Elder Holland on Depression

Elder Jeffrey R. Holland gave a talk at the Saturday afternoon session of the October 2013 General Conference that resonated with many struggling with psychiatric and psychological disorders. He specifically addressed Major Depressive Disorder but his words are broadly applicable. As someone with a PhD in clinical psychology, I appreciated his message of hope and love to those who struggle. While my interests and specialties are in understanding and helping those with neurological disorders, I have experience and training in helping people who struggle with depression, anxiety, ADHD, addictions, and other emotional and mental disorders. Thus I can say as a professional that Elder Holland nailed the issue of mental and emotional disorders right on the head.

In the past, many church leaders and members had unflattering views of psychological and psychiatric treatment; frankly, much of it was deserved. Diagnosis and treatment of psychiatric disorders in the past was mediocre to harmful in the past. We have come a long way. Most of this improvement in the fields of psychiatry and psychology has come in the past 30 years, with broader improvements in public understanding over the past 15-20 years.

At any given time in the U.S., 5-15% (varies by state) of adults meet criteria for clinical depression with an overall prevalence around 6.5% (Sources: http://www.cdc.gov/features/dsdepression/http://www.nimh.nih.gov/statistics/1mdd_adult.shtml). The 6.5% rate is from 2008 and rates have increased since then. 2% of the U.S. adult population suffer from severe depression (actual rate is slightly higher due to under-reporting and under-treatment).

The good news is that psychological and psychiatric treatment for depression and anxiety is highly effective (in general, effectiveness for individuals will vary). Around 70% of individuals will respond well to a combination of medication and “talk therapy”. That is not comforting for those who do not respond but there is always room for hope. You can find out more about depression and validated treatment by reading this information from the National Institute of Mental Health: http://www.nimh.nih.gov/health/topics/depression/index.shtml

If you missed Elder Holland’s talk, you can watch it below. If you didn’t miss it, it is well worth your time to watch it again. I’ll write more on this topic soon. If you have any questions about psychological, psychiatric, or neurological disorders, I’ll be happy to try to answer your questions. If you are struggling with depression or anxiety or some other similar (or more severe) challenge, seek help from a competent professional in conjunction with seeking help from the Lord.

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7 thoughts on “Elder Holland on Depression

  1. I was not surprised to hear Elder Holland, a man I used to admire, condone the use of psychiatric prescription drugs… So many Latter-days Saints heard this talk and believed it came from God. Sadly, many will take the plunge and chemically lobotomize themselves after hearing his words. Find the cause instead of diagnosing the effect.

  2. When people have headaches, many take acetaminophen to reduce the pain, even though it just treats the symptoms of the headache and does not treat the cause. People who sprain an ankle usually take ibuprofen to reduce inflammation even though the cause (the injury) of the inflammation is still there. People with Parkinson’s disease take levodopa, which the brain turns into a brain chemical that is depleted by the disease process; this medication doesn’t treat the cause of Parkinson’s disease, it simply treats the symptoms (to the great benefit of most people with Parkinson’s disease). A cast holds a broken arm in place even though it doesn’t fix the break. A coronary stent helps increase blood flow in a restricted vessel without changing the underlying cause of the heart disease.

    Much of our medical care is symptomatic because treating symptoms helps reduce suffering, it also can help reduce things turning worse. Elder Holland, since you are swatting at a perceived gnat in his talk, simply encouraged people to not be afraid to obtain standard medical and psychological care if warranted (and that people who do not suffer from those conditions should not think less of those who do). Our understanding of psychiatric and psychological conditions has improved tremendously. There is a lot we still do not know about many psychiatric conditions but for now, what seems to have the most effective outcomes for treatment of depression, for example, is a combination of medication and psychotherapy. I’d personally argue that staying away from medication if possible is the best course but I’ll let physicians and patients make that decision. I’ve seen huge benefits in my own patients when they take medication because sometimes what is needed is stabilization and medication can provide that. In addition, there are also times when psychiatric medications likely treat the cause rather than just the effect since sometime the cause is depletion of particular brain chemicals (neurotransmitters).

