(These series of 6 messages on "Depression and the Christian" are also available on .pdf, .mp3 and video formats which can be downloaded from the website ofSermon Audio)
DEPRESSION AND THE CHRISTIAN
BY DR. DAVID P MURRAY
(3) THE CONDITION
We began this series of lectures on “Depression and the Christian, by suggesting eight reasons why we should study depression. We then proposed two principles to govern how we should study depression. We also examined three extreme positions some take regarding the causes of depression: all physical, all spiritual, or all mental (or “psychological”). We concluded that it was vital to resist the extremes, and instead to recognise the causes of depression to be complex and varied. The importance of this point was underlined by Martyn Lloyd-Jones:
“Many Christian people, in fact, are in utter ignorance concerning this realm where the borderlines between the physical, psychological and spiritual meet. Frequently I have found that such [church] leaders had treated those whose trouble was obviously mainly physical or psychological, in a purely spiritual manner; and if you do so, you not only don’t help. You aggravate the problem.”1 
Having laid this groundwork (the “why” and the “how”), we can now consider the question: what is depression?
There are two reasons why we should be concerned about getting a right answer to this question.
The first is physical and the second is spiritual.
The physical reason is that only by knowing the symptoms can I know if I or loved ones are suffering from mental illness, and so seek appropriate help. Many people suffer varying degrees of depression without knowing it, because they do not recognise the symptoms for what they are, and so go for years without getting help that is readily available and which would transform their lives.
The spiritual reason, and the one I am most concerned about, is that many who have the symptoms of depression, without identifying them as such, reason that, “If I have these thoughts and feelings, I cannot be a Christian!” My aim in this lecture is not only to outline the symptoms of depression, but also to show from Scripture that such symptoms are not only compatible with being a Christian, but are also commonly found in some of the most eminent Bible characters.
We will answer the question, “What is depression?” by looking at how it is related to and reflected in five areas of our lives: our life situation, our thoughts, our feelings, our bodies, and our behaviour. Before we do so, however, we must state three caveats. Firstly, these five areas are all linked, connected and inter-related. We cannot separate our thoughts from our feelings, or our feelings from our behaviour, etc. What we think affects how we feel. What we think and feel affects our physical health. Our thoughts, feelings and physical health affect what we do. Secondly, though we number these areas 1-5, this is not necessarily the chronological order in which the symptoms of depression always manifest themselves. Thirdly, we shall focus most of our attention on the second area, our thoughts, as false thought patterns are often the biggest contributor to depression, and also because it is an area where, with God’s grace, we can most help ourselves in.
I. LIFE SITUATION
Life in this world is full of ups and downs. Our providence can change so rapidly from smooth and happy to rough and upsetting. It is important to recognise how providential changes (e.g.
bereavement, loss of job, family difficulties, relationship problems) can seriously damage our mental health. A person may feel very down and yet never link such experiences with such life events. Therefore, one of the first steps to treating depression is to take time to examine our lives and, with God’s help, to trace back our present depressed thoughts and feelings to events in our lives.
This can be a painful process of self-discovery. Although we are frail and weak creatures, we like to think that we can cope with everything that life throws at us. We are, therefore, often reluctant to link our depressed thoughts or anxiety to life situations, because such a link exposes our weakness and frailty. As a result, there is often a desperate search for a purely physical cause (e.g. a virus) behind our lack of well-being because that will enable us to keep viewing ourselves as “mentally strong” or as a “coper”.
This is not to deny that there are usually, to one degree or another, physical factors involved in causing depression (see previous lecture). Indeed, in some people, there is undoubtedly an inherited genetic tendency to depression. However, there is almost always a providential trigger involved to some degree. Just because we coped with great stresses at some time in our lives, does not guarantee that we will cope with lesser stresses at other points in our lives. We age, our hormones and brain chemistry change, responsibility increases as marriage and children come along. Sometimes the adverse reaction to life events will be delayed, even for some years.
