Op-Ed: For all of the Obamacare Haters

You know what boils my blood?

Hearing all of the GOP presidential candidate frontrunners vowing to repeal Obamacare once they are in office.

To me, this is purely an "us vs. them" move. Conservatives vs. Liberals. Is it just a matter of jealousy? Is the GOP jealous that a Democrat president beat them to the implementation of a wildly successful nationwide healthcare access program? Is this why Congressional Republicans have voted over SIXTY TIMES to repeal the Affordable Care Act? Quite honestly, the jealousy angle is the only thing that makes sense to me. However, I have yet to hear a candidate propose a replacement plan for Obamacare.

I would hate to think that the alternative is true: that GOP candidates want to take health insurance away from the people who most need it, people who HAVE it now under the Affordable Care Act. They claim that they want to repeal Obamacare as an act of "liberty," a return to American "freedom," a fight against government control in our lives. But here's the thing - most of the people complaining about the infringement on their rights DON'T EVEN HAVE TO RELY ON OBAMACARE. Sure, they can paint it as 'sticking up for the little guy,' but I'm pretty sure the 'little guys' here are enjoying their access to affordable healthcare.

Perhaps a look at some common GOP-propagated myths will help us understand this insanity.

Myth #1: Obamacare is socialized medicine.
Not quite - it is a product of socialism, in the sense that everyone has access to it, but it is not funded solely by the government, the way socialized medicine is. Families and individuals with incomes in a certain range may qualify for a yearly tax credit to offset the cost of the health insurance plans available in the Marketplace. The tax credit comes from government funds, but it's the same idea as income tax refunds - and last I heard, the GOP is not against tax refunds.

Myth #2: Obamacare is a significant violation of your rights. 
The right to go uninsured and pay out of pocket for all health-related costs? Yes. The right to die from a treatable condition because you couldn't afford the treatment? Sure. Other than that, your rights are fine. You can even retain your right to not participate in universal healthcare for a small fee. But honestly, why would you want to NOT have health insurance? I don't understand how this argument is working for the GOP candidates.

Myth #3: Obamacare is Big Government's way of controlling your healthcare decisions.
Only insofar as the decision of whether to have health insurance. And again, you can pay the yearly fine to be uninsured. The pundits make it sound like Obamacare is a dictator's dream: control who can access what, control what healthcare everyone gets, control everything related to your health.
Here's how the Marketplace actually works: you create an account with basic information about yourself, your income, your pre-existing health conditions, and your household living situation. And if this sounds like Big Brother, just remember that the NSA can collect more information on you through your phone and internet usage in ten minutes than is contained in your Marketplace application. Plus, HIPAA protections are still a thing. Relax. Based on your answers, particularly the ones about your income and the number of people in your household, either your application will go to your State Department of Health to determine Medicaid/Medicare eligibility, or you will be sent on to the actual Marketplace, where you can peruse health plans available in your state. You can see who the providers are, what the plan's yearly deductible and monthly premiums cost, what the plan covers, what the plan doesn't cover, and links to more information from the provider's website. Let me say this clearly: YOU GET TO PICK THE PLAN YOU WANT HERE. You are not assigned to a plan; you get to see all the options, not just the ones the site thinks you can afford; and none of the plans is provided by the federal government. In fact, since the providers are private companies, the Marketplace is a great example of the free market at work - several companies competing to be your health insurance provider, meaning that they are each trying to offer their services at a price that is just a little bit lower than the other companies' prices! How does the GOP not want this shining beacon of capitalism preserved?
Now, if you're bounced to the Medicaid route, then yes - in a sense, your healthcare decision has been controlled by the government. But even within Medicaid, there is a choice of providers (in Michigan, at least, which is the state I live in). In fact, I think I had a choice of 5 different providers when it came to my application. If you don't choose a plan, the state will choose one for you, but that doesn't mean you have to use it. Plus, you can appeal the decision that bounced you to Medicaid, and then you pay that yearly fine to go without insurance.
For most people, their employer has more control over their health insurance than the government does. the Marketplace is designed for people who are unemployed, who don't get health benefits through their job, or who opt out of employee health benefits. It's likely that your employer offers fewer options than the Marketplace does.

Myth #4: Obamacare is destroying the economy.
The economy is a complicated monster, but here's a basic rebuttal to this "economy destruction" claim. If people have affordable healthcare, they don't have to spend as much of their income on doctor visits, prescriptions, treatments, counseling, etc. If they are saving money in this area, they can spend it in other areas, like food, housing, clothing, family life, transportation, or, best of all, entertainment and material possessions. This will cause an increase in demand, which will encourage an increase in supply, and through some voodoo magic, a revitalized economy.
Here's another approach: if people can afford to meet their healthcare needs, they will be more healthy (imagine that). If they are healthy, they can go to work regularly and enjoy a high rate of productivity. From what I've heard, a strong economy needs consistent productivity, not flash-in-the-pan ventures. If people can generally rely on a steady job, steady economy, and steady access to basic need fulfillment, their stress levels go down. When stress goes down, mental and physical health goes up. And healthy people go to work.

