Mental Illness in Children & Teens

Does your child go through intense mood changes?

Does your child have extreme behavior changes too? Does your child get too excited or silly sometimes? Do you notice he or she is very sad at other times? Do these changes affect how your child acts at school or at home?

Some children and teens with these symptoms may have bipolar disorder, a serious mental illness. Read on to understand more.

What is bipolar disorder?

Bipolar disorder is a serious brain illness. It is also called manic-depressive illness. Children with bipolar disorder go through unusual mood changes. Sometimes they feel very happy or “up,” and are much more active than usual. This is called mania. And sometimes children with bipolar disorder feel very sad and “down,” and are much less active than usual. This is called depression.

Bipolar disorder is not the same as the normal ups and downs every kid goes through. Bipolar symptoms are more powerful than that. The illness can make it hard for a child to do well in school or get along with friends and family members. The illness can also be dangerous. Some young people with bipolar disorder try to hurt themselves or attempt suicide.

Children and teens with bipolar disorder should get treatment. With help, they can manage their symptoms and lead successful lives.

Who develops bipolar disorder?

Anyone can develop bipolar disorder, including children and teens. However, most people with bipolar disorder develop it in their late teen or early adult years. The illness usually lasts a lifetime.

How is bipolar disorder different in children and teens than it is in adults?

When children develop the illness, it is called early-onset bipolar disorder. This type can be more severe than bipolar disorder in older teens and adults. Also, young people with bipolar disorder may have symptoms more often and switch moods more frequently than adults with the illness.

What causes bipolar disorder?

Several factors may contribute to bipolar disorder, including:

  • Genes, because the illness runs in families. Children with a parent or sibling with bipolar disorder are more likely to get the illness than other children.
  • Abnormal brain structure and brain function.
  • Anxiety disorders. Children with anxiety disorders are more likely to develop bipolar disorder.

The causes of bipolar disorder aren’t always clear. Scientists are studying it to find out more about possible causes and risk factors. This research may help doctors predict whether a person will get bipolar disorder. One day, it may also help doctors prevent the illness in some people.

What are the symptoms of bipolar disorder?

Bipolar mood changes are called “mood episodes.” Your child may have manic episodes, depressive episodes, or “mixed” episodes. A mixed episode has both manic and depressive symptoms. Children and teens with bipolar disorder may have more mixed episodes than adults with the illness.

Mood episodes last a week or two—sometimes longer. During an episode, the symptoms last every day for most of the day.

Mood episodes are intense. The feelings are strong and happen along with extreme changes in behavior and energy levels.

Children and teens having a manic episode may:

  • Feel very happy or act silly in a way that’s unusual
  • Have a very short temper
  • Talk really fast about a lot of different things
  • Have trouble sleeping but not feel tired
  • Have trouble staying focused
  • Talk and think about sex more often
  • Do risky things.

Children and teens having a depressive episode may:

  • Feel very sad
  • Complain about pain a lot, like stomachaches and headaches
  • Sleep too little or too much
  • Feel guilty and worthless
  • Eat too little or too much
  • Have little energy and no interest in fun activities
  • Think about death or suicide.

Do children and teens with bipolar disorder have other problems?

Bipolar disorder in young people can co-exist with several problems.

  • Substance abuse. Both adults and kids with bipolar disorder are at risk of drinking or taking drugs.
  • Attention deficit/hyperactivity disorder, or ADHD. Children with bipolar disorder and ADHD may have trouble staying focused.
  • Anxiety disorders, like separation anxiety. Children with both types of disorders may need to go to the hospital more often than other people with bipolar disorder.
  • Other mental illnesses, like depression. Some mental illnesses cause symptoms that look like bipolar disorder. Tell a doctor about any manic or depressive symptoms your child has had.

Sometimes behavior problems go along with mood episodes. Young people may take a lot of risks, like drive too fast or spend too much money. Some young people with bipolar disorder think about suicide. Watch out for any sign of suicidal thinking. Take these signs seriously and call your child’s doctor.

How is bipolar disorder diagnosed?

An experienced doctor will carefully examine your child. There are no blood tests or brain scans that can diagnose bipolar disorder. Instead, the doctor will ask questions about your child’s mood and sleeping patterns. The doctor will also ask about your child’s energy and behavior. Sometimes doctors need to know about medical problems in your family, such as depression or alcoholism. The doctor may use tests to see if an illness other than bipolar disorder is causing your child’s symptoms.

How is bipolar disorder treated?

Right now, there is no cure for bipolar disorder. Doctors often treat children who have the illness in a similar way they treat adults. Treatment can help control symptoms. Treatment works best when it is ongoing, instead of on and off.

1. Medication. Different types of medication can help. Children respond to medications in different ways, so the type of medication depends on the child. Some children may need more than one type of medication because their symptoms are so complex. Sometimes they need to try different types of medicine to see which are best for them.

Children should take the fewest number and smallest amounts of medications as possible to help their symptoms. A good way to remember this is “start low, go slow”. Always tell your child’s doctor about any problems with side effects. Do not stop giving your child medication without a doctor’s help. Stopping medication suddenly can be dangerous, and it can make bipolar symptoms worse.

2. Therapy. Different kinds of psychotherapy, or “talk” therapy, can help children with bipolar disorder. Therapy can help children change their behavior and manage their routines. It can also help young people get along better with family and friends. Sometimes therapy includes family members.

What can children and teens expect from treatment?

With treatment, children and teens with bipolar disorder can get better over time. It helps when doctors, parents, and young people work together.

Sometimes a child’s bipolar disorder changes. When this happens, treatment needs to change too. For example, your child may need to try a different medication. The doctor may also recommend other treatment changes. Symptoms may come back after a while, and more adjustments may be needed. Treatment can take time, but sticking with it helps many children and teens have fewer bipolar symptoms.

You can help treatment be more effective. Try keeping a chart of your child’s moods, behaviors, and sleep patterns. This is called a “daily life chart” or “mood chart.” It can help you and your child understand and track the illness. A chart can also help the doctor see whether treatment is working.

How can I help my child or teen?

Help your child or teen get the right diagnosis and treatment. If you think he or she may have bipolar disorder, make an appointment with your family doctor to talk about the symptoms you notice.

If your child has bipolar disorder, here are some basic things you can do:

  • Be patient
  • Encourage your child to talk, and listen to him or her carefully
  • Be understanding about mood episodes
  • Help your child have fun
  • Help your child understand that treatment can help him or her get better.

How does bipolar disorder affect parents and family?

Taking care of a child or teenager with bipolar disorder can be stressful for you too. You have to cope with the mood swings and other problems, such as short tempers and risky activities. This can challenge any parent. Sometimes the stress can strain your relationships with other people, and you may miss work or lose free time.

If you are taking care of a child with bipolar disorder, take care of yourself too. If you keep your stress level down you will do a better job. It might help your child get better too.

Where do I go for help?

If you’re not sure where to get help, call your family doctor. You can also check the phone book for mental health professionals. Hospital doctors can help in an emergency.

I know a child or teen who is in crisis. What do I do?

If you’re thinking about hurting yourself, or if you know someone who might, get help quickly.

  • Do not leave the person alone
  • Call your doctor
  • Call 911 or go to the emergency room
  • Call a toll-free suicide hotline: 1-800-273-TALK (8255) for the National Suicide Prevention Lifeline.

Contact NIMH to find out more about bipolar disorder.

National Institute of Mental Health
Science Writing, Press & Dissemination Branch
6001 Executive Boulevard
Room 8184, MSC 9663
Bethesda, MD 20892-9663

Phone: 301-443-4513 or
Toll-free: 1-866-615-NIMH (6464)
TTY Toll-free: 1-866-415-8051
Fax: 301-443-4279
E-mail: nimhinfo@nih.gov
Web site: www.nimh.nih.gov

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On the Wire Once Again

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“I hope everybody can find a little flame
Me, I say my prayers,
then just light myself on fire
and walk out on the wire once again.”  

Counting Crows, “Goodnight Elizabeth”

Hope is a powerful thing— nothing compares. It truly is the ‘anchor of the soul.’ Without it, life would be hopeless, and that is intolerable to a human being. We will implode without hope. The psalmist was well aware of this tendency; he speaks to himself about this. He ‘talks to himself’ which can seem a little weird to some.

“Why are you discouraged, my soul?
    Why are you so restless?
        Put your hope in God,
            because I will still praise him.
                He is my savior and my God.”

