Understanding my confusing past

One of the greatest advantage of my diagnosis with proneness to bipolar disorder or manic-depressive illness last March was that it helped me to understand that it is a medical condition that can be treated with medication and other helps. These have helped to relieve or shortened my suffering and enabled me to be more functional.

The other greatest advantage was it helped me to understand my confusing past.I have had some 10 or more episodes of severe depression over the last 20 years or so, prior to my diagnosis. And my life was like a big mess.

Whenever I am well, I am slightly manic and I will have more energy. I have many happy thoughts, able to accomplish many things and can be very creative. I like to make others happy by making small gifts for them like bookmarks and cross-stitch. I will also write to my friends to let them know that I am thinking of them and praying for them, especially those who are suffering in some ways. I enjoyed my family, my church, friends and work very much. I loved being with people, and I tend to be very talkative and overly friendly, even to strangers. Some friends said they find me very warm and friendly at such times. I am also a very excellent worker when I am manic and I alway take pride in whatever I do. I am some kind of a perfectionist and so I can do even a very small job very well. I do all things as unto the Lord, and will not mind even menial or boring jobs. I can be a great motivation to others who lead a mundane life by being very enthusiastic in whatever I do.

But whenever I am severely depressed, I am totally the opposite. I will be so slowed down that I can hardly wake up in the morning and I dragged myself through the day. My mind which used to be very positive and cheerful, filled with ideas and projects, suddenly seemed to have turned against me. My thoughts are all negative and self-condemning. My mind condemns me for all my past sins and failures. It kept playing back my past mistakes and weaknesses. It mocked at me for all my enthusiams and foolish plans. It no longer found anything interesting or enjoyable or worthwhile. I can't concentrate in anything I do or read. My thoughts turned time and again to the question, "What is the meaning of my life?". I can't enjoy prayer, reading the Bible or church. I can't enjoy my family, friends, work, hobbies or anything in general. And I simply can't find anything meaningful to do or worthy to live for. I often wished that the Lord will take me home quickly as every day is a living hell for me. As my depression usually lasted at least 3 to 6 months, or sometimes longer, you can imagine how challenging it will be for me to face that annoying question "What is the meaning of my life?" or "What is the point of living?" daily. It drained me.

Actually, in some sense of the word, Rob is right when he pointed out in my last post, that people only have the luxury to think about the meaning and purpose of life when they have no other more urgent problems. During depression, I don't have the energy or desire to do anything. So I did have plenty of time on hand and the luxury to ruminate over the meaning of my life. The only problem is because I was severely depressed, all my thoughts were negative and self-condemning. So I naturally can't find any meaning in my life during such time.

By the mercies of God, in January 2007, through the help of a Christian lady counsellor, Sarah and her team, at Counselling and Care Centre in Singapore, I have embarked on a new journey of self-discovery, of knowing God, myself and others better. Sarah counselled me for 9 sessions between end January 2007 to April 2007. These were life-changing sessions for me. Sarah uses a method of counselling or psychotherapy that is called "Cognitive Behavioural Therapy" (CBT).

CBT is a form counselling with a focus on understanding how our thoughts affect our behaviours. Bipolar alternates between 2 extreme mood swings ie. mania and depression, and our thoughts and behaviours are shaped by these mania and depression episodes which can at times be very confusing. CBT helps to make sense some of these confusions, and help to pick up skills to manage these mood swings so that one can be more functional. Through CBT I discovered some faulty or unhelpful thinking patterns I have been having which either can trigger off an episode of depression or can make it worse. These are still great challenges to me now.

CBT helps to make sense of my confusing past. In my first 2 sessions with my counsellor, Sarah, I recounted to her my past relapses of severe clinical depression in the last 20 years. Sarah noted at the end of my second session with her that there is a phrase I keep repeating and that is during every depressive episodes I will wonder "What is the meaning of my life?". Sarah felt that there is a necessity for me to explore this question and to see how I can get a more realistic and biblical view on this question as that will have an impact in my recovery.

Through my counselling sessions with Sarah, I realized that the question "What is the meaning of my life?" recurs only when I was depressed. It is part of the symptoms of depression as well as the effect of depression. Whenever I am well or manic, I do not have problem with this. I always find life meaningful as I live for the Lord and serve Him. I love life because God has given it to me, to know Him, love Him and serve Him.

Maybe not everyone who experience depression or prolonged severe depression, struggle with this question on the meaning or purpose of their life. Sarah suggested that one possible reason why I contantly struggle with it whenever I fall into depression, could be because I am a very purposeful person. I do things with purpose in my mind. I thought through why I choose a certain path or why I do a certain thing. I do no just go through the motion or follow the crowd and do things because everyone is doing it. I think she has got a point. I am not someone who likes to join the rat race in the working world. I do not work just to earn money but I want to enjoy what I am doing and to make significant contribution to my work. When I make friends, I don't just make and keep them for my own enjoyment or benefit. I seek to find ways to help and encourage my friends and be a blessing to them.

Sarah helped me to understand that the meaning in my life is found not just in having something meaningful to do although that is important and gives meaning to my life. But the meaning in my life is also found in having a meaningful relationship with God and with others in my life. I found that life is only meaningful to me when I have a right relationship with God. I cannot imagine my life now without God. Life is definitely meaningless to me if I do not have God in my life. The ability to pray, to read the Bible and to go to church is very important to me. I will be very saddened and discouraged whenever I am prevented from enjoying these when going through severe depression. This is one of the greatest reason why I will conclude life is meaningless whenever I am depressed.

I found that life is meaningful to me not just in having a meaningful relationship with God. Even if I enjoy God on my own and have all the knowledge of the Bible and doctrines, something is still missing in my life if I keep these to myself. I found meaning in my life when I am able to share my life with others. I love to care for people. I have been a care giver of my parents for the last 15 years until my father passed away in 2001. I am still the main care giver of my aged mother who battles many illness. I have a wonderful relationship with my siblings and nieces and nephew. I am my nieces and nephew's favourite aunty. Sometimes when we go out, people thought that my nieces and nephew are my children because they will cling on to me :-)

I have may wonderful friendships in my life among my church friends and other friends. I value friendships a lot as I am someone who feels very deeply. Friendships make my life very meaningful. I can give up many things for my friends. Many times I will not buy many things for myself but I readily buy those things for my friends. I like to make people happy by giving them gifts and cheering them up. I like to spend time with people who are lonely and needy. I enjoyed serving in the elderly ministry in my church together with my church friends in which we reach out to a group of poor and elderly people in my church neighbourhood. I enjoyed the friendships with these elderly when many people do not enjoy it. They too seemed to enjoy my friendships and they remembered me though I have not been able to be actively serving in this ministry since my relapse of severe depression in December 2006. I missed them every now and then and it is still a joy for me whenever I get to see them.

