DEALING WITH DEPRESSION

“Why art thou cast down, O my soul? and why art thou disquieted in me?” (Ps 42:5a).


Depression is an age-old and a very common problem. Some of us may have experienced it ourselves, or know of friends or relatives who had. Though the word ‘depression’ is not found in the Bible, there are numerous passages which suggest that various persons did experience depression or at least symptoms of depression. Amnon lusted after his half-sister Tamar so intensely that he was “vexed” and “fell sick” for her (2 Sam 13:2). Ahab coveted Naboth’s vineyard so much that “he laid him down upon his bed, and turned away his face, and would eat no bread” (1 Kgs 21:4). Ahithophel was so depressed that his counsel was not followed by Absalom, that he hanged himself (2 Sam 17:23).


Moreover, a believer who had experienced depression himself or herself will no doubt identify with numerous of the Psalms as probably referring to a state of depression. I well remember Dr. Tom Holland, a Calvinistic Baptist minister, speaking from his own experience to show how Psalm 22 was probably written by David at a time when he was depressed or experiencing depression. Although I would have difficulty preaching Psalm 22 this way, I was intrigued by Dr. Holland’s insight. The more famous doctor, Dr. Martyn Lloyd-Jones, begun his series of messages on “Spiritual Depression” with the verse we cited at the head of this article (see his Spiritual Depression: Its Causes and Its Cure [Eerdmans, 1965]).


I have no doubt that David was in fact expressing feelings of depression when he penned those words, under inspiration. Perhaps, this verse and numerous parts of the Psalms were so inspired partly so that they may be of help to Christian men and women throughout the ages, who would experience similar kinds of depression. But let’s look at Psalm 42:5. There are three things we may learn about the nature of depression from this verse.

Nature of Depression

Firstly, we note that depression involves a baffling feeling of sadness, hopelessness, anxiety, despondency and/or inability. In the context of Psalm 42, David was being pursued by Absalom his son, and he was prevented from doing what he greatly delights to do, namely to worship the LORD with the saints (vv. 1–4). Obviously David knew the reasons for his present predicament. Yet, he asked: “Why art thou cast down, O my soul? and why art thou disquieted in me?” (Ps 42:5a). He was, as it were, baffled by his own feelings.


Secondly, we note that depression involves introspective confusion. David felt that he was “disquieted” within. The word translated ‘disquieted’ (hamah, in Hebrew literally means ‘murmur,’ ‘growl’ or ‘roar.’ David felt a murmuring or growling spirit within. We may say that he was hearing himself complaining about his own situation and feeling terrible about it.


Thirdly, we must not forget that depression involves the soul. Note how David locates his feelings in the soul. We must not neglect the fact that depression could also have bodily causes, especially in what may be known medically asendogenuous depression (contra reactive depression), which may result from a biochemical imbalance in the brain. However, we must not forget the fact that depression always involves the soul—even if in a particular case, it may not be the primary cause. This is because the human being, in this life, cannot be cleanly dichotomised into soul and body. There is such a complex inter-relationship between the two parts of our being, that especially in matters of emotion, it is practically impossible to isolate it as being entirely spiritual or entirely biological. Thus, spiritual causes and remedies must not be ruled out in whatever case of depression.

Causes of Depression

There are many different causes of depression. But let me begin with thephysique and disposition of a person. I am referring to the fact that God makes us very different from one another, and some of us may be more prone to depression than others. David was probably a man prone to depression. It is not necessarily a bad thing to be prone to depression. There were many great men in the past who were thus inclined: Jeremiah, Elijah, perhaps John the Baptist, Martin Luther, Charles Haddon Spurgeon, Henry Martyn, Martyn Lloyd-Jones, etc. These could be prone to depression due to a variety of reasons, such as their introspective or introverted disposition. Or, it could be due to some physical illnesses or physical limitations they had to live with.


