Reformed Reflections

Woody Allen says life seems "to be divided into the horrible and the miserable." Allen's outlook seems overly pessimistic. But he is right in believing that life is not smooth sailing. One of the most obvious facts of human existence is the reality of suffering. It is common to us all, Christians included. We can expect trials. "Through many tribulations we must enter the kingdom of God" (Acts 14: 22). Earthquakes, floods, and fires do not differentiate between the good and the devout, and the sinner and the unbeliever.

The Dark Cloud of Depression

When we think of suffering, we usually have in mind physical pain caused by illness or an accident. We rarely think of the reality of emotional suffering. But depression is a condition which is much more common than many people realize. Despite greater awareness in our time, the subject is still often veiled in silence, disapproval or suspicion. One of the problems of depression is that there are no external signs to show what is wrong - it's not as if a person has a plaster cast around his leg or needs injections. Because no physical infirmity is apparent to the outsider, the depressed person all too easily feels, "I'm not really ill. People will think I'm faking it." But depression is not new on the list of human afflictions. It is common in every culture and many of the expressions used throughout the world describe it in graphic terms. The Dutch talk about "being fed up", or "beaten down". In Ghana, "the heart is hidden in a case". We talk about "the blues", "being down in the dumps", and "lifeless". Historical figures such as Isaac Newton, Beethoven, Darwin, Van Gogh, Tolstoy, and many others suffered from severe depression at some time in their lives. Winston Churchill was dogged by depression much of his life. He described it as his "black dog". It is said that only because Churchill had faced his own black periods he was able, at sixty years of age, to rally those who felt overwhelmed by the Nazi threat. His own experience of adversity enabled him to be a leader who helped to save the world from the darkness of tyranny.

The intensity of depression varies very greatly from one individual to another. For many it is a sporadic experience, and may be only short lived. For others it is a constantly recurring problem, and can indeed become virtually a permanent condition. For a depressed person the world appears black as a thousand midnights. He senses indescribable loneliness. He is frustrated with life and circumstances. He has the feeling that he has been abandoned, that he is worthless, and unlovable. The pain is excruciating. In Facing Suffering: a Christian Response Herbert Carson said, "For one it is like a black cloud on a summer day, blotting out the sunshine, unpleasant while it lasts, but mercifully, of fairly short duration. For another it is like a really bad summer in which the sun appears fitfully in an overcast sky, as one atmospheric depression is quickly followed by another." A depressed person may experience loss of appetite or weight loss. He is easily agitated and finds it hard to concentrate. He feels fatigued; sleep patterns are usually interrupted so that waking at two or three in the morning is not unusual. For some, with the day too painful to face, there is a longing to sleep forever.

Causes for Depression

Depression has many faces. It can be the experience of a youth who has learned that he must succeed to please his parents. But he does not live to his parent's expectations and feels rejected, unable to please. A study in Canada found that men were more vulnerable to depression later in life if they had lost a parent, particularly father, before the age of 17. It is not only loss by death. Studies have shown the link to be stronger if the loss is by separation caused, for example, by parent's divorce. Depression can be an unwanted intruder into the life of a middle-aged man. For example, he may have lost his job to a younger man and becomes unemployable. He has nothing to do, no place to go, and no way to support his wife. Depression is a common problem of the elderly. The typical retired older person is a widow. She is alone. Her family may be scattered all over the country. Her friends are mostly gone. She gets few visitors. Her life seems without meaning. Some older Christians bemoan the fact that they missed so many opportunities - opportunities to be there for their children when they were growing up, for doing good and helping others and opportunities for service. Missed opportunities. "If only I had known." They believe they are a failure in the sight of God. This acute awareness of their own deficiencies and needs oppresses them. There is the general fear of the future, while they cannot put their finger on anything in particular.

