Sunday, March 29, 2009

Depression and the Christian Life

Depression and the Christian Life


Sermon Statement
It is a myth that Christians do not suffer from depression. The community of faith must be prepared to help those suffering from depression.

Introduction
The pencil sketch shown is a picture of a depressed man. This drawing has the power to evoke strong feelings of depression in us. Makes us feel depressed just by looking at it. It is drawn by Vincent Wan Gogh. (30 March 1853 – 29 July 1890) was a Dutch Post-Impressionist artist. Van Gogh spent his early adult life working for a firm of art dealers. After a brief spell as a teacher, he became a missionary worker in a very poor mining region. He did not embark upon a career as an artist until 1880. He produced a large body of great impressionist art. However he struggled with depression his whole life. Van Gogh's depression deepened, and on 27 July 1890, at the age of 37, he walked into the fields and shot himself in the chest with a revolver.

Examples of Depression in the Bible

(1) Prophet Elijah
a. The duel with 450 Baal prophets (1 King 18:20-39)
1KI 18:20 So Ahab sent word throughout all Israel and assembled the prophets on Mount Carmel. 21 Elijah went before the people and said, "How long will you waver between two opinions? If the LORD is God, follow him; but if Baal is God, follow him."
But the people said nothing.

1KI 18:22 Then Elijah said to them, "I am the only one of the LORD's prophets left, but Baal has four hundred and fifty prophets. 23 Get two bulls for us. Let them choose one for themselves, and let them cut it into pieces and put it on the wood but not set fire to it. I will prepare the other bull and put it on the wood but not set fire to it. 24 Then you call on the name of your god, and I will call on the name of the LORD. The god who answers by fire--he is God."
Then all the people said, "What you say is good."

1KI 18:25 Elijah said to the prophets of Baal, "Choose one of the bulls and prepare it first, since there are so many of you. Call on the name of your god, but do not light the fire." 26 So they took the bull given them and prepared it.
Then they called on the name of Baal from morning till noon. "O Baal, answer us!" they shouted. But there was no response; no one answered. And they danced around the altar they had made.

1KI 18:27 At noon Elijah began to taunt them. "Shout louder!" he said. "Surely he is a god! Perhaps he is deep in thought, or busy, or traveling. Maybe he is sleeping and must be awakened." 28 So they shouted louder and slashed themselves with swords and spears, as was their custom, until their blood flowed. 29 Midday passed, and they continued their frantic prophesying until the time for the evening sacrifice. But there was no response, no one answered, no one paid attention.

1KI 18:30 Then Elijah said to all the people, "Come here to me." They came to him, and he repaired the altar of the LORD, which was in ruins. 31 Elijah took twelve stones, one for each of the tribes descended from Jacob, to whom the word of the LORD had come, saying, "Your name shall be Israel." 32 With the stones he built an altar in the name of the LORD, and he dug a trench around it large enough to hold two seahs of seed. 33 He arranged the wood, cut the bull into pieces and laid it on the wood. Then he said to them, "Fill four large jars with water and pour it on the offering and on the wood."

1KI 18:34 "Do it again," he said, and they did it again.
"Do it a third time," he ordered, and they did it the third time. 35 The water ran down around the altar and even filled the trench.

1KI 18:36 At the time of sacrifice, the prophet Elijah stepped forward and prayed: "O LORD, God of Abraham, Isaac and Israel, let it be known today that you are God in Israel and that I am your servant and have done all these things at your command. 37 Answer me, O LORD, answer me, so these people will know that you, O LORD, are God, and that you are turning their hearts back again."

1KI 18:38 Then the fire of the LORD fell and burned up the sacrifice, the wood, the stones and the soil, and also licked up the water in the trench.

1KI 18:39 When all the people saw this, they fell prostrate and cried, "The LORD--he is God! The LORD--he is God!"

