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758px-Van_Gogh_-_Starry_Night_-_Google_Art_ProjectThis weekend I got to see empowering love in action. Jim Savage is a therapist in Addison, TX who hosts a monthly meeting at the Dallas Recovery Center called the Artist’s Recovery Meeting. In typical 12 step fashion, the first part of the meeting includes a testimony from a local artist who is in recovery. The stories of metamorphosis from a raging alcoholic or addict to a recovered and contributing member of the arts community is as inspiring and beautiful as the art being displayed and performed.

The second half of the meeting is an open forum for artists of all mediums and levels of ability to express themselves through their work. Music, poetry, painting, photography, and even a standup comedy routine were on the lineup. What struck me the most throughout the evening was the level of support, encouragement, and admiration for the artists, no matter what their stage of development. One member of the group had never done art before, but was so inspired from attending these monthly meetings that she decided to purchase a sketchbook of her own. That night she presented her drawings for the first time. She wanted to be involved. Share herself with us. Become a part of something bigger than herself. We were all impressed by her bravery, her openness, and her creativity. In return for what she shared, the group gave her praise, encouragement, and a challenge to keep drawing, keep sharing, and keep inspiring others through her personal and artist journey.

The experience that night taught me something about therapy and life. Every human being wants three things from their relationships:

  1. To be known: Art is an expression of self. Copying someone else’s painting, singing another person’s song, or mimicking another person’s dance is only art insofar as it allows the performer to infuse some element of themselves into the experience. When clients enter my office, they do so in order to express themselves. Many are nervous about the encounter. They wonder and worry whether or not they will be heard, understood, and related to.  Clients share the good, the bad, and the ugly about their lives, trusting that their therapist will not form quick judgments or opinions, but will take the time to know them fully. The best therapists do so with diligence and care. Common phrases that I hear in therapy are “I don’t know where to begin”, “does that make sense”, “not sure if I’m explaining this correctly”, “I know I’m just scratching the surface here”,  and “I hope you understand where I’m coming from.” It is hard to be vulnerable. There is always a chance of being misunderstood. I tell my clients every day that they may need to tell me their story several times and several ways before I “get it”, but if we keep working at it and don’t give up, the understanding will come. If we want to experience deep, fulfilling relationships we must know ourselves and be known by others as we truly are. Take the risk, keep sharing your story, and don’t forget to hear and understand others too.
  2. To be accepted: Being known is not synonymous with being accepted. Just watch some of the early episodes of American Idol. Some contestants are accepted and advance in the competition and others are rejected and sent home. Rejection is one of the biggest fears associated with transparency. It is a risky business. When someone understands who we truly are and refuses to accept us, the blow to our psyche can be staggering, but when we share our struggles and find understanding and acceptance, it can heal the deepest of wounds. Supportive environments like AA/NA/CR/Al-Anon/CoDA help struggling members find the love and acceptance they need to discover their true selves and decide how they need to change. Therapy is a place where this can occur as well. Many clients fear abandonment. They sit in a therapist’s office because they have been abandoned by people like friends and family who should have loved and accepted them the most. Often, they seek counsel on how to change themselves so they can become more acceptable to others. The goal of therapy is to shift their insight toward loving and accepting themselves. If you cannot do this, you will never be able to accept the love and acceptance that others provide you. This is the value of sponsorship in the recovery community. Individuals seek out members with similar life experiences who can understand their stuggle  and will accept them in whatever stage of recovery they may be. Nothing should surprise a sponsor or a therapist. If something does, it doesn’t mean they or you are bad. It just means you need someone with a different expertise or experience to guide you. Don’t get discouraged if it takes you several tries to find that right fit.
  3. To be empowered: Understanding and acceptance are great, but if we stopped there, no one would ever change, grow, or experience new challenges and opportunities. Ultimately, each of us wants to be empowered to succeed in life. True love empowers. In AA, the motto is “keep coming back. It works if you work it.” Artists are never satisfied with painting one picture, singing one song, or writing one story. We want to continually create, improve, push the limits, grow. The same is true for life. Relationships should empower us to be better, more fulfilled, and complete. Psychologically, we would describe this process as self-actualization. Friendships challenge us. Sometimes there is conflict. Unfortunately, this is the destructive illusion of social media. We surround ourselves with virtual people who like all our posts or simply defriend us if they don’t. As a result, we have become sensitized to the friction that should be a natural part of any relationship. We disagree, we argue, we question, we push, all the while providing love and acceptance in the process. This is the beauty, the dance, the song of relationships. Feedback is important. Those who observe your life, much like those who observe art, have the right to say “I like that” or “I don’t like that.” Don’t dismiss the dislikes. Observe and explore them. It doesn’t mean you have to accept them as the truth, but they can challenge you in ways that simple praise may not.

