Depression

Depression has become ubiquitous in our culture. Both men and women suffer from it, including kids and even animals (http://pets.webmd.com/dogs/features/depression-in-dogs). Everyone, it seems, is suffering from depression.

Text:

Why are you cast down, O my soul, and why are you in turmoil within me?  (Ps. 42:5)

You have taken my companions and loved ones from me; the darkness is my closest friend. (Ps. 88:18 NIV)

When the sun rose, God appointed a scorching east wind, and the sun beat down on the head of Jonah so that he was faint. And he asked that he might die and said, “It is better for me to die than to live.” (Jon.. 4:8)

What Depression Feels Like:

There is a range, or spectrum, of feelings associated with depression from mildly melancholic to dramatic levels of clinical depression. Here are a few descriptive phrases from people trying to describe their experience with depression:

The images are dark and evocative. Desperately alone, doom, black holes, deep wells, emptiness. “I felt like I was walking through a field of dead flowers and found one beautiful rose, but when I bent down to smell it I fell into an invisible hole.” “I heard my silent scream echo through and pierce my empty soul.” “There is nothing I hate more than nothing.” “My heart is empty. All the fountains that should run with longing are in me dried up.” “It is entirely natural to think ceaselessly of oblivion.” “I feel as though I died a few weeks ago and my body hasn’t found out yet.”

“Depression… involves a complete absence: absence of affect, absence of feeling, absence of response, absence of interest. The pain you feel in the course of a major clinical depression is an attempt on nature’s part.., to fill up the empty space. But for all intents and purposes, the deeply depressed are just the walking, waking dead.” (Both of these sections came from Ed Welch, Depression: Looking Up From the Stubborn Darkness)

Abraham Lincoln suffered depression, “I am now the most miserable man living. If what I feel were equally distributed to the whole human family, there would not be one cheerful face on earth. Whether I shall ever be better, I cannot tell; I awfully forbode [sic] I shall not. To remain as I am is impossible. I must die or be better, it appears to me.

“There was no control on my mind—thoughts ravaged me, brutally harsh ideas, thoroughly crushed ideals, incomprehensible feelings.” The mind is stuck. How can people think about anything else when it is there? “I’m in a straitjacket.” “I’m completely bound and tied up—there is a gag in my mouth.” Without one’s normal mental resources, the world is frightening. Panic. Left unchecked, hallucinations and delusions can seize the imagination with such force that they are indistinguishable from reality itself. Self-reliance seems impossible. Infantile dependence is the only way to survive. Being alone is terrifying. Abandonment is a constant fear. “I fear everyone and everything.”

Another time Welch describes it this way, “The only thing you know is that you are guilty, shameful, and worthless. It is not that you have made mistakes in your life or sinned or reaped futility. It is that you are a mistake; you are sin; you are futility…God has turned his back. Why bother going on in such a state? You might as well join God and turn your back on yourself too.”

Definitions and Causes:

The DSM-IV-TR lists the mildest kind of depression as Dysthymic (Dis-thigh-mic) Disorder or Symptomatic Depression (349). This is in contrast to Major Depressive Disorder or Clinical Depression which is much more severe (327). The following symptoms appear with a depressed mood: poor appetite or overeating, insomnia or hypersomnia low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, feelings of hopelessness, and in the most severe cases thoughts of suicide. This is a simplistic view of what the diagnosis entails, but these criteria need to be present in varying degrees to be diagnosed with the various levels of depression. You could also add feelings of anxiousness, guilt, anger, and being unloved to the list. You can see patterns of behavior that a Christian might easily attribute to sin rather than disease.

When we begin to talk about causes of depression it is important to note first of all that depression is not always caused by sin. There are a variety of biological causes of depression that need to be considered before assuming that a person is not handling their sin life well. Various medications can have depression as side effects. Also, problems with hormone levels, thyroid problems, etc. can cause depression. In addition, if a person continues taking depression medication when they no longer need the medication, they can have more depression as a side effect. For example, if a woman is taking depression medication in order to balance her hormones, once her hormones get back into balance, she can become even more depressed because the medication may sling her over to the depression ditch on the other side. For this reason, I start a session with a person reporting depression with a number of biological questions: have you seen a doctor for your depression? What kind of doctor? What kinds of tests were run? What were their findings? Etc.

While depression may not always be caused by sin, depression is always a form of suffering. So a person who is depressed because of the meds they are taking, or because of something else going on in her body, still needs to draw near to God and to treat the depression as she would treat any other form of suffering.

Another factor to consider is that Jesus seemed to have been depressed a couple of times: Jesus said, “My soul is overwhelmed with sorrow to the point of death. Stay here and keep watch with me.” (Mat 26:38); and “Now is my soul troubled. And what shall I say? ‘Father, save me from this hour’? But for this purpose I have come to this hour” (Jn. 12:27); Paul, speaking of Epaphroditus, adds, “Indeed he was ill, near to death. But God had mercy on him, and not only on him but on me also, lest I should have sorrow upon sorrow. (Phi 2:27). You might argue that this is not properly depression, but it certainly sounds like it. And we know that Jesus did not sin and Paul is not apologetic about his sorrow.

