Showing posts with label Complexity of Depression. Show all posts
Showing posts with label Complexity of Depression. Show all posts

Friday, May 9, 2008

A video on Depression - A Stubborn Darkness by Edward T Welch

My friend and brother-in-Christ, George, sent me a link to a very encouraging video on depression "Depression - A Stubborn Darkness" by Edward T Welch. It turned out to be a video that was posted by another of my friend and brother-in-Christ, John.

This short and moving video on depression sheds some light on depression and it's impact upon the sufferer and his loved ones.

If you are a Christian and you are suffering from prolonged clinical depression, you will likely have to cope with false guilt. I recommend that you read the messages of Dr David P Murray on the "Depression and the Christian" and you will find much encouragement and help. Clinical depression is a medical condition that can be treated. I hope you will seek help besides praying to God.

Know that you are not alone and we can find comfort in God and His Word while we await His restoration through His Words and the various means He has made available for us in this generation.

Hope this short video will bring some comfort to you if you or your loved ones are suffering from depression.

How do you find this video? Has it in anyway speaks to you? Has it helped you to see yours or your loved ones' sufferings in a different way?

Thanks for stopping by. Hope you have a blessed day!

Tuesday, February 12, 2008

Complexity of Depression

Tomorrow, my church will be observing the Lord's Supper. It is a day we will remember as a church, the Lord Jesus Christ's death on the cross for us and our partaking of spiritual blessings through His sacrifice for us.

The Shorter Catechism Q96: What is the Lord's Supper?
Answer: The Lord's Supper is a sacrament, wherein, by giving and receiving bread and wine, according to Christ's appointment, his death is showed forth; and the worthy receivers are, not after a corporal and carnal manner, but by faith, made partakers of his body and blood, with all his benefits, to their spiritual nourishment, and growth in grace.

As I prepare myself to partake of this Lord's Supper, I remember afresh the Lord Jesus Christ's great sacrifice on the cross to redeem us from sins and eternal damnation. It is through the severe relapses of depression in my life, that I am able to understand a little better, the sufferings of Christ our Lord.

I am thankful to God for my family, friends and church for their understanding (or willingness to seek to understand) the complexity of bipolar or severe depression, the prayers, encouragements, kindness and supports they have rendered to me. These are tokens of God's love and faithfulness to me. These have been invaluable in my process of recovery.

But it has been my painful experiences in the past that whenever I am down with severe depression there will be people who think that the problem is definitely due to something wrong with my spiritual life. They think I am not trusting in God or I am not obeying God. Or they will think that if I pray and trust in the Lord, I will get well. There might be instances when they are right, but not always so. Severe depression can be due to various causes. And whenever I am down with severe depression, I do trust in God and pray whenever I can. I cast myself upon God daily as I could not find the strength to cope with anything daily. But I still do not recover until a few months later.

Actually, depression can sometimes be rather complex and not that straight forward or simple. Pastor David P Murray has 6 very informative video on “Depression and the Christians”. In his 6th lecture on “The Carers”, he wrote on the importance of studying mental illnesses, “As Christians, we surely want to be the person whom our loved ones turn to in time of need. And, when they do turn to us, we want to be able to help them and not hurt them further. It is, therefore, imperative that we learn about depression and other mental illnesses in order to avoid the very common mistakes that lay-people often make when dealing with the mentally ill, and in order to be of maximum benefit to those who are suffering.”

In his second lecture, Pastor David did a very excellent analysis on “The Complexity” of depression which I found to be very balance in his views, to avoid dogmatism and the danger of viewing mental illnesses as purely physical, purely spiritual or purely mental. He encouraged us to recognise the exceeding complexity of mental illness and resist the temptation to propose and accept simple analysis and solutions.

As for Bipolar Disorder which is also known as manic-depressive illness, it is a brain disorder that causes unusual shifts in a person’s mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. They can result in damaged relationships, poor job or school performance, and even suicide. But the good news is bipolar disorder can be treated, and people with this condition can lead full and productive lives.

