Showing posts with label Depression and the Christian. Show all posts
Showing posts with label Depression and the Christian. Show all posts

Tuesday, February 12, 2008

Depression and the Christian : 6 - The Carers

(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 )

DEPRESSION AND THE CHRISTIAN

BY DR. DAVID P MURRAY

(6) THE CARERS

INTRODUCTION

We have been studying depression from a biblical perspective, and have covered five areas so far:

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

We now come to the final area of our study – The Carers. For our purposes, the carers are the depressed Christian’s family, friends, and fellow-Christians, who will be involved to one degree or another in helping the sufferer to get better. Usually these carers will have no medical training and often they will have very limited or incorrect knowledge of mental illness. However, they have a critical role in helping a depressed person get better. Research has shown that mental health patients will get better much quicker if they have someone close to them whom they can confide in and get support from.

This lecture, then, will consider ten areas for carers to consider when trying to help a depressed person get better.

1. Study

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.

Apart from studying how Jesus dealt with the ill, the weak, and the distressed you might want to read some of the very helpful books, written from a Christian perspective, which are now available. In order of readability and usefulness they are:

Overcoming Spiritual Depression by Arie Elshout.

I’m not supposed to feel like this by Chris William, Paul Richards, and Ingrid Whitton Broken Minds by Steve and Robyn Bloem.

A Practical Workbook for the Depressed Christian by Dr John Lockley

Another book, of course, is the well-known Spiritual Depression by Dr Martyn Lloyd-Jones. However, you should be aware that Dr Lloyd-Jones does not deal with every aspect of depression as an illness, but rather only with some of the spiritual consequences of depression.

A book which is written from a non-Christian perspective, but which is still useful, is Mind over Mood by Dennis Greenberger and Christine Padesky.

It is important to remember that reading these books will not turn you into a mental health professional, but it will make you more useful and helpful to loved ones in distress.

2. Sympathy

Thoughtful and prayerful study of mental illness should naturally and automatically increase our sympathy for those who suffer with it. By sympathy we mean an ability to communicate that we truly understand the problem and the symptoms, that we are deeply concerned, and that we will do all that we can to help. In many cases, such sympathy can have powerful therapeutic effect on the sufferer. The lack of it can only multiply the pain and deepen the darkness. Consider the following quote from Russell Hampton, who suffered himself from depression:

"If there were a physical disease that manifested itself in some particularly ugly way, such as postulating sores or a sloughing off of the flesh accompanied by pain off an intense and chronic nature, readily visible to everyone, and if that disease affected fifteen million people in our country, and further, if there were virtually no help or succour for most of these persons, and they were forced to walk among us in their obvious agony, we would rise up as one social body in sympathy and anger. There isn’t such a physical disease, but there is such a disease of the mind, and about fifteen million people around us are suffering from it. But we have not risen in anger and sympathy, although they are walking among us in their pain and anguish."

It will greatly help you to sympathise if you always remember that you could just as easily be in the same position, suffering the same illness.

For who maketh thee to differ from another? and what hast thou that thou didst not receive? now if thou didst receive it, why dost thou glory, as if thou hadst not received it? (1 Cor.4:7).

If you treat depressed people with impatient contempt, you may, like many others before you, have to learn sympathy the hard way.

3. Support

Support follows sympathy. It involves being available to listen and talk either in person or at the end of a phone. It includes praying with the person, especially as the mentally ill may find it impossible to put words and sentences together in prayer. It means unconditional love, love which is maintained even when you do not agree with every decision your loved one is making, and even when they may unjustly turn on you. It requires practical help such as child-minding to enable a young mother to get a few free hours each week, or such as taking an elderly person out in the car to give them a refreshing change of scenery. It demands wisdom to know when you are getting out of your depth and more professional support is needed from medical services. The benefits of such supportive friendship cannot be overestimated:

The presence, the availability, just the existence of a friend like this provides a tremendous degree of comfort to the depressed person, as it demonstrates in physical terms how much he is cared for, accepted, loved, as he is, warts and all. It is not difficult for the depressed person to go on to realise that if individual Christians can love him that much, how much more will God do the same.

Unconditional friendship is the key, as is loyalty. The real friends are the one who can accept the depressed person as he is – on good days, bad days, sad days, frightened days and angry days. Friends like this don’t put pressure on in any way, but allow the sufferer to be himself, however horrid that may seem to be. As one of my depressed friends said, “It’s a relief not to have to put on a disguise.”

On a congregational level, pastors and officebearers should encourage a supportive atmosphere: For our churches to be really effective in supporting those with mental health difficulties, we need to establish a culture where everyone in the local church knows that it is acceptable to have problems
from time to time, and that the church as a whole – and especially its leadership – is there to support church members during these times as well as in times of success.

The Church should be especially aware of the need to “support the supporters”. To be an effective support to the mentally ill is physically, mentally, emotionally, and spiritually demanding. As Christians we need to be conscious of the need not only to support the depressed person but also to minister to the needs of their nearest and dearest.

4. Stigma

There is still a stigma attached to mental illness, and depression in particular. Ignorance and misunderstanding have filled the public mind with many prejudices and falsehoods. As a result, many still view mental illnesses such as depression as a choice, or as a sign of weakness, or as an excuse to opt-out of life. The depressed person may also share these mistaken beliefs, and so double their sense of guilt and failure. Consequently, they will often be very reluctant to admit what they are feeling, and so go for many long months or even years without asking for help or seeking treatment.

Following steps 1-3 above will help to reduce this stigma. But the Church can also help by making clear that Christians do not have to be perfect with no problems, and by demonstrating that when people do experience problems they will not be ignored or avoided.

Also, the preacher should present a balanced view of the Christian life, as represented in the Psalms, over a third of which deal with fear, anxiety, and despair. This is part and parcel of normal Christian experience in an abnormal world. Let us remind ourselves again and again:

For who maketh thee to differ from another? and what hast thou that thou didst not receive? now if thou didst receive it, why dost thou glory, as if thou hadst not received it? (1 Cor.4:7).