"The LORD--he is God! The LORD--he is God!"

b. The prediction of rain (1 King 18: 41-45)
1KI 18:41 And Elijah said to Ahab, "Go, eat and drink, for there is the sound of a heavy rain." 42 So Ahab went off to eat and drink, but Elijah climbed to the top of Carmel, bent down to the ground and put his face between his knees.

1KI 18:43 "Go and look toward the sea," he told his servant. And he went up and looked.
"There is nothing there," he said.
Seven times Elijah said, "Go back."

1KI 18:44 The seventh time the servant reported, "A cloud as small as a man's hand is rising from the sea."
So Elijah said, "Go and tell Ahab, `Hitch up your chariot and go down before the rain stops you.' "

1KI 18:45 Meanwhile, the sky grew black with clouds, the wind rose, a heavy rain came on and Ahab rode off to Jezreel.
After three and a half year of draught as foretold by God the rain came.

“the sky grew black with clouds, the wind rose, a heavy rain came”

c. Depression (1 King 19: 3-4)
1KI 19:3 Elijah was afraid and ran for his life. When he came to Beersheba in Judah, he left his servant there, 4 while he himself went a day's journey into the desert. He came to a broom tree, sat down under it and prayed that he might die. "I have had enough, LORD," he said. "Take my life; I am no better than my ancestors."

"Take my life; I am no better than my ancestors."

d. God’s response
i. Ministering angels (1 King 19: 5-8)
5 Then he lay down under the tree and fell asleep.
All at once an angel touched him and said, "Get up and eat." 6 He looked around, and there by his head was a cake of bread baked over hot coals, and a jar of water. He ate and drank and then lay down again.

1KI 19:7 The angel of the LORD came back a second time and touched him and said, "Get up and eat, for the journey is too much for you." 8 So he got up and ate and drank. Strengthened by that food, he traveled forty days and forty nights until he reached Horeb, the mountain of God

The angel of the LORD came

ii. God’s presence (1 King 19:9-18)

9 There he went into a cave and spent the night.
And the word of the LORD came to him: "What are you doing here, Elijah?"

1KI 19:10 He replied, "I have been very zealous for the LORD God Almighty. The Israelites have rejected your covenant, broken down your altars, and put your prophets to death with the sword. I am the only one left, and now they are trying to kill me too."

1KI 19:11 The LORD said, "Go out and stand on the mountain in the presence of the LORD, for the LORD is about to pass by."
Then a great and powerful wind tore the mountains apart and shattered the rocks before the LORD, but the LORD was not in the wind. After the wind there was an earthquake, but the LORD was not in the earthquake. 12 After the earthquake came a fire, but the LORD was not in the fire. And after the fire came a gentle whisper. 13 When Elijah heard it, he pulled his cloak over his face and went out and stood at the mouth of the cave.
Then a voice said to him, "What are you doing here, Elijah?"

1KI 19:14 He replied, "I have been very zealous for the LORD God Almighty. The Israelites have rejected your covenant, broken down your altars, and put your prophets to death with the sword. I am the only one left, and now they are trying to kill me too."

1KI 19:15 The LORD said to him, "Go back the way you came, and go to the Desert of Damascus. When you get there, anoint Hazael king over Aram. 16 Also, anoint Jehu son of Nimshi king over Israel, and anoint Elisha son of Shaphat from Abel Meholah to succeed you as prophet. 17 Jehu will put to death any who escape the sword of Hazael, and Elisha will put to death any who escape the sword of Jehu. 18 Yet I reserve seven thousand in Israel--all whose knees have not bowed down to Baal and all whose mouths have not kissed him."

I am here and you are not alone.

(2) Prophet Jonah

Jonah is one of the misunderstood prophet in the Old Testament. We are all taught that he ran away from God. We are also taught that he ran away because he was disobedient. He was disobedient not because he do not know God but because he knew God very well. He know God is a forgiving God. Jonah himself is not forgiving. He is not going to bring God’s compassion to his people’s enemies. Nineveh is the capital of Assyria. And it was a big fish, not a whale!

a. God’s instruction (Jonah 3:4-10)
4 On the first day, Jonah started into the city. He proclaimed: "Forty more days and Nineveh will be overturned." 5 The Ninevites believed God. They declared a fast, and all of them, from the greatest to the least, put on sackcloth.

