The Reality of Depression
Although the stigma surrounding mental health disorders has lessened in our society, it is far from absent, especially the stigma around depression. One of the most damaging and prevalent misconceptions about depression is that depression looks and feels the same for everyone.
Depression is pervasive across all demographics and socioeconomic groups. A study conducted in 2020 by the National Institute for Mental Health showed approximately 21.0 million adults in the United States had suffered at least one major depressive episode in the previous year, with an estimated 14.8 million adults experiencing severe impairment with the depressive episode (Ref 1). However, this type of depressive episode is only one form of depression.
Depression manifests itself in various forms and can be associated with grief, related to trauma, or accompanying another medical condition. Depending on the severity and form, it can also be bipolar depression, postpartum depression, a major depressive episode, dysthymia (a “milder” but more persistent form of depression), or depression accompanied with psychosis. Surprisingly, depression can also present in the form of a reversible dementia. There simply is no singular cause for depression, nor is there a universal treatment or solution that addresses not only the symptoms but the true underlying cause. When we find ourselves suffering from depression, our recovery might be hindered by cultural stigma or even our own misconceptions about depression. We see one well-intentioned yet damaging response to depression in the biblical story of Job. After Job lost his children, wealth, and health, his closest friends came to sit with him and support him – and to seek a “quick fix.” Just like Job’s friends, sometimes we can sit and bear another’s sorrows, but likely not forever. Eventually, they suggested that Job’s suffering was his own fault. As in this example, if we fail to appreciate the complexities surrounding depression, we run the risk of saying the wrong thing, making a loved one’s depression worse, and stifling his or her willingness to get needed professional help.
Had I not battled depression myself, I might have bought into some of these misconceptions–even as a board-certified psychiatrist. Several years ago, I went through a period of depression after experiencing a series of traumas. My depression manifested itself as an intense cloud of darkness that seemed to isolate me from anything good in this world. I felt unworthy, helpless, hopeless, and joyless. Although I had accepted God’s free gift of salvation as complete forgiveness of my sins and eternal life, I wasn’t experiencing the peace that comes with it. I was restless one moment, and then despondent at another. I felt utterly broken. These feelings of powerlessness, detachment, isolation, and imbalance that I experienced often accompanies many forms of depression. Their effects are debilitating and real. Sadly, in many cases, they are the reason those battling depression commit suicide. The anguish that accompanies depression seems never-ending, and it feels as if nothing can make the pain go away.
Until I faced depression myself, I never knew how truly impossible it was to simply “get over” depression when only relying on sheer will power. The only way I emerged from the other side of depression was through God and other believers encouraging me along the way, patiently supporting me with no timetable in mind.
MYTH #1: Depression is weakness
Depression can manifest itself as a general decrease in interest, a feeling of lethargy, an inability to experience pleasure, and low or no motivation. Many people believe that sufferers can move past their depression by “sucking it up,” and “pulling themselves up by their bootstraps.” Some think that a simple change in mindset, such as a commitment to focusing on one’s blessings, is the key to overcoming depression. However, depression is associated with numerous structural and chemical changes to the brain (Ref 2). Willpower cannot reverse all the physiological alterations to the brain connected with depression.
Numerous people in the Bible are described as suffering from depression. King Saul had bouts of depression and headaches as well as murderous mood swings. Jonah suffered from depression and asked God to kill him after surviving the belly of a fish and sharing God’s message to the Assyrians. Elijah, one of the most powerful prophets in the Bible, battled a severe bout of depression. In 1 Kings 19, after witnessing God’s awesome power in raining fire from heaven in the presence of several hundred prophets of the pagan god Baal, Elijah was pursued and threatened by his earthly mortal enemies. He would have never expected to encounter such dire circumstances following God’s demonstration that He alone was God. Elijah became extremely depressed and asked God to kill him. Was Elijah weak? Not at all! Was he without faith? Absolutely not! Elijah was depleted, isolated, and the events he thought would finally turn God’s people back to Him didn’t have the effect he anticipated. As a result, he became depressed.