Myth #5: Obamacare is just another program that we don't need and can't afford.
And a corollary - Obamacare is going to cost way more than Obama says. Here's what's happened instead: almost 30 million people have obtained insurance since 2013 thanks to the Affordable Care Act. That's people who weren't insured before, not people who have switched to Obamacare offers. Put another way, 18% of adults in this country didn't have insurance in 2013. Now, that rate is down to 12.3%. Repealing the ACA will put 30 million people back where we started, possibly even more people than that, based on GOP promises to make drastic cuts. Can you honestly get behind a candidate that wants to ruin people's lives like that?
As for the overall cost of Obamacare, the Congressional Budget Office estimates that federal subsidies (those tax credits I talked about earlier) will cost $208 billion less than projected initially. That's billion with a B. That surplus will go to cover deficits in other areas of the national budget. But, then again, Republican presidents seem to be more comfortable with budget deficits.

Myth #6: "Illegal immigrants are going to pour into this country now that they can get free healthcare."
Where to begin on this one...first of all, UNDOCUMENTED IMMIGRANTS is the appropriate term. Second, undocumented persons cannot apply for Medicaid or Marketplace plans because a social security number is required. The ACA doesn't provide free healthCARE to anyone, only free health insurance coverage. And only in very specific circumstances. Most people still have some premium costs or pay-sharing programs to contribute to. Emergency rooms are still required to provide emergency care to everyone, including undocumented immigrants, but that law was in place way before the ACA was passed.

I'm now tired of debunking myths. Let's switch to some facts, peppered with personal anecdotes and impassioned pleas for sanity.

1. The ACA made it illegal for insurance companies to deny coverage to individuals with pre-existing conditions. This meant that if a company found out that you had, say, depression, they could deny your application because it would cost them more to insure you than it would cost to insure someone without depression. This sort of discrimination is what caused so many people to be uninsured. It could have caused me to be uninsured. Now, people don't have to worry about that when applying.
2. The ACA allows parents to keep their kids on their insurance plan until they turn 26. Personal anecdote time: I turned 26 last October and I was not looking forward to it because I knew it would mean that I'd lose my dad's primo health insurance. That policy covered almost everything; most notably, unlimited counseling, physical therapy for vertigo, and incredibly dental services. The previous age was 22, I think, and I am so thankful that the age was raised to 26. I used more health services between ages 22 and 26 than I used in the previous twenty-two years combined. I wear glasses ($250 per pair), I take two prescriptions every day (almost $100/month for both in addition to the 15-minute psychiatrist visits 4 times per year to get the prescription) plus a number of over-the-counter supplements, I see my therapist once a week ($140/session), and I've had two episodes of disabling vertigo in the last year (I don't know what the physical therapy treatments cost). With five of us contributing to the yearly deductible, I didn't even have to make co-payments after, like, February every year. I miss that insurance so much.
3. The ACA is improving people's lives, if not completely saving them. One example - my mom is a physical therapist's assistant and her company has seen its number of clients soar because of the Medicaid expansion. And this is not just clients who want a massage, or are rehabbing a sports injury. These are people who are chronically unemployed because of chronic pain from a decades-old injury. These are people who have been injured on the job and worker's comp didn't cover their needs. These are people whose every last dime goes toward food, clothing, housing, and childcare, and who never dared dream that PT was within their reach. Can you really tell me that it is in our nation's best interest to keep "the least of these" trampled under our feet? Where is the Christian family value in that?
4. The ACA indirectly lightens the burden on community agencies that provide healthcare. This year, I'm working at a school that serves a high percentage of low-income families. We're talking Free and Reduced Lunch Program participation at 85% of students. Cherry Street Health Services provides free vision and dental check-ups every year to students who qualify for them. The dentists were at our school right before Christmas break and I made small talk with one of the dentists while I waited for a student I was working with. She told me that the number of students they've seen in schools has been declining in the last few years. I asked if this was a good thing or a bad thing, and she said that the decline was the result of increased access to Medicaid and Obamacare. This meant fewer free check-ups to provide, lowered stress levels for clinicians who were serving a population that just kept growing, and less strain on the budget for providing services to uninsured clients. So yeah...fewer student participants was a great thing.
5. The ACA represents a move forward for the United States. All this GOP talk about "restoring America's glory" and "making America great again" generally makes me roll my eyes because the ACA is a piece of legislation that caught the US up to other developed nations. Access to universal healthcare overwhelmingly raises the standard of living, longevity, emotional health, and prosperity of a nation's people. Why would the GOP not want this?! How does the GOP propose to "make America great again" if they're champing at the bit to cut off access to health insurance for 30 million of their own citizens? Does this party really represent the interests of our people?

By way of conclusion, a personal plea - please don't vote for any GOP candidate who promises to repeal the Affordable Care Act. The ACA has saved my life - from the extra four years on my dad's insurance to the expanded Medicaid access that I use now until I land a career job. The ACA has allowed me to attend over 150 therapy sessions for free in the last 3 years. The ACA provided me with physical therapy for vertigo, enabling me to return quickly to work and school. The ACA allowed me to put my money toward graduate school and training for a career that I absolutely love, instead of having to spend it on healthcare. Most of all, the care I've received under the ACA has kept me from giving in to depression, a condition which has tried to knock me out every day.

Please don't put anyone in office whose platform is to ruin my life and the lives of 29,999,999 other Americans. 

In Which I (possibly) Become a Guinea Pig

Hello, friends.