I am finding meaning in my relationship with God and all these other relationships in my life, and in my service in the church and my work. These all make my life worth living. My life is no longer a big mess or a confusing one. It is fill with meaning and purposes, and I look forward to each day the Lord has given me so that I may spend it for Him and others. I look forward too to the day when my tasks here are completed, and I can enter into my eternal rest and enjoy God in worship and fellowship forever more, never to be hindered by sins or sicknesses anymore. Until then, I continue to run the race that is set before me, looking unto Jesus the Author and Finisher of my faith. Praise God.

What about you? Do you also struggle with a confusing life due to bipolar or depression? Have you found something helpful to cope?

"Whereas ye know not what shall be on the morrow. For what is your life? It is even a vapour, that appeareth for a little time, and then vanisheth away." James 4:14

"....I am come that they might have life, and that they might have it more abundantly." John 10:10

"Jesus said unto her, I am the resurrection, and the life: he that believeth in me, though he were dead, yet shall he live: And whosoever liveth and believeth in me shall never die. Believest thou this?" John 11:25-26

What is the meaning of Life? - Part 3

Over some 20 years prior to my diagnosis of bipolar disorder or manic-depressive illness, I have had some 10 to 11 episodes of severe depression each lasting between 3 to 6 months or longer. During such a difficult time, I have a constant struggles with the question "What is the meaning of Life?". Whenever I am severely depressed, this question will surface over and over again.

Thank God for leading me to seek medical help in Dec 2006. In end January 2007, the Lord led me to seek counselling help. As I recounted my past history with my Christian counsellor, Sarah, she realized that the phrase "What is the meaning of Life" or "I find life so meaningless" keep recurring. So we decided to explore this together as she felt it will have an impact in my recovery process.

On Wednesday, I shared about my thoughts on what I think is the meaning of Life (Part 2). This is a difficult question as it can mean different thing to different people. Is there really a meaning to Life? Or am I here by accident and for no reason or purpose? If life has a meaning, what is it? If God has a purpose for me here, how can I know about it?

I told Sarah that I think to live a meaningful life is to be a useful person. For me it is to be able to serve God, care for my family and do a good job at work. I always strive to do my best at work. When I am able to contribute to my church work, my family situation or work or charity work, I feel that I am living a very meaningful life. Whenever I go through severe depression, I lost all my energies, strength and motivation to do anything. I felt that I am very useless and a total failure. Life seems so meaningless to me. But whenever I am well, I am able to pray, read the Bible, know God's love and comfort, able to take care of my mother, able to go to church, to work, enjoy my hobbies, etc etc. I find life very meaningful now.

Sarah listened attentively. She clarified some of my thoughts by asking me some questions. She didn't say very much whether she agrees with my views or not. Then she suggested that maybe we try and explore further through another method.

Sarah took out a very huge piece of paper and some colored markers. I wondered what she intended to do?

Sarah suggested to me to chart the major events in my life in a graph. For major events in my life, I was to use a black marker to chart the time/year it happened. For every happy and wonderful event, I was to use a green marker to chart the time/year it happened. I was then to use a red marker to mark out those periods of time when I went through severe depression. As I use these different markers to chart the different event over the last 20 years, there are often some overlappings.

Before I met Sarah, I used to look at my life as a total failure (this is one of the faulty or unhelpful thinking pattern Sarah helped me to recognize and try to change). Sarah helped me to see that in my life there were not just the black timeline, there were the green ones as well though also intertwined with the red ones. And by the mercies of God, I began to see that the green timelines scattered throughout my life, and they were not few. I began to see God's goodness and mercies in my life in a different way! Sarah helps me to see that in life we do experience up and down throughout different periods of time. Sometimes we cry, sometimes we laugh. Sometimes we are well, sometimes we are sick. Sometimes we succeed, sometimes we failed. But none of these experiences represent us as a person. They are just events in our life, and everyone go through it. My past and present failures does not make me a failure. I can seek God's forgiveness and help to learn from my mistakes and to do better the next time, by His grace. I can become a better person and grow through each experiences, though they are painful and difficult.

We started charting with the events that happened after I became a Christian in 1990.

1) My relationship with my father improved.

One of the first thing that changes in my life after I came to know the Lord as my personal Saviour and Lord was that I was able to forgive my father for a past mistake he made. For a long time, I would not talk to my father. But after I became a Christian, I was greatly moved by the knowledge that I am a great sinner but that God loves me and send the Lord Jesus Christ to die on the cross for me to pay the penalty of my sins and delivered me from the bondage of sin and eternal destructions in Hell. I was greatly touched by God's love for me and the joy of forgiveness in Him. Though I am weak and continue to fail Him daily, He forgives me of my sins daily, He guides and leads me in life, and provides for my every need.

By God's mercies, He changed my heart. When I went home, I took the initiative to talk to my father. I no longer feel that I could not forgive him. I felt compassion in my heart for him. He is so lost without God, and that is why he committed that awful mistake in the past. I felt sorry for him. This event is very significant in my life, because this is one of the biggest changes I notice in my life after I became a Christian. I know that I would never have been able to forgive my father if not because God changed my heart and enable me by His Spirit to do so.

As I recounted this event in my life to Sarah, I was filled with thankfulness to God for His mercies in my life in leading me to know Him savingly, and also to forgive my dear father so that my relationship with him improved. I began praying for my father and my family. My father's relationship with other members of my family then began to improve.

Sarah, asked whether I realized that I had caused an impact in my family situation and especially in my father's life. That particular event, was used by God, in His mercies to bring about a reconciliation in my family. The Lord was using me! I didn't see it then. But now I realized that God was using me to reach out to my father and helped him to be reconciled to my family.

Sarah asked whether that particular event has any impact to the question "What is the meaning of Life?" which I have struggled with. Do I think my life is meaningful at such a time?

I thought about it for a moment. I said I think Life is meaningful because I was able to know our Lord Jesus Christ as my Saviour and Lord. And I was able to forgive my father and love him once again. Sarah said I also did something very meaningful. She said God was using me to reach out to my father and reconciled him to my family.