Almost anyone can experience mental health problems, given the wrong sequence of life experiences and stressors.

5. Secrecy

As is clear from the above, it often takes a huge amount of courage for someone to admit to depression, often due to the fear of what people will say. If someone, therefore, trusts you enough to confide in you, then you must maintain the strictest confidence. There must be no “sanctified” gossip – “I’m just telling you this so that you can pray about it…!” It is tragic that so many depressed Christians have to prolong their secret suffering because of a justified fear that no one can keep a secret in the Church! The Church is in desperate need of Christians who are known to have this simple talent – they keep confidences.

6. Self-esteem

Depression and anxiety bring to the surface deeply rooted self-doubts and self-criticism. The depressed person will often feel useless and worthless. They will have very low self-esteem. What should we do to address this?

Some Christians are reluctant to give people any praise or encouragement because of the risk of making a person proud. However, it is safe to say that pride is one of the least risky vices for someone who is depressed. Pride results from having an over-inflated view of oneself. Depression involves the opposite.

Other Christians misconstrue the doctrine of original sin and total depravity to mean that there is no kind of “good” in anyone, and so again fail to say anything positive to the person. However, without minimising the wickedness of the human heart and without denying our inability to do anything pleasing to God apart from through faith in Christ, we should feel free to encourage the depressed person to have a more realistic view of themselves by highlighting their God-given gifts, their contributions to the lives of others, their usefulness in society, and, if they are Christians, their value to the Church. For example, a depressed young mother may feel a total failure in every area of her life because she has not got a perfect home or perfect kids. We can help such a person to see that she achieves a lot in a day even though she might not manage to do everything she would like. We might remind her of all the meals she makes, clothes she washes and irons, the shopping she organised, and so on, and so help her to see herself and her life in a more accurate and realistic light.

It is wrong to pat ourselves on the back when something has been accomplished as a result of our initiative. It is equally wrong, however, to focus on what we have not accomplished. In 1 Corinthians 15:10 we have a clear example of humility accompanied with a healthy opinion of one's accomplishments: "But by the grace of God I am what I am: and his grace which was bestowed upon me was not in vain; but I laboured more abundantly than they all: yet not I, but the grace of God whichwas with me." Paul knew very well that he daily offended in many things (James 3:2; cf. Rom. 7; Phil. 3:12), and yet he did not go so far as to cast out all his accomplishments. I do not believe that this is God's will. In contrast to sinful forms of self-confidence and self-respect, there are also those that are good, necessary, and useful. Without a healthy sense of these, human beings cannot function well. We may pray for an appropriate sense of self-confidence and selfrespect, clothed in true humility, and we must oppose everything that impedes a healthy development of these things (be it in ourselves or others) with the Word of God.

7. Subjectivism

One of the most common tendencies in depression is to focus on feelings, and to base beliefs and conclusions on these feelings. This is especially true of Christians. They may feel forsaken and so conclude they are forsaken, etc. There is also the tendency to read Bible passages and books which address the feelings in the hope that this will help to restore true feelings, whereas such a focus tends only to make things worse.

We should encourage the depressed person to move away from the realm of the subjective and to instead think on the objective truths of Christianity – things which are true regardless of our feelings – justification, adoption, the atonement, the attributes of God, heaven, etc.

8. Speak

The general rule is to listen much and to speak little. However, here are a number of things not to say:

• Pull yourself together
• Don’t get so emotional
• O, you’ll soon get over it
• It’s a sin to be depressed
• Just believe the promises
• Smile, it can’t be that bad
• Well, things could be worse
• At least it’s nothing serious
• You should confess your sins
• You are not still on medication, are you?

The more you understand depression the less likely you will say such hurtful and damaging things.

9. Suicide

If you suspect someone is considering suicide then you should sensitively and wisely ask the person if they are thinking along these lines. This will not plant suicidal thoughts in their minds, but may allow the suicidal person to admit to this and to seek professional help.

In Broken Minds, the pastor Steve Bloem gives a number of reasons he has, at times, used to convince himself not to commit suicide:

• It is a sin and would bring shame to Christ and His church.
• It would please the devil and would weaken greatly those who are trying to fight him.
• It would devastate family members and friends, and you may be responsible for them following your example if they come up against intense suffering.
• It may not work and you could end up severely disabled but still trying to fight depression.
• It is true – our God is a refuge (Ps.9:10)
• Help is available. If you push hard enough, someone can assist you to find the help you need.
• If you are unsaved, you will go to hell. This is not because of the acts of suicide but because all who die apart from knowing Christ personally will face an eternity in a far worse situation than depression.
• If you are a Christian, then Jesus Christ is interceding for you, that your faith will not fail.
• God will keep you until you reach a day when your pain will truly be over.

10. Slow

It is important to realise that there are no easy answers and there are no quick fixes in dealing with depression. It usually takes many months and in some cases even years to recover. You should, therefore, take a long-term view and patiently wait for improvement. Don’t get frustrated over lack of progress and be aware that temporary relapses may occur.

Patience is essential, because, by the nature of illness, the depressed person is likely to go over the same ground time and again, needing the same reassurance that was given a day, a week or a month ago.

In the meantime let us take our depressed Christian brethren continually before the throne of grace and plead, “Lord, he whom thou lovest is sick.”

CONCLUSION

In the course of these lectures we have been looking particularly at how depression affects the Christians. In closing I would like to refer back to something which I have touched upon now and again – the way God will sometimes use depression to bring an unconverted person to the Saviour. If you are unconverted and feeling depressed, at least part of the solution may be repentance from your sins and faith in Christ. That is not to say that you may not need medication and counselling as well. However, medication and counselling will only be a temporary solution if you do not seriously address your spiritual state before God. Pills might get you through this world, but they will not be available in hell, the place of ultimate torment, despair, and gnashing of teeth.“Believe in the Lord Jesus Christ and you shall be saved.”


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

Depression and the Christian : 5 - The Cures

(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 )

DEPRESSION AND THE CHRISTIAN

BY DR. DAVID P MURRAY

(5) THE CURES

In our last lecture we looked at some of the causes of depression. Now we will look at some of the cures. However, before we do so, we must ask the depressed person a vital question, “Do you want to be made whole?” This was the question Jesus asked of the lame man at the pool of Bethesda (Jn.5:6).