About a week ago, I was at the Christian Counseling Center for my weekly session with Sherry. Next to a stack of magazines, there was a new notice:

"Pine Rest is sponsoring a clinical research study for clients who have a diagnosis of Major Depressive Disorder (MDD) and who have not experienced relief through medication or therapy. Research is now being conducted to examine the efficacy and safety of Sirukumab, which is also being studied as a treatment for rheumatoid arthritis. If you have any questions or have interest in participating in this study, please call our research coordinator at (phone number)."

(That's the gist of what the notice said. It was a lot longer and had a lot more description and screening information. I would have wasted both my time and yours in retyping all of it.)

I mulled that study description over in my head for a week. What I should have done was asked Sherry about it right away at our session, since I had just read it and it piqued my interest. I had always thought that my diagnosis was more along the lines of Persistent Despressive Disorder instead of MDD, though, so it didn't cross my mind to ask her about the study.

Over the weekend, I kept thinking about it and I did some of my own research. What was Sirukumab? Where else was this study being conducted? Is this drug approved and safe and legit? Could I maybe get paid if I qualify to participate? Would I have to stop going to therapy? Thank goodness this sort of activity is all federally regulated and monitored, so there is an entire .gov website devoted to clinical trials happening in the US. I'll get into what the study is all about in just a little bit.

During the following week, I corresponded with the research coordinator at Pine Rest to tell her that I was interested and to ask for some more information to see if I qualify. I opted to do some pre-screening questions over the phone, but we couldn't get a solid half-hour on the phone til Friday because I had parent-teacher conferences and professional development during the second half of the week. Plus, I wanted to bring it up to Sherry before making any appointments. On Thursday, I had counseling again, so I got some more information and signed a consent form to be contacted about participation (just in case, I think, since I had already been in contact with the coordinator).

Then on Friday, after PD and some lengthy conversations with parents, I was able to get on the horn with Pine Rest for the pre-screening. She asked me a bunch of questions about my health, my age, my depression symptoms, comorbid conditions (i.e., my anxiety), and logistics of participating for the full six months the study would require (i.e., could I come to Pine Rest's main campus for appointments, could I take off of work if needed to accommodate appointments that might last up to five hours, would I be living in the area for the next six months, etc.). After answering all of her questions, she told me that as of right now, I seem to be a great candidate for this study. The only concern is whether my depression is "severe" enough. Anyone reading this who has depression will understand why I put that in quotation marks - one's experience of depression (and its severity) will fluctuate from day to day or season to season. In my case, the question is whether I am currently in a "major depressive episode." As in, is my depression worse right now than my baseline depression? Honestly, I couldn't begin to tell you, since what on earth is my baseline for depression? It's not "no depression symptoms present," since I haven't experienced that since I was 18. And if history is any indicator, my "major depressive episodes" tend to coincide with fall and winter, which means that I may be (and definitely probably am) heading into one right now. Plus, how are we gauging my symptoms? Symptoms with antidepressants + therapy? Symptoms with antidepressants without therapy? Symptoms with neither? It's too hard to evaluate myself on those terms since I've taken meds nonstop for four years and gone to therapy every week for three years.

Do you see why it takes so long for new treatments to hit the market?

Anyway, I will go to the study clinic on Thursday morning for official screening and, if all goes well, the initial contact session. Here's what the study entails, and some Research Methods 101 for those of you who are not familiar with how this sort of thing works:

 - Participants will receive either an injection of Sirukumab, the treatment under investigation, or an injection of placebo (so that the doctors can determine if there is any clear benefit experienced by the people getting the Sirukumab). The participants won't know which injection they get, and neither will the study doctors, so that the results will be as free as possible from bias and unconscious interpretation. In studying a condition like depression, this is extra extra super extra important, as reporting of symptoms is entirely subjective - there's no blood test or exam to determine if my "level of depression" has gone down. If I think I'm getting the Sirukumab, I may unconsciously skew my reporting of symptoms by describing them as less severe than they may actually be. In other words, I may want so badly for this drug to work that I try to prove to myself and the clinicians that it is working. I'm hoping that my background understanding of research and my long-term experience of depression will help me to evaluate my symptoms accurately.

- Participants will get bloodwork done on a regular basis to see if the Sirukumab is having an effect on the thing they want it to have an effect on. From what I understand, Sirukumab works like an anti-inflammatory drug - something is signalling the body's immune (?) system to have a certain response, indicated by inflammation. And we're talking inflammation on a cellular level, not like inflammation of the lips or ankles. If only it were that visible. Introducing an anti-inflammatory tells the system to cool it, stop inflaming, nothing to see here. Sirukumab was first developed as a treatment for rheumatoid arthritis, which is all about inflammation, but research conducted recently claims to show a link between inflammation markers in the blood and experience of symptoms of depression. That is, the more "severe" the depression, the more likely it is that the person also has high levels of these markers. This study is meant to explore this link and see if an anti-inflammatory that is specifically designed to cooperate with antidepressants (many AIs are not) will lessen the severity of depression symptoms. Antidepressants have no effect on inflammation, so a positive outcome from this study could revolutionize the treatment of long-term depression (like I have) that doesn't go away with just antidepressants.

- Participants get three injections over 12 weeks, with appointments in between the injections as well, and then there are 5 or 6 appointments over 14 weeks after the set of injections is completed. This is probably to gauge response to the injection over time. To compensate for all the driving and time spent in the clinic, participants get a $50 Meijer card for every appointment completed. Lucky for me, I live in the Grand Rapids area and Pine Rest is not that far away from me. BLAMMO.

