Understanding Depression

What is depression? Is depression sin or sickness? How can we recognize Clinical Depression? What makes some people more vulnerable to depression than others? How can we help people who are depressed?

A Spectrum of Mood

• Blues…feeling low or down… Mild depression…discouragement
• Clinical depression

Sickness or Sin?

• “Depression is a mental illness that needs treatment.”
• “Depression is sin.”
• “Depression comes as a result of a failure of self-control and self-discipline.”  Jay Adams

'Clinical' Depression

• Depressed mood (sadness, hopelessness) and/or Loss of Pleasure for at least 2 weeks and almost every day + 4 of the following:
  • Appetite disturbance
  • Fatigue/loss of energy/lethargy/slow movements
  • Agitation/restlessness/anxiety/irritability
  • Worthlessness/inappropriate guilt
  • Slow thinking/loss of concentration/indecisiveness
  • Suicidal ideas
• Sometimes - delusions, paranoia and hallucinations
  • Prayer useless, Bible meaningless
  • God far away
• He has made me walk in darkness…my soul is downcast within me. Lamentations 3
• My God, why have you forsaken me? Psalm 22
• The darkness is my closest friend  Psalm 88

Bipolar Disorder

• Mania………………………………….Depression
  • Overactive
  • Talking ++
  • Racing thoughts
  • Little sleep
  • Grandiose ideas
  • Easily distracted
  • Risk taking

Coping with Depression

• Suicidal saints… Job, Elijah, Moses, Jonah…
• Spurgeon, Cowper…

Causes and Vulnerability

• Psychological, Social and Biological
• 'The World, The Flesh and The Devil'
• 'The World'
• A Fallen World
• Adam and Eve’s sin
• No fault of your own
• Disease, accidents…
• A Sinful World
• Other’s sin
• Our own sin
• Sinful reaction to other’s sin

'The Flesh'

• Sinful nature
  • Selfishness
  • Pride, Control
  • Fear…
• Body
  • Brain chemistry
  • Hormones…

Psychological Vulnerability

• Temperament
• Thinking patterns
  • Perfectionism
  • Pessimism
  • Idolatry
  • Repressed anger
  • Self centeredness, pride, envy…

Sociological Vulnerability

• Divorce
• Abuse
• Loss
  • Person
  • Property
  • Dream

Why do women get depressed twice as much as men?

• Different expression - less recognized in men

Life events and depression

• Accumulation of stressful events before onset of depression

Biological Vulnerability

• Genetics

Bipolar (Unipolar) genetics

• Identical twins  70% (45%)
• Non-identical twins 20% (18%)
• First degree relative 20% (20%)
• General population 1% (6%)

Biological Vulnerability

• Temperament
• Physiology
• Antidepressants and ECT
• Postpartum depression
• SAD
• Physical illness

'The Devil'

• Job and the invisible world
• Roaring lion (1 Peter 5:8)
• Liar and accuser (John 8:44, Rev 12:10)
• Enraged with the church (Rev 12:17)
• Fiery darts (Eph 6:16)
• Footholds where we are weak (Eph 4:27)
• Thou shalt never make mistakes
• Thou shalt upset thyself when things go wrong
• Thou shalt blame thy neighbor as thyself
• Thou shalt neither love nor forgive, nor accept thyself
• Thou shalt always expect things to be different from the way they are Richard Mason

Reducing Vulnerability to Discouragement and Depression

• Talk to…
• Acceptance of feelings of grief...
• Godly sorrow, discouragement or clinical depression?
• Examine expectations, longings, reactions to other’s sin…
• Face and deal with anger, guilt, shame, envy, bitterness, perfectionism, control, ways we try to dull the pain, disappointment with God…
• Repentance
• Resist the devil
• Community
• Exercise, nutrition…
• Medication if and when necessary
• Patience, hope…perspective on suffering
• Learning to “groan” well
• Confidence that he is for us and not against us
• “Sorrowful yet always rejoicing” (2 Cor 6:10)

Richard Winter, The Roots of Sorrow: Reflections on Depression and Hope, Wipf and Stock

© 2006 Richard Winter