The best approach to treating depression is holistic and involves doctors (psychiatrists), counselors, and pastors. Though not exclusively spiritual, depression has a spiritual dimension. People who suffer from depression may also struggle with understanding how God can allow them to suffer such great pain. Kathryn Green-McCreight described her pain as so intense that “every breath, every thought, every moment of consciousness hurt.”
Christians should consider medication.
Sometimes Christians are not open to medication because they imagine that the use of medication is somehow contrary to a life of faith, or that it denies that God is active in the world to bring about his good purpose for everything, but the truth is that God often works through ordinary natural means. It’s a mistake to think that either doctors heal or God heals. In every case it’s both. God created a world in which doctors can heal and treat all sorts of illnesses, from broken bones and bacterial infections to cancer and mental illness.
Michael Horton shows that the creation account is an example that God can work supernaturally and naturally through ordinary means. He writes,
Ordinarily, God does not act immediately and directly, but indirectly through secondary causes. It’s interesting that in Genesis 1 and 2, we have not only the direct command, “Let there be…!” followed by the report, “And there was…,” but also the command, “Let the earth bring forth…!” with the report, “And the earth brought forth….” Even in this mighty act, God created the world out of nothing (ex nihilo), and he worked through the physical elements and processes he himself had created to bring about their fruitfulness. Both are God’s acts. When he sustains the world each moment even now, in the Son and by his Spirit, the Father ordinarily guides the natural processes he put in place rather than acting as the only cause, as he did in bringing everything into existence in the first place.
This is true about depression. “If depression consisted solely of spiritual problems,” says Ed Welch, “there would be no reason to talk about medication or other physical treatments. But depression does have physical symptoms. Because depression is related to the body, we should be open to the options that doctors and medical professionals offer. This does not mean that medication is always the answer. It’s more complicated than that, and only through working with a doctor and psychiatrist should a person make the decision to take or not take medication. There are risks and difficulties for both options. Ed Welch gives helpful advice when he says, “medical treatments might be helpful to ease or erase physical symptoms of depression (and other psychiatric problems). In this generation, there are a handful of treatments available. None of them helps all the time. All of them can have harmful side effects.”
It’s good for a Christian to consider medication but not to expect that to be the only aspect toward living with and dealing with depression.
Christians should work with their doctors to consider more than medication.
According to the American Psychiatric Association, “There are a number of things people can do to help reduce the symptoms of depression. For many people, regular exercise helps create positive feeling and improve mood. Getting enough quality sleep on a regular basis, eating a healthy diet and avoiding alcohol (a depressant) can also help reduce symptoms of depression.”
Even though medication is a great blessing, people shouldn’t see medication as the only answer to the problem. Medication and other medical treatments like electroconvulsive therapy (ECT) may be an important part of treatment, but the best approach to depression is to focus on whole body health and not simply brain health. Though diet and exercise may not alone be enough to help a person suffering from depression, it can greatly aid a person who is depressed and often struggles to accomplish the ordinary tasks that can seem impossible at the moment: eating, socializing, praying, exercising, bathing, getting out of bed.
Christians should take the spiritual aspects of struggling with depression seriously.
Christians who suffer with depression will likely experience suffering associated with their faith. They may doubt about God’s goodness or mercy. They may feel as though God does not love them. They may struggle to make sense of how God could allow them to suffer and their families to suffer as a result of their mental illness. Struggling with depression can often leave one hopeless and despairing of life itself, imagining that death could be a salvation for their suffering, or even secretly considering suicide as an option for relief.
Depressed people need to be reminded of the hope that Jesus Christ offers. Michael Horton writes,
“Pray more” and “Read your Bible more.” In itself, this is good advice. But what suffering people of any type need most is good news! When you’re depressed, being told that you just need to “trust God more” or be more devoted to spiritual exercises simply drives you deeper into yourself. Because of your body’s chemistry, you’re not in a position to get out of bed and face the day. Apart from the gospel, calls to more prayer and Bible reading become burdensome laws that drive us farther from resting in Christ. It’s the proclamation of the gospel in word and sacrament that pulls us out of ourselves to cling to the Father of all mercies in his Son, by his Spirit, and to seek his revealed purposes and will for our lives.
The gospel of Jesus Christ has a lot to say to people suffering depression because the gospel promises the renewal of creation that has been plunged into darkness. The gospel isn’t just an answer to personal sin; it’s God’s act of healing the world, ending death and decay, and restoring the world to its proper order:
The hope of the resurrection is not mere optimism, but leans the Christian life ever facing toward the future, not merely dwelling in the present. The Christian hope is not only for the individual Christian, nor the church itself. It is for all of creation, which was bound in decay by the first sin: “Cursed is the ground because of you…thorns and thistles it shall bring forth for you” (Gen. 3:17–18). This curse of even the land and its increase will be retracted at the resurrection. All of creation will be redeemed from pain and woe. Even for those with broken brains, this understanding of the Christian hope can comfort and encourage.
This kind of gospel, a gospel that speaks to every aspect of creation, gives hope. It leads us to “pray honestly, casting ourselves on God’s mercy” because we can trust that we “aren’t coming to a judge, or even to a therapist, but to our heavenly Father who has accepted us in his Son. We’re not rubbing a lamp and making a wish, but we are children crying out to the sovereign God who cares for us and answers our feeble, half-hearted, and even intemperate rants with love, wisdom, and compassion.”
Footnotes
Kathryn Green-McCreight Darkness is My Only Companion: A Christian Response to Mental Illness, 44–45
Michael Horton “Faith and Mental Illness,” Modern Reformation, July/August 2014.
Ed Welch Blame It on the Brain, 125
Ed Welch Blame It on the Brain, 125
https://www.psychiatry.org/patients-families/depression/what-is-depression
Michael Horton “Faith and Mental Illness,” Modern Reformation, July/August 2014.
Kathryn Green-McCreight Darkness is My Only Companion: A Christian Response to Mental Illness, 51.
Michael Horton “Faith and Mental Illness,” Modern Reformation, July/August 2014.