Consequently, we often need an objective view of our lives; an independent person such as a doctor, or counsellor, or minister, who can help us look at our lives more objectively. It is often the case that when we are helped to review our lives, we begin to see the real and significant effects our problems or difficulties have had on us, and the extent to which they may have contributed to the trigger for our depression or anxiety.
Perhaps, the most obvious symptoms of depression are the unhelpful patterns of thinking which tend to distort a depressed person’s view of reality in a false and negative way, and so add to the depression or anxiety.
While we often cannot change the providences we have passed through, or are passing through, we can change the way we think about them so as to present to ourselves a more accurate and positive view of our lives, and so lift our spirits.
We will focus on ten false thought patterns which reflect and also contribute to the symptoms of depression. We will summarise each thought habit, and look at three examples of each, one from ordinary life, another from our spiritual life, and another from the Bible. The Biblical examples are not necessarily examples of depressed person but they are examples of false thinking often present in depression.
It is important to see how our depressed thought patterns affect our ordinary life; and even more important to see how that is then carried into our spiritual life. It is almost always that order in which our thoughts are transferred – false thinking in ordinary life is eventually transferred into our spiritual life.
1. False extremes
This is a tendency to evaluate our personal qualities in extreme, black or white categories – shades of grey do not exist. This is sometimes called “all-or-nothing thinking”.
Life example:You make one mistake in cooking a meal, and conclude you are a total disaster.
Spiritual example:You have a sinful thought in prayer, and conclude that you are an apostate.
Biblical example:Despite most of his life being characterised by God’s blessing and prosperity, when Job passed through a time of suffering he decided he must be an enemy of God (Job 13:24; 33:10)
2. False generalisation
This happens when, after experiencing one unpleasant event, we conclude that the same thing will happen to us again and again.
Life example:If a young man’s feelings for a young woman are rebuffed, he concludes that this will always happen to him and that he will never marry any woman
Spiritual example:When you try to witness to someone you are mocked, and you conclude that this will always happen to you and that you will never win a soul for Christ.
Biblical example:At a low point in his own life Jacob deduced that because Joseph was dead, and Simeon was captive in Egypt, that Benjamin would also be taken from him. (Gen.42:36). “All these things are against me,” he generalised.
3. False filter
When depressed we tend to pick out the negative detail in any situation and dwell on it exclusively. We filter out anything positive and so decide everything is negative.
Life example:You get 90% in an exam but all you can think about is the 10% you got wrong.
Spiritual example:You heard something in a sermon you did not like or agree with, and went home thinking and talking only about that part of the service.
Biblical example:Despite having just seen God’s mighty and miraculous intervention on Mt Carmel, Elijah filtered out all the positives and focussed only on the continued opposition of Ahab and Jezebel (1 Kings 19:10).
4. False transformation
Another aspect of depression is that we transform neutral or positive experiences into negative ones. Positive experiences are not ignored but are disqualified or turned into their opposite.
Life example:If someone compliments you, you conclude that they are just being hypocritical, or that they are trying to get something from you.
Spiritual example:When you receive a blessing from a verse or a sermon, you decide that it is just the devil trying to deceive you.
Biblical example:Jonah saw many Ninevites repent in response to his preaching. But, instead of rejoicing in this positive experience his mood slumped so low that he angrily asked God to take away his life (Jonah 4:3-4).
5. False mind-reading
We may often jump to negative conclusions which are not justified by the facts of the situations.
Life example:A friend may pass you without stopping to talk because, unknown to you, he is late for a meeting. But you conclude that he no longer likes you.
Spiritual example:Someone who used to talk to you at church now passes you with hardly a word, and so you decide that you have fallen out of her favour. But, unknown to you, the person’s marriage is in deep trouble and they are too embarrassed to risk talking to anyone.
Biblical example:The Psalmist one day concluded that all men were liars, a judgment which on reflection he admitted to be over-hasty (Ps.116:11)
6. False fortune-telling
This occurs when we feel so strongly that things will turn our badly, our feelings-based prediction becomes like an already-established fact.
