Coping with Depression - Part
1
To cope, according to the dictionary, means "to engage in a contest or battle on even terms or with success." One of the problems in coping, however, arises when we face a battle sorely hindered by inadequate weapons. Misinformation, no information, an inadequate understanding of the adversary — all weaken our position and assure the struggle will be long and painful.
Nowhere is this more true than in coping with depression. Whereas in many confrontations our weapons and strategies are developed and sharpened in the battle itself, the nature of depression is such that it dampens our energies in those directions. A mild depression may motivate us to generate ways of resolving it, but the deeper depressions seem to suck all ambition from us and leave us with a growing difficulty in maintaining any sense of perspective on our problem.
Fortunately, there is much you can do — ways you can contend with most depressions that will lessen their severity and shorten their duration. I'll be describing these in this and the next chapter.
IS THERE SOME FORMULA I CAN FOLLOW TO OVERCOME DEPRESSION?
There's no easy prescription. In one sense, no two depressions are identical, and no two people experience depression the same way. Yet there are fundamental
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principles that should be followed; I've touched on some of them already.
The "formula" must be tailored to the type of depression you experience. If you get depressed regularly without any apparent cause, the first step is to get a good medical evaluation and try to discover if there's a physical cause for your depression. If there is, have the depression taken care of with appropriate treatment.
If the depression is reactive, caused by a loss of some sort, there are several things you can do.
First, let me say again, if it's a minor depression, don't do anything. Just accept it and allow yourself to go through it. You may well realize what's causing it. Minor depressions are usually self-healing provided you don't feed them with too much introspection.
If, however, you feel your depression is more serious, try the following steps:
Step 1: Identify the loss with all its implications.
Step 2: Accept the loss, do your grieving, and try to put the loss in some perspective.
Step 3: Then get on with your life.
Of these three steps, identifying and understanding your loss is the most difficult. Sometimes the loss is very subtle or abstract, making it hard — even impossible — to identify. Or you may be so depressed that it's tough to do this sort of self-searching. In that case, I suggest you talk with somebody you feel can be understanding and nonjudgmental, perhaps a friend or your spouse. Just discussing your depression with someone else may help you to see what's causing it. If that doesn't help and the depression lasts for several days or weeks, seek further help from your pastor, counselor, or a psychologist.
Identifying the loss isn't always necessary, however. Many depressions burn themselves out if we remain patient. Fortunately, our brains are designed to forget, so much that bothers us gets washed away with the passage of time. But if you find yourself unable to come out of the depression, you need to seek professional help.
Suppose you lose your job. For economic reasons, the company lets you go. You become depressed. That's natural. (If you didn't become depressed, I'd be concerned.) If the depression lasts even a couple of weeks, that's probably not significant. You'll get over it as soon as you pull your life together. However, if you not only lose your job but also have difficulty finding another, your depression
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may intensify to the point where you need help. It may be so severe that you can't do what's necessary to get another job.
HOW DO I DEAL WITH THE LOSS AFTER I'VE IDENTIFIED IT?
It's often difficult to understand the full implications of a loss. Some losses are so subtle that you need someone like a therapist to help you understand their full meaning. The next step is to move to an acceptance of the loss. You must stop fighting or resenting it. You can't go on wishing the thing you've lost will come back. This acceptance is an act of your will, a conscious decision in your mind. The grief process, allowing yourself to become sad, helps this.
The last step often goes hand in hand with acceptance, or it may follow it. You must pull back and put the loss in some larger perspective so it does not continue to dominate your life. As a Christian, you must begin to see the loss from God's point of view. Some of the things we grieve over are rather insignificant when we put them in the context of the larger scheme of things. Having a clear plan and purpose for your life, with a deep understanding that God is in control, can help you accept and put losses in perspective more easily than if you lack such beliefs.
WHAT IS THE ROLE OF ANGER IN DEPRESSION?
Anger and depression often coexist, but the notion that depression is anger turned inward is a misunderstanding of the relationship between the two. The loss that causes a depression often simultaneously causes a feeling of frustration. And when we're frustrated, we become angry. The anger is designed to help overcome our frustration. This is then interpreted as the anger "turned inward."
SO IT WOULD BE WRONG TO SUGGEST IN MOST CASES THAT ANGER IS A TRIGGER MECHANISM IN DEPRESSION?
Anger may be the trigger mechanism in some cases, but it usually occurs simultaneously with the depression in reaction to a common loss. In rare cases, depression may occur without anger, but usually the loss triggers both. People suppress the anger in some depressions.
Perhaps the best example of this is in bereavement. You can't be angry at the person who just died, so you don't allow your anger to surface. Often, as I help people through the grief process, a large part of the counseling is focused on getting them in touch with this anger. It may be directed at the hospital, at the
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doctors, at fate, or even at God. Sometimes there is anger at the deceased for abandoning them. Identifying and dealing with this anger is essential in resolving the depression.