I really really really really hope that they will select me to participate in this. It's fascinating to me. While I have (more or less) come to terms with the idea that my depression may be a lifelong struggle, I still hold my candle of hope that new discoveries will be made that lessen the symptoms and severity of depression. This sounds like it could do that, since it's an entirely different direction for research of depression treatment. I honestly don't even care if I get the placebo. I just want to be a part of something like this. I want to put my depression to work for me, instead of working against me, like it seems to do a lot of the time. If it works and becomes a thing, I think it would be so cool to be able to say down the line, "hey, I was part of the clinical trials for that drug!"

This is going to sound like a very bizarre request, but would you all pray that my depression meets the criteria for "severity"? Odd, I know, to pray that a disease is bad enough instead of praying for it to get better. I just hope that I can convey to the interviewer that mine is the depression they are looking for - it may not prevent me from going to work or class or getting things done, but it is still with me every single day, in spite of meds and therapy. In fact, I think it would be a LOT worse without therapy. Maybe they can use my description of how I felt before starting therapy. Compared to now, that was pretty severe.

Hopefully, I will be able to tell you all on Thursday afternoon that I was accepted to the study! Until then, more middle school drama and joys of adolescence. I'll have to write about that sometime. That could keep me busy writing for weeks.

What good is a picture of the dark?

When I was in high school, I went on a youth group trip to Rehoboth, New Mexico. There was a student a few years younger than me who took pictures of the most bizarre things. He would take multiple pictures of the same bizarre thing, too. A cactus needle really close up. A person from very, very far away. The sun at noon. Things that no one else would think to take pictures of.

One of those bizarre things was a completely black night sky. If you flipped through the pictures of this sky, you would think that he had taken pictures of the inside of his pocket by mistake because they showed up simply as black rectangles. But here's the real story: there was a lightning storm many miles away that night. We could see it from the dorms we were staying in. Lots of us set up camp to watch it for a little while because it looked so cool. The student, let's call him Craig, wanted to take pictures of the lightning storm. He was convinced that if he pushed the button at exactly the right moment, he would capture a streak of brilliant lightning against the black sky. It didn't matter to him that he all he had so far was a bunch of black pictures, or that he was using a simple point-and-shoot digital camera. Craig wanted a picture of lightning and he was going to try to get one no matter how many people said it was impossible.

Without knowing the story of the black pictures, you would learn absolutely nothing from them. You wouldn't know who took them, where they were taken, what they were of, or what the point was. You would say, "What good is this picture of the dark? And why are there so many?" Craig would be able to tell you exactly why he taken those photos, if you'd only ask.

Depression is a collection of black pictures. There's the obvious connection that depression feels like a black cloud or a walk through darkness with no light to guide you. It goes deeper than that, though. From the outside looking in, it's hard to understand depression when all you have to look at is a series of black pictures. The photos themselves don't tell a story, don't show anything useful, don't explain a damn thing. You need the photographer's story - words on paper, words spoken aloud, words that form a story.

But depression can rarely be explained adequately with words. Believe me, I've tried. It's invisible, so I can't describe what it looks like. I can describe what a person may look like if they are experiencing certain symptoms, but that's not the same thing. That's like saying that wind looks like trees moving back and forth. The pain is intangible - I can't point to where it hurts and I can't explain how it hurts, only that it does. You would have to crawl into my head (or perhaps my heart) to understand what depression is and does. All I'm left with are these photographs of the dark that say, "I have borne witness to this, I have been here, I have lived to tell you about it."

Society has taught us to keep quiet about our pictures of the dark. It has taught us that if you can't take a picture of something, it may as well not even exist. A picture of the dark means nothing and proves nothing.

That's not true though. A picture of the dark proves that there was someone present to witness the dark and capture it, if only for a moment. That dark represents something that cannot be seen, but must be felt or heard or lived. And just because you cannot see it does not mean that it doesn't exist.

Five Years

Hmm. I seem to be doing that thing where you write only 3 times per year. Like, every four months. I'm a bit embarrassed by that, really, because I used to be so good about posting at least once a week. I can't say that I've been more busy. In fact, I probably have more free time now than I did last semester. I can't say that nothing interesting has happened to me in four months, because my life is nothing if not a ball of interesting. And I can't say that I haven't been inspired by anything, because that's not true either. If anything, too much has been happening and I simply don't know how to write about it.

What I want to write about tonight is this: I've surpassed the 5-year mark in having depression. It makes me feel like I should receive one of these:

I have split feelings about this. On one side, I think, why do I still have depression? How have I not kicked this thing yet? Does this mean that my meds aren't working and I should get different ones? Is my counseling not working and I should find a new therapist? Why can't I be done with depression now? 
But then I remember that depression is its own animal. It's not a case of pneumonia that can be cured with a round of antibiotics. (I had pneumonia over Christmas, by the way. Unpleasant.) The fact that I have had depression for 5 whole years is incredible, really, when you consider that depression has a mortality rate of 20%. For those of you bad at math, that means that 1 in 5 people die from depression (by suicide, alcohol poisoning, overdose, etc).  It means my meds and counseling are working. They're working to keep me alive. This is what makes me want a 5-year chip - it's like, hey, I have survived five years of this horrid disease (by the grace of God, quite frankly) and I did not give up or give in. I'm still here. So don't tell me that I need to try something else, or buck up, or be tougher. Would you say any of those things to a cancer patient who still had cancer five years after being diagnosed?

