Ten Myths and Misconceptions Related to Depression
January 26, 2007 • By David B. Biebel
1. You’re depressed because you want to be depressed.
We can only imagine what Charles Spurgeon, undoubtedly the best-known English preacher of his day, whose collected sermons fill sixty-three volumes—the largest set of books by a single author in the history of Christianity—might have said to the suggestion that he was depressed because he wanted to be. This great man of God, who struggled with depression for years once wrote, “There are dungeons beneath the castle of despair.” In other words, Spurgeon’s view was that he had suffered with depths of depression even deeper than those described by John Bunyan in Pilgrim’s Progress.
It is possible for people to become accustomed to being depressed or to become so familiar with it that change is threatening. In other words, it is possible to become “addicted to sadness.” I (DB) coined this phrase as a result of reading Gerald G. May’s book, Addiction and Grace, in which the author describes the various components of addictions and how the grace of God can heal them. I realized that the five characteristics of addiction described by this author could relate not only to substances and behaviors, but also to sadness—my sadness. All of them have been true of me at one time or another during my journey with depression.... [Note: for an expanded discussion of addiction to sadness, see New Light on Depression, chapter 4.]
Some might say that the pattern just described proves that depression is a matter of deliberate choice. Based on what we’ve experienced and observed, we would say that while some conscious choices are certainly made along the way, most of the dynamics are not deliberate, but unconscious.
Not all depressed people will become “addicted to sadness,” but none of those who do so have willfully chosen to subject themselves to something that will ultimately control their lives to a greater or lesser degree any more than a drug addict had a similar end in mind when he smoked his first “joint.”
We would agree that some people seem to “hold on to their depression” because it elicits sympathy, attention, or care from those around them. These cases, however, are not very common, and many of them may represent unconscious choices, as well. Most people who are depressed aren’t depressed because they want to be. Most Christians who are depressed long to joyfully fulfill the purpose for which God has called them out of darkness into his marvelous light.
In fact, depression is often more difficult for Christians because the pain they feel is compounded by guilt that they cannot be who they long to be in Christ. Their guilt is further compounded by their knowledge that they ought not to feel guilty, since in Christ they are forgiven. The whole experience is like a spiral staircase leading nowhere, while the effort to progress leaves them exhausted—physically, emotionally, and spiritually. Having reached this state, pressed down by life, their hearts hammered by their “friends,” people who are depressed could no more choose to be happy than they could choose not to feel pain if they banged their finger with a real hammer.
2. You can beat depression with willpower.
This myth could be considered the flip side of the first one. But it was my strategy (HK). I was determined to find my own way out of the emotional mess I was in. I would listen to no one and rejected the advice of friends and family. I figured that I could do it entirely on my own through sheer self-mastery. I would “pull myself up by my own bootstraps.” It didn’t work; it never does, because it can’t. John Donne said, “No man is an island, entire of it self.” We were created to live in relationship, which includes receiving input and guidance from others, since no one person has complete knowledge from all perspectives on a situation.
Over time I became increasingly isolated, withdrawn into a fantasy world of my own creation. This led to my being expelled from medical school, living on the streets, and near insanity.
It took years of senseless wandering and a string of broken relationships before I was finally rescued by coming to know the Lord, who gave me the power to overcome my problems, a direction for my life, and a faith community that cared and that I allowed to support and guide me. Willpower wasn’t enough. The force of my emotional demons was just too strong for me. I needed God and his people to get me straight.
When we choose to align ourselves with God’s will, he gives us both the will and the ability to work for his good pleasure, which is that ultimately all things in heaven and earth will be brought under the Lordship of Jesus Christ. How our lives witness to his power, including his power over depression, is part of that process. We cannot will ourselves well; we can only willfully entrust ourselves and our needs to the One who understands us best, asking him to enable and empower us to live with our depression in a way that will honor him.
3. You’re depressed because of unconfessed sins in your life.
Christian psychiatrist, Dr. Dwight Carlson, wrote in his preface to Why Do Christians Shoot Their Wounded? “In my experience, Christians are intolerant, if not prejudiced, against individuals with emotional difficulties. Most view all such problems as due to personal sin. Some well-known Christian authors have fueled the fires of stigma and judgment toward those suffering with emotional illness.”
To continue the military analogy for a moment, we think that the church should function more like a “MASH” unit, patching up the wounded so they can get back to the front lines to engage the enemy, perhaps even more effectively than before due to the insights and wisdom they’ve gained into the enemy’s strategies and methods.