As a person with bipolar, I have experienced severe mood swings over the last 20 years. I experience severe depression which alternates with hypomania or normal moods, each lasting a few months and is cyclical. I realized that often there are various misconceptions, misunderstandings and stigmas associated in particular with depression. Most people still associate depression with feeling down or blue. When they feel that way, all they need to do is do something they enjoy and they will get better. For Christians, we usually pray and read God's Words, fellowship with His people, etc and we will feel better. If the depression is due to our sins, once we confessed our sins, God forgives us and we will experience the joy of the Lord again. If we do not confess our sins and seek God's forgiveness, God will hide His face from us and He will not hear our prayers. In time of severe backsliding, we can experience spiritual desertion or spiritual depression. But thank God that with Him there is forgiveness of sins. He is faithful to forgive us of our sins (1 John 1:9).

But some of us may suffer from a different form of depression or our depression may worsened till it became a condition that need to be treated through medication, counsellings, correcting some faulty lifestyle and thought patterns, taking some Omega-3 supplements or for some people St. John's Worts, vigorous exercise, etc etc. These are times in our life when somehow due to hormonal changes or some stress or strain in our life, the chemical in our brain became imbalance. Some of us are born with a brain that is prone to depression or bipolar because of its makeup. Just as I am born with a lung that is hypersensitive to cold air, etc and I am prone to asthmatic attacks during cold rainy season. Or a prolonged cold or flu will trigger off asthmatic attacks in me while it does nothing to another person, because I have a weak and sensitive lung. So it is the same with some of us who suffers from chronic depression and bipolar because of our brain condition. We are more prone to these mood swings than other people.

In such an episode of severe depression, I do pray and trust in the Lord, but I still don't get well. There is a cycle to it which is usually 3 to 6 months, or more. Without medication it is possible to recover as there is somehow a cycle to it. But the long wait can be very painful and unbearable. Thank God that He sustains and deliver us. What is painful and difficult for me to bear is whenever I am very severely depressed, there are times when I can't even pray much or read the Bible much. My concentration level is extremely low. I have difficulties reading or understand what I read. Sometimes, when I read the Bible I will feel even worst as I could not feel any comfort from God's Words and I will mistakenly think that God has forsaken me. But no amount of confession, repentance and calling upon God will deliver me. Usually it takes 3 to 6 months or sometimes more, before I am finally better and then I can pray and find comfort from God's Words. Severe depression can cause our brain to degenerate over times. And each relapse of severe depression makes the next relapse more possible. The reasons why I finally sought medical help was because my episodes of relapses of severe depression have become closer and closer over the years and every episode has become harder and harder to endure. The temptation to do away with my own life during such a severe relapse of depression is always there and it worsens recently. My down time was becoming more regular and harder to manage. I know I need professional help besides praying as God does provide doctors and other helps when we are unwell. So it was with prayerful consideration that I finally decided to seek medical and professional help, so that I can be more functional and continue to seek and serve our Lord.

After my diagnosis, I am convinced that this is a medical condition that can be treated because I have benefited from the help of medications which is shortening my relapses and helping me to be more functional. The medication doesn't cure me completely but it lift me up to a level I can function so that I can pray and derive comfort from God's Words. I can also then tackle the stressful or straining situations in my life which might have caused the relapse or aggravate it. I also then can challenge and correct my thinking patterns which have become faulty during depression or some of my existing faulty thinking patterns which might have either caused or aggravated my condition when I am depressed. I noted that whenever I am depressed my thought patterns all became negative and so when I am better, I will challenge these negative thoughts and use God's Words to correct these wrong thoughts so that I can think more biblically. These faulty thoughts can result in detrimental spiritual consequences of not trusting in God or doubting His sovereignty or goodness. So it is imperative for me to recognize them and correct them prayerfully using God's Words. But often they are the consequences of depression rather than the cause, and they still need to be corrected so that we can live aright with God even in our darkness.

In the past, I also have the misconception that as Christians we should not take medication for depression. We should pray and wait for God to deliver us. So I never sought medical help. But now while I sincerely believe that God can heal us of all our diseases, I do believe from my own experiences and that I have read on the internet, that when our condition is a chronic medical condition God does provide medication or other helps (St. John's Worts and Omega-3 fish oil also work for some people, while vigorous exercise helps some) as means of healing. So in this case to take medication or use other helps are means of grace from God to help us to get better and not a sign of a lack of faith in God. And when we make use of medications, supplements, exercise and many other helps, we use it prayerfully knowing that God alone can make use of these to heal us. This is the same when we make use of anything God has given to us in this life. It is with the purpose of serving God more effectively. Anything that hinders us from trusting in God is an idol. If our medications, our exercise, our counsellings replaced our looking to God and His Words, then these too are idols and God will not make these means a blessing to us. These will become a curse to us and bring about our spiritual downfall. So means when used prayerfully and appropriately, can be of maximum benefit to us, so that we can be more functional and able to serve God and His people.