Psalm 42:11, GW

Day-to-day life can be arduous. Sometimes faith falters and hopelessness becomes a deadly option. For those of us with debilitating illnesses this can be significant hazard. Depression can severely hinder us. The writer of Psalm 42 understood this. Discouragement was a real issue for him. (And I daresay he is not alone in this.)

He states certitude to himself. He refuses to give in to the idea that failure is final. He will not allow himself to accept the finality of hopelessness. He will not surrender himself to this idea that ‘all is lost.’ The way he battles back is seen in an inner conversation with his soul. He speaks to himself concerning the great faithfulness of God to his situation. It is real, and not fluff. He operates in reality. But he can’t pretend that the feeling of despondency is imaginary, for it is far too real.

Having a hope will cement me in the goodness and mercy of God. It is the sterling-silver belief that He cares for me. The verse in 42:11 ties in with praise and worship. This is no minor thing. When we praise we break the bonds of hopelessness, in a way that our souls can know, and appreciate. It decisively disarms the depression, and fills the embattled soul with hope. Pain can be a powerful indicator of depression unchecked. But hope changes the manner of which we live.

“Every Christian who struggles with depression struggles to keep their hope clear. There is nothing wrong with the object of their hope – Jesus Christ is not defective in any way whatsoever. But the view from the struggling Christian’s heart of their objective hope could be obscured by disease and pain, the pressures of life, and by Satanic fiery darts shot against them… All discouragement and depression is related to the obscuring of our hope, and we need to get those clouds out of the way and fight like crazy to see clearly how precious Christ is.”  

–John Piper

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Dancing With Bruises

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Bruises seem to be part of life’s package to us. Some will be serious, most minor. But each are noted, and some will just have to be endured.

Dancers are some of the most wonderful people I know. Their gracefulness can be seen both on and off the stage. A dancer’s training is far from easy. By choosing to become dancers they have made a decision to absorb pain. Their toes and feet are blistered and bruised; they take constant abuse. Some must live with chronic tendinitis. Their feet bleed sometimes, and pain is their constant companion. Two things to consider.

  • They choose to dance. Dancers have an iron-will and a elegant grace. I suppose that is why they can dance.
  • The scars and bruises often become “badges of honor.” And they wouldn’t have it any other way. They would rather dance in pain, than not to dance at all.

Someone once compared depression as a “mental bruise.” I understand this. As depressed people, we must choose to walk out our lives from this pain. I know what it is like to bury myself in my bed for several weeks. My own mental bruise was simply more than I could take. There was a sensation of sinking into blackness, a sense of total and complete despair. I felt completely lost, and completely alone.

I prayed. I groaned, and I prayed. My sense of being totally lost was beyond comprehension. Dear reader, this was something quite real, and you must become aware of these things. Some of your friends are suffering. And it is a hellish and desperate depression.dancer-feet

To my Christian friends. Yes, I believe Jesus died for all my sins. He has forgiven me of much evil, I know that will live for eternity (with you). But mental illness is real, and like other illnesses it seldom is caused by evil or Satan. We would never say that diabetics are that way because of the enemy. Now the dark one will surely exploit it, but I think you give him far too much credit if you suggest he was able to initiate it. Satan just doesn’t have the spiritual “voltage.”

So, inspired by my dancing friends, and the Holy Spirit– I will make the choice to dance again. I’m pretty bruised, but I will try to ignore the pain. I would exult in my God, walk in His love, “leaping with joy like calves let out to pasture” (Malachi 4:2.)

“A bruised reed he will not break, and a smoldering wick he will not snuff out, till he has brought justice through to victory.”

Isaiah 42:3

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Drowning in Despair

 

despair (2)“For we do not want you to be ignorant, brethren, of our trouble which came to us in Asia: that we were burdened beyond measure, above strength, so that we despaired even of life.”

   2 Corinthians 1:8

“…we should all fortify ourselves against the dark hours of depression by cultivating a deep distrust of the certainties of despair. Despair is relentless in the certainties of its pessimism. But we have seen again and again, from our own experience and others’, that absolute statements of hopelessness that we make in the dark are notoriously unreliable. Our dark certainties are not sureties.”

