Missionary
Medical
Moment
A brief summary of a current topic of medical interest to missionaries.
Topics are updated frequently; if you have a topic or question, let us know!
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MISSIONARY MEDICAL MOMENT
Depression - Part One
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A king once said: "How long must I wrestle with my
thoughts and every day have sorrow in my heart? My life is
consumed by anguish and my years by groaning ... I am weary
with my sighing; every night I make my bed swim, I dissolve
my couch with my tears."
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| Ps 13:2, 31:10, 6:6 |
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A wealthy man once said: "Why did I not perish at birth,
and die as I came from the womb? I have no peace, no
quietness; I have no rest, but only turmoil."
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| Job 3:11,26 |
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A prophet once said: "I have had enough, Lord. Take
my life; I am no better than my ancestors."
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| 1 Kings 19:4 |
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A missionary once said: "O, Lord, take away my life,
for it is better for me to die than to live."
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| Jonah 4:3 |
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What did David, Job, Elijah, and Jonah experience that would
bring them to make such statements as those above? We do not
know whether these men of God suffered from the condition that
we call "Depression", but it is evident that even for
such giants of faith, there were times when circumstances left
them feeling great emotional pain. The same can happen today,
even to men and women who have been called to serve God.
Depression and stress-related disorders are the third most common
reason for missionaries having to return home early. In this and
the next installments of Missionary Medical Moment, we will explore
the different facets of the condition called "Depression".
The "official" name for the condition that we call
"depression" is a mood disorder. There are a
number of subtypes of mood disorders, but the more pervasive and
severe type is known as major depressive disorder. This
condition, which we will call "depression" in this
discussion, may occur as a single or as recurrent episodes.
Some people experience a particular subtype, with mood that cycles
between depressed and elated ("manic") or restless
irritability; this is known as a "bipolar disorder",
the newer term for what used to be called "manic-depressive
disorder".
Causes of depression are usually multiple. Situational
factors often contribute: stressful circumstances,
relationship difficulties, and recent losses can all lead to
depression.
Psychological factors may also be involved; these
arise from problems which may occur in childhood and early
development: deprivation, abuse, neglect, and loss during childhood
can emerge as depression in later years.
Biological
factors may also play a significant role, in two separate
ways. First, there are "typical" medical problems which
can mimic, aggravate, or create symptoms of depression; examples
would be thyroid disease, medication reactions, hormonal changes,
and even certain types of surgery.
Second, it is known that biochemical imbalances can occur in
particular regions of the brain (collectively known as the
"limbic system") which accompany more severe depressive
symptoms.
Spiritual factors can be causative as well;
obviously, if one does not have the assurance of forgiveness and
salvation which comes with a personal relationship with Jesus, then
the consequences of sinful behavior can lead to profound
depression. But even for believing Christians, issues of
unconfessed sin can work to cause depression symptoms: "When
I kept silent about my sin, my body wasted away through my
groaning all day long. For day and night Thy hand as heavy upon
me; My vitality was drained away as with the fever heat of
summer... " (Ps 32:4).
It is unusual to see someone with a depression that can be traced
back to just a single cause; usually, most or all of these four
areas are involved.
A study of who gets depression finds that it can
effect anyone, at almost any age. Women are twice as likely to
have the illness of depression, and the highest incidence is
in the 25-44 year old age group. Estimates vary showing from
10-25% of women will experience a clinical depression in their
lifetime (men have a lifetime risk of 5-12%). At any given time,
5-10% of all women and 3-5% of men are suffering from depression.
Other factors may increase risk; having other family members with
the illness, the use of alcohol or other drugs, and even the
absence of adequate amounts of sunlight make depression more
likely (see a prior Medical Missionary Moment topic:
Seasonal Affective Disorder).
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