Another diagnosis would be major depressive episode. Five or more of the following symptoms during the same two-week period that represent a change from normal functioning and that affect daily life in a negative way – so here they are: Depressed mood most of the day nearly every day. Loss of interest or pleasure in all, or almost all, activities. Significant weight gain or loss. Insomnia or hypersomnia. Psychomotor agitation or retardation. Fatigue or loss of energy nearly every day. Feelings of worthlessness. Excessive or inappropriate guilt. Diminished ability to think or concentrate and indecisiveness. Recurrent thoughts of death or suicide without a specific plan or attempt. So, if you’ve ever felt any of these things, that’s what you call it.
Who gets depressed? Well, women are more likely than men to get depressed. Nearly 25% of all females will be clinically depressed at some time in their lives. Why women? Well, depression is generally understood to be a form of anger. Women tend to turn anger in on themselves. You see young girls cutting themselves – sometimes older ones, too. They have suicidal thoughts. Men tend, more often than women, to take it out on others with violence or crime. Although, men do talk less about their feelings. They tend to stuff their feelings more than women.
What causes depression? According to some, body chemistry has a lot to do with it. Brain researchers have demonstrated that there is a chemical imbalance present when people get depressed. Some people take that for proof. But, actually, there’s a battle raging now over what causes that imbalance. Drug companies would like you to believe that it’s an organic cause, because the solution to that is a pill, which you could buy from them. Others believe the chemical imbalance is caused by the way we think about life and poor mental health practices. So they propose therapy. So the issue is, is the brain chemical issue causing the depression, or does depression cause the brain chemical issue? I’m inclined to believe that there are cases of both, with the vast majority being that the chemicals are produced when we’re depressed.
A fifty-year-old man came to me some time back. He’d been a Christian all his life. He told me that he was always discouraged and feeling worthless, did a lot of therapy in the past. And the key here is his next statement: “I’ve never known a time when I felt really good.” I suggested he go to a psychiatrist, tell him what he told me, and see if he could get some mild medication to see if it helped. Now he’s fine, as long as he takes the pills. He’s probably the kind of person whose brain chemistry is out of balance no matter how he’s thinking or trying to think. You know, those of us who don’t have that issue don’t understand what that’s like. And even though he can’t identify it, it might have been from something that occurred in his background – but probably not.
Now, this can be really tricky, however. I had a client who told me she used to watch her father beat her little brother. And, in her four-year-old mind, she decided it would be better to be on her father’s side, so she would pick on her little brother, too. She identified with the perpetrator, rather than the victim. She also told me she could not remember a time when she was not depressed, except for the three years after she was struck by lightning. There’s a little tiny pinhole in the roof of her car and one in the floorboard. She also reported being depressed from an early age, but there was plenty of evidence that her depression came from her environment. People ask me, “What does that mean?” Well, I have no idea. It does make me wonder about electro-convulsive therapy though – you know, ECT?
Another example: A man came to my office one day. He said, “I don’t seem to have any interest in life anymore. It goes up and down, but generally, it’s getting worse.” I said, “Have you ever been to a counselor for any reason?” “No.” “Have you ever been on medication for your depression?” “No.” “Sleep?” “Well, I sleep too much. I’m tired all the time.” “Appetite?” “Little – no interest in food.” “Suicide?” “No thinking that way.” While he was talking to me, he was wiggling his foot furiously, and was unaware of it. So, there’s that psycho-motor agitation that sometimes comes along with depression. “Self-esteem?” He judged that to be low. He said, “I got married, and that lifted it for a while, but now, a month later, I’m back to the blahs.” “How about work?” “Well, my boss is a Hitler. I hate working – at least, for him.” “How about your childhood?” “Well, my parents divorced when I was a kid.” “Were you abused?” “No.” “Neglected?” “Well, sometimes, I guess.” “Relationship with parents now?” “Well, they both live in town. I see them, but we’re not close.” “Friends?” “Uh, maybe a few college buddies.” So, he came in the following week, intent on working on it, and I said, “So just start talking about whatever seems important to you.” He looked at his feet. He looked at his fingernails. He looked down at his shirt. He looked at the pictures on my wall and the carpet on the floor. And then he said, “Where did you get that picture?” I said, “It’s hard to settle on anything personal to talk about.” “Yeah, it feels like I’m under a microscope.” “You really feel self-conscious and uncomfortable.” “I can’t think of anything to say.” “Your mind feels like it’s locking up – resisting you. Just keep saying whatever comes to your mind, just like you did just then.” He said, “Will it always be this hard?” “You’re wondering if you can even do this work. It’s so hard for you to think about your own thoughts.”