John Piper

It is my ‘deliberateness’, and not my impulsiveness that gives me the most concern.   I know ‘despair’.  I know what it is like to be ‘backed into a corner’ and then feel the empty desperation of being lost.  But you must understand, there can be a weird seductiveness to ‘being lost’, a ‘strange sort of nobility’, a twisted honor, when it comes to despair.

Piper talks about the ‘dark certainties’ of knowing you are lost.  Now this really seems rather bizarre, that people could do this intentionally, without duress.  But I’m afraid to tell you that it happens all the time.  Despair is chosen over the option of life. This is the ‘lostness’ of the race of Adam.

Pop culture has given us words, albeit in a simplistic form.  I just happened to think right now of an old AC/DC  song, ‘Highway to Hell‘.  The lyrics are pretty basic, very simple, but the lead singer seems to really have a chronically, decided dedication to being one of the irretrievably lost.  He formats a ‘certain glory’ to being part of the damned.  This is a simplistic approach to the next stop– a more advanced case of stark-white despair, suicide. (We can call this ‘spiritual hubris,’ or even, “drugs, sex, and rock-n-roll.”)

In examining the striated world of despair, we must come to the interesting place when our foolishness combined with our arrogance produces a decision to be lost.  Of course, our fear of God must be extracted from the situation.  But for the eager candidate for despair, this is not an insurmountable problem.

Escaping this ‘drowning despair’ we must first dethrone our right to personal sovereignty.  And secondly, we need to grab the concept that God’s grace has an ultimate power that supersedes our notions of a ‘deserved’ love.  (It is completely undeserved).  We must believe that somehow, someway God chooses us out of a pile, a pile of the worst and ugliest.  And somehow, He delights in doing this, and He is Lord.

We are meant to be the people of redemptive hope. 

Because of our problems, our addictions, we must clearly renounce our evil folly of despair.  These are the issues that make us vulnerable.  There is a seductiveness to ‘giving up’ and taking up the sin of despair.  There can be a ‘weird romance’ that lures those who ‘walk out lostness’.  We are pulled into a vortex of an exotic melancholy with a dash of fatalism, which makes it reasonable and weirdly heroic. But is it not even more heroic to live in hope?

“Why are you downcast, O my soul? Why so disturbed within me?  Put your hope in God, for I will yet praise him, my Savior and 6 my God. My soul is downcast within me; therefore I will remember you.”

Psalm 42:5-6

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“Darkness is My Only Companion”

“Lord Jesus Christ, you are for me medicine when I am sick; you are my strength when I need help; you are life itself when I fear death; you are the way when I long for heaven; you are light when all is dark; you are my food when I need nourishment.”

—Ambrose of Milan (340-397)

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Our theology makes all the difference in fighting depression, writes Kathryn Greene-McCreight, Author of “Darkness, Is My Only Companion” and Episcopal priest. Here is an excerpt where she introduces the depression of Christians.

*** 

In his Problem of Pain, C. S. Lewis says that suffering is uniquely difficult for the Christian, for the one who believes in a good God. If there were no good God to factor into the equation, suffering would still be painful, but ultimately meaningless, because random.

For the Christian, who believes in the crucified and risen Messiah, suffering is always meaningful. It is meaningful because of the one in whose suffering we participate, Jesus. This is neither to say, of course, that suffering will be pleasant, nor that it should be sought. Rather, in the personal suffering of the Christian, one finds a correlate in Christ’s suffering, which gathers up our tears and calms our sorrows and points us toward his resurrection.

In the midst of a major mental illness, we are often unable to sense the presence of God at all. Sometimes all we can feel is the complete absence of God, utter abandonment by God, the sheer ridiculousness of the very notion of a loving and merciful God. This cuts to the very heart of the Christian and challenges everything we believe about the world and ourselves.

I have a chronic mental illness, a brain disorder that used to be called manic depression, but now is less offensively called bipolar disorder. I have sought help from psychiatrists, social workers, and mental health professionals; one is a Christian, but most of my helpers are not. I have been in active therapy with a succession of therapists over many years, and have been prescribed many psychiatric medications, most of which brought quite unpleasant side effects, and only a few of which relieved my symptoms. I have been hospitalized during the worst times and given electroconvulsive therapy treatments.

