That Awful Wasteland of Alzheimers


The human toll is devastating

What is Alzheimer’s disease (AD)?

Alzheimer’s disease (AD) is an irreversible, progressive brain disease that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks of daily living. In most people with AD, symptoms first appear after age 60.

AD is the most common cause of dementia among older people, but it is not a normal part of aging. Dementia refers to a decline in cognitive function that interferes with daily life and activities. AD starts in a region of the brain that affects recent memory, then gradually spreads to other parts of the brain. Although treatment can slow the progression of AD and help manage its symptoms in some people, currently there is no cure for this devastating disease.

AD is named after Dr. Alois Alzheimer, a German doctor. In 1906, Dr. Alzheimer described changes in the brain tissue of a woman who had died of an unusual mental illness. He found abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary tangles).

Today, these plaques and tangles in the brain are considered hallmarks of AD. The third main feature of AD is the gradual loss of connections between nerve cells (neurons) in the brain. This loss leads to diminished cell function and cell death.

We don’t know what starts the AD process, but we do know that damage to the brain begins as many as 10 to 20 years before any obvious signs of forgetfulness appear.

As nerve cells die throughout the brain, affected regions begin to shrink. By the final stage of AD, damage is widespread, and brain tissue has shrunk significantly.

How many Americans have AD?

According to recent estimates, as many as 2.4 million to 4.5 million Americans have AD. Unless the disease can be effectively treated or prevented, the number of people with AD will increase significantly if current population trends continue. That’s because the risk of AD increases with age, and the U.S. population is aging. The number of people age 65 and older is expected to grow from 39 million in 2008 to 72 million in 2030, and the number of people with AD doubles for every 5-year interval beyond age 65.

In the years to come, AD is expected to pose physical and emotional challenges for more and more families and other caregivers, in addition to those with the disease. The growing number of people with AD and the costs associated with the disease also will put a heavy economic burden on society.

How long can a person live with AD?

AD is a slow disease that starts with mild memory problems and ends with severe brain damage. The time from diagnosis to death varies—as little as 3 or 4 years if the person is older than 80 when diagnosed to as long as 10 or more years if the person is younger. Other factors that affect how long a person will live with AD include the person’s sex, the presence of other health problems, and the severity of cognitive problems at diagnosis.

What is dementia?

Dementia is a general term that refers to a decline in cognitive function so extensive that it interferes with daily life and activities. This loss in the ability to think, remember, and reason is not a disease itself, but a group of symptoms that often accompanies a disease or condition.

Many conditions and diseases cause dementia. Two of the most common causes of dementia in older people are AD and vascular dementia, which is caused by a series of strokes or changes in the brain’s blood supply.

Other conditions that cause memory loss or dementia include:

•medication side effects

•chronic alcoholism

•certain tumors and infections in the brain

•blood clots in the brain

•vitamin B12 deficiency

•dehydration

•high fever

•some thyroid, kidney, or liver disorders

Many of these conditions are temporary and reversible, but they can be serious and should be treated by a doctor as soon as possible.

Emotional problems, such as stress, anxiety, or depression, can make a person more forgetful and can be mistaken for dementia. Someone may feel sad, lonely, worried, or bored when facing retirement or coping with the death of a spouse, relative, or friend. Adapting to these changes leaves some people feeling confused or forgetful. Supportive friends and family or professional help from a doctor or counselor can help older adults adjust to big changes.

 

Source: National Institute of Aging, http://www.nia.nih.gov/

Dipped in Shame

“All day long my disgrace is before me, and shame has covered my face.” Psalm 44:15

Some of us truly understand shame. It’s like we have been dipped in it, we have wallowed in it and things are sticking to us. We live out our lives in disgrace and in the sense of nasty embarrassment which we can’t truly resolve. And it affects all that we do, even in those rare moments we are not aware of it.

I honestly wish I was “teflon.” I would love to have a ‘non-stick’ heart. There is however, a constant sense of being totally insufficient as a person. It is a very deep awareness of being defective and unworthy. Many of us feel this way all the time. It is welded to us, and we keep trying to figure how to break that dark bond that’s on our hearts and minds.

