Dealing with Depression

Thanks Johnny, nice to be with you here in Carrickaline tonight.

I think I've just been through Carrickaline before so I've never actually stopped in it.

So it's nice to stop in it and stay in tonight so I don't have to go the whole way back to cabin.

So it's nice to be here.

You may be thinking already that doesn't sound much like a cabin accent.

Well it's not.

And in case you're trying to work out where it's from, it's from the other great footballing county in Ireland.

Which of course is Tyrone.

And I'm from Tyrone originally and lived in England for a while so my accent got mixed up there.

And I've been in cabin now for the past eight years.

So I have children with cabin accents.

They've got the real genuine thing.

But hopefully you'll be able to understand and follow me tonight.

But as Johnny said, if you have any questions as we go along, feel free to ask those.

Or we'll have time at the end as well for your questions.

Or if you want to come up and chat to me afterwards.

I can't claim to have all the answers.

As Johnny said, I trained as a doctor.

Worked in hospitals for a while and then as a GP.

And I've been working as a pastor then recently.

And I'll say a bit about that as we go through.

And maybe talk about the experience in medical practice and the experience now as a pastor.

Sure.

So in thinking then about this subject of depression.

I wonder how you're feeling tonight.

If somebody asks you a question like that.

That's the way they ask it in cabin.

How are you?

And then usually people will say something like, not a bother.

And you maybe try to give the impression that you feel a bit like this.

But perhaps on the inside you're feeling a bit more like that.

So the subject of depression is one that is common.

And it's one also that may affect you.

Maybe that's why you've come this evening.

If it doesn't affect you personally, it will affect someone that you know.

And the thing is, as we know, it's a serious condition.

It's a condition that causes a lot of suffering, a lot of pain, a lot of mental turmoil.

And it is, of course, a condition that can lead to end of life.

That suicide happens in some of the people who are depressed.

I read a statistic recently that in Ireland, around 500 people a year will take their own life.

So it's a serious condition.

It's something that it's good to be concerned about.

It's good to think about.

So I'm glad then that you've come this evening.

And hopefully you learned something in our time together.

As it said on the little invite card, if you had one of those, my wife is working as a psychiatrist.

She's a doctor in the community mental health team for Cabin and Monaghan.

So she's working part-time in that.

So it's something that we talk about from time to time.

So even though I've been out of medical practice for a few years now,

my wife is doing it from week to week.

And she helps to keep my head right.

So it's good to be able to talk things over with her and to talk about these issues.

So I try and keep a bit up to date.

And we'll talk a little bit about the definition, what actually is depression.

It can be a bit of a slippery term.

And then we'll look at some of the symptoms that you may experience with depression.

Then we'll take some time and think about the causes before we come on to the cure for depression

and helps with those who have depression.

So what is depression?

Probably all of us have thought at times in some way, I'm depressed and just fed up.

But there's a difference between just having a day when you're a bit down and actually having depression.

So I checked up with my wife about this recently.

Actually, my wife and I were sharing a seminar.

We did a training seminar for youth workers a few weeks back to help youth workers,

help young people with mental health issues.

So I was able to update some of my knowledge on depression as I was listening to my wife.

And she used this slide.

And psychiatrists have quite a defined, definite way of classifying depression.

And so I'll just mention something about this slide and then I'll go on to use my other slide

to kind of break it down a bit.

So psychiatrists will divide depression into mild, moderate and severe.

And there's three key symptoms as far as they're concerned.

Number one, depressed mood.

Number two, a loss of interest.

And number three, easily tired.

So for someone to have what they classify as a mild depressive episode,

you need to have two out of those three at the top for at least two weeks.

So just feeling depressed a day here and there, that isn't actually clinical depression,

what a psychiatrist would call depression.

But if it goes on for, I think it's for most days in a two-week period,

then it could be diagnosed as mild depression.

Two out of three of those key symptoms plus two of these other symptoms.

So I know it's a bit small, so I'll just run through what's on the right.

Reduced concentration, reduced attention, reduced self-esteem and confidence,

ideas of guilt, pessimistic about the future,

ideas or acts of self-harmers or of suicide,

disturbed sleep or disturbed appetite.

So we'll come back to some of those and I'll say a bit more about it.

You might be wondering for yourself tonight,

do I really have depression, do I not?

