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Beating Depression

Summer 2003

From triple helix - Summer 2003 - Beating Depression [pp14-15]

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Psalms 42 and 43 give a good description of the clinical features of depression and provide assurance that depression is both part of normal human experience and understood by God. The psalmist describes the depressed person's mood changes, loss of appetite, grief and mourning, difficulty in planning and paranoia. The immediate cause is not clear - but may have been due to circumstances, as a result of physical symptoms or spiritual. Depressed people often find prayer difficult so need friends who will pray for them, encourage them to put their hope in God and remind them that better times will come.

One of the glories of God's Word is that it speaks of human experience just as vividly now as when first written. For a detailed account of the vicissitudes of old age look no further than Ecclesiastes 12:1-7, which describe fading eyesight, poor dentition, tremor and fear of falling. Or perhaps Proverbs 23 :29-35 for the experience of the bloodshot, bruised, swaying and hallucinating alcoholic. Depression is commonly diagnosed in general practice and up to half of us may suffer depression at some time in our lives. Might there be something in God's Word to describe depression? I believe psalms 42 and 43 give us a good insight.

All of us will come across depression at some time, whether in ourselves or others. These psalms suggest that it is a common part of the human experience and give us a clear view of how it feels to be depressed. The psalmist describes his mood as 'downcast' and 'disturbed' three times. He says, 'tears have been my food,' suggesting a chronicity to his condition, and perhaps loss of appetite. His depression has physical sensation, 'My bones have suffered mortal agony' with perhaps an indication of morbidly expecting his own death. Depressed people often have feelings of grief and mourning either as a cause or effect of depression, 'Why must I go about mourning' occurring in both psalms 42 and 43. He has feelings of chaos, represented by the deeps in the waterfall, and of being overwhelmed: 'all your waves and breakers have swept over me.' Many depressed people do seem to struggle with organising their thoughts and feel out of control. Planning in depressed people may become difficult: 'When can I go and meet with God?' Paranoia-like feelings may occur in depression and are described in 43:1.

Since there is such a detailed description of depression in God's Word, we can reassure depressed Christians that God understands the depressive condition. Some depressed people report feeling guilty that they do not feel happier, considering all of God's gifts to them. These psalms give us 'permission' to be depressed.

The cause for the psalmist's depression is not clear. The cause may be spiritual; a felt separation from God. One of the striking features of these two psalms is this feeling. From the beautiful and wellknown opening verses of Psalm 42 describing thirsting for God, he asks rhetorically, 'where can I go and meet with God?' and poignantly, 'why have you forgotten me?' This separation is felt rather than real as Romans 8:39 reassures us that 'neither height nor depth nor anything else in all creation will be able to separate us from the love of God that is in Christ Jesus our Lord.' His sense of separation from God may be either a cause or a consequence of his depression. Certainly no Christian can be content or complete without fellowship with God.

Perhaps it is his circumstances that are causing his depression. He is separated from his fellows and may be lonely living in Jordan away from his Jerusalem home. Perhaps he has withdrawn from his friends as a result of his depression. Persecution undermines the toughest man (Ps 42: 3), and the depressed Christian maybe more susceptible to mocking, 'Where is your God?' Physical symptoms can be a cause or at least a precipitation for depression. It might, however, be argued that the psalmist rejects any of these as the cause of his depression as he repeatedly asks why he is depressed. The Christian depressive and his attendants may find it difficult to separate cause and effect; spiritual, physical or emotional. Since the answer eloquently stated in these psalms is to turn to God, this may not matter very much anyway.

Some of the distortion and slowing of mental processing which may occur in depression can prevent the depressed Christian from praying to God for himself. The practical effects of this means that his Christian friends may need to do the praying for him. The very fact of the depressed person's inability to pray can add to his feelings of guilt. Since he may already have low self-esteem and low self-confidence or even paranoia, he will not find it easy to express this inability to Christian brothers and sisters. These two psalms then give us one way to pray for, and counsel, the depressed Christian. We can point out that the depressed person should try to put their hope in God, for he sends forth his light and truth, which will guide our depressed brother. We can reassure our brother that he will praise God again and that God will be his delight (43:3-4), even if he doesn't feel it possible at that moment. The psalmist makes a deliberate decision to put his hope in God (42 :5, 11, 43:5). He is entirely confident that God will respond - that God will send forth his light, guide him, and that he will be with God on his Holy Mountain, where there is no chance of depression.

I am very grateful to my friends, brothers and colleagues, Dr Leon LeDune and Dr Joss Bray for their helpful criticism and comments.