Mental illness lives on that blackness. Depression feeds on that stuff, it seems to cycle through us. Our pasts become its nourishment, and at certain times it flourishes. Sometimes it explodes in our minds, just like when you give your roses a dose of “Miracle Grow” (but in a bad way.)

I read recently, that chemists are trying very hard to develop a drug that would erase bad memories. The thinking is that people suffering from PTSD will find freedom from very ugly events. Many of us, at certain points in our lives, truly absorb the evil. Some of us end up in prison, others are addicted, and a few go ahead and commit suicide. Shame when its at its best can completely incapacitate and destroy a person.

Most end up with a mental illness, and because we are so complex, it is difficult to view it as a simple ’cause and effect.’ It really is much more complicated than that. Mental illness has many layers. But if we look at our issues from a different view point we can see things we might never see.

Shame is a monster that is constantly tracking us. At times we can put some distance between us. But occasionally it leaps up on our backs and drags us down. We are humiliated with our guilt. That is precisely when we should scream out for help.

There are pastors and psychiatrists, therapists and friends who are most helpful. Practicing prayer and soaking in worship can drive the monster away. Meds can very often provide a respite. All of these have helped me. But in all of this, we must be patient.

We are dealing with guilt, and there are spiritual issues that trump everything else. Human beings were never created to bear guilt, we don’t know what to do. Shame is vigorously parasitical and consuming. If it runs amok through your life it can and will destroy you.

“You know my reproach, and my shame and my dishonor; my foes are all known to you.” Psalm 69:19

“…in whom we have redemption, the forgiveness of sins.” Col. 1:14

“To the Lord our God belong mercy and forgiveness, for we have rebelled against him.” Daniel 9:9

God has made an incredible provision for your guilt. Your sin, though it is crimson red in its intensity and very obvious, it can become as white as snow. Your shame and guilt can be erased.

“Do not fear, for you will not be ashamed; Neither be disgraced, for you will not be put to shame; For you will forget the shame of your youth, And will not remember the reproach of your widowhood anymore.” Isa. 54:4

It was Mark Twain, who once said, “Man is the only animal that blushes, and the only animal that needs to.”  We are ashamed, are we not, of things we’ve done in the past? Nobody is free who is unforgiven. Instead of being able to look God in the face or to look one another in the face, we want to run away and hide when our conscience troubles us.

 

Should I Take Medication?

by John Piper

What’s Your Take on Christians Using Antidepressants?

In the end I’m going to say that there are times when I think it is appropriate, but I want to go there cautiously and slowly, with warnings.

Depression is a very complex thing. It’s got many layers. I think we all would agree that there are conditions in which nobody would deny that certain people are depressed in a pathological way, because they’re immobile. They’re not even able to function.

And then there’s a continuum of discouragements and wrestlings with having an ‘Eeyore-type’ personality, which may or many not be depressed.

So that means that I want to be so careful not to have a knee-jerk reaction. When you come into my office and describe to me your discouragements, I don’t want my first response to be, “See a doctor and get a prescription.”

I fear that is way too quick today. The number of people on antidepressants as a first course rather than a last course is large.

And the assumption is that you can’t make any progress in counseling unless you get yourself stabilized or something.

So I just want to be very cautious.

As a Christian who believes that Christ is given by the Holy Spirit to deliver us from discouragements and from unbelief and from sorrow and to help us live a life of usefulness, what makes me able to allow for antidepressants is the fact that medicine corresponds to physical realities.

And the physical realities are that we get headaches that make us almost unable to think. Migraine headaches can put a man out. And we are pretty much OK if the doctor can help us find some medicine that would not let us get these immobilizing headaches.

And the headaches clearly have a spiritual impact, because they’re making me unable to read my Bible and function in relation to people that I want to love and serve. And so medicine becomes spiritually effective in that way.

So we apply this principle that we all use to depression, and then the fact that the body is included in depression. Whether we should use the terms “chemical imbalances”—I’ve read both sides on that. Some people say that there is no scientific evidence for such a thing and others say that it is a given. Whatever. Everybody knows that there are physical dimensions to depression.

If that physical dimension could be helped by medicine—in the short run especially, sometimes long term—then I think, in God’s grace and mercy, we should take it as a gift from his hand.