JNH 3:6 When the news reached the king of Nineveh, he rose from his throne, took off his royal robes, covered himself with sackcloth and sat down in the dust. 7 Then he issued a proclamation in Nineveh:

"By the decree of the king and his nobles:

Do not let any man or beast, herd or flock, taste anything; do not let them eat or drink. 8 But let man and beast be covered with sackcloth. Let everyone call urgently on God. Let them give up their evil ways and their violence. 9 Who knows? God may yet relent and with compassion turn from his fierce anger so that we will not perish."

JNH 3:10 When God saw what they did and how they turned from their evil ways, he had compassion and did not bring upon them the destruction he had threatened.

He had compassion

Jonah followed God’s instruction and the one of the greatest revival in history occurred. The whole city (>120,000) and the king repented. This is exactly what Jonah expected and feared.

b. Depression (Jonah 4: 3, 8c)
3 Now, O LORD, take away my life, for it is better for me to die than to live."
v.8c "It would be better for me to die than to live."

"It would be better for me to die than to live."

Jonah became depressed.

c. God’s response (Jonah 4: 10-11)
JNH 4:10 But the LORD said, "You have been concerned about this vine, though you did not tend it or make it grow. It sprang up overnight and died overnight. 11 But Nineveh has more than a hundred and twenty thousand people who cannot tell their right hand from their left, and many cattle as well. Should I not be concerned about that great city?"
Should I not be concerned about that great city?


Important points
• Comes after service for God
• Even prophets get depressed
• God helps
• Depression improves in response to God

What is Depression?

There are two groups of depression
(1) Reactive depression (figure 1)
(2) Major Depression (figure 2)

Reactive Depression
Reactive depression occurs when something unpleasant occurs to us and we are temporary unable to cope with it. We are robbed of our happiness and describe it as ‘feeling down’ or ‘under the weather.’

Features are
• It is temporary
• Disappear with distraction
• Do not interferes with normal functioning of life



Major Depression

The American Psychiatric Association offers the following diagnostic criteria:
Major depression is diagnosed when an adult exhibits one or both of two core symptoms
• depressed mood
• lack of interest
along with four or more of the following symptoms, for at least two weeks:
• feelings of worthlessness or inappropriate guilt
• diminished ability to concentrate or make decisions
• fatigue
• psychomotor agitation (cannot sit still) or retardation (just sitting around);
• insomnia or hypersomnia (sleeping too much)
• significant decrease or increase in weight or appetite
• recurrent thoughts of death or suicidal ideation.

Deep depression is embodied emotional suffering.

In the United States, 5 to 10 percent of adults currently experience the symptoms of major depression (as previously defined), and up to 25 percent meet the diagnostic criteria during their lifetime, making it one of the most common conditions treated by primary care physicians. At any given time, around 15 percent of American adults are taking antidepressant medications.


What are the Causes of Depression?
(1) Personal factor

Victor Frankl, author of Man’s Search for Meaning coined the term noogenic neurosis which is depression arising from “the pointlessness and meaninglessness of life”. Failure of the human drive to find meaning in life can lead to depression.

(2) Psychological factors
a. Unresolved conflicts (includes childhood)
b. Stress
c. Life events
d. Personality

(3) Biological factors
a. Lack of a neurotransmitter, serotonin.
b. Diseases

(4) Spiritual Warfare
a. Demonisation

Note: Need to differentiate depression and dark night of the soul.

Can Christians suffer from Depression?
It is one of the many cruel myths in the church that Christians cannot be suffering from depression. The impression given is that Christians are the happiest people on earth. Christians are excluded from ill health, poverty and all unfavorable circumstances. In our drive for conversion decisions, we often market “Jesus Saves” to “Jesus Saves you from anything bad.”

