Signs and Symptoms of Bipolar Disorder or Manic-Depressive Illness

(This blog is for me to share my experiences and information I have found, or resources I have found useful. This is not a place for self-diagnosis. But if you recognize some of these signs and symptoms in yourself or your loved ones or friends, you/they may need medical attention, please consult the medical physician.)

Most of the time, people with Bipolar Disorder are either not diagnosed or mis-diagnosed. This is because when a person is well or manic, he may not realized it. He feels good, energetic and productive. And when he is depressed, he is confused and ashamed. So he hides his sufferings.

There is still such a terrible stigma associated with mood disorders such as Bipolar Disorder or Manic-Depressive Illness and conditions such as Major Depression, Compulsive Obsessive Disorders, etc etc. More information and education on this aspect will greatly lessen the suffering of both such sufferers and their loved ones.

People with mood disorders can lead an almost close to normal life with medical and other helps. Most people with mood disorders also are very creative and have many talents such as writing, photography, drawing, etc. They are also more compassionate towards the suffering of other people, because they have gone through so many near death experiences in their own battle with mood disorders, especially those painful, dark and distressing severe depression episodes that often last for months, if not years.

Hopefully with more awareness and information, we can lead a meaningful and productive life, live up to our potentials and use our gifts and talents for God's glory and the benefit of others.

This article is taken from the website of National Institute of Mental Health (NIMH). NIMH said "NIMH publications are in the public domain and may be reproduced or copied without the permission from the National Institute of Mental Health (NIMH). NIMH encourages you to reproduce them and use them in your efforts to improve public health. Citation of the National Institute of Mental Health as a source is appreciated."

Introduction
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person's mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. They can result in damaged relationships, poor job or school performance, and even suicide. But there is good news: bipolar disorder can be treated, and people with this illness can lead full and productive lives.

What Are the Symptoms of Bipolar Disorder?
Bipolar disorder causes dramatic mood swings—from overly "high" and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called episodes of mania and depression.

Signs and symptoms of mania (or a manic episode) include:
• Increased energy, activity, and restlessness
• Excessively "high," overly good, euphoric mood
• Extreme irritability
• Racing thoughts and talking very fast, jumping from one idea to another
• Distractibility, can't concentrate well
• Little sleep needed
• Unrealistic beliefs in one's abilities and powers
• Poor judgment
• Spending sprees
• A lasting period of behavior that is different from usual
• Increased sexual drive
• Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
• Provocative, intrusive, or aggressive behavior
• Denial that anything is wrong

A manic episode is diagnosed if elevated mood occurs with three or more of the other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, four additional symptoms must be present.

Signs and symptoms of depression (or a depressive episode) include:
• Lasting sad, anxious, or empty mood
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in activities once enjoyed, including sex
• Decreased energy, a feeling of fatigue or of being "slowed down"
• Difficulty concentrating, remembering, making decisions
• Restlessness or irritability
• Sleeping too much, or can't sleep
• Change in appetite and/or unintended weight loss or gain
• Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury
• Thoughts of death or suicide, or suicide attempts

A depressive episode is diagnosed if five or more of these symptoms last most of the day, nearly every day, for a period of 2 weeks or longer.

A mild to moderate level of mania is called hypomania. Hypomania may feel good to the person who experiences it and may even be associated with good functioning and enhanced productivity. Thus even when family and friends learn to recognize the mood swings as possible bipolar disorder, the person may deny that anything is wrong. Without proper treatment, however, hypomania can become severe mania in some people or can switch into depression.

Sometimes, severe episodes of mania or depression include symptoms of psychosis (or psychotic symptoms). Common psychotic symptoms are hallucinations (hearing, seeing, or otherwise sensing the presence of things not actually there) and delusions (false, strongly held beliefs not influenced by logical reasoning or explained by a person's usual cultural concepts). Psychotic symptoms in bipolar disorder tend to reflect the extreme mood state at the time. For example, delusions of grandiosity, such as believing one is the President or has special powers or wealth, may occur during mania; delusions of guilt or worthlessness, such as believing that one is ruined and penniless or has committed some terrible crime, may appear during depression. People with bipolar disorder who have these symptoms are sometimes incorrectly diagnosed as having schizophrenia, another severe mental illness. It may be helpful to think of the various mood states in bipolar disorder as a spectrum or continuous range. At one end is severe depression, above which is moderate depression and then mild low mood, which many people call "the blues" when it is short-lived but is termed "dysthymia" when it is chronic. Then there is normal or balanced mood, above which comes hypomania (mild to moderate mania), and then severe mania.