So you can see that this man has dysthymic disorder. He’s not thinking about death or suicide. And it’s been going on a lot longer than a couple of weeks. It’s been going on longer than two years, even. He suffered through a divorce as a child, where he heard a lot of mean-spirited arguing and screaming. He’s not used to putting his feelings, or even his personal thoughts, into words, so he keeps everything inside. As he gets older, all the big and little hurts never get healed. They just keep piling up and getting heavier and heavier – taking more and more energy to keep all those hurts out of his conscious awareness. And the result is that creeping, slow, blah kind of depression that is called dysthymia. He’s angry about all that and he won’t let himself feel it. You know, the Bible talks about how “God desires truth in the inward parts.” Well, this man isn’t being truthful with himself about how he really feels. Now, he might now even know that. He doesn’t know what’s causing the problem, but he needs to start putting his own feelings into words and understanding himself better, and then he’d be able to do more about what was going on.
Let’s think about depressive thought patterns. Many people have learned a way to think about life that makes them depressed. It becomes an issue of character and personality. Well, what way is that? Well, essentially, they believe that they have no control over their lives.
I worked with a teenage girl once, who was from a divorced family. She lived with her mother, saw her father on weekends. He was a disorganized, procrastinating, manipulative workaholic. He would promise her things to get her to spend time with him, and never deliver because of the chaotic nature of his life. We’re all hard-wired to love and be loved by our parents. And she would valiantly try and try to get his attention, but she never could. And, as she hit teenage, when she would be faced with difficult things, like speaking in public, which was hard for her, she would shrink back. She loved to sing, but she would not sing with the other girls in the Feast choir. The thing she loved to do was suddenly boring. When she might have to speak in Bible classes, she would flee the scene, red-faced with fear, and go cry in the bathroom. Bible classes were boring, too. It was hard for her to meet new people and nearly impossible for her to talk about her feelings with anyone. So she wore a mask. You could never tell what she was thinking. This girl, in her interactions with her father, had learned that she was not worth the attention of the main man in her life. She felt completely unable to face difficult tasks in life. She stuck with the things that were easy. School was terrible for her. She shrunk back from challenge. She didn’t believe she could achieve. She didn’t believe she could measure up. She told me once that she couldn’t understand why everyone else could do their homework and get good grades, but she could not. This girl didn’t believe that she could take charge of her life – that she could win her father’s love and respect. So, her conclusion was that she must not be very good, and she spend a lot of time depressed and didn’t even recognize it.
Sometime ago, we did a series on Reclaiming Lost Children – children who had left the faith and gotten spiritually lost. Have you ever heard anyone talk about that before? Most of us think we have no control over it at all. Many of us are so sad over the loss of our children, we can’t even bear to think about it and we stuff the feelings. Yet, the Bible shows us there are things we can do in addition to prayer. We can take action to help them, if we will. When we do that, we feel better. One of the highest paid therapists I know keeps a roll of trash bags in his desk, and he takes depressed clients out to pick up trash. And after they’ve been at it a while, he said, “Now don’t you feel better?” I know many people my age, who have given up on the idea that their children can ever come back. It’s just one more hurt they have to keep in their hearts. It feels like it’s beyond their reach to take any productive steps.
So learned helplessness is a big part of being depressed. When we think that we don’t have any control over our own life, when we just sit back and feel bad about it, or we don’t let ourselves even feel that, then that’s depression territory. But when we get up and start doing what we can do, and being creative about it, things look rosier.
The next area that we want to think about, when it comes to being depressed, is loss. These thought patterns have to do with the way we deal with the losses in our lives. Depression is about loss – the loss of a loved one – you know, a child – or the loss of the love of a loved one – you know, romantic fallings out, divorce, a child who leaves – the parable of the lost son, right? – the loss of safety, loss of self-respect or esteem or status. If we stuff our feelings about our losses, if we don’t grieve our losses, we get stuck. Grief turns to depression and anger over the loss.