The fear of death, the assaults which the fact of death makes upon a man's life and upon his whole family relationships and the very thought of the inevitable fact of death can hang like a dark cloud over you. Is there anything that tends to affect life more than death? When death takes a loved one from your side, you may feel guilt for the things you might have said and did not, or for the things you said and now regret. St. Augustine struggled with its effect upon his mind. He discussed the death of a much-loved friend in his youth. He and Augustine had played together as children and grown up together in the closest possible friendship. Then the friend caught a fever and died. St. Augustine wrote, "My heart was black with grief. Whatever I looked upon had the air of death. My native place was a prison house and my home a strange unhappiness. The things we did together became sheer torment without him." Death "creates" a deep sense of loss, of emptiness, of being torn apart inside. C. S. Lewis wrote in A Grief Observed: "No-one ever told me that grief felt so like fear. I am not afraid, but the sensation is like being afraid. The same fluttering in the stomach, the same restlessness, the yawning. I keep on swallowing." The origin of the word bereaved is "broken up" and that for many people, is just how it feels.

How Not to Help

When the home is turned into a battlefield by a family member who acts in an anti-social manner, frustrations and shame know no bounds. It soon leads to anger, often hidden, but it is there nevertheless. Christian families are not exempted. How can we help in such a situation? Family members are not helpful if they try to become therapists. Therapy takes skill. It is no job for the amateur. No one in his right mind would set a layman loose with a scalper and tell him to perform brain surgery. Unless you know what you are doing you can do more harm than good. This includes self-diagnosis or treatment via internet. Furthermore, knowing the cause for depression does not guarantee recovery, most therapeutic efforts on our part are actually a hindrance to progress and impede recovery for the person whom we are concerned about.

Some tell the sufferer "pull yourself together", and others cannot understand why they can't get up and get moving. This is the worst, and unfortunately the most frequent of the mistakes made by people who wish to help. The problem with depression is that you can't pull yourself together. It implies that it is your fault for being depressed, and you could get out of your depression very quickly if you only were sensible. When you are depressed, you don't need to hear, "Cheer up. Chin up. Better days are coming." The problem is, the depressed person does not believe better days are coming.

Depression is still often misunderstood and feared by the Christian community. Some believe it's a sin to be depressed. The depressed Christian needs to learn, it is said, what it means to live "the victorious Christian life." Or perhaps he needs "inner healing." Other well-meaning Christians may say, "If you are depressed there must be something wrong with your faith. Look at the Biblical promises, and be happy. Have faith." If only life were that easy. It is a miracle already that the depressed person still has his faith. It was once aptly remarked that the Christian church is the only army to shoot its own wounded. There is nothing more depressing to an already depressed Christian than being gunned down by a critical Christian who has never suffered from a bout of depression, and who hasn't the wisdom nor the subtlety to see that he is hurting his fellow Christian.

How to Help

We can help by treating depression as a real disease. As we pray for fellow Christians with physical ailments, we should offer the depressed our prayer support. Tell them, "I am praying for you." Be willing to listen when the depressed person wishes to talk. It is astonishing to note the way in which people are helped merely by having someone who will listen to them. Be patient both with the sufferer and with the speed of his recovery. John Piper advised that if depressed saints cannot read the Bible, we should read it to them. Instead of being judgmental, show compassion. To bring relief to the suffering is the mark of discipleship (cf. Luke 10:30ff). Be a constant, loving and loyal friend. Real friends are the ones who can accept the depressed person as he is - on good days, bad days. The real curse in depression is that the sufferer loses confidence not only in the outside world, he also loses confidence in himself, and the knowledge that somebody else actually has confidence and cares about him can have positive results. Someone wrote, "how precious are those who seem to genuinely care. Their presence is like a cool breeze in a parched desert." A Christian friend does not become weary in well doing. He does not give up. He reminds himself of Jesus' words, "It is more blessed to give than to receive" (Acts 20:35).

As we help the sufferer, we remind ourselves that we are only pilgrims on earth. As fellow pilgrims we share the love of God. Jesus said, "My command is this: Love each other as I have loved you" (John 15:12). In Spiritual Depression: Its Causes and Cures D. Martyn Lloyd-Jones notes, "As you become absorbed in the love of God you will forget about yourself. 'The spirit of love!' It will deliver you from self-interest, self-concern." How true! If we love God, we show love to others. Some who suffer from depression may have never experienced real love. We can demonstrate in word and deed that knowing we are loved and accepted just as we are means that we do not have to earn love from others. This is the only real escape from the vicious circle of self-criticism and self-destruction for those who have never known love and acceptance from their parents.