Jesus does saves. He saves us from eternal damnation by God. However he does not promise that he will save us from suffering. In fact, he said that if we are to follow him, we will suffer more.

We need to differentiate happiness and joy. Happiness is often a superficial emotion dependent on our external circumstances. We are happy when we received a fat bonus, a new contract for our company, not retrenched from our jobs or a good medical report. This good feeling evaporates when there is no fat bonus, no contract, retrenchment and sickness. Joy is a deeper emotion. It comes from being right with God. Therefore it is not dependent on external circumstances. Joy is still present when happiness is absent.

Christians may be unhappy yet joyful. Christians may suffer from depression yet retain the joy in their heart.

Studies of religious groups, from Orthodox Jews to evangelical Christians, reveal no evidence that the frequency of depression varies across religious groups or between those who attend religious services and those who do not. So in a typical congregation of 200 adults, 50 attendees will experience depression at some point, and at least 30 are currently taking antidepressants.

Martin Luther, the great leader of the Reformation struggled with depression. Charles Spurgeon, considered by some to be one of the greatest preacher of all times was unable to preach two to three months out of a year because of depression.


How can the Church Help?
(1) Rest

One of the causes of reactive depression is stress. This is especially active in people who are chronic caregivers: people to have to give care constantly like mothers or people nursing bed-ridden elderly or chronically ill people. It will be helpful if someone offer to lend a hand so that the caregiver may take a few hours off. Our bodies need rest and it is not built to function continuously under stress. Something will break. Even the Ever-Ready Bunny runs out of power.

(2) Personal choice

We can choose to be happy or sad. As persons, we are much affected by our surroundings and our inner life and beliefs. Dr. Willaim Backus identifies 3 misbeliefs in depression in his book, Telling The Truth to Troubled People :

Misbelief #1 : “I’m no good” The belief in personal worthlessness is found in several variations.”I’m a failure.” “I haven’t got what it takes”. The changes on the theme of self-devaluation are endless.

Misbelief #2 : “My daily life is no good”. The belief that nothing is really rewarding, that life is not worth the effort is another theme in those who are depressed.

Misbelief #3 : “My future is hopeless”. Most depressive believes that they will not recover.

We are influenced by our perspective of God. And it is from our perspective of God that we derive our perspective of ourselves. Unresolved sin needs to be deal with. As we seek the Lord through prayer and personal bible study, the Holy Spirit will transform us to the following truths.

Truth #1: “You are a creature of infinite worth and value.” The fact that God created you in His image and sent His Son to give His Life a ransom for your freedom establishes that you have worth and value.

Truth #2: “Even a depressed person can find meaning and reinforcement in activity.” One of the keys to treatment is to get the depressed person activated and doing things. Nearly always, the depressed person finds that the doing of the activity is very rewarding. The daily life of the Christian comes from the hand of God and is lived by God’s call. It has worth because of that.

Truth #3 : “God’s Word says that the future is not hopeless.” The future is not hopeless because “we have been born anew to a living hope through the resurrection of Jesus Christ from the dead.”(1 Peter 1:3 RSV).

This is where the teaching of the church comes in. Teaching in the church must always be helping us to discover what it is to be the sons and daughters of the living Go and what it means to be a people after his own heart.

(3) Talk to a friend
The church is a community and we must always look after one another. That is why everyone must belong to a cell or small group. In a small group, you can know everybody. In a church, very few people know everybody. People may be absent for long periods without anyone noticing. If they have migrated to another state or church, that is their choice. However people who are depressed will avoid people and not turn up. In a small group their absence will be noticed. In a large church setting, it may not be. Unfortunately, it is such people who fall through the gaps. The next thing we hear is that they have committed suicide! This shows how we have failed as a church.

(4) Group support
There is a tendency for people to form cliques. This is natural as people like to be with people who they are comfortable with. However, any church must intentionally form a support group for people who are depressed. These people may be receiving counseling from someone e.g. a pastor or counselor but they also need a group to belong to. The group will consist of other people who suffer from depression. It is really very helpful to know that you are a not alone.

John Ortberg is a popular preacher and author. Aside from a M.Div., Ortberg also earned a Ph.D. in psychology from Fuller Theological Seminary—and has penned two books on depression. He is the senior pastor of Menlo Park Presbyterian Church in California? In an interview with Christianity Today (March 2009), he said:

“One of the most appreciated ministries in our church is our HELP ["Hope, Encouragement, Love, Prayer"] ministry for people who are suffering from mental or emotional health issues. It has evolved into a support group for them and their families. These people will say that the single most important thing for them is to be a part of a community where other people share the same struggles, speak the same language, and are able to bear each other's burdens..”

(5) Discernment and Prayer
Another area the church may help is in the area of prayer and discernment. Prayer is important as prayer changes people and circumstances. Discernment is important as it reveals whether the cause of the depression is spiritual or emotional.

(6) Counseling
Counseling is an important ministry of the church. Often counseling falls to the pastor because it is assumed that he or she will be trained to counsel. Unfortunately counseling is only a small part of the training of the pastors. I believe that God will provide in the faith communities people who are gifted to counsel. These people may not even be in leadership of the church. It is important for the church to recognize and affirm these people.

(7) Medication
Anyone who is doing counseling must recognize their limitations. They must know when to refer to some other professionals such as psychiatrist or clinical psychologists. This is not an admission of their failure or inadequacy. Psychiatrist will to able to augment their counseling with medication such as Prozac or Zoloft. These are powerful anti-depressants who can make a world of difference to people suffering from major depression.

Conclusion
Christians may suffer from depression. Being a Christian does not exclude us from ailments of the body and of the mind. It is unfortunate that depression in Christians are often not acknowledged or recognized. The number of people (including Christians) suffering from depression continues to increase. The church must be ready to help such people.

Soli Deo Gloria

16 comments:

sp lim said...

One of my favorite hymns is "There is a fountain filled with blood" penned by William Cowper.Cowper penned many other well known hymns and poems. He suffered from severe depression and tried committing suicide a few times.

His life is truly a testimony of God's grace. How God not only preserve his life but to use him to bless so many long after he is dead.

Sometimes the church is not a safe place to be depressed. So much triumphalism. So often we want instant healing. Instant results. Anything less than that, our faith is called into question. We really ought to be a healing community extending to each other restorative grace.

Kansas Bob said...

I think that SP Lim's last paragraph in his comment is very insightful. People are simply not comfortable discussing depression in Christian circles.

It has been a few years since I blogged about my bouts with depression.. maybe I need to rethink those thoughts?

Ann said...

The advice was great until the recommendation of Prozac and Zoloft.

Did you see any of the prophets take these drugs? The angels brought food, not drugs. These prophets could not have felt deeply enough to accomplish their missions had they taken these drugs.

WHY? Because antidepressants cut you off from God. (And yes I can show you the science as to why.)

They are the deception John wrote of in Rev. 18:21-24. The Greek translation of sorcery is pharmakia or medicine from a pharmacy. John tells us the whole earth will be deceived (lied to) about drugs in our day.

WE ARE THERE NOW!

The truth came out last year from manufacturer's studies kept hidden for years that these drugs are of NO more benefit than a sugar pill, yet they have listed side effects as deadly as "homicidal ideation" and "suicidal ideation."

MANY good Christians have had their lives destroyed by these deadly drugs already, do not become another one!!

Dr. Ann Blake-Tracy, Executive Director, International Coalition for Drug Awareness, www.drugawareness.org & www.ssristories.com

Alex Tang said...

Hi SP Lim and Bob,

I agree that SP Lim's comment on the church as a healing community is so very important.

Alex Tang said...

Hi Bob,

I read through your blog posts about depression. Many of us suffering through reactive depression. However I do want to awaken the church to the fact that there are people who are suffering from major depression.

In major depression, you are so deep in despair that you cannot summon your energies to get up, let alone connect with God. They need help. It is cruel to say to them 'snap out of it and praise the Lord.' If they could, do you think they would not have done so? That's like asking them to lift themselves by their bootstraps.

Kansas Bob said...

Thanks for the reply Alex. Is "major depression" a chemical imbalance in the brain that can be treated with Rx drugs? I was wondering because it seems that would have to be if it not was a reaction to the events of one life (as in "reactive depression").

I am pretty ignorant about this and I appreciate your helping us understand this better.

Blessings, Bob

Alex Tang said...

Hi Bob,

Major depression is multifactorial, which means there is no single cause. However it is often associated with low serotononin level (a neurotransmitter) so medication that increases serotonin level may be used at some time or other.

Kansas Bob said...

Thx Alex. What other non-chemical and non-reactionary factors are involved in major depression?

Alex Tang said...

Psychological; emotional;unresolved conflicts; childhood trauma; self-esteem,; psychosocial deprivation; chronic diseases and disabilities; loss of sense of worth; loneliness; and presence of family history of suicides.

Kansas Bob said...

The list confused me a bit Alex. It seems that most of those you listed are reactionary factors.. folks reacting to their childhood, environment, and trials.

The line between reactionary and major depression seems to be an arbitrary and tenuous one based more on the extent of the depression and the amount of treatment required.

For me.. almost every day is a trial getting out of bed.. watching my wife suffer with her disability and the limitation it has put on our lives is very depressing and heart breaking. It seems that people like me who overcome the temptation to be depressed every day are trivialized because we do not react negatively towards our environment and trials.

I am not lacking in compassion for those suffering from major depression.. I have dealt with many depressed people in a pastoral role.. but I wonder if we allow people to be victims by not instructing them about how depression is a journey that is taken one step at a time as folks give into temptation.

Of course I am not speaking of people who suffer from depression that comes form chemical imbalances or other physical impairments of the brain.

I may be missing the big point here Alex.. I want to better understand the dynamics of depression. Hope that my questions and my comment has not offended.

In friendship, Bob

Alex Tang said...

Hi Bob,

We're cool. No problem. I am not offended.

I was just answering your question about factors other than chemical.

Depression is a continuum (see figure 2. It ranges from a negative mood to severe 'non existence' state. And there are many manifestations in between.

I do not trivialise people who fight against depression everyday. Heavens forbid! In fact, I applaud their courage and stamina.

What I tried to emphasise in my sermon is twofold:
(1) for the church to accept that Christians also suffers from depression
(2) we as a community of faith must walk with them through this dark valley.

People suffering from depression must resis the temptation to give up. They need help. They need flesh and blood company. They need prayers. Sometimes they also need medication (sorry, Ann).

I hope I am making sense here. :)

Kansas Bob said...

Thanks Alex for the very nice reply. I think that the words "reactive" and "major" are kind of confusing because depression can be both major and reactive. In my experience the church does a very bad in the areas of mental health.. sometimes they engage in areas like grief recovery, life after divorce or other groups around addictive behaviors but I have not seen a class that deals with the topic of depression. I wonder if there is a good short term study on the topic that might be helpful? Have you seen or been involved with such a group?

Blessings, Bob

Alex Tang said...

Hi Bob,

I am not aware of any short term study course on the subject.

I have been teaching classes on the subject and is/have been walking with people with depression, teaching them to cope and even dealing with a few suicide attempts.

Kansas Bob said...

So glad to hear of your ministry Alex.

Many blessings, Bob

Dr.palin said...

It is not true that the old men and women are more susceptible to depression than their younger counterparts and it must be mentioned that an individual is said to suffer from depression when he exhibits symptoms, namely, hopelessness, chronic tiredness, appetite loss, loneliness, sadness et al for one week or more. Therefore, it is important for you to get hold of right information on depression related details before starting to treat your depression.

Alex Tang said...

Hi Dr.palin,

I agree with you that a diagnosis of depression must be established before any form of treatment is instituted.