When I started to open myself up last year to share with my family, church brethren and friends, I knew that I was putting myself at risk of having to debate with people who still think depression is solely a spiritual matter and should be overcome by faith in God alone despite the means God has provided. I did have to contend with a few friends, Christians and non-Christians. But I also felt it is worth the difficulties and it is a risk worth taking, because depression and other mental illness still has such a terrible stigma in our societies, and the church sometimes instead of supporting such a member who suffered tremendous pain and anguish, can actually worsened his condition by accusing him of a lack of faith in God. This I learnt through my own painful experiences.

So it was with the great burden in my heart to bring some help and relief to fellow sufferer by telling them that there is help that I decided to start my website and blog. I was also greatly burdened to educate the carers and friends so that they may know how best to relate to such a sufferer so that they can be of maximum help and not hurt the person further or aggravate his conditions.

When I started my blog recently, I started it with the same burdens. But I know yet once again, that I must be prepared to receive comments or emails from friends or reader of my blog, on their own version of their understanding of depression, bipolar, etc and the appropriate treatments. I wasn't sure whether I will be able to answer these contentions. So I tried to put as many useful articles as possible on my blog to help others to understand the complexity of depression.

I know that there is a possibility that I might lose some friends because of what I am going through or what I have put on this blog. But the aim of this blog is foremost to help other sufferers of bipolar and depression, and so the goal is to help them to find helps in their sufferings and enable them to be more functional and able to serve God and His people. Whatever lose I shall suffer through my writings on this blog, if it is due to the efforts to help others to attain to a more biblical and compassionate view on this complex condition so that sufferers and carers can benefit, and it glorifies God, I shall humbly and prayerfully bear them, by God's grace.

I am still new to understanding depressions, bipolar and other mental conditions. I have much to learn and am open to learning. It is my sincere prayers that I do not make my own experiences the norm. I understand that there are various reasons that can caused depression and various treatments available. God is also able to heal us without using any means. When medications or men failed us, God still never leaves us nor forsake us.

I agree with Pastor David P Murray that for Christians at times there will need to be a balance between medicine for the brain, counsel for the mind, and spiritual encouragement for the soul. Recovery will usually take patient perseverance over a period of many months, even years.

There may be reasons why God sometimes wants us to go through depression for extended periods of time and no medication or human help will bring any relief. It is at such times, that we are thrown completely upon our Lord. No one understands, no one can help us. Only to the Lord can we go daily and only to Him alone can we find deliverance. During such experiences we may find God to be truly our refuge and strength. We can identify with the many struggles and anguish of believers in the past when they undergo extreme sufferings. The psalmists often recounted their deep depression of the spirit when they are deprived from going to the house of God or when they were persecuted for righteousness sake. David also talked of his spiritual depression when he sinned in his adultery and murder. He also spoke of the forgiveness of sins when he confessed his sins to God.

Another reason why sometimes God allows us to go through severe depression without any relief is so that we may understand a little better what our Lord has gone through when He was on the cross. When our Lord was on the cross, He cried out "...My God, my God, why hast thou forsaken me?" (Matthew 15:34). When we go through severe depression, we often feel as if God has forsaken us. Many of us often prayed and cried unto God too "...My God, my God, why hast thou forsaken me?" It is through my many relapses of severe depression, that I am able to understand a little better the great sufferings our Lord has gone through on the cross for us to redeem us from eternal damnation. He took upon Himself the curse for our sins and suffered as a sinner though He Himself is without sin. He endured being forsaken by God so that we will not be forsaken by God. Ah, the depth of His love for us, is immeasurable! "Greater love hath no man than this, that a man lay down his life for his friends." (John 15:13). Our Lord Jesus Christ demonstrated His love for us by laying down His life for us. Our Lord Jesus Christ becomes more and more precious to me throughout the years, despite my many episodes of severe depression, because I become more and more aware of His love as I understand a little better of His sufferings for my sins. His sufferings was infinite in comparison to my sufferings, and it has eternal value. Gladly therefore will I endure my darkest moments, if it is His wills, that I may be drawn closer to Him and enjoy His love even more. This is a paradox. Depression is awful and painful beyond words and yet it can have such a sanctifying influence and advantage. Truly, God is faithful. He is working all things for His glory, our good and that of the church! (Romans 8:28). I never ceased to be amazed by His sovereignty and love, and it is this that thrown me upon Him completely. May He enable us to comprehend with all saints what is the breadth, and length, and depth, and height; And to know the love of Christ, which passeth knowledge, that ye might be filled with all the fulness of God. (Ephesians 3:18-19).

