Lesson 7

Depression

Sharon was seventy-five when her husband died. After his death, she developed symptoms similar to those she had experienced half a century before, when she gave birth to her daughter and suffered postpartum depression. In addition to profound sadness, she complained of having no energy and no appetite and of not being able to get a goodnights sleep. She began to feel that she could no longer handle the tasks that she had cared for previously, and the thought of adding to her burden the matters her husband had been responsible for, such as banking, insurance, and the maintenance of her car, overwhelmed her. Additionally, though her religion had always been important to her, she no longer wanted to pray.

Sharon new that she needed medication to alleviate the terrible pain of depression she was experiencing, and she had no objection to placing herself under the care of a doctor to obtain them. But she also knew that psychiatric drugs weren’t the complete answer to her problem and that she’d also need counseling. The doctor she saw helped her find the right kind of medicine, and she recommended a good counselor who had worked extensively with older people.

This counselor, a middle-aged woman, was so warm and sympathetic that Sharon soon took a liking to her weekly appointments. There she could talk about her past and her current life and all the feelings and emotions she experienced. The therapist was a good listener and knew how to ask questions that encouraged Sharon to talk more.

Just talking with the assurance that the person listening cared about her and that their conversation was strictly confidential helped Sharon to start feeling better. Her self-confidence grew, and she felt the desire to learn the new tasks that her widowhood demanded. Once again, she found enjoyment in going out, relating to people, and eating, and she recovered from her insomnia. The counselor also sent a volunteer to help Sharon understand the paperwork her husband used to do and who kept visiting her regularly to make sure she was on top of things. And as soon as Sharon felt a bit better, she took up prayer and Scripture reading again, which also helped her immensely.

The number of people who experience depression has been growing dramatically since World War II. Depression is now the most common mental disorder. According to the World Health Organization, depression effects about 121 million people worldwide and is the number one cause of disability in terms of numbers of years live with disability by the people who contract it. In the United States alone, it touches between 10 and 25 percent of women and between 5 and 12 percent of men. This problem affects people of all ages, classes, races, and backgrounds, as well as the myriads of family members and friends who live near the afflicted person.

Symptoms of major depression include depressive mood, absence of interest in or pleasure from favorite things, lack of energy, lack of appetite, sleep disturbances, motor retardation, feelings of low self-esteem or guilt, cognitive limitations, and suicidal thoughts or behaviors. (Some 10 to 15 percent of people with major depression manage to take their lives) A solid diagnosis can be made when someone experiences five or more of these symptoms persistently for more than two weeks. Just three or four of the symptoms can make a person feel miserable without being officially depressed.

Religion and Depression

Many secular psychotherapists used to charge that religion was a cause of depression. They argued that guilt-prone believers suffered from depression because religions impose rules that people can’t keep, and religion minimizes the inner goodness of people and completely ruins their self-esteem. This perspective has changed considerably. In the past two decades, a large body of research on the positive effects of religion on physical and mental health (depression included) has become available and the benefits of religion are now fairly well established.

For example, a recent issue of Geriatrics, a medical journal for physicians, Gerontologist and geriatric nurses, contained an article titled “Incorporating Religion and spirituality to Improve Care for Anxiety and Depression in Older Adults.” The authors discuss evidence showing the benefits of discussing religious/spiritual activities with older patients, and they suggest specific ways to integrate religion/spirituality into the treatment prescribed – among them, promoting thoughts of gratitude, encouraging forgiveness, asking patients to let go of hurt and anger, inviting them to resume religious attendance if depression has made them interrupt such practices, and so forth. The journal even published with this article an advertisement inviting doctors to attend a continuing education course on prayer and spirituality offered by the American College of Physicians.

While religion is helpful in preventing depression and other problems, it may be so only under certain circumstances. I heard of research on health and religion conducted by Dr. Montagu Barker at Bristol University. Dr. Barker’s reported in one of his lectures on the result of the many studies emerging at that time that showed the connection between religious practices and physical health (longer life, reduced risk of arteriosclerosis and heart disease, faster recovery from illness, etc.) as well as mental-emotional behavioral health (decreased incidence of depression and anxiety, a hopeful outlook, and low risk of criminal behavior and of substances dependence). However, Dr. Barker pointed out that it was people with a firm commitment to their religion who got these dividends, not the nominal members. In fact, occasional churchgoers who didn’t have a firm commitment obtained fewer health benefits than those who didn’t attend at all.

Depressed People in the Bible

The Bible doesn’t contain enough details about symptoms and their incidence for us to know for sure whether the characters in its stories suffered from depression. But it does tell us enough about the symptoms of some of the characters to enable us to surmise that they would probably have met the criteria for depression as understood today. The Bible has preserved these examples, so we can gain insight into how God can help the brokenhearted today as He did the men and women of the past. Let’s consider a few examples.