WILL ANGER FUEL A DEPRESSION SPIRAL?
Anger easily creates other emotions, and it can fuel a spiral in which a depression keeps getting worse. You're not only angry at the loss, but you're angry at yourself for being depressed.
Because many have been taught that depression is wrong, they feel guilty about being depressed. This in turn makes them angry at themselves for not being able to shake off the depression. The anger represents further loss — the loss of self-esteem for being unable to control their emotions — which perpetuates and intensifies the depression. They find themselves in a spiral: more depression followed by more anger, which causes deeper depression. Soon they feel as if there is no way out.
HOW CAN I HANDLE MY ANGER IN A HEALTHY WAY?
Dealing with anger is just as complex and difficult as dealing with depression. Briefly, though, handling anger involves three steps. First, you must recognize and own the feeling of anger. For many people, anger goes unnoticed or is denied. They will sit there, livid in the face, breathing hard. But if you say to them, "Oh, you're angry," they'll immediately answer, "Angry? I'm not angry!" and nearly bite your head off.
My strong conviction, based on scriptural principles, is that the feeling of anger is legitimate. What you do with your anger (the aggressive behavior), however, may not be. The feeling is a symptom that something is wrong — something is hurting or frustrating you. But taking that anger out on somebody else — attacking the object of your anger— is wrong. Angry behavior has more potential for sin than just the feeling.
If you can admit your anger and use it to direct you back to what's causing it, you'll be in a better position to dispose of the anger. Unfortunately, we tend to want to savor the emotion. We want to feel hurt. And that, of course, contributes to depression.
Once you identify the cause of your anger, whether it's something someone else has done or something you did yourself, you can take the next step to resolving it: go to the person who is hurting or offending you and deal with the issue.
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Resolution occurs when you come to terms with whatever is causing the anger.
All of us would benefit greatly by dealing with our anger causers in our "sane" moments. We often get angry at the same things over and again. Our spouses or our children do the same things repeatedly, and we get angry every time. For example, sometimes we have too-high expectations that are never met, causing frustration and anger. In our calm moments, we can reduce our anger by evaluating our expectations and making sure they're not unreasonable.
MUST A PERSON ALWAYS EXPRESS ANGER TO AVOID A DEPRESSION?
I strongly oppose the popular notion that you should always express anger at the time you feel it. Certainly you should be aware of your anger and strive hard to understand yourself and your emotions. But expressing your anger through angry behavior almost always creates more problems than it solves. It usually means you attack others and hurt feelings. They, then, have a need to hurt you back, and the process has no satisfactory ending.
I would distinguish, however, between aggressive expression of anger and simply saying to somebody, "I feel angry right now. I take responsibility for my anger, but I want to talk about it." The latter is healthy. It helps you to get a perspective on what's causing your anger. It also helps you to better understand why you're depressed.
The translation of anger as feeling into anger as aggression is where we have the greatest potential for sin. To act out your anger risks hurting others. Aggression is simply a way of getting revenge on those who cause your anger.
In summary, it's not necessary to act out your anger, but it is necessary to be in touch with it — to recognize it, to be able to label it accurately, and even to talk about it. You must accept the anger as your own. No one forces you to be angry. You bring it on yourself. Use it as a means of understanding your loss and helping you to put the loss in better perspective.
IF THE PHYSIOLOGICAL REACTIONS IN ANGER ARE BEYOND MY CONTROL, HOW CAN I BECOME LESS ANGRY WITHOUT REPRESSING THE EMOTION?
Physiological reactions to anger are beyond your control, but the anger itself is fueled and controlled by thoughts. If you put yourself in a pattern of resenting your loss, your physiology is going to follow that pattern. So while you can't stop
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your physiology, you can change your thinking. If you put your loss in perspective and deal with the hurt, your physiology will react in a different way. Remember that feelings are a product of a complex exchange between your mind and your body. Your thinking can cause your body to react in certain ways.
This is why the Christian gospel is so wonderful in helping you achieve mental health. It gives you fantastic resources. I'm thinking particularly of the gift of forgiveness, which can release you from a lot of anger.
Much of what causes anger can be handled internally without ever having to express it outwardly. Mind you, this is only true if you're able to understand your anger. (More about this later.)
CAN I AVOID SELF-HATE DURING A DEPRESSION?
The self-hate that occurs in a depression is part of the depression itself. The best way to deal with it is to be aware that it's one of the symptoms. In other words, the self-hate is so intimately bound up with your depression that you can't really avoid it. To get rid of it would be like getting rid of the depression itself. If you can recognize this and accept it as part of your depression at the time, you can avoid giving it too much attention. You're better off ignoring it.
