Counseling God’s Attributes (Part 1 – Prolegomena)
- Published in Counseling & Theology
Adam Sandlin on the Speak the Truth Podcast
- Published in Counselors, Podcast Episodes
Adam on the King’s Highway Radio Podcast
- Published in Uncategorized
Book Review: “The Freedom Of Self-Forgetfulness” by Tim Keller
- Published in Book Reviews
Why Are You ‘Depressed,’ O My Soul? (Part 3)
Part 3: Body and Soul
“My flesh and my heart may fail, but God is the strength of my heart and my portion forever” (Psalm 73:26).
(Note: See the “Blog Disclaimer” at the main blog page before reading this article.)
There’s a quote you may have seen floating around cyberspace that’s often falsely attributed to C. S. Lewis: “You don’t have a soul. You are a soul. You have a body.” Unfortunately, as well intentioned as that statement may be, it falls short of the biblical testimony about what makes up a person. For Christians, while we will eventually be rid of the dying bodies we have now, our eternity will be spent in new incorruptible bodies, living face-to-face with God as part of a new and perfect universe (1 Cor 15:35-49; 1 Thes 4:16-17, 2 Pet 3:10). Heaven and earth will be one and the same (Rev 21:1-8). In fact, one of the most amazing aspects of our faith is that we will be resurrected—bodily—exactly like our Lord and Savior Jesus Christ (Rom 6:5; 1 John 3:2) to future glory (Rom 8:18-24)!
But what does this matter when it comes to the topic of depression? It’s impossible to understand who we are and what it means to have a healthy mind without consulting the One who made us and knows us better than we even know ourselves (Psalm 139:1-16; Jer 17:9-10; Rom 8:27). If it weren’t so neglected, a biblical understanding of this issue would relieve boatloads of confusion about how to address problems of human psychological suffering. But this disregard has not always been so prevalent in God’s church. Take the catechism for example:
Q1: What is your only comfort in life and death?
A: That both in soul and body, whether I live or die, I am not my own, but belong wholly unto my most faithful Lord and Savior Jesus Christ…
Addressing psychological problems and experiences starts with understanding how the spiritual part of us relates to the physical part. Are we aware, for instance, that the brain and the mind—while linked—are not the same thing? Both the biblical and historical Christian witness is that a complete person is made up of “soul and body” [1]—as a unity of two parts—a dichotomy. [2] To put it another way, you and I are psychosomatic creatures—embodied souls uniquely made in the image and likeness of our Creator God (Gen 1:27). God made all mankind out of the material “dust of the ground” and breathed into us the immaterial “breath of life,” resulting in our being made “a living creature” (Gen 2:7). Christians specifically—as new creations (2 Cor 5:17)—are to “not lose heart” because “Though our outer self [our present, corruptible body] is wasting away, our inner self [our regenerate, everlasting soul] is being renewed day by day” (2 Cor 4:16). Though “My flesh [my material body] and my heart [the affectionate core of my immaterial soul] may fail…God is the strength of my heart and my portion forever” (Psalm 73:26). All this means that psychological change should be pursued as an “inside-out” process. This view gives special attention to the soul while refusing to neglect the body—yet it also recognizes the constant interplay happening between the two as a connected whole [3]. But how do we know when something is a physical issue versus a spiritual one?
Making Distinctions
When speaking of depression, a helper’s first response is to be compassionate. The next is distinguishing between the physical and the spiritual (or soul-related). Physical symptoms of depression may include low energy, changes in sleep or appetite, a decreased ability to concentrate or focus, and a slowing down of physical motor activity/an anxious physical agitation. Spiritual symptoms may include feelings and expressions of sadness and/or irritability, a diminished desire to take initiative/action, feelings of guilt/shame or purposelessness, and thoughts of suicide/self-harm or death.
Physical Problems
Physical problems that are not depression—There can be depressive effects to certain physical illnesses that are not depression but can cause some of the same physical symptoms, while being absent the spiritual ones. This can include things like low thyroid, heart disease, certain autoimmune diseases, and others. For this reason, if you are experiencing the physical symptoms listed above, especially if the onset was sudden or if this is your first episode, you should first check with your physician. I typically recommend that people explore this avenue before immediately seeking out an antidepressant or other psychiatric medications, unless the person is in more immediate danger of harming themselves or others. The presence of these physical symptoms alone does not necessarily mean that depression is the culprit.
