Why Are You ‘Depressed,’ O My Soul? (Part 2)
Part 2: What Is This Misery?
“Why are you cast down, O my soul, and why are you in turmoil within me?” (Psalm 42:5).
(Note: See the “Blog Disclaimer” at the main blog page before reading this article.)
In my last article, I considered the reality of depression in the church and the comfort of our hope in Christ, with the aid of An Orthodox Catechism. In this article, I will focus on defining “depression,” while giving attention to the phrase “sin and misery” in the catechism. Let’s take a look again at question two:
Q. 2. How many things are necessary for you to know that, enjoying this comfort, you may live and die happily?
A. Three. The first, what is the greatness of my sin and misery. The second, how I am delivered from all sin and misery. The third, what thanks I owe to God for this delivery.
Most people will speak in terms of situational versus clinical depression [1] even if they don’t realize it. Simply speaking, mild to moderate versus severe expressions of sadness and/or lethargic mood. Both can be chronic in duration but only the less severe expressions are ever brief [2]. For example, the disappointment and exhaustion that accompanies an extended season of high stress or pressure, but which fades with changing circumstances is less severe than, say, a repetitive and besetting feeling of melancholy or purposelessness that at times seems to descend upon you for no immediately perceivable reason. Those ways of thinking about this aren’t necessarily wrong, and are certainly helpful in many ways, but more needs to be said and biblical clarifications need to be made. Most, if not all “mental disorders” should be thought of in terms of being on a continuum. I don’t find it helpful to think of “mental illness” or “depression” in terms of haves and have-nots. All of us get sad and apathetic sometimes, but only some of us experience this in a besetting way—and everything in between.
So, rather than focusing on duration and intensity—though those things are certainly important—I would like to turn our attention to the motivations behind manifestations of depression. And, while experiential severity matters, Scripture makes spiritual distinctions that explain depression on a level that simple clinical observation never can and never will. I’ll hold off speaking about the more physiological aspects of depression until my next article.
Misery
When God’s Word speaks of what we broadly call “depression,” it is not always negative, unhealthy, or disordered and is not always a direct result of personal sin. Rather, “all…misery” we endure this side of eternity is due to the presence and affects of sin in and upon God’s creation, and therefore, upon us [3]. Misery then refers, in general, to the results of our collective sin.
As many of us know, “Jesus wept” (John 11:35) and for good reason. He was grieving the death of a friend—and death is not natural—it came about as a consequence of our fall into disobedience. In one sense, we have all contributed to the fact that we live in a broken world where things like depression exist. However, in another sense, we may suffer with depression not because we have committed any specific personal sin, but instead because this world is a place broken by sin, which includes our own bodies and brains. Thankfully, as I spoke of before, God allows and—in one sense—plans these trials into our lives by his good and loving providence (Rom 8:28; James 1:2-4). A great example of this is when Jesus healed a man born blind. His disciples asked him what sin was committed that caused his blindness and Jesus responds, “It was not that this man sinned, or his parents, but that the works of God might be displayed in him” (John 9:3). Scripture doesn’t tell us how that previously blind man felt about being blind all those years, but I’m assuming there was some suffering and grief involved. What Scripture does tell us is that the conclusion of this matter ended with this man believing in and worshiping Christ with joy.
Therefore, we can conclude that there is a kind of godly grief we can experience when longing for heaven because we live in a fallen world, broken by sin, where pain, sickness, suffering, oppression, weakness, fatigue, and death are ever-present (Job 1:6-2:10; John 16:33). This includes the presence of neurological deficiencies and abnormalities. It is good and right that we hate what sin—personal and collective—has done to God’s good creation; and it is right that we should patiently wait with deep longing for the Day when Christ will return and put an end to those things forever (2 Cor 5:8-9; Rev 21:1-10). The experience of this pain itself is not sinful and there is even a way to hate our pain that is holy, as long as we maintain this kind of godly grief with faith and hope (Rom 8:18-25). Godly grief can be just as painful and just as chronic as any other form of “misery,” and could be diagnosed as situational or even clinical “depression” by a mental health professional.
In his first letter to the church in Corinth, the Apostle Paul also spoke of a kind of godly grief that comes from seeing our personal sin and mourning over it that leads to repentance and increased faith. So, a subset of godly grief might be described as godly remorse [4]. This kind of sorrow is a result of our own personal sin—“my…misery”—but it leads to confession and repentance (Psalm 51) and precedes any true healing (James 5:16; Psalm 32). Paul differentiates this from worldly grief or remorse in that godly remorse “produces a repentance that leads to salvation without regret, whereas worldly grief produces death” (2 Cor 7:9). It is good and right that we should feel sorry and be remorseful before God when we sin against him and others. “Blessed are those who mourn, for they shall be comforted,” (Matt 5:4) and, “The LORD is near to the brokenhearted, and saves the crushed [or contrite/humbled] in spirit” (Psalm 34:18). There is nothing more grievous than the fact that we have separated ourselves from God. And there is nothing sweeter than to know that we are free from guilt because Christ has brought reconciliation to that relationship. Genuine remorse results in our joyfully turning from our sinful attitudes and behaviors, turning back to God, and likewise loving our neighbor. Sinful, worldly remorse is merely the result of our selfish distaste for the consequences of our sin (Prov 9:7-9; Heb 12:5-11).