© Desiring God, desiringGod.org

John Piper is the Pastor for Preaching at Bethlehem Baptist Church in Minneapolis, Minnesota. He grew up in Greenville, South Carolina, and studied at Wheaton College, where he first sensed God’s call to enter the ministry. He went on to earn degrees from Fuller Theological Seminary (B.D.) and the University of Munich (D.theol.). For six years he taught Biblical Studies at Bethel College in St. Paul, Minnesota, and in 1980 accepted the call to serve as pastor at Bethlehem. John is the author of more than 30 books and more than 25 years of his preaching and teaching is available free at desiringGod.org. John and his wife, Noel, have four sons, one daughter, and an increasing number of grandchildren.
http://www.desiringgod.org/ResourceLibrary/AskPastorJohn
/ByTopic/81/4233_Whats_your_take_on_Christians_
using_antidepressants/

Mental Health Commercial

This is a 60 second commercial used on TV in New Zealand for a couple of years.  It functioned as a sort of PSA raising awareness.  It features part of a catchy song by Des’Ree, entitled “You Gotta Be.”

It’s a great commercial, and it is a great visual effort to communicate to those who know little about mental illness, and then go on to stigmatize others of us who battle staying sane and whole.

But it certainly isn’t a panacea for all the issues that are out there.  But it is a start. Hope you enjoy this.  I know it is a different kind of post, and it may not be “your cup of tea.”  (I personally have a slight aversion to videos from YouTube, but this is really an exception.)

Wrong Things Said in Church

Jesus loves His broken ones.

Jesus loves His broken ones.

 “There must be something wrong with your spiritual life.”

Yes, depression CAN be a result of sin. BUT depression is NOT always a result of  sin! If it is, God will tell you loud and clear what the problem is. This saying piles on the guilt for the depressed Christian. It’s unlikely that their depression has a spiritual cause, and this implies that they are not good enough spiritually.  

 “Repent and ask forgiveness for your sin!” 

Depression is a result of sin, in that if there was no sin in the world depression wouldn’t exist. But then, neither would diabetes, or cancer, or any other illness… Sin caused the word to be not-perfect, therefore illness exists. It is not a sin to be depressed, any more than it is to have any other illness. Depression can be used by God to encourage repentance, but in that case, it will be crystal clear exactly what sin you should repent of. If you don’t know, or have just a vague sense of guilt, your depression is not the result of a sin. Accusing someone of having depression because you think they committed some random sin is arrogant. It wouldn’t be the act of a loving God to refuse to tell you what you need to repent of.

 “Real Christians don’t get depressed.”

The implication behind this is that someone with clinical depression is not a “Real Christian”. That hurts, especially if it comes from someone who holds authority. It is hard to be depressed and Christian, very hard. I’d say it takes more faith to hold on to the fact that God exists when your situation is screaming out that even if there was a God, he hates you, than it does when all is going your way.

You need to have more faith.”  “Have faith in God.”

Hebrews 11:1, Now faith is the substance [or realization] of things hoped for, the evidence of things not seen. How much faith does it take to hold onto the basic tenets of the Christian faith when emotions scream at you daily to give up, get out and avoid God? Very often a depressed Christian will be hanging onto faith by their fingernails in a situation that requires more faith than the average.  

“Taking antidepressants is playing God, He can heal you.”

Yes, God can heal. Sometimes he doesn’t just flick a switch make the illness vanish, sometimes the healing comes through the conventional ways of doctors, psychiatrists, counsellors, therapists and medication. By persuading someone not to take their medication in preference for a fast, supernatural healing that God may not have in store for them, the sufferer is being denied something that will help them, right now. In John 5:1-15, Jesus only healed one man out of the many who were gathered. Not everyone will receive supernatural healing. We don’t always understand why God does as he does, only that he is God and will do what is right.

“Scripture says everything that happens is for your own good!”

The actual verse says: Romans 8:28, “And we know that in all things God works for the good of those who love him, who have been called according to his purpose.” This verse in no way implies that the sufferer should sit back and accept the illness for the rest of their life. It also does not say that illnesses are not to be fought with the intention of a cure. While God may well have things to do with a depressed person, the illness is not a good thing of itself, and it may take years before you see positive results from it.  

