A Biblically Robust Approach to Depression

In this series we are seeking to explore how the Scriptures provide us with robust frameworks for life’s problems. A framework is more than just a series of Bible verses on a subject. The Scriptures acknowledge the diverse ways in which human beings are designed by God, the diverse ways in which we experience troubles, and the diverse ways in which troubles manifest. Therefore, it provides us not with just one approach to a common problem, by diverse approaches that meet each of us where we are in life’s troubles. When it comes to depression, the Bible offers us at least four different frameworks for facing depression.

We begin again, however, by seeking to understand depression and the diverse experiences of depression. David Murray, in his wonderful little book Christians Get Depressed Too suggests that depression develops across five different arenas: Life situation, thoughts, feelings, bodies, and behaviors. Let’s look at each briefly.

Life Situation – Sometimes depression arises because of what is going on in our circumstances. Life changes can have a dramatic affect on our mental health. The circumstantial details can help us distinguish between disordered sadness and logical sadness.

Thoughts – Our thought life is probably the biggest contributor to depression. The way we think about ourselves, our circumstances, and our God can dramatically affect our mental health. Proverbs 23:7 establishes that as a man thinks in his heart so he is. The things we think about the most become soul convictions.

Feelings – We obviously understand depression to be a feeling. How we feel is a reflection of what we think about. If my thoughts are dominated by problems and negative assessments of self and life then I am going to feel negative. These negative feelings tend to reinforce my negative assessments. It creates a little circle where the more intense my feelings the more convinced I am of their legitimacy.

Bodies – Long-term struggles with depression can manifest in physical maladies. It’s also important, however, to note that some physical maladies can cultivate what looks like depression Medical conditions like Hypothyroidism, Anemia, and Hypercalcemia (to name a few) can cultivate feelings and symptoms of depression. It’s always important, then, to get a medical check-up.

Behavior – lastly, we should note that depression impacts our behavior. Depression affects our motivation and our ability to enjoy things that we previously enjoyed. It can also tempt us to find destructive means of escape like substance abuse, pornography, or reckless living.

Let’s turn attention now to a Biblical approach to Depression. We recognize that at the heart of depression is a loss of hope. It could be temporary or it could be more enduring, but we feel that intense and prolonged sadness because we don’t see a way forward in our circumstance or in life in general. The Bible provides at least four different frameworks for navigating depression.

First, we might look at a Sin Framework. Depression has many causes and despite what some Christians think, sin is not the cause of all depression. But it is the cause of some types of depression and so it is worth investigating. In the midst of depression caused by sin, God invites us to repent and receive forgiveness. Psalm 32 gives us an example of spiritually-rooted depression. Verses 3-4 speak of what happens when the Psalmist doesn’t deal with his sin: he experiences symptoms of depression: loss of appetite (bones wasting away), groaning (sounds of despair), loss of energy. How does he deal with this sin? He confesses it (v. 5). V verses 1-2 start off the psalm with the basis of hope: blessed is the one whose transgression are forgiven! So, with depression we want to always consider life context. Sometimes sin can be the cause.

Second, consider a Sorrow Paradigm. In the midst of depression caused by sorrow, God invites us to look at the bigger picture. Psalm 73 illustrates this principle. The Psalm is written retrospectively. That is the author is looking back to a time when his feet had almost slipped (v. 2). And they had almost slipped because suffering had narrowed his vision. All he could see was the injustice and wickedness of his world (v. 3-12). He helps himself out of this sorrow by finding firm footing in an eternal perspective (v. 16-20; 27-28). By reminding himself of God’s justice and God’s plan he is able to reorient his heart in the midst of sorrow.

Third, consider a Self-Talk Paradigm. Since depression is often heavily related to our thoughts, and the things we tell ourselves I will spend some extra time focused on this approach. In the midst of depression caused by self-talk, God invites us to fight back with the truth. Psalm 42 is a great example of this practice.