At first glance it may seem like a silly question. Surely every sick person wants to be made whole! However, Christ’s question may imply that the man was not making use of all the means available to get better. Or, perhaps he had given up hope of getting better. These are common scenarios with depression. Doctors and pastors are often faced with the frustrating situation of people who need the help they can give, and yet who are not taking the steps required to benefit from this help. Perhaps they have just learned to live with their illness. Perhaps they have given up hope of getting better. Perhaps they lack the will to play their part in the healing process. Perhaps they are frightened of all the responsibilities of life which would come upon them should they be viewed as “well” again. Perhaps they would miss the attention and sympathy which being ill may generate. These are all possibilities. So, if you are depressed, the first searching question you must ask yourself is “Do I want to be made whole?”

You have no hope of recovery from depression unless you want to recover and are, therefore, prepared to play your own significant part in the recovery process. We will look at four measures which should be considered as part of a “package” of healing.

1. Correct your lifestyle

It is vital to lead a balanced lifestyle in order to reduce the “stretch” that threatens our physical, mental, emotional and spiritual well-being. Some of the practical points made here also apply to depressions resulting from stressful life events.

a. Routine

One of the keys to a balanced lifestyle is regular routine. This is also one of the first things to fall by the wayside when someone becomes depressed. The depressed person often finds it very difficult to resist being guided by their feelings. When a person feels down they will often only do what they feel like doing and avoid what they don’t feel like doing. For example, if we don’t feel like getting up, we won’t. If we don’t feel like working, we won’t. If we don’t feel like doing the ironing, we won’t. If we feel we want to drink or eat to excess, we do it. A positive step in recovering from depression is to restore order and discipline in our lives. Regular and orderly sleeping, eating, and working patterns will rebuild a sense of usefulness and healthy self-esteem. It is also glorifying to God who is a God of order, not of confusion (1 Cor.14:33).

b. Relaxation

We need to build times of relaxation into our lives. This may involve finding a quiet spot at various times throughout the day to simply stop, pause, calm down, and seek the peace of God in our lives. Jesus recognised and provided for this need in his disciples when he took them “apart into a desert place to rest a while” (Mark 6:31). Also, moderate physical exercise helps to expel unhelpful chemicals from our system and stimulates the production of helpful chemicals.

c. Rest

Regular sleep patterns enable the body and mind to repair and re-charge. The Sabbath Day was graciously made for us (Mark 2:27), partly to ease the tension of our busy overstretched lives.

d. Re-prioritise

Examine your life and see what you can do to reduce your commitments and obligations. Areas to consider are your family, your work, your church, your neighbours and travel. Once you are better you may be able to pick up some of these activities again. But the priority is to get better.

2. Correct your false thoughts

As we have noted throughout these lectures, one of the most common contributory factors to depression is wrong and unhelpful thoughts. Many Christians, who wouldn’t dream of viewing God’s Word in a false way, yet view God’s world in a false way. As they view themselves, their situations, and their relationships with others, they tend to dwell on and magnify the negatives and exclude the positives. This distorted view of reality inevitably distorts and depresses their mood. Christians are obliged to challenge falsehood and distortions of reality, especially when found in themselves. In the appendix to this lecture you will find two questionnaires to help you do this. The first is to help you examine your thoughts, and the second is to help you challenge your false and unhelpful thoughts. Questionnaires such as these are recommended for use by many Christian and non-Christian psychiatrists. They may look a bit strange to you, and you may wonder, “Is this not all just psychological mumbo-jumbo?” However, I would like to show you here how each step is grounded in Biblical Christian experience. In Psalm 77 we have a perfect example of Asaph investigating and challenging his thoughts with God’s help, in order to raise his mood and spirits. There are also slightly more abbreviated versions of the same biblical strategy in Psalm 42, Psalm 73, Job 19, Habakkuk 3, etc. So, this is not “psychological mumbo-jumbo”, but true Bible-based Christian experience. Let us look at Psalm 77 to prove this.

Download the following file :

asaph.pdf

3. Correct your brain chemistry

This is not an area I have any expertise in and so I shall keep my comments to a minimum. I would refer you to sympathetic and trained medical personnel for diagnosis and prescription of appropriate medication. Even a low dose of anti-depressants is sometimes enough just to begin to restore depleted brain chemicals and so pick up your mood sufficiently to enable you to begin to take the steps necessary to correct your lifestyle, thoughts, etc. However, more serious depressions sometimes require medication for 2-5 years in order to permanently restore the brain’s chemistry and processes. There are a number of myths and false ideas about anti-depressants which have lodged in the public mind.

Here are some examples: “If I take anti-depressants I won’t be my true self…there will be horrible side-effects…I might get addicted…people will look down on me…it will mean I am crazy.” Your doctor should be able to refute these myths and reassure you. However, as mentioned above, anti-depressants don’t replace the need for you to identify and work at changing false and unhelpful thinking and harmful behaviour.

4. Correct your spiritual life

a. Correct the spiritual consequences

We have tried to emphasise that for Christians their depression is usually not caused by spiritual factors. However, there are spiritual consequences in all depressions. There are a number of steps a depressed Christian can take to help reverse at least some of the spiritual consequences. You may find Martyn Lloyd-Jones’ book Spiritual Depression to be helpful in this regard – although he can be a bit sweeping and dogmatic in his generalisations. Here are some practical things you can do to help address the spiritual consequences of depression.

(i) Accept that being depressed is not a sin and indeed is compatible with Christianity. Many Bible characters and many of the greatest Christians passed through times of depression.

(ii) Try to understand that your loss of spiritual feelings is not the cause of your depression, but rather the depression has caused a general loss of feeling in all parts of your life, your spiritual life included.

(iii) Patiently wait for the corrections in your lifestyle, thinking, or brain chemistry to have an effect on your feelings as a whole and your spiritual life will pick up at the same time also.