“You’ve been prayed for, why has nothing changed?”

This can be expressed in several ways and spoken by one of two different groups of people: either the person who asked for prayer, or those who prayed for them. We’ll break the underlying situation into two areas: something definite was experienced in the prayer time: chains were obviously broken and a new freedom gained, or, nothing apparently happened at all. That is, “I know God set you free, [as testified to by experience, or, simply accepted by faith] why are you not walking in that freedom?” When God steps in and answers believer’s prayer for a person to be freed from the influence of unclean spiritual influence there may well be a noticeable sense of having been freed.  

Why is it then that we don’t all immediately change?

The Bible speaks of our lives as being like clay; we are molded through everything we go through. There are 3 sources of spiritual influence on our lives:

  1. God’s Holy Spirit,
  2. our own human spirit,
  3. and unclean demonic spirits.

Take, for instance, temptation – it might not always be the devil himself tempting us, it may be our own human spirit / human nature having issues. Lots of things work to shape this clay, the onus is on us to give ourselves progressively more and more to God and open our lives to His molding process.

Let’s expand on the clay metaphor some more. Clay is not a very elastic substance. If you press a thumb into it and pull it away you’ll get a thumb print. A balloon, on the other hand, would spring back immediately when the outside influence is removed (the thumb). God’s word talks of us as being like clay, not balloons. Clay is solid, has substance, is useful for creating utensils that can be used in his service.  Balloons are insubstantial, have nothing solid inside and are full of hot air. So, take away the outside “thumb” pressing on our life and we are still left with a thumbprint: habits that have formed, certain ways of thinking or reacting to things, etc.

God can (and does) change things like these instantly in some people, however, there are times when such a fundamental change would shatter who the person is and a longer, more sustained healing process is needed. That is, we are freed from the oppressive spiritual influence but over the course of weeks, months and years following the prayer time we see a gradual change as the unsightly “thumbprint” is smoothed out.

God wants us whole and healthy, it also says in Scripture that “the prayer of a righteous believer avails much” but it also says that one the fruit of God’s Spirit dwelling within us is patience and endurance. Prayer gets the job done … it’s just that the process started by the prayer may be an ongoing one.

 “Depression is a self discipline problem.”

Self discipline is important to a Christian. We have to be disciplined enough not to break the laws of the land, and to obey our God. But no amount of self discipline will get rid of a medical problem. This statement implies that the sufferer is lazy and could become better by sheer force of will. This is not possible, and causes a lot of guilt.

 “You should be praying about this.”

Implicitly, whoever says this is also saying “This wouldn’t have happened if you’d been praying enough.” That’s a big assumption to make about someone. To a person with depression, it can seem like God left town a long time ago without leaving a forwarding address. It can seem as if your prayers bounce straight back off the ceiling, and that prayer is as fulfilling and satisfying as yelling at a block of wood. When you’re depressed, you may not “feel” God as you had before. Often you don’t feel anything but numb and hollow. For me, and for many people, depression had a shrivelling effect on my faith. I found it hard to hang onto anything but the most basic elements of Christianity, and sometimes lost my grip on those. When I did manage to pray, it was a yell of pain and confusion. This is why we are supposed to base our faith on facts (God loves you, he loved you when you were a sinner too, Jesus paid the full price for all our sins, etc.) rather than feelings, which are fickle at the best of times. It can be incredible hard to hold onto those facts in depression, like trying to run into a very strong wind.

John Lockley says: In Christians, spiritual effects follow from the depression, and seldom the other way round. I repeat – in Christians, nearly always the depression comes first, followed by a sense of remoteness from God, rather than depression being the result of “falling away.“  One of the most eloquent and heartfelt prayers a depressed Christian can pray is “Help me God, I’m hurting!” This is a better prayer than the thirty minute meltdown that doesn’t actually say anything. It’s honest, open and sincere. God is listening, even if everything within you is screaming that he isn’t. Prayer during depression can take an awful lot of effort. One comeback to this saying is “I am praying, as best I can. Will you pray for me too?”

job“You just need to rebuke that spirit of depression and tell it to leave you. Don’t let Satan steal your joy.”

