we want to believe in ourselves.
No matter who you are, where you are, don’t feel forgotten just because someone has forgotten you.
The famous preachers everyone raves over? The ones you must think, “They’re actually accomplishing stuff for Christ.” Sure, they are. And I thank God for them. Deeply. But do you think God is impressed by the crowds they draw? No, he looks at the heart the minister has.
We know this from Christ’s explicit and implicit teachings (“last is first” theme, his numerous parables, the people he honored etc), and we also know this from one of the verses I have to keep in mind a lot, as someone who’s keenly aware of his own failures, smallness, and penchant for guilt at “not doing enough for him.”
Psalm 147:10-11: “He takes no pleasure in the strength of a horse or in human might. No, the Lord’s delight is in those who fear him, those who put their hope in his unfailing love.”
Now, my heart is often far from him, I often lose hope in his unfailing love, and oh Lord, many times I live with indifference to his Lordship.
But… no matter where you are – if you are confined to a hospital bed, if you are confined to a restricted life where you’re unseen, and even if you’re suffering from guilt over your failures or your sins: This moment is this moment. And you and I can turn our hearts towards him, and that’s all God wants. That’s where it all begins and even if it’s in the midst of ending, of dying in that lonely hospital room, you have already become great in God’s kingdom.
Don’t listen to Christians who rebuke you for not “doing enough.” Christ says, “I did enough. Now let’s build our relationship.”
If you’re depressed, or struggle with any aspect of mental health…
For readers from the United States….
Find a psychiatrist here.
Find a therapist here.
For readers, internationally, seek help from a local resource.
For salvation, Christ and Christ alone.
A brand new study from Epic Research finds that birth order is correlated with an increased likelihood of experiencing symptoms of anxiety and depression in children at their 8 year old wellness checkup.
The researchers combed through the numbers on 182,477 children over a seven year span, and found that 8 year old firstborns were 48% more likely to have anxiety and 35% more likely to have depression than their younger siblings at their own 8 year old checkups.
Further, 42% of only children were more likely to have anxiety and 38% more likely to have depression compared to children in other houses who were born second or later.
A few notes.
First, on the only child variable. The comparison group is interesting because with whom do you compare the only child group?
One option is first born children from families with multiple children. That way, you’d be capturing the phenomenon of a child being born first. And that’s exactly what researchers did here.
But it’s incomplete because it doesn’t answer the separate question of whether there’s something unique about being born into this world, without siblings, and how that affects development going forward.
Because even those who have siblings later are, in fact, entering the world alone to begin with.
Child development starts in the womb, and this study doesn’t answer a lot of questions about how entering the world without a sibling might affect a child.
But it does note an important correlation, even if it lacks explanatory power.
And that correlation is that, yes, if you’re an only child you’re more likely to have depression or anxiety at 8 years old than 2nd or 3rd etc born kids from other families.
And if you’re the oldest in a family with multiple siblings, you’re also significantly more likely to have depression or anxiety than the rest of your siblings at that age.
So, according to this study, there is something unique about being first, although exactly what that is remains unclear.
And it should also be noted: data from other studies directly contradicts the suggestions in the current study, and actually show first born children having higher levels of self-esteem (ages 7-12) and significantly lower rates of depression than children born later.
In fact, there have been a number of studies on just this question, and a number of different conclusions. Of course, study design is a major factor. Perhaps the most significant factor.
But the current study is impressive in the scope of its data, but it also has significant limitations in design and leaves a lot of questions unsolved.
Practical implications: No study is perfect, and no matter which data you go by, the one thing researchers agree on is that birth order does matter – for each child.
Therefore, it’s important that when members of the church are quick to judge (which we tend to unfortunately do, despite Christ’s warnings), we remember that birth order is one of the many things that can explain so much.
And it’s another variable that we need to take into account when we address anyone.
So, for example, to be very non-scientific – if an adult firstborn seems tense and frustrated, instead of chalking it up to a character flaw, we might say, “You know what, they might be feeling unusual weight and responsibility to be perfect and keep it together because that’s often the role an older child plays in relationships growing up. Maybe I should consider that when I want to judge them for being a certain way.”
Or, if someone who grew up as a youngest child seems particularly prone to questioning norms, instead of the church saying, “Oh dear, that person is a troublemaker,” instead, we might have more understanding and, in fact, gain by saying, “You know what? Perhaps they have unusual insight because they were never taken seriously and could see a lot of the hypocrisies, growing up, then, and now in life. Let’s not write them off as simply a troublemaker.”
