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Depression: A Real Problem for Real People
Posted by Tony Sisk in Uncategorized
Malignant sadness; like the static in between stations on the radio; the blues; smog settling on your soul; a dull, rainy day; chronic unhappiness; irrepressible darkness; these are ways I have heard depression described. Probably the most common spiritual problem I encounter in ministry is depression.
Depression plagues us all. It affects many people and has affected many people in the Bible: Job, Naomi, Hannah, the psalms are wrought with depressed utterings, Jeremiah, and even Jesus demonstrated the mire of despair. Other people down through history wrestled with depression such as Martin Luther, John Bunyan, Charles Spurgeon, and even one man who said, “I am now the most miserable man living. If what I feel were equally distributed to the whole human family, there would be not one cheerful face on earth. Whether I shall ever be better, I cannot tell; I awfully forbode I shall not. To remain as I am is impossible. I must die or be better, it appears to me.” That man was Abraham Lincoln.
Perhaps depression has settled over your soul. Perhaps depression is a common part of your life. The mire of despair, the slough of despond, and the giant depression have beset many travelers on that slender road that will find life and joy in the city of God. Do you feel as if your mind is stuck? Do you feel constantly exhausted, that there is no end to your incessant labor? Does anything hold your interest? Would you rather endure a root canal than make a decision? Do you ask yourself questions, like why work? Why get out of bed? Why eat? Why communicate? Why do anything? Depression is different for everyone. For some it is quieter, more subtle. For some, it is a black howling abyss in which you are falling and unable to feel anything. Malignant sadness. Perpetual numbness. Grotesque hopelessness.
There will be no more crying, weeping, mourning or pain—one day. All travelers who take that slender path will find themselves, sooner or later, in the swamp of endless melancholy. Depression can make the most dedicated friends and ministers feel incompetent because there are times when the depression seems absolutely resistant to change. However, a depressed person is just like any other person. The inner person can be transformed and renewed by faith even in the midst of the most relentless inner pain. Depression is a real problem—for real people—but it also has a real solution. Consider a Proverb.
The spirit of a man will sustain him in sickness, but who can bear a broken spirit? Proverbs 18:14.
King Solomon asks a rhetorical question, where the answer to the question is smuggled in the asking of it. Who can bear a broken spirit? The answer is, of course, no one. The heart of depression is that your spirit is broken. You do not have the fortitude to deal with everyday life; the strength to go on just is not there. Solomon says no one can deal with that. What happens though is that instead of going to God, the devil steps in and drives us into the pit of despair. In Proverbs 17:22 Solomon says, “A merry heart does good like a medicine, but a broken spirit dries the bones.” A broken spirit can only be mended by God.
However, Satan and the world want you to believe something else, something altogether different. You can find help in the bottom of a bottle. A pill can help. (It is amazing how many of God’s children are on depression medications. They are not bad in and of themselves and in some cases are necessary but are in some instances over-prescribed. A pill cannot change the heart, which is ultimately where many depressions begin.) The latest self-help book can help. Dr. Phil can help.
But your pastor cannot help you. The Word of God can’t help. And certainly God Himself cannot help you. All these things feed hopelessness, throwing additional fuel on the fire of depression. When your depression says, “I have no hope,” ask what you are hoping for. Are you asking that your depression might be relieved? Are you asking that you might be rid of depression? You are hoping for too little. Read Romans 5:1-5. Though we do not know what prompted Paul to write this little account, we do know that Paul was suffering at the time, because he writes from the hand of experience; yet his faith triumphed in a time of trouble. Depression is a real problem and it affects real people, and the solution is found in a real Savior.
Because He lives, I can face tomorrow.
Because He lives, all fear is gone.
Because I know, I know He holds the future;
And life is worth the living just because He lives!
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Tony,
Thanks for the thoughtful post. I agree with you that meds for depression have been over-prescribed, however, I think we need to be careful when saying that depression is only a heart condition.
Frankly, I believe that some depression is due to medical conditions such as bi-polar disorder, chemical imbalances, poor diet, etc. Even Elijah was told to eat and rest in the midst of his depression.
I think we should address the spiritual condition while not ignoring a possibility of a medical condition as well. Many Christians feel guilty for taking anti-depressants. I always encourage them to continue to take their meds because I am not a doctor. However, I always explore their spiritual condition and address any issues there.
Regards,
Les
Les,
I agree. My overarching point was not to discount any of the physical problems for depression and attribute all forms of depression to spiritual causes. In most cases, spiritual problems manifest themselves as physical symptoms and a whole-person response would be to minister to the physical as well as the spiritual.