    There are risks to any medication (even placebo pills are associated with adverse physical symptoms in some people but so is eating, drinking, exercising, sleeping, and anything else we might do) and the decision to take the powerful psychiatric medications should not be made lightly; understanding benefits and risks of medications is important.

    The main message of Elder Holland’s talk was one of love – love those who are struggling, love those who help those struggling. He encouraged us not judge others who are suffering from emotional and psychological conditions. We need to love and support them.

  3. One more comment. There are people who are so depressed (just sticking with that as an example) that they have difficulty doing anything. I’ve worked with people who were essentially comatose because of depression (as in sleeping nearly 20 hours per day). Once they started on medication, they started to improve to the point where they were at least functional. Mood disorders are also common in neurodegenerative disorders (such as Alzheimer’s disease or Parkinson’s disease). Sometimes it’s an emotional reaction to having the disease but most of the time the mood disorders are caused by the disease process by reducing or otherwise changing the normal mixture of brain chemicals. When given medication, mood and behavioral difficulties often improve. Caregivers often need some form of anti-depressant at least temporarily because of the overwhelming stress that caregiving can become. Not everyone copes with stress and challenges the same way. Just because some people can work through depression or anxiety or bipolar or even personality disorders without medication does not mean that others can or should.

    I’ve seen medications help stabilize people by taking them out of the risk zone of suicide. I’ve seen people go from being at risk of harming themselves or others to being functional. Medication is not always the answer and probably should be the answer less often than it is (but more often for some people) but there are many people who are under-treated for psychiatric conditions because they are afraid of the stigma associated with mental illness.

    Most people I’ve worked with do not want to be on psychiatric medication. There are people who abuse the medications but they are a minority. What medication can do though, when used appropriately under the supervision of competent medical care, is provide stability and help people get to the point where they can address underlying issues should any exist that can be changed cognitively or behaviorally (there are always things people can do better).

    Speaking of underlying issues or causes of emotional dysregulation – understanding the causes is often not as helpful as just fixing the effects. Many times it does not matter what caused a depression; what matters is what people do to cope and move forward. The past is important but not as much as the present and the future. I’ve seen people spend much time digging around trying to figure out why they were depressed, what caused them such emotional anguish, while others let the past be and worked on changing the future. Sometimes causes need to be addressed but other times it’s more beneficial just to work on symptoms (behaviorally and cognitively in therapy) and move on. With psychological and psychiatric treatment there is no one size fits all.

  4. Thank you for sharing your very personal experiences and your faith. I’m sure Elder Holland would love to know the effect his words and testimony are having on you. Hold on to that faith you have and press onward! Thank you again for sharing.

  5. Hello,

    This talk came from an Apostle we sustain as one who speaks God’s will. I am grateful that we have such a man who is wise, sensitive and compassionate. Recent research in neuroscience indicates that the brain can be changed through mindful living. A major tenet of mindfulness is meditation (prayer is one way). Years ago, we didn’t have this knowledge. Medication saved the lives of many, including me. As a therapist, medication is my last resort. However sometimes it is necessary. Let us be kind as President Monson asked us to be. I would rather someone be alive and functioning with medication rather than visiting his/her gravesite. Coping with depression is hard, very hard. Some have a chemical deficiency (like diabetes). Let us not criticize them if medication helps them live a better life…

  6. Depression is a complex illness. That said, all who suffer from it need one thing that is universal. They need to be looked upon and treated as Brother Holland’s advises us, with understanding, respect, love and compassion. Hearing or reading his words is not enough. We have to act upon it. Those who suffer from it live in a cold unpleasant world of self doubt, loneliness and darkness. If each of us who have been taught this lesson and act on Brother Holland’s words, it will help to turn their darkness into light.

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