Thank God! Now I saw afresh that my life was a very meaningful one right after my conversion.

Sarah suggested that we continue with the next important event in my life as we seek to explore the meaning of Life......

To be continued......

What is the meaning of Life? - Part 2

Last Thursday, I shared about my constant struggles during severe depression episodes with the question "What is the meaning of Life?". Whenever I am severely depressed, this question will surface over and over again. I did not know that later, by the mercies of God, this painful and difficult recurring question was to eventually led me to embark on a new journey which is changing my life now in many wonderful ways!

I thank God for leading me to seek help at Counselling and Care Centre in Singapore in January 2007. As I recounted my past relapses of severe clinical depression in the last 20 years, to my Christian counsellor, Sarah, she noted that there is a phrase I keep repeating and that is during every depressive episodes I will wonder "What is the meaning of Life?".

Sarah felt that there is a necessity for me to explore this question and to see how I can get a more realistic and biblical view on this question as that will have an impact in my recovery. That was around beginning of February 2007, and I had just started anti-depressant (20 mg Fluoxetine every morning) for about 2 weeks. Thank God that I am very sensitive to medication and so I was lifted up to a more functional level about 1 week after I took Fluoxetine. So when I was recounting all these past relapses to Sarah, I was more rational and able to think more clearly.

After my second session with Sarah, she asked me what I think is the meaning of life? Sarah wants me to go home and think about this question and to discuss with her in our next counselling session the following week.

Throughout that week, I prayed much and thought through what really is the meaning of Life to me? I know many people will look at it in many ways. What is the meaning of Life? Is there really a meaning to Life? Is there a purpose for my Life? Or am I just here for no reason? If there is a meaning to Life, then what is the meaning or purpose of my life? What really is God's purpose for my life here?

I tried to recall some lessons I learned many years ago during Bible study of the Westminster Shorter Catechism on the chief end of our purposes here:

Westminster Shorter Catechism Question 1 : What is the chief end of man?

Answer: Man's chief end is to glorify God, and to enjoy him for ever.

Bible references:

1 Corinthians 10.31 : Whether therefore ye eat, or drink, or whatsoever ye do, do all to the glory of God.

Psalm 73.25-26 : Whom have I in heaven but thee? and there is none upon earth that I desire beside thee. My flesh and my heart faileth: but God is the strength of my heart, and my portion forever.

I thought from what I learned from the Catechism question above that God has created me for a purpose and I am here daily to accomplish His purposes, to glorify His name and enjoy Him. I glorify Him when I serve Him and do my best in whatever I do. I glorify Him when I love others and serve them as a way to show my love for God. As at that time I was no longer severely depressed, I do not feel that life is meaningless.

I prayed, look into the Bible and then wrote down some of my thoughts and feelings over the week. When I next saw Sarah, we continued to explore the question on the meaning of life.

I told Sarah that to live a meaningful life is to be a useful person. To be able to serve God, care for my family and do a good job at work. I always strive to do my best at work. When I am able to contribute to my church work, my family situation or work or charity work, I feel that I am living a very meaningful life. Whenever I go through severe depression, I lost all my energies, strength and motivation to do anything. I felt that I am very useless and a total failure. Life seems so meaningless to me.

Sarah listened attentively. She clarified some of my thoughts by asking me some questions. She didn't say very much whether she agrees with my views or not. Then she suggested that maybe we try and explore further through another method.

Sarah took out a very huge piece of paper and some colored markers. I wondered what she intended to do?

(Little did I know that by God's mercies and love, He was using Sarah, my Christian counsellor, to teach me many precious truths which indirectly led me to embark on a new journey, a journey that changes my life in many wonderful ways, and my relationship with God, my family, my church, my friends and others around me. A journey that I am still pressing on now joyfully, by the grace of God.....)

To be continued....

What is the meaning of Life?

Whenever I am severely depressed, this question will surface over and over again. During an episode of severe depression that is clinical and last between 3 to 6 months or sometimes longer, to have to face this question every day is a tremendous challenge. Due to some chemical imbalance in my brain in such an episode, I couldn't think clearly nor feel rightly. Depression has a way of numbing my brain so that I am either not able to concentrate to read or think, or my thoughts will be all negative and condemning myself. I seemed incapable of doing anything or deriving any joy in anything I used to enjoy. I could not feel aright, my feelings are either flat most of the time or down most of the time. For some people, during severe depression they will break down in tears and sometimes cry for no particular reasons. For me it was the opposite. In the face of such tremendous pain and struggles, I wanted very much to cry as I felt that may help to release the pain and frustration I am going through during such an episode, but often there are no tears.

During such a episode, I dread to wake up each morning as I couldn't bring myself to face each day. Every morning, when I wake up, I found myself asking over and over again, What is the meaning of life? What is the point of going on like this day after day? I can't see any light at the end of the tunnel. There is no way out of this depths. I have no energy to fight on. So many times I prayed that God will take me home. Living on without the ability to enjoy His love, His Words, public worship, personal devotions, family, friends, work, hobbies, etc is so meaningless. During severe depression, nothing seems to help. Day in day out, night in night out, is the same thing and it goes on for days, weeks, months. Others said they have been depressed before and they just prayed, look to God and they are better. But in severe clinical depression, nothing helps. So no one will understand. What is the meaning of life? Why am I here to go through this suffering over and over again as I have been through it some 12 times by now?

I thank God for leading me to seek help at Counselling and Care Centre in Singapore in January 2007. In my first 2 sessions with my counsellor, Sarah, I recounted to her my past relapses of severe clinical depression in the last 20 years. Sarah noted at the end of my second session with her that there is a phrase I keep repeating and that is during every depressive episodes I will wonder "What is the meaning of Life?". Sarah felt that there is a necessity for me to explore this question and to see how I can get a more realistic and biblical view on this question as that will have an impact in my recovery.

When I first saw Sarah in end January 2007, I had just sought medical help and was on anti-depressant (20mg Fluoxetine or common brand name Prozac). Thank God that I am very sensitive to medication and 1 week after taking Fluoxetine, I was feeling better and more functional. The anti-depressant did not cure me totally but it lifted me up to a more functional level so that I can pray and read the Bible once again and find comfort in God and His Words. I was able to wake up without dreading to face each day and therefore able to cope better with work and life in general. The anti-depressant helped to lift up to a level where my thoughts and feelings are more normal, and I can think more rationally. It was then that I can benefit from counsellings/psychotherapy.

