DEALINGWITH DEPRESSION

“Why art thou cast down, O mysoul? and why art thou disquieted in me?” (Ps 42:5a).

Depression is an age-old and a very common problem. Some of us may haveexperienced it ourselves, or know of friends or relatives who had. Though theword ‘depression’ is not found in the Bible, there are numerous passages whichsuggest that various persons did experience depression or at least symptoms ofdepression. Amnon lusted after his half-sister Tamar so intensely that he was“vexed” and “fell sick” for her (2 Sam 13:2). Ahab coveted Naboth’s vineyard somuch that “he laid him down upon his bed, and turned away his face, and wouldeat no bread” (1 Kgs 21:4). Ahithophel was so depressed that his counsel wasnot followed by Absalom, that he hanged himself (2 Sam 17:23).

Moreover, a believer who had experienced depression himself or herself will nodoubt identify with numerous of the Psalms as probably referring to a state ofdepression. I well remember Dr. Tom Holland, a Calvinistic Baptist minister,speaking from his own experience to show how Psalm 22 was probably written byDavid at a time when he was depressed or experiencing depression. Although Iwould have difficulty preaching Psalm 22 this way, I was intrigued by Dr.Holland’s insight. The more famous doctor, Dr. Martyn Lloyd-Jones, begun hisseries of messages on “Spiritual Depression” with the verse we cited at thehead of this article (see his SpiritualDepression: Its Causes and Its Cure [Eerdmans,1965]).

I have no doubt that David was in fact expressing feelings of depression whenhe penned those words, under inspiration. Perhaps, this verse and numerousparts of the Psalms were so inspired partly so that they may be of help toChristian men and women throughout the ages, who would experience similar kindsof depression. But let’s look at Psalm 42:5. There are three things we maylearn about the nature of depression from this verse.

Nature of Depression

Firstly, we note that depression involves a baffling feeling of sadness, hopelessness, anxiety,despondency and/or inability. In the context of Psalm 42, David was beingpursued by Absalom his son, and he was prevented from doing what he greatlydelights to do, namely to worship the LORD withthe saints (vv. 1–4). Obviously David knew the reasons for his presentpredicament. Yet, he asked: “Why art thou cast down, O my soul? and why artthou disquieted in me?” (Ps 42:5a). He was, as it were, baffled by his ownfeelings.

Secondly, we note that depression involves introspectiveconfusion. David felt that he was “disquieted” within. The word translated‘disquieted’ (hamah, in Hebrew literallymeans ‘murmur,’ ‘growl’ or ‘roar.’ David felt a murmuring or growling spiritwithin. We may say that he was hearing himself complaining about his own situationand feeling terrible about it.

Thirdly, we must not forget that depression involves the soul. Note how David locates hisfeelings in the soul. We must not neglect the fact that depression could alsohave bodily causes, especially in what may be known medically asendogenuousdepression (contra reactive depression), which may resultfrom a biochemical imbalance in the brain. However, we must not forget the factthat depression always involves the soul—even if in a particular case, it maynot be the primary cause. This is because the human being, in this life, cannotbe cleanly dichotomised into soul and body. There is such a complexinter-relationship between the two parts of our being, that especially inmatters of emotion, it is practically impossible to isolate it as beingentirely spiritual or entirely biological. Thus, spiritual causes and remediesmust not be ruled out in whatever case of depression.

Causes of Depression

Thereare many different causes of depression. But let me begin with thephysique and disposition of a person. I am referring to thefact that God makes us very different from one another, and some of us may bemore prone to depression than others. David was probably a man prone todepression. It is not necessarily a bad thing to be prone to depression. Therewere many great men in the past who were thus inclined: Jeremiah, Elijah,perhaps John the Baptist, Martin Luther, Charles Haddon Spurgeon, Henry Martyn,Martyn Lloyd-Jones, etc. These could be prone to depression due to a variety ofreasons, such as their introspective or introverted disposition. Or, it couldbe due to some physical illnesses or physical limitations they had to livewith.

Some claim that genes have a contributing factor. The result of seven studiesinvolving twins in the United States and Europe suggests that in the case ofidentical twins (who are genetic carbon copies of each other), in 76% of thetime, when one sibling is affected by mental disorder, the other would also besimilarly affected. This compared with 19% in the case of fraternal twins. Arelated study based on reports in psychiatric literature suggests that in thecase of identical twins who were raised apart and so did not experience thesame environment, the percentage drops to 67%. This data, if correct, suggestthat there is a genetic link toone’s propensity to depression. However, it also suggests that the genes arenot the only cause and cannot be blamed for every case of mental disorder ordepression, since in 33% of the cases, when one of the identical twin had adisorder, the other did not. Moreover, this study does not indicate how muchregeneration, which involves the soul, and living in obedience to the Word ofGod, would affect the percentages.

The second cause of depression is reactionto the circumstances in which wefind ourselves. Ahithophel fell into depression and committed suicide inreaction to failure. David was depressed because of a frustrating circumstance.Elijah fell into depression in reaction to great blessings followed by anunexpected turn. He had just experienced the power of God on Mount Carmel andsaw the LORD sending the rain in answer to his prayers. He had high hopes thatIsrael would finally turn back to the LORD. Instead, he received news thatJezebel was going to kill him and he became so depressed, he wanted to die.

In our present context, death of a loved one, failure in examinations, break-upof a cherished relationship, business failures, marital strains, lost of jobs,etc., can all be causes of depression.

The third cause of depression, a very major one, is unbelief. Note David’s words in Psalm42:5, “Why art thou cast down, O my soul? and why art thou disquieted in me? hope thou in God: for I shall yetpraise him for the help of his countenance.” Notice how David recognises thathis failure to trust and hope in God is one of the causes of his presentinternal turmoil. Reason should show us that most of the occasions fordepression given under the second cause above would have little effect, if onlywe fully trust the Lord that He is sovereignly directing all things togetherfor the good of His children (Rom 8:28). For example, one who fails anexamination despite having tried very hard, really needs not feel frustrated ordepressed, if he learns to submit to the will of God. Or similarly one who hasbroken up in a relationship or lost a job would not feel depressed if he seesclearly that God has other plans for him. It is because we do not see thefuture and because we fail to trust the Lord with our future that we becomedepressed. The Lord surely knows our heart when He exhorts us to seek first Hiskingdom and His righteousness rather than worrying about tomorrow (Mt 6:33–34).

The fourth general cause of depression is disobedience and guilt.David wrote the 32nd Psalm sometime after he was confronted by the prophetNathan for his adultery with Bathsheba and murder of her husband. Listen to hisexpression of guilt: “When I kept silence, my bones waxed old through myroaring all the day long. For day and night thy hand was heavy upon me: mymoisture is turned into the drought of summer” (Ps 32:3–4). He felt as if hisbones were decaying. There was no soundness within. He felt listless andhelpless. Something was rotting within, but he could not do anything about it.He groaned his heart out, but he found no relief. At the same time, he felt asif God’s heavy hand was pressing upon him. God, who was a friend in Christ, hadbecome, as it were, his enemy. When He thought about God, he could no longerconceive Him as a loving heavenly Father. All he saw was an angry judge andking. He felt crushed under the weight of his sin and the wrath of God. And hefelt like a helpless man in the desert craving for water to ease hisdiscomfort. He felt his energy sapping away and life becoming so meaningless asjoy fled him. Does this not suggest that he was experiencing depression orsinking into depression?

The fifth cause of depression is that which particularly affects women,namelychildbirth. It is estimated that maternal blues is experienced by 70 to80% of all new mothers in the first days or weeks following childbirth.Normally this begins between the third or fourth day of childbirth and lasts nolonger than two weeks. It is characterised by rapid mood swings, a tendency toburst into tears, irritability and even hostility towards others, including thehusbands. Many believe that the cause is primarily biological as every newmother experiences a rapid decline of hormones (estrogen and progesterone)as the body adjusts from pregnant to non-pregnant states.