Physical problems that contribute to depression—At the same time, since our bodies are constantly affecting our souls (and vice versa) physical pain, illness, injury, and affliction of all kinds can precede experiences of depression by creating the opportunity for a depressive spiritual response in us. These sufferings can be self-inflicted (e.g., substance abuse or neglecting proper diet and exercise) or merely the result of living in a fallen world (e.g., pain from an accidental injury, postpartum hormonal imbalances, or a chronic illness). Grief over physical suffering that maintains hope is very appropriate though difficult. But temptations toward hopelessness and discontentment can also be very strong when experiencing physical suffering and weakness (see my previous article for differences between righteous versus sinful depression). For example, those with neurological or brain abnormalities like various forms of autism, dementia, some aspects of Obsessive-Compulsive Disorder, or possibly a traumatic brain injury—being no fault of their own—can sometimes find it very difficult to resist temptations to lash out at others, be impatient or worrisome, or hopelessly give up on God, life, and others. We should give extra measures of patience to individuals who struggle with these pathologies (1 Thes 5:14), while also remembering that we are all people, made in the image of God, with a conscience, and therefore responsible for how we respond to both sweet and bitter providences in our lives. Our physical circumstances don’t cause but can contribute to depressive experiences.
Spiritual Problems
Notice how I gave no option for actual physical depression absent of spiritual components or consequences. That’s because “Psychiatric problems are always spiritual problems and sometimes physical problems…Most psychiatric problems are hybrids—a combination of spiritual problems and physical ones” (Welch, pp. 106-107) [4]. Our brains and bodies cannot make us sin (pp. 49-61), which is why you “will never find a psychiatric problem where biblical counsel—counsel directed to the heart—is anything less than essential” (p. 106).
Spiritual problems with immediate physical consequences—We must understand that a person’s spiritual/psychological state will affect their physical state, albeit to varying degrees. A hopeless person will likely lack motivation, which can manifest in low energy and diminished physical vigor. A person who feels guilty, whether justified or not, can have crying spells and might choose to self-harm. Spiritual/psychological pain can tempt a person to abuse substances that have intoxicating physical results and the accompanying consequences. The same principle is true, of course, for joy. A person who finds their identity in the Christ who saved them and is thankful to the Father God who has adopted them—that person can find lasting joy in spite of suffering and unhappy feelings (James 1:2-4; 1 Pet 1:6-7). Somehow, someway our internal spiritual reality will expose itself in our physical existence—for better or for worse (Matt 15:18; Luke 6:45).
Spiritual problems with delayed physical consequences—You may not always be able to immediately tell that a person’s adrenaline has just spiked, they’re blood pressure is rising, they have a tension headache, they aren’t getting proper nutrition, or their focus is diminished—but that doesn’t mean it isn’t happening. Usually there are signs that these things are occurring, but we are self-deceived if we believe that our spiritual problems are not having physical consequences even if they aren’t immediately apparent to us—“Do not be deceived: God is not mocked, for whatever one sows, that will he also reap” (Gal 6:7). It is also important for us to remember that though sin has negative consequences, that in righteous living there is great reward—always spiritual, sometimes temporal (Psalm 19:11; Prov 10:16; Psalm 1; Isaiah 40:30-31). This is not a promotion of a health, wealth, and prosperity “gospel”—righteous living will never allow us to escape physical death, and will never guarantee us temporary, earthly treasures including the life we expect or desire (Job 1:21; Matt 6:19-21; Matt 16:24-26). But God is a good and gracious parent to his children and knows how to give them good and perfect gifts (Matt 7:11; James 1:17), including appropriate and timely rewards for their obedience as well as loving discipline when it is required (Heb 12:3-17). At the same time, we must communicate to those who do not believe, that they sit under God’s judgment and should flee from it by coming in empty-handed faith to his Son (Mark 1:15; 1 Cor 6:9-11). All of us have those areas of our lives where we should have experienced greater consequences but somehow did not. Thank God today for his patience and mercy. He owes us nothing, yet he gave everything for his people (John 15:13; 2 Cor 5:21). “Or do you presume on the riches of his kindness and forbearance and patience, not knowing that God’s kindness is meant to lead you to repentance?” (Rom 2:4).