In some people, however, symptoms of mania and depression may occur together in what is called a mixed bipolar state. Symptoms of a mixed state often include agitation, trouble sleeping, significant change in appetite, psychosis, and suicidal thinking. A person may have a very sad, hopeless mood while at the same time feeling extremely energized.

Bipolar disorder may appear to be a problem other than mental illness—for instance, alcohol or drug abuse, poor school or work performance, or strained interpersonal relationships. Such problems in fact may be signs of an underlying mood disorder.

Diagnosis of Bipolar Disorder
Like other mental illnesses, bipolar disorder cannot yet be identified physiologically—for example, through a blood test or a brain scan. Therefore, a diagnosis of bipolar disorder is made on the basis of symptoms, course of illness, and, when available, family history. The diagnostic criteria for bipolar disorder are described in the Diagnostic and Statistical Manual for Mental Disorders, fourth edition (DSM-IV).2

Descriptions offered by people with bipolar disorder give valuable insights into the various mood states associated with the illness:

Depression: I doubt completely my ability to do anything well. It seems as though my mind has slowed down and burned out to the point of being virtually useless…. [I am] haunt[ed]… with the total, the desperate hopelessness of it all…. Others say, "It's only temporary, it will pass, you will get over it," but of course they haven't any idea of how I feel, although they are certain they do. If I can't feel, move, think or care, then what on earth is the point?

Hypomania: At first when I'm high, it's tremendous… ideas are fast… like shooting stars you follow until brighter ones appear…. All shyness disappears, the right words and gestures are suddenly there… uninteresting people, things become intensely interesting. Sensuality is pervasive, the desire to seduce and be seduced is irresistible. Your marrow is infused with unbelievable feelings of ease, power, well-being, omnipotence, euphoria… you can do anything… but, somewhere this changes.

Mania: The fast ideas become too fast and there are far too many… overwhelming confusion replaces clarity… you stop keeping up with it—memory goes. Infectious humor ceases to amuse. Your friends become frightened…. everything is now against the grain… you are irritable, angry, frightened, uncontrollable, and trapped.

Read on Treatments for Bipolar Disorder or Manic-Depressive Illness.

This publication, written by Melissa Spearing of NIMH, is a revision and update of an earlier version by Mary Lynn Hendrix. Scientific information and review were provided by NIMH Director Steven E. Hyman, M.D., and NIMH staff members Matthew V. Rudorfer, M.D., and Jane L. Pearson, Ph.D. Editorial assistance was provided by Clarissa K. Wittenberg, Margaret Strock, and Lisa D. Alberts of NIMH. NIH Publication No. 3679
Printed 2002
NIMH publications are in the public domain and may be reproduced or copied without the permission from the National Institute of Mental Health (NIMH). NIMH encourages you to reproduce them and use them in your efforts to improve public health. Citation of the National Institute of Mental Health as a source is appreciated. However, using government materials inappropriately can raise legal or ethical concerns, so we ask you to use these guidelines:
• NIMH does not endorse or recommend any commercial products, processes, or services, and publications may not be used for advertising or endorsement purposes.
• NIMH does not provide specific medical advice or treatment recommendations or referrals; these materials may not be used in a manner that has the appearance of such information.
• NIMH requests that non-Federal organizations not alter publications in a way that will jeopardize the integrity and "brand" when using publications.
• Addition of Non-Federal Government logos and website links may not have the appearance of NIMH endorsement of any specific commercial products or services or medical treatments or services.

If you have questions regarding these guidelines and use of NIMH publications, please contact the NIMH Information Center at 1-866-615-6464 or at nimhinfo@nih.gov.

Updated: 01/24/2007

A story of Bipolar Disorder or Manic-Depressive Illness : Does it sound like you?

(This blog is for me to share my experiences and information I have found, or resources I have found useful. This is not a place for self-diagnosis. But if you recognize some of these signs and symptoms in yourself or your loved ones or friends, you/they may need medical attention, please consult the medical physician.)

How does one know if he or she has Bipolar Disorder of Manic-Depressive Illness? It took me 20 years to get a diagnosis. And my first diagnosis was proneness to major depression. It was after a manic episode several months after taking anti-depressant that my Doctor realized that I am actually prone to Bipolar Disorder or Manic-Depressive Illness.