However, many other reasons associated with childbirth could also causedepression, such as (a) when expectations clash with reality, such as when anexpectant mother is eagerly looking forward to an angelic little baby but ismet by a sickly or colicky child who is extremely demanding; (b) a change fromhaving a structured 9 am to 5 pm work-week to an unstructured round-the-clocksingle-handed looking after the baby; (c) lack of sleep and fatigue; (d)conflicting feelings of becoming a mother; (e) undesirable customs imposed bymothers or mother-in-laws; (f) undue pressure or lack of support to breast-feedthe baby; (g) social isolation, etc.

The final cause of depression is the devil.Lloyd-Jones is quite right when he says:

In a sense, and in the lastanalysis, that is the one and only cause of spiritual depression—it is thedevil, the adversary of our souls. He can use our temperaments and our physicalcondition. He so deals with us that we allow our temperament to control andgovern us, instead of keeping temperament where it should be kept. There is noend to the ways in which the devil produces spiritual depression. We mustalways bear him in mind. The devil’s one object is so to depress God’s peoplethat he can go to the man of the world and say: These are God’s people. Do youwant to be like that? (op. cit., 19).

The devil will take advantage of all our infirmities to make us doubt and todrive us to self-pity and so depression. Remember, however, that the devil doesnot plant thoughts into our minds. It is always our thoughts and our emotions.The devil simply makes use of them for his own purpose. So do not go aroundattempting to distinguish whether a thought is planted there by the devil or byGod or by yourself. Such an exercise is not only futile but dangerous.

Remedies Against Depression

There are so many different causes of depression, thatit is extremely difficult to prescribe any useful remedy in this short article.Let me therefore suggest a few general principles for purpose of awareness, andleave you to seek further pastoral counselling if you find yourself sinkinginto depression. I am aware that in many instances of depression, whether majoror mild, the depressed person may not want any help at all. So this article isboth to prepare you, should you find yourself depressed as well as to prepareyou to help others, be it your family members or brothers and sisters inChrist.

The first general remedy, I believe is to pray.This is particularly necessary if the depression is brought about by cripplingguilt. Notice David’s experience as recorded in Psalm 32: “When I kept silence,my bones waxed old”. I acknowledged my sin unto thee, and mine iniquity have Inot hid. I said, I will confess my transgressions unto the LORD; and thouforgavest the iniquity of my sin” (Ps 32:3–5). David was joyless as long as heremained silent concerning his sin, but he found relief when he begun toconfess to the Lord. The Apostle Paul, referring to a joyless condition whichwould be included in a depressed state, also recommended prayer:

Rejoice in the Lord alway: andagain I say, Rejoice.… Be careful for nothing; but in every thing by prayer andsupplication with thanksgiving let your requests be made known unto God. Andthe peace of God, which passeth all understanding, shall keep your hearts andminds through Christ Jesus (Phil 4:4–7).

In other words, if you feel depressed, do not continue to dwell on your ownfeelings, but look to the Lord Jesus Christ, casting your anxieties upon Himbecause He cares for you.

The second remedy is to talk toyourself. This may sound strange and contradictory, for in a depression aperson is introspective and tends to be led about by many suggestions in hisheart: “I am so depressed…,” “I can’t do anything…,” “I better not do anythingor I may make matter worst…,” “It’s all my fault…,“ etc. Why then do Irecommend that you talk to yourself? Well, remember that there is a differencebetween talking to yourself and talking withyourself. When you talk withyourself and listen to yourself talk about your feelings and inability, you arelikely to sink deeper into depression. But when you talk to yourselfto exhort yourself, it makes a difference. AgainDavid demonstrated that. “Why art thou cast down, O my soul? and why art thoudisquieted in me? hope thou in God: for I shall yet praise him for the help ofhis countenance” (Ps 42:5). Notice how David questioned himself rhetorically,and then called himself to do what is right. He knew that he was not trustingthe Lord, and he told himself to trust in the Lord. You may have experienced ityourself. Sometimes when I am particularly discouraged by things that happen inthe ministry, and I feel like Jeremiah, I would not only go to the Lord, but standbefore the mirror and exhort myself from the Word of God, and I find myselfcomforted or stirred to continue the work. A ministerial friend of mine onceshared with me that he would preach to himself before the mirror before hepreach to his congregation, and that he is encouraged by his own sermon! I didnot understand what he meant until I had occasion to do what David did: toexhort himself and to encourage himself in the Lord (1 Sam 30:6).