Psalm 42

For the director of music. A maskil of the Sons of Korah

1 As the deer pants for streams of water, so my soul pants for you, O God.
2 My soul thirsts for God, for the living God. When can I go and meet with God? .
3 My tears have been my food day and night, while men say to me all day long, 'Where is your God?' .
4 These things I remember as I pour out my soul: how I used to go with the multitude, leading the procession to the house of God, with shouts of joy and thanksgiving among the festive throng. .
5 Why are you downcast, O my soul? Why so disturbed within me? Put your hope in God, for I will yet praise him, my Savior and .
6 my God. My soul is downcast within me; therefore I will remember you from the land of the Jordan, the heights of Hermon-from Mount Mizar. .
7 Deep calls to deep in the roar of your waterfalls; all your waves and breakers have swept over me. .
8 By day the LORD directs his love, at night his song is with me- a prayer to the God of my life. .
9 I say to God my Rock, 'Why have you forgotten me? Why must I go about mourning, oppressed by the enemy?' .
10 My bones suffer mortal agony as my foes taunt me, saying to me all day long, 'Where is your God?' .
11 Why are you downcast, O my soul? Why so disturbed within me? Put your hope in God, for I will yet praise him, my Savior and my God.

Psalm 43

1 Vindicate me, O God, and plead my cause against an ungodly nation; rescue me from deceitful and wicked men. .
2 You are God my stronghold. Why have you rejected me? Why must I go about mourning, oppressed by the enemy? .
3 Send forth your light and your truth, let them guide me; let them bring me to your holy mountain, to the place where you dwell. .
4 Then will I go to the altar of God, to God, my joy and my delight. I will praise you with the harp, O God, my God. .
5 Why are you downcast, O my soul? Why so disturbed within me? Put your hope in God, for I will yet praise him, my Savior and my God.

Further Reading

  • Jones S and Butman R. Modern Psychotherapies. Downers Grove: IVP 1991
  • Hurding R. The Tree of Healing. Grand Rapids: Zondervan 1985
  • Crabb L. Effective Biblical Counselling. London: Marshall Pickering 1977
  • Hicks P. What could I say? IVP 2000. £9.99 Pb 305pp, ISBN 085115381
  • Williams C, Richards P, Whitton I. I'm Not Supposed to Feel Like This. Hodder and Stoughton 2002. £6.99 Pb 280pp, ISBN 0340786396
  • Lockley J. A Practical Workbook for Depressed Christians. Authentic Publishing, 2nd edition 2002. £12.99 Pb 478pp, ISBN 18624226X
  • Townsend A. Good enough for God. Triangle (SPCK) 1996. £5.99 Pb 144pp, ISBN 0281049610

Depression

Non-drug therapy

Psychoanalysis
  • Classical Freudian psychoanalysis is based on a naturalistic philosophy and underlying determinism
  • Psychoanalysis of Carl Rogers is based on liberal humanism
  • Both conflict, at least in part, with Christian theology
Behavioural Therapy
  • Based on behaviourism and determinism
  • This robs man of his significance and personal responsibility
Cognitive Behavioural Therapy
  • Loosely based on behaviourism but this is much less strictly adhered to
  • The morality of the therapy can be determined by the shared beliefs of the therapist and patient, making the technique adaptable to Christian counselling
Drug therapy
  • Well established and evidence-based
  • Morally neutral but may fail to recognise the psychological, social, spiritual and environmental factors in the development and maintenance of mental illness

For further information see articles written by Consultant Psychiatrist Nick Land: Psychiatry and Christianity (parts 1 and 2):

  1. Nucleus 2002; July: 13-19
  2. Nucleus 2003; April:12-20


Article written by Paul Vincent

More from triple helix: Summer 2003

  • Patient (Assisted Dying) Bill - A dangerous document that Christian doctors should oppose
  • The Sexual Health Enquiry - Good on diagnosis but offers an ineffective Prescription
  • Designer babies
  • Homeopathy
  • The United Nations Population Fund
  • How to heal the culture
  • Keeping Lists
  • When do contraceptives work?
  • Beating Depression
  • Meeting God in hospital
  • Spirituality and health
  • Eutychus
  • Letters
  • Doctors and Patients: an anthology (Book Review)
  • Culture of Life - Culture of Death (Book Review)
  • Building the Body: Transforming Relationships in the Local Church (Book Review)
  • Journeys of Faith. Churchbased responses to HIV and AIDS in three southern African countries (Book Review)
  • Anxious Christians. Psychological Problems and The Christian Faith (Book Review)
  • When prayer seems unanswered
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