Examples In Scripture
What we call depression today is actually an age-old problem for people in our fallen world. There are a number of healthy and unhealthy examples in Scripture of both spiritual and physical depressive experiences. These symptoms are not something modern researchers and practitioners have discovered, but something that God has spoken about for thousands of years. David said that when he “kept silent” about his sin his “bones wasted away” [loss of appetite/weight] through his “groaning all day long” [feelings of sadness/guilt]. He felt the anxious weight “day and night” [insomnia] and his “strength was dried up” [low energy/fatigue] (Psalm 32:3-4). After Jezebel threatened Elijah’s life he asked God to “take away my life” [thoughts of death] and twice he “lay down and slept” [hypersomnia/fatigue] (1 Kings 19:4-6). Judas Iscariot, in his guilt for “betraying innocent blood” gave in to hopelessness “and hanged himself” (Matt 27:4-5). When Cain saw that his sacrifices were unacceptable to God, he “was very angry [irritability], and his face fell [hopelessness]” (Gen 4:1-7). And Jesus Christ, the completely sinless “man of sorrows” who “in agony…sweat…great drops of blood” (Luke 22:44), was “acquainted with grief”—he has willingly “borne our griefs and carried our sorrows…he was pierced for our transgressions; crushed for our iniquities…upon him was the chastisement that brought us peace, and with his wounds we are healed…He was oppressed, and he was afflicted, yet he opened not his mouth” (Isaiah 53:3-7). Instead of hopelessness and discontentment he “[laid] down his life for his friends” (John 15:13) and “for the joy that was set before him endured the cross” (Heb 12:2). He gave himself, trusted the Father, hated sin, and loved God and his people unconditionally. He was not passive but active. As God he has not destroyed us but instead had mercy (2 Cor 4:8-11; Lam 3:22). He was faithful and obedient in the midst of the trials God gave him (Acts 2:23). It is only by his death in our place and gifted righteousness that we are saved (Rom 3:23-24; Eph 2:8-9). For all these reasons we know “we do not have a high priest who is unable to sympathize with our weaknesses, but one who in every respect has been tempted as we are, yet without sin” (Heb 4:15). We are meant to trust him and follow in his footsteps by giving him our lives, faith, and loving obedience (John 14:15, 23) even when that feels impossible (1 Cor 10:13).
The Role of Psychiatric Medications
The role of psychiatric medications can be a sensitive topic that I cannot cover in its entirety. Generally, there are those who believe that depression is a purely spiritual matter and therefore psychiatric medications are not a viable option, while others see depression as purely physical and therefore medications become a necessity or close to it. I want to offer a biblical, moderated view in line with what has already been said above. I believe this to be an issue of godly wisdom and sanctified conscience. Scripture outlines the working principle here:
Let not the one who eats despise the one who abstains, and let not the one who abstains pass judgment on the one who eats, for God has welcomed him…One person esteems one day as better than another, while another esteems all days alike. Each one should be fully convinced in his own mind. The one who observes the day, observes it in honor of the Lord. The one who eats, eats in honor of the Lord, since he gives thanks to God, while the one who abstains, abstains in honor of the Lord and gives thanks to God…So then each of us will give an account of himself to God. (Rom 14:3-6, 12)
Like issues of abstaining or not from certain food or drink, or observing certain ceremonial days as holy or not, psychiatric medications are an issue of Christian liberty for which someone must appeal to their conscience before God. In other words, there is nothing inherently sinful about psychiatric medications. Taking psychiatric medications can be a good and righteous help (though never a cure) for some, but can also be a harmful or even sinful thing for others to use.