The Psalm begins by noting how sorrow attacks our experience of God. In the opening lines the Psalmist is longing for God – like a deer pants for water. But in verse 2 we see that he feels like the Lord will not give him an audience or a hearing. “When shall I appear before you?” Verse 3 emphasizes the sorrow he’s feeling – he’s so depressed he doesn’t eat, he just cries. “My tears have been my food.” And again, he wonders, where are you God? In fact, he poetically describes his tears as mocking his faith.

In verse 4 he is remembering how life used to be, how it used to feel. Sometimes depression is made worse by the memory of how much joy we used to experience. The loss of interest and motivation is hard because there was a time, at least for some, when life didn’t feel this way. Life wasn’t always grey and dull, but now it is. The Psalmist describes how he used to lead the crowds in the procession and in worship.

Verse 5 is a moment of contrast in the Psalm. Here the Psalmist changes the focus and starts talking to his discouraged soul about hope: Hope in God for you shall again praise Him. And then he tells his soul who this God is: the God of my salvation! He allows himself to sorrow, but He also speaks back to that sorrow with hope!

Verse 6 continues the focus on God by speaking more specifically about who this God is. He mentions here: “I remember you from the land of Jordan and of Hermon, from Mount Mizar.” These are key historical locations in Israel’s life where God had revealed himself in remarkable ways. The Psalmist is latching on to truths about Yahweh. In the midst of depression our hope is not in God generically, but specifically. Want to remind our souls of who God is.

Verse 9 takes all this God-talk and shifts it back to place of confusion. If this is who you are God, then, why does it feel like you have forgotten me. Why do I mourn and receive no answer from you? His enemies, in this case literal people, taunt him saying “Where is your God.” Previously it was his own tears who mocked him, now it’s outside voices. The point of course is that prolonged sorrow does raise our doubts about God, doesn’t it? 

Verse 10, however, shifts back to that important soul-talk: hope in God, for you shall again praise him. So, we learn here to be honest about our sorrow, to talk to God about our sorrow and confusion and frustration, and we learn to speak hope to ourselves in the midst of sorrow.

Finally, consider an Endurance Framework. Sometimes depression can feel impossible to understand. Why do I get depressed? Why is it going on so long? Where did this come from? Often there aren’t clean, simple, and straightforward answers. And in such situations the Bible encourages us simply to endure, to believe that God is with us in the valley of the shadow of death.

Psalm 88 is helpful on this point because it is such an utterly dark psalm! Psalm 88 has been called the darkest psalm in the Scriptures. Most psalms of lament have at least one turn of hope in them. They are full of hard and bitter words, they feel weighty, and the psalmist is frustrated and despondent. But he always says something like, “But I will trust in the Lord.” Psalm 88 has no turn. The last words of the Psalm are simply: darkness is my only friend.

So, how on earth can such a depressing Psalm be helpful to the depressed? In part, I think the answer is that it encourages honesty and endurance. So, for example, this Psalm encourages us to endure in our pain. That is to feel our pain. Don’t resist it, don’t feel bad for feeling bad, acknowledge your feelings…even if they last a long time. You don’t have to suppress those dark emotions – you can acknowledge them. The Psalmist certainly does.

Secondly, the Psalm encourages us to endure with the Lord. The psalmist starts in verse 1 by “crying out to the Lord.” Even in his despair, even in his frustration he keeps talking to the Lord. So, don’t give up on your faith when faith is hard, when life is hard. Keep going to God. God knows about depression and included a dark psalm in the Bible to reflect the states that we can find ourselves in. He wrote this for our good to help us keep plodding, to endure and keep moving forward. Nearly all depression requires some levels of endurance, and the Scriptures and God’s Spirit can help us endure.

There is, of course, much more that must be done to help people navigate depression. We ought to consider issues of medication, social support, exercise and diet, and practical strategies to implement the right thoughts. But if we don’t start with a useful framework these strategies will feel pointless, random, and detached from hope. Identifying the right framework for yourself or someone you are helping requires lots of listening, asking good questions, and prayer. But thank God that He doesn’t just give us platitudes and trite counsel. He gives us multiple approaches for understanding our experience of depression and responding to it. A robust approach to depression offers a diverse means of hope.