The third remedy is to attend toall duties against and regardlessof feelings. When you are depressed you will feel very despondent and will tendnot to want to do anything. You feel like just sitting down and sulking. But ifyou do that you will simply spiral down into further depression, as guiltrelated to duties undone began to beset you. A father, who is depressed becauseof job lost and so fail to lead the family in worship, will soon become moredepressed because he is failing in his duties as a father. A mother who isdepressed because she hardly sees her husband may become even more depressed asshe began to neglect her household chores, e.g., of ironing, cooking, washing,etc. What is the remedy but to wake up and do something which had beenneglected!

When you are depressed, it is unlikely that you can do anything about yourfeelings. So it may be futile to try, for as you are trying, you are likely toaccumulate more reasons to feel bad. Therefore ask yourself rather: (a) Whatduties am I neglecting (including attending to the means of grace)? and (b) When,where and how shall I begin? Then begin to take the first step as soon aspossible, and list the rest down, and resolve to do them as soon as you havecompleted the first task. As you attend to your duties, and conquer one smallstep at a time, you will begin, as it were,—in the words of Jay E. Adams,—to“spiral upwards” in recovery.

Fourthly, I would recommend that if you remain depressed for more than a fewdays, that you seek pastoralcounselling before it gets worst.Let your pastor help you if he can, and let him recommend you to see a doctorif necessary—if he has reason to suspect that you are facing a major depressionwith a biological cause.

Finally, for our mothers (and fathers), maternal blues will usually go offafter a few days, though it has been estimated that in about 10% of the cases,the maternal blues develop into major postpartum depression that may last along while and need medical help. Major postpartum depression can be mild,moderate or severe enough to include suicidal thoughts and requirehospitalisation. Symptoms include rapid mood swings, insomnia or hypersomnia,serious inability to concentrate, irritability, panicky feelings, withdrawaland isolation even from the husband, obsessive thoughts about baby falling orbeing stolen, etc. Thus, if you find yourself being depressed for more than amonth after delivery of your child, it would be prudent to see your pastor, whowill recommend medical help if necessary.

Other than that, just be prepared for it, and make sure your husband isprepared for it and lend you a supporting shoulder rather than reactingimpatiently with hurting words, such as: “Snap out of it! Don’t beunreasonable! Stop crying for no reason!” Do not feel ashamed to ask for helpor counsel from older believing women who have had experience with childbirthand child-rearing. Here, the husband should lend a hand because when your wifeis feeling depressed, she may not want to talk to anyone. You may just have toinitiate the call for her. Call someone she respects, whom you know can be ofcounsel and help. But mothers, I would urge you to persevere on in yourmotherly duties despite your feeling depressed. The Lord will be your help andwill surely deliver you out of your doldrums and grant you the joy of motherhoodas you trust in Him.

Conclusion

Lloyd-Jones is right, is he not: “In a sense adepressed Christian is a contradiction in terms, and he is a very poorrecommendation for the gospel” (Ibid., 11)? There are many people in the worldwho are excited about what they believe in, whether it be soccer or some latestcraze promoted by the toy or film industry. They talk excitedly about theiridols, and it rubs off on others. But too many serious Christians seem to bealways in the doldrums, and give an appearance of lack of freedom and joy. Iam, of course, not talking about the Charismatics who are excited abouteverything but the pure Gospel. I am talking about serious-minded disciples ofChrist. If we persist in our doldrums, we would give a foothold to the devil tocast doubt on the credibility of the Gospel. May the Lord grant that as asanctified people we will not only be aware of ourselves and of the devil’sschemes, but seek to be a joyful people constantly excited about the Lord JesusChrist. Let us not allow the devil to take advantage of our infirmities in theremnant of our corrupt nature, but be ever diligent to serve the Lord until theday we finally put off this body of sin. Amen.

—JJ Lim