• Hannah, First Samuel 1 offers a good picture of Hannah’s emotional condition. We are told of a number of things that reveal her deep discouragement. The Lord had closed Hannah’s womb (verse 5). In that cultural context, motherhood was a clear sign of divine blessing, and its absence, a sign of a curse. Hannah’s condition may have given her a sense of guilt and inferiority both feeling typically found in depressive patients.
• The maternal differences between Hannah and Peninnah must have mortified Hannah, but to top it all, Peninnah purposefully provoked Hannah (verse 6), even though she knew that by law her first son would receive a double share of the inheritance (see Deuteronomy 21:15-17). To understand Peninnah’s behavior fully, we must remember that Elkanah, the husband of both women, loved Hannah more than he did Peninnah – a typical complication in polygamous families.
• Hannah wept bitter over her infertility (I Samuel 1;7, 10). In part she cried because of Peninnah’s provocation, but – as indicated by her praying at the temple – her sorrow was rooted in other matters too. Weeping is one of the most common symptoms of depression.
• She wouldn’t eat (verse 7). Loss of appetite is a common sign of depression, and Hannah must have displayed it more than once, for Elkanah asked in frustration, “Why don’t you eat?”
• Hannah experienced bitterness of soul (verse 10). Her deep sadness may have been what we refer today as depressive mood, which may have worsened when Elkanah showed he didn’t understand by asking “Why are you downhearted? Don’t I mean more to you than ten sons?” (verse 8).
• Hannah spoke “your servant’s misery (verse 11) and said she was “Deeply troubled” (verse 15) and “In great anguish and grief” (verse 16). It’s likely that these expressions refer to the deep sadness that characterizes clinical depression.
• Hannah’s face was downcast. Her facial spark was gone, She was sad until Eli blessed her (see verse 17, 18).

The solution to Hannah’s condition began with the comforting words of Eli: “Go in peace, and may the God of Israel grant you what you have asked of him” (verse 17). Scripture says her troubled countenance changed and she ate something. Notice that Hannah’s mental healing came even before her request was granted. Eventually, her deeply felt prayer was answered – she was granted the privilege of being the mother of one of the greatest prophets ever. And then she had three other sons and two daughters (see I Samuel 2:21).

Elijah. By divine intervention, through great miracles that occurred in the midst of adversity, Elijah went through a spectacular series of victories (I Kings 16-18). But then we see the prophet taking an emotional downturn (see chapter 19).

• Having won the crucial battle against Baal, Elijah could have gone on to fight the final battle. But instead, he experienced intense fear (I kings 19:3) and ran away. He may have thought that God wasn’t treating him fairly when He allowed a death warrant to be placed on his head after his long battle against evil.
• He prayed for God to take his life (verse 4). Thoughts of death are quite common in depressive people. Some try to take their lives, and some who try are successful. Elijah didn’t attempt suicide, but he thought death preferable to the emotional pain that continued to plague him.
• On two occasions Elijah spoke of how discouraged he felt because the Israelites rejected God’s covenants, destroyed His altars, and killed His prophets (verse 10, 14). This must have been a significant source of the depression he felt after his experience on Mount Carmel.

Heaven’s treatment of Elijah’s symptoms began with an angel cooking a meal for him and then sending him for serious physical exercise. He was healed through the encounter with God that ended in a gentle whisper. God’s assurance that there were “seven thousand in Israel – all whose knees have not bowed down to Baal” (I Kings 19:18) must also have been therapeutic to Elijah, who had believed that he was the only remaining faithful one.

David. Israel’s shepherd-king died at the age of seventy. Although his life wasn’t particularly long by today’s standards, it was full of action and excitement. From his early days on, David faced a great deal of emotional turmoil because he was the youngest in his family and later the object of obsessive persecution by King Saul. When David became king over Judah, he continued to experience a great deal of mental agony – at that time because of his own mistakes, and harassment of his enemies, and trouble in his family.

The book of Psalms contains many passages that are precious jewels to the brokenhearted. In part, they’re attractive because of their rich language, but a greater reason is their author’s experience in heartache. In these Psalms, David wrote of a loving God who is the Balm needed by those who suffer.

David himself recognized that his experiences with life and with God would be useful to other sinners. When the prophet Nathan came to him after his adultery with Bathsheba, David wrote a psalm in which he fully admitted his transgression and asked God for forgiveness. He prayed, “Restore to me the joy of your salvation,” and said, “then I will teach transgressors your ways, and sinners will turn back to you” (Psalm 51:1, 13). Let’s look at a few of David’s states of mind as expressed in Psalm 42.

