Monday, August 01, 2005

The Problem of Depression

Of all the organs of the body, the brain is by far the most mysterious. It is mysterious because it is fantastically complex. It is hard to research the brain because if you manipulate it, you'll most likely kill or injure the patient. Many of the reactions in the brain are chemical and electrical and difficult to observe, if not impossible. It is a strange, wonderful organ, and I am so ignorant of how it works that I do not even fully understand the things that doctors do not understand, if you follow me. I do not even know the correct questions to ask!

To further complicate matters, there is the issue of the human soul. Is our soul in our brain? If so, how does the soul affect the brain? And how would you study such a thing in a lab to get conclusive results? The answers to these questions can not be answered simply by biological study.

This gets to the heart of the problem of depression and its cure. The question that I am wrestling with, and the question which ultimately I cannot answer, is this: Is depression a purely spiritual issue, or is it also a biological one? Or, is it both? Though I cannot concretely answer such questions, I think that we may make some helpful observations.

Let's take hypothetical number one. That is, let's assume that the source of depression is a purely spiritual problem. Though the problem's source may stem from a spiritual source, it will never be contained there. Spirit inevitably affects the body. A depressed spirit will have negative consequences to a physical bodies. Nevertheless, the hope here is that if the spirit is cured, the body will follow. How should you deal with depression if it is purely spiritual in nature?

First, and most obvious, the cure for depression would be to counsel the gospel. The gospel, after all, is "good news." It is the best news. It gives us hope, and hope is a balm for depression. The Bible teaches that "hope deferred makes the heart sick, but a desire fulfilled is a tree of life" (Proverbs 13:12). If a shattered hope brings depression, then the antidote would be fresh hope.

This is no simplistic answer. It could be that the hope lost is the death of a fiancee, a parent, a child, a dream of life with someone coming to an abrupt halt. The regret over the loss of virginity, or the betrayal of a spouse, or any other such thing that seems to place all hope beyond recall. These are the things that the gospel has an answer for.

You have to begin counseling by determining if the person depressed knows and trusts in Christ Himself. Counseling begins with Jesus Christ, our Wonderful Couselor. Teach them the beauty of the gospel, and if they do believe, then teach how God's promises guarantee that in the end, we will be satisfied that we do not suffer in vain. (For brevity's sake, I will not go into that here because I want to address the other two concerns first and if a blog post goes too long, no one will read it.)

Here is where a decision has to be made after counseling. If the source of the depression is spiritual, is it appropriate to give medication that only affects the physical body? I believe that the answer can be yes, depending on the seriousness of the depression. Though medication will not cure such a problem, it may help to affect a cure.

If we knew someone who is a smoker, and they contracted lung cancer from smoking, would we refuse to treat them until they gave up smoking? This would be absurd. One may argue that treatment would be futile, and that the real problem is the smoking. But we will still treat the patient. The same goes for high blood pressure. Maybe a person's excessive worry is causing the stress leading to high blood pressure. Do we refuse to medicate until that get worry under control? Certainly not. We can still treat the side effects, even when we haven't cured the source of the ill. I am not arguing for medication every time someone has "the blues," but in some instances people, even Christians are so overcome with depression that you cannot even speak reasonably with them.

The real problem of a depression that stems from a purely spiritual source is a lack of faith in God. What a scary thing to say to an evangelical Christian! If we are depressed because of a past sin, then are we not doubting God's promise in Christ to absolve us from all sin? If we overly mourn the deceased, do we not deny the exhortation of Scripture that we will see our loved ones who died in Christ again? And if they we not believers, do we not demonstrate doubt in God's integrity to be fair and just, and that when we witness their trial, we will indeed believe God to have done right. Who among the Church of God has not wavered in such doubt at some point in time?

For a person who does not know Christ, such depression is even more dangerous. For one, they do not have the power of the Holy Spirit in their lives to uphold them in dark times. Further, they are defenseless against demonic manipulation, a factor which should not be discounted. This is, after all, spiritual war. We know from Scripture that demons certainly have the ability to affect physical bodies. Would we deny then that they have the power to affect brains, perception, and mental well-being? In Luke 13:11, Jesus encounters a woman who is hunchbacked due to demonic oppression. Is it not possible that with modern medical technology that surgery could have corrected this affliction? I think that we would have tried such treatment despite the fact that it was a purely spiritual problem with physical consequence. Why not with depression?

This post is already longer than I anticipated, and my own writing has spurred more thought in my mind. I think that I will stop for now and leave room for comment before I post more on the subject.


centuri0n said...