But having said that, when depression is clinical and a medical condition, God does send healings by providing ways out for us through usage of medicine, supplements, counsellings, exercise, etc. At such times, we must recognize God's goodness and faithfulness in working a way out for us and delivering us so that we can be more functional and serve Him.

No one can really understand what is severe clinical depression unless he has gone through it himself. It is so different from the normal ups and downs we experience every now and then. Even among sufferers of depression, the experiences, causes and cures can be so varied. We are made to be dependent upon God alone to deliver us whether by means or without means.

I thank God that now my family, friends and church are more understanding whenever I suffer relapses of severe depressions and their prayers, encouragements, kindness and supports have been invaluable in my process of recovery. I thank God for them and for His mercies in using them, and for encouraging and strengthening me day by day.

Pastor David P Murray wrote a very conclusion to his article on "The Complexity” of depression as follows:


Let us try to recognise the exceeding complexity of mental illness and resist the temptation to propose and accept simple analysis and solutions. Just as no two hearts are identically diseased, and just as no two cancers are the same, no two mental illnesses are the same in cause, symptoms, depth, duration and cure. Therefore, we must avoid making our own experience the norm for others.

The body, the soul, and the mind are extremely complicated entities and the inter-relation of the physical, the spiritual, and the mental is even more complicated. Unravelling the sequence of what went wrong in a depressed person’s brain, soul, or thoughts is usually a humanly impossible task. Analysis of the mental, physical, and spiritual contributions to the situation is equally difficult.

Consequently, the prescription of solutions is often a matter that takes much time and even trial and error. There are no quick fixes. For Christians there will need to be a balance between medicine for the brain, counsel for the mind, and spiritual encouragement for the soul. Recovery will usually take patient perseverance over a period of many months, even years.

Great care is therefore required in coming to conclusions about our condition or that of others. We finish by underlining our two main principles. Avoid dogmatism and seek humility. Avoid extremes and seek balance.

Depression and the Christians : 2 - The Complexity

(These series of 6 messages on "Depression and the Christian" are also available on .pdf, .mp3 and video formats which can be downloaded from the website of Sermon Audio )





Last week we began the study of depression by considering eight reasons why the Christian should study this subject. This week we would like to look at how the Christian should study depression - with what attitude and in what spirit the subject should be approached.

We will here propose two principles which should condition all our thoughts and the expression of them in studying depression.


Firstly, let there be an absence of dogmatism. Where the Word of God is dogmatic the preacher must be dogmatic. He must clearly and boldly declare God’s Word with all authority. He must have no hesitation or equivocation. He must not make mere suggestions or proposals. He must pronounce, “Thus saith the Lord...”

Unfortunately, Christian preachers and writers have often taken a dogmatic attitude into areas where the Word of God is not dogmatic. One such area is that of mental illness. In researching these addresses, I have been frequently shocked by the almost ex cathedra infallibility assumed by Christian writers and speakers when writing or speaking about mental illness. This dangerous dogmatism often reflects not the principles of the Word of God but their own prejudices and experiences.

It must be admitted that confident, sweeping dogmatic certainty appeals to the writer or preacher, and also to the hearer who craves simplicity in a confusing world. However, it is highly damaging in this complex area of mental illness which requires careful, balanced, and sensitive thinking and speaking.

When we look back on the treatments which used to be offered for bodily diseases we shudder with horror at the frequently crude and unsuitable advice and potions which were confidently given to patients. With the advances in medical research such advice and medicines now look ridiculous. It is very likely that in the years to come, with increased research into mental illness and also increased understanding of the Bible’s teaching, that much of the confident certainty which presently masquerades as biblical or medical expertise will then also look ridiculous, cruel, and even horrifying.

In our study, and in our contact with those suffering from mental illness, let us avoid unfounded and unwarranted dogmatism; and let us study, listen and speak with humility and an awareness of our own ignorance and insufficiency when faced with the complex and often mysterious causes and consequences of mental illness.