So that's been happening. And with that comes this wonderingment...when someone is successfully treated for depression and says they no longer feel depressed, people will say "you're back to your old self." I wonder, what would that look like for me?  Five years ago, I was 19. Do I want to go back to who I was at 19? Not really. I was barely an adult, for crying out loud. Depression has been happening during my self-identity formation years. So who am I? Who is that old self?

I sometimes wonder who I would be if I hadn't had depression all this time. Would I be a better person? Would I be a worse person? I like to think that depression has taught me a lot of things, like how to better understand and have compassion for other people. I also like to think that is has made me more patient and less judgmental. Would I have developed those qualities in the absence of depression? And, perhaps most importantly, would I have ended up in a masters program learning how to be a counselor? I can't imagine that I would.

Now that it's mid-March, I've thought of a New Year's Resolution. I almost never make resolutions. Chalk it up to laziness. But this year, it seems that mantras are becoming a Thing, so it came to me one day to combine the two. My mantra/resolution is "Rationalize less. Feel more." Basically, I want to not let my thinking and analyzing minimize my emotions. I've done that practically my whole life. It goes kind of like this:

"I feel very sad." ---> Why do you feel sad? ---> "I don't know." ---> That's not a reason. ---> "Seriously, I don't know why I feel so sad." ---> You probably don't have a good reason, so you should just cheer up.

Instead, I want to do away with that kind of thinking. There doesn't have to be a reason for everything. If I can't find a reason for feeling depressed, I a) shouldn't try to create one, and b) shouldn't feel bad about myself. I should focus instead on truly feeling what I'm feeling and not trying to stuff it down somewhere and compartmentalize it. It is what it is.

Do you hear me? It is what it is. 

Op-Ed: For Those Who Say that Christians Shouldn't Be Depressed / Para Ellos que Dicen que los Cristianos no Deben Estar Deprimidos

Pastor Cordova's piece is written in Spanish and I have translated it into Spanish; my piece is written in English and translated to Spanish as a courtesy to Spanish-speaking readers. 

Por cuanto la DEPRESION no tiene causa orgánica; es muy poco lo que la medicina (anti-depresivos; y otros medios) pueden hacer. Atacan los síntomas; pero no van a la raíz; que en última instancia es el pecado. Una persona, sea creyente o no; que no asume sus responsabilidades; peca contra Dios. Un patrón no va a excusar a su empleado que le diga:" Hoy no voy a trabajar porque me siento deprimido".

         Culpar a otros por nuestras conductas pecaminosas no es nada nuevo: "La serpiente me engañó, la mujer que me diste…nuestros primeros padres querían evadir su responsabilidad. Dios les dijo: ¿QUE HICISTES? No bebamos las inútiles teorías de muchos "profesionales" en relación a este asunto. El deprimido puede ser ayudado por los recursos del consejo divino. El semblante de Caín decayó (Gen.4:5) cuando mató a Abel. Estaba deprimido por su pecado. Dios no le excusó; en esencia le digo que era lo que tenía que hacer para salir de ese siclo: "Si bien hicieres, ¿no serás enaltecido? v.7. "Asume tu responsabilidad, Cain arrepiéntete y serás restaurado. No pequemos contra Dios pensando que un psicólogo inconverso tiene más recursos que nosotros para ayudar al deprimido. Tenemos el Espíritu de Dios y los recursos de Su Palabra.

                Because depression has no organic cause, there is very little that medicine (antidepressants, y other methods) can do. They attack the symptoms, but they don’t go to the root, which ultimately is sin. A person who, whether a believer or not, doesn't assume his/her responsibilities, sins against God. A boss is not going to excuse his/her employee that says “Today I’m not going to work because I feel depressed.”

Blaming others for our own sinful conduct is nothing new: “The serpent deceived me, the woman gave me…” Our original parents wanted to shirk their responsibility. God told them, “What did you do?” Let’s not drink in the useless theories of many “professionals” in relation to this matter. The depressed person can be helped by the resources of divine counsel. Cain’s demeanor got worse when he killed Abel. He was depressed because of his sin. God did not excuse him; in essence, He told him what he had to do in order to escape that cycle: “If you do what is right, will you not be lifted up?” Assume your responsibility, Cain, repent and you will be restored. Let’s not sin against God thinking that an unbelieving psychologist has more resources than us in order to help the depressed person. We have the Spirit of God and the resources of His word.

Here’s where I’d like to start: how can you say that depression has no organic cause? There is a mountain of research that indicates that depression can be caused by neurotransmitter imbalance in the brain. Sure, some people experience depression because they did something that they feel guilty about, but that’s certainly not true of everyone. Or what about someone who begins to suffer from depression after someone close to them dies? How did that person sin? Surely the loss of a meaningful loving relationship isn’t a sin.

I will agree with Pastor Cordova that pharmaceuticals alleviate the symptoms of depression without fixing the root of it, but that’s not true for everyone. I have met people whose depression has been managed so well with antidepressants to the point that they no longer experience symptoms of depression. I’m sure one could make the argument that those people are simply using drugs to deceive themselves, but that’s not proof that medications can’t eradicate depression.