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person's mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. They can result in damaged relationships, poor job or school performance, and even suicide. But there is good news: bipolar disorder can be treated, and people with this illness can lead full and productive lives.

Early recognition of symptoms can lead to earlier diagnosis. And early diagnosis can lead to earlier finding helps and means to cope.

National Institute of Mental Health (NIMH) produced a very useful article on the real account of someone with Bipolar Disorder and it gives important information on the symptoms of Bipolar Disorder.

The article starts by asking "Are you feeling really “down” sometimes and really “up” other times? Are these mood changes causing problems at work, school, or home? If yes, you may have bipolar disorder, also called manic-depressive illness. "

James’ story:

“I’ve had times of feeling “down” and sad most of my life. I used to skip school a lot then I felt like this because I just couldn’t get out of bed. At first I didn’t take these feelings very seriously.

I also had times when I felt really terrific, like I could do anything. I felt really "wound up” and I didn’t need much sleep. Sometimes friends would tell me I was talking too fast. But everyone around me seemed to be going too slow.

My job was getting more stressful each week, and the “up” and “down” times were coming more often. My wife and friends said that I was acting very different from my usual self. I kept telling them that everything was fine, there was no problem, and to leave me alone.

Then, all of a sudden, I couldn’t keep it together. I stopped going to work and stayed in bed for days at a time. I felt like my life wasn’t worth living anymore. My wife made an appointment for me to see our family doctor and went with me. The doctor checked me out and then sent me to a psychiatrist, who is an expert in treating the kinds of problems I was having.

The psychiatrist talked with me about how I’d been feeling and acting over the last six months. We also talked about the fact that my grandfather had serious ups and downs like me. I wasn’t real familiar with “bipolar disorder,” but it sure sounded like what I was going through. It was a great relief to finally know that the ups and downs really were periods of “mania” and “depression” caused by an illness that can be treated.

For four months now, I’ve been taking a medicine to keep my moods stable and I see my psychiatrist once a month. I also see someone else for “talk” therapy, which helps me learn how to deal with this illness in my everyday life.

The first several weeks were hard before the medicine and talk therapy started to work. But now, my mood changes are much less severe and don’t happen as often. I’m able to go to work each day, and I’m starting to enjoy things again with my family and friends.”

Many people who have bipolar disorder don’t know they have it. This booklet can help. It tells you about four steps you can take to understand and get help forbipolar disorder.

Four steps to understand and get help for bipolar disorder:

1. Look for signs of bipolar disorder.
2. Understand that bipolar disorder is a real illness.
3. See your doctor. Get a checkup and talk about how you are feeling.
4. Get treatment for your bipolar disorder. You can feel better.

Download this Free Booklet from National Institute of Mental Health (NIMH) and read further:

A story of bipolar disorder.pdf

Read on Signs and Symptoms of Bipolar Disorder or Manic-Depressive Illness.

Read on Treatments for Bipolar Disorder or Manic-Depressive Illness.

Thank God for the joy of worship and fellowship

Thank God for the joy of going to church today to worship God and to have fellowship with my church friends. It is spiritually very refreshing to me and it lifts up my spirit to continue to seek God and walk with Him and serve Him in the coming week.

This is a privilege which I can't enjoy very much whenever I go through relapses of severe depression. Whenever I go through severe depression, I will be so slowed down and miserable that I could hardly function. I have no energy nor will to do anything. From the moment I wake up in the morning until the time I go to bed, I will be extremely miserable. This often can go on for about 3 to 6 months, or longer. I dragged myself through each day, incapable of feeling any pleasure or joy. The most painful of all was the sad fact that I lost my joy in the Lord too at such times. This is because the chemical in my brain is not functioning properly or sending the appropriate messages. I was not able to think or feel aright generally. So I often mistakenly thought that either God has forsaken me or I was not a true Christian. Sometimes I wondered whether I was a hypocrite destined for eternal damnation. Life seems so meaningless to me without God. What is the point of going on?

I cannot imagine how I could have survived the 10 or so dark and painful depression episodes without God’s preservation and mercies. During those years, I didn’t know that my condition is an illness and that there is actually a pattern to it. After several months of normal or high (hypomania), a relapse of clinical depression will follow for another few months. In the recent years, my relapses have become more closer and more difficult to cope. With every severe depressive episodes, there is the tendency to have suicidal thoughts as life seems so meaningless without God and the ability to enjoy anything or do anything. The seemed no light at the end of the tunnel.