(iv) Have a set time for reading your Bible and praying. Depressed Christians may either give up reading and praying, or they may try to read and pray “excessively” in order to try and bring back their spiritual feelings. Both approaches are unhelpful. Instead, set aside a regular time each day to read and pray. If concentration is a problem, keep things short (5-10 minutes) until you feel better. Depression will only be deepened by setting unrealistic spiritual goals.

(v) Bring objective truth to mind (e.g.: the doctrine of justification, or the atonement), especially “positive” verses which set forth God’s love, mercy and grace for sinners (e.g.: Rom.8:1; 8:38-39; 1 Jn.4:9-10; 1 Jn.1:9). You may want to write out a verse and carry it around with you. When negative thoughts overwhelm you, bring out the verse and meditate upon it.

(vi) When you pray, tell God exactly how you feel. Be totally honest. Ask God to help you with your doubts and fears and to restore to you the joy of salvation. Thank Him for loving you and being with you even though you do not feel His love or presence. Praying for others who suffer can also help to turn your thoughts away from yourself for a time.

(vii) Keep going to church and seek out the fellowship of one or two sympathetic Christians you can confide in, and ask them to pray with you and for you. Be careful about who you talk to. Sadly, some Christians cannot keep confidences, and others will have little understanding of or sympathy for your condition.

(viii) Remember God loves you as you are, not as you would like to be.

b. Correct the spiritual causes

In the lecture on the causes of depression, we mentioned the possibility that a Christian’s depression may be the result of some specific sin or sins. If having examined your life you find that there is a sin which you are deliberately and stubbornly persisting in, or grave sins which you have never really repented of, it is time to fall on your knees and seek God’s pardon for the sin, and God’s power over the sin. See Psalm 32 and Psalm 51 for examples of how to do this.

APPENDIX

Download the file : Thought Investigation Questionnaire.pdf

Download this article in .pdf format - 5TheCures.pdf

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

Depression and the Christian :4 - The Causes

(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 )

DEPRESSION AND THE CHRISTIAN

BY DR. DAVID P MURRAY

(4) THE CAUSES

In previous lectures we mentioned some of the causes of depression. We also noted the complexity of trying to analyse the causes of depression, and concluded that it is often a combination of various factors. In this lecture we will look in a bit more detail at the various causes of depression, and then we will consider some of the cures for depression.

Depression is often divided into two main categories – reactive or endogenous. Reactive depression is usually traced to some obvious trigger – perhaps a stressful life event or unhelpful thought patterns. Endogenous depression is the name usually given to depressions which seem to have no obvious trigger and are often traced to genetic pre-disposition. For no obvious reason, the brain chemistry becomes unbalanced and a person becomes depressed. However, this distinction between reactive and endogenous is not as clear-cut as it once was, as skilled investigation of many so-called endogenous depressions will often reveal a “trigger event”, though a genetic pre-disposition may mean that the trigger is relatively small. We will consider four triggers of depression: stress, psychology, sin, and sovereignty.

1. Stress

When you stretch a piece of elastic, you can often extend it to two or even three times its size. However, the further you stretch it, the greater the tension on the rubber, the less flexible it becomes, and the greater the danger of it eventually snapping. Like rubber bands, we are all “stretched” from time to time. We are stretched by life events, which we have little control over, and by our lifestyle which we do have considerable control of. Let’s look at each of these stretching forces.

a. Life events

Life events include marriage, moving house, exams, bereavement, illness, unemployment, birth of children, etc. Each of these events put a strain upon us, to one degree or another. When we are “stretched” in this way, our body and brain chemistry changes, and one of the results is often a dip in or lowering of our mood. This is normal. And, as the stressful events pass, our chemistry usually returns to normal along with our mood.

Sometimes, however, these stressful experiences can continue over a lengthy period, or they can occur one on top of another, or they can affect us more seriously than other people. The result is that our brain chemistry remains abnormal and so also does our mood. We just can’t “pick ourselves up”, no matter how many people urge us to. This is depression. At the very worst, like an elastic band, we can “snap”, sometimes unexpectedly. This is what some call a “nervous breakdown”.

Changes in brain chemistry greatly affect our ability to think and feel in a balanced way. Stressful events make our minds go into overdrive, exhausting and depleting the chemicals we need to think and feel in a normal and helpful way. Think of a computer with too many programmes open and working at the same time, and how this slows down all the processes until eventually the machine “crashes”.

b. Lifestyle

While we have little if any control over life events, we do have substantial control over our lifestyle – the proportion of time and energy we give to work, socialising, shopping, travelling, recreation, exercise, rest, sleep, etc. Much of the increase in depression and anxiety today is largely the result of an unbalanced lifestyle where people are on the one hand working too hard and spending too much, and on the other hand are exercising, resting, and sleeping too little. This deliberate overstretch

beyond our capacities and abilities is not glorifying God in our body and spirit (1 Cor.6:20). It is also in breach of the sixth commandment which requires us to take “all lawful endeavours to preserve our own life” (Shorter Catechism 68). The effects and result of a stressful lifestyle will often be the same as that of stressful life events – depression.

2. Psychology (the way we think)

In Lecture 3 we looked at 10 false thinking patterns which contribute to depression. It cannot be emphasised enough how vital it is to learn to recognise these unhelpful thoughts by prayerful self examination. It is also important and useful to note that some of these habits of thinking may be involuntarily absorbed or learned in early life and so may be deeply ingrained. When we feel down, or when we are stressed, these latent false thinking patterns tend to occur more frequently and tend to dominate. This can often lead to depression, worsen an existing depression, and, if persisted in, make recovery from depression so much harder. Sometimes, the Church can reinforce or add to false thinking patterns by over-emphasis on the negatives in the Bible and in people’s lives, or by setting standards of commitment which may discourage or depress those who are unable to attain them.

3. Sin

A non-Christian may be depressed because of their sin, in which case the cure is repentance and faith in Jesus Christ. Sadly, many depressed unbelievers are being treated with chemicals when what they need is conversion. If you are unconverted and depressed then seriously consider whether your depression is related to a guilty conscience and conviction of sin. If so, then what you need is repentance from sin and faith in Jesus Christ. There are many Christians who will testify that this was the key to relieving their depression.