The same kind of understanding should go for the struggles of only children and middle children and adopted children and children who grew up living in blended families.
We rarely know the birth order of someone with whom we interact, and yet so often, we’re prone to making judgments that perhaps we wouldn’t make if we understood the context.
The novelist Graham Greene wrote in the marvelous, The Power and The Glory, “Hatred is a failure of the imagination,” and we should probably insert, “Judgment is a failure of the imagination,” as well, because once we use our imagination and we also think in terms of rigorous scientific study (at a medical, sociological, psychological, socioeconomic and everything else-else level), then suddenly, it’s much easier to not only get past our judgments, but actually feel humility and remorse for having arrived at them so quickly.
If there’s one thing I’m convinced that I need more of — and that the church needs more of — it’s humility.
That is a much more difficult virtue, personally and collectively, to cultivate than it sounds. But it can change worlds.
Another thing to remember – so often, we feel alone. “Am I the only one who feels this way?” And it’s always the case that there are millions who struggle with the same thing, and if you feel particular weight or frustration or, really, any feeling, remember how powerful birth order is in the way we’re shaped.
I came into this world last, and yeah, a lot of the stereotypes apply. And sometimes when I’m feeling alone in a certain way, I know that I can call someone else who was born last and they’ll immediately get it.
Maybe we should start asking potential friends (discreetly, of course) the order they popped out, make a mental note, and perhaps they’ll be that friendly ear when it feels that no one else will hear you.
If you’re depressed, or struggle with any aspect of mental health…
For readers from the United States….
Find a psychiatrist here.
Find a therapist here.
For readers, internationally, seek help from a local resource.
For salvation, Christ and Christ alone.
[Photo: Legends of the Fall, which is the first movie off the top of my head that, somewhat stereotypically, nevertheless highlights some of the fundamental birth order things. Also, the score is one of my favorite, and of course the Mountain West of the United States – soaring and haunting.]
In his new book, On Getting Out of Bed, author Ryan Noble acknowledges the extraordinary difficulty for those with depression on just… getting out of bed.
For those of us who have the condition, the struggle to “get out of bed” is sometimes literal, but very often, metaphoric for a lot of things that we have to do, but can’t imagine how we have the capacity to.
And I don’t mean things the world would call ambitious.
I mean things that your neighbor might say, “Wha?! You can’t even open that stack of envelopes on your table?”
Getting out of bed can mean so many things to someone struggling with depression, and often, it simply means everything, as I wrote at length of my personal experience here.
But Ryan Noble has a heartening way of thinking of getting out of bed, and it’s a truth that, unfortunately, many Christians might sneer at, but, hey, that’s on them.
Rising out of bed each day is also a decisive act. Living is a wager. It is a severe gamble. You do not know the suffering and sorrow that awaits. You do not know the heartache. But you know it is coming to you… to choose to go on is to proclaim with your life, and at the risk of tremendous suffering, that it is good.
Even when it is hard, it is good. Even when you don’t feel that it is good, even when that goodness is unimaginable, it is good.
When we act on that goodness by rising out of bed, when we take that step to the block in radical defiance of suffering and our own anxiety and depression and hopelessness, with our heads held high, we honor God and His creation, and we testify to our family, to our neighbors, and to our friends of His goodness.
This act is worship.
Couple things here.
First, I think the getting out of bed phenomenon might be one of the truest forms of worship, because no one will recognize your merely getting up as both a monumental achievement and a trust in God’s plan except…. you and God.
That kind of worship is private and because it is so private, I believe that God honors it, uniquely, just as he does our prayers in the closet.
In fact, when we get out of bed in the face of our depression and anxiety and PTSD and OCD and whatever else, it seems so pedestrian to the world-at-large that we’re not even tempted to say, “I got out out of bed for God today.”
So unlike our private prayers, which may sneak out in conversation, we will almost certainly never let it slip in the church community that our getting the mail today or going to work or brushing our teeth was worship.
Context matters. And in the face of severe depression or other conditions, doing all those things because you hear God saying, “Come on, my son and and daughter, I’m here, I’m pulling for you, I’ve got you,” well… that’s private and pure worship.
Second, even if you can’t get out of your literal or metaphoric bed, just remember that God will never judge you for it.
Jesus often escaped from the crowds out of weariness, and if he weren’t Jesus, perhaps Christians would condemn him too for “taking that precious so-called ‘self-care time’ when others need you.”
But Jesus was perfect. He didn’t sin.