There are two problems with this statement. One problem is the assumption that depression is caused by demonic oppression. The other problem is the assumption is that joy and happiness are the same thing. Blaming a “spirit of depression” can be a wonderful cop-out. Just cast out the spirit and you’re cured! No need for long term support, for prayer, for counselling, for anything at all! And with this statement comes the implicit assumption that once again it’s your fault you’re depressed, this time because you’re not “spiritual” enough to get rid of the troublesome spirit yourself. Yes it is possible that demonic oppression can cause depression. No, demons are not responsible for every case of depression. Imagine what would happen if this statement was directed at someone with cancer, or hemophilia, or osteoporosis (“Just cast out that demon attacking your bones and be strong again! God wants to see you running marathons!”).

The second problem with this statement is that joy is equated with happiness. People with depression are not going to be the happiest souls in the church. I’ve heard it said that happiness depends on what happens, whereas joy can exist in very unhappy situations.

 “There’s no such thing as mental illness, it’s all in your mind”

Saying this denies that there is anything actually wrong with the depressed person, and implies that they are just making it up. This piles on the guilt again! A mental illness can be defined as one that affects the mind; the brain is allowed to get ill, just as the liver and lungs are.

“You’ve got nothing to be sad about”

 Depression isn’t about being sad, often the real situation may well have no effect on the disease at all. This statement misunderstands the disease, depression can have an origin that has nothing to do with the surroundings of the sufferer. Depression may make you feel as if your emotions have been switched off, leaving you less sad than numb and empty.

“It’s your own fault you’re depressed”

This is the kind of thing that Job’s “comforters” said, and it didn’t help then either. Bad things can happen to good people. Denying this hurts the sufferer.

 “Pull yourself together”

If you’ve been trying, someone saying this to you comes across as “You haven’t been trying hard enough, do more, and more, and more until you get it right. ” So back you go, trying more and more, and still getting nowhere because you cannot pull yourself out of depression by your bootstraps, and you can’t fix a medical problem by force of will.

“You’re just being lazy”

One of the common features of depression is a disturbed sleep pattern. This can often take the form of waking early each day (say 2 AM) and being unable to get back to sleep. Multiply this over several months, and the results can be severe. On top of this, everything is screaming that the world is a horrible place and nothing is worth the effort any more.  It is not laziness, it is a consequence of the illness.

It is a good thing to be helped by friends.  It hurts deeply when they take on these comments and drill you with them.  Understanding is critical, and a little bit goes a long way.

 

The Meat Grinder

I feel like I am going through a meat grinder. Pushed against my will (and desire) I’m finding myself in a place I’d rather not be. My therapist confirmed today that I’m in a “mixed state” where bipolar mania and depression come together.  I compare it to two massive ocean currents smashing into each other.  (please Google, “mixed state“).

I’ve been into this state for just two weeks and the urge to commit suicide is starting to become surprisingly strong. For my own safety, I’m almost thinking that it maybe time to go to the hospital again.  I must tell you that these are places that you really don’t want to go if you don’t have to.  (FYI, my particular choice is Alaska Psychiatric Institute in Anchorage. It’s actually a somewhat “nicer” degree of miserable, and they have cooler art.)

I also get paranoid that people are attacking me and are plotting to ruin me. I am quite  suspicious of FaceBook and my depression chat. I believe that the people that I encounter there are trying to get at me behind my back. Social networking with these type of services can be a nightmare.  But, then there is also the grandiosity. I believe that I think clearer, better, and faster than other people. It’s like I have superpowers.  I will think of myself as extremely gifted, superior to others.  I paint and write poetry and do “noble” things.

But I also have tremendous anxiety, with racing thoughts, and even heart palpitations esp. when I am sitting trying to relax. I don’t sleep well at all, in spite of the sleeping pill, the Klonopin and the melatonin, and the Benadryl, (to make sure I sleep).

I continue to take my psych meds like a good boy. But they don’t seem to work like they used to. I think they can’t handle this particular concoction of depression/mania.  Sometimes, I feel like I’m getting better, but I never seem to get well.  The endless cycle of feeling really good and then feeling really bad is a challenging thing.  It is difficult to have a stable walk of discipleship under these circumstances.  I think being starkly honest and broken over my own fallenness and sin is the key for me. (Now if I can only remember this.)