While sin may be the last thing an unconverted person may think is causing their depression, the opposite is true for Christians. When a Christian becomes depressed, there are often spiritual consequences, and so the depressed believer jumps to the conclusion that there is also a spiritual cause – usually their own sins or hypocrisy or failures of one kind or another. Skilled and experienced Christian pastors, doctors, and psychiatrists unite in affirming that depression in Christians is not usually caused by problems with their spiritual life. In Christians, depression is usually caused by stressful life events and lifestyles, or unhelpful thought patterns (see 1 and 2 above). Here are some sample quotations from various experienced Christian pastors, psychiatrists, counsellors, and doctors to prove this point:

“For Christians, depression hardly ever has a spiritual cause…In Christians, spiritual

effects follow from the depression, and seldom the other way around.”[1]

“True spiritual causes of depression are not common. Most Christians with an apparently religious content to their depression in fact have one of the mental/emotional causes rather than a true spiritual cause. I cannot emphasise enough that solely spiritual causes of depression are infrequent in Christians.[2]

David and other psalmists often found themselves deeply depressed for various reasons. They did not, however, apologize for what they were feeling, nor did they confess it as sin. It was a legitimate part of their relationship with God. They interacted with Him through the context of their depression.”[3]

“We completely agree that there are always spiritual aspects to anxiety and depression (as there are in everything in life for a Christian). However, we see these as being a secondary consequence of the emotional distress that is part of these illnesses. Strong claims that all anxiety and depression is spiritual in origin are unhelpful because they miss the point that the actual problem is anxiety and depression.”[4]

I emphasise this point again and again because blaming our depression on our sin is not only usually wrong, it is also very harmful. It is harmful because it increases false guilt and deepens feelings of failure. It also makes depressed Christians seek a spiritual solution to a problem which is actually being caused by life events, lifestyle, or unhelpful thinking patterns. However, having said all that, we must still leave open the possibility that the depression may sometimes be the result of specific sin or sins (e.g. Ps.32). The Westminster Confession of Faith says: “The most wise, righteous, and gracious God doth oftentimes leave, for a season, His own children to manifold temptations, and the corruption of their own hearts, to chastise them for their former sins…” (WCF 5.5).

How then does a Christian know if his depression has a spiritual cause or simply spiritual consequences. The Practical Handbook for Depressed Christians puts it like this: “For the Christian, truly spiritual causes of depression usually involve behaviour which the Christian knows to be wrong, but which he still deliberately and arrogantly persists in…I am not talking about repeated sins that the Christian wishes he could control but can’t…but a deliberate and continued rebellion against God….”[5]

4. Sovereignty

One final cause of depression in the Christian is the sovereignty of God. Hard though it may be to accept, the ultimate cause may be, “It pleased God.” This however is not some sheer arbitrary, sadistic and pointless infliction of suffering. Not at all. God has wise and loving motives and aims in all His dealings with his children. The Westminster Confession of Faith proposes another reason why God will sometimes allow his children to descend into the depths of depression. It is “to discover unto them the hidden strength of corruption and deceitfulness of their hearts, that they may be humbled; and, to raise them to a more close and constant dependence for their support upon Himself, and to make them more watchful against all future occasions of sin, and for sundry other just and holy ends (5.5)".

A well known example of this is Job. A lesser known example is Hezekiah. “God left him, to try him, that he might know all that was in his heart” (2 Chronicles 32:31). This does not mean that God actually left Hezekiah. God will never leave nor forsake His people. This, then, is not an objective leaving, but a subjective leaving. God withdrew Himself from Hezekiah’s spiritual feelings, so that he lost his feelings of God’s presence, protection, and favour. So, Hezekiah felt God had left him. But God had a wise and loving purpose in this. It was to test Hezekiah and to reveal to Hezekiah what was in his heart when God’s felt presence was withdrawn.

Sometimes we can take God’s presence in our lives for granted. We forget what we might be without him. And so He wisely, temporarily, and proportionately withdraws the sense of his favour and presence to remind us of our state without Him and to lead us to greater thankfulness and appreciation for Him

[1] Dr John Lockley, A Practical Workbook for the Depressed Christian (Bucks: Authentic Media, 1991), 53-54.

[2] Ibid. 58.

[3] S & R Bloem, Broken Minds (Grand Rapids: Kregel, 2005), 204.

[4] C Williams, P Richards, I Whitton, I’m not supposed to feel like this, (London: Hodder & Stoughton, 2002), 121.

[5] Dr John Lockley, A Practical Workbook for the Depressed Christian (Bucks: Authentic Media, 1991), 57


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

Depression and the Christians : 3 - The Condition

(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 )

DEPRESSION AND THE CHRISTIAN

BY DR. DAVID P MURRAY

(3) THE CONDITION

INTRODUCTION

We began this series of lectures on “Depression and the Christian, by suggesting eight reasons why we should study depression. We then proposed two principles to govern how we should study depression. We also examined three extreme positions some take regarding the causes of depression: all physical, all spiritual, or all mental (or “psychological”). We concluded that it was vital to resist the extremes, and instead to recognise the causes of depression to be complex and varied. The importance of this point was underlined by Martyn Lloyd-Jones:

“Many Christian people, in fact, are in utter ignorance concerning this realm where the borderlines between the physical, psychological and spiritual meet. Frequently I have found that such [church] leaders had treated those whose trouble was obviously mainly physical or psychological, in a purely spiritual manner; and if you do so, you not only don’t help. You aggravate the problem.”1[1]

Having laid this groundwork (the “why” and the “how”), we can now consider the question: what is depression?

There are two reasons why we should be concerned about getting a right answer to this question.

The first is physical and the second is spiritual.

The physical reason is that only by knowing the symptoms can I know if I or loved ones are suffering from mental illness, and so seek appropriate help. Many people suffer varying degrees of depression without knowing it, because they do not recognise the symptoms for what they are, and so go for years without getting help that is readily available and which would transform their lives.