I recall going to Big Sandy, Texas, years ago. Because this area used to be a power center for a large Church of God group, this area was rich with anger over abuses of authority from the past. You’ll meet people there who will go off at the mention of someone’s name, who did something to them twenty-five years earlier. Rage, but unable to get at the hurt that’s under the rage, it seems.
Let’s look at a biblical example of depression. King Saul suffered depression. We can see that. He had episodes of melancholia and manic episodes as well. David would play his harp for him to lift his mood. And he would tell David that he was the best, but then his paranoia would overcome him, and he would rage at David. He even threw a spear at him one time. We’re also told that he was bothered by demons. Do we remember what the loss was that caused his affliction of mood? Well, God told him to execute Agag, the king of the Amalekites, and all their people and all their animals. And he didn’t do it. Why would God do such a cruel thing? Well, because God is God, and He can do what He wants. And these people harassed Israel, and picked off their weak people mercilessly as they traveled through the desert for nearly forty years. And Saul wasn’t will to execute God’s judgment. And God, through Samuel, told him that he had just lost his relationship with God and His throne by his disobedience. Instead of repenting, and changing his attitude, he hardened himself and got stuck in his guilt. And then, that changed to paranoia, and then to rage, and then depression alternately – rage and depression. So he suffered a huge loss of status with God. And guilt and shame are very much a part of that. So he failed to deal with it appropriately in his early life, and years later, it came back to haunt him.
So, repentance is a great mental health practice – getting unstuck, moving forward. But stuffing and denial is not. If you’ll notice, when we read of people in the Bible, who suffer from any form of the demonic, it’s usually because they either dabbled in it deliberately, or they sinned, failed to repent and got depressed, or they were mentally ill to begin with and became susceptible to that kind of influence. If you’ll just think about it, I’ve heard of several Christian psychologists that believe you can’t even be demon possessed unless you have some sort of mental disability. So that’s something for all of us to think about – not to worry about, but just to be aware of. Most people are strong-minded enough that demons don’t bother them, whether they know about God or not.
How does a person overcome depression? Well, if a person needs medication, because their body is lacking something, taking it may help. It’s very difficult to tell, though, if that’s the case. If you’re too depressed to work through depression, it might be good to take medication. I tell people, “If you’re too depressed to come in and do the EMDR work that we do with folks – which is good for depression – maybe they should get on something until they don’t need it any longer.” However, depression meds are powerful drugs that alter brain chemistry. Some of them are hard to stop using. Medication in place of working through just masks the problem, which, I believe, ultimately can become a spiritual problem. So changing our thinking can help overcome depression – you know, the doctor said, “Now, don’t you feel better?” after doing something productive. So, it might be a surprise to some people – “Oh, you mean there are things I can do to feel better?” Yes. What would you do, if you were not depressed? Well, go do it – you know, “Fake it till you make it.”
There’s a TED Talk by Shawn Achor. He teaches the most popular class at Harvard, and it’s about happiness. In the TED talk, he details a number of proven ways to be happier. You know, it’s really hard to be happy and depressed at the same time. So, if you’re happy, that means you’re not depressed. What are some of the things he talks about? Well, things like doing random acts of kindness with intentionality. “I’m going to go out and do three random acts of kindness today” – keeping a list of them and reviewing them at the end of the day – a little kindness journal. Keeping a list of the nice things that happen during the day – this is different – the nice things that happen to you – and reviewing them at night. In other words, counting blessings. Isn’t that amazing? You might want to look him up – A-C-H-O-R. Just Google TED and Shawn Achor, and he’ll pop up – very hilarious public speaker. But you get the point. If you take a positive outlook and set out intentionally to be positive, things will get better. Of course, this is solid biblical teaching as well, isn’t it? That’s why it works.
Let’s look in Philippians 4:8 and 9:
Philippians 4:8-9 – Finally, brothers, whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is commendable, if there is any excellence, if there is anything worthy of praise, think about these things. What you have learned, and received, and heard and seen in me, practice these things. And the God of peace will be with you.