There are three simplistic extremes which we should avoid when considering the causes of depression. Firstly, that it is all physical. Secondly, that it is all spiritual. Thirdly, that it is all mental. Let us examine these three propositions in turn.

1. Depression is all “physical”

For many years, the foundational presupposition behind the largely drug-driven solutions offered by many doctors and psychiatrists has been that depression has purely physical roots – one of which is that of chemical imbalances in the brain. And, if the presupposition of a physical cause is correct (chemical deficiency), then the prescription of antidepressants (chemical correction) is a logical conclusion. This is often called the “medical model”. It can also be called the “drug-treatment model”

There is, undoubtedly, much scientific evidence to support the “drug-treatment model”. Studies have shown that the brains of depressed patients have a different chemistry compared to people with good mental health. To put it simply, the brain needs chemicals to move our thoughts through the brain, and when these are depleted, as they often are in cases of depression, then the whole process slows down, or even stops in certain areas.

Obviously, the “drug-treatment model” or the “all-physical model” for depression is supported by those who wish to deny the existence of a non-physical, or spiritual element to human beings. However, there are Christians who also take the “drug-treatment model” approach. An example of this is found in the book Broken Minds by Steve and Robyn Bloem. Steve is a Christian pastor who has struggled with serious depression throughout his ministry. His book, co-written with his wife, gives a deeply moving account of his lifethreatening battle with mental illness. There is no book I know of which gives such an honest and hard-hitting insight into the pain and distress which the mentally ill and their families have to endure. If you wish to increase your sympathy and compassion for sufferers and their loved ones, then this heart-rending and tear-jerking book is for you.

However, the book’s greater usefulness is limited by the adoption of the purely “drugtreatment model” approach to causes and cures. As we have said, there is unquestionably a physical element to most depressions, often requiring medication. And, in Steve Bloem’s case, there would appear to have been a very large and serious physical problem, which required necessary and life-saving medication. However, it is far too big a step to move from this to proposing the “drug-treatment model” as the only model in every case, and medication as the only solution to every case. In this complex area, it is a big mistake to use one’s own experience as the “norm” for everyone else.

In some ways, the Bloem’s “all-physical” position is understandable. For far too long, Christian writers and speakers in this area have been over-influenced by the Jay Adams extreme position of “all-spiritual” in both causes and cures (see below). However, we must not over-react to one unhelpful extreme (“it’s all spiritual”) by going to another (“it’s all physical”).

2. Depression is all “spiritual”

This extreme position takes two forms. We shall look at the first briefly, as it is not so common in our circles, and then we shall look in more detail at the second. Thirdly, we shall consider the rare situations when depression does have a sole spiritual cause.

a. Mental illness is caused by demonic possession and therefore exorcism is required

This idea is associated with some Pentecostal and Charismatic Churches which place a large emphasis on “spiritual warfare”. The “spiritual warfare” movement takes the view that mental illness (just like alcoholism and immorality) is usually due to the demonisation of the believer – either demonic oppression or possession. The “treatment” therefore is to effect “deliverance” from or expulsion of these demons.

As we have already highlighted, there is substantial scientific evidence that connects mental illness with physical causes, a fact confirmed by the success of medications in relieving many of the symptoms.

Hopefully, such dangerous views and practices will eventually be swept away by the increased knowledge of medical research, just like advances in research and increased education of the public eventually swept away the once-common view that epilepsy was caused by demons.

b. Mental illness is caused by sin and therefore rebuke, repentance and confession are required

This idea is widespread in the Evangelical church, largely as a result of the writings of the American Christian counsellor, Jay Adams, and those who follow him.

We shall, firstly, summarise Adams’ approach. Secondly, we shall highlight the strengths of Adam’s reasoning, And, thirdly, we shall look at the weaknesses.

(i) Summary

Like the Bloems, Jay Adams’ approach is founded on his own personal experience of mental illness, in his case as he encountered it at two treatment centres in Illinois. He summarised his experience-based conclusion as follows:

“Apart from those who had organic problems like brain damage, the people I met in the two institutions in Illinois were there because of their own failure to meet life's problems. To put it simply, they were there because of their unforgiven and unaltered sinful behavior”[1]

On the basis of this he argues in another place:

“The hope for the depressed persons, as elsewhere, lies in this: the depression is the result of the counselee's sin.”[2]

If this diagnosis is correct, then we would expect the logical prescription to be “rebuke and repentance”, or counseling with a view to conviction and conversion, and that is exactly what we find in Adams’ writings. He describes his counseling method as “nouthetic counseling”. The word “nouthetic” is from the Greek noun nouthesia and verb noutheteo, to admonish, correct or instruct (Rom.15:14).