So I was more rational and able to think more clearly when I saw Sarah. After hearing my accounts, Sarah asked me what I think is the meaning of life? Sarah wants me to go home and think about this question and to discuss with her in our next counselling session the following week.

At that time, I was seeing Sarah once a week for about an hour each session. Thank God for my employer and colleauges who allowed me to take time off during working hours to see Sarah. Sarah works in a team with several other counsellors, and our sessions are video taped with my permission. In the room where Sarah counselled me, I only get to see her. Her other colleagues in her team were in the next room, watching the video of our taped session. Towards the end of the session, Sarah will go for a short break of 10 mins to discuss with her team members. She will then come back and conclude the session with me by highlighting some discoveries we made during our sessions and to post some question for me to take home and think and pray about. This was how she helped me to explore my thoughts as I do have some faulty or unhelpful thinking patterns which are so ingrafted in me that I am not conscious of them. But they have tremendous negative effects on my life and learning to identify them will help me to challenge them and turn them to more realistic and biblical thoughts and actions. This is the gift of Cognitive Behavioural Therapy (CBT) or counselling/talk therapy/psychotherapy. I will share more about CBT in future posts.

So on my second session with Sarah, I took the question "What is the meaning of Life?" home with me to pray and explore it further.

To be continued......

A new journey begun (my reflections on 29th March 2007)

I am still trying to understand the many precious lessons our Lord is teaching me through these difficult trials in my life. I know that He in His faithfulness has afflicted me (Psalm 119:75). He is sanctifying me through these difficult experiences and drawing me to know more of His saving grace and faithfulness. I may not always understand His dealings with me but I have no doubt at all of His love for me.

I am reminded of some of the encouraging words from some poems quoted in a small booklet written by Rev John J Murray, “Behind a Frowning Providence”:

Not till the loom is silent
And the shuttles cease to fly
Shall God unroll the canvas
And explain the reason why.

The dark threads are as needful
In the weaver’s skillful hand
As the threads of gold and silver
In the pattern he has planned.

God moves in a mysterious way
His wonders to perform;
He plants His footsteps n the sea,
And rides upon the storm.

Deep in unfathomable mines
Of never-failing skill
He treasures up His bright designs
And works His sovereign will.

Ye fearful saints, fresh courage take
The clouds ye so much dread
Are big with mercy, and shall break
In blessings on your head.

His purposes will ripen fast,
Unfolding every hour;
The bud may have a bitter taste,
But sweet will be the flower.

Judge not the Lord by feeble sense,
But trust in His grace,
Behind a frowning providence
He hides a smiling face.

For me, personally, this turned out to be a very significant event in my life and God in His faithfulness is working it out for my good (Romans 8:28). I can sense myself growing in many different ways and experiencing the joy and peace of the Lord in many wonderful ways. I have now begun on a new journey, by God’s grace.

The counseling, in particular, is being used by our Lord to change my perspective of many things in life and indirectly it is changing me. It is actually a process of self-discovery, and of knowing God, self and others better. I am thankful to God for hearing my prayers and provided someone who is very gentle, caring, sympathetic and encouraging to be my counselor. She always sees something positive and encouraging that God is doing in all my difficult trials. She constantly seeks to help me to see the many mysterious outworking of our faithful God, Who loves us dearly and gave His Son for us, in the various paths I have gone through in the past or are going through now.

I will be 41 this October but I found to my surprise that I have been wondering in the wilderness for the last 40 years! And now, by the mercies of God, I am finally coming out of the wilderness and entering into the land of Canaan! You see, she is helping me to discover some faulty patterns in my thoughts and feelings which have affected my life and various relationships for so many years. They are not just occasional thoughts but deep-seated patterns! No wonder I am often overcome by them as I am not conscious of them. I am surprised to discover these truths and felt as if I am just getting to know myself! She is now slowly helping me to recognise these faulty thought patterns, and change these faulty ways of thinking to more biblical ways, by God’s grace. And these are beginning to have such tremendous effects on my life, my relationship with God and others around me.

I am thankful to God for providing such a help in her and her willingness to walk through this difficult journey with me. By God’s grace, each session yields some positive outcome. Accumulatively, these new discoveries of self and God’s mercies in them, is beginning to change my life in many wonderful ways.

I wish I could share more of the details with you but I think I will have to write a book in order to do so and I am just in Chapter One! I know the process may be a long and tedious one and I need much patience and perseverance to go on slowly. But it will be a journey worth taking… and I am looking forward to each session with her because I get to know myself better each time, can see more clearer God’s love, mercies and faithfulness and am enabled to improve in my relationships with various people, and also learning to improve in managing the various challenges in my life. Thank God for His mercies and faithfulness!

First published on 29 March 2007 on www.believersencouragement.com

(I am still trying to recognize some of the faulty thinking patterns which is explained in greater detail in Dr David P Murray’s lectures in the series “Depression and the Christian”. I have extracted part of his writings from 3 of his articles and shared them under the topic “Correcting my false thoughts” of “My Coping Strategies“. I know that sometimes I do have quite a number of the faulty thinking patterns that is listed in the Dr David’s articles. I am also quite a perfectionist which means my expectation of myself can be rather high, and indirectly I stressed myself up unknowingly. I am also not an assertive person. I have problem saying “no”. So I also put myself through a lot of difficulties or take on more than I can handle. I used to have difficulty relaxing or taking breaks. In some sense, I am a workaholic. I am also fulfilling the role of care-givers in quite a number of context, and having little respite. All of the above or the combinations of some of these, could well have weakened my body and mind, and lead to the relapses of clinical depressions.)

Correcting my faulty thoughts / thinking patterns

One of the discovery I made from reading some self-help book and through some of my counsellings sessions with some counsellors, was that I do have some faulty thinking patterns which may have either contributed to some relapses of clinical depression in the past or worsened their symptoms. These faulty thought patterns are most prominent during my relapses of depression.

These are not just occasional thoughts but a rigid thinking pattern which I was not conscious or aware off. Though at times I realized that I was not thinking correctly, but most of the times I wasn’t aware that some of my thought patterns were incorrect as they were so much a part of me. It is only recently through the relapse in Dec 2006, when I sought professional help and started reading deeper into depression, that I came to the realization.

I thank God for enabling me to see these faulty thought patterns more clearly now and enabling me to slowly learn how to recognize them, challenge them and correct them by using the Word of God so that I can think more biblically and live for the glory of God.