Now we come to the point with which I have the most contention: Depression is caused by sin? I can see how you would think that, especially if your experience is that depression pulls people away from God, but I wholeheartedly disagree with the assertion that depression is caused by sin. As many of you know, I have suffered from chronic depression since 2008. I take antidepressants each morning, and I go to counseling with a wonderful psychologist (who is also a Christian) three to four times a month. I have a problem with people that say that I am depressed because of my sin. I admit that I am a sinner and that there’s nothing I can do to save myself from that. But what am I supposed to have done that has caused me to feel this way for so long?

The example of an employee who calls in depressed to work shows that Pastor Cordova has little to no understanding of the true nature of depression. As I have written before, depression is not simply feeling sad. It’s a condition that can decimate a person’s will to live. It can put a person flat on his or her back just as effectively as pneumonia can. It may be the common cold of mental illness, but that doesn’t mean that it’s not an intense, painful, and dangerous disease.

I find it somewhat unfortunate that Pastor Cordova needs to refer to doctors and psychologists as “professionals” with the quotation marks. Have those people not gone to school for many years, worked many internships, and earned the right to be considered professionals, no quotation marks? Pastors go to school, obtain graduate degrees, work internships, and must be ordained in order to be pastors. Just because you think their science is faulty does not mean that they do not deserve respect for what they have accomplished.

The example of Abel’s murder at the hands of his brother is particularly revealing of Pastor Cordova’s attitude toward the relationships between what mental health professionals call the ABC: affect, behavior, and cognition (feelings, actions, and thoughts). According to Pastor Cordova’s interpretation of the account in Genesis, Cain experienced depression after killing his brother. This is an example of behavior influencing feelings. But that’s not always the way it goes. Some people experience the feelings first with no sinful behavior. That’s how it was with me. I had graduated from high school, started college three months later, worked after the summer at a job I absolutely loved, and had plans to pursue a career in teaching. I was not mean-spirited, I did not step on other people to get what I want, I worked hard in school and at work, I did my best to help other people, and I certainly did not murder my brother. During that period of my life, when I first realized that I suffered from depression, I spent a lot of time searching my head and heart, trying to determine what I had done to deserve this. It took a long time for me to come to terms with the fact that Christians can be depressed just the same as non-Christians. It was almost as if I had to forgive myself for a condition that I couldn’t control.

I don’t believe that depression has to pull Christians away from God. It certainly can; it is a serious condition that should not be underestimated. At the same time, it has the power to bring people closer to God as well. I don’t always feel close to God, but I trust Him to always be close to me. I don’t believe that God is punishing me for my sin with depression any more than God punishing someone with cancer or a miscarriage or fatal car accident at the hands of a drunk driver. And while I know that it was not God’s original intention for me to be depressed, I have faith that He will use it to bring me and other closer to Him. I already see that in my life in my training to be a counselor and my ability to relate to and empathize with other people.

So, Pastor Cordova, what would you say to me about my experience with depression? Is my experience valid, or am I simply deluding myself?

Quiero empezar aquí: ¿cómo puede usted decir que la depresión no tiene una causa orgánica? Hay un montón de hallazgos de investigación que indican que la depresión puede resultar a causa de un desequilibrio de neurotransmisores en el cerebro. Cierto, algunas personas experimentan la depresión a causa de algo que hicieron por el que se sienten culpables, pero eso no es verdad de todos. O pensemos en la persona que empieza a padecer la depresión después de que un querido se muere. ¿Cómo pecó esa persona? Por seguro, la pérdida de una relación significante y cariñosa no es un pecado.

Estaré de acuerdo con Pastor Cordova que los farmacéuticos alivian los síntomas de depresión sin arreglar la raíz del problema, pero, otra vez, no es verdad para todos. He conocido a personas cuya depresión ha sido suficientemente manejada hasta el punto que ya no experimentan sus síntomas de depresión. Estoy segura que se puede formar el argumento que esas personas simplemente usan las drogas para engañarse, pero eso no es una prueba que los medicamentos no pueden erradicar la depresión.

Ahora venimos al punto con el que tengo la más disputa: ¿La depresión es causada por el pecado? Puedo ver cómo usted puede pensar así, especialmente si tu experiencia es que la depresión le fuerza a la gente alejarse de Dios. Pero disiento con todo corazón con la aserción que la depresión viene del pecado. Como muchos de ustedes ya saben, he padecido depresión desde 2008. Tomo un antidepresivo cada mañana, y asisto a terapia con mi psicóloga maravillosa (quién también es cristiana) tres o cuatro veces al mes. Tengo un problema con la gente que dice que estoy deprimida a causa de mi pecado. Admito que soy pecadora y que no hay nada que puedo hacer para salvarme de mi pecado. Pero ¿qué es lo que se supone que he hecho que me causa sentir estas emociones?

El ejemplo de un empleado que llama a su jefe y dice que se siente deprimida muestra que Pastor Cordova tiene poco entendimiento de la esencia verdadera de la depresión. Como he escrito antes, la depresión no es simplemente sentir triste. Es una condición que puede diezmar la voluntad para vivir de una persona. Puede confinar a una persona a la cama tan eficazmente como la neumonía. Se dice que la depresión es el resfriado del mundo de enfermedad mental, pero eso no quiere decir que no es una enfermedad intensa, dolorosa, y sumamente peligrosa.