Though that individual may be experiencing depression due to, for example, a deceased parent whom they had been caring for a long time, that person would need to see their dependence should lie heavily upon the Lord (rather than the parent) and then also meet the need for close human companionship as well.
The challenge is in finding that balance.
You said, Many Christians feel guilty for taking anti-depressants. I agree; many of the folks I serve have come to me and told me that they had been taking meds for depression for a l-o-n-g time and they wanted to be out from under that bondage. By God’s grace He sufficiently met their need. I have never counseled to quit meds cold turkey but to evaluate their genuine need for them.
Thanks for the clarification!
Tony,
Thanks for bringing this up. I ran across some interesting facts lately. The country with some of the highest depression in the world is this country, and the country with possibly the lowest rate of depression is Nigeria (where perhaps the poorest in the world).
The richest nation on the face of the earth has the highest rate of depression. The poorest has the lowest. There is less depression in Chernobyl than in the US. Solomon wrote,“He who loves silver will not be satisfied with silver; nor he who loves abundance with increase. This also is vanity.” (Ecc. 5:10)
This answer is simplistic beyond reason, but I think it bears consideration. The primary cause of depression is wanting more than we have. Depression is the fruit of dissatisfaction with what God provides, with who God is. Poor people get depressed. Faithful people get depressed. But, I still believe that the root of virtually all depression is a failure to be satisified in Christ alone.
Cyle – I wonder if part of the disparity in poor versus rich is not in the fact that the poor countries don’t have many psychiatrists and psychologists making depression diagnoses. Surely all those people in Nigeria haven’t been accurately evaluated?
“You are hoping for too little.”
That’s just good.
I turned 28 a few months ago, but I wrestled for most of a decade with assurance and depression. For most of that time I was doing just that – hoping for too little.
Thanks for this post, and along the lines of the balance offered by Les Puryear, a friend recommended Spiritual Depression by Lloyd Jones, so I read it before graduating from college. It was the turning point for me. Sorry for the bulky quote, but he writes with balance, “We must not forget the existence of the devil, nor allow him to trap us into regarding as spiritual, that which is fundamentally physical. But we must be careful on all sides in drawing this distinction; because if you give way to your physical condition you become guilty in a spiritual sense. If you recognize, however, that the physical may be partly responsible for your spiritual condition and make allowances for that, you will be better able to deal with the spiritual.”
He also talks about preaching to yourself in the beginning of the book. It’s a fantastic book for anyone struggling.
Thanks for the post, Tony! Blessings,
Tony wrote:
“The heart of depression is that your spirit is broken…What happens though is that instead of going to God, the devil steps in and drives us into the pit of despair.”
Over Christmas, I had a mild case of the flu that just wouldn’t go away. I felt weak, tired, exhausted, and definitely wasn’t in high spirits for almost two weeks. Can a broken spirit explain my battle with the flu? Did the devil have a role in making bigdaddyweave sick as a dog?
“However, Satan and the world want you to believe something else, something altogether different…A pill can help…They are not bad in and of themselves and in some cases are necessary but are in some instances over-prescribed. A pill cannot change the heart, which is ultimately where many depressions begin.”
Are you saying that Satan is working through psychiatrists who have devoted their careers to making the sick well again? How do you know that depression medication is over-prescribed? Did you get that bit of info from the Bible or perhaps from a medical journal?
I have a form of Bipolar II which is much different from Bipolar. I’ve relied on psychiatrists through high school, college, and graduate school to prescribe drugs and monitor my meds so that my chemicals remain balanced and so I don’t fall into a funk. They’ve done a good job and the meds have always worked. But, it’s somewhat insulting when Christians like yourself either implicitly or explicitly claim that the root of any problem relating to chemical imbalances such as Bipolar II or mild to major depression is the heart. A pill can’t change the heart. But a pill can heal mental sickness similar to how a pill can heal physical sickness. Why do we treat mental illnesses different from physical illnesses? If we don’t blame the Devil for the latter, why do we blame him for the former?
I’d like to think that our sovereign Lord works through the ministry of psychiatrists, Christians and non-Christians alike.
Cyle wrote:
“I still believe that the root of virtually all depression is a failure to be satisified in Christ alone.”
I can’t wrap my mind around such absolutely ridiculous statements.
Cyle,
I would agree with your assessment and statistics. It reminds me of a story I once used as a sermon illustration (you know all of us preachers, always looking for good illustrative material).