All of this has helped, I must say, despite my disinclination toward medicine and hospitals. They have helped me to rebuild some of “myself,” so that I can continue to be the kind of mother, priest, and writer I believe God wants me to be.

During these bouts of illness, I would often ask myself: How could I, as a faithful Christian, be undergoing such torture of the soul? And how could I say that such torture has nothing to do with God? This is, of course, the assumption of the psychiatric guild in general, where faith in God is often viewed at best as a crutch, and at worst as a symptom of disease.

bad-times-333-300x250How could I, as a Christian, indeed as a theologian of the church, understand anything in my life as though it were separate from God? This is clearly impossible. And yet how could I confess my faith in that God who was “an ever-present help in trouble” (Ps. 46:1) when I felt entirely abandoned by that God? And if this torture did have something to do with God, was it punishment, wrath, or chastisement? Was I, to use a phrase of Jonathan Edwards’s, simply a “sinner in the hands of an angry God”?

I started my journey into the world of mental illness with a postpartum depression after the birth of our second child. News outlets are rife with stories of women who destroy their own children soon after giving birth. It is absolutely tragic. Usually every instinct in the mother pushes toward preserving the life of the infant. Most mothers would give their own lives to protect their babies. But in postpartum depression, reality is so bent that that instinct is blocked. Women who would otherwise be loving mothers have their confidence shaken by painful thoughts and feelings.

Depression is not just sadness or sorrow. Depression is not just negative thinking. Depression is not just being “down.” It’s walking barefoot on broken glass; the weight of one’s body grinds the glass in further with every movement. So, the weight of my very existence grinds the shards of grief deeper into my soul. When I am depressed, every thought, every breath, every conscious moment hurts.

And often the opposite is the case when I am hypomanic: I am scintillating both to myself, and, in my imagination, to the whole world. But mania is more than speeding mentally, more than euphoria, more than creative genius at work. Sometimes, when it tips into full-blown psychosis, it can be terrifying. The sick individual cannot simply shrug it off or pull out of it: there is no pulling oneself “up by the bootstraps.”

And yet the Christian faith has a word of real hope, especially for those who suffer mentally. Hope is found in the risen Christ. Suffering is not eliminated by his resurrection, but transformed by it. Christ’s resurrection kills even the power of death, and promises that God will wipe away every tear on that final day.

But we still have tears in the present. We still die. In God’s future, however, death itself will die. The tree from which Adam and Eve took the fruit of their sin and death becomes the cross that gives us life.

The hope of the Resurrection is not just optimism, but keeps the Christian facing ever toward the future, not merely dwelling in the present. But the Christian hope is not only for the individual Christian, nor for the church itself, but for all of Creation, bound in decay by that first sin: Cursed is the ground because of you … It will produce thorns and thistles for you …” (Gen. 3:17-18).

This curse of the very ground and its increase will be turned around at the Resurrection. All Creation will be redeemed from pain and woe. In my bouts with mental illness, this understanding of Christian hope gives comfort and encouragement, even if no relief from symptoms. Sorrowing and sighing will be no more. Tears will be wiped away. Even fractious [unruly, irritable] brains will be restored.

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“Darkness: My Only Companion”

Kathryn Greene-McCreight is assistant priest at St. John’s Episcopal Church in New Haven, Connecticut, and author of Darkness Is My Only Companion: A Christian Response to Mental Illness (Brazos Press, 2006).

On the web:  http://www.hopeandhealing.org/contentPage.aspx?resource_id=311

 

 

 

 

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Despondency and David’s Theology

For those on the mat and wrestling, things can move very fast.  Our adversary is strong, and he knows us too well.  He is counterintuitive and quite aware of the sequence of moves needed to pin us to the floor.  He is dangerous.  And he also despises us.

I get bewildered and rattled by his attacks.  He knows how to pressure me at just the right time, and he refuses to follow the rules. He is no gentleman, you might say that he is both a cheater and a bully.

Of course I am talking about Satan and his team of demons.  I will not dispute their reality with you.  There is almost as much scriptural support for his existence as there is for Jesus’.  His hostility is  toward God and His people, and his viciousness cannot be camouflaged.  Evil is real, and believe this– Satan has a terrible, and ugly plan for your life.