Perhaps this will help you with that.

Or maybe you're wondering if it's somebody that you care for,

somebody that you are concerned about and you're wondering how to help them.

So mild depression and then moderate is really more of those symptoms,

more of what's on the right-hand side.

It says plus three or preferably four of those symptoms.

And it's really impacting your daily life.

It stops you doing your normal things.

And then severe, it includes agitation and distress

and often a loss of self-esteem, guilt or worthlessness.

So that's just to give you a little flavor of the way in which psychiatrists define depression.

They look on it very specifically.

These come from, I think it's the ICD-10,

which is an international way of classifying all kinds of diseases,

not just mental but all physical diseases as well.

So we break it down into something a bit more straightforward.

It can come down into physical symptoms, emotional,

and then ways that affects your behavior and thinking.

So physical symptoms, sleep disturbance.

Classic one in depression, can't sleep.

Often it is that you wake up earlier in the morning

and it's classically defined as waking up two hours before your normal awakening time.

Now I know with the clocks come back there,

our sleep might be a bit mixed up.

I'm finding myself waking even earlier than usual.

And we're all different, but these are sort of general guidelines.

Change of appetite, usually loss of appetite,

but it can be an increase in appetite as well.

Loss of energy and poor concentration.

Perhaps you can't concentrate to read like you used to.

That would be one way it would affect people.

Change in behavior, stop doing things.

Maybe because of the poor concentration,

perhaps because of a loss of interest,

you become withdrawn.

Maybe take to the bed, find it hard to get up.

Those who maybe were very careful about their physical appearance

begin to neglect themselves and self-harm.

So if self-harm is an issue and suicidal thoughts,

do you think that it's a sensible thing to bring that up?

With somebody who's suffering from depression,

do you think that it might put that idea in their head

so you shouldn't bring it up?

Anybody?

Is it okay to bring up the people?

Ask them, have you ever thought of farming yourself?

I don't think it's okay to bring it up.

It is, yeah.

Yeah, you're right.

That's the general advice,

that it's fine to bring it up

because somebody,

if they're thinking about it anyway,

it'll just give them a chance to talk about it

and a chance for them to unburden themselves to you.

So we're jumping ahead there a little bit

to how to help people with depression,

but it's okay to talk about.

It's a good thing to ask somebody

who's feeling dying.

Emotional symptoms, low mood.

I've got a book here that I've found helpful about depression

and it's got some descriptions of just how people feel

and they say here,

depressive speech is poetic.

Prose doesn't capture the experience,

so it's either silence or poetry.

And here's how some people have put it.

I felt like I was walking through a field of dead flowers

and found one beautiful rose,

but when I bent down to smell it,

I fell into an invisible hole.

I heard my silent scream echo and pierce through my empty soul.

Or somebody else says,

I feel as though I died a few weeks ago

and my body hasn't found out yet.

Or, here's another one, one more,

I could weep by the hour like a child

and yet I know not what I wept for.

So it's not just a feeling a bit off,

but a profound sadness often

with those who are suffering from depression.

Anxiety can often go along with it,

not always, but often.

Irritability,

shorter fuse than usual,

loss of enjoyment.

Loss of enjoyment in the things

that you used to really like doing.

That's often an important symptom

in depression and in apathy,

not wanting to be bothered.

Altered thinking then.

So depression can affect

the way you think about yourself,

the way you think about the past,

the way you think about the world in general,

and the way you think about the future.

So yourself,

the feelings of low self-worth,

lack of confidence.

The past, guilt.

Well, it's normal to be guilty

and you've done something wrong.

But in depression,

that can tend to be exaggerated.

So somebody has minorly offended someone

like years ago

and they start to get really guilty about it

and feel really, really bad about it.

Or maybe it's even a guilt

that they didn't actually do something wrong,

they just feel guilty.

And that can be a symptom in depression.

Or altering thinking about the world,

feeling people are against you.

Sometimes at the severe end of depression,

there are actually delusions

where people have a fixed false belief.

So they might think their next-door neighbours

are in a plot to poison them

or put poisonous gas into their house.

So that can be at the severe end of depression.

Or it might be just a general feeling of

they're looking at me,

I think they're against me.

And then,

altered thinking about the future.