Artist’s in recovery was a great experience for me. I witnessed something amazing that night: not just the beautiful products of art but the beautiful processes of art. Life is the same. May each of our lives continue to produce beauty. Don’t give up on the process!!

Question: If your life was a piece or product of art, what would it be? How would you describe it? Who have you shown your art to? What was the response? Where have you found a community that understands, accepts, and empowers the beauty of your life?


This is the third part of an interview I participated in for the Texan, a publication of the Southern Baptists of Texas Convention. I was asked to comment on the motion presented to the SBC Executive Committee in favor of improving churches’ care for those with mental health challenges. I see this as a huge step forward in reducing the stigma associated with mental illness, which has unfortunately been propagated by the church at times. In this section, I answer the question, “What are some ways in which you see churches failing in their attempts to biblically and adequately address mental health?” I’d love to get your thoughts on it:

“Our failure has come from turning a blind eye to the science and the research that has been done over years and years of studying human development and functioning. As I’ve said, we have turned a blind eye to it out of fear, fear of what it would mean for us to step outside the bounds of the Bible and using other forms of truth, natural revelation, that are just as God-given. We know so much more about how the mind and brain work than we did even 10 years ago. Why would we waste that knowledge in our efforts to help redeem the brokenness of mankind?

At Criswell, we take an integrated approach to counseling. We don’t shy away from what natural revelation might reveal to us. We absolutely filter it through the lens of Scripture; we make sure that the theories we’re espousing are consistent with the Word of God, but we don’t shy away from knowledge that might make us more efficient at helping the mentally ill. And this is one of my biggest pet peeves with people in the Christian community and with people in Christian academia: when they completely refuse to even study a field of knowledge because they say, “Well that’s not based on biblical truth.” I think it was Augustine who said, “All truth is God’s truth.”

For example, it’s very emotionally taxing to be in the presence of someone with a mental illness. You can share Scripture. You can share truth with them through the Bible, and it doesn’t seem to penetrate; they don’t seem to get it. Without training, we get tired very quickly. It’s why the statistics associated with pastor burnout are so high. So in an academic program like Criswell, we teach more effective ways of working with someone with mental illness. Why? Well for one, it reduces your own emotional exhaustion so that you can sit in the presence of someone with a mental illness and have greater strength bear the load. In the end, it makes us more efficient as counselors and as lovers of people.”

Question: What do you think? Is the church helping or hurting people with mental health problems? How and why?

(Be sure to follow me on Facebook, Twitter @DaveHendersonMD, and Linkedin for more articles like these.)

This is the second part of an interview I participated in for the Texan, a publication of the Southern Baptists of Texas Convention. I was asked to comment on the motion presented to the SBC Executive Committee in favor of improving churches’ care for those with mental health challenges. I see this as a huge step forward in reducing the stigma associated with mental illness, which has unfortunately been propagated by the church at times. In this section, I answer the question, “How does mental illness relate to the fallen nature of mankind?” I’d love to get your thoughts on it:

“However you view the “mind-body-spirit” dynamic—you have to acknowledge that sin taints our entire essence. We sin as an act but we are also sinners in our essence and that essence spans our spirituality, our psychology—I would use that term psychology—and our physiology, our bodies. When you see it from that standpoint, it allows for the uniqueness of the individual and their struggle. It allows for the infusion of truth, grace and mercy into their specific circumstances. And the gospel becomes very real to them because you’re not taking a cookie-cutter approach to every single person. You’re recognizing that we’re all tainted by the fall, but that tainting is very different for each person. So Sally, for example, may struggle with pride or arrogance or gossip, but Johnny over here struggles with pornography or violence, anger, rage. What makes them different? They’re both sinners. They’re both tainted by the fall. But their genetics, personalities, sex, and life circumstances are all different. And so it creates both a dynamic of collective sinfulness, commonality, while maintaining a uniqueness in these other areas. And when I see clients that come to my office, I take each one as an individual and try to tease out what is the essence of their struggle in this life, how the fall has tainted them, but also how they can be redeemed, in body, in soul, in spirit.

To address the physical nature of our humanity, let me point out that researchers have done studies looking at people with severe anxiety and demonstrated that certain areas of their brain are not just functionally overactive, but actually physically larger. One area in particular, called the amygdala, is larger and hyperactive in those who are extremely anxious. So then we must address the nature of their struggle. If somebody has a larger amygdala and it’s overactive, are they going to struggle more with worry and with anxiety, which the Bible says we clearly should not do? Yes, absolutely. Does that affirm their sinfulness? Of course, it affirms that they are broken people just like all of us. The statistic, as far as brokenness, is 100 percent—it just differs in the areas that we struggle. The joy and excitement of what I do is to learn about the nature of their anxiety and help equip them to battle it effectively, incorporating all tools at our disposal, given to us by God through both divine revelation and natural revelation.