Pastor Brad:

It's both. There is no way to say that depression cannot be treated by medicine in spite of what Dr. Tom Cruise has told us, but there is a spiritual component of depression that cannot be ignored for the long-term good of the patient.

Don't wrestle too much with this. You don't have to "trust psychology" to get good medical help for a person suffering from depression -- just find a phsychologist who is also a good Christian person -- man or woman. Then be the minister of the Gospel to the sick person.


Waterfall said...

Do you think that it's ever the other way around -- that depression (chemical imbalance or whatever) can ultimately lead to spiritual sickness?

Sojourner said...

I believe that you are correct. It is a complex discussion, and it doesn't help that there really aren't a great number of Christian Psychologists out there. At least, this has been my experience.

Yes, I think so. I used this example in an earlier post but I find that when I am not well rested I suffer spiritually. I am more irritable, can't concentrate on prayer or study, etc. Jesus told his disciples that "the spirit is willing, but the flesh is weak." Post-partum depression in mothers is an excellent example, and so is menopause. (Despite what Mr. Cruise has to say.)

The brain is an organ just like the heart, and just like the heart or liver or kidneys, it only seems logical that it could develop problems that need medical attention. Because the brain effects so much of 'who we are' and how we perceive things, then it seems certain that it would effect things such as mood.

What I am thinking further is that it is almost impossible to tell whether the source is physical or spiritual. The two are very intimately related. I may suffer spiritually from lack of sleep, but then I may have trouble sleeping because of a guilty conscience. Or, it may be that I simply have a sleep disorder. I am arguing that in either case it is appropriate to use medical help to bring relief to the situation.

centuri0n said...

Pastor Brad:

What if I said that dualism is a false assumption and that in this life we cannot distinguish, for any practical purpose, the body from the soul?

For example, theologically we can say, "the soul is present before the Lord when the body dies," but in this life -- right now, today -- we can not meaningfully say that the soul does not suffer, for example, when the body has cancer or when the body suffers the loss of a family member?

I'm not saying this is dogma: I'm asking you opinion. :-)

Sojourner said...


I would say that I believe that you are correct. For all "practical purposes" we cannot treat one and not have an effect upon the other.

However, the prevailing notion seems to be that the spirit rules over the body to the point that the body must be/can be brought into line by the spirit. Depression is a great example. The idea is that if we are depressed, we ought to be able to express enough faith in the spirit to make the "bad hormones" go away.
This is close to the Pentecostal idea of naming and claiming health by faith.

I vividly remember a talk with an evangelical elder about the Mel Gibson movie, "The Passion of the Christ." He was upset because he believed that the depiction of Jesus' physical suffering was overplayed, and that the "real suffering" was what went on in His spirit. My question was, "How do you display 'spiritual suffering' without physical symptoms? Are they not very, very intimately related?" I.E. Jesus' passion caused His body to burst blood vessels that caused Him to sweat blood. Did that hurt? Did He tremble? That's physical, isn't it? The source was spiritual, but the physical element cannot be denied. On the other end, we may ask, "How did the scourging affect His spirit?" I do not know because I can't see that, but I believe that it did have an effect.

There's my long two more cents. I hope earnestly that I am not a heretic.

ColinM said...

Assuredly, you are not a heretic...I sincerely plea to God to protect me from posting something heretical and leading people astray-know how you feel.

One question I have had that has plagued me is, "Lord, how will I know if someone is demonically possessed; and if they are, what do I do?" I have been working out in my mind a blog post on the subject, and your post seems to be providentially relevant.

If demonic posession exists, then it can be a spiritual condition that may (probably will) bring about physical symptoms. Otherwise, I don't know how the disciples were so sure when a man was possessed. But then we get into the area of calling everything demonic possession, and you then have people wanting to exercise your generational demons. My comment is always, "I think they are good enough shape already- they don't need a coach." Seriously, I don't subscribe to generational demons and curses, but I don't discount demonic possession because we have been given no hint that demons no longer need to be cast out of possessed persons.

What are your thoughts on a link?

Sojourner said...


The demonic is particularly tricky. If you had someone who was truly demon possessed/oppressed sitting next to someone who had the same condition due to biological factors, unless the former's head spun around, how would you know the difference?

I think that we treat what we know for certain. We treat the physical problem, and then we counsel the individual to determine if there is any further assistance needed, much as Centuri0n has indicated.

As for linkage, link away, my friend.

centuri0n said...

I have no idea if you're a heretic, but I like you. :)