I am still trying to recognize some of these faulty thinking patterns. I know that sometimes I do have quite a number of the faulty thinking patterns that is listed in the articles below. I am also quite a perfectionist which means my expectation of myself can be rather high, and indirectly I stressed myself up unknowingly. I am also not an assertive person. I have problem saying “no”. So I also put myself through a lot of difficulties or take on more than I can handle. I used to have difficulty relaxing or taking breaks. In some sense, I am a workaholic. I am also fulfilling the role of care-givers in quite a number of context, and having little respite. All of the above or the combinations of some of these, could well have weakened my body and mind, and lead to the relapses of clinical depressions.

I will try and share more about my own experiences when I am more clear about them. But in the meantime, I will just share the following excerpts from a few people whom I found to be very useful and instructive :

1) Dr David P Murray in Lecture 3 “The Condition” of a series of 6 messages on “Depression and the Christian” said:

“Perhaps, the most obvious symptoms of depression are the unhelpful patterns of thinking which tend to distort a depressed person’s view of reality in a false and negative way, and so add to the depression or anxiety.

While we often cannot change the providences we have passed through, or are passing through, we can change the way we think about them so as to present to ourselves a more accurate and positive view of our lives, and so lift our spirits.

We will focus on ten false thought patterns which reflect and also contribute to the symptoms of depression. We will summarise each thought habit, and look at three examples of each, one from ordinary life, another from our spiritual life, and another from the Bible. The Biblical examples are not necessarily examples of depressed person but they are examples of false thinking often present in depression.

It is important to see how our depressed thought patterns affect our ordinary life; and even more important to see how that is then carried into our spiritual life. It is almost always that order in which our thoughts are transferred – false thinking in ordinary life is eventually transferred into our spiritual life.

1. False extremes

This is a tendency to evaluate our personal qualities in extreme, black or white categories – shades of grey do not exist. This is sometimes called “all-or-nothing thinking”.

Life example: You make one mistake in cooking a meal, and conclude you are a total disaster.

Spiritual example: You have a sinful thought in prayer, and conclude that you are an apostate.

Biblical example: Despite most of his life being characterised by God’s blessing and prosperity, when Job passed through a time of suffering he decided he must be an enemy of God (Job 13:24; 33:10)

2. False generalisation

This happens when, after experiencing one unpleasant event, we conclude that the same thing will happen to us again and again.

Life example: If a young man’s feelings for a young woman are rebuffed, he concludes that this will always happen to him and that he will never marry any woman

Spiritual example: When you try to witness to someone you are mocked, and you conclude that this will always happen to you and that you will never win a soul for Christ.

Biblical example: At a low point in his own life Jacob deduced that because Joseph was dead, and Simeon was captive in Egypt, that Benjamin would also be taken from him. (Gen.42:36). “All these things are against me,” he generalised.

3. False filter

When depressed we tend to pick out the negative detail in any situation and dwell on it exclusively. We filter out anything positive and so decide everything is negative.

Life example: You get 90% in an exam but all you can think about is the 10% you got wrong.

Spiritual example: You heard something in a sermon you did not like or agree with, and went home thinking and talking only about that part of the service.

Biblical example: Despite having just seen God’s mighty and miraculous intervention on Mt Carmel, Elijah filtered out all the positives and focussed only on the continued opposition of Ahab and Jezebel (1 Kings 19:10).

4. False transformation

Another aspect of depression is that we transform neutral or positive experiences into negative ones. Positive experiences are not ignored but are disqualified or turned into their opposite.

Life example: If someone compliments you, you conclude that they are just being hypocritical, or that they are trying to get something from you.

Spiritual example: When you receive a blessing from a verse or a sermon, you decide that it is just the devil trying to deceive you.

Biblical example: Jonah saw many Ninevites repent in response to his preaching. But, instead of rejoicing in this positive experience his mood slumped so low that he angrily asked God to take away his life (Jonah 4:3-4).

5. False mind-reading

We may often jump to negative conclusions which are not justified by the facts of the situations.

Life example: A friend may pass you without stopping to talk because, unknown to you, he is late for a meeting. But you conclude that he no longer likes you.

Spiritual example: Someone who used to talk to you at church now passes you with hardly a word, and so you decide that you have fallen out of her favour. But, unknown to you, the person’s marriage is in deep trouble and they are too embarrassed to risk talking to anyone.

Biblical example: The Psalmist one day concluded that all men were liars, a judgment which on reflection he admitted to be over-hasty (Ps.116:11)

6. False fortune-telling

This occurs when we feel so strongly that things will turn our badly, our feelings-based prediction becomes like an already-established fact.

Life example: You feel sure that you will always be depressed and that you will never be better again. This, despite the evidence that almost everybody eventually recovers.

Spiritual example: You are convinced that you will never be able to pray in public. Again, this

despite the evidence that though difficult at first, with practice almost everybody manages it.

Biblical Example: Anticipating the opposition that Jesus would face in Bethany, Thomas falsely predicted not only his own death there but also that of the Lord and the other disciples (John 11:16).

7. False lens

This is when we view our fears, errors, mistakes through a magnifying glass, and so deduce

catastrophic consequences. Everything then is out of proportion.

Life example: When you make a mistake at work, you conclude, “I’m going to be sacked!”

Spiritual example: You focus on your sins from the distant past in a way that leads to continued feelings of guilt, self-condemnation, and fear of punishment.

Biblical example: When Peter sinfully denied the Lord, he not only wept bitterly but decided that as his mistake was so spiritually catastrophic, there was no alternative but to forget about preaching Christ and go back to catching fish (Jn.21:3).

8. False feelings-based reasoning

In depression we tend to take our emotions as evidence for the truth. We let our feelings determine the facts.

Life example: You feel bad, therefore conclude that you are bad.

Spiritual example: You feel unforgiven, therefore conclude you are unforgiven. You feel cut off from God and so conclude that you are cut off from God.

Biblical example: At one of his low points, David felt and so hastily concluded that he was cut off from God. “I said in my haste, I am cut off from before thine eyes” (Ps.31:22).

9. False “shoulds”

Our lives may be dominated by “shoulds…” or “oughts”, applied to ourselves or others. This heaps pressure on us and others to reach certain unattainable standards and causes frustration and resentment when we or others fail.

Life example: The busy mother who tries to keep as tidy and orderly a house as when there were no children is putting herself under undue pressure to reach unattainable standards.