A king who was very unhappy sent word to all his wise men that he wanted the shirt of a truly happy man. He had heard a myth that if a truly unhappy man wore the shirt of a truly happy man he would become happy.
So, the king sent messengers all throughout his kingdom yet they could not find one truly happy man to fulfill the king’s request. Finally, after months of searching, a messenger returned with the news that he had found a truly happy man.
The king, excited having received the news, met the messenger at the gate. The messenger relayed the story and discovered that the man whom he had found that was truly happy had no shirt.
We place so much stock in material possessions to keep us happy when in the end, the only thing that truly satisfies our deepest needs is Jesus.
Bernard,
That’s just funny.
Patrick,
Thank you so much for dropping in and commenting. It is a blessing to have you here, and if this is your first visit to our humble blog, welcome! I hope you will return and engage in discussion more.
Thank you for your testimony and also the quote from Lloyd-Jones. That volume is timeless and essential reading, in my opinion, especially for those who feel called to help others deal with depression.
May God continue to walk with you through any other trying times you may experience. God bless, brother!
BDW – Wow, I must confess that, while you and I sometimes occupy different sides of the fence, I’m pretty well sympathetic to your statments here, even though I don’t mean, by that, to attack Tony or Cyle.
I honestly think that a lot of people who have never really experienced depression – either personally or at least up close and personal through an immediate family member – are really speaking out of their league when they claim that the victim has a spiritual problem at the root. As gently as I know how to say this – That’s dangerous, guys. Depression is deadly.
A spiritual weakness can lead to depression, I admit. But “accusing” the depressed one of just having a spiritual problem when you don’t KNOW much at all about their individual illness and makeup is a terrible thing to do.
I hope Bowden weighs in on this, due to his counseling background.
Tony – I see the humor, but I was seriously quite serious.
Aaron,
I am sorry about your condition and I pray God’s grace upon you as you deal with it, and by Gods’ grace, may you be healed of it.
This post was not mean as any kind of slap against anyone who has diagnosed chemical imbalances. I think you have read something back into this post that is not there. From my previous comments, and possibly I wasn’t as clear as I should have been, I do not discount at all that there are legitimate and diagnosable incidences of clinical depression.
You asked, Are you saying that Satan is working through psychiatrists who have devoted their careers to making the sick well again? Of course I am not saying that. Do you not understand a generality?
What I am taking about is a lot of the general, run-of-the-mill episodes of depression where a person “feels depressed” and the freely available depression meds from any family doctor you might find in town.
You also said, I’d like to think that our sovereign Lord works through the ministry of psychiatrists, Christians and non-Christians alike. In response I wrote this to Les Puryear, I have never counseled to quit meds cold turkey but to evaluate their genuine need for them.
With due respect, people should evaluate their need for any medicine, not just depression meds.
You also said, But, it’s somewhat insulting when Christians like yourself either implicitly or explicitly claim that the root of any problem relating to chemical imbalances such as Bipolar II or mild to major depression is the heart. Frankly Aaron, I did not assert this. I think you projected your own issue against Christians who have made those assertions back into my post, and I don’t appreciate that. Perhaps if you would reread the title, you might try to understand a bit where I am coming from; my point as a pastor is to help those with depression as much as God will allow me, including folks like yourself.
I did not discount meds nor the work of psychiatrists, secular or Christian. As a matter of fact, I have referred folks who have depression to psychiatrists and professional counselors. I follow a general rule, and its one I did not learn in the nouthetic counseling courses I took in seminary, that after the first three to four sessions, if the individual has made little to no progress, I recommend they get professional care, care I know I am unable to give. I’m not beneath that.
May God bless you.
BDW,
I didn’t say that dissatisfaction was the only cause. I only said I believe it is the primary cause. I have very personal experiences with mood disorders which I will not enumerate here. I was also a mental health professional for 10 years working with what we then called chronically mentally ill. I’m not uninformed. I’m just observant, and those are my observations. My closest friend in ministry has bipolar disorder and, if not treated, becomes manic very quickly.
Bernard,
The study I’m quoting was coordinated through Harvard Medical and used both clinically collected statistics from MH organizations in the various countries as well as self-report surveys asking people about their moods. I disagree with you when you say that it is dangerous to imply that spirituality can be at the root of depression. Taking that supposition to the extreme is dangerous, but the supposition itself is sound clinincally and scripturally.