The spiritual reason, and the one I am most concerned about, is that many who have the symptoms of depression, without identifying them as such, reason that, “If I have these thoughts and feelings, I cannot be a Christian!” My aim in this lecture is not only to outline the symptoms of depression, but also to show from Scripture that such symptoms are not only compatible with being a Christian, but are also commonly found in some of the most eminent Bible characters.

We will answer the question, “What is depression?” by looking at how it is related to and reflected in five areas of our lives: our life situation, our thoughts, our feelings, our bodies, and our behaviour. Before we do so, however, we must state three caveats. Firstly, these five areas are all linked, connected and inter-related. We cannot separate our thoughts from our feelings, or our feelings from our behaviour, etc. What we think affects how we feel. What we think and feel affects our physical health. Our thoughts, feelings and physical health affect what we do. Secondly, though we number these areas 1-5, this is not necessarily the chronological order in which the symptoms of depression always manifest themselves. Thirdly, we shall focus most of our attention on the second area, our thoughts, as false thought patterns are often the biggest contributor to depression, and also because it is an area where, with God’s grace, we can most help ourselves in.

I. LIFE SITUATION

Life in this world is full of ups and downs. Our providence can change so rapidly from smooth and happy to rough and upsetting. It is important to recognise how providential changes (e.g.

bereavement, loss of job, family difficulties, relationship problems) can seriously damage our mental health. A person may feel very down and yet never link such experiences with such life events. Therefore, one of the first steps to treating depression is to take time to examine our lives and, with God’s help, to trace back our present depressed thoughts and feelings to events in our lives.

This can be a painful process of self-discovery. Although we are frail and weak creatures, we like to think that we can cope with everything that life throws at us. We are, therefore, often reluctant to link our depressed thoughts or anxiety to life situations, because such a link exposes our weakness and frailty. As a result, there is often a desperate search for a purely physical cause (e.g. a virus) behind our lack of well-being because that will enable us to keep viewing ourselves as “mentally strong” or as a “coper”.

This is not to deny that there are usually, to one degree or another, physical factors involved in causing depression (see previous lecture). Indeed, in some people, there is undoubtedly an inherited genetic tendency to depression. However, there is almost always a providential trigger involved to some degree. Just because we coped with great stresses at some time in our lives, does not guarantee that we will cope with lesser stresses at other points in our lives. We age, our hormones and brain chemistry change, responsibility increases as marriage and children come along. Sometimes the adverse reaction to life events will be delayed, even for some years.

Consequently, we often need an objective view of our lives; an independent person such as a doctor, or counsellor, or minister, who can help us look at our lives more objectively. It is often the case that when we are helped to review our lives, we begin to see the real and significant effects our problems or difficulties have had on us, and the extent to which they may have contributed to the trigger for our depression or anxiety.

II. THOUGHTS

Perhaps, the most obvious symptoms of depression are the unhelpful patterns of thinking which tend to distort a depressed person’s view of reality in a false and negative way, and so add to the depression or anxiety.

While we often cannot change the providences we have passed through, or are passing through, we can change the way we think about them so as to present to ourselves a more accurate and positive view of our lives, and so lift our spirits.

We will focus on ten false thought patterns which reflect and also contribute to the symptoms of depression. We will summarise each thought habit, and look at three examples of each, one from ordinary life, another from our spiritual life, and another from the Bible. The Biblical examples are not necessarily examples of depressed person but they are examples of false thinking often present in depression.

It is important to see how our depressed thought patterns affect our ordinary life; and even more important to see how that is then carried into our spiritual life. It is almost always that order in which our thoughts are transferred – false thinking in ordinary life is eventually transferred into our spiritual life.

1. False extremes

This is a tendency to evaluate our personal qualities in extreme, black or white categories – shades of grey do not exist. This is sometimes called “all-or-nothing thinking”.

Life example: You make one mistake in cooking a meal, and conclude you are a total disaster.

Spiritual example: You have a sinful thought in prayer, and conclude that you are an apostate.

Biblical example: Despite most of his life being characterised by God’s blessing and prosperity, when Job passed through a time of suffering he decided he must be an enemy of God (Job 13:24; 33:10)

2. False generalisation

This happens when, after experiencing one unpleasant event, we conclude that the same thing will happen to us again and again.

Life example: If a young man’s feelings for a young woman are rebuffed, he concludes that this will always happen to him and that he will never marry any woman

Spiritual example: When you try to witness to someone you are mocked, and you conclude that this will always happen to you and that you will never win a soul for Christ.

Biblical example: At a low point in his own life Jacob deduced that because Joseph was dead, and Simeon was captive in Egypt, that Benjamin would also be taken from him. (Gen.42:36). “All these things are against me,” he generalised.

3. False filter

When depressed we tend to pick out the negative detail in any situation and dwell on it exclusively. We filter out anything positive and so decide everything is negative.

Life example: You get 90% in an exam but all you can think about is the 10% you got wrong.

Spiritual example: You heard something in a sermon you did not like or agree with, and went home thinking and talking only about that part of the service.

Biblical example: Despite having just seen God’s mighty and miraculous intervention on Mt Carmel, Elijah filtered out all the positives and focussed only on the continued opposition of Ahab and Jezebel (1 Kings 19:10).

4. False transformation

Another aspect of depression is that we transform neutral or positive experiences into negative ones. Positive experiences are not ignored but are disqualified or turned into their opposite.

Life example: If someone compliments you, you conclude that they are just being hypocritical, or that they are trying to get something from you.

Spiritual example: When you receive a blessing from a verse or a sermon, you decide that it is just the devil trying to deceive you.

Biblical example: Jonah saw many Ninevites repent in response to his preaching. But, instead of rejoicing in this positive experience his mood slumped so low that he angrily asked God to take away his life (Jonah 4:3-4).

5. False mind-reading

We may often jump to negative conclusions which are not justified by the facts of the situations.

Life example: A friend may pass you without stopping to talk because, unknown to you, he is late for a meeting. But you conclude that he no longer likes you.