So this resolution seems to me to be the equivalent of Christendom’s acceptance that the world is round. In Galileo’s time, there was a lot of fear about what the acceptance of this fact would do to the Faith.  It challenged people’s worldview. This is an equivalent issue in that it’s challenging our worldview today. But I think in the end, it will not do anything as far as shaking the core doctrines of our faith and what we believe, but will instead help us to be more effective as ambassadors of the truths we find in scripture about our brokenness and our need for a Savior.”

Question: What do you think? What causes mental illness? Is it physical, psychological, spiritual, or all of the above? How do you think we can reduce the stigma associated with mental illness while still remaining true to our faith?

(Be sure to follow me on Facebook, Twitter @DaveHendersonMD, and Linkedin for more articles like these.)

Tonight on For Christ and Culture, I interview Dr. Matthew Stanford, neuropsychologist, author and co-founder of the Mental Health Grace Alliance, an organization dedicated to helping those who feel stuck in the “treatment box” discover the true process of recovery. They provide personal assistance to navigate professional care and improve personal life management (mental health recovery). Their Mental Illness Recovery Program (THRIVE) and support groups reinforce professional care, reducing symptoms, building recovery and improving personal faith.

Dr. Stanford was one of the plenary speakers at Rick Warren’s Mental Health and the Church Conference at Saddleback Church in California. On today’s program we discuss some key factors necessary to help people understand the nature of mental illness and how best to approach treatment. Here are a few key points to remember:

  1. Recovery vs. Cure: Many people diagnosed with mental illness ask, “Can I be cured?” Unfortunately, this is a very black and white way of viewing mental illness that sets people up for certain discouragement and failure. If the cause of mental illness was as simple as identifying a bacteria that could be eradicated with an antibiotic, we might used the word cure. However, mental illness usually falls within the spectrum of disorders that require ongoing management of symptoms and signs. Similar disorders would include Diabetes, Parkinson’s syndrome, Heart Disease, and Lupus. When you consider the nature of mental illness, we use the diathesis/stress model. A diathesis is a predisposing factor that makes the acquiring of a disorder more likely. When we use this term, we are usually referring to a person’s genetics or heritability. The stress or stresses are the environmental factors that precipitate and perpetuate a bout of the disorder. These environmental factors include diet, exercise, traumatic life events, upbringing, belief systems, and relationships that generate the “perfect storm” so to speak. It is important to remember that these factors are always in flux and can either exacerbate or improve symptoms depending on the individual’s handling of them. Recovery comes when a person’s symptoms abate and/or the stressors are diminished.
  2. Resiliency vs. Avoidance: No one can completely escape the pain of life. That is why the second goal of treatment is called resiliency. Our goal is to help clients develop strength to overcome day to day challenges that before might have precipitated or exacerbated the symptoms of their mental illness. Just as diet and exercise enable an individual to overcome obesity, heart disease, diabetes, and other such disorders, treatments for mental illness can do the same. Medications are one tool out of a host of options that provide this strengthening. They are not cures and they do have side effects. That is why a holistic approach to treatment that includes talk-therapy, group accountability and social support, diet, exercise, spiritual practices, and educational advancement is vital.
  3. Reminders vs. Results: Sometimes clients get focused on results and need reminders of how far they have come in treatment. “I feel worse today” is a common statement I hear. It is natural to have ebbs and flows of emotion. At any given moment, we might feel worse and it seems like we are taking steps backward. The encouraging part of what I do is to point out those subtle changes that I’ve noticed occurring in peoples’ relationships and daily life tasks, being a witness to the strength that clients demonstrate during very challenging times. We all need to be reminded that life is hard and full of surprises, but as our endurance builds, we rise to meet those challenges. We can have confidence in ourselves, looking back at some of the hurtles we’ve already jumped, knowing that the ones to come can be taken in stride using the tools we are continually acquiring.

Question: What has given you endurance to keep pushing forward, even when life gets tough?