As a mentally ill Christian, my depression quickly morphs into despondency.  When I sink to that level I start to abandon hope.  It’s like I’m in a lifeboat and decide that I should abandon it and tread water on my own.  Despondency is not rational and just a little bit is deadly.

David knew all about desperation and disheartenment.  He had been chased by his enemies, and maneuvered into the most difficult of situations.  To observe him at a distance we would say that “there is no hope for him in God.” Even God can’t save him, he is reprobate.  We would be convinced that there is nothing for him in God’s thinking.  Nothing.

It would be so easy to make this judgement.  For David was a moral failure; he was an adulterer and a brazen killer.  David had sinned deeper and more intensely than Saul ever had.  Join with the crowd, “There is no hope for him in God!”  No hope, none, nada, zero.

“Yet I am always with you;
you hold me by my right hand.

You guide me with your counsel,
and afterward you will take me into glory.

Whom have I in heaven but you?
And earth has nothing I desire besides you.

My flesh and my heart may fail,
but God is the strength of my heart
and my portion forever.” 

–Psalm 73

David defied the theology of his day.  He embraced the Lord God with a desperate passion.  It was not orthodox or logical.  You could say it was disturbing.  But David would not let go of God!  He hung on, and continued to sing in faith.

I encourage you besieged brother, and embattled sister.  Hold on to Him, even if it defies logic or theology.  Seek His promises with a fervency, open your heart to Him with a passion.  Remember that sin can and will destroy you.  It is part of Satan’s stratagem.  Sing in the cave, and never lose hope. Never.

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Plunging the Depths of Grace

“One of the Pharisees asked him to eat with him, and he went into the Pharisee’s house and reclined at the table. 37 And behold, a woman of the city, who was a sinner, when she learned that he was reclining at table in the Pharisee’s house, brought an alabaster flask of ointment, 38 and standing behind him at his feet, weeping, she began to wet his feet with her tears and wiped them with the hair of her head and kissed his feet and anointed them with the ointment. 39 Now when the Pharisee who had invited him saw this, he said to himself, “If this man were a prophet, he would have known who and what sort of woman this is who is touching him, for she is a sinner.”

Luke 7:36-39, ESV

A woman of the city, that explains so much.  She comes with a lot of baggage; she has seen all the world at its worst.  Her life has been hard, she has made poor decisions. Enough to pull her into the presence of Jesus.

She may be a stripper, an addict, a porn star. It doesn’t matter, she is a sinner, and scripture does not elaborate beyond this.  All we know is she is ‘a woman of the city,” and that she is referred to as “a sinner.” The sin has made her a desperate person. She steps forward, and does not care about what the crowds are saying about her. She has heard it all before. She comes with her flawed and inadequate heart, to anoint him with an ointment that is somewhat susceptible because of her past.

She pushes forward, pressing past the inner ring of disciples who are ‘protecting’ Jesus.  She takes what she has, and pours it on Jesus’ feet.  It is a concentrate of a perfume that is intense, and very much a declaration of what her heart is wants to do. The scent of this ointment undoubtedly very strong, and lingers, being a concentrate. It probably comforted Jesus while he was being nailed to the cross. He would remember what she had done to him. Her love would comfort him as he was dying.

Jesus acknowledges her decision to bless him in this unique way.  She pushes to him with a single mindedness that we can only marvel at.  She falls at his feet, and Jesus allows himself to be touched by a women that has such a difficult and dark past.  I truly believe He takes everyone whoever comes to him. He passes no judgement on her, and people who are like her— like me.

He has no issues, and accepts all who the Father brings to him.

This sinful woman has shown the way for sinners like us to connect.  Her action establishes for us a precedent— a sure way to advance into his presence.  We start by admitting that we are in a very desperate state.  Her example focuses everyone to all  what is truly important, and we dare not slip past her example. “All have sinned, and come short of the glory of God.” We know that this is true.

We must come, as she has come, in faith that only He can forgive us.  We should come with a radically intense intention to be with him.  There must be a real decision (on our part) to follow after him.  When we actually fall at his feet, we will find ourselves to be completely forgiven.

“Therefore I tell you, her sins, which are many, are forgiven—for she loved much. But he who is forgiven little, loves little.” 48 And he said to her, “Your sins are forgiven.”

Luke 7:47-48

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