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Some of you may have heard about the recent article published in the Archives of General Psychiatry calling into question the wisdom of the FDA’s 2004 decision to issue a “black box warning” about the purported link between antidepressant use and suicide. I have found it interesting to study the trends associated with antidepressant prescribing and its effects on depression and suicide after the issuing of the black box warning. Ironically, suicide rates in teens actually increased after the issuing of the warning. It is believed that many doctors became fearful and stopped prescribing antidepressants even though many who were suffering needed the help.

I thought about how this mass hysteria created by the news media is a parallel to our own lives. Each of us has a black box that we carry around with us. It may be the fear of an impending job loss, a spouse’s betrayal, a financial crash, an injured child, or a potential life-threatening illness. We carry this black box with us whereever we go, allowing it to rule our thoughts and our behaviors, but never once do we consider opening it to examine the evidence for what we fear. The ultimate fear that all of us carry is the fear of DEATH, or as I like to call it, the fear of “an unlivable life.” In confronting this fear we must do three things:

1. Live Realistically.  Don’t ignore the black box. Unpack it. Examine it’s contents. Consider what it would really mean for you if the dreaded contents came true in your life. I had a client who had a morbid fear of having his personal identity stolen. He never thought beyond this fear to the end result. He just knew that he could never survive it. As we unpacked his black box, he realized that his identity being stolen would mean significant hassle in getting his bank accounts changed, his money refunded from his credit card company, and his credit resecured. As we walked through the steps of doing each of these things, he came to realize that, YES, it would be difficult but it would not destroy him. The mysterious fog that loomed over him lifted and he could come through sucessfully on the other side.

Live Responsibly. We’ve all heard that Tim McGraw song, “Live Like You Were Dying.” I get his point but I disagree with some of the things he would change. If we knew that we were dying, I don’t think we would need to quite our jobs, move to the mountains, sky-dive, or party until we drop. I believe the truly responsible act would be to continue our normal daily activities but with a deeper intentionality and commitment, knowing that we may be doing them for the last time. With this attitude, even the most mundane of activities would be magnificent.

Live Resiliently. Our fear of the unlivable life can stir within us a desire to give up on life completely. Fight against that desire! Even as treasured aspects of life are lost (your health, your job, your loved-ones, your valuables), recognize that you can always draw deeper from the LIVING WATER and discover that the depths of HIS LIFE are unfathomable. How do we do this practically? I was once asked in a Florida Television interview what I would say to the elderly invalid watching the program from the prison of their bed. My answer was this. “Even if you can’t make it from your bedroom to the kitchen. You can still do something more powerful than any human act imaginable. You can commune with an Almighty God and intercede on behalf of those who desperately need God’s presence in their lives.” Oswald Chambers said, “Prayer does not fit us for the greater work. Prayer is the greater work.” The older I get in this life, the more I believe this is true.

So what is your black box? How are you dealing with it? Can you say that you are living realistically, responsibly and resiliently in the face of death? I hope your answer is a resounding “YES!”

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I am a board certified psychiatrist, author, speaker and the Director of Counseling and Psychology at Criswell College 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.

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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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