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Recently, I was interviewed by the Texan, a publication of the Southern Baptists of Texas Convention. I was asked to comment on the motion presented to the SBC Executive Committee in favor of improving churches’ care for those with mental health challenges. I see this as a huge step forward in reducing the stigma associated with mental illness, which has unfortunately been propagated by the church at times. Here is an exerpt from the the article. I’d love to get your thoughts on it:

“The challenge for Christians wrestling with how to define mental health and mental illness has always been, “How much of this issue is a spiritual problem, how much is psychological, and how much is physical?” Where does the brain stop and the soul begin? Is it even possible to separate the two practically? I would suggest that our desire to draw a hard and fast line between those three components is because it sets up a definition and model of treatment that is easy and comfortable for us. As humans, we gravitate toward the black and white. If I see a person in counseling and I can say with absolute authority that he or she is suffering from unconfessed sin, it makes my job a lot easier. Confess the sin and you will get better. On the other hand, if I can draw blood and say with absolute authority that the test results show a low thyroid level, again my job is very easy. Treat the thyroid and you will recover. The problem is that much of medicine in general (not just psychiatry) is not this clear cut. [Examples abound.] More importantly, Christians need to acknowledge that this is true of life. That is why the Bible speaks so much about wisdom, which is the application of knowledge to given situations, not in a cookie-cutter sort of way, but in a way that uses discernment, taking each case as it is presented to us. It is easier and more comfortable to make everything a black and white issue, but it is not the Biblical model in dealing with people. The essence of humanity is body and soul. Some would say body, soul and spirit. We separate these elements out in order to understand them intellectually, but in real life, in the context of counseling, we treat the whole individual. This might be messier, but God never called us to remain in the ivory towers of intellectualism. He called us to love people, broken people who need him. That takes a lot of work. So defining mental health and illness becomes a process of understanding the component parts of a person (their biology, their psychology, and their spirituality) and how they interact as a whole to effect an individual’s understanding of themselves, how they relate to God and others, and how they act in that context.

I see the SBC resolution (last summer on mental health) as extremely important to the shift in mindset that we are taking as evangelical Christians on dealing with the mentally ill. Do we still acknowledge the reality of sin? Absolutely. But we acknowledge it in the sense that it taints us spiritually, emotionally and physically. This means that we must accept that our physical bodies, our psychology, society, and our history of life experiences impacts the way we think and the way we feel, even the way we live out our faith.

Question: What do you think? Do you agree or disagree? How should we determine what problems are caused by the unhealthy practices of an individual’s faith tradition vs. a psychological or psychiatric condition that might benefit from medication or psychotherapy? Is the question even relevant?

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Tonight on For Christ and Culture, Barry Creamer hosts the show as I call in from Chicago, The Windy City, where I attended the American Academy of Clinical Psychiatrists’ annual meeting.* Be sure to tune in on KCBI 90.9 at 6:30pm or 10:30pm or by listening online any time after 7:30pm as we discuss the role of medication in treating psychiatric illnesses, when to prescribe and when not to, and how doctor’s determine when and how to use medications. We also dispel some myths about overprescribing in our culture and give some recommendations for clients seeking treatment. Seeing a mental health professional can be a scary thing to do, but with some preparation ahead of time, you can be confident that you are taking the right steps toward securing your own or a family member’s mental health. Here are just a few recommendations:

  1. Do your research ahead of time. Reading online reviews of a doctor can be helpful, but more often than not, getting a recommendation from a friend, a primary care physician, or another therapist who has had a positive experience with the doctor is the best way to feel comfortable that you have made a good choice.
  2. Consider the style of the professional. Is the doctor’s method of evaluation conducive to your needs? Ask questions of the staff before making an appointment: How long is the initial evaluation? Do I see the doctor the whole time or are their other individuals, assessments, and time commitments involved? It would even be appropriate to ask about the personality style of the doctor. Many people want to know if a doctor is sensitive to their spiritual and religious beliefs. These are all valid inquiries to help you make an informed decision. If staff seem inpatient and unwilling to respond, you might take that as a warning sign for future experiences. (Realize, however, that most doctors’ offices are extremely busy, so it would be helpful to think out your questions ahead of time, write them down, and take notes while you talk in order to get as much information in as short amount of time as possible.)
  3. Don’t hesitate to get a second opinion. No physician should get upset by a client’s decision to obtain a second opinion. It is always helpful to have another set of eyes on the situation to help determine the appropriateness of the diagnosis and the effectiveness of the treatment. If opinions differ, however, it will ultimately be your choice to decide on whose advice you act. Just realize that most doctors will require that you make a decision and see one or the other professional. Doctors do get concerned when a client shifts from doctor to doctor because it interrupts what we call “continuity of care.” Continuity of care allows us to follow an individual over time, make sure that treatments are effective and safe, and intervene quickly if a problem arises.
  4. If you’re hesitant to start medication, consider seeing a psychologist first. Most psychologists are trained in assessing personality styles and symptoms related to mental illness. If you are really wanting to keep medication as a last resort and fearful that a psychiatrist will automatically prescribe (It happens sometimes!), you might start here and allow the psychologist to recommend psychiatric treatment if they are concerned. Just realize that this adds an addition step onto the process and may lengthen the time it takes to find relief from your symptoms.
  5. Trust your instincts. After you’ve done your research, talked to friends and family, and prayed about the decision, move forward with the treatment recommendations that have been agreed upon. Most doctors today are collaborative in their approach. They don’t “force” you to do things unless they have an immediate concern for your safety or the safety of others. In these instances, they will likely involve friends and family who love and understand you. Each step of the way, ask questions. Talk openly about your concerns. That’s why the doctor is there. Perhaps you are unsure of your decision-making abilities. You have a right to an advocate who could join you, at least for the initial evaluation. And remember, if it doesn’t work out between you and the doctor for some reason, it doesn’t mean that you or the doctor has failed. It may simply mean that there is a better person suited to care for your needs.