Spiritual example: Someone who used to talk to you at church now passes you with hardly a word, and so you decide that you have fallen out of her favour. But, unknown to you, the person’s marriage is in deep trouble and they are too embarrassed to risk talking to anyone.

Biblical example: The Psalmist one day concluded that all men were liars, a judgment which on reflection he admitted to be over-hasty (Ps.116:11)

6. False fortune-telling

This occurs when we feel so strongly that things will turn our badly, our feelings-based prediction becomes like an already-established fact.

Life example: You feel sure that you will always be depressed and that you will never be better again. This, despite the evidence that almost everybody eventually recovers.

Spiritual example: You are convinced that you will never be able to pray in public. Again, this

despite the evidence that though difficult at first, with practice almost everybody manages it.

Biblical Example: Anticipating the opposition that Jesus would face in Bethany, Thomas falsely predicted not only his own death there but also that of the Lord and the other disciples (John 11:16).

7. False lens

This is when we view our fears, errors, mistakes through a magnifying glass, and so deduce

catastrophic consequences. Everything then is out of proportion.

Life example: When you make a mistake at work, you conclude, “I’m going to be sacked!”

Spiritual example: You focus on your sins from the distant past in a way that leads to continued feelings of guilt, self-condemnation, and fear of punishment.

Biblical example: When Peter sinfully denied the Lord, he not only wept bitterly but decided that as his mistake was so spiritually catastrophic, there was no alternative but to forget about preaching Christ and go back to catching fish (Jn.21:3).

8. False feelings-based reasoning

In depression we tend to take our emotions as evidence for the truth. We let our feelings determine the facts.

Life example: You feel bad, therefore conclude that you are bad.

Spiritual example: You feel unforgiven, therefore conclude you are unforgiven. You feel cut off from God and so conclude that you are cut off from God.

Biblical example: At one of his low points, David felt and so hastily concluded that he was cut off from God. “I said in my haste, I am cut off from before thine eyes” (Ps.31:22).

9. False “shoulds”

Our lives may be dominated by “shoulds…” or “oughts”, applied to ourselves or others. This heaps pressure on us and others to reach certain unattainable standards and causes frustration and resentment when we or others fail.

Life example: The busy mother who tries to keep as tidy and orderly a house as when there were no children is putting herself under undue pressure to reach unattainable standards.

Spiritual example: The conscientious Christian who feels that despite being responsible for meals and raising children, that she ought to be at every prayer meeting and service of worship, and also reading good books and feeling close to God.

Biblical example: Martha felt deep frustration that Mary was not fulfilling what she felt were her obligations and complained bitterly about it (Luke 10:40-42).

10. False responsibility

This is when we assume responsibility for a negative outcome, even when there is no basis for it.

Life example: When your child does not get “A” grades you conclude that you are an awful mother. The reason may be instead that your child has a poor teacher or that his gifts are not of an academic nature.

Spiritual example: When your child turns against the Lord and turns his back on the church you assume that, despite doing everything you humanly could to bring him up for the Lord, it is all your fault.

Biblical example: Moses felt responsible for the negative reactions of Israel to God’s providence and was so cast down about this that he prayed for death (Num.11:14-15).

IMPORTANT

1. False thinking patterns are compatible with being a Christian.

2. False thinking patterns will have a detrimental effect on our feelings, our bodies, our behaviour, and our souls; usually in that order.

“For Christians, depression hardly ever has a spiritual cause…In Christians, spiritual effects follow from the depression, and seldom the other way around.”[2]

3. One of the first steps in getting better is recognising these false thinking patterns which do not reflect reality.

4. While we can do little if anything to change our providence (our life situation), we can change the false way we may think about our providence.

III. FEELINGS

Obviously, these unhelpful false thought patterns are going to give you unhelpful emotions and feelings. If you are always thinking about problems and negatives, or imagine the future is hopeless, or think everyone hates you, etc., then you are going to feel down very quickly. Your feelings about ordinary life and your spiritual life are going to reflect what you think in each arena (Prov.23:7).

Here, we shall briefly look at some of the emotional symptoms of depression. And, as with the area of our thoughts, let us honestly examine the area of our feelings in order to consider whether our emotions are related to a depressive tendency or illness. Also, as with the area of our thoughts, in this area of feelings we shall also highlight Biblical examples of true believers also experiencing such emotions, in order to show that such feelings are compatible with being a true believer.

1. Do you feel overwhelming sadness?

Everyone feels sad and down from time to time, but depression-related sadness is overwhelming and long-term. It often results in tearfulness and prolonged bouts of unstoppable sobbing.

Biblical Examples: Job (Job 3:20; 6:2-3; 16:6, 16), David (Ps.42:3,7).

2. Do you feel angry with God or with others?

A common characteristic of depression, especially in men, is a deep-seated and often irrational irritability and anger.

Biblical Example: Jonah (Jonah 4:4,9), Moses (Num.20:10-11).

3. Do you feel your life is worthless?

It may be that despite your life being highly valued by others, and despite you being useful to others and to the Lord, that because of your distorted view of yourself you feel your life is worthless. Indeed you may feel your life is just a burden to and a blight upon others.

Biblical Example: Job (Job 3:3ff), Jeremiah (Jer.20:14-18)

4. Do you feel extreme anxiety or panic?

“In anxiety, the person often overestimates the threat or danger they are facing, and at the same time usually underestimates their own capacity to cope with the problem.”[3]

Biblical Example: David (1 Samuel 21:12), disciples (Matt.8:25)

5. Do you feel God hates you and is far from you?

Although to any outside observer your past and your present may be replete with examples of God’s good favour towards you, you feel that God has either become your enemy or else has given up on you. You feel as if you are in spiritual darkness

Biblical Examples Job (6:4; 13:24; 16:11; 19:11; 30:19-23, 26), Jeremiah (Lam.3:1-3).

6. Do you feel suicidal or do you have a longing to die?

Biblical Examples: Job (Job.3:20-22; 6:9; 7:15-16), Moses (Num.11:14), Elijah (1 Kings 19:4)

These deeply depressed feelings are movingly articulated for us by the depressed Charles Spurgeon, when commenting on the experience of Heman in Psalm 88.

