For our third installment of Dealing with It, we will be discussing Depression. Depression and mental health has been a point of contention for many Christians over the years, so I thought I’d open up the subject by first addressing some untruths:
1. Depression is the Same as Being Sad:
I think this is a common misconception held by those who don’t have a lot of personal experience with depression. It makes sense. Obviously depression and sadness are correlated. Colloquially, we tend to use “I’m sad” and “I’m depressed” synonymously. Even the word “depression” conjures up a mental image of a graph or a line of trajectory that momentarily dips with the promise to eventually resurface.
But though sadness is certainly a defining characteristic of depression, it’s not the whole story. Depression is a complex and multi-faceted physiological and psychosocial phenomenon that effects much more than mood. Someone experiencing a major depressive episode may have a wide range of physical and mental symptoms as well as behavioral changes; everything from sleep problems to drastic fluctuations in appetite, cognitive impairment, extended periods of withdrawal, or loss of interest in things that they normally took to with pleasure.
In my experience, a depressive episode looks less like weeping and sighing and more like hibernating: I can’t seem to get enough sleep, and when I am awake, I’m physically and mentally spent, drained of all energy. I don’t want to interact with people. I alternate between overeating and self-starving. My spiritual disciplines are sapped. For me, depression is like a sudden halt to all external and internal activities. The desires and motivations that are normally present may suddenly disappear overnight, and I become immobile. There aren’t any clear changes in mood driving the experience…just an oppressive feeling of “nothing”. A great blah.
The colors of the depressive emotional spectrum are not just shades of blue, either. In many people (especially younger men) depression can look a lot like anger. But for many, depression isn’t marked so much by overt emotions as a sudden lack of emotions, an all-encompassing numbness.
Now as you can imagine, this suite of symptoms can in and of itself be very disheartening and frustrating. The sadness and gloom often associated with depression (at least in my experiences) are subsequent emotions of a depressive episode, not the catalyst. The tears come when I find a lack of pleasure in hobbies I once relished or when I find myself dreading work or hard-up to accomplish whatever tasks are on my list. The guilt and shame of finding myself suddenly “unable” is usually where the despair comes in.
This is different than the elongated periods of sadness, grief, or bereavement that naturally follow a negative circumstance or period of stress. The death of a loved one, for instance, will naturally produce a season of sadness and pain that is less an affliction of the mind and body rather than the appropriate response to loss. As Rick explained in his article on Anxiety there are conditions when the emotional responses of sadness or fear make sense and serve a purpose in the short term; relational conflict or a hectic season at work. But then there are times when these emotional states, if prolonged past being useful or making sense, become disorienting and disabling. Just as there’s an important different between the adrenaline before taking a test and chronic anxiety, chronic depression turns otherwise natural and healthy forms of sadness or “down”-ness into something toxic and debilitating.
2. Depression is Inherently Sinful (or Indicative of Sin):
In the 17th century, a Puritan doctor called Richard Baxter wrote of depression:
“Sinful Impatience, Discontents and Cares, proceeding from a Sinful Love of some bodily Interest, and from want of sufficient Submission to the will of God, and Trust in him, and taking Heaven for a satisfying Portion.”
His opinion was not unique. Puritans and early Protestants took less-than-gracious stances on the nature of depression, or “melancholy” as it was then called. Even before them, early church fathers had similarly equated bouts of depression with the sins (“passions”) of sloth, dejection, and acedia, an affliction often believed to be demonic in nature to which ministers and clergy were particularly vulnerable.
In the modern church era, we haven’t been much more generous in our assessments of depression. It is not uncommon for Christians to see depression as either a failure to trust God and believe in His promises or a lack of sufficient faith in His ability to heal. Many modern Christians (evangelicals in particular) sometimes see depression as a willful and rebellious state of mind that needs behavioral and moral correction. If you aren’t told to simply “snap out of it”, you will probably be told you aren’t praying enough and you need to have more faith.
Naturally, depression isn’t openly talked about much in religious communities due to stigma and a fear of being dismissed as “spiritually weak” or sinful. In her doctoral thesis “Exploring the Role of Shame and Stigma Surrounding Suicidal Depression among Christians”, scholar Alice Allen-Ervine writes:
“Christians pray to be relieved of their suffering, and they believe that God has the ability to heal them; therefore, they believe they should not be depressed… Further, they may believe that if they are depressed it is because they lack faith … Therefore, many parishioners may suffer in silence. Without seeking proper counseling with trained professionals, many parishioners may find themselves falling deeper into depression, withdrawing from interactions with others, and may even stop attending church. These parishioners are also unlikely to seek professional therapeutic services due to the stigma surrounding mental health issues.”
In the past century and a half or so, things like psychiatry and behavioral science were set up in opposition to the things of religion, with psychologists like Sigmund Freud famously disparaging the Christian worldview. As a result, many Christians were, at best, skeptical of psychotherapy and neuroscience and were hesitant to consider medical treatment for mental illness. But as the relational bridge between the scientific disciplines and Christians is being repaired, we have learned more about the human brain in the last twenty years than we had ever known about it to before. We now know that depression has a lot more to do with neurological, genetic, and biological factors than it has to do with character or behavior.
As a result, I’d argue depression is no more inherently sinful than diabetes or a broken leg, and it is no more a sign of spiritual weakness to treat mental illness with medicine and therapy than it is to take insulin or imbibe anesthesia for surgery. God gave us everything in nature as well as the intellect to explore it and make the most of its resources. And though, yes, we believe God has power to heal us of our afflictions, he has also provided ways for healing outside of miracles, such as good doctors and good medicine.