Questions: Why do you think it is so scary to see a psychiatrist or other mental health professional? Is it possible that some of your fears can be assuaged by following the steps above? What other helpful tools have you developed to find the right professional for yourself, your family, or your friends?

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Ever seen that movie, What About Bob? One of the funniest scenes in the movie is also one of the most glaring proofs of how ignorant many people are about mental illness. Bob has been placed in a sanatorium by his analyst, and he sits casually telling a joke to the hospital staff. “Roses are red. Violets are blue. I’m a schizophrenic and so am I.” Many people still believe that schizophrenia is a disorder of split or multiple personalities. It’s actually not that at all. For the DSM V diagnostic criteria of Schizophrenia, click here.

Another misunderstood diagnosis in psychiatry is called Bipolar Disorder. You yourself may have been accused of being Bipolar if you’ve changed your mind on an issue recently, become suddenly sad or angry for no apparent reason, or chosen to do something foolish on a whim. I see many clients who ask to be evaluated for Bipolar Disorder, so I know that it is a real concern for many. If you believe that someone you know may suffer from it, I hope to clear up the most common misconceptions. Please note that this blog post does not substitute for a thorough psychiatric evaluation nor does it provide all of the various diagnostic criteria to make a diagnosis of Bipolar Disorder. The internet provides basic information about the disorder, but this is no substitute for a medical evaluation by a trained professional.  With that CYB (Cover Your Butt) disclaimer, here are the top five most common misconceptions I’ve heard:

  1.  People with Bipolar don’t sleep well. This is true but only part of the truth. Many people who do not have Bipolar disorder experience insomnia. When daylight savings time rolled around, I was struck by how many people on facebook reported several nights of insomnia as a result. We all have times of poor sleep for a number of reasons. Stress, worry, depression, too much caffeine, exercising too close to bed time, indigestion, a lousy mattress, or a snoring spouse all can interfere with our sleep. What constitutes a positive symptom of Bipolar disorder is a decreased NEED for sleep. If most of us have a few bad night of sleep, we are out of commission for the next day. We feel lethargic, unmotivated, and miserable. Not people with Bipolar Disorder. During a manic episode, a patients will not want to sleep, forget to sleep, or feel they are wasting time by sleeping. Even if patients want to sleep, their bodies say no. They have so much energy and drive; they can do without sleep for several days or weeks at worst.
  2. People with Bipolar are moody. Mood changes, as the old name implies (Manic-depression), constitute part of the criteria for the disorder.  However, these changes in mood are distinctly different from the individual’s normal personality. Some people are prone to moodiness by nature. They may be up one minute and down the next. These shifts of emotion are usually the result of circumstantial stressors. By definition, however, a manic episode must last at least seven days (4 for a Type II diagnosis) or require immediate hospitalization due to the severity of the shift. Depressive episodes must last at least 2 weeks. These changes are drastically different from the affected individual’s normal disposition. So if you’ve ever said to someone, “You’re so Bipolar,” you are probably describing a personality trait rather than a feature of a true mental illness.
  3. People with Bipolar have racing thoughts. Again, this is true only in part. Many people complain of racing thoughts, but what they really mean is “I feel anxious.” A person who feels anxious can have a subjective sense that their mind is racing. Someone with Bipolar disorder, however, actually has an increase in the flow of ideas rushing through their brain as a result of excitement, overstimulation, and excessive energy, not worry or fears. In fact, individuals in the midst of a manic episode tend to feel grandiose or invincible, as if they could conquer the world. They are more likely to be impulsive as a result. Because of the racing thoughts, they are easily distracted. Their speech is pressured and fast. You might have trouble keeping up with their train of thought. Don’t confuse the racing thoughts of an anxious person with the racing thoughts of a manic person.
  4. People with Bipolar Disorder are drug addicts. This is an unfortunate stigmatization of Bipolar patients. Many individuals who have a first break episode of mania or depression have never even tried alcohol, let alone hard drugs like cocaine. Is it possible for drug-use to mimic the symptoms of Bipolar? Absolutely. It is also common for someone with Bipolar Disorder to have a comorbid (co-occurring) addiction. At times it can be difficult to distinguish the two from each other. The key difference is that people with Bipolar Disorder experiment with drugs because of the grandiosity, invisibility, and pleasure-seeking desires they feel during a manic episode. The egg comes before the chicken in this case. In many instances, proper treatment of the disease reduces the addictive behaviors.
  5. People with Bipolar Disorder are dangerous. Though it is true that in the midst of a manic or depressive episode, people can be a danger to themselves or to others, they are not evil, scary, criminal, or crazy as pop-culture might like to portray them. With the proper education, treatment, and follow-up, most people with Bipolar Disorder live very normal lives. Indeed, some of the most powerful, creative, and influential people in society have had Bipolar Disorder. I would encourage anyone who would like a first-hand report of life with Bipolar Disorder to read Kay Jamison’s book, An Unquiet Mind.