Some claim that genes have a contributing factor. The result of seven studies involving twins in the United States and Europe suggests that in the case of identical twins (who are genetic carbon copies of each other), in 76% of the time, when one sibling is affected by mental disorder, the other would also be similarly affected. This compared with 19% in the case of fraternal twins. A related study based on reports in psychiatric literature suggests that in the case of identical twins who were raised apart and so did not experience the same environment, the percentage drops to 67%. This data, if correct, suggestthat there is a genetic link to one’s propensity to depression. However, it also suggests that the genes are not the only cause and cannot be blamed for every case of mental disorder or depression, since in 33% of the cases, when one of the identical twin had a disorder, the other did not. Moreover, this study does not indicate how much regeneration, which involves the soul, and living in obedience to the Word of God, would affect the percentages.


The second cause of depression is reaction to the circumstances in which we find ourselves. Ahithophel fell into depression and committed suicide in reaction to failure. David was depressed because of a frustrating circumstance. Elijah fell into depression in reaction to great blessings followed by an unexpected turn. He had just experienced the power of God on Mount Carmel and saw the LORD sending the rain in answer to his prayers. He had high hopes that Israel would finally turn back to the LORD. Instead, he received news that Jezebel was going to kill him and he became so depressed, he wanted to die.


In our present context, death of a loved one, failure in examinations, break-up of a cherished relationship, business failures, marital strains, lost of jobs, etc., can all be causes of depression.


The third cause of depression, a very major one, is unbelief. Note David’s words in Psalm 42:5, “Why art thou cast down, O my soul? and why art thou disquieted in me? hope thou in God: for I shall yet praise him for the help of his countenance.” Notice how David recognises that his failure to trust and hope in God is one of the causes of his present internal turmoil. Reason should show us that most of the occasions for depression given under the second cause above would have little effect, if only we fully trust the Lord that He is sovereignly directing all things together for the good of His children (Rom 8:28). For example, one who fails an examination despite having tried very hard, really needs not feel frustrated or depressed, if he learns to submit to the will of God. Or similarly one who has broken up in a relationship or lost a job would not feel depressed if he sees clearly that God has other plans for him. It is because we do not see the future and because we fail to trust the Lord with our future that we become depressed. The Lord surely knows our heart when He exhorts us to seek first His kingdom and His righteousness rather than worrying about tomorrow (Mt 6:33–34).


The fourth general cause of depression is disobedience and guilt. David wrote the 32nd Psalm sometime after he was confronted by the prophet Nathan for his adultery with Bathsheba and murder of her husband. Listen to his expression of guilt: “When I kept silence, my bones waxed old through my roaring all the day long. For day and night thy hand was heavy upon me: my moisture is turned into the drought of summer” (Ps 32:3–4). He felt as if his bones were decaying. There was no soundness within. He felt listless and helpless. Something was rotting within, but he could not do anything about it. He groaned his heart out, but he found no relief. At the same time, he felt as if God’s heavy hand was pressing upon him. God, who was a friend in Christ, had become, as it were, his enemy. When He thought about God, he could no longer conceive Him as a loving heavenly Father. All he saw was an angry judge and king. He felt crushed under the weight of his sin and the wrath of God. And he felt like a helpless man in the desert craving for water to ease his discomfort. He felt his energy sapping away and life becoming so meaningless as joy fled him. Does this not suggest that he was experiencing depression or sinking into depression?


The fifth cause of depression is that which particularly affects women, namelychildbirth. It is estimated that maternal blues is experienced by 70 to 80% of all new mothers in the first days or weeks following childbirth. Normally this begins between the third or fourth day of childbirth and lasts no longer than two weeks. It is characterised by rapid mood swings, a tendency to burst into tears, irritability and even hostility towards others, including the husbands. Many believe that the cause is primarily biological as every new mother experiences a rapid decline of hormones (estrogen and progesterone) as the body adjusts from pregnant to non-pregnant states.