This isn’t to say that all forms of depression are necessarily clinical or require medication. In order to determine that, it is essential to seek professional opinion. However, to dismiss an illness such as depression as being disobedient or distrustful of God is no more truthful or helpful than to say the same of someone suffering from a physical ailment. Though an illness may be invisible, it is no less legitimate or un-asked for than a visible one.
3. Depression is Only Either Spiritual or Pathological:
There has been a prevalent assumption in Western thinking that the human being is compartmentalized: there is the body, there is the mind, and if a spirit exists, it exists separate of these other two. This assumption has informed a lot of the way we approach medicine, but also how we approach things of faith.
When it comes to how we deal with depression, this assumption can sometimes result in one of two overly-reductive views: that depression is only ever a spiritual affliction, or that it is only ever a pathological affliction.
As Christians – believing in and emphasizing things of the spirit – we have often made the mistake of equating depression with merely spiritual struggle. Sometimes we have conflated depression with sin and lack of faith (as addressed before), but sometimes we conflate depression with spiritual warfare or demonic influence. The danger in this kind of thinking is that it may lead a depressed Christian to believe that their struggles with mental illness are signs of a “lost battle with the enemy” and can actually reinforce feelings of failure and hopelessness. Though it’s absolutely true that we have an enemy who will exploit whatever he can in order to attack us, mental illness included, to equate the ups and downs of depression and anxiety with the ebb and flow of spiritual attack can sometimes result in unfair judgmental introspection on the sufferer “not doing enough” to win the fight. Joe Padilla of Grace Alliance writes more about this sort of issue here.
The truth is that though we are spirit, we also have minds and bodies which can be effected by our environments, circumstances, genetics, biology, and one another. Our spirits can be effected by the health of our minds and bodies, and visa-versa.
On the other extreme (and this is especially true in a secular materialist worldview), we might think of depression as no more than a chemical imbalance in the brain, curable with a prescription and some behavioral changes. While again, medical treatment for depression is absolutely legitimate and someone looking for relief should explore their options, I would argue that as an illness, depression is uniquely existential in nature and requires treatment of the spirit as well as the mind/body.
Depression may not be due to a person’s lack of faith, but a growing body of research suggests that faith is a big part of a person’s journey to healing. A psychiatrist named Aaron T. Beck conducted a long-term prospective study into the relationship between depression and risk of suicide. What he discovered ended up surprising many people in his field: a person’s likelihood to commit suicide had actually very little to do with the quality or severity of their symptoms, but rather their sense of hopelessness. Of the 1,400 patients tracked over the course of a decade, the most likely candidates for suicide proved to be the people who felt that their future would yield nothing of value or meaning.
Beck’s study was conducted throughout the 70’s and 80’s. Well before that, Danish philosopher and theologian Soren Kierkegaard wrote his treatise on the human condition, The Sickness Unto Death, in which he outlines a formula for despair: suffering without meaning produces despair. A Christian theologian and existentialist, Kierkegaard argued that in order for man to not spiral into despair, he needed to reorient himself in accordance with a balance between the finite and infinite (i.e. his “self” and God’s truth). Suffering was a given in the human condition, but without an underlying meaning to our existence, all that suffering would produce was despair and hopelessness, a key ingredient for depression.
The auther of Proverbs once wrote, “Hope deferred makes the heart sick…” A lack of hope can literally create illness in a person.
In a culture in which the default worldview of life in increasingly materialistic, “atoms in motion”, there-is-no-meaning-so-make-your-own, we are reaping the fruits of our ideas in a surge of diagnoses of depression as well as an increased sense of hopelessness with each new generation, and ever increasing rates of suicide.
There is, of course, no medication or medical procedure to instill hope; but this is where – and I argue from experience – the Christian worldview provides an antidote to despair.
It offers hope and it offers meaning.
A hope in an eternal future in which our hearts are forever satisfied and spirit’s freed of misery made possible through Christ’s redemptive work of the cross, and a meaning to be known and loved by our Maker just as we are. These beliefs are not soft, unsubstantial mental band-aids to aid in positive thinking: this is our reality.
In Scripture, we find God’s promises to the despairing spirit:
“The LORD is close to the brokenhearted; He rescues those whose spirits are crushed.” (Ps. 34:18)
“I will never fail you. I will never abandon you.” (Heb. 13:5)
“For I know the plans I have for you…plans for welfare and not for evil, to give you a future and hope.” (Jer. 29:11)
“He will wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning, nor weeping, nor pain anymore for the former things have passed away.” (Rev. 21:4)
“I am convinced that nothing can ever separate us from God’s love. Neither death nor life, neither angels nor demons, neither our fears for today nor our worries about tomorrow— not even the powers of hell can separate us from God’s love.” (Rom. 8:38)
“Surely there is a future, and your hope will not be cut off.” (Prov. 23:18)
“We have this as a sure and steadfast anchor of the soul, a hope that enters into the inner place behind the curtain.” (Heb. 6:19)
“O Lord, you hear the desire of the afflicted; you will strengthen their heart; you will incline your ear.” (Ps. 10:17)
“And after you have suffered a little while, the God of all grace, who has called you to his eternal glory in Christ, will himself restore, confirm, strengthen, and establish you.” (1 Peter 5:10)
For further reading and resources on Depression: