Counsel for Christians in Crisis: Depression

“Why art thou cast down, O my soul” (Psalm 43:6 KJV)

Believers are not immune to depression. Even David puzzled over the source of his own depression. We do the same today, too. Privately of course, as the stigma of depression leaves us to confront this challenge on our own. Isolated, we become burdened, not knowing how to get help.

Using current statistics, it is safe to say that at any point in time during the year, nearly one in 10 sisters in your assembly is struggling with depression, and nearly 1 in 20 brothers. With the increasing disconnectedness of our lives, the ongoing deterioration of family values and the deepening grip of sin in our world, we should not expect this statistic to improve.

It is worth noting that there is a variety of depression types, including:

  • Major depression (intense, lasting a number of months).
  • Chronic (dysthymic) depression (ongoing, less intense).
  • Post-partum depression.
  • Seasonal depression (SAD), and more.

Believers who experience depression often burden themselves with a lot of guilt, feeling they should be more joyful and expressing remorse over the emptiness felt in devotions. This is often compounded by the idealistic (but unrealistic) and well-intended (but unbiblical) teaching, that believers should experience uninterrupted joy in this broken world. However, even Paul acknowledged there was a time when he “despaired even of life” (2Cor 1:8, NKJV). The sense of this word, “despair,” points to a loss of mental or emotional composure. It is comforting to know that even the great apostle was driven to extremes by the circumstances of life.

It follows that depression is not just for the wayward. It can impact both strong and weak believers, new believers and those who have been on the road to heaven for decades. It touches the married and the single, widows and young mothers alike. It touches people with great potential and devout, pious hearts, along with those of us who are often struggling and inconsistent in our walk. Depression touches a wide variety of believers in diverse ways and a plethora of circumstances.

This makes David’s question in Psalm 43:5 particularly informative. The “why” of depression is also the pathway to recovery. It is my belief and experience that the most effective strategy to recovering from depression is to uncover its source.

A cautionary note is in order. Christians have a bad habit of spiritualizing depression. Shepherds and well-meaning friends often offer Christian platitudes as antidotes to this complex issue, failing to recognize that roots are intertwined in biological, psychological, social, and spiritual domains. We are not merely spiritual beings; God has created us body, soul and spirit. As Proverbs 14:30 points out, “A tranquil heart gives life to the flesh” (ESV. Note the connection from emotion to body) and, “a crushed spirit dries up the bones” (Prov 17:22, ESV. Spirit to body).

Consequently, a holistic approach to recovery should involve more than just spiritual means. Shepherds will also help members of their flock in the same way by offering both spiritual counsel and recommending various professional resources such as family doctors, psychiatrists, and counselors. Let’s look at some common areas of distress and resources connected to them.

Physical health is a good place to start. It’s worth noting that God’s response to Elijah’s depression after his escape from Jezebel began with ministering to his physical needs (1Kings 19:5-6) through the provision of food and water. The angel might have challenged Elijah’s thinking or asked if he was still reading and praying regularly. Yet, his first step was to gently address Elijah’s physical needs. We should also consider this approach when confronted with depression. For example, there is a strong connection between diabetes and depression. Treating one can often create positive outcomes in the other. There are a profound number of ways that our biological makeup can predispose us to depression. A visit to your family doctor is a good first step.

Believers are often concerned about taking medication that may be prescribed by a doctor to help with depression. I tend to shy away from this as well, but my experience has been that they help you get your head above water so that you can start to do the other work you need to do in order to recover from depression. Antidepressants have their place and it is not unscriptural to use them.

These drugs do not alter your personality, but are meant to lift your mood. Depressed people fall prey to distorted interpretations of events around them. These interpretations create negative views of themselves, others, and their future. Certainly this can be seen in Elijah’s assessment of his situation. He felt as though he alone was left to stand for God (v14). In his gentle but direct response, the Lord challenged his thinking. In the same way, pharmaceuticals taken under the counsel of professional medical personnel can create some breathing room so that our interpretations can be challenged and changed.

In the emotional realm, there are an equally vast number of possibilities. I am often interested in the early, formative beliefs that were instilled during childhood. These impact the way we interpret the world around us as adults. Beliefs about love, the dependability of significant others, the relative safety of the world in which we live, and the nature of God all may be impacted by sin in the lives of our parents and siblings. Where maladaptive beliefs are created, depression will often follow. While we’re often tempted to tell others (and ourselves) how we should feel and think, these beliefs are best uncovered by simple, open-ended questions such as the Lord asked: “What are you doing here, Elijah?” (v13, ESV). It is worth noting that the Lord did not approach Elijah prescriptively or with a “take-two-verses-and-call-me-in-the-morning” approach. Rather, He gently prompted him to consider his own misshapen beliefs and then challenged them.

A further challenge is that we all carry a deeply embedded, but rarely acknowledged, set of beliefs about ourselves. We may secretly believe that we are unwanted or that if others truly knew us they would reject us. Such beliefs can lead to a profound sense of sadness, cascading into depression. These are paths in our brain formed by our own understanding but they need to be brought into subjection to the truth of who God says we are in Christ. In this way, we can learn to apply the gospel to our thinking, by trusting in the Lord with all our heart, and refraining from relying on our own understanding (Prov 3:5).

Unresolved emotion is another possible source. Perhaps a major loss was experienced: the death of a spouse, the failure of a business, or one’s dreams for how their life might turn out have been dashed. If time has not been taken to grieve and to process these losses, they become a deep burden carried in the heart. As Proverbs 12:25 says, “Heaviness in the heart of a man maketh it stoop” (KJV).

In any of these cases involving the emotional realm, wise shepherding and many hours of listening and counsel are necessary. Few will resolve these burdens alone, and those called to help must do so in a spirit of gentleness (Gal 6:1). When progress is not being made, referral to a trustworthy, credible counselor is prudent.

Further, the spiritual realm must be considered. When I was in training to become a counselor, a supervisor made the striking claim that, “The fastest way to depression is to live incongruently with your values.” This makes perfect sense. If you have a new nature and are a child of God, but choose to live differently, you should expect significant emotional, physical, and spiritual distress. How you conduct yourself on a daily basis must follow from who you are in Christ. Although it is a short-term scenario unlike depression, the sorrow of Peter following his denial of the Lord (Mark 14:72) illustrates this point sufficiently.

Another significant area of concern in the spiritual realm is legalism. The Lord spoke of these rules we create as “heavy burdens and grievous to be borne” (Matt 23:4, KJV). Legalism leads to a performance treadmill that never stops, to comparison with others, and to constant disapproval and judgment. This unscriptural, spiritually rooted perspective will certainly lead to a joyless existence.

Finally, unforgiveness could be another common source of ongoing distress leading to bitterness and depression. I believe that one application of the tormenters of the parable of the unforgiving servant in Matthew 18:21-35 (see v34 particularly) is depression, although other mental and physical illnesses could follow from deeply rooted bitterness and unforgiveness.

Our created world groans under the weight of sin, as do our hearts. In seeking recovery, our deepest needs are only fully met in Christ and yet, since the root of depression is multifactorial, a multi-disciplined response is most helpful. Wisely prescribed pharmaceuticals can create space for the mind and body to function more effectively. Spirit-guided counseling can open our hearts to see truth about ourselves and our world through God’s eyes. And wise shepherds can point us back to the Chief Shepherd who is our coming hope.