I worked with some of the most well-medicated clients in the world. Our psychiatrist was a Christian and Rice and Harvard trained. He was a consummate clinician, and he knew the limitations of pharmacology and psychology. We were holistic in our approach to the patient. As much as possible we treated the spiritual condition as well. So, I do not back off the assertion that dissatisfaction with life and the desire to have more than we have is at the root of the majority of depression. That’s one reason that 12 step programs pray the first part of the Serenity Prayer. God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. Sounds like learning to be satisfied with what I have.
Cyle – Definitely not going to belabor the point or argue needlessly, because I’m NOT a trained MH professional, or anything close, just someone that has REALLY seen it.
To all – This is terribly off topic, but I feel it’s appropriate… Can we PLEASE try to control the “snippiness” of our responses when we reply to someone who has disagreed with us? We sound like a bunch of ten year olds around here, with all the “you attacked me” and the “I don’t appreciate that” and “that’s not very Christian” sound bites. Folks, we’re first and foremost Christians. Winning an argument is NOT part of our calling. If we can’t discuss these kind of things with true, gentle brotherly love, we need to all turn off our computers, open up our Bibles, and get on our faces before God, because it is nothing less than absolute hypocrisy to preach unity and love on Sunday morning and then slap people in the face on a blog on Tuesday evening. If you would say it “gently” in person, it really should be said gently on the web. Even MORE gently, simply because there are no auditory and physical cues involved which indicate emotion. Snarkiness and snippiness is becoming INCREASINGLY predominant here on Impact, and that’s a shame. So, with love in my heart, I ask that ALL of us make a special, strong effort to write with love – even when we feel like preaching – when we comment on the blog.
Is that out of line? If so, I’m sorry. I’m not an admin here, or anything else, and most of you are trained pastors with doctorates and degrees out the yazoo, while I’m just a layman with limited Bible training, so I’m genuinely sorry for calling you to task. I think most of you would be really surprised at how harsh you “sound” in many of your posts.
Non-Christians read these blogs too, and this kind of thing is a terrible witness.
NOTE – I didn’t say not to disagree. I said “write with love”. There’s a big difference
Bernard,
It is virtually impossible to interpret the mood of the one writing. Maybe we could come up with emotional inflection codes. We could add the code to the end of the paragraph.
#1 means tongue in cheek
#2 means “just making a point”
#3 means “I really disagree”
#4 means “I really need to stop posting before I blow”
I love the discussion but hate the inability to communicate it in person.
Bernard,
You’re right. I have said some things out of line in this thread to BDW so I apologize. I don’t want to contribute to a downward spiral on Impact so I commit to do better, if in fact I have crossed the line.
Thanks for pointing it out, Bernard, and holding us accountable.
Tony,
You made the claim. I’m not projecting anything.
You wrote:
“A pill cannot change the heart, which is ultimately where many depressions begin.)”
How else am I expected to interpret that statement? I read it plainly and interpreted it literally. If depression is caused by a chemical imbalance in the brain and MANY people who suffer from depression can trace the root of that depression to the HEART – then how can I with the following statement be guilty of projecting my “own issue against Christians.” I wrote:
“But, it’s somewhat insulting when Christians like yourself either implicitly or explicitly claim that the root of any problem relating to chemical imbalances such as Bipolar II or mild to major depression is the heart.”
Now as a personal side note, I don’t suffer from depression, mild or major, because I take my two prescriptions every night and have done so for a decade. My mom is a licensed professional counselor and growing up our phone would occasionally ring at 2am because some college student (at the Baptist college where my mom worked) had had an episode. Many of these episodes were because the student had foolishly stopped taking their meds. All this to say, I think my mom would tell you that she’s never met a person whose heart was the root problem of their mental health issues.
Cyle – Believe me, I know it’s difficult, and that’s why I’m encouraging us all to make a very special effort to NOT sound rude or even harsh. The slightest harshness seems to escalate really quickly, and my desire is to encourage everyone to TRY to give the other guy the benefit of the doubt and not just grab our torches and burn his village.
If I were witnessing to you on the street, or if I WANTED you to come to my church, I would try to present myself much differently than I would if I didn’t care about you.
That’s all
Smilies, seriously, can go a long way. Even frownies :{ and oopsies. 8P Sure, they’re a little silly, but anyway. I won’t belabor this point either.
Peace.
I read Bernard’s post after this one. Please don’t interpret my words to be snippy. I know they can come across that way from time to time.
Rarely do I get truly snippy or angry.
I suspect its the meds that keep me that way.
