Is depression purely a physiological condition of hormones or chemicals out of balance. Or, is there a heart/mind connection. Or, do both play a role?
The experts have disagreed, so how do we as biblical counselors help those who suffer from depression? How can we help without pushing them further down into the quagmire of despair and shame?
Depression Is Real
First, we must acknowledge that depression is real. Just read Psalms 32, 38, 102 to see that God gives voice to our deepest pain and hears our cries. The symptoms of depression affect both body and soul, and are enough to make a person deaf and mute, withdrawn and unproductive. Life turns inward and nothing but one’s pain matters at that moment.
The depressed need empathy, not sympathy.
Encouragement, not excuses.
Help, not judgment.
A Comprehensive Approach
We are fearfully and wonderfully made, and God created us with both a body and a living soul. One without the other is an incomplete human experience. Heart, soul, spirit, mind, and conscience are all aspects of the inner person, the place where desires and emotions emanate. The body gives expression to those desires. To understand depression requires looking at both the body and the inner person and connecting the dots.
If the person has not recently had a thorough physical, that should be step one. You want to be sure a medical doctor has determined there is no disease (such as Parkinson’s or diabetes) causing the body to respond in depression.
I remember one woman we counseled that presented increasingly depressed. And after several sessions, no obvious reason for her depression surfaced. We sent her to another doctor for a second opinion, and Dr. #2 found a small tumor on her thyroid that he removed. In just a few weeks she bounced back into the office to report how good she felt again. Depression all gone! Her issue was not spiritual, and all the Bible studies in the world would not make her feel upbeat until the physical problem was corrected.
Exploring Spiritually-Rooted Dimensions of Depression
However, our experience is that much depression has a root in the spiritual dimension of a person’s life. Disappointment sets the stage for depression. No, it’s not sin to feel disappointed about something. But disappointment can lead to a sinful attitude when that desire is not processed through a heart that loves and desires to please God more than any temporal thing or achievement. When heart desires lead us back to God’s sovereignty over our life and submission to His plans for us, the disappointment and related trials lead us to growth and maturity (James 1:2-4).
If the person has responded to disappointment and difficult circumstances with anger toward God and others, then the downward spiral into depression begins. Discontentment with situations and often with God becomes evident as bitterness and complaining grow. Unless repentance and change occur at this stage, the downward spiral continues into despair. Then the person loses all hope and believes life will never be good again.
The ultimate sinful solution is destruction through suicide or homicide, depending on whether the person focuses internally or externally.
Suicide Is NOT Always Physical
Let me also say here that suicide is not always physical.
One person may commit social suicide by leaving everyone and moving on to avoid the disappointing people. Another commits mental suicide with drugs and alcohol, zoning out of the disappointing circumstance.
Spiritual suicide denies God, trying to erase Him from a disappointing life. And emotional suicide retreats inward to hopeless despair through a psychological diagnosis that debilitates life and normal function. At least these can all be reversed, whereas a successful physical suicide is permanent.
The downward spiral from disappointment to discontentment to despair to destruction can move very quickly in some, and more slowly in others, but this is a common pattern we observe with those who are depressed.
More Help for Spiritually Rooted Depression
When I show the chart The Development of Spiritually-Rooted Depression to my counselees, they typically recognize very quickly where they are at that moment and how they progressed to that point. We then begin to identify the belief system that allowed them to process the disappointments as they did. We also begin to replace those wrong beliefs with a Biblical worldview that honors Christ.
I will often ask a depressed counselee to journal daily how she is feeling. I also ask her to trace that back to what she was thinking about hert life circumstances. In addition, we consider how her behaviors corresponded to what she was thinking and feeling about the situations she faced.
My goal is to help a depressed person who has evaluated their circumstances as too hard, or hopeless, or some other negative, to begin to see that negative evaluations produce negative behaviors, producing negative emotions!
Another biblical help is to think about the Psalms. They are a kind of emotional journal, with the psalmist pouring out a heart of disappointment, fear, anger, depression, shame, loneliness, or betrayal and expressing the pain that comes with wrong thinking or wrong actions or being sinned against.
The focus is inward, on self as it relates to circumstances. It often exposes a wrong view of self, others, or God. But the Psalms have what I like to call a “But GOD!” verse that lifts our chins upward to see the true and living God Who is much bigger than our problems and circumstances. That can change everything in our thinking and actions!
Therefore, my goal in asking someone to journal (or even talk during a counseling session) is to help them see her own belief system about their problems and circumstances, and then help them compare that to what Scripture teaches about our God.
Seeing God as He Is
As they begin to see God as He IS and to adjust their beliefs to embrace Truth, their actions begin to adjust, and in time their emotions can adjust, too. The depression that they once experienced because of believing their circumstances were hopeless and their God was impotent is replaced with trust in God and joy in the Lord, even if the disappointing circumstances continue and even if some trying emotions remain.
Why? Because their new (biblical) interpretation of the circumstances sees God as bigger than any circumstance He could ever face!
Join the Conversation
- As a biblical counselor, how do you address depression compassionately and comprehensively while exploring spiritually-rooted dimensions?
- As you personally struggle with depression, how could exploring the development of spiritually rooted depression help?
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Very informative article. I am in the process of getting my certification. My heart is that every believer know how to use the Word of God for rebuking, correcting and training in righteousness with a motive of love. My approach when someone comes to me, Pray first, ask the person if they have had a recent physical exam. If not, have them get one. Discern if there is any spiritual oppression in a believer. I give them my testimony of depression and how the Word of God changes me. If the person just needs a little guidance I continue to help them. If they truly have major issues I suggest a certified Christian Counselor
Yes, Julie Ganschow’s article spells out the problem of and solution for bitterness. As you know, a believer in Jesus Christ is indwelt by the Holy Spirit and has every resource he or she needs to overcome this sin problem. (A physical exam by a medical doctor is always a good idea to rule out organic causes.) I wouldn’t worry about spiritual oppression with a believer. Satan is a defeated foe. Usually, the person’s difficulty centers on choose self-rule over God-rule of one’s life. Thanks for your comment and keep going for certification!
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In your intro you mention a heart mind connection “Or, is there a heart/mind connection”.
Many biblical counselors are starting to make this distinction as if they are two different elements of the non organic aspect of a human being. Does the Bible make this distinction and can you explain the difference. The heart is surely an umbrella word for at least one’s cognitive and emotional component so is it not misleading to speak of them being distinct (i.e. heart/mind). Can you please explain what you mean by ‘heart’.
Thanks for your questions. People are unified beings. We experience the world as spiritual beings made to reflect God. Scripture uses different words — heart, soul, spirit, mind — to describe the heart, or the inner self. The Greek — kardia means “the focus of his beging and activity as a spiritual personality.” In Western culture, it’s common to think of people as made up of different components. A better way is to think of people as embodied souls. I recommend Jeremy Pierre’s The Dynamic Heart for further study. Thanks again. –LAM
I use heart/mind because both terms are used in Scripture to refer to the inner man, the one you cannot see but that rules the body you can see. They are used interchangeably in Scripture, just as terms like the flesh or the outer man refer to the body. We function as a unit but various terms are used as descriptions but not as separate entities. I see n distinction between soul and spirit, just as I see none between heart and mind. Yet we sometimes use one term more than the other in our cultural speech, or attempt to assign nuances to one or the other. I don’t see a distinction in Scripture beyond inner man and outer man that function quite well together…at least while we are alive!