“Where is thy God? Why art thou cast down, O my soul? And why art thou disquieted within me? Hope thou in God” (Psalm 42:10-11).
Depression is one of the most common illnesses in modern society. In the general population of Canada and the United States, approximately one out of five people will suffer from depression in their lifetime. Yet, it is an illness that is under-diagnosed and greatly stigmatized in our society. For believers especially, it poses special problems and warrants special consideration.
From the outset, it must be recognized that all disease, mental or physical, is an aberration from God’s original design for mankind, entering our individual lives only after the Fall. Living with sinful natures in a fallen world, we are prone to a host of illnesses and frailties. Sickness and suffering were never meant to be a part of normal human experience.
Clinical depression is a medical illness not unlike other illnesses such as diabetes, asthma, or hypertension. It differs, however, in that it greatly affects a person’s ability to engage in the activities of life and in relationships. Furthermore, it is critical that depression be distinguished from sadness. Sadness is one facet in a spectrum of emotions occurring in the course of everyday living. Although a major or clinical depression may include sadness or melancholy, it encompasses a lot more. A prolonged (two week or more) period of loss of interest or pleasure in usual activities in conjunction with various other symptoms is necessary for a diagnosis of depression. These symptoms may include some, but not necessarily all, of the following: loss of appetite, weight and sleep changes, physical agitation or slowing down, loss of attention and concentration, difficulty making decisions, loss of self esteem, feelings of guilt and preoccupation with thoughts of death or suicide. Also, it is important to note that depression may not necessarily be related to a “triggering” stressful event but that its onset may occur in a slow, subtle manner.
Many believers with depression do not recognize that they are depressed and struggle on in despair for long periods of time, accepting their condition as a normal component of life and feeling helpless to change it. Although they may seem to function adequately at work or at home, they feel miserable and trapped in a life that can seem void of meaning. They may even attend all the assembly meetings and appear to live an outwardly “normal” life.
Depression has a tremendous impact on Christian testimony. For the depressed believer, the burden of maintaining a positive Christian testimony in spite of these symptoms can be overwhelming and only intensifies the depression, especially feelings of guilt, worthlessness, and hopelessness. The suffering believer realizes the “joy” that is meant to be a central feature of Christian living is unattainable in his depressed condition. This causes him to feel that he presents a flawed testimony to the world. Under such circumstances, it is not unusual for the believer to attribute his depressed feelings to spiritual deficiencies. This may actually intensify and prolong his depression and cause him to examine every aspect of his life for spiritual failure.
Today, a depressed believer who understands the true nature of depression may be relieved to know that he can reach out to God for help. In our reading, the Psalmist is in despair. In fact, in this Psalm and the one following, the refrain of despair appears three times. His thoughts are turned inward and he feels abandoned. But in the midst of it all there is that determination to continue to hope in God. The depressed believer can learn from this passage the necessity of reframing the focus from questioning God about his misery to understanding that God is still present and cares despite his depressed condition. It may not necessarily cause the depression to lift but it will shed a ray of light into the deep hopelessness and despair associated with it.
We, as fellow believers, can also be used by God to help. All too often, we aggravate the situation by trying to give a “pep talk” or other unsolicited advice to a depressed believer. This, however, can be very intimidating because it reinforces a common societal view that depression is a character flaw or weakness. It is important to understand that, despite seeming so withdrawn, a depressed believer is yearning to return to a sense of vitality but feels so helpless in his depressed condition. No depressed person wants to be in that state – his sense of helplessness is a symptom of the depression. A more helpful suggestion would be to try to understand and empathize with what the suffering believer is going through. This may take considerable time and patience due to his tendency to withdraw from those who are close to him. The depressed believer often is incorrectly convinced that nobody loves him or cares for him. In this case, just “being there” for this loved one and accepting him unconditionally can be so vitally important.
Depression can resolve spontaneously but its course can be greatly modified by diagnosis and treatment. Encouraging this person to seek treatment from a medical professional may be the most important step to recovery. Most people with major depression are treated effectively by family doctors as outpatients and usually do not need referral to psychiatrists. If appropriate, medications may be of benefit. Also, therapies are available which focus on changing the patterns of thinking associated with depression.
In summary, depression is a medical illness that has special implications for the believer. Believers are not “immune” to this disorder and may require medical treatment or counseling as much as any individual in the general population. While going through a depression, a believer may not feel that God is near but the Word of God in many places states the fact that He truly cares and does play a vital role in recovery. “Casting all your care upon Him; for He careth for you” (1 Pet 5:7).