At the same time, we must understand that no medication can ever change the heart. That is a job for the Holy Spirit via God’s Word (2 Tim 3:16-17; Gal 3:3). There are many common misconceptions about psychiatric medications that need to be exposed. They do not do what most people think they do. Dr. Welch (1998) says it this way:
Psychiatric medication is not treating a verifiable chemical imbalance in the brain. Contrary to public perception, psychiatric medications are not chemical bullets that target one particular brain chemical. They are more like chemical blitzkriegs, strafing chemical sites in the brain and hoping for the best…The most we can reliably say is that psychiatric medication may minimize some symptoms, but it is not necessarily treating a chemical deficiency…human behavior is represented on a neurochemical level. This doesn’t mean that the brain causes all these behaviors, but that the brain expresses differences in behavior at a chemical level. (pp. 109-110)
The bottom line is that psychiatric medications can be helpful and they can also be harmful, both physically and spiritually. There are particular physical risks everyone should research and ask about before beginning a medication regimen, and all medications have side effects. But there are also spiritual risks. The moment medications become our comfort over and above God, we have slipped into idolatry, and exchanged the Creator for created things as our object of worship and source of peace and satisfaction. A person thinking about or already taking psychiatric medications should also consider the possibility that medications could numb a person to a refining work of God in them. We can all agree that in general, relief from suffering is a wonderful gift from God, but also have to acknowledge that God—in his loving mercy—allows earthly pain into our lives for redemptive purposes. God will not allow his children to trade him in for fleeting pleasures and possessions. This is quite evident from the many accounts we find in Scripture of God’s work in the lives of his people. And certainly we can all agree that Christ’s suffering was necessary for our salvation, and rejoice that he did not avoid his cross (Isaiah 53). It is an inescapable fact that suffering will be part of the life of any Christian person (Matt 7:13-14; John 15:20; Phil 1:29; 2 Tim 3:12). Are we stewarding our suffering well? What might God being doing in us through our suffering?
So what’s next?
Over the past three articles we have looked at the hope we have in Christ in the midst of depression, the differences between righteous versus unrighteous expressions of depression, and now how our body and soul interact during a depressive experience. Next time, in the last installment of this series, we will look at practical ways to think about and address depression from a biblical perspective.
Footnotes & References
[1] The term “soul” is interchangeable with “spirit” and corresponds to the “inner self” or inner person. Additionally, the inner person is made up of three faculties: the mind, the affections or “heart,” and the will. The bible uses all these terms interchangeably to describe the inner person, with different terms being used to give specific emphasis as needed. For further discussion on the issues of the psychosomatic or dichotomous nature of mankind and the three faculties of the immaterial soul see: Samuel Renihan, God Without Passions: A Primer: A Practical and Pastoral Study of Divine Impassibility (Palmdale, CA: Reformed Baptist Academic Press, 2015), 35-48. Additional free online audio resources can be found here and here.
[2] Time and space do not permit me to discuss the different views concerning the composition of a person, especially the immediately relevant disagreement between those who hold to dichotomy (that a person is made up of two parts; outer self and inner self, or body and soul) versus those who hold to trichotomy (that a person is made up of three parts: body, soul, and spirit). I believe that the trichotomy position embodies a number of significant flaws, that when taken to their logical conclusions, lead to dangerous doctrines and practices. The historical Christian view has been that of dichotomy. For further discussion on the issue of dichotomy versus trichotomy see: Louis Berkof, Systematic Theology (Grand Rapids, MI: Wm. B. Eerdmans Publishing Co., 1932), 191-201.; Charles Hodge, Systematic Theology: In Three Volumes, 6th ed., vol. 2 of 3: Anthropology (Peabody, MA: Hendrickson Publishers Marketing, LLC, 2013), 42-51.; and Wayne A. Grudem, Systematic Theology: An Introduction to Biblical Doctrine (Grand Rapids, MI: Zondervan & Intervarsity Press, 1994), 472-489. Additional free online audio resources can be found here. This issue is also addressed by Dr. Welch in the work listed below.
[3] While it is true that the separation of soul and body results in physical death and that our souls will live temporarily in an intermediate state without a body (2 Cor 5:6-10)—either the believer in paradise or the unbeliever in hell/hades (Luke 16:19-31; Rev 20:14)—our ultimate and eternal destinies are to be experienced in both soul and body—either in the new heavens and new earth with resurrected, incorruptible bodies and souls (1 Cor 15:50-58; Rev 21:1-7), or in the lake of fire along with Satan and his demons (Rev 20:11-15).
[4] Edward T. Welch, Blame It On the Brain: Distinguishing Chemical Imbalances, Brain Disorders, and Disobedience (Phillipsburg, NJ: Presbyterian and Reformed Publishing Company, 1998).
- Published in Depression
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