Lo encuentro un poco desafortunado que Pastor Cordova necesita referirles a los doctores y psicólogos como “profesionales” con las comillas. ¿No han asistido esas personas a las escuelas graduadas, trabajado muchos prácticas y residencias, y ganarse el derecho de ser considerados profesionales, sin comillas? Los pastores asisten a la escuela, obtienen especializaciones graduadas, hacen las prácticas, y necesitan ser ordenados para ser pastores. Puede que su ciencia sea incorrecta, pero no significa que no merecen la respeta por lo que han logrado.

El ejemplo del asesinato de Abel por su hermano Cain es particularmente relevador de la actitud de Pastor Cardova hacia lo que los profesionales de la salud mental llaman el ABC: affect, behavior, y cognition (sentimientos, acciones, y pensamientos). Según la interpretación de Pastor Cordova del cuento en Genesis, Cain experimentó la depresión después de matar a su hermano. Éste es un ejemplo de lo del comportamiento influyendo los sentimientos. Pero no es siempre lo que pasa. Algunas personas experimentan los sentimientos primero sin las acciones pecadores. Eso es lo que me pasó a mí. Había graduado del colegio, iba a empezar la universidad tres meses después, había trabajado en un trabajo que realmente me encantó, trabajé duro en la escuela y en el trabajo, me esforcé ayudar a otros lo más posible, y ciertamente no maté a mi hermano. Durante ese período de mi vida, cuando primero me di cuenta que padecí depresión, pasé mucho tiempo buscando en mi mente y corazón, intentando determinar lo qué había cometido para merecer esto. Me costó mucho antes de que yo aceptara que los cristianos pueden estar deprimidos tanto como los no cristianos. Era como si tuviera que perdonarme por una condición que no podía controlar.

No creo que la depresión tenga que estirar a la gente y despedazarle de Dios. Se puede hacerlo, seguramente; es una condición muy grave que no debe ser subestimada. Pero al mismo tiempo, tiene el poder de hacerle a la gente acercarse a Dios también. No siempre me siento cerca de Dios, pero confío que Dios siempre estaré cerca de mí. No creo que Dios me castiga por mi pecado con la depresión; después de todo, Dios no castiga con el cáncer o el aborto espontaneo y un accidente fatal a causa de un conductor emborrachado. Y mientras que sé que no era la intención original de Dios que esté deprimida, confío que Él lo usará para traernos a mí y a otros más cercanos a Su mismo. Ya veo esto en mi vida y en mi entrenamiento  de ser consejera y mi habilidad de verme reflejada en otras personas y mostrar empatía.

Así que, Pastor Cordova, ¿qué me puede decir usted sobre mi experiencia con la depresión? ¿Es válida mi experiencia, o simplemente me engaño?

The OCD Monster

So here's an interesting story...

I was working in the ole candy store tonight and after the dinner rush subsided, I had a chance to look around and see what a hot mess the store had become in all the mayhem. Boxes on the floor, empty ice cream containers on every surface, and containers of candy everywhere thanks to our new shipment. I started darting around like a crazy person, breaking down boxes and tidying up. After a few trips to drop off bags of trash and a stack of cardboard, I took a good look at the shelves underneath the candy counters. Boxes of Sour Geckos were in nine different locations. 50¢ candy was on the shelf beneath the 5¢ candy. Several half-full boxes of Gummi Hot Dogs were scattered around. The candy was out of control.

There is little that irks me more than unnecessary disorganization.

Something snapped inside me and I became singularly obsessed with organizing the candy as soon as possible. I looked like a maniac, pulling boxes off of one shelf and tossing them onto the floor near the shelf on which they were supposed to sit. It's a good thing there weren't any customers around because I was wearing my crazy eyes.

Several other small incidents contributed to my psychosis later that night, but I won't list them for you. Let's just say that I became so agitated and worked up and ready to snap that I put myself to work in the back stock room. I was so afraid that I would let loose on a customer who said the wrong thing. It was better for all involved that I just go and work on something else with no people around.

So I grabbed a cloth and set to work on wiping down freezers and shelves and restocking and organizing and consolidating. Let me just say that I am the queen of consolidation. I absolutely love it. Anyway, I started moving faster and faster, flitting from job to job and definitely not doing them in the most efficient way possible. I'm usually very efficient (unless I am purposely trying to drag out a job), but my brain was so full of little tasks that I kept adding to my mental list. I ended up not even finishing jobs because I was so agitated.

When I got around to the freezer, I sat on a stool and scrubbed at the smallest spots for minutes on end. I was determined to scrub every square inch completely clean. I wanted every tiny blemish gone. I had become obsessed by the thought that I had to get the freezer clean before I could relax.

Anyone who knows me, most especially my mother, will tell you that I am not an obsessive cleaner. I like to have things neat, I don't like to have food laying around, and I definitely don't like visible grime. But am I immediately going to grab a washcloth and wipe up after my roommates? No. Therefore, this obsessive frenetic cleaning was completely out of character for me.