If you or someone you love suffers from Bipolar Disorder, check out The Bipolar Survival Guide for more helpful information and tips on how to control it.

Question: What are some of the other common misconceptions about Bipolar Disorder that you have heard? What is our role as a society to help those with mental illness? How can we better equip people to understand and relate to people with a mental illness?

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The Center for Disease control reports that insufficient sleep contributes to:

1. Depression
2. Unattractiveness
3. Skin aging
4. Weight gain
5. Less sex
6. More arguments
7. Marital dissatisfaction

As a physician and psychiatrist, poor sleep quality is one of the most common complaints I hear. Insomnia can include trouble falling asleep, trouble staying asleep, and early morning awakenings. There are a number of factors that contribute to a poor night’s sleep. Many people think that medication is the only option, but with a few simple tricks, the majority of people with insomnia can see drastic improvements. Here are some that my clients have found helpful:

1. Only use the bed for sleep and for sex. The body learns by association. If you use the bed for anything other than what it was designed for, the body begins to associate it with that activity. So if you study in bed, watch T.V. in bed, or handle marital problems in bed, your body will not associate the bed with sleep but with stimulation and frustration and will prepare accordingly. The only exception is sex. Researchers recommend sexual intercourse right before bed because in the postcoital state (after orgasm), the body releases a hormone called oxytocin which helps you relax.

2. Get up at the same time every morning…EVERY morning. Yes, that means even on the weekends. Studies have shown that it doesn’t matter as much what time you go to bed, but what time you get up that helps to regulate the sleep cycle. Even if you have a crummy night’s sleep, you are better off cutting your losses, lowering your expectations for the coming day, and catching up the following night. And as much as you love a lazy morning on the weekend, if you are sleeping in late, it probably means you are not allowing yourself enough time to sleep on the weekdays and your body has learned to exclude the weeknights as a restful time.

3. Only sleep when you are tired. A lot of people get into bed at 9, 10, or 11 because it’s the expected thing to do. The problem is, if you are not tired (because of poor sleep hygiene, perhaps), getting into bed begins a ritual of tossing and turning before you can sleep. You are better off getting 5 hours of continuous sleep rather than 8 hours of fitful sleep. So, pick the time that you need/want to get up each morning and subtract the total number of hours you actually spend asleep. That is the time you should go to bed. For example, if you need to be up by 7am and you are only getting about 5 hours of actual sleep time a night, then start out going to bed at 2 am. Eventually, as your body resets itself, you might start getting tired at 1:30am or 1 am or 12:30am. Gradually add a ½ hour onto the total time and watch your sleep return. This step also means that if it takes you more than 20 minutes to fall asleep, you should get back out of bed, proceed to step 4 and return only when you start dosing off again.

4. Create a ritual before bed. You would think this is the easiest part. For many, it is actually the hardest. We live in an over-stimulated culture. Winding down after a long day of work has become difficult. Gone are the days of sitting on the front porch in a rocker sipping a mint julep (never had one, myself, but an old southern gentleman at my church in South Carolina used to talk about it and it sounded so delicious!). Nowadays, most people watch T.V., work on the computer, or check apps on their smartphone right up until the time of sleep. These kinds of activities are so over-stimulating, that the brain takes longer to shut down. People who engage in these activities report a subjective sense of “racing” thoughts. Some ritual behaviors to incorporate include:

a. Reading a pleasant book (No studying – I usually recommend James Herriot books like All Creatures Great and Small.)
b. A warm bath/shower.
c. Application of a fragrant cream/lotion to help you relax.
d. A light snack.
e. Go to the bathroom!! (I thought my kids were the only ones I needed to remind on this one, but no, adults forget too!)
f. Journaling the events of the day.
g. Quiet music.