Okay, that’s a promise. Right? “Whatever you’ve learned and received and heard and seen in me, practice these things.” What was Paul talking about? Well, Paul was a man who suffered a great deal in his life after he came to God. He said he faced wild beasts at Ephesus. He said that the things that happened to him there in Asia Minor were just beyond his ability to cope with them – that he almost gave up, but God sustained him. So Paul knew what he was talking about when he talked about being positive, and being positive under serious circumstances. So, if we want God’s peace to be with us, we have to make an effort – “fake it till we make it,” in some cases. And God will honor that effort.
I was talking to a lady the other day, who has an eleven-year-old daughter. And when her daughter was born, she came down with a wicked case of post-partum depression. She had a hard time even being around her own baby. Her doctor told her what it was, and he told her that, over time, as her hormones leveled out, her mood would change. And so she decided to just be positive anyway, even though she didn’t feel like it. And she nurtured her daughter as best she could. She had lots of support from the family, because they knew how she was feeling. But she told me that she had to fake it until she made it, and sure enough, the depression lifted after a while, and because she acted loving toward daughter, her daughter doesn’t show any signs of attachment issues to this day.
So we just need to remember, God’s always on our side, no matter how we feel. We don’t need to give up. He’s there. And everything comes and goes. Everything passes. Life has a lot of cycles in it – ups and downs. If you’re down, if you wait, then you’ll be up. And if you’re up, don’t worry. It won’t last forever either. You’re going to be down. So up and down is a part of life. Some of us get stuck in down, however, and we don’t know what to do to lift ourselves out of it.
What else? Well, working through the losses that we suffer – the anger, the pain. That helps us overcome depression. David said, “When I kept silent, I dried up inside.” So we need to be open with our feelings. I think, though, he was probably talking about prayer and when he kept silent to God. So we need to be open with our feelings to God and, sometimes others, and repent of the things we feel guilty about, and let go of our anger, and heal from our hurts. It helps us as we talk about it with someone who understands us. It makes it less fearsome. Just having the words come out of mouth takes some of the fright out of it, or some of the upset. It helps us to understand ourselves.
Many people think rehashing the same old territory over and over is working things through, but that’s not what I’m talking about. That can actually be detrimental. It just digs the rut deeper. Rehashing and spewing out our negative feelings doesn’t help us. It may feel better in the moment, but in the long run, it drives people away from us, if they’re not trained to help. They don’t know what to do to help, so they feel helpless and frustrated. If they feel frustrated enough, they may say, “Can’t you just get over it?” If somebody says that to you, that means that you’ve maxed out their ability to listen, and they don’t know what to do to help you and are frustrated. So you probably don’t need t talk them about your problems.
When someone understands what we need to do, they can reframe things for us in ways we never thought of before, or ask questions that cause us to think differently about the things that help us move past the place where we are stuck.
A friend of mine got depressed and did some therapy. And after quite a while, the therapist said, “Well, you’ve been dealing with all these losses you suffered at the hands of your church and your church friends, but there’s something I’ve noticed you’ve never mentioned – your parents.” And my friend then saw that he had been avoiding the real problem all along. Because the therapist knew to listen for what was missing, it changed the course of the therapy at that point. So we don’t just need an ear, we need a trained ear. That can be helpful to us to process the pains of life, so we can set things right, move past them, take charge of our lives, and move forward.
To wrap this up, I also want to mention that depressed people can also be suicidal. Those who are really intent on taking their lives, usually don’t tell others for fear of being stopped. So, if you suspect someone is thinking about it, especially if they have a plan and the means to carry it out, get help!
I took a crisis class during my master’s program, and on the first day, the instructor put a large poster up on the wall. It stayed there through the entire course. It was a poster of the Lone Ranger. When dealing with someone who may be suicidal, don’t try to be the Lone Ranger. Involve others, who know more than you, to help. I do that, and I’m a professional. You know, there are emergency rooms at two hospitals in our town, where there are doctors and psych people that talk to dozens of depressed people every day. They’re going to know more about it than I do, because I don’t see that much of it. If you run into that situation, get help. Where do you get help? Well, you can call 911, if you don’t know of a hospital with a psych room or a psych department, and they’ll be able to help you find the help that you need. Also, there may be some crisis intervention lines for depression in your community. So, if you can learn about those, that would be helpful, too.
Well, that’s it for today. This is Bill Jacobs for LifeResource Ministries, serving children, families and the Church of God.