• David’s tears were copious (verse 3). He tells us that they have been his “meat day and night” (KJV). In the context, it seems obvious that these were tears of sorrow.
• Past events disturbed him (verse 4). At this time, David was probably in exile, and he missed the temple services. Memories from the past do tend to disturb – in one way or another – those suffering from depression
• He was experiencing inner turmoil (verse 5). He says that his soul is “downcast” and “disturbed within me,” revealing the spiritual pain inside that is comparable to someone going through physical affliction.
• Insurmountable barriers surrounded him (verse 7). David uses waterfalls as a metaphor to express the clamor of his circumstances. These waters aren’t mere noisemakers; they contain impassable power – the waves breaking over him.
• He had the impression that God had left him (verse 9). This internal tension and the pressure from his enemies make David mourn. The trial is of such intensity that he wonders, as do many in the midst of depression, where God is.
• His emotional pain produces physical symptoms (verse 10); “My bones suffer mortal agony as my foes taunt me.”
• He didn’t receive the social support he needed (verses 3, 10). Loving people are a good source of healing to the brokenhearted. However, the people surrounding David were not only unsupportive, but they were positively venomous as they kept asking Where is your God?”

The solution to David’s problem comes from God, but David needs to take the initiative. He decides to remember God even from a distant land, to put his hope in him, and to praise him in spite of his troubles. As a result, the Lord directs His love toward David during the day, and at night, He sends a song to his heart. And in response, David sends a prayer to the God of his life (see verse 8).

Hezekiah. This king witnessed a number of remarkable events and victories attributed only to God. Then he became sick unto death, a fate confirmed by the terrible words of Isaiah: “Put your house in order because you are going to die; you will not recover” (Isaiah 38:1). But Hezekiah prayed for a miracle, and God answered his prayer, granting him an additional fifteen years of life. Later Hezekiah wrote of the emotional journey he experienced when he thought his death was sure. His words of despair are recorded in Isaiah 38. Hezekiah’s agony was not a silent one. He wept bitterly (verse 3), comparing the pain he felt to that which he would have experienced if a lion had broken all his bones (verse 13)! He said he chattered like a crane or a swallow, mourned like a dove, and his eyes grew weak (KJV); but, in his agony, he turned to God and prayed, “I am troubled O Lord come to my aid!” (verse 14). And God answered his prayer.

Jeremiah. This prophet witnessed the chaos his nation went through at the time Nebuchadnezzar devastated Jerusalem. When Jeremiah was “only a child,” God called him to be a prophet (Jeremiah 1:7). However, his appeals to his fellow citizens seemed useless; nobody wanted to follow God’s instruction. So he was a witness when Israel instead of winning victories, disintegrated morally and suffered physical destruction. He saw Nebuchadnezzar besiege Jerusalem and then sack the city, taking its citizens captive to Babylon. Then the remnant that was left forced him to flee with them to Egypt. Jeremiah’s lamentations vividly show his agony.

• The mental distress is both external and internal (Lamentations 1:20). Jeremiah expresses his condition with words such as “distressed, disturbed, and torment. The pressure comes not only from the outside sources (the sword bereaves) but also from within (I am in torment within”).
• He experiences darkness (Laminations 3:1, 6). In describing their condition, those suffering from depression frequently picture themselves as in darkness rather than light.
• Jeremiah’s emotional pain is so intense that it affected his physical being (verse 4, 16). He notices his skin and flesh is growing old and feels as though his bones and teeth are broken.
• He feels like he can’t escape the agony (verse 5, 7). He speaks of being “besieged,” “walled,” “weighted . . . down with chains,” and “surrounded . . . with bitterness and hardship” – Words and phrases that convey hopelessness, a common feature of depression.
• Jeremiah has no supportive social network (verse 14). He’s the laughingstock of his own people – one of the wort consequences depressed people experience.
• His thoughts are memories are focused on the negative (verses 17-20). Jeremiah seems to share what is commonly found in people subject to depression – a selective memory, focused on the somber aspects of the past. The text indicates that Jeremiah has lost his hope in God, together with a sense of God’s splendor. He remembers instead his affliction, wandering, bitterness, and gall, and, as a result, his soul is downcast.

When Jeremiah reached his turning point (verse 21), he decided to have hope, to recognize God’s unfailing love and great faithfulness, and to wait for Him, because “the LORD is good to those whose hope is in him, to the one who seeks him; it is good to wait quietly for the salvation of the LORD” (verse 25, 26).

In our next post, we will talk about “What to do About Depression”