So don’t feel pressure to get out of bed when your body and mind say it’s not wise. You’re not, in any way, sinning.
In fact, you may be following Christ’s call to stay in bed.
There are so many in Christian ministry who felt compelled by others and their own sense of guilt and calling to get out of bed when they were literally at their max, and they ended it all by ending it all. And committing suicide.
So even though I love and appreciate and think it’s helpful to see getting out of bed as an act of worship, it’s important to remember that staying in bed shouldn’t be seen as its opposite.
In fact, it can be God’s Spirit demanding you rest, or perhaps his love asking you to show yourself grace because you live with a chronic illness and sometimes people with chronic pain can’t get out of bed, and neither can we.
Would we ever say it’s a sin for someone with horrible knee pain to just rest? God forbid.
So I wanted to add that really important disclaimer, and it’s a balance we all have to find for ourselves, with the help of the Spirit and also the wisdom of a therapist.
If you struggle with knowing that balance, I’m right there with you!
I’ve been through it and still struggle on this. In fact, I haven’t posted on this blog for some time, because I just haven’t had it in me. And I know God isn’t displeased. I needed to rest for the sake of my family, for the sake of Christ, for the sake of others and myself.
The main thing to remember is that Jesus knows us, loves us perfectly, and no other human can know us or love us in the same way, and so listen above all to the Spirit’s voice and a therapist’s wisdom.
If you’re depressed, or struggle with any aspect of mental health…
For readers from the United States….
Find a psychiatrist here.
Find a therapist here.
For readers, internationally, seek help from a local resource.
For salvation, Christ and Christ alone.
One more thing — If you want to read an incredibly gripping interview with a long-time pastor who experienced severe anxiety and depression and an absolute inability to get out of bed, please read my interview with Pastor Kirby Smith. I think you’ll find a friend in him and comfort in his story.
I’ve had a difficult summer, physically, with both continued and new complications from my perforation a year ago. Of course, that hasn’t helped things mentally. We’re also going through a big change as a family, and so my posting has been sparse this summer.
Hopefully, I will get back to it in a few weeks once some logistical issues are concluded.
But I’ve been slowly reading two of my favorite chapters in the Bible, Matthew 1 and 2.
And I wanted to share this verse from you that I read this morning. I’m pretty sure you know it.
Matthew 2:1-2: “About that time some wise men from eastern lands arrived in Jerusalem, asking, ‘Where is the newborn king of the Jews. We saw his star as it rose, and we have come to worship him.”
Some translations omit “as it rose” and, instead, say the wise man saw Christ’s “star in the east”; this translation says “as it rose,” and scholars agree that “as it rose” or “when it rose” is best.
And that’s beautiful.
If you’re reading this blog you probably know a thing or two about dark times. Maybe you’re in one right now. Nothing good seems possible now or on the horizon.
Sure, others can talk about heaven, the hope of it and all that, but all that just feels like “all that.”
The night is so dark.
But if you can, look up. Look up when it’s quiet in your room, and it’s dark outside and in your mind.
There are stars.
And to see a star rising is to see life, and to see that a star has risen is to see that its potential has now turned into a fixed object of luminescence – one that will be there all night. One that will look down on you all night.
This star, the star of Christ, didn’t just rise in the dark for the wise men at the beginning.
It also rose from the grave for you and me, at the end of his life, and that star will never fall.
This star, the star of our Protector, rises in the night and watches over us as we’re sleepless. We just have to look up.
If we’re going to get through these nights, we can’t ever stop looking for that star. And if we find it, we may still feel the dark all around us. I can’t pretend otherwise.
But we do often feel comfort, despite the dark. The star is there.
God bless you, dear friends. Look for his rising star.
If you’re depressed, or struggle with any aspect of mental health…
For readers from the United States….
Find a psychiatrist here.
Find a therapist here.
For readers, internationally, seek help from a local resource.
For salvation, Christ and Christ alone.
In his wonderful book, Praying Like Monks, Living like Fools, Tyler Staton reminds us of how God will use two precious and painful companions to renew the world.
“Scripture makes it clear that God collects two things — prayers and tears.
This world in its current form is passing away, but our prayers and tears are eternal.
God collects our prayers. In Revelation, we are offered a glimpse at the receiving end of our prayers: ‘The twenty-four elders fell down before the Lamb. Each one had a harp and they were holding golden bowls full of incense, which are the prayers of God’s people’.”
But God doesn’t just hold and treasure those prayers. Instead, at the right time, he pours out those prayers onto the world.