Sin
But there is a form of depression that is caused by “my sin,” that is not characterized by godly grief or remorse, and does not lead to joy or repentance. This takes two general forms that correspond with situational and clinical levels of depression. The less severe, situational experiences of sadness and lethargy are typically rooted in discontentment (Gen 3:6; Phil 4:10-13; 1 Tim 6:6-10), while the more severe experiences are typically rooted in hopelessness (Lam 3:1-18; Eph 2:12). These things are poison to our souls and distort our minds, but “godliness with contentment is great gain” (1 Tim 6:6) and, “this I call to mind, and therefore I have hope: The steadfast love of the LORD never ceases; his mercies never come to an end” (Lam 3:21-24). In any given circumstance this may not feel true—yet it remains true—and that truth anchors us when, “my soul is bereft of peace” and “I have forgotten what happiness is” (Lam 3:17). God has made us in his image as rational and emotions beings and that is a good thing. But the moment we allow our finite understanding and flawed feelings to become the controlling factors in the way we think and how we live, rather than God’s perfect word, we fall into sin and consequential misery (Psalm 119:9, 105). Our experience cannot be what ultimately governs how we see and interact with God, people, or our surroundings and circumstances, but instead, only the truth of God and his gospel should hold that kind of power in our lives and should be shaping and molding the way we perceive and engage our experiences.
If you notice in yourself that hopelessness or discontentment is taking over, then be on the look out for a kind of inward-turned pride and self-pity. This attitude says things like, “Woe is me! I deserve the things I want (including to be out of this painful experience immediately) and I’m not getting them! I am without hope or purpose.” This attitude esteems and elevates self and personal autonomy rather than Christ and his kingdom (John 3:30). These thwarted desires may not be what we normally think of when we think of pride, but they are just as sinful and just as destructive. When we notice these attitudes in ourselves it is imperative that we acknowledge their presence and turn from them by God’s grace—”Blessed is the one whose transgression is forgiven, whose sin is covered” (Psalm 32:1). For the helpers reading this, our first response to the presence of depression in others should certainly be compassion. But, it is absolutely not compassionate to sit back while sinful thoughts, attitudes, and actions consume and destroy a person’s life. Yes, start with “encourag[ing] the fainthearted,” but don’t forget that there is a time to “admonish the idle” as well, as long as you are “patient with them all” (1 Thes 5:14). You may have to risk offending the other person—that’s okay—“Faithful are the wounds of a friend; profuse are the kisses of an enemy” (Prov 27:6). It is possible to be compassionate about the pain someone is going through while still “speaking the truth in love,” (Eph 4:15) which includes calling someone to repentance (2 Tim 4:2; Jonah 4).
One last point of clarification should be made that is not often recognized. Depression is very frequently displayed through unrighteous anger (Gen 4:5-6; Jonah 4:1-3). I see this most often in children who express an inordinate desire for control and authority, and in spouses who have idolatrous and unrealistic expectations for marriage and their partner. Angry behavior is another way people can show discontentment and hopelessness that can also be confusing and can draw attention away from these deeper matters of the heart.
So What’s Next?
One thing I haven’t mentioned much about yet is how all this relates to our bodies and our brains. What about all that talk of chemical imbalances we hear so much about? Don’t our brains have something to do with this? What about psychotropic medications? My next article will consider the relationship between body and soul and why it matters that, “both in soul and body…I belong wholly unto…Jesus Christ.”
Footnotes & References
[1] Welch (2004) gives essentially the same generalized classifications in his work. [Edward T. Welch, Depression: A Stubborn Darkness: Light For the Path, 2nd ed. (Winston-Salem, NC: Punch Press, 2004), 27-28.]
[2] The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association [APA], 2013), is the most recent publication that outlines what the secular mental health community uses to define various “mental disorders,” including those described as depressive disorders and adjustment disorders. Diagnoses described in the DSM-5 associated with situational depression would most often be Persistent Depressive Disorder (previously called Dysthymia) or some versions of Adjustment Disorder. Those that describe clinical depression are going to fall into the category of Major Depressive Disorder. See this publication for further details on the APA’s classification system and criteria. [American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (Arlington, VA, 2013), 155-188, 286-289.]
[3] Question 22 of The Baptist Catechism (which is also question 27 of The Westminster Larger Catechism) reads as follows: “What is the misery of that estate whereinto man fell?” The answer helps us define the term “misery” in its historical context: “All mankind by their fall lost communion with God, are under His wrath and curse, and so made liable to all miseries in this life, to death itself, and to the pains of hell for ever.” [Reformed Baptist Publications of the Association of Reformed Baptist Churches of America, comp., The Baptist Confession of Faith & The Baptist Catechism (Birmingham, AL: Solid Ground Christian Books, 2014), 97.]
[4] These categories are obviously not the only ways of describing these concepts. For example, John Henderson outlines four things that may have the appearance of depression but are not. I wholeheartedly agree with Dr. Henderson’s assessment and formulation, and my presentation is really just a simplified version of what he is saying. I am making “remorse for sin with repentance” one sub category of an overarching grouping together of “despondency with faith,” “grief with hope,” and “longing for heaven with perseverance.” [John Henderson, Equipped To Counsel: A Training Program In Biblical Counseling, Leader Notebook ed. (Fort Worth, TX: Association of Biblical Counselors, 2008), 228-229.]
- Published in Depression