Life example:You feel sure that you will always be depressed and that you will never be better again. This, despite the evidence that almost everybody eventually recovers.
Spiritual example:You are convinced that you will never be able to pray in public. Again, this
despite the evidence that though difficult at first, with practice almost everybody manages it.
Biblical Example:Anticipating the opposition that Jesus would face in Bethany, Thomas falsely predicted not only his own death there but also that of the Lord and the other disciples (John11:16).
7. False lens
This is when we view our fears, errors, mistakes through a magnifying glass, and so deduce
catastrophic consequences. Everything then is out of proportion.
Life example:When you make a mistake at work, you conclude, “I’m going to be sacked!”
Spiritual example:You focus on your sins from the distant past in a way that leads to continued feelings of guilt, self-condemnation, and fear of punishment.
Biblical example:When Peter sinfully denied the Lord, he not only wept bitterly but decided that as his mistake was so spiritually catastrophic, there was no alternative but to forget about preaching Christ and go back to catching fish (Jn.21:3).
8. False feelings-based reasoning
In depression we tend to take our emotions as evidence for the truth. We let our feelings determine the facts.
Life example:You feel bad, therefore conclude that you are bad.
Spiritual example:You feel unforgiven, therefore conclude you are unforgiven. You feel cut off from God and so conclude that you are cut off from God.
Biblical example:At one of his low points, David felt and so hastily concluded that he was cut off from God. “I said in my haste, I am cut off from before thine eyes” (Ps.31:22).
9. False “shoulds”
Our lives may be dominated by “shoulds…” or “oughts”, applied to ourselves or others. This heaps pressure on us and others to reach certain unattainable standards and causes frustration and resentment when we or others fail.
Life example:The busy mother who tries to keep as tidy and orderly a house as when there were no children is putting herself under undue pressure to reach unattainable standards.
Spiritual example:The conscientious Christian who feels that despite being responsible for meals and raising children, that she ought to be at every prayer meeting and service of worship, and also reading good books and feeling close to God.
Biblical example:Martha felt deep frustration that Mary was not fulfilling what she felt were her obligations and complained bitterly about it (Luke 10:40-42).
10. False responsibility
This is when we assume responsibility for a negative outcome, even when there is no basis for it.
Life example:When your child does not get “A” grades you conclude that you are an awful mother. The reason may be instead that your child has a poor teacher or that his gifts are not of an academic nature.
Spiritual example:When your child turns against the Lord and turns his back on the church you assume that, despite doing everything you humanly could to bring him up for the Lord, it is all your fault.
Biblical example:Moses felt responsible for the negative reactions of Israel to God’s providence and was so cast down about this that he prayed for death (Num.11:14-15).
1. False thinking patterns are compatible with being a Christian.
2. False thinking patterns will have a detrimental effect on our feelings, our bodies, our behaviour, and our souls; usually in that order.
“For Christians, depression hardly ever has a spiritual cause…In Christians, spiritual effects follow from the depression, and seldom the other way around.” 
3. One of the first steps in getting better is recognising these false thinking patterns which do not reflect reality.
4. While we can do little if anything to change our providence (our life situation), we can change the false way we may think about our providence.
Obviously, these unhelpful false thought patterns are going to give you unhelpful emotions and feelings. If you are always thinking about problems and negatives, or imagine the future is hopeless, or think everyone hates you, etc., then you are going to feel down very quickly. Your feelings about ordinary life and your spiritual life are going to reflect what you think in each arena (Prov.23:7).
Here, we shall briefly look at some of the emotional symptoms of depression. And, as with the area of our thoughts, let us honestly examine the area of our feelings in order to consider whether our emotions are related to a depressive tendency or illness. Also, as with the area of our thoughts, in this area of feelings we shall also highlight Biblical examples of true believers also experiencing such emotions, in order to show that such feelings are compatible with being a true believer.