5. Avoid stimulants and alcohol before bed. We all like our Starbucks coffee! (Actually, I can’t stand their Pike, which is all they brew after noon, but I still buy it for some reason! That is a subject for another post!) Using a stimulant like caffeine actually interferes with the chemical fluxes that help to regulate our sleep. Adenosine is a chemical that builds in our system the longer we stay awake. It is a byproduct of energy molecules in the body. The longer we stay awake, the more adenosine we have flowing through our system and the sleepier we get. Caffeine is an adenosine receptor antagonist, which means it blocks adenosine’s ability to induce sleep. Alcohol, on the other hand, binds to GABA receptors in the brain, which do sedate us, but prevent us from experiencing the deeper, more restful stages of sleep. For this reason, it is important to avoid both.

If you have done all of these things consistently and still can’t seem to sleep or if you sleep through the night and still don’t feel rested during the day, talk to your physician about an underlying medical or psychiatric condition that may be contributing.

Question: What tips or tools have you found helpful in getting a good night’s rest?
Thanks to for some of the statics in this post.

Tonight on For Christ and Culture, I discuss a recent article in the Huffington Post. (Cue not so subtle guffawing from Dr. Creamer, who clearly has a great deal of regard for their political leanings!). The title is quite a mouthful: 10 Surprising Things That Benefit Our Brains That You Can Do Every Day. I’d like to address just five of them. If you’re interested in reading the entire article, you can click the link above. And be sure to tune into the show tonight at 6:30pm or 10:30pm to hear the entire discussion.

1. A tired brain is a creative brain. When we get tired, most of us want to veg out on the couch, watch our favorite DVR’d television show, play video games, or surf the internet. If you do, you may be missing out on the creative processing your brain is capable of. Why? Because when your brain is tired, it is more prone to distractions. The decrease in focus allows for the connecting of more random pieces of information, making it more likely to generate new ideas and associations. Here’s what Scientific American had to say about it: “Insight problems involve thinking outside the box. This is where susceptibility to “distraction” can be of benefit. At off-peak times we are less focused, and may consider a broader range of information. This wider scope gives us access to more alternatives and diverse interpretations, thus fostering innovation and insight.” So the next time you feel tired, don’t immediately veg out. Instead, let your mind wander and see where it goes. You might be surprised at the new and exciting ideas that arise. I also think times like this are important for our spiritual life as well. Yes, we need to be disciplined in spiritual practices like studying, prayer, meditation, and worship. But God also encourages us to “be still” and “know” Him. What new insights about His nature might He reveal to you in those quiet moments? You’ll never know unless you try.

2. A stressed brain is a weaker brain. More and more studies are demonstrating that stress has a powerful impact on the body. Remember David’s words in Psalm 32? The Brain is no exception. In fact, it’s the primary organ where these changes take place. There is a correlation between anxiety and the size of the amygdala, the emotional hub of the brain. People with high stress levels tend to have larger amygdalas. We also see an inverse correlation between the amount of chronic stress and anxiety in a person’s life and the size of their hippocampus, the memory processing part of the brain. This makes sense when you consider someone with Posttraumatic Stress Disorder and the difficulty they have with memory and concentration. (For more information about stress and the body, click here.) The take home point is this: If you want a strong mind, you have to give it time to rest. Take a vacation, slow down and enjoy your favorite meal, do something fun with a friend, read a relaxing book, write out all the things in your life you are thankful for. If you’ve experienced significant trauma in your life, consider meeting with a therapist to process those life events in a healthy way. Taking care of your emotions is taking care your brain.

3. A multitasking brain is an inefficient brain. I did a radio interview on this very topic a while back. If you’d like to listen to it, you can click here. The book Brain Rules explains how multitasking is a myth: “Research shows your error rate goes up 50 percent and it takes you twice as long to do things.” I recently had a client tell me that he had trouble reading. “I get so distracted by my own thoughts. I think of things I need to buy at the store, a friend who asked me to do something for him, a work project that I’ve been neglecting, a fear that I have about the upcoming work week. After an hour, I find that I haven’t even made it through a single page.” Does this sound like you? It is pretty easy to eliminate external distractions. (Turn off the T.V., close out your facebook account, turn on some quiet music, find a conducive environment.) Eliminating the internal distractions of our minds takes more work, but it is possible to do. Here are just a couple of suggestions. First, remember your priorities for the moment. If you really want to read, then the other activities on your mind need to take a backseat. If this not possible, then maybe reading should be done after you get some of the other projects taken care of. If reading is your priority for the moment, set a time limit and take a break. While reading, keep a notebook by your side and anytime a distraction pops up, remove it by writing it down on the notepad. Tell yourself you will come back to it when you are finished reading and then return to the task at hand. The more you do this, the easier it will be to stay with one task for a longer period of time. You will notice your efficiency begin to improve with time and practice. Don’t give up!

