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Depression: a physical, mental, or spiritual problem?

January 5, 2010

The number of people that I’ve talked to in the last year who are struggling with depression has been staggering to me.  I read this post from JD Greear last week and it was so good I wanted to post it at length for you…

What are your thoughts on depression, specifically as it relates to chemical imbalance and other physiological factors?

I am not a trained counselor, but I do enjoy reading a good bit in the counseling arena. One of my favorite seminary professors was my counseling professor, as I remember how he used to be able to open the Bible up, and then me up, and then apply the Gospel to the most dysfunctional parts of my heart. Jesus preached like a counselor, and while I’m not a skilled one-on-one counselor, I really want to preach like a counselor.

All that to say, I’m not an expert here, but there’s 2 ways I think you can go wrong when it comes to the question of depression. You can treat it as all a problem of the body and environment (your chemicals are out of balance; you need more positive feedback; you’re not not getting enough sleep; you’re too stressed) and overlook the spiritual roots of the problem; or, on the other hand, you can treat depression as a spiritual problem without recognizing the physical and environmental questions.

Man is a psychosomatic unity (body and soul), and it is not easy to unscramble that egg. Both weave in and out of each other.

Here are a couple of things to think about:

1. Depression almost always has its roots in a problem we have with God. I know this might be a little jarring for some of you, so give me a chance to explain. It’s not nearly as out-of-touch as it may appear at first.

As David Powlison, Ed Welch, Tim Keller, St. Augustine and our own Sam Williams & Cynthia Mann have pointed out, depression almost always arises out of worshipping something in the place of God.

Depression usually arises because we are deeply dissatisfied with our lives or marriages or careers or bodies because, deep down in our soul, we think we need success in those areas to be happy. We either don’t believe God approves of us or we don’t give God’s approval enough “weight” in our lives. By believing the Gospel (that God’s approval of us is established and He could not love us more and His approval is the most valuable thing we need), we learn to trust and delight in God. The opinions of others, the beauty of our bodies, our marriages and families how well we’ve lived up to our own standards, etc, become less important to us because God’s approval and presence in our lives is so meaningful to us.

(Please note that I did not say “sadness.” Sadness, even deep sadness, is a legitimate response to life’s bereavements. Depression is where sadness takes over our lives–leading us to despair, making us wonder if life is worth living, if we have any worth, and that there is no purpose or joy in it all.)

Depression can also arise because we are deeply worried about the future. We are either not confident that He is sovereign, working all things according to His perfect plan, or we are not content with what He may send, or has sent, us in life. In other words, we are not satisfied with His plan and the sufficiency of His presence in our lives.

(If you know someone who struggles with depression, please don’t think that I am singling them out and saying they have spiritual issues that they are being punished for. As any person who even cursorily knows their heart will acknowledge, and as I will admit below, all of us, including me, have places where we still don’t really trust God and we are not satisfied with Him.)

2. Physiological and relational factors exacerbate our spiritual dysfunctions. As I mentioned, man is a psychosomatic unity. Having our “chemicals” out of balance, not getting enough sleep, not having good stress relief or a healthy family life can really cause our spiritual dysfunctions to flourish. Notice I didn’t say these things created the dysfunctions, only brought them to the surface. Chemical imbalances, stress, a lack of sleep, relational problems at home, and etc. are like pouring nitrus on a fire… they don’t create the fire, they just cause it to flare up uncontrollably.

Let me use a quick personal example. A few years ago I was really having trouble sleeping through the night. I would wake up about 3 am every night really worried about something in my life, or at the church… or just really “depressed” about some things going wrong in my life. I would get angry, sad… and I would feel almost hopeless. I would resolve to quit my job, yell at someone the next day, etc. But when I got up in the  morning and got going, those emotions were completely gone! I even told my staff that if I ever called them up at 3:30 am and fired one of them just to ignore it and come on into work the next day because I probably wouldn’t be angry anymore. I was shortly after diagnosed with a type of acid reflux, which was throwing my ‘chemicals’ off while I slept and creating bad moods. Taking medicine at night has taken away that problem. But don’t think the problem is entirely fixed… The chemical imbalance and the sleeplessness just allowed the fires of my idolatry to flare up. They revealed the mistrust and idolatry between me and God. They didn’t create those things, and the medicine didn’t make them go away. The right stress situations will bring them back out again. So, I have had to really try to apply the Gospel to those areas. As John Owen says, we take care of sin not by trimming off the fruits but by pulling up the roots. Learning and resting in the love of Jesus pulls up the roots of depression.

Now, please know that I don’t mean to trivialize your depression by comparing it to my acid reflux problems. I’m just trying to illustrate that for many people who go in and out of depression, there are significant chemical factors that trigger and exacerbate it. Part of your healing process may be seeing a Christian clinical psychologist who can help you take the medicines that can restore the physiological balance to your body, and that may help your “fears” and “sadness” to appear so large in your life. But that is not enough. You’ve only waved away the smoke and put a bandaid on the bleed. Depression is smoke from the fire of the altar at which you worship. Anger, depression, jealousy, etc can be helpful messengers pointing you to where idolatry exists in your life. Don’t simply wave away the smoke by medicating yourself. Use depression to get to the root of the issue and correct what is dysfunctional in your relationship to God.

Again, I know this is not a full answer… but if you are struggling with depression or you know someone who is, get some help. Our church employs 2 wonderful counselors, Sam Williams and Cynthia Mann. Both are fantastic. Get some help. What you are doing through is not uncommon–no spiritual problem is (1 Cor 10:13). And God has put the tools in His church to help you with it. Use them.

I would also suggest a few books that have really helped me on this issue, all available from my “recommended reading” page:

  • When People are Big and God is Small by Ed Welch
  • Seeing with New Eyes by David Powlison
  • Counterfeit Gods by Tim Keller
One Comment leave one →
  1. January 5, 2010 11:58 pm

    Great post–Just wanted to weigh in on this based on my experience with depression.

    Though I’ve always struggled with times of being overly emotional and battled some different self-destructive compulsive tendencies, I never made it to the point of needing antidepressants until I developed some chronic health conditions in September of 2007. At that time, I was faced with the reality that my life as I knew it may be forever changed. I may not be able to have children, I definitely would not be able to spin as many “plates” as I used to. I felt like I wouldn’t be “me” anymore, and my plans for the future were no longer realistic. So, I guess for me it was a physical issue that set it off, but at the same time was spiritual b/c I was not sure how to trust God with the new reality.

    One thing that is for sure, it is extremely difficult to be a Christian dealing with depression. Before going through this, I honestly always looked down on people and judged them for “relying on medication rather than God.” I’m still conflicted about antidepressants in that they can numb your emotions to the point that you fail to recognize the true root of the issues that are causing pain. Pain is there for a reason–it tells you that something is not right, whether it be with your body, your mind, or your relationship with the Lord. At the same time, the Christian community is overly quick to brush off the pain and suffering of fellow believers by just saying that they need to pray about it or get into the Bible more–though those things are necessary, someone who is truly depressed often needs something to jolt them out of the emotional hole they’ve created. I was so ashamed to be on anti-depressants b/c my prideful nature made me think that it meant I had failed in my relationship with God. It’s just hard. During times like that, it is absolutely imperative to have a strong support system in the body of Christ.

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