Following on logically from Adams’ belief that bad feelings are the result of bad actions, is the usual nouthetic remedy of, “If you do right, you feel right.” If you get depressed because of sinful behavior, then, obviously, you get better by righteous behavior.

(ii) Strengths

Adams was reacting against the humanistic view which explained sinful addictions like alcoholism as “sickness”, or which attributed immoral behavior to one’s genes, and so tried to remove people’s guilt feelings by encouraging them to deny personal responsibility for their actions and simply accept themselves as they were. Adams’ emphasis on the need to accept personal responsibility in these situations was very much needed.

Also, Adams’ approach is correct and pastorally useful in situations where the problem is everyday mood swings and simply “feeling down”. There are times in all of our lives when, often in response to difficult personal situations, we allow ourselves to wallow in hopeless self-pity and slip into blaming everybody else for our problems. At such times, nouthetic counseling is exactly what we need. We need to be confronted with the sinfulness of our reactions and to be encouraged to get on with our daily duties and responsibilities.

In addition, though he has gone too far in saying “mental illness is all spiritual”, Adams has shown the need for the spiritual dimension of mental illness to be addressed, and therefore has secured the role of Christian pastors and counsellors in treatments.

Finally, though we disagree with Adams’ argument that depression is almost always caused by sin, we must accept that sometimes, as a result of depression, people can adopt unhelpful attitudes and sinful behaviour patterns which should be sympathetically addressed and corrected.

(iii) Weaknesses

While Adams is to be commended for giving an important place to personal responsibility, he greatly errs in placing all responsibility on the patient.

The fundamental weakness of Adams’ approach is that he fails to appreciate the significant difference in kind between bad moods or short-term depressions of spirit, which are sometimes sinful and to be repented of, and the far deeper kinds of “depression” which have far more complex causes than the sinful choices of individuals. When comparing “feeling down” with “depression”, Adams says:

“This movement from down (not depression) to down and out (depression) occurs whenever one handles down feelings sinfully (thus incurring guilt and more guilt feelings), by following them rather than his responsibilities before God.”[3]

In Broken Minds the Bloems comment, “This is not Christianity, but the good old American pioneer, self-sufficient spirit.”[4]

To always put all the blame for depression on the individual is wrong, damaging and dangerous, as it can only increase the feelings of guilt and worthlessness. Such mistaken views have been around for a long time. Almost 150 years ago the depressed Charles Spurgeon said:

“It is all very well for those who are in robust health and full of spirits to blame those whose lives are sicklied or covered with the pale cast of melancholy, but the [malady] is as real as a gaping wound, and all the more hard to bear because it lies so much in the region of the soul that to the inexperienced it appears to be a mere matter of fancy and diseased imagination. Reader, never ridicule the nervous and hypochondrichal, their pain is real; though much of the [malady] lies in the imagination it is not imaginary.”[5]

Let us, for a moment, allow that Adams’ diagnosis is correct in some situations. Here is a person who has major depression as a result of his sinful handling of down feelings or his sinful reactions to difficult life events. A knock-on effect is that his brain chemicals are now imbalanced and his thought circuits are malfunctioning. He is at the bottom of the black hole of depression. He cannot do and he can hardly think. The last thing he needs is a preacher telling him to repent and shouting down the hole, “Do right and you will feel right.” He needs someone to shine a light and throw down a rope. Medicine can play this role. It can restore the chemicals required to help a person think. And then, if required, repentance can take place.

As we noted above, the nouthetic counseling movement grew out of a frustration at the way in which secular doctors and psychiatrists squeezed Christian pastors and counsellors out of any role in the treatment of mental illness. However, in the valiant and commendable attempt to secure a much-needed place for Christian pastors and counselors in the treatment of mental illness, the nouthetic counseling movement has often gone to the opposite extreme in attempting to exclude doctors and psychiatrists from the treatment process. In both cases the sufferer is the one who loses out.