4. A napping brain is a stronger brain. I’m not talking about the 2-3 hour naps we take after a huge Thanksgiving or Sunday dinner. Power naps, as they have been appropriately termed, are no longer than 20-30 minutes and they are like a quick reboot for the brain. When dealing with computer problems at the office, our IT guy has a saying, “If you haven’t first tried turning it off and back on again, don’t ask me for help.” The same is true for the brain. If you are feeling tired or inefficient, if your brain seems to be working slowly, try powering down for a few minutes and then restarting. Studies have shown that your memory, concentration, and efficiency will be drastically improved.

5. A seeing brain is a believing brain. Your vision is the most powerful sense that you have. It trumps all other senses. For example, professed wine connoisseurs have been known to mistake a dyed white wine for a red wine. A picture really is worth a 1,000 words. So the next time you turn on your computer, get ready to watch a movie, or read that book, remember this: ‘whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy—[picture] such things.” Fill your mind with beautiful and healthy things and the possibilities for a beautiful, healthy life will be endless!

Question: What changes do you need to make in your life for a healthier brain?

BTW, be sure to follow me on Facebook at David Livingstone Henderson, MD or Twitter @DaveHendersonMD or through LinkedIn. Stay in touch!!

In the last post, I discussed some of the psychological treatments of depression. Today, I want to give just a basic overview of the medical treatments available for depression.


a.       How to decide – In psychiatry, we have flexible protocols by which we make decisions about biological treatment for depression. My rule of thumb is to evaluate a client’s level of functioning. If they are depressed but capable of engaging in psychotherapy, keeping up with their activities of daily living, and maintaining healthy relationships with those around them, medication may not be necessary. If however, a client is suicidal, unable to effectively process information, failing to keep up with daily life activities, or isolating from social supports, medication becomes an imperative for healing.

b.      The chemical model of treatment – There are two ways in which the nerves communicate. One is through electrical signaling within each nerve and the other is through chemical releases between the nerves. Initial treatment protocols for depression recommend using medications that impact the nerves indirectly through increases in chemical neurotransmitters. There are two main classes: the SSRIs (or selective serotonin reuptake inhibitors) and the SNRIs (or serotonin norepinephrine reuptake inhibitors). These medications act by increasing the levels of neurotransmitters in the spaces between nerves (the synaptic spaces).  With consistent use, these medications are thought to change the structure of nerve cells, making them more responsive to chemical signaling and thus more active. An analogy might be the ongoing stimulation of muscles in the arms and legs during weightlifting which increases the overall ability of the body to handle strenuous activity.  

c.       The electrical model of treatment – The gold-standard for treatment-resistant depression is still electroconvulsive therapy (ECT). Because of side effects, however, many people are reluctant to consent to this. Fortunately we do have medications and some other modalities of treatment that affect the nerves’ electrical signaling. Often, we will use mood stabilizers like lithium to augment the antidepressants’ chemical effects on the brain. Lithium is thought to affect the channeling system that propagates the electrical impulses of nerves. There is also a new treatment available, approved by the FDA, called Transcranial Magnetic Stimulation (TMS) which has shown promise in treating refractory cases of depression.  I did a previous post on this treatment modality so I will not go into great detail on it here.

It is important to understand that medications are an integral part of a comprehensive plan for overcoming depression. They are rarely a stand-alone treatment. Just like with diabetes, if you only take insulin but continue to eat McDonald’s super-sized “Happy” meals, your condition is bound to get worse. In the same way, we must treat depression from all angles and be sure to assess faulty thinking, social stressors, and spiritual maturity as we strive for healing.

Question: What about you? Do you know someone who is wrestling with depression? How have you been able to help?

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I am a board certified psychiatrist, author, speaker in private practice with Southwest Clinical and Forensics in Dallas Tx. I also serve as an adjunct professor at Dallas Theological Seminary. I have a passion for helping people through painful circumstances, be they physical illnesses of the brain, psychological conditions of the mind, social problems of everyday life, and/or spiritual crises of faith and worldview.


All information provided is for educational purposes only. It is not a substitute for a professional evaluation or treatment. If you are experiencing emotional distress, please contact a mental health professional. Dr. Henderson cannot respond to inquiries about prescription refills, or medical or psychiatric emergencies over the internet. If you are a patient in need of assistance, please contact Dr. Henderson’s office directly, call 911 or go to the nearest emergency room.

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