However, many other reasons associated with childbirth could also cause depression, such as (a) when expectations clash with reality, such as when an expectant mother is eagerly looking forward to an angelic little baby but is met by a sickly or colicky child who is extremely demanding; (b) a change from having a structured 9 am to 5 pm work-week to an unstructured round-the-clock single-handed looking after the baby; (c) lack of sleep and fatigue; (d) conflicting feelings of becoming a mother; (e) undesirable customs imposed by mothers or mother-in-laws; (f) undue pressure or lack of support to breast-feed the baby; (g) social isolation, etc.


The final cause of depression is the devil. Lloyd-Jones is quite right when he says:

In a sense, and in the last analysis, that is the one and only cause of spiritual depression—it is the devil, the adversary of our souls. He can use our temperaments and our physical condition. He so deals with us that we allow our temperament to control and govern us, instead of keeping temperament where it should be kept. There is no end to the ways in which the devil produces spiritual depression. We must always bear him in mind. The devil’s one object is so to depress God’s people that he can go to the man of the world and say: These are God’s people. Do you want to be like that? (op. cit., 19).


The devil will take advantage of all our infirmities to make us doubt and to drive us to self-pity and so depression. Remember, however, that the devil does not plant thoughts into our minds. It is always our thoughts and our emotions. The devil simply makes use of them for his own purpose. So do not go around attempting to distinguish whether a thought is planted there by the devil or by God or by yourself. Such an exercise is not only futile but dangerous.

Remedies Against Depression

There are so many different causes of depression, that it is extremely difficult to prescribe any useful remedy in this short article. Let me therefore suggest a few general principles for purpose of awareness, and leave you to seek further pastoral counselling if you find yourself sinking into depression. I am aware that in many instances of depression, whether major or mild, the depressed person may not want any help at all. So this article is both to prepare you, should you find yourself depressed as well as to prepare you to help others, be it your family members or brothers and sisters in Christ.


The first general remedy, I believe is to pray. This is particularly necessary if the depression is brought about by crippling guilt. Notice David’s experience as recorded in Psalm 32: “When I kept silence, my bones waxed old”. I acknowledged my sin unto thee, and mine iniquity have I not hid. I said, I will confess my transgressions unto the LORD; and thou forgavest the iniquity of my sin” (Ps 32:3–5). David was joyless as long as he remained silent concerning his sin, but he found relief when he begun to confess to the Lord. The Apostle Paul, referring to a joyless condition which would be included in a depressed state, also recommended prayer:

Rejoice in the Lord alway: and again I say, Rejoice.… Be careful for nothing; but in every thing by prayer and supplication with thanksgiving let your requests be made known unto God. And the peace of God, which passeth all understanding, shall keep your hearts and minds through Christ Jesus (Phil 4:4–7).


In other words, if you feel depressed, do not continue to dwell on your own feelings, but look to the Lord Jesus Christ, casting your anxieties upon Him because He cares for you.


The second remedy is to talk to yourself. This may sound strange and contradictory, for in a depression a person is introspective and tends to be led about by many suggestions in his heart: “I am so depressed…,” “I can’t do anything…,” “I better not do anything or I may make matter worst…,” “It’s all my fault…,“ etc. Why then do I recommend that you talk to yourself? Well, remember that there is a difference between talking to yourself and talking withyourself. When you talk with yourself and listen to yourself talk about your feelings and inability, you are likely to sink deeper into depression. But when you talk to yourself to exhort yourself, it makes a difference. Again David demonstrated that. “Why art thou cast down, O my soul? and why art thou disquieted in me? hope thou in God: for I shall yet praise him for the help of his countenance” (Ps 42:5). Notice how David questioned himself rhetorically, and then called himself to do what is right. He knew that he was not trusting the Lord, and he told himself to trust in the Lord. You may have experienced it yourself. Sometimes when I am particularly discouraged by things that happen in the ministry, and I feel like Jeremiah, I would not only go to the Lord, but stand before the mirror and exhort myself from the Word of God, and I find myself comforted or stirred to continue the work. A ministerial friend of mine once shared with me that he would preach to himself before the mirror before he preach to his congregation, and that he is encouraged by his own sermon! I did not understand what he meant until I had occasion to do what David did: to exhort himself and to encourage himself in the Lord (1 Sam 30:6).