Spiritual example: The conscientious Christian who feels that despite being responsible for meals and raising children, that she ought to be at every prayer meeting and service of worship, and also reading good books and feeling close to God.

Biblical example: Martha felt deep frustration that Mary was not fulfilling what she felt were her obligations and complained bitterly about it (Luke 10:40-42).

10. False responsibility

This is when we assume responsibility for a negative outcome, even when there is no basis for it.

Life example: When your child does not get “A” grades you conclude that you are an awful mother. The reason may be instead that your child has a poor teacher or that his gifts are not of an academic nature.

Spiritual example: When your child turns against the Lord and turns his back on the church you assume that, despite doing everything you humanly could to bring him up for the Lord, it is all your fault.

Biblical example: Moses felt responsible for the negative reactions of Israel to God’s providence and was so cast down about this that he prayed for death (Num.11:14-15).

IMPORTANT

1. False thinking patterns are compatible with being a Christian.

2. False thinking patterns will have a detrimental effect on our feelings, our bodies, our behaviour, and our souls; usually in that order.

“For Christians, depression hardly ever has a spiritual cause…In Christians, spiritual effects follow from the depression, and seldom the other way around.”

3. One of the first steps in getting better is recognising these false thinking patterns which do not reflect reality.

4. While we can do little if anything to change our providence (our life situation), we can change the false way we may think about our providence.

III. FEELINGS

Obviously, these unhelpful false thought patterns are going to give you unhelpful emotions and feelings. If you are always thinking about problems and negatives, or imagine the future is hopeless, or think everyone hates you, etc., then you are going to feel down very quickly. Your feelings about ordinary life and your spiritual life are going to reflect what you think in each arena (Prov.23:7).

Here, we shall briefly look at some of the emotional symptoms of depression. And, as with the area of our thoughts, let us honestly examine the area of our feelings in order to consider whether our emotions are related to a depressive tendency or illness. Also, as with the area of our thoughts, in this area of feelings we shall also highlight Biblical examples of true believers also experiencing such emotions, in order to show that such feelings are compatible with being a true believer.

1. Do you feel overwhelming sadness?

Everyone feels sad and down from time to time, but depression-related sadness is overwhelming and long-term. It often results in tearfulness and prolonged bouts of unstoppable sobbing.

Biblical Examples: Job (Job 3:20; 6:2-3; 16:6, 16), David (Ps.42:3,7).

2. Do you feel angry with God or with others?

A common characteristic of depression, especially in men, is a deep-seated and often irrational irritability and anger.

Biblical Example: Jonah (Jonah 4:4,9), Moses (Num.20:10-11).

3. Do you feel your life is worthless?

It may be that despite your life being highly valued by others, and despite you being useful to others and to the Lord, that because of your distorted view of yourself you feel your life is worthless. Indeed you may feel your life is just a burden to and a blight upon others.

Biblical Example: Job (Job 3:3ff), Jeremiah (Jer.20:14-18)

4. Do you feel extreme anxiety or panic?

“In anxiety, the person often overestimates the threat or danger they are facing, and at the same time usually underestimates their own capacity to cope with the problem.”[3]

Biblical Example: David (1 Samuel 21:12), disciples (Matt.8:25)

5. Do you feel God hates you and is far from you?

Although to any outside observer your past and your present may be replete with examples of God’s good favour towards you, you feel that God has either become your enemy or else has given up on you. You feel as if you are in spiritual darkness

Biblical Examples Job (6:4; 13:24; 16:11; 19:11; 30:19-23, 26), Jeremiah (Lam.3:1-3).

6. Do you feel suicidal or do you have a longing to die?

Biblical Examples: Job (Job.3:20-22; 6:9; 7:15-16), Moses (Num.11:14), Elijah (1 Kings 19:4)

These deeply depressed feelings are movingly articulated for us by the depressed Charles Spurgeon, when commenting on the experience of Heman in Psalm 88.

“He felt as if he must die. Indeed he felt himself half dead already. All his life was going, his spiritual life declined, his mental life decayed, his bodily life flickered; he was nearer dead then alive. Some of us can enter into this experience for many a time have we traversed this valley of death shade, and dwelt in it by the month together. Really to die and to be with Christ will be a gala day’s enjoyment compared with our misery when a worse than physical death has cast its dreadful shadow over us. Death would be welcome as a relief by those whose depressed spirits make their existence a living death. Are good men ever permitted to suffer thus? Indeed they are; and some of them are even all their lifetime subject to bondage….….It is a sad case when our only hope lies in the direction of death, our only liberty of spirit amid the congenial horrors of corruption…. He felt as if he were utterly forgotten as those whose carcasses are left to rot on the battle field. As when a soldier, mortally wounded, bleeds unheeded amid the heaps of slain, and remains to his last expiring groan, unpitied and unsuccoured, so did Heman sigh out his soul in loneliest sorrow, feeling as if even God Himself had quite forgotten him. How low the spirits of good and brave man will sometimes sink. Under the influence of certain disorders everything will wear a somber aspect, and the heart will dive into the profoundest deeps of misery.”

2) And in Lecture 4 “The Causes“, Dr David P Murray wrote:

2. Psychology (the way we think)

In Lecture 3 we looked at 10 false thinking patterns which contribute to depression. It cannot be emphasised enough how vital it is to learn to recognise these unhelpful thoughts by prayerful self examination. It is also important and useful to note that some of these habits of thinking may be involuntarily absorbed or learned in early life and so may be deeply ingrained. When we feel down, or when we are stressed, these latent false thinking patterns tend to occur more frequently and tend to dominate. This can often lead to depression, worsen an existing depression, and, if persisted in, make recovery from depression so much harder. Sometimes, the Church can reinforce or add to false thinking patterns by over-emphasis on the negatives in the Bible and in people’s lives, or by setting standards of commitment which may discourage or depress those who are unable to attain them.