“He felt as if he must die. Indeed he felt himself half dead already. All his life was going, his spiritual life declined, his mental life decayed, his bodily life flickered; he was nearer dead then alive. Some of us can enter into this experience for many a time have we traversed this valley of death shade, and dwelt in it by the month together. Really to die and to be with Christ will be a gala day's enjoyment compared with our misery when a worse than physical death has cast its dreadful shadow over us. Death would be welcome as a relief by those whose depressed spirits make their existence a living death. Are good men ever permitted to suffer thus? Indeed they are; and some of them are even all their lifetime subject to bondage….….It is a sad case when our only hope lies in the direction of death, our only liberty of spirit amid the congenial horrors of corruption.... He felt as if he were utterly forgotten as those whose carcasses are left to rot on the battle field. As when a soldier, mortally wounded, bleeds unheeded amid the heaps of slain, and remains to his last expiring groan, unpitied and unsuccoured, so did Heman sigh out his soul in loneliest sorrow, feeling as if even God Himself had quite forgotten him. How low the spirits of good and brave man will sometimes sink. Under the influence of certain disorders everything will wear a somber aspect, and the heart will dive into the profoundest deeps of misery.[4]

IV. BODILY SYMPTOMS

“A merry heart doeth good like a medicine: but a broken spirit drieth the bones” (Prov.17:22). Thus does the Bible confirm for us the link between distorted thoughts or emotions and many of our bodily ailments. Every day, doctors are faced with patients complaining of various physical symptoms whose root problem is their depressed thoughts and feelings.

These bodily symptoms include abnormal sleep patterns (Job 7:4, 13-15), fatigue and loss of energy (Ps.6:6, 69:3), weight fluctuations (Job 17:7; 19:20), digestive problems (Lam.3:5), loss of appetite (Ps.102:4; 42:3), pain in various parts of the body (Ps.32:3-4 31:10; 38:3), choking feelings and suffocating breathlessness (Ps.9:18; 42:7; 69: 1-2) . In Psalm 32:3-4 the Psalmist describes the bodily consequences of true guilt, but the same can also be the result of false guilt.

V. BEHAVIOUR AND ACTIVITY

As we might expect, the impact of depression on our thoughts, feelings and bodies will inevitably have an effect on our behaviour and activity. This is usually seen in two ways. Firstly, we may stop doing things we enjoyed or that we were good at, or that were good for us. This may involve no longer going to church or fellowships, not contacting family and friends, or the cessation of hobbies and other beneficial leisure interests. Secondly, we may start doing things that make us feel worse like staying indoors, drinking alcohol, or pushing away people who care.

CONCLUSION

1. Assess the five areas of your life as outlined above, perhaps with the help of a trained professional, and try make an honest judgment about yourself. Remember that even one false thought pattern will have an adverse effect on your feelings, physical health, and activity patterns.

2. Try to remain open to the possibility that physical symptoms may well be related to depressed thoughts and feelings.

3. Seek medical advice regarding the suitability of anti-depressants for you.

4. Focus particularly on the area of your thoughts and try, with God’s help, to reverse false thinking patterns and recover and maintain a true view of God, of yourself, and of others.

5. Pray for yourself and others. Tell the Lord exactly how you feel. Neither Job, David, Elijah or Jeremiah “hid” their feelings from God.

6. Seek the sympathy of Christ. The words used to describe his mental sufferings in Mark 14:33 and Matthew 26:37 may be translated “surrounded with sadness” or “deeply depressed”. Charles Spurgeon wrote:

“When our Lord bore in His own person the terrible curse which was due sin, He was so cast down as to be like a prisoner in a deep, dark, fearful dungeon, amid whose horrible glooms the captive heard a noise as of rushing torrents, while overhead resounded the tramp of furious foes. Our Lord in His anguish was like a captive in the dungeons, forgotten of all mankind, immured amid horror, darkness, and desolation.”[5]

7. Believe the depression is part of the “all things” that are working together for your good (Rom.8:28).

If He had said, ‘Go out and preach ...', you'd have gone. If He'd said, ‘I want you to be a missionary', you'd have gone (possibly reluctantly, depending upon your own hopes and desires!). But because He has said. ‘Sit there and be depressed for a bit, it will teach you some important lessons', you don't feel that it is God calling you at all ... do you? Do you remember Naaman, who wanted to be cured of his leprosy? (See 2 Kings 5.) If he had been asked to do something glorious he would have been happy. Because he was asked to bathe in the murky old Jordan he wasn't so keen - yet this was God's plan for him, and it cured him. God has better plans for us than we have for ourselves - unfortunately, as we can't see into the future, we don't always appreciate just why God's plans are better. With hindsight it's somewhat easier! However strange it may seem to you, God wants you to go through this depression - so look at it positively, not negatively. What does He want you to learn from it? What can you gain from going through it? When you begin to think in this fashion your guilt feelings start to drop away. You can begin to understand that what is happening is part of God's plan for you - and so your depression is not a punishment from God. You are actually where God wants you to be, even if it is emotionally painful. To put it another way, if God wants you to go through this it it would be wrong for you to avoid it, wouldn't it?[6]

[1] D Martin Lloyd-Jones, The Christian Warfare (Grand Rapids: Baker, 1976), 206-208.

[2] Dr John Lockley, A Practical Workbook for the Depressed Christian (Bucks: Authentic Media, 1991), 53-54.

[3] Williams, Richards & Whitton, I’m not supposed to feel like this, (London: Hodder & Stoughton, 2002), 31. Williams, Richards & Whitton, I’m not supposed to feel like this, (London: Hodder & Stoughton, 2002), 31.

[4] Charles Spurgeon, Treasury of David, (Newark, Del.: Cornerstone, 1869), 2.131-132.

[5] Charles Spurgeon, Treasury of David, (1869: repr., Newark, NJ.: Cornerstone, n.d.), 1.261-262.

[6] John Lockley, Practical Workbook for the depressed Christian, (Bucks: Authentic Media, 2002), 18.


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