Thank God that even though I was not able to feel His presence or love for me during a relapse of severe depression, He has never leave me nor forsake me. In fact, it is He that is sustaining me. Underneath me is His everlasting arms! What a mercy!

"The eternal God is thy refuge, and underneath are the everlasting arms: ...." Deuteronomy 33:27a

It is a mercy that I can have opportunities to worship God in a Church that love God and love me. I thank God for His love for me in leading me to know Himself in 1990, some 18 years ago, and how He has sustained me through so many challenges in my life. Even now in this bipolar disorder, He is continuing to enable me to know more of His love and faithfulness.

I thank God for my family, my Pastor, my church elders and deacons, church friends and other friends, for all their prayers and encouragements, and kindness in so many ways. These are tokens of God's love for me and they strengthen my heart as I seek to walk with the Lord Jesus Christ and serve Him. It gives me courage to continue on despite my condition. Though I know that there is always the possibility that I might have to go through severe depression again though on medication and with other help (as this is the nature of the illness), but I find much joy and courage in the Lord daily as I look to Him for strength and grace to live for Him. I know that He will continue to take care of me even as I strive to take care of myself so that I can continue to seek and serve Him. And I can look forward to the day when my tasks on this earth is completed, and the Lord takes me home to be with Himself, to my eternal rest, to enjoy His love, to worship Him and to spend eternity with Him. What a blessed hope!



My brother, Arthur, took this lovely photo at Muriwai Beach, West Auckland, New Zealand.



"...for he hath said, I will never leave thee nor forsake thee." Hebrews 13:5

John 14
1 Let not your heart be troubled: ye believe in God, believe also in me.
2 In my Father's house are many mansions: if it were not so, I would have told you. I go to prepare a place for you.
3 And if I go and prepare a place for you, I will come again, and receive you unto myself; that where I am, there ye may be also.
4 And whither I go ye know, and the way ye know.

Rejoicing in God's sovereignty

Thank God that I was able to attend my church Prayer Meeting last evening. My Pastor is sharing with us from the Book of Psalms serially. Last evening, we read Psalm 47.

Pastor JJ reminded us that Psalm 46 which we studied last Friday, was a Psalm about the great anxiety and turmoil that can come upon the lives of God's people. The Psalmist painted a very gloomy picture and it seems things are going to get worst. But the Lord exhorts us to be still and to know that He is God (Psalm 46:10). We are not to fear because God is our refuge and strength (Psalm 46:1). We are to understand that come what may, God is sovereignly in control.

Psalm 47 begins with a triumphant note. The Psalmist exhort God's people to clap their hands and shout unto God with the voice of triumph (v1). We are to sing praises to God Who is our King. God is the King of all the earth and He sitteth upon the throne of his holiness. (vs 6-8).

This is a very joyful Psalm. It seems to be a Psalm that is sang in celebration after all our troubles are gone. But Pastor JJ think that this is not so much a Psalm to be sung in celebration but it is a Psalm to be sung in anticipation of victory or rest as indicated in verse 3-4. Therefore, even when we are going through severe trials in our lives, we can sing this Psalm to encourage ourselves through all the pain and sufferings in this life. The reason for our rejoicing in God even admist our suffering, is the comforting truth that God is the King of the universe and He is sovereignly in control of all things. This is the reason to praise the Lord. We must praise the Lord because our eyes of faith ought to see what the Lord is doing. We are often unable to praise the Lord because of sin and the tendency to look at the winds and the waves surrounding us. If we think and meditate on the great things of God, His love and sovereignty and we set our heart upon God, we can rejoice in Him. May God help us to turn our eyes upon Him. Our afflictions and trouble are light compared to the eternity God is preparing us to enjoy.

Psalm 47
1 O clap your hands, all ye people; shout unto God with the voice of triumph.
2 For the LORD most high is terrible; he is a great King over all the earth.
3 He shall subdue the people under us, and the nations under our feet.
4 He shall choose our inheritance for us, the excellency of Jacob whom he loved. Selah.
5 God is gone up with a shout, the LORD with the sound of a trumpet.
6 Sing praises to God, sing praises: sing praises unto our King, sing praises.
7 For God is the King of all the earth: sing ye praises with understanding.
8 God reigneth over the heathen: God sitteth upon the throne of his holiness.
9 The princes of the people are gathered together, even the people of the God of Abraham: for the shields of the earth belong unto God: he is greatly exalted.