3) In Lecture 5 “The Cures“, Dr David P Murray wrote:

2. Correct your false thoughts

As we have noted throughout these lectures, one of the most common contributory factors to depression is wrong and unhelpful thoughts. Many Christians, who wouldn’t dream of viewing God’s Word in a false way, yet view God’s world in a false way. As they view themselves, their situations, and their relationships with others, they tend to dwell on and magnify the negatives and exclude the positives. This distorted view of reality inevitably distorts and depresses their mood. Christians are obliged to challenge falsehood and distortions of reality, especially when found in themselves. In the appendix to this lecture you will find two questionnaires to help you do this. The first is to help you examine your thoughts, and the second is to help you challenge your false and unhelpful thoughts. Questionnaires such as these are recommended for use by many Christian and non-Christian psychiatrists. They may look a bit strange to you, and you may wonder, “Is this not all just psychological mumbo-jumbo?” However, I would like to show you here how each step is grounded in Biblical Christian experience. In Psalm 77 we have a perfect example of Asaph investigating and challenging his thoughts with God’s help, in order to raise his mood and spirits. There are also slightly more abbreviated versions of the same biblical strategy in Psalm 42, Psalm 73, Job 19, Habakkuk 3, etc. So, this is not “psychological mumbo-jumbo”, but true Bible-based Christian experience. Let us look at Psalm 77 to prove this.

Download the following file :

asaph.pdf

To be continued ….

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My Coping Strategies:

1. Looking to God

2. Accepting the diagnosis

3. Medical Helps

4. Balance lifestyle

4a. Exercise

4b. Omega-3 fish oil supplements

5. Research and readings

6. Mood tracking and Journalling

7. Learning to cope with stress and challenges

8. Leisure, hobbies and recreations

9. Support Network (family, church, friends, etc)

10. Counselling / Talk Therapy

11. Correcting faulty thoughts patterns

Counselling/Talk therapy/Psychotherapy

Actually, besides medication, counselling / talk therapy / psychotherapy / Cognitive Behavioural Therapy is one of the most important tools for a person with bipolar or depression to get well. Cognitive Behavioural Therapy (CBT) which is a form counselling with a focus on understanding how our thoughts affect our behaviours. Bipolar alternates between 2 extreme mood swings ie. mania and depression, and our thoughts and behaviours are shaped by these mania and depression episodes which can at times be very confusing. CBT helps to make sense some of these confusions, and help to pick up skills to manage these mood swings so that one can be more functional.

Through CBT, I do realize that I have quite a number of character traits and faulty thought patterns which might have contributed or aggravated my relapses. I will share more about it in my next post on the topic “Correcting my false thoughts”.

I am also quite a perfectionist which means my expectation of myself can be rather high, and indirectly I stressed myself up unknowingly. I am also not an assertive person. I have problem saying “no”. So I also put myself through a lot of difficulties or take on more than I can handle. I used to have difficulty relaxing or taking breaks. In some sense, I am a workaholic. I am also fulfilling the role of care-givers in quite a number of context, and having little respite. All of the above or the combinations of some of these, could well have weakened my body and mind, and lead to the relapses of clinical depressions.

At the moment, I am not seeing any professional counsellers. I do seek my Pastor’s counsel and some other friends or family members’ counsels when necessary. I also read books and internet articles to understand my condition better and how best to manage it. Thank God that there are a lot of resources available on the internet. One such website is Bipolar and Depression Support Alliance which has very useful information on symptoms, treatment, resources, etc etc.

When I was first diagnosed with depression in January 2007, I have benefitted from a group of counsellors at Counselling and Care Centre, Singapore. I am thankful to God for providing me with a team of very compassionate, kind, understanding and encouraging Christian counsellors who are trained to manage bipolar, depression, OCD and other brain condition. My time with my counsellor, Sarah, was most meaningful and useful. Sarah and her team were helping me to trace the history of my relapses in the past 18 years which I could remember better, the possible causes of them so that I can learn to manage my illness better. That was actually a journey of self-discovery, of knowing God, myself and others better. Each session with Sarah and her team have yielded some positive results. Accumulatively, these knowledge of self and God’s mercies in them, are changing my life in many wonderful ways. Thank God! My counselling session ended in April 2007 when Sarah who was a trainee at that Centre completed her training. I am deeply indebted to Sarah for the help that she has rendered to me. They have been invaluable to me as I journey on.

I have tried out some other counsellors and am, in particular, indebted to Dr Spencer Lee and Yvonne Ying of Association of Christian Counsellors of Singapore for their valuable helps for some weeks in July and August 2007. They are most compassionate and helpful.

The above counsellors are all trained in cognitive behavioural therapy, etc and they have been helping many people who suffer from depression, bipolar and other mental illnesses. The reasons why I sought their help, besides receiving pastoral counselling from my Pastor, was because I needed someone who understands mental illness and therefore able to help me to manage my illness and symptoms. I am thankful to God for providing them at such times when I needed them the most.

Now I am not seeing any of these professional counsellors but just receiving pastoral counsellings from my Pastor, elders and brethren in my church. I am learning to look to God and use other available means too ie reading God’s Words, prayers, medications, regular exercise, Omega-3 fish oil supplements, learning to manage stressful situations in my life, learn to pace myself more slowly and realistically, learn to take breaks and to relax whenever necessary, etc.

I have written 2 emails to Sarah and a tribute to her as follows:

——

Dear Sarah,

Warm greetings to you in the name of our merciful Saviour and Lord Jesus Christ!

Just a short note to thank you and your team for the help and support you are giving me as I seek the Lord’s guidance to understand and manage my condition better. I really appreciate what you are doing to help me. Your sincerity and warmth really touched my heart. Though we have met only for 3 sessions so far, I thank God that I have been helped by every one of the session. I appreciate what we have been able to discuss so far and the way you & your team are helping me to see things from a different angle. I am learning to be more thankful daily!

I thank God for His goodness and mercies in leading me to your centre and placing me under you and your team. The care and helpfulness of all of you and the other staffs at your centre really impressed me. Thank God for using all of you to help me and others who are in need of help.

May God continue to use you, your team and all the staff at Counselling and Care Centre for His glory. May all of you continue to be used in many wonderful ways to help others and especially God’s suffering people. I am praying for all of you too.

Many thanks again for your enthusiasm to help me and your prayers. It is one of the factors that gives me a lot of encouragement and motivation to come for the sessions. I thank God for you. May you continue to serve our Lord joyfully and faithfully for His glory.

Wish you and your family a blessed Chinese New Year.

With sincere thanks & prayers,
Nancie
15 February 2007

——

Sarah’s reply to me:

Dear Nancie,

Warm greetings to you too in the name of our loving and gracious Saviour, Lord Jesus!

Thank you very much for your lovely, thoughtful and heartwarming email. I am touched by your gracious gesture. It is a privilege to be used by God to extend His presence for His precious ones. And you’ve been a great joy to come alongside with. I thank God too for you and for giving me this privilege.

