What did Charles Spurgeon, Abraham Lincoln, the prophet Elijah, Winston Churchill, and King David all have in common? They all suffered at various times from the dark cold of depression. Someone has called depression the “common cold of emotional illnesses.” It is a problem that affects approximately 18.8 million Americans (nearly 10 percent of the population) and is often misunderstood, misdiagnosed, and confused with lack of faith. Let’s take a look at the causes, types, and treatment of depression, with a special focus on its effect on a person’s spiritual walk.
Believing Christians and those who minister to others are most certainly not immune to depression. Pastors, missionaries, caregivers, and other ministry workers (as well as their spouses) live highly-stressed lives, bearing many responsibilities, changes, and expectations.
If you are in ministry, people may come to you and share their heavy problems. Often the images of their horror stories stay alive in your own mind. It’s easy to believe that you must rescue them and fix their painful situations. This is very wearing. Some of you may experience what is called secondary traumatization, in which you pick up the depression of the people you are helping. You need to be aware of the signs of depression in yourself and in those to whom you minister.
WHAT IS DEPRESSION?
Depression can be a simple mood or a serious disorder. It can range from feeling a little down to feeling suicidal. It is an emotional state of pain, a thinking state of confusion, and a physical state of deregulation. The Bible describes it in Psalm 6 and Psalm 13 with such expressions as: ” … my bones are in agony, my soul is in anguish, I am worn out from groaning, I flood my bed with weeping, my eyes grow weak with sorrow. How long, O Lord? Will you forget me forever? How long will you hide your face from me? I wrestle with my thoughts and every day have sorrow in my heart. Give light to my eyes or I will sleep in death.” Depression is what Job experienced when he wished he had never been born.
WHO GETS DEPRESSED?
Christians and non-Christians, children, teenagers, adults, and the elderly all can become depressed. One out of every four women and one out of every seven men become clinically depressed at some point in their lives. Depression is a leading health problem worldwide.
CAN DEPRESSION BE SERIOUS?
Depression can be fatal since it is the primary cause of suicide; 15 percent of depressed people will commit suicide. Depression is the reason for multitudes of medical visits and tests that bear no diagnostic results. People lose their jobs over depression. Marriages fail and people leave the ministry or mission field because of depression. Some severely-depressed people are entirely unable to function and become prisoners in their own bedrooms. Depression can also be the underlying problem behind failing grades, alcoholism, withdrawal, teenage rebellion, and affairs (entered into when people search for something — anything — to make them feel better). In the most serious situations, depression lies behind attempts at suicide, with middle-aged men being most likely to succeed in their attempts.
WHAT CAUSES DEPRESSION?
Depression is complex and has many causes. Some people are genetically predisposed to the chemical imbalances in the brain that bring on depression. Certain medications and some physical illnesses (such as hypothyroidism, migraines, heart disease, diabetes, fibromyalgia, and others) have depression as a side-effect.
Depression is often the result of trauma, loss, or adjustment. Childhood trauma or neglect can trigger depression at the time or later in life.
Depression can also be caused by:
- feeling helpless
- chronic unmet needs
- negative thinking patterns
- unresolved grief
- unresolved anger
- chemical imbalances in the brain
- pent-up emotions
- sleep deprivation
- lack of forgiveness
- spiritual dryness
WHAT ARE THE SYMPTOMS OF DIFFERENT KINDS OF DEPRESSION?
There are, generally speaking, four different kinds of depression.
1. Depressed Mood
This is a short-lived emotional state of “feeling down” or “blue” and it is generally a feeling that comes and goes. You lose energy, mull over a loss or a problem, and find less enjoyment in life. As you process the loss or resolve the problem, you come out of it. It may even pass when the weather improves.
2. Dysthymic Disorder
This is a “low grade” depressed mood state that is experienced on a regular basis for two years or longer (one year for children and adolescents).
The symptoms include:
- low self esteem
- low energy or fatigue
- loss of appetite or overeating
- difficulty in sleeping or over-sleeping
- negative outlook
- feelings of hopelessness
- poor concentration or having difficulty making decisions
3. Major Depression
Major depression is severe clinical depression, an illness. Your physiology, thinking, and emotional state are disturbed. It is disabling and interferes with your ability to function and think normally. It can be experienced at one time in your life or at repeated intervals. It can go on for months or for years, if untreated. The symptoms need to be constant for two weeks or longer to be diagnosed as major depression.