And this is something that's

really important to counteract in depression.

It's a dangerous thing

when people lose hope.

And if you're trying to help somebody

with depression,

an important thing to counteract that with

is that encourage them

that there is hope,

that there is light at the end of the tunnel,

that there's hope.

There's hope.

And I would want that to be a message

to you tonight as well.

If it's you,

if some of these symptoms are describing you,

that there is hope.

There is hope.

There is help out there.

When people start to lose hope,

it's a dangerous thing, really.

So we need to be encouraged

and remind that there is hope.

So what causes depression then?

Let's move on to the causes.

And then, as I said,

we've come to think about treatments.

So there's not usually a single cause

in somebody's depression.

It's usually what doctors call

multifactorial.

Lots of different factors.

Different things contributing to it.

Loss events

can often precede depression.

So losing a loved one,

bereavement,

or maybe losing your job

through redundancy,

or even through retirement.

Or maybe it's loss of health,

or loss of money,

financial crisis,

or something like that.

It can sometimes be good life events

that could be like a promotion,

or the birth of a baby.

Something that triggers it off.

Some change

can often trigger depression.

Family history.

It's in your family.

You're a bit more likely.

It doesn't mean you're going

to suffer from depression,

but there can often be

a family connection.

Early experiences,

particularly abuse.

Those who've been abused as children,

there is a link

with developing depression

later on in life.

personality.

Those who generally are

melancholy,

melancholy type of personality.

But it doesn't always go along.

Sometimes people are very outgoing,

they appear very happy,

on the outside even,

and inside there can be

deep sadness.

Physical illness.

So,

we're going to be saying

in a moment with treatment

that it is important

to go to

your doctor

if you have a significant

level of depression.

The doctor then

would check

for

physical illnesses,

particularly those

that are related

in some way

to depression.

Hypothyroidism

is one that needs

to be ruled out

or ruled in

by your doctor.

So,

checking the level

of the thyroid hormone

in your body

because people

that have low

thyroid hormone,

hypothyroidism,

can end up

with depression.

And if it's treated

with a simple

tablet every day

to keep your thyroid hormone

normal,

it can often

improve things,

improve your general energy

and improve your mood.

Other things

like diabetes,

certain forms of cancer,

can be related

in some way

to developing depression.

So,

physical illness

can sometimes

be linked to depression.

Alcohol

and drugs.

People think

about alcohol

as something

that makes you happy,

stimulates you,

but it's actually

a depressant.

And to drink

when you're sad

can be a dangerous thing

and it can lead

into addiction.

And drugs

are similar as well.

A friend of mine

in Calvin,

he's been struggling

with heroin

and other drugs

as well.

And since he's

come off drugs,

I've noticed

a great change

in his mood

and just how

happier he is

when he was on them.

He's often

a lot more

depressed.

Medication.

Some medications

prescribed by doctors

for other conditions

have the side effect

of contributing

to depression.

For example,

beta blockers

that are used

for high blood pressure

and heart disease,

some of them

can be linked

to causing depression.

But don't go out there

and stop your medication

right away.

Best to talk

that over

with your doctor.

So those are

some of the causes

anyway.

And as I say,

it often can be

more than one

in some kind

of combination

that leads

to the development

of depression.

So what about

the treatment then?

What can be done

to help?

Well,

this is the sort

of classic

somebody going to see

what the Americans

call their shrink.

And that's not

the first line

in helping you

with depression.

Most people

with depression

don't need to end up

seeing somebody

like my wife

going along

to see a psychiatrist.

That's kind of

just for some

and I'll say

in a moment

who it's helpful for.

First line

of treatment

really is to talk

to somebody.

It doesn't have

to be a doctor

even.

It doesn't have

to be some

official person

but just talking

to somebody

about how you're

feeling.

Sharing it.

There is some

truth in that

old saying

that a problem

shared is a

problem halved.

So it's good

to talk to

somebody,

to find somebody

you can trust

and to talk

to a pastor

like Johnny

or to talk

to perhaps

your husband

or wife

or girlfriend,

some family

members,

maybe a friend,

maybe somebody

has brought you

tonight or whatever.

It's good to talk

with someone.

And then

establish a routine.

As we saw

earlier,

when you're

depressed,

you often

don't feel

like doing

things.