A much more balanced view is reflected in the book I’m not supposed to feel like this:

“Being a Christian does not inoculate us from the possibility of experiencing anxiety or depression; many Christians have experienced quite severe depressive illnesses. This is true in the same way that being a Christian does not prevent you from becoming ill or falling victim to crime or assault.”[6]

Finally the Adams remedy of do right and you will feel right fails to address the faulty thought processes which have contributed to or have even caused the depression. Such superficial behavioristic solutions will often fail in the long-term.

c. Mental illness can sometimes be caused by sin

When a Christian becomes depressed, the first conclusion he usually jumps to is that the cause is spiritual, that his relationship with God, or poverty of it, is all to blame. While almost every depressed Christian will feel that their relationship with God is all wrong and all to blame, this overly-self-critical feeling is usually one of the fruits of depression and, therefore, is usually wrong. It is important for the Christian in such situations to doubt, question and even challenge the accuracy of their feelings as they rarely reflect the facts.

Having said that, however, it is important to acknowledge the occasional possibility of a primarily spiritual cause. The Psalms of lament describe the depressed feelings of the Psalmists which were usually no fault of their own. However, we do have Psalm 32 and 51 which clearly link the traumatic physical and mental symptoms of depression with David’s sins of murder and adultery.

In later addresses we will examine how to decide if depression has spiritual causes or simply spiritual consequences. However, I agree with the general stance taken by the authors of I’m not supposed to feel like this, that we should, in general, reassure Christians suffering with depression that most often their damaged spiritual relationships and feelings are not the cause of their depression but the consequence of it.

3. Depression is all mental (“in the mind”)

“It’s all in the mind” can mean two very different things. Some people who say it, may be correctly identifying the seat of the depression – the chemical imbalances in the brain. However, most people who say it are incorrectly alleging that the depression is a fiction, a delusion, something made up. Usually implicit, and sometimes explicit, in this view is the idea that the depressed person is someone with a weak and fragile mind.

Charles Spurgeon, who suffered from frequent deep depression and anxiety, and who could hardly be accused of mental weakness, addressed this fallacy in the quote we looked at previously. He said:

“Reader, never ridicule the nervous and hypochondrichal, their pain is real; though much of the [malady] lies in the imagination it is not imaginary.”[7]

Mental illnesses, such as depression, afflict the strong and the weak, the clever and the simple, those of a happy temperament and those of a melancholy temperament. Never was the caution so much needed, “Let him that thinketh he standeth, take heed lest he fall” (1 Cor.10:12)


Let us try to recognise the exceeding complexity of mental illness and resist the temptation to propose and accept simple analysis and solutions. Just as no two hearts are identically diseased, and just as no two cancers are the same, no two mental illnesses are the same in cause, symptoms, depth, duration and cure. Therefore, we must avoid making our own experience the norm for others.

The body, the soul, and the mind are extremely complicated entities and the inter-relation of the physical, the spiritual, and the mental is even more complicated. Unravelling the sequence of what went wrong in a depressed person’s brain, soul, or thoughts is usually a humanly impossible task. Analysis of the mental, physical, and spiritual contributions to the situation is equally difficult.

Consequently, the prescription of solutions is often a matter that takes much time and even trial and error. There are no quick fixes. For Christians there will need to be a balance between medicine for the brain, counsel for the mind, and spiritual encouragement for the soul. Recovery will usually take patient perseverance over a period of many months, even years.

Great care is therefore required in coming to conclusions about our condition or that of others. We finish by underlining our two main principles. Avoid dogmatism and seek humility. Avoid extremes and seek balance.

[1] Jay Adams, Competetent to Counsel (Grand Rapids: Zondervan, 1970), xvi

[2] Jay Adams, Christian Counselor Manual (Grand Rapids: Zondervan, 1973), 378.

[3] Jay Adams, What about Nouthetic Counseling, 4 n.7.

[4] S & R Bloem, Broken Minds (Grand Rapids: Kregel, 2005), p187.

[5] Charles Spurgeon, The Treasury of David, 3 Vols (Newark, Del.: Cornerstone, 1869), 2.132

[6] C Williams, P Richards, I Whitton, I’m not supposed to feel like this, (London: Hodder & Stoughton, 2002), 33.

[7] Charles Spurgeon, The Treasury of David, 3 Vols (Newark, Del.: Cornerstone, 1869), 2.132.

All 6 articles on Depression and the Christian:

  1. The Crisis
  2. The Complexity
  3. The Condition
  4. The Causes
  5. The Cures
  6. The Carer