The symptoms include:
- a persistent, sad, empty mood
- crying or the inability to cry
- loss of interest and enjoyment in most things
- significant weight loss or gain
- waking in the early morning hours and not being able to go back to sleep; insomnia
- excess sleep, fatigue
- loss of energy
- social withdrawal
- feeling agitated
- a profound sense of worthlessness
- feelings of inadequacy or shame
- loss of sexual desire
- difficulty thinking and concentrating
- recurrent thoughts of death or dying, possibly with suicidal plans
- substance abuse
4. Bipolar Disorder
Bipolar disorder is a physiological disease that affects an individual with alternating periods of depression and manic or hyper behavior. Approximately three percent of the population has this disorder. People suffering from bipolar disorder can at times change and lose their sense of reality, potentially causing many problems in all their relationships, including those in the church. They might want to invest the church’s money in some far-out scheme. They might become paranoid, violent, or grandiose, claiming to be a prophet with visions. They might become outlandishly immoral. They need consistent, long-term medical treatment by a psychiatrist.
DOES DEPRESSION AFFECT YOUR SPIRITUAL LIFE?
Typically, depression does not affect your basic faith and beliefs; however, it is a time of deep anguish of the soul, so you don’t “feel” very spiritually renewed or revived. During depression, you might feel like the worst of sinners, worthless to God and others. When you read your Bible, the wrath of God may be exaggerated in your mind, and you may have difficulty grasping His grace. You might feel far from God or find it difficult to experience His love or joy, yet it may be a time — more than any other in your life — when you need to cry out to God for His help and presence, as David did in the Psalms. It is a testing time of your faith because the “feelings” are just not there, so you need to stand firm on what you know to be true. The lives of Elijah, Job, and King David help us understand that depression is not a sign of inferior discipleship.
HOW CAN DEPRESSION BE TREATED?
Pray for healing. Pray for the right helpers, both personally and professionally. Pray that God will give you strength to cope and insight into how you can help yourself.
Reach Out to Others
Ask others to pray for you. Share with those close and trusted friends what you are feeling and what you are going through. Not everyone will understand, so setting some boundaries during your healing time is appropriate. Depression makes it hard to for you to concentrate on praying or reading God’s Word. Have others pray with you, listen to CDs, and listen to Christian music. When you are depressed, you feel like avoiding meetings, but being in worship and fellowship does help. In serious depression, you may need to ask for extra help with your responsibilities and a leave of absence from work.
Check Out the Cause
Look for the cause of your depression and, if possible, take the necessary steps to help yourself. For example, get a medical checkup, check the side effects of your medications, grieve a loss, exercise, problem-solve, change a situation, or take a needed vacation.
Seek Out Professional Help
If, after you have done all you can, your depression is still present, you need to seek the counsel of a good Christian therapist or psychiatrist.
Once in therapy, you might need to work on:
- unresolved issues from the past
- present-day problems
- learning how to process hurt, shame, or anger
- deciding what needs confronting
- deciding what needs forgiving; learning to apply forgiveness throughout life
- changing negative, untrue, unrealistic beliefs you hold about yourself, God, or others.
In severe or long-lasting depression, there is a biochemical imbalance in the brain and hormonal system. The body deregulates after too much internal or external stress. Antidepressant medications are then needed. Physical symptoms such as poor concentration, fatigue, crying, and sleep and/or appetite disturbances are indicators of a chemical imbalance. Antidepressants and/or other medications simply replace what is depleted in the body. They help you return to normal. They are not addictive. They are not “happy pills.” They do not change your feelings. In fact, if you are not chemically imbalanced, they will act like sugar pills and do nothing. Their function is similar to what insulin is to the diabetic. Today’s antidepressants are safe and have few side effects. Typically, it may take from six to 12 months of medication to recover from a major clinical depression.
Depression is a very painful, but treatable condition. Don’t suffer alone. Help is available and you can lead a normal productive life.
First published justbetweenus.org. Published with permission.*Statistics have been updated throughout.
Ingrid is a ministry wife in Brookfield, WI, with a Master’s Degree in social work. She has worked as a clinical social worker at a Christian outpatient mental health clinic. Ingrid and her husband, Mel, have two children.