And it's

easy to get

out of routine,

to maybe lie

in bed longer,

to not do

the stuff

that you used

to do.

And often

that can send

you into

a downward

spiral.

Because you're

not doing

things,

you lose

confidence.

Because you're

losing confidence,

you don't do

things and

you end up

feeling worse.

But if

somehow you can

keep a routine

going,

and by routine

I mean

continuing to

eat,

continuing to

have

mealtimes,

continuing to

do stuff,

even though

you're maybe

not enjoying

it as much

as you used

to,

just sort of

keep that

routine.

Exercise.

I spoke

on this

subject a

while back

up in

County

Antrim,

and a

man came

to him at

the end

and he

said,

what is it

about exercise

that cures

depression?

And that

was his

experience.

He had

been quite

severely

depressed,

and his

doctor told

him to

exercise,

and he

had got

into this

habit of

going out

for regular

walks,

and it

really transformed

how he felt.

So it is

important,

it won't cure

everybody like

that,

but it is

important to

get out there,

to do something

physical,

to keep a

routine going

of some sort.

Again,

with sleep,

there's a lot

of you might

think,

I need a

sleeping tablet,

I need

medication,

but there's

other things

you can do

to help

with sleep.

Doctors call

it sleep

hygiene,

sleep hygiene,

it doesn't

mean having

a wash

before you

go to bed,

but it's

just tidying

up your

sleeping.

For example,

not looking

at screens,

not doing

Facebook just

before you

go to bed,

not having

your tea

and coffee

maybe too

late in the

evening,

things like

that you can

change around

to perhaps

help your

chances of

getting a

good sleep.

Then visit

the doctor.

As I've

said,

if you're

feeling down

on most

days in the

two week

period and

you've got

some of

those other

symptoms and

you feel,

you know,

I think I

am depressed,

then go to

your doctor,

talk to your

doctor about

it and the

doctor will

most likely

do some of

those initial

blood tests

and give you

some advice,

you might be

thinking,

just give me

a tablet

doctor.

But that's

not necessarily

the best

thing.

When I was

young,

growing up in

the north,

there was an

ad on the

telly which

said something

like,

you don't need

a pill for

every ill,

let the

doctor decide.

And it's

true,

the answer

isn't always

in pills.

Sometimes the

doctor will

refer you for

counselling or

something like

CBT,

cognitive

behavioural

therapy.

An idea

of that is

affecting your

cognitive

function,

that's just

your thinking,

cognition,

thinking,

in order to

affect your

behaviour.

Because often

with depression

we've got

negative thoughts

and that leads

to negative

behaviour.

But if we

can challenge

our negative

thinking,

often our

false,

wrong thinking,

and remind

ourselves of

what is

actually true,

some good

thoughts that

can help

our behaviour.

That's what

CBT is,

in a nutshell,

that's the

basis of it.

So that can

often be

helpful.

So what about

the place of

medication and

psychiatrists?

Well,

medication does

have a part to

play.

I checked up

these statistics

with my wife

and the

thinking is

that medication

will help

around one

third of the

people who

have depression.

So around

one third of

those diagnosed

with depression

will improve

when they're

given medication.

A third

will just

stay the

same and

a third

will likely

end up

getting worse.

So it's

not the

cure for

everybody,

but it can

be helpful.

And you

maybe think,

well, why is

it helpful?

How does it

work?

And why

does it

not work?

Is it not

just that we

have got a

chemical imbalance

and surely if

you give a

tablet then

that will

help?

A bit like

the thyroid

problem that

we talked

about earlier.

But it's

not just as

straightforward as

that with

depression in

general.

You can't

do a test of

the chemicals

in your brain

to see what

needs boosted.

Doctors only

know that

there's a

chemical imbalance

from others

tests and

looking at

brains and

all kinds of

complicated

laboratory tests.

You see,

it could be

that the

chemicals are

imbalanced in

your brain

because your

thinking has

gone wrong.

So doctors

don't quite know

which leads

to which.

Maybe your

thinking isn't

going quite well

for various

factors and

then the

chemicals go

down.

and so

some of the

medication

that's used,

Prozac type

medication,

the family of

drugs,

are they

serotonin

reuptake

inhibitors.

So they boost

serotonin in

your brain and

that can help

some people.