I took this lovely photo at Sentosa Flower exhibition at Sentosa Island, Singapore.

I will praise thee; for I am fearfully and wonderfully made:
marvellous are thy works;
and that my soul knoweth right well.
Psalm 139:14

Don't be discouraged

Sometimes it is easy to be discouraged when things do not turn out the way we wish them to or people do not appreciate what we are doing. Thank God for the reminders through His Words that we are not to be weary in well-doing, for one day we shall reap if we faint not (Galatians 6:9).

It is my prayers that God will continue to enable me to do my best for Him daily because of His love for me. I want to love God and love the people He places in my life, by doing my best for God and for them. It is not so much about taking pride in a job well-done, but rather it is in being able to live in gratitude to God. And reflecting His love and grace to others so that His name may be greatly magnified and His saving grace made known.

Don't be discouraged if your efforts
are sometimes greeted with indifference.
The sun puts up a wonderful show at daybreak
yet most of the people in the audience go on sleeping.

This beautiful picture is taken by my friend, Heng Sau, at Tai Po, Hong Kong.

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

But ye, brethren, be not weary in well doing. 2 Thessalonian 3:13


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

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......

From the rising of the sun

Thank God for the joy of waking up each morning! Whenever I am severely depressed, I dreaded waking up in the morning. That was always the hardest part of the day. I dreaded the thought of having to face another day of hopeless, useless and pain.

But now it is so different! Thank God for restoring me from my recent relapse of severe depression in July 2007. The wonderful thing about bipolar disorder or manic-depressive illness is that whenever I am better or well, I am usually kind of hypomanic. And at such time, I wake up each morning with joy and thankfulness. I look forward to the many challenges each day. I have a lot of ideas, become more creative, have more energy and there seemed to be so many things I want to do or accomplish each day.

Thank God for every opportunity to know Him and serve Him with each new given day. I pray that I may always know His love and faithfulness, no matter what He sovereignly allows me to go through in this pilgrim journey. I am thankful to God for enabling me to know His love and mercies experientially especially through my severe depression episodes. Those severe depression episodes are painful beyond words, but they also have a very sanctifying influence in my life. They are mercifully used by God to purge me of my dross.

Sometimes when I am well, I can be very complacent. Sometimes I get carried away by many things and thoughts that I have daily. I can be quite a workaholic and neglect God, my family, friends and people around me. I can become very task-orientated and just want to accomplish as much as possible daily. I derived satisfaction from doing a good job at whatever I do, as I am some kind of a perfectionist. Sometimes I forget to spend more time with God, forget to pray, forget to follow His Words and seek His guidance or direction.

Severe depression episodes are mercifully used by God to humble me, to bring me down more to earth and realize afresh what really matters in this life. Nothing in this life will last for eternity. Not my possessions, my reputations, my family, my career, my friends, my church, my hobbies, etc etc. None of these things will last. One day they shall all perish. But my relationship with our Heavenly Father and our beloved Saviour Lord Jesus Christ, shall last for all eternity! One day when all things are gone, and even my own life ends, our Lord Jesus Christ shall take me home to be with Himself in to enjoy His love and glory for all eternity. What a blessed hope!

Thank God for the encouraging reminders at the Westminster Shorter Catechism class at my church last evening. It was the first time I attended the Class together with my sister-in-Christ, Grace Lim. Pastor JJ was lecturing on Westminster Shorter Catechism Question 20:

Westminster Shorter Catechism Question 20: Did God leave all mankind to perish in the estate of sin and misery?

Answer: God having, out of his mere good pleasure, - from all eternity, - elected some to everlasting life, - did enter into a covenant of grace, to deliver them out of the estate of sin and misery, and to bring them into an estate of salvation by a Redeember.

Pastor JJ reminded us that God has established a covenant of grace with His people. He is a covenant keeping God and He will not break His covenant/promise/contract with us. Despites our sins and failures, God remains unchanging! Nothing can separate us from the love of God.

How I pray for grace to know God in very real and personal ways, to remember His love and faithfulness through all the changing scenes of life. And to be able to praise Him from the rising of the sun until the going down of the same.



This beautiful picture is taken by my friend, HH Sau, at Tai Po, Hong Kong.

From the rising of the sun unto the going down of the same the LORD'S name is to be praised. Psalm 113:3

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....