I am greatly encouraged to hear that you have been helped through our sessions. Your words give me impetus to continue and persevere in the work with and for others in the offering of presence and support .

Thank you for praying for us and your continual prayer support is much appreciated. Glad to hear that you have experienced the help of prayers. Indeed, our Lord is the source and the enabler of all we do. All praise and glory to Him!

I shall relay your email to my team. I am sure each one will be encouraged by your words.

Wishing you and your family a Blessed Chinese New Year too.

With grateful thanks and prayers
Sarah
21 February 2007

—–

Dear Sarah,

Thanks for your kind and encouraging reply! Glad that the email has encouraged you. Thank God.

May you and your colleagues continue to press on in the good work that you are doing for God’s glory. I know your work can be very difficult and draining at times. I am glad you work in a team and can discuss and pray with your colleagues. Do take care and may our Lord continue to bless your labours in Him. May you continue to find much joy in helping and supporting others.

Looking forward to see you again soon on Monday, 26th Feb 2007 for our next session! Trust our Lord will continue to bless our time together. Many thanks again for all your help and support.

“For God is not unrighteous to forget your work and labour of love, which ye have shewed toward his name, in that ye have ministered to the saints, and do minister.” Hebrews 6:10

“And let us not be weary in well doing: for in due season we shall reap, if we faint not.” Galatians 6:9

With appreciation,
Nancie

—

A Tribute to my Counsellor, Sarah

16 April 2007 was my last session with my Counsellor, Sarah because she has ended her training attachment and will be returning to her actual work. I am grateful to God for placing me under Sarah’s care for the last 3 months (since 29 January 2007). I would like to express my deep appreciation and gratefulness to Sarah for helping me to embark on a new journey in my life which is changing my life and my relationships with God and the people in my life in many wonderful ways. Sarah, I will never never forget you. I thank God always for you. I hope you get to read this Tribute I have written especially for you. May God bless and keep you.

Dear Sarah,

Warm greetings to you in the name of our beloved Saviour and Lord Jesus Christ!

Thanks once again for your prayers, listening ears, counsels and encouragements. I have learnt much from our sessions together in the last 3 months. Thank you for your willingness to help me and to go along this journey of self-discovery with me. I will forever thank and praise God for you and your team in the way our Lord is wonderfully using you to help me.

I am thankful to God for causing our paths to cross in such a wonderful way at Counselling and Care Centre during your training sessions there. Surely this is not by coincidence but by God’s providence that I should be seeking help at this particular point of time and you should be under attachment there.

I am grateful to God for hearing my prayers and provided someone like you who is very gentle, caring, sympathetic and encouraging to be my Counsellor. You always see something positive and encouraging that God is doing in all my difficult trials. You constantly seek to help me to see the many mysterious outworking of our faithful God, Who loves us dearly and gave His Son for us, in the various paths I have gone through in the past or are going through now. You have helped me to discover some faulty patterns in my thoughts and feelings which have affected my life and various relationships for so many years. Thanks for slowly helping me to recognise these faulty thought patterns, and change these faulty ways of thinking to more biblical ways, by God’s grace. These are beginning to have such tremendous effects on my life, my relationship with God and others around me. I am thankful to God for providing such a help in you and your willingness to walk through this difficult journey with me. By God’s grace, each session yields some positive outcome. Accumulatively, these new discoveries of self and God’s mercies in them, is beginning to change my life in many wonderful ways. I do look forward to each session with you because I get to know myself better each time, can see more clearer God’s love, mercies and faithfulness and am enabled to improve in my relationships with various people, and also learning to improve in managing the various challenges in my life. Thank God for His mercies and faithfulness!

I trust that when you return to your actual work environment, God will continue to use you to be a blessing to others in need just like the way you have been to me. I have no doubt at all that they will be blessed as I am in their acquaintance with you. You are a very special person who is always gentle, kind, encouraging, uplifting, full of faith and hopeful in the Lord. I will never never forget you and hopefully, by the grace of God, will never forget the precious lessons I am now learning through our sessions together too.

Thank you for sharing my joy and sorrows as I recounted my past history to you. I could sense the deep anguish and pain you feel for me in all my sorrows and trials, and also your delight and joy with me in all my joy. I felt very privilege that you cared for me in this way and I thank God for your kind friendship. It is a tremendous source of strength and support to me in this difficult trial. I know you are praying with me and I want to encourage you, as well as give praise and Glory to God, for His faithfulness and mercies by assuring you that the Lord in His faithfulness is strengthening me each day as I look to Him. Thanks for helping me to identify some of the possible causes of the relapses of my illness and discuss with me how I can better manage them. The many precious lessons we have learnt together in the past months is helping me now to cope better with my illness, with the various challenges in my life, and improve in my relationship with God, my church, my family and people around me. Praise God!

It was hard for me to say goodbye to you yesterday, being our last session together but I know it was necessary in God’s sovereign plan for us. I wish we can remain as friends and keep in touch always. But as you have explained to me that due to some professional ethics, yours and my contacts have to be restricted to this centre and as yesterday was our last session together, our contacts have to terminate there too. I hope I will get to meet you again one day, if God wills, on this earth or if not then, by His mercies, in Heaven when we both see our Lord face to face.

Please take care. I will remember you in my prayers always. May God keep you in His loving care always and bless you in all your various callings. May He continue to make you a blessing and encouragement to His suffering children.

With sincere thanks and prayers,
Nancie
17 April 2007

———————-

Contact Information for Counselling Helps

i) Counselling & Care Centre
Block 536 Upper Cross Street
#05-241 Hong Lim Complex
Singapore 050536
Tel: (65) 6536-6366
Fax: (65) 6536-6356
Email : info@counsel.org.sg
Webwsite : www.counsel.org.sg

ii) Association of Christian Counsellors of Singapore
c/o 422-A Telok Blangah Road
Singapore 098848 (Near Grace Methodist Church)
Tel: 6274-7480 Fax: 62760024
Email: info@accs.org.sg
Website: http://www.accs.org.sg/

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My Coping Strategies:

1. Looking to God

2. Accepting the diagnosis

3. Medical Helps

4. Balance lifestyle

4a. Exercise

4b. Omega-3 fish oil supplements

5. Research and readings

6. Mood tracking and Journalling

7. Learning to cope with stress and challenges

8. Leisure, hobbies and recreations

9. Support Network (family, church, friends, etc)

10. Counselling / Talk Therapy

11. Correcting faulty thoughts patterns