What a bold title! Well, at least I got your attention. But really, I hope to briefly unpack what I think will be a helpful set of four things to consider if/when you are struggling with depression and anxiety and/or trying to help someone else who is in the midst of such a crisis.
The evangelical church has struggled to get on the same page and to hold a Biblically robust view of depression and anxiety (DA). Therefore, how to diagnose it, treat it, and persevere in it is a debate and often argument among different Christians, professional, pastoral, and laity. One of the reasons for this is that certain schools of thought or theological dispositions tend to focus on only a part of the issue. As I have thought about this, as a pastor that counsels many with DA, who has had my own bouts with DA, and who comes from a family that has a history of DA, I think it would do us well to have a multidimensional understanding and approach to diagnosis, treatment, and also the notion of what it means to suffer well in something that may never go away this side of heaven. What I want to propose is that there are four things to consider in the realm of DA. If we have a theology and psychological method that does not take these four into account, my sense is that the understanding, treatment, and pastoral approach will be less than helpful. Not all four factors will be a part of every crisis or longterm situation, but all four must factor into our theology and practice in the big picture.
Everyone will struggle with DA at some point. Everyone is going to feel the pangs of loss, disappointment, relational hurt, etc. Most DA is short term and a result of a painful experience. DA in such cases is a natural response to living in a fallen world with fallen circumstances. If losing a job, losing a loved one, losing a dream, losing financial stability, or losing reputation does not lead to some form of DA, you are probably not actually alive anymore. DA is natural in these situations and is not necessarily a sign of something deep in the soul or longterm. Most of the DA I experience is this kind. When something hard happens to me, extrinsically, and I react with DA – God’s psychological nerve ending of pain kicks in, if you will.
Victimization is like circumstance in that causality is outside of us, but what I have in mind here is affliction at the hands of a person, or group of people, or situation, that was long term, very powerful, and the affects are long lasting. An example is physical or sexual abuse. That kind of an experience can permanently scar someone with longterm DA. To some degree, all of us are victims in this way. It may have been a parent who was chronically distant, or we had a childhood within financial poverty, or we got picked on a lot as a kid. It may not have been fraught with deeply troubling sin or pathology, but it was scarring nonetheless. Many people carry around a residual DA because of that. In other cases, where the sin was horrendous and vicious, the scar is massive and the DA is debilitating.
Understanding and treatment in this area must factor in moving out of being defined by those experiences, finding healing in the Gospel, and often the work of grace to enable us to forgive our brutalizer. New thought patterns have to be formed. And, we must not try to relive our lives by our present efforts or through someone else in order to find healing. Healing is with Jesus, regardless of what specific method is used to help.
This is the one area we conservative Christians have not paid enough attention to, or seen to be in accord with the Bible. This is a hard one because it may not have a circumstantial cause. Some people are chronically depressed and not because of their bad decisions or someone else’s, or a moment of affliction, but just because. What’s going on? Some people are born with a disability, and that disability is a bio-chemistry that causes them to experience DA, frequently. Now, life still happens, hard circumstance and victimization can still happen, but those tend to reinforce and worsen the affects of bio-chemistry, so there is a double whammy for many who experience bio-chemical depression. I have a history of this in my family. It is hard and scary. But, it must be accepted as a reality for some people.
In this case, medication may be a good idea. The decision to take meds is not a sign of punting, or slacking, or not living by faith. It can be a wise stewardship of technology to help you with a physical disability. My only caution is not to make it all about the meds. There is still a spiritual reality that your life is ultimately a part of, so Jesus is still the centerpiece of dealing with bio chemical DA.
Do not neglect that we are in a battle not of flesh and blood. Satan is assailing our hearts with lies. That can cause DA. Often after a sermon, one that seemed especially Spirit filled and effective, I feel afflicted. I can struggle the rest of Sunday with anxiety, self loathing, and questions as to my call and effectiveness as a preacher and pastor. Many, many pastors have experienced that in church history. Why? The servant of God is an afflicted creature. Satan is going to go after those who glorify the Son of God. You better believe that some forms of DA are a result of spiritual attacks. The key in treatment then is to do what the Bible says to do: put on the full armor of God, rest in the protection of Jesus, assail Satan back with the Word of God, and do not trust the feelings you have since they are lies from the pit of hell. You must at that point believe what the Gospel says about you: you are loved, accepted, and have an eternal hope and reward with God because of Jesus.
There are Christian counseling camps that say DA is always a result of personal sin and that treatment then is about repenting of that sin and believing truth about God. We have to be more nuanced than that, because the Bible is. Sin is not necessarily the reason for DA. Often it is not. Sometimes it is. We have to study each situation.
But, we cannot overreact to the sin-only school and throw sin out as a part of every form of DA. It is a part of all DA. Am I contradicting myself? No. The issue is causality. The Bible does not require that DA is caused by sin. In many cases, personal sin is not the reason we are depressed. But, because of Adam’s sin in Genesis 3, because we live in a fallen world, and because our personal sin commingles with all our feelings, decisions, actions, and words, we have to factor in how sin can worsen all forms of DA and that our application of the Gospel to our hearts is the most foundational means of growth, healing, and perseverance. So, DA may be bio-chemically caused, but sin can reinforce it, strengthen it, and delay its resolution. And, fighting with faith in God’s promises by the power of the Spirit can lessen its impact, hasten resolution, and allow us to experience a vision of Jesus we could not otherwise have. In other words, while causes may vary, the core of treatment must always incorporate Biblical truth, Gospel belief, and walking in step with the Spirit. Psychology can help us in some methods of treatment, but not at the expense of a Biblical understanding of our hearts, our minds, and our souls.
In conclusion, each form and experience of DA is unique but all four of the above should be considered with the last one being the aspect that is the common thread in each. So, for me, when I struggle with DA, while I may be experiencing a short term sense of loss, or a longterm brain chemistry thing, or feel attacked by Satan, I must always seek Jesus in prayer and Word and have him meet me in my brokenness. He may not fully make it go away. He often does not. But, he can be present, and he often brings joy and purpose. In fact, I have grown more spiritually and in my vision of God during times that produced DA or were defined by DA than any other time. God hammers us into beautiful objects on the anvil of affliction. Remember that.
Whether you want to understand your own DA, or you want to help others, or you are a professional counselor, please think about these four parts of depression and anxiety.