Medical Help

What should a depressed sufferer do to get help? Sometimes he can be his own worst enemy. He may cover up his troubled mind with a cheerful face. If that is the case, he deprives himself of the counsel and help which he may so desperately need. Someone explained, "Depression has a cause. It's not the result of some mysterious visitation of the gods. It's an illness that is the result of certain biological or social forces that in some complex way are acting detrimentally to your health." One possible cause for depression, which is all too often overlooked by Christians is the physical. In their readiness to find a solution to their problems, they forget that sometimes there is a bodily need which requires attention. Our bodies and minds are so closely interwoven that we do not have a clear idea of how much is due to biology and how much is due to psychology, but biological and genetic factors do have considerable influence on our temperament and personality. Charles Haddon Spurgeon, one of the greatest preachers of all time, was subject to depression . The main explanation in his case was undoubtedly the fact that he suffered from a gouty condition which finally killed him.

The theory, which claims that depression is a disease that needs to be diagnosed and treated with drugs like any other illness is called the "medical model." For some kinds of depression, medication can make the difference between a person's continuing to function or becoming totally disabled. So the treatment for depression will vary enormously according to the person and the situation. Regrettably, the discovery that medication can bring help and hope to those who suffer from severe depression has been a mixed blessing. It has also led thousands of other unhappy people to believe that there is an easy chemical answer to life's problems and pains.

Looking for a Counsellor

There is no "text book" cause for depression. We are all born different. No two of us are exactly the same; we have our peculiar characteristics, our virtues, our failures, our likes and dislikes. We have our different temperaments and cultural backgrounds. Some types of depression are rooted in some physical condition. Some are caused by a period of particular emotional stress or tension. We would love to have some simple solutions, but there are few easy answers when facing the complexities of life in this world. This is hard for us to accept in our age of the snap slogan and the slick answer. In other words, it must be firmly stated that there is no standard answer.

An often asked question is: "Should a Christian who struggles with severe emotional issues seek the help of a counsellor?" I think it is an illusion that counsellors are unnecessary in the Christian life. What kind of a counsellor should he seek out? I strongly recommend a Christian counsellor who not only can pray for and with his client but who also has a Christian world and life view. His faith must be controlled exclusively by the teaching of the Bible. The approach to counselling is never neutral. Throughout the centuries, there have always been many schools of thought and as many different therapies. In our contemporary North American culture, psychotherapeutic approaches being propagated under the umbrella of psychology are often recognizably anti-Christian. They deny the sovereignty of God and promote the exaltation of "self." Two dominant schools of psychology that emerged in the 20th century were Freudian psychoanalysis and Skinner's behaviourism. Their view of man is essentially mechanistic, deterministic and pessimistic. Counsellors influenced by these schools of thought ultimately hoped that man would learn a measure of self-control by understanding himself better. As the Humanist Manifesto says, "No deity will save: we must save ourselves."

Why the emphasis on a Christian counsellor? In their book Depression: Finding Hope & Meaning in Life's Darkest Shadows Don Baker and Emery Nester note, "Psychology without an adequate theology will be as ineffective as theology without an adequate psychology. Both are needs for a therapist who is to be effective in the life of a Christian." A therapist who lacks a Biblical understanding of guilt, as opposed to feelings of guilt, would never be able to walk with a person lacking assurance of salvation. For example, if the patient acknowledges that he is scared of the thought of death and that this is really the "bottom line" of his problems, then the counsellor can mention the advantages of the Christian faith and the fact that Christ has conquered death. What if the counsellor is asked whether a divorce should be recommended? What are his obligations when he sees a patient acting out fantasies which are likely to be destructive to himself or others? Basic to all these questions is whether the counsellor has his ethical norms firmly rooted in the Word of God.

(To be concluded)

Johan D. Tangelder
March 2006