In the church, words are often the bullets used to put the wounded out of their misery. Based on our experience and observation, well-meaning Christians have the distressing habit of saying hurtful things to people in pain, including people with depression. For example, if you’re depressed, you’ve been told at least once (perhaps many times) that that the root of your depression is unconfessed sins in your life. Some counseling methods are based on helping people identify (or dredge up from their “unconscious”) sins they must confess.
While spiritual disciplines—such as confession and prayer—may be helpful in alleviating some symptoms of depression the myth we’re dealing with here is based, in our opinion, on a superficial understanding of sin and its consequences. In one sense “sin” is directly related to all diseases, including depression, since disease is a part creation’s current “bondage to decay” (Romans 8:18ff) from which it (creation, including we who believe) will be liberated at the Lord’s coming, and the new heavens and new earth are realities. For now, creation and we as part of it eagerly await, even long for, this liberation.
Further, the Scriptures rarely identify a person’s sins as the cause for his or her disease. Yes, some cases are cited, but the fact that they are cited may be because they are exceptions rather than the rule, for if all sins were punished by illness, most humans would be sick most of the time. In order to be certain that a person is depressed due to his or her sins, one would need to know the mind of God. This, too, is rare, both in Scripture and in life as we know it.
The biblical view is that sin is a part of our nature (even after we become believers) and that our sins are proof of this fact. All believers experience an ongoing inner conflict between their new nature (which comes from God, gives life to the soul, enabling one to become more Christ-like) and their old nature (which still wants its own selfish way). Those who deny this conflict are misinformed about themselves and the Scriptures, where there are no perfect humans (with the exception of Jesus), only imperfect people God uses.
The only antidote to sin, or the guilt relating to it, is total and absolute reliance on faith in Christ, which places us “in him,” as a result of which we are justified before God. This means that when God looks at us, he sees the righteousness of his Son instead of our sin. This is a simple explanation of the doctrine called “justification by faith.”
In relation to the myth in question, the main problem for depressed believers is not so much their unconfessed sins as their guilt feelings over sins that God has already forgiven, combined with lack of knowledge about, inability to, or reluctance to personally appropriate the meaning of Christ’s death in relation to their sin in this broader sense.
Depressed Christians are sometimes so painfully aware of their sins that this is all they can focus on. A single-minded focus like this is called an obsession. When a person is in this state, he or she may be unable to reflect rationally about this matter until the biochemistry causing such self-deprecation has been repaired. Thus, it surely will not help to state that he or she is being disobedient (as in not simply accepting God’s forgiveness) or more of a sinner than anyone else. Such allegations can only further wound a wounded heart, leaving the person feeling more disconnected from the supposedly righteous rest.
4. If you’re depressed, you’re just feeling sorry for yourself.
People without depression often glibly tell those who are depressed to stop feeling sorry for themselves, and to “snap out of it.” These “advisors” don’t want to be burdened by or with the struggles of others. They might be burdened by the struggles of others should those struggles remind them that sometimes life isn’t one long “climb, climb, up sunshine mountain; faces all aglow,” and that God’s primary involvement with his children is not handing out smiley face stickers day by day....
Potential helpers would be burdened with the struggles of those who are depressed, should they choose to get involved with those who hurt, supporting and encouraging them, which (in order to be done well) makes demands on a helper’s time and energy. It also immerses the helper in a process that ultimately may challenge the helper’s presuppositions and bring change to the helper’s mind and heart. For some people, the possibility that change leading to growth in themselves might be brought about by interacting with the depressed person, is threatening, indeed.
Usually, people who promulgate myths like the one we’re considering only have experience dealing with minor problems that anyone could probably cope with, and not with a history of repeated major losses, abuses, or tragedies that have drained life of purpose and meaning. In addition, they probably don’t have a biological predisposition to depression, which can magnify the weight of such problems a thousand times. [Note: for an expanded discussion of this subject, see New Light on Depression, chapter 4.]
5. Depressed believers have weak faith.
People who haven’t experienced depression can’t imagine how this disorder makes it difficult to concentrate, sucks away energy and motivation, draws people into themselves, and paralyzes action. For these reasons, it should not be surprising that depressed Christians have difficulty praying, having devotions, or going to church....
Critical observers sometimes conclude that a depressed person’s inability to engage in spiritual activities is the cause of his or her depression, when it is actually a result of depression. When well meaning helpers become critics of a depressed believer’s spiritual life, as did Job’s advisors, they add to the burden rather than lighten it. This is not only unhelpful, but it may be displeasing to God, who held Job’s friends accountable for they way they treated him.
For many believers who, through the ages, have struggled with depression, their experience has engendered deeper spiritual insight, because their pain has forced them to reach out to God in a new way. Rather than being evidence of weak faith, depression has been, historically, a common route to spiritual growth and insight for many of our spiritual guides, including St. John of the Cross and Martin Luther. [For more about Martin Luther’s struggle with depression, see New Light on Depression, chapter 4.]