You might worry

about medication,

will it be

addictive?

Well, the

types of

medication that

doctors tend to

use nowadays

aren't

addictive in

the same way

as some of

those that were

used more in

the past are.

And I mean

medications like

the benzodiazepine

family, like

Valium,

Diazepam,

D10s,

D5s,

whatever,

Xanax,

those types of

medication

aren't prescribed

near as much

by doctors now

and they do

tend to be

very addictive.

So the ones

that are used

more commonly

nowadays,

like Prozac

and the

like,

are not

near,

I wouldn't say

they're completely

non-addictive

because it can

be a bit

difficult coming

off and sometimes

they need to be

reduced down a bit

gradually and often

you do need to be

on them for a

significant length

of time.

But the thing to

remember about

medication is that

it's, even if it

does help you,

it's not the

whole answer.

If you think of it

a bit like being

stuck down a

slimy pit,

medication is a

bit like giving

you a leg up

so that you can

start to begin

to think more

clearly and

climb your way

out of the pit.

It's not just

as simple as

if I get the

right tablet

then I'll be

okay.

The tablet

helps you to

think clearly

and address some

of the other

issues.

So going to

psychiatrists then,

yes, they do

have a part to

play in more

severe or

complicated

depression and

going to a

psychiatrist can

be helpful.

So is that

it?

Is that all?

That's a question

that occurred to

me quite a lot

when I was

working as a

GP.

Is that all

we can do?

I, after I

finished studying

medicine at

university, I

went and worked

in the hospitals

for a few years

and then I did

some training in

general practice

and that was

right up on the

north coast.

So you're right

down here in the

south, aren't you?

And I was up on

the north coast

near the Giants

Causeway where

they have a

funny accent.

They almost

sound Scottish,

even funnier

accent than me.

In fact, one of

the first patients

that came in,

he sat down

in the chair

and he said,

a hey, a hack.

And I looked at

him and I said,

could you repeat

that please?

He said, a hey, a

hack.

And what he was

saying was, I

have a cough.

A hey, a hack.

So I had to

learn that sort

of Ulster Scots

language up there.

But when I

learned it and

when I got to

talk to people,

I realised that

yes, it could

help some people

with medication

and referring them

to hospital for

operations and

others through

medication for

their mind and

counselling.

But I could

see as well,

there were other

issues.

People had

spiritual problems

and that was

part of what

led me from

being a doctor

full-time to

being a doctor

part-time for a

little while and

then being a

full-time Christian

pastor as I

work out now.

And so just

before we come

to the question

time, just

explain a little

bit of where the

spiritual aspect of

things I think

comes into

something like

depression.

One of the

early church

fathers was a

man called

St. Augustine.

And he,

oh yeah, I was

going to show you

that first.

Because we're

not just mental

and physical, but

we're spiritual

beings and it

all interacts with

each other.

That's why the

spiritual is

important.

And here's what

Augustine said.

He said about

God, you have

made us for

yourself and we

are restless until

we find our rest

in you.

So you see what

he's saying to

God?

You've made us

for yourself and

so we're restless.

There's an inner

restlessness.

Even people who

have never

suffered from

depression,

there's still,

people have

described it as

like a God

shaped hole.

Something,

something missing.

And I'd say that

was part of what

led me out of

medicine.

To be able to

explain, I

couldn't sit in

the doctor's

surgery and talk

to people about

God all day.

We had like

seven minutes or

something to see

people.

So the waiting

room would soon

fill up.

And so

anyway, that was

part of what

led me to

leave medicine

at that time.

Even better than

Augustine, we can

go back to the

source itself,

back to the

Bible.

And Peter, who

wrote one of the

books, the New

Testament, St.

Peter, described

our existence as

being like an

empty way of

life.

And it's

something that

was passed

down from

generation to

generation.

And in

Peter's first

letter, he

said it like

this.

And we talked

about the way

we can be

delivered or

redeemed, as he

said, set free

from this empty

way of life.

He says, it

wasn't with

perishable things

such as silver

or gold that

you were

redeemed from

the empty

way of life,

but with the

precious blood

of Jesus.

So he's

saying it's

not through

getting lots of

stuff, silver

and gold.

We've tried

that in

Ireland, haven't

we?

And it's

nice to have

nice things.

We're a lot

better off than

we were 40,

50 years ago in

Ireland, maybe

even 30 years

ago in

Ireland, back

in the 80s.

But it

doesn't deal

with all the

inner problems.

And Peter's

saying in this

part of the

Bible, well,

there's something

more.

It's through

Jesus that

there can be

this freedom.

But here's

a fact.

Christians,

those who

have a

personal

relationship

with God

through Jesus,

also get

depressed.

In fact,

one of those

descriptions of

depression that

I read to you

earlier came

from a famous

Christian pastor.

So Christians

also get

depressed.

And you

might say,

well, surely

that should just

sort out all

your problems.

You get the

spiritual help.

But we have

to remember that

we're not just

spiritual beings,

but we are

mental,

psychological

aspect to us.

And we're

physical as

well.

So all these

things are

going on

together.

together.

But the

good news is

that not

only can

we get

help from

doctors and

psychologists

and so on,

but there's

other help

there in

the Bible.

It's a

resource for

people with

different

conditions.

There's a

book in the

middle of the

Bible that's

especially

helpful,

the Psalms,

and those

were the

songs and

poems,

really,

about

experience

with God.

And there's

one in

particular that

I just want

to focus

in on and

just finish

off by

looking at

it.

Psalm 42

and 43.

We have

some little

booklets

that are,

there's some

literature

down the

back,

and one

of them is

this little

one called

Finding

Hope.

So that's

good.

A number

of verses

from the

Bible,

quite a few

from the

Psalms in

it,

something that

might be

helpful to

some of

you.

And one

of the

Psalms,

the Psalms

deal with

all different

kinds of

emotions in

their lives,

and it's

good to read

something like

that and

perhaps to

help have

it explained

to you.

Johnny

mentioned that

the church

here meets

on a Sunday,

and that's

something I

know that

everybody would

be welcome

to,

and part

of that

is explaining

what the

Bible is

saying and

showing how

it's relevant

to our

lives.

One of the

places down

in the

Bible that's

helpful for

depression is

Psalm 42

and 43.

These Psalms

kind of go

together,

and I just

want to point

out a couple

of things in

it to you.

It seems like

the man who

wrote this

Psalm was

depressed.

I know

it's a bit

small,

but I'll

just read

it out for

you.

Verse 3

there,

he says,

My tears

have been

my food

day and

night.

So he's

got tears,

he's crying,

he's sad.

He says,

My tears

have been

my food,

so he's

not eating

very much.

Your tears

are your

food,

you're not

going to

put on

much weight.

And he

says it's

day and

night,

so it's

affecting

his sleep.

So just

in that

little

phrase,

you've

got a

number of

the symptoms

of

depression,

I should

have said

earlier

that with

medication,

I did

say that

it didn't

help

everybody,

but it

can be

helpful

with

the,

especially

with the

symptoms like

sleeping and

eating,

what's called

the physical

or biological

symptoms of

depression.

But this

man,

writing,

as the

Psalms were

written about

a thousand

years ago,

people suffered

from depression

back then

too,

he didn't

have access

to medication,

so how

could he

be helped?

Well,

one of the

ways,

we've mentioned

about the

value of

talking to

others,

and do you

know who the

most influential

person is,

the most influential

human being is

in your life?

Well,

it's the person

who talks to

you the most,

and you know

who the person

who talks to

you the most

is,

it's you,

yourself.

That's right,

because we're

always talking

to ourselves.

From the moment

we get up in

the morning,

we're just

kind of

conversation

going on.

And just

like we

mentioned

earlier about

cognitive

behavioural

therapy,

it's good to

challenge the

negative thoughts,

and that's

actually what

this man does

in this psalm.

He talks to

himself,

look at

verse 5

down at the

bottom there,

why are you

downcast?

Oh my soul,

speaking to

himself,

speaking to

yourself isn't

a sign of

madness.

It's actually

very good,

you don't

have to do

it out

loud,

or you

can if

you want,

but why

so disturbed

within me?

He's asking

himself,

why are you

so down?

And then he

gives himself

some good

advice,

he says,

put your

hope in

God,

for I will

yet praise

him,

my saviour

and my

God.

So he's

someone who

knows God

personally,

and it's

possible to

come into

that personal

relationship,

and he's

telling himself,

put your

hope in

God.

So he's

speaking truth

to himself,

and it's

just an

example of

what we

need to

do,

not just

for depression,

but for

other issues

that can

trouble us

in life.

It's something

you can also

do for

others.

So how can

you help

others?

Well, you

can speak

truth to

them,

you kind

of have

to gain

their trust,

and you

can't just

go in,

jump in,

put yourself

together,

that's probably

not going to

help anybody,

but you

need to

draw alongside.

In the

New Testament

there's a

lovely phrase

about speaking

the truth

in love.

Truth and

love together

can be

such a

help.

Then,

as the

psalm goes

on,

he describes

his condition

in another

poetical way.

He says

there in

verse 7,

Deep calls

to deep

in the

roar of

your

waterfalls.

All your

waves and

breakers

have swept

over me.

So it's as

if he feels

he's out in

the sea of

life and

a little

boat and

all the

waves of

sorrow and

trouble and

they're just

coming in and

he feels like

he's going

down and

he's sinking

down.

But even

in that

expression

there's

hope.

Because notice

what he says

to God.

This is like

a song,

a prayer to

God.

He says

all your

waves and

breakers have

swept over

me.

So he

realizes even

in his

turmoil that

somehow God

is in

charge.

Somehow,

not that

God is

just causing

his sadness

and trouble

directly,

but somehow

behind it

God is

still in

control.

And that

can be a

real comfort

to people

who are

struggling

with any

suffering in

life.

One of the

stories of

suffering that

really has

helped and

challenged me

over the

years is

a young lady

called

Johnny.

At the

age of

17,

she

dived into

some water

that she

thought was

fine,

but there

were actually

rocks

submerged and

she was

paralyzed from

her neck

down at

age 17.

And she

had a real

struggle with

that to

begin with,

but then

came to

terms with

it and it

was her

relationship

with God

that helped

her.

She's had

cancer since

and a lot

of pain

along with

that,

but she's

still going

on.

She speaks

regularly about

suffering and

she has an

organization

helping people

with disabilities.

And this is

something that

she said about

her own

suffering.

She said,

today as I

look back,

I'm convinced

that the

whole ordeal

of my

paralysis was

inspired by

his love.

I wasn't a

rat in a

maze.

I wasn't the

brunt of

some cruel

divine joke.

God had

reasons behind

my suffering

and learning

some of them

has made all

the difference

in the world.

He has

reasons for

your suffering

too.

That might

sound very

strange,

might sound

like a million

miles away

from where you

are at the

moment,

but I just

put it out

there as

something that

has given

comfort to

Johnny and

to others

who have

been in

deep suffering

as well,

and something

that is based

on what we

looked at in

that psalm,

and coming to

realize somehow,

even though we

can't understand

how we could

get through

this time,

that coming to

a realization

that overall

there's a

sovereign God,

there's a God

who can help,

a God who's

in control,

if that can help

to get us

through.

But often

it's a long

haul.

I like to

do long

distance running,

and one of

the reasons

why I like to

do that is

because it

reminds me

just about

life,

and how

often you

just have to

keep going.

It's not the

first mile that's

important in

running a

marathon,

it's keeping

going every

mile.

And that's a

bit like the

man in this,

because he

comes back and

he says exactly

the same

thing to

himself in

verse 11,

and then on

into Psalm

43,

he says the

same thing,

why are you

downcast,

oh my

soul?

Why are you

so disturbed

within me?

Put your

hope in God.

So there's a

need often just

to keep going,

and if you

came tonight

looking for a

quick fix to

just explode you

out of

depression,

I'm sorry,

it often is a

long haul,

it's baby

steps,

it's keeping

going,

but the

important thing to

remember is that

there is hope,

that's why he's

saying put your

hope in God,

there is hope,

there is hope,

but often it's a

long battle,

it's a keeping

going.

One final thing

then from this

Psalm is what

we have here in

43,

they all originally

seem to be part

of one song,

with the same

refrain,

because you've

got the quiet

and cast on my

soul at the end

of this,

but he seems to

get a lot more

positive here,

in verse 3,

send forth your

light and your

truth,

let them guide

me,

let them bring

me to your

holy mountain,

to the place

for you dwell,

then I will go

to the altar

of God,