Aaron,
OK–I responded a bit harshly. I apologize for my snippiness, as Bernard correctly pointed out. However, I think context is important here. I did make the claim but the assertion you have ascribed is not there–honest.
Again, I am talking about general, run-of-the-mill depression, which is often the case with many people. They experience depression as a result of a loss, a life change, a change of seasons, sin, a failure to pray, or any number of factors (the broken spirit Solomon wrote about). I am sure there are many more.
I have not discounted legitimate, diagnosable chemical imbalances nor the use of medications. I will stand by my original claim that many depressions (many, not all) are caused by heart issues.
So, your mom is a professional counselor? That must be pretty irksome.
Since Bernard asked me to weigh in, I’ll offer a few thoughts.
1) I find it more helpful to think in “and/or” terms rather than “either/or”. There is a spiritual component, a cognitive component, and a neuro-biological component to depression. Differential diagnosis is very important in deciding on a course of treatment.
2) I don’t know if meds are over-prescribed, but my experience is they are often mis-prescribed. The National Institutes for Mental Health (NIMH – sort of the mental health version of the CDC) recommends a combination of counseling and medication for treating a Major Depressive episode; many of my clients come to me having been prescribed anti-depressants for months on end with no referral to a therapist.
3) The cognitive component I spoke of above involves global thoughts of hopelessness and helplessness; there are huge spiritual implications when dealing with thoughts of hopelessness and helplessness.
4) “Depression” covers a lot of ground. Major Depression, Dysthmia, Seasonal Affective Disorder, Bipolar types I and II, Cyclothymia, Schizoaffective Disorder are all different types of depression, each with it’s own etiology and recommended course of treatment.
Major Depression has been called the “common cold” of mental illness and is often reactive (“I got depressed when…”), especially if it is a “single episode” of a major depressive disorder. Cyle’s claim of spiritual discomfort being a source of depression often fits (in my opinion) this particular scenario quite well.
Bowden…you are right on with all of the above.
BDW…so that explains it!
Just kidding.
Tony: outstanding jumping off post to discuss and incredibly misunderstood problem in America. I would say the main reasons folks don’t get better when they see a doctor for depression, is mis-prescribed, no follow-up, no monitoring, no support system, and folks who just don’t understand. They can understand a need for medication when a person has diabetis, heart failure, or anything of that nature…but they can’t understand why folks just can’t get a hold of themselves and let go and let God.
It’s simply not that simple.
Bernard, you are such a great hall-monitor. I’m gonna call on you when I post something controversial and have to be away from my computer. selahV
SelahV & Bowden,
SelahV, I don’t find that doctors have a hard time prescribing medications for mood disorders. I know more people who are taking them or have taken them than who are not or have not. The use of antidepressants doubled between 1975 and 1995. Double digit percentage increases in the prescription of mood disorder drugs has continued every year since. There has been an even sharper rise in the frequency of prescribing them for children.
I agree with you and Bowden that there must also be a change internally in the person facilitated by counseling, support and discipleship. Faulty thinking and believing are always a part of depression, contributing to the onset of depression and chronicity of it, as well as to its recurrence.
I’m not aware of any medication that cures any mental illness or mood disorder. They often help, but they don’t cure.
Tony, this is a great article. I appreciate you having the courage to approach such a potentially controversial topic. This is a real problem that for far too long we have had our heads buried in the sand. Thanks for opening the discussion.
Bowden,
Thank you for weighing in. I was hoping you would share some of your expertise.
Mrs. V,
I would tend to agree. Oftentimes for “mild” depressions, people go too quickly to see a family doctor and not someone with expertise in this area. The family doctors my family has had are very quick to not listen to depressed patients and dismiss them even more quickly with a prescription for Paxil or Wellbutrin. I am certainly not saying that is the case all the time, but from my experiences, it has been that way in several cases.
The point is it isn’t simple–you are spot on there. In many cases meds are prescribed when they aren’t needed and in many cases meds are not prescribed when they should be; but then again, my evidence is from personal experiences with the folks in the church I serve, not from a medical journal or manual.
Gordon,
I am not sure if this is the first time you have commented here; I don’t recall if I have seen you here before. I so, though, I don’t think you will mind a double welcome.
Welcome!
Thanks for the encouraging words. I hope you will weigh in on some of our posts here more often.
[...] Depression: A Real Problem for Real People [...]
i think when it comes to depression one should not see a family doctor but go to an expert in depression for good treatment
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gin davis
http://www.dual-diagnosis.net