“Redemption comes when he rains down those prayers on the earth once and for all. The renewal of the world, heaven and earth restored as one, begins with God pouring out all the prayers of his children like a purifying fire with one great, resounding yes.
Every prayer in the end is an answered prayer.
Some are still awaiting that yes, but it’s coming.”
Now, it’s not just our prayers that God uses, but also something else – for lack of a better word – aquatic?
In the Psalms, David famously notes that God “bottles our tears,” but a less famous moment comes in Psalm 123 when the Psalmist says: “Those who sow with tears will reap with songs of joy.”
Staton notes:
“God is not merely bottling up our tears. He also promises that when they touch the earth, they will bring renewal… The new creation is seeded by the prayers of God’s people and watered by their tears. Both are key ingredients in remaking the world.”
Amen.
It’s a beautiful thing – that God uses these very private things (prayers and tears) to help bring about creation’s redemption.
So we pray alone and we usually cry alone, and God sees the sacred in loneliness, and will someday publicly use all that to turn the world into a place with no more tears and where our prayers are only continual hallelujahs.
I don’t know about you, but loneliness can either be a place of refuge or dread for me, and it’s not always clear whether it will be one or the other.
But we do know that prayers can arise from refuge or terror, and those are probably the prayers that most catch God’s ear because they’re not uttered from, potentially, obligation (a family table) or, potentially, from pride (a fellowship).
Our silent prayers aren’t obligatory or vain, because who would pray from pure obligation or vanity while alone?
So keep praying in silent, alone. God hears you, and he blesses your prayers and tears and promises they’re of greater use than we could ever imagine.
For readers from the United States….
Find a psychiatrist here.
Find a therapist here.
For readers, internationally, seek help from a local resource.
For salvation, Christ and Christ alone.
A brand new study, published in JAMA Network Psychiatry, establishes a bidirectional relationship between memory decline and depression.
In other words, greater depressive symptoms accelerated memory loss, while significant memory loss accelerated depressive symptoms.
The link between depression and neurological diseases has been increasingly established in recent years, and depression is a risk factor for earlier onset of dementia.
Memory loss and depression involve similar neurological processes, as the study authors explain.
[Dr. David] Merrill [director of the Brain Health Center at the Pacific Neuroscience Institute] said the activity in the prefrontal cortex and hippocampus are similar in both conditions. When there’s a decrease in frontal lobe activity — as is seen with depression — there is a reduced ability to hold things in working memory,” Merrill explained.
“The circuitry and the cells and the synapses involved in memory formation have a profound overlap with the circuitry involved in moods, mood regulation, and mood formation,” Merrill said.
I’d suggest reading more about nuts and bolts of the neurological processes in Medical News Today, but of note, the study author reminds us that the high cortisol levels often seen in depression can lead to hippocampal atrophy — not to mention increased levels of pro-inflammatory cytokines that can play a major role in neurotoxicity.
Now… I sometimes hate posting studies like these because if you’re depressed, well, this hasn’t exactly made your night better.
However, I post it for three reasons.
First, it has important practical implications. The more scientists know about the relationship between depression and memory decline, the better treatment available.
Second, studies like this can also sometimes get depressed folks to seek help from a doctor who might be able to prescribe an antidepressant, if he or she determines it’s appropriate (it’s clutch to remember that many antidepressants fight inflammation).
The study authors also note that exercise is a powerful way to help both depression and memory decline and the mechanism for that is well-established.
Finally, I think it’s really important to post anything that reminds Christians that depression is a real medical condition – that scientists can actually see what’s happening in the brain of a depressed person.
That goes a long way to reducing the horrible stigma that so many Christians feel of “I just don’t have the joy of the Lord… what’s wrong with my faith?”
Science is increasingly suggesting (read here) that major depressive disorders are likely neurological disorders with psychiatric symptoms, which represents the natural, evidence-based conclusion of numerous studies and, hopefully, will further reduce stigma surrounding this disease.
You can’t blame someone’s Alzheimer’s on a lack of faith. Nor their Parkinson’s. It’s time for us to get to that point with depression.
So Christians, as a whole, need to be aware of studies like this, and for those like you and me – who struggle with depression – the memory decline thing might offer a bit of motivation to look for treatment.
Although… I am keenly (way too keenly) aware of depression’s ability to sap us of any motivation. That word “motivation” can seem so distant it’s almost fantastical. “Oh, I once was motivated, wasn’t I? Or was I? Could I really have been? Was that just a dream?” And actually, it was just three weeks ago. Such is the intensity of this thing).