1. Do you feel overwhelming sadness?
Everyone feels sad and down from time to time, but depression-related sadness is overwhelming and long-term. It often results in tearfulness and prolonged bouts of unstoppable sobbing.
Biblical Examples:Job (Job 3:20; 6:2-3; 16:6, 16), David (Ps.42:3,7).
2. Do you feel angry with God or with others?
A common characteristic of depression, especially in men, is a deep-seated and often irrational irritability and anger.
Biblical Example:Jonah (Jonah 4:4,9), Moses (Num.20:10-11).
3. Do you feel your life is worthless?
It may be that despite your life being highly valued by others, and despite you being useful to others and to the Lord, that because of your distorted view of yourself you feel your life is worthless. Indeed you may feel your life is just a burden to and a blight upon others.
Biblical Example:Job (Job 3:3ff), Jeremiah (Jer.20:14-18)
4. Do you feel extreme anxiety or panic?
“In anxiety, the person often overestimates the threat or danger they are facing, and at the same time usually underestimates their own capacity to cope with the problem.” 
Biblical Example:David (1 Samuel 21:12), disciples (Matt.8:25)
5. Do you feel God hates you and is far from you?
Although to any outside observer your past and your present may be replete with examples of God’s good favour towards you, you feel that God has either become your enemy or else has given up on you. You feel as if you are in spiritual darkness
Biblical ExamplesJob (6:4; 13:24; 16:11; 19:11; 30:19-23, 26), Jeremiah (Lam.3:1-3).
6. Do you feel suicidal or do you have a longing to die?
Biblical Examples:Job (Job.3:20-22; 6:9; 7:15-16), Moses (Num.11:14), Elijah (1 Kings 19:4)
These deeply depressed feelings are movingly articulated for us by the depressed Charles Spurgeon, when commenting on the experience of Heman in Psalm 88.
“He felt as if he must die. Indeed he felt himself half dead already. All his life was going, his spiritual life declined, his mental life decayed, his bodily life flickered; he was nearer dead then alive. Some of us can enter into this experience for many a time have we traversed this valley of death shade, and dwelt in it by the month together. Really to die and to be with Christ will be a gala day's enjoyment compared with our misery when a worse than physical death has cast its dreadful shadow over us. Death would be welcome as a relief by those whose depressed spirits make their existence a living death. Are good men ever permitted to suffer thus? Indeed they are; and some of them are even all their lifetime subject to bondage….….It is a sad case when our only hope lies in the direction of death, our only liberty of spirit amid the congenial horrors of corruption.... He felt as if he were utterly forgotten as those whose carcasses are left to rot on the battle field. As when a soldier, mortally wounded, bleeds unheeded amid the heaps of slain, and remains to his last expiring groan, unpitied and unsuccoured, so did Heman sigh out his soul in loneliest sorrow, feeling as if even God Himself had quite forgotten him. How low the spirits of good and brave man will sometimes sink. Under the influence of certain disorders everything will wear a somber aspect, and the heart will dive into the profoundest deeps of misery. 
IV. BODILY SYMPTOMS
“A merry heart doeth good like a medicine: but a broken spirit drieth the bones” (Prov.17:22). Thus does the Bible confirm for us the link between distorted thoughts or emotions and many of our bodily ailments. Every day, doctors are faced with patients complaining of various physical symptoms whose root problem is their depressed thoughts and feelings.
These bodily symptoms include abnormal sleep patterns (Job 7:4, 13-15), fatigue and loss of energy (Ps.6:6, 69:3), weight fluctuations (Job 17:7; 19:20), digestive problems (Lam.3:5), loss of appetite (Ps.102:4; 42:3), pain in various parts of the body (Ps.32:3-4 31:10; 38:3), choking feelings and suffocating breathlessness (Ps.9:18; 42:7; 69: 1-2) . In Psalm 32:3-4 the Psalmist describes the bodily consequences of true guilt, but the same can also be the result of false guilt.