6. It’s easy to tell when you are depressed.
Depression is not easy to identify, especially for the person who is depressed. One of the hallmark symptoms of severe depression is that people lose the ability to recognize that they have an illness that needs treatment. They believe they are dealing with reality, for which there is no possible change or cure. This sense of helplessness and hopelessness is a lie that the vulnerable depressed person easily accepts.
Many people also have difficulty differentiating depression from normal grief or normal mood swings. It is very difficult for most of us to tell when our depression has crossed over from normal discouragement related to failure, loss, or disappointment to a dysfunctional depression. Furthermore, the negative stigma associated with depression makes us feel embarrassed over having this condition, so we deny it to ourselves, claiming that there is nothing seriously wrong, and that the sadness will pass with time.
Depression is not easy to identify even for professionals used to making this diagnosis. “Masked” depression (depression that is covered up by other behaviors or health conditions) is very common. Depression may be masked by self-medication with drugs or alcohol, self-treatment with gambling or sex, or physical symptoms that are misinterpreted as coming from medical causes.
On the other hand, weight loss from cancer or other medical conditions, reduced emotions due to Parkinson's disease, or reduced motivation seen in Alzheimer’s disease, dementia, or mental conditions such as a personality disorder, anxiety disorder, or schizophrenia may either first appear with symptoms that are similar to depression (being incorrectly diagnosed as depression) or may actually have depression as a complication. Discerning “which came first” is more of a challenge with depression than answering the old “chicken-and egg” riddle.
If proper diagnosis of depression can be difficult for professionals trained to do so, it is only reasonable that for a non-professional it would be much harder. This is why, as the saying goes in medicine, “He who treats himself has a fool for a doctor.” If doctors are foolish to treat themselves, their families, or even their friends (because of denial that something might be wrong or the lack of objectivity another doctor might provide) then it is surely prudent to seek an objective professional opinion when the signs or symptoms of depression are evident....
7. Depression is just another word for grief.
Normal grief occurs when someone loses a close friend or family member (or even a favorite pet). In such circumstances it is normal to feel sad, down, and to cry when one thinks about the departed loved one. Most people must work through certain stages of grieving in order to fully resolve their sense of loss, or most likely they will become depressed later…perhaps much later. [For more on the stages of grief, see New Light on Depression, chapter 4.]
Such a delayed reaction often occurs in social contexts that reward “saying the right things and doing the right things” when a person is grieving, expecting that person to pretend that the loss does not really hurt. Months, or possibly years, later when loneliness and sadness over the loss envelop this person and the natural process of grieving actually begins, he or she may be criticized by those who could (we would say “should”) have been encouraging and supportive through the entire process—encouraging the person to tell the truth and supporting him or her through the pain of facing that truth head-on.
The feelings associated with the depression of grief may come and go for a year or more, becoming more intense on birthdays, holidays, or anniversaries. For some losses that are particularly severe this periodic sadness may last an entire lifetime.
8. Your pastor and Christian friends will be understanding and supportive.
“If somebody comes into my church,” the very famous preacher boasted, “and they look like they got up on the wrong side of the bed….” He paused for emphasis and momentarily affected the face and posture of a chronically depressed person. “Then I just want to go on down there and tell them to go back home and get up on the right side of the bed!”
A similar perspective is common in the evangelical church today, where depression may be a cardinal sin because it violates one of the church’s primary tenets—that Jesus wants us happy. Or to say it another way, depressed Christians are like lepers in a congregation convinced that Jesus wants us well.
What Jesus really wants is for us to know true joy (versus happiness, which comes and goes with happenings). And he wants us whole. Often the depressed of our day are nearly as maginalized, ostracized, and stigmatized as the lepers of Jesus’ day. It is high time that the stigma attached by many in the church to their brothers and sisters with depression be exchanged for the attitude the Lord had toward first century lepers, which was to reach out and touch them in lovingkindness when no one else would even go near them....
We don’t want to sound like we’re indicting “the church,” since some churches are making an effort (and we hope more will do so) in this arena. But the truth is that seldom have we heard of Christians making it their mission to reach out to the depressed among them, or better, to the depressed in their community, at large. Without doubt, turning this particular myth on its head in Jesus’ name would go far toward convincing those observers in the community that his followers actually are willing to be like the One whose name they bear. They can do this if they adopt his attitudes of gentleness, mercy, and kindness toward those who hurt—for a bruised reed he would not break off; a flickering wick he would not snuff out. Concerned compassion would mean that pastors and others would leave the ninety-nine “sheep” safely in the fold to go out to find and rescue the one who is lost.