The third remedy is to attend to all duties against and regardless of feelings. When you are depressed you will feel very despondent and will tend not to want to do anything. You feel like just sitting down and sulking. But if you do that you will simply spiral down into further depression, as guilt related to duties undone began to beset you. A father, who is depressed because of job lost and so fail to lead the family in worship, will soon become more depressed because he is failing in his duties as a father. A mother who is depressed because she hardly sees her husband may become even more depressed as she began to neglect her household chores, e.g., of ironing, cooking, washing, etc. What is the remedy but to wake up and do something which had been neglected!


When you are depressed, it is unlikely that you can do anything about your feelings. So it may be futile to try, for as you are trying, you are likely to accumulate more reasons to feel bad. Therefore ask yourself rather: (a) What duties am I neglecting (including attending to the means of grace)? and (b) When, where and how shall I begin? Then begin to take the first step as soon as possible, and list the rest down, and resolve to do them as soon as you have completed the first task. As you attend to your duties, and conquer one small step at a time, you will begin, as it were,—in the words of Jay E. Adams,—to “spiral upwards” in recovery.


Fourthly, I would recommend that if you remain depressed for more than a few days, that you seek pastoral counselling before it gets worst. Let your pastor help you if he can, and let him recommend you to see a doctor if necessary—if he has reason to suspect that you are facing a major depression with a biological cause.


Finally, for our mothers (and fathers), maternal blues will usually go off after a few days, though it has been estimated that in about 10% of the cases, the maternal blues develop into major postpartum depression that may last a long while and need medical help. Major postpartum depression can be mild, moderate or severe enough to include suicidal thoughts and require hospitalisation. Symptoms include rapid mood swings, insomnia or hypersomnia, serious inability to concentrate, irritability, panicky feelings, withdrawal and isolation even from the husband, obsessive thoughts about baby falling or being stolen, etc. Thus, if you find yourself being depressed for more than a month after delivery of your child, it would be prudent to see your pastor, who will recommend medical help if necessary.


Other than that, just be prepared for it, and make sure your husband is prepared for it and lend you a supporting shoulder rather than reacting impatiently with hurting words, such as: “Snap out of it! Don’t be unreasonable! Stop crying for no reason!” Do not feel ashamed to ask for help or counsel from older believing women who have had experience with childbirth and child-rearing. Here, the husband should lend a hand because when your wife is feeling depressed, she may not want to talk to anyone. You may just have to initiate the call for her. Call someone she respects, whom you know can be of counsel and help. But mothers, I would urge you to persevere on in your motherly duties despite your feeling depressed. The Lord will be your help and will surely deliver you out of your doldrums and grant you the joy of motherhood as you trust in Him.

Conclusion

Lloyd-Jones is right, is he not: “In a sense a depressed Christian is a contradiction in terms, and he is a very poor recommendation for the gospel” (Ibid., 11)? There are many people in the world who are excited about what they believe in, whether it be soccer or some latest craze promoted by the toy or film industry. They talk excitedly about their idols, and it rubs off on others. But too many serious Christians seem to be always in the doldrums, and give an appearance of lack of freedom and joy. I am, of course, not talking about the Charismatics who are excited about everything but the pure Gospel. I am talking about serious-minded disciples of Christ. If we persist in our doldrums, we would give a foothold to the devil to cast doubt on the credibility of the Gospel. May the Lord grant that as a sanctified people we will not only be aware of ourselves and of the devil’s schemes, but seek to be a joyful people constantly excited about the Lord Jesus Christ. Let us not allow the devil to take advantage of our infirmities in the remnant of our corrupt nature, but be ever diligent to serve the Lord until the day we finally put off this body of sin. Amen.

JJ Lim