So, depression may not necessarily be caused by sin, or even be related to sin. It may, however, be a source of temptation to sin, which once given in to, may create a downward spiral that didn’t begin because of sin.

Some Things to Keep in Mind:

While we recognize that some depression is not caused by sin, much of it is. I’ve already alluded to the soft balloon being squeezed between the hands. Another way to view this is to understand that the heat of life warms up until we feel like we must do something. That something is often sinful. At the end of the day, it is all about temptation, desires, and personal make up. When things get tough, what is our response? What do we do when things aren’t going our way? Do we run to God? Or do we run to our pet desire, lust, peaceful place, a drink, or other kind of idol? What do we substitute for God when the trauma of life hammers us? Depression is where many people go when things are difficult. They don’t always go there on purpose, but sometimes it is a peaceful place, at least at first. It is a familiar place. And familiar is what is needed in the moment.

What kinds of indicators or clues, should we keep our eyes open for while chatting that point to sin as the probable the culprit in her situation? I’ve already listed some feelings that the DSM-IV suggests to watch for. Here are a few more typical words that point to sin:  fear, anger, guilt, shame, loneliness, jealousy, unfulfilled wants/desires, and despair over loss. The person who is depressed is generally very self-focused. As you listen to them him can almost see him turning in on themselves, into a self-absorbed ball. He has bought into the notion that life is about happiness, self-indulgence, that he has a right to be entertained and that boredom is bad. This is all hidden behind the depression telling the person to surrender, life is over, life is worthless, he is worthless. But these are all expressions of idolatry. The person expressing these has put himself over God and said, “God made me ugly, he lied to me,” or “I’m right about life and myself and God hasn’t a clue.” These kinds of comments show that depression is about wrong worship, lack of submission, and misplaced trust.

Encouraging Your Friend:

Discussing the history, story, and life of the person who is presenting depression to you will reveal the intricacies of the depression she is experiencing. Ask numerous questions pertaining to feelings and emotions. Depression is a mood, an expressed emotion, a feeling about life and so the depression can be spoken of as a noun at times. What is the depression telling you? What are you experiencing as the depression takes you in its grip? Tell me the feelings you experience in your story as depression comes upon you.

You are asking these kinds of questions, not because you think that talking about life will magically fix anything. You are simply getting to know her and find out what she is experiencing. You are also working to help her see herself in her story and to see Jesus in her story. Suffering is not a situation to be alone in (2 Cor. 1:7, 7:6-7). The way you talk with her will be redemptive and incarnational as you examine her various stories through the lens of Scripture. As we said in the earlier meetings, you always want to bring everything back to Jesus and where he is in her story. If he isn’t in her story, you need to surprise your friend with his strong desire, willingness, and urge to enter into her life (Mt. 11:28-30).

Depression reveals the heart. Who are you trusting, serving, and believing? The problem of the human heart is misplaced trust. The person suffering from depression is seeing the results, in their body, of this misplaced trust. They have sinned against God and man and their bodies are reacting to that sinful and guilty state. Ed Welch says that depression does not appear from nowhere (p. 106), it has its reasons. Why is it here in this place, now? What is going on? How is your friend reacting to life’s circumstances? What is she feeling and thinking as these things are coming together around her? What is she actually doing as a result? Why is she doing it? What is she trying to accomplish? How is that working out for her? What would God have asked of her that might have produced a different result? What can she do the next time to avoid this situation altogether? Generally, there is there is a significant story that has happened before the depression came to visit. Depression has its own story and is often the result of a story. Listen to her weave experiences and emotions together in her story. Come along side your friend. Reflect Christ on her and let him overwhelm her with his love and hope. Hope is something that depression is devoid of, so you want to pile it on.

Depression can also take on an accusatory look. In the Bible, Satan is the accuser (Rev. 12:9-10). It is important to point out to your friend that God loves her more than she does and God does not accuse. He convicts, but once she admits her sin and desires to repent, he forgives and in the process showers mercy and grace on her in abundant measure. It is important for you to help her see that we were never meant to carry the load that depression puts on us. Help her to take her load to Jesus and let him have it (Mt. 11:48).  Help her to see that Jesus took our shame on himself and made it so that she can be above her shame by putting that on Jesus as well (Rom. 10:7-11; 1 Pet. 2:6-8). She need not be concerned for the things of her past anymore. God does not remember them (Heb. 10:15-18) and neither should she.

O soul, are you weary and troubled?
No light in the darkness you see?
There’s a light for a look at the Savior,
And life more abundant and free!

Turn your eyes upon Jesus,
Look full in His wonderful face,
And the things of earth will grow strangely dim,
In the light of His glory and grace.

Recommended Resources:

Edward Welch, Depression, Looking Up From the Stubborn Darkness, Martin Lloyd-Jones, Spiritual Depression, Wayne Mack, Out of the Blues, John Piper, When the Darkness Will Not Lift