9. Depression is a waste of time.
One popular Christian book actually says that depression is a waste of time, but when you take a God’s-eye view—remembering that he is not in a hurry, you see something else. For the Scriptures are clear that God is going somewhere in our lives—remaking us into the image of Christ. How long this process takes, or the methods required are secondary to achieving the goal. Anything that is being remade experiences some degree of distress, but the craftsman works with the end in mind. A woodcarver once said, when asked how he made an Indian out of a log, “I just chip away everything that doesn’t look like an Indian.” Depression is one tool (though not the only one) that God, the master craftsman, employs to make us into people he can use.
J.B. Phillips wrote: “And where, you may well ask, does the Christian faith come into all of this? The answer is that probably emotionally it is of little help at all. It is only at the very center of our being that, despite any negative or evil attack, we can rest on the eternal and unchanging God. We may well have to learn to trust this living God without any comforting feeling whatever, and this is no easy lesson to learn. In fact, it seems to me that, for the Christian anyway, the undoubted evil of this form of suffering can be turned into good by learning a deeper trust in the real and living God. It may be that we have relied too much upon the props of true and earthly friends. But in this painful experience we are stripped of our pride and pious imaginings. Temporarily at least we have no one who can understand what we are going through. We are alone in this bewildering world and our only hope is in God, not probably the God who has satisfied us in past years or the God whom we imagined for our comfort, but the Spirit behind all creation. It is to know more deeply this real true God that we are permitted to go through the pains and humiliations of mental pain.... "
Though many modern Christians mouth the word “dependence,” in reality they only depend on God to do for them what they cannot do for themselves. As a result, God is more or less an addendum to their daily lives. Those who have journeyed with him into and out of depression KNOW (experientially and not just theoretically) that they can only survive when God, in every present moment, is the first and only focus of their faith.
God has a purpose in all that he causes or allows. In other words, he is going somewhere in our lives. The question is: Are we willing to go there, too? On his terms, not ours? Whatever it takes, even depression? Surely, the mere consideration of these questions is not a waste of time. Their resolution is, for many, the pathway to purpose and fulfillment, even joy.
10. Depression arises from repressed anger.
Some popular Christian therapeutic approaches embrace Freud’s theory of depression as “frozen rage,” though they are far more directive about dealing with one’s repressed resentments than Freudian therapists would be. Christian therapists using this model of depression can be expected to probe a patient’s memories for grudges, from which the patient must repent, since holding grudges even temporarily is thought to be sinful:. : “‘In your anger do not sin’: Do not let the sun go down while you are still angry…” (Ephesians 4:26-27).
Depressed Christians may or may not experience this therapeutic approach. For believers, the main issue should not be whether or not this method works, but whether or not its biblical foundations are valid. It is doubtful, for example, that the apostle Paul, who penned the passage above, intended it to say anything about the cause and cure of depression. The context of the passage is an extended comparison of the unconverted life with new life as a member of the body of Christ (Ephesians 4:17-32). Here Paul is offering guidance to former pagans about relationships within the church. Believers, having put off the old self (including falsehood, anger, theft, unwholesome talk, bitterness, rage, brawling, slander, and malice) are to put on the new self with its new attitudes and actions. This new self is created to be like God in righteousness, holiness, kindness, compassion, and forgiveness, attitudes which are extended to other members of the church because in Christ God has forgiven us all, equally. [See New Light on Depression, chapter 4 for an expanded discussion of this question.]
We believe that when anger is a part of a clinically depressed Christian’s constellation of unhealthful emotions, the Christian therapist should help that person to forgive the sources of his or her anger—whether living or dead; self or other—as a part of adopting a more constructive, mature Christian approach to living as an interdependent part of the body of Christ. However, anger, in our view, is only one of many destructive attitudes (to self and others) that a depressed follower of Christ may need to put off. Focusing on the resolution of anger (repressed or otherwise) while ignoring a depressed person’s uniquely unhealthy habits of thought or action will not facilitate true healing, and may produce, in the patient and others, unnecessary psychic and spiritual pain.
If you as a patient are subjected to this approach, and you believe you have transparently and forthrightly revealed you anger, yet the counselor persists in trying to dredge up more, you should feel free to suggest to him or her that in relation to anger (or suppressed grudges), your conscience is clear before God, because you are resting in the finished work of Christ, and you would like to move on to other issues. Should your counselor remain in the grudge-hunting mode despite such a request, you need to find a different counselor, one willing to engage your depression in all its complexity.
The above material is adapted from New Light on Depression, by David B. Biebel, DMin and Harold G. Koenig, MD (Zondervan, 2004). Copyright David B. Biebel and Harold G. Koenig; all rights reserved.