This is an important principle in dealing with many negative emotions. Numerous feelings can't be avoided. But an emotion doesn't have to control you. You simply set it to one side. You say to yourself, I realize this feeling is part of my depression, so I'm not going to give it any attention. I'm not going to respond to this false signal. It takes some willpower, but it can be done.
HOW IS GUILT RELATED TO THE DEPRESSION SPIRAL?
Guilt feelings may be associated with the loss itself, especially if you see yourself as contributing to the cause of the loss. More frequently, though, guilt feelings arise because you think you should not be depressed. The guilt is caused by rejecting the right to be depressed. This guilt represents further loss, of course, the loss of self-respect. It adds to, and may be more significant than, the original loss.
Let's say you slam a door because you're angry, and it falls off its hinges. You're confronted with a concrete loss. You'll have to pay to fix the door. That loss would probably cause a mild depression even in the absence of any other emotion. But reacting to what you've just done, you begin to feel guilty. You sense a loss of respect for yourself because you're so quick-tempered. The guilt
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creates further loss that's probably larger than the original loss. So it produces a deeper depression that masks the earlier one. The guilt then feeds your depression with further loss and further depression, creating a depression spiral.
IS THERE A DIFFERENCE BETWEEN REAL AND FALSE GUILT?
Yes, there's an important difference. Some actions should make us feel guilty, such as failure to pay our debts or deliberately hurting others. That's real, legitimate guilt arising out of our responsibility for some wrong. It has a basis in reality.
False guilt, however, has no basis in reality. It's a tendency to internalize arbitrary rules and principles. Often they're instilled by parents, although they may be picked up from many other sources as well.
Let's say, for example, that your parents taught you to place your knife and fork at a certain angle on the plate when you finish eating. That was the "right" thing to do. Years later, as an adult, you have internalized that rule to such an extent that if your plate is taken from you before you can adjust the knife and fork to the correct angle, you feel extremely guilty. That's false guilt.
Sometimes it's called neurotic guilt. You're being controlled by an extremely arbitrary set of rules and values. They're not moral absolutes but a set of human quirks. Many of us are full of these petty rules. They should be confronted, their power to control you challenged.
HOW CAN I FORGIVE MYSELF FOR MY PAST FAILURES?
The tendency not to forgive ourselves is common in our culture. It seems to be related to the amount of false guilt we generate. Its roots are in early childhood, when parents fail to demonstrate forgiveness to their children, who keep on punishing themselves even as adults.
Self-forgiveness starts by accepting God's forgiveness in Christ and really letting that get down into the deepest part of your being. You have to believe Christ died for you and that God's forgiveness is for all your faults.
HOW CAN I DEAL WITH THE GUILT I FEEL ABOUT THE WAY MY DEPRESSION IS AFFECTING MY SPOUSE?
The first thing to do is to be open with your spouse about how you feel. We often walk around feeling guilty because we don't check things out. Since we
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don't talk it over, we get into the trap of imagining lots of things that may not be true at all. But even if your family is feeling bad because you're depressed, it's important to talk about it so they understand where you're coming from and you understand what they're feeling. Even if they're genuinely hurting, that's no reason for you to feel guilty. Don't allow your guilt to feed the depression or to create further negative emotions that could feed it.
HOW CAN WE AVOID DEPRESSIONS THAT APPEAR TO BE RELATED TO HELPLESSNESS?
People in our culture tend to feel helpless when they're manipulated by circumstances. They feel control is beyond them, so they don't try to take control of their lives. We call this "learned helplessness." If you regularly give control to others — a spouse, parents, church officials — you will often find yourself in depression.
You need to find ways to take control of your life. This requires some assertiveness, a characteristic usually lacking in those who frequently feel helpless. And people who are not as assertive as they should be, who can't or won't stand up for their rights, will often become depressed. So, very simply, the answer is to begin taking control of your circumstances.
CAN A PERSON WHO FEELS GOOD ABOUT HIMSELF EVER BECOME DEPRESSED?
Absolutely. Feeling good about yourself doesn't prevent depression because, again, depression is a natural and normal reaction to loss, which we all experience. However, feeling good about yourself because you're in Christ and know He is doing His work in you does help to put losses in perspective and so resolve your grief more effectively.
HOW IS SELF-PITY RELATED TO DEPRESSION?
Self-pity is also one of the by-products of symptoms of depression. Depression not only makes the world look bleak, but it makes you look bleak as well, so you tend to feel sorry for yourself. Self-pity gives rise to the aspect of depression known as melancholia, the tendency to feel very, very sad. Nothing seems worthwhile, especially yourself. As with the other negative emotions that accompany depression, self-pity can deepen the depression by adding further losses to the original one. This cycle must be broken to prevent the depression from deepening.