It was scary. It was unnerving. I didn't know how to handle it. I've never been diagnosed with full-blown Obsessive Compulsive Disorder, but I do have obsessive-compulsive tendencies. Here's the difference: my life is not ruled by obsessive thoughts and compulsive behaviors to assuage those thoughts. But, from time to time, I get overcome by obsessive thoughts that simply will not go away. Case in point: I got unreasonably upset about being pulled away from cleaning that freezer because of an ice cream rush. In my right mind, I would jump at the chance to get out of cleaning. My mom can testify to the fact that I put off my weekly chores as long as possible when I was younger. But tonight, all I wanted to do was clean. Maybe "wanted" isn't the right word...it was more like a force inside of me was compelling me to clean.

I've calmed down now, but at the time, it was scary. Whenever I talk to my psychiatrist about these little sparring matches with the OCD monster, he tells me to ride it out. Don't try to fight it, because that will make it worse. Just ride it out. Do what you have to do and survive each episode.

So I guess that's what I'll do. I don't have a better solution or answer right now.

Simple Fixes

It appears that my tiredness and fatigue and lethargy has a simple fix: Zoloft and Vitamin D.

That's right. My blood work showed that I have a Vitamin D deficiency. I know what you're thinking: how can Andrea, whose backyard is Lake Michigan, have a Vitamin D deficiency?! I was wondering the same thing. I pointed this out to the doctor who suspected the deficiency, and she said that it was probably more likely that my body has an inability to produce Vitamin D from sunlight. She prescribed two 2,000 IU Vitamin D pills for me to take every day. That is one THOUSAND percent of my daily need of Vitamin D. In my Google research, I didn't find any tie between Vitamin D and fatigue/energy. But I guess between those pills and the new antidepressants, something is working.

I'm finally feeling better. I've made it all the way to midnight the last three nights. That hasn't happened in MONTHS. I haven't had to talk myself into getting out of bed in the morning this week. I no longer find myself yawning as I hand over ice cream cones and hamburgers. Perhaps best of all, my strength is returning. I can lift the 3-gallon tubs of ice cream again, I can go upstairs without getting tired, and I'm back to being a scooping machine.

Part of me wishes that the answer had turned out to be something more glamorous, like a rare disease or condition that stumps the experts. But then I think, hello, those rare diseases and conditions hardly ever have such cheap and simple fixes as a nutrition supplement. Two hundred Vitamin D pills cost me, like, eight bucks or something and last me three months. Don't be a martyr, Andrea. Enjoy your simple fix.

So here's to hoping that this actually IS the simple fix and not just a weird side effect of two new prescriptions. I have a follow-up with the sleep clinic in about three weeks to discuss how the Vitamin D supplement is working. If my fatigue comes back, we move forward with a sleep study. My muscle twitching and leg jerking haven't gone away yet, so if that's still happening, then I think I get a referral to a neurologist.

Thank you so much for your prayers and encouragement. I really appreciate all of you. I'm thankful that we are finally getting somewhere and for all that God is teaching me through this ordeal.

On a separate, unrelated note, this is post #100. :)

Change of Pace

Now that we are well into summer, I've determined that my constant tiredness was not simply a result of school year stress. In fact, some days, it's worse than ever. Hmm. Dilemma. I wake up so very tired (and often sore) every morning, go to work, and never quite wake up. Yesterday, it was my turn to mop the kitchen and it took me twice as long as it did before because I had to stop and rest so often. I feel so pathetic in this malfunctioning body.

A few Sundays ago, something truly scary happened to me. I yawned my way through morning church, much like the way I yawn my way through devotions and Bible School on the weekdays, and when I got back to my cottage, I fell into bed and closed my eyes. Three hours later, I woke up and got out of bed, but only because I knew I needed to eat something for lunch. It was a good thing that my parents had left some lunch in the refrigerator or I probably would have sat at the table and just stared at the cupboard, waiting for something to jump out and land in front of me. My motivation to find something to eat was zero.

I crawled back into my bed after returning to the cottage. There was nothing I wanted to do. Nothing sounded good. I had no energy and no motivation to do anything but lay in bed with my eyes closed. I didn't even care that I wasn't sleeping. Usually, if I'm in my bed under the covers, I'm trying to fall asleep. This time, I didn't even care. I passed several hours this way that Sunday. My housemates thought I simply wasn't feeling well, mostly because I didn't correct them when they asked what was wrong. And truly, I wasn't feeling well. They assumed physically, and I didn't tell them otherwise. My mind was a dangerous place.

Now, wait a minute, Andrea...aren't you taking medication that is supposed to get rid of these types of feelings and symptoms of depression?

My meds, which I have depended on since September, weren't working anymore. Or rather, they were working to make me worse. I was experiencing negative emotions that I never even had before meds. I spent awhile on the phone with my friend Jessica that night talking about how I felt and wondering aloud why I felt this way when I wasn't supposed to. She kept telling me that it was probably the result of my medication, but I was so reluctant to believe her. I refused to believe that my medication had failed. In my mind, it meant that I had failed. To the rational mind, this makes no sense. I have no power over how my body reacts to certain chemicals. But my rational mind was on vacation at that point.

I finally saw my doctor yesterday and asked to switch anti-depressants. In hindsight, it seems like it should have been so much easier than it actually was. Why on earth would I want to continue taking pills that make me feel worse than I already feel? I came back over and over to the feeling of failure. In truth, failure has absolutely nothing to do with it. My meds did not fail. They worked for me for over nine months. My brain eventually built up a tolerance to them, and they stopped doing what they were supposed to do. The time had come to find a new medication to do the job my old meds did.

I did not fail. Failure would have been refusing to be courageous and make a change.