Read the whole study here.
If you’re depressed, or struggle with any aspect of mental health…
For readers from the United States….
Find a psychiatrist here.
Find a therapist here.
For readers, internationally, seek help from a local resource.
For salvation, Christ and Christ alone.
[Photo: Pexels, free stock photography].
In his book, The Power of the Cross, Raniero Cantalamessa writes of our tears, suffering, and one of the most precious verses to remember – Revelation 5:5: “Stop weeping! Look, the Lion of the tribe of Judah, the heir to Judah’s throne, has won the victory!“
Cantalamessa urges us to repeat the verse to ourselves continually, as if to defy the darkness that overwhelms us (I know, however, that for those of us with depression, anxiety or any other clinical disorder, it’s not that easy and see footnote for medical links).
Still, this is truth, however difficult it is to feel.
“The more a person repeating these words suffers, is weak, and seems defeated, humanly speaking, the louder his cry bellows, shaking the foundations of the powers of darkness.
Through faith, refined like silver in a smelting pot, the person not only resembles but identifies with the Lam who became a victor by accepting to become a victim.
Before the tomb of her dead brother, Jesus said to Martha, ‘Did I not tell you that if you believe you will see the glory of God?’
When humanly speaking, we face a situation that seems to have no good outcome, Jesus repeats those words to us: ‘Did I not tell you that if you believed, you would see the glory of God?’
Later, Cantalamessa returns to our cry, and the One who listens, always, and has overcome, forever.
“When we experience a situation that seems overwhelming, or when God’s plan for our life, or the lives of our loved ones, or for the entire Church, appears to a be a scroll sealed with seven seals, or when we have to endure something without understanding, the whys or wherefores, or when we see people dying surrounded by indifference, that is the time for us to kneel and cry out with all our faith: ‘The Lion of the tribe of Judah has conquered and he will open the scroll and break its seven seals!’
In him, all victims have received the hope of becoming victors.
Amen.
Cantalamessa notes that Revelation was written while the church was facing intense persecution, despair and doubt.
And for people like you and me — for those with depression or anxiety or OCD or an eating disorder or whatever our struggles — well, that can feel like a daily persecution of its own, can’t it — one that produces both despair and doubt.
The persecution of living in a fallen world, with a fallen (and failing) body. Our own minds can persecute us. Accusing, doubting, despairing.
And we certainly don’t have to be reminded that there’s darkness in the world, or pain in our heart. “Man is born to trouble.”
But, as certain as that sadness is, there is another certainty and it’s attached to eternity: “The Lion has won the victory.”
He has. You have to hold onto that tighter than anything, and I have to, as well, or else I would surely fall.
And even though we’ve found our home in Christ, we are not in his home yet. But we will be one day. And for every day.
May the Lord bless you. The Lion did this for you and me.
If you’re depressed, or struggle with any aspect of mental health…
For readers from the United States….
Find a psychiatrist here.
Find a therapist here.
For readers, internationally, seek help from a local resource.
For salvation, Christ and Christ alone.
[Screencap: the empty tomb from The Passion of the Christ].
There are few better.
Highlights from Psalm 71:
“Oh, Lord, I have come to you for protection;
don’t let me be disgraced.
Save me and rescue me,
for you do what is right.
Turn your ear to listen to me,
and set me free.
Be my rock of safety
where I can always hide.
Give the order to save me,
for you are my rock and fortress.
My God, rescue me from the power of the wicked,
from the clutches of cruel oppressors.
O, Lord, you alone are my hope.
I’ve trusted you, O Lord, from childhood.
Yes, you have been with me from birth;
from my mother’s womb you have cared for me.
No wonder I am always praising you!
…You have been my strength and protection
That is why I can never stop praising you;
I declare your glory all day long.
And now, in my old age, don’t set me aside.
Don’t abandon me when my strength is failing.
For my enemies are whispering against me.
They are plotting to kill me.
They say, ‘God has abandoned him.
Let’s go and get him, for no one will help him now.’
O, God don’t stay away.
My God, please hurry to help me.
…. I will keep on hoping for your help;
I will praise you more and more.
I will tell everyone about your righteousness.
All day long I will proclaim your saving power.
…. You have allowed me to suffer much hardship,
but you will restore me to life again
and lift me up from the depths of the earth.”
If you’re depressed, or struggle with any aspect of mental health…
For readers from the United States….
Find a psychiatrist here.
Find a therapist here.
For readers, internationally, seek help from a local resource.
For salvation, Christ and Christ alone.