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HOW DO I DEAL WITH DEPRESSION THAT SEEMS TO BE RELATED TO AN INADEQUATE SELF-IMAGE?
The depressions having to do with one's self-image are the result of very subtle losses. They're difficult to get a handle on. To deal effectively with them, you have to work at it in your "sane" moments. You can't do this sort of work while you're depressed, because there is usually a lot of irrational thinking associated with it.
Building self-esteem involves two steps, the first of which is self-understanding. Often low self-esteem stems from a childhood that has created an erroneous self-image. Perhaps the parents used put-downs excessively, expressions like "You're dumb." "You'll never amount to anything." "You really disappoint me!" Coming from people who had a lot of power in their lives, such critical statements produce a distorted self-image. Although the statements may have been made in anger, they were made by people who were trusted and who should have shown love. Because of that, they were especially damaging.
It's vital that those early self-images be explored. The amazing thing is that most of us have a totally erroneous and negative view of ourselves. With help, we can correct those distortions and come to realize we're not nearly as bad as we believed.
The second step is self-acceptance. This is where being a Christian is so important. In Christ we have the whole basis for our self-acceptance. Whether we're better than we think we are or even worse, we can, through Christ's acceptance of us, move into accepting ourselves.
WHAT'S THE DIFFERENCE BETWEEN ACCEPTING MYSELF AND EXCUSING MYSELF?
This is an important distinction to make. Excusing yourself involves a lot of rationalizing, such as: "The reason I didn't perform well was that my grandmother was dying." That's not realistic self-knowledge but making an excuse for your behavior. Accepting yourself is having the courage to face both your strengths and your weaknesses and accept what you see. You may need to ask others to help you understand yourself. Then be honest enough to look at yourself from their point of view.
HOW CAN I HAVE CONFIDENCE IN MYSELF WHEN EVERYTHING I DO SEEMS TO TURN OUT WRONG?
I'm sure most of us at one time or another have lacked confidence because everything seemed to be going wrong. One event after another seemed to collide
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with us in a destructive way. While this may occur due to an unfortunate series of circumstances over which we have no control, it may also be because we're not functioning maturely. We make bad decisions, so it's not surprising that things go wrong.
In those cases, it's a good idea to get some help. Maybe you need to understand yourself better. Maybe you're "blowing" things constantly because you have no understanding of what causes you to do what you do. I suggest you find professional help or at least talk things over with your pastor or a close friend.
HOW CAN I LOOK TO THE FUTURE WHEN MY PAST HAS BEEN SO DISMAL?
Many people have a deep-seated fear of the future because of the frequent and painful depressions they've experienced in the past. Often they have an endogenous form of depression. Medication or other medical treatment may be needed to restore the biochemical balance and thus assure the sufferer of a more-hopeful future.
If the frequent depressions are reactive, you're going to have to do some work within yourself to reduce your sense of hopelessness about the future. It may require you to make changes in how you cope with life. Improving how you handle stress could probably cut by half the depressions you experience. Even if the depression is legitimate and caused by a loss you can't control, better stress management increases your coping ability.
You need, then, to work on yourself, to improve your tolerance for stress and frustration. It's tragic to realize how many Christians are lethargic in this area, believing it will all take care of itself or that God will magically make everything right.
WHY DO I FEEL WORTHLESS EVEN THOUGH I KNOW I'M INTELLIGENT?
This is what depression does to our rational processes. Emotions, once triggered, are much more powerful in determining our actions than our intelligence or our reasoning. Depression is a deep emotion that interferes with our thinking process. Our rational abilities just get set aside as we focus on the emotion we're experiencing at the moment.
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HOW CAN I COPE WITH FEELINGS OF INFERIORITY AND WORTHLESSNESS?
Feelings of inferiority and worthlessness form a cycle. They follow the depression, but they also feed it, thus keeping it going. Reacting to the depression with guilt, anger, or some other emotion gives the depression cycle extra momentum. That puts you into an ever-deepening depression. Somewhere you have to break the cycle by realizing that your feelings are part of the depression.
For example, if you haven't slept all night and the next morning you find you can't do your work properly, you don't need to go far to find the reason. So you don't punish yourself for your lack of effectiveness. You ask to be excused, and you go home and sleep. That's how you take care of such a problem. It's also how you should deal with your feelings of worthlessness and inferiority. Recognize that they're a consequence of your depression, and focus on dealing with the depression itself rather than letting the feelings add to the depression.
HOW CAN I SET REALISTIC GOALS FOR MYSELF IN THE CONTEXT OF PURSUING CHRISTLIKENESS?
Conformity to Christ, as I see it, is a direction in which we move