V. BEHAVIOUR AND ACTIVITY
As we might expect, the impact of depression on our thoughts, feelings and bodies will inevitably have an effect on our behaviour and activity. This is usually seen in two ways. Firstly, we may stop doing things we enjoyed or that we were good at, or that were good for us. This may involve no longer going to church or fellowships, not contacting family and friends, or the cessation of hobbies and other beneficial leisure interests. Secondly, we may start doing things that make us feel worse like staying indoors, drinking alcohol, or pushing away people who care.
1. Assess the five areas of your life as outlined above, perhaps with the help of a trained professional, and try make an honest judgment about yourself. Remember that even one false thought pattern will have an adverse effect on your feelings, physical health, and activity patterns.
2. Try to remain open to the possibility that physical symptoms may well be related to depressed thoughts and feelings.
3. Seek medical advice regarding the suitability of anti-depressants for you.
4. Focus particularly on the area of your thoughts and try, with God’s help, to reverse false thinking patterns and recover and maintain a true view of God, of yourself, and of others.
5. Pray for yourself and others. Tell the Lord exactly how you feel. Neither Job, David, Elijah or Jeremiah “hid” their feelings from God.
6. Seek the sympathy of Christ. The words used to describe his mental sufferings in Mark 14:33 and Matthew 26:37 may be translated “surrounded with sadness” or “deeply depressed”. Charles Spurgeon wrote:
“When our Lord bore in His own person the terrible curse which was due sin, He was so cast down as to be like a prisoner in a deep, dark, fearful dungeon, amid whose horrible glooms the captive heard a noise as of rushing torrents, while overhead resounded the tramp of furious foes. Our Lord in His anguish was like a captive in the dungeons, forgotten of all mankind, immured amid horror, darkness, and desolation.” 
7. Believe the depression is part of the “all things” that are working together for your good (Rom.8:28).
If He had said, ‘Go out and preach ...', you'd have gone. If He'd said, ‘I want you to be a missionary', you'd have gone (possibly reluctantly, depending upon your own hopes and desires!). But because He has said. ‘Sit there and be depressed for a bit, it will teach you some important lessons', you don't feel that it is God calling you at all ... do you? Do you remember Naaman, who wanted to be cured of his leprosy? (See 2 Kings 5.) If he had been asked to do something glorious he would have been happy. Because he was asked to bathe in the murky old Jordan he wasn't so keen - yet this was God's plan for him, and it cured him. God has better plans for us than we have for ourselves - unfortunately, as we can't see into the future, we don't always appreciate just why God's plans are better. With hindsight it's somewhat easier! However strange it may seem to you, God wants you to go through this depression - so look at it positively, not negatively. What does He want you to learn from it? What can you gain from going through it? When you begin to think in this fashion your guilt feelings start to drop away. You can begin to understand that what is happening is part of God's plan for you - and so your depression is not a punishment from God. You are actually where God wants you to be, even if it is emotionally painful. To put it another way, if God wants you to go through this it it would be wrong for you to avoid it, wouldn't it? 
D Martin Lloyd-Jones, The Christian Warfare (Grand Rapids: Baker, 1976), 206-208.
DrJohnLockley, A Practical Workbook for the Depressed Christian (Bucks: Authentic Media, 1991), 53-54.
Williams, Richards & Whitton, I’m not supposed to feel like this, (London: Hodder & Stoughton, 2002), 31. Williams, Richards & Whitton, I’m not supposed to feel like this, (London: Hodder & Stoughton, 2002), 31.
Charles Spurgeon , Treasury of David, (Newark, Del.: Cornerstone, 1869), 2.131-132.
Charles Spurgeon, Treasury of David, (1869: repr., Newark, NJ.: Cornerstone, n.d.), 1.261-262.
JohnLockley, Practical Workbook for the depressed Christian, (Bucks: Authentic Media, 2002), 18.