MYTH #2: Depression involves a lack of faith
When we do not fully understand what another person is going through, one of the worst things we can do is to judge him or her for not having “enough faith.” This can greatly compound feelings of pain, inadequacy, and isolation. If we really examine the differences between faith and feeling, we realize that faith is what we have when we trust in something intangible– when we can’t simply feel that the object of our belief is real. To measure someone’s faith, then, by the presence of a negative feeling like depression is an illogical and unhelpful endeavor.
The author of Psalm 42 wrote about his intense and powerful feelings of depression. He felt cut off from God, and had been crying day and night. Although he poured out his soul to God in prayer and in faith, his depression didn't subside. Despite this deep depression, he actually demonstrated considerable faith in the face of what he felt. He still trusted God as his only hope, and pursued and worshiped Him in the midst of his suffering. This is an example of a man of God who didn’t do anything to bring on the depression, but learned how to unconditionally love and serve God even when he did not find the healing he so desired. There is no lack of faith in this passage, but in fact quite the opposite.
Psalm 42:1-5 (NKJV) As the deer pants for the water brooks, So pants my soul for You, O God. My soul thirsts for God, for the living God. When shall I come and appear before God? My tears have been my food day and night, while they continually say to me, “Where is your God?” When I remember these things, I pour out my soul within me. For I used to go with the multitude; I went with them to the house of God, with the voice of joy and praise, with a multitude that kept a pilgrim feast. Why are you cast down, O my soul? And why are you disquieted within me? Hope in God, for I shall yet praise Him for the help of His countenance.
MYTH #3: Depression is punishment
Although the book of Job completely dispels the misconception that God reserves suffering only for evil people, it was still a widespread belief in Jesus’ day that all suffering is a form of punishment. While we may balk at this belief, this mindset still persists today, and is an easy trap to fall back into when bad things happen to us or our loved ones. Yes, God’s children will experience discipline when we fall into temptation and darkness, however, it is in order to bring us to freedom and back on God’s path, not condemn us or make us suffer just for the sake of suffering. Jesus mentioned that His followers would suffer in John 16:33, and there are also numerous passages that describe how suffering produces the character of Jesus Christ (see 2 Corinthians 4:17, Colossians 1:24, James 1:12, Philippians 3:10, Romans 5:3).
How to Break the Stigma
Grow in awareness. One of the first and most important steps in breaking the stigma surrounding depression is becoming aware of the suffering around us and even in our own lives. We will encounter people who are suffering, if we haven’t already, and we don’t want to say the wrong thing.
Don’t jump to conclusions. When we hear about or see someone struggling with depression, we must not assume that he or she is going through the same thing as somebody else we know who has experienced depression. If the person will let you, try to gain a better understanding of the contributing factors to his or her depression. There is enormous healing power in simply sharing one’s story and having someone else truly listen.
Educate yourself. It is important that we accurately assess the extent of our knowledge about depression and, as best we can, to increase our understanding so that we don’t steer others in the wrong direction for help. If you are unfamiliar with potential contributing factors to depression or the treatment options available for people experiencing depression, spend some time exploring the vast number of online resources dedicated to offering education and support related to mental illness. NAMI.org. Is a good place to start.
Seek professional help. In order to receive the appropriate treatment, it is critically important that a person struggling with depression be given the correct diagnosis for his or her specific form of depression along with contributing factors. Do some research to identify mental health professionals in your area who are reputable, have been vetted, and can be recommended.
In John 9, Jesus used the example of a man who was born blind to illustrate that bad things happen even to people who are undeserving of them–sometimes so that God’s glory might be displayed through them. This man was born blind so that one day Jesus could miraculously heal him and, through that miracle, lead many others to believe that He was the Messiah. Talk about using something “bad” for the ultimate good! Our suffering can empower us to witness God’s amazing love, glory, and power and to share them with a hurting world in ways that we could never have imagined without it. That is what happened in my life through my own battle with depression. I often found myself praying to God much as the author of Psalm 42 did, pleading, God, please don’t waste this. He hasn’t and He won’t. My story–and the stories of others who faithfully battled depression with God’s help–prove that.
Zhang FF, Peng W, Sweeney JA, Jia ZY, Gong QY. Brain structure alterations in depression: Psychoradiological evidence. CNS Neurosci Ther. 2018 Nov;24(11):994-1003. doi: 10.1111/cns.12835. Epub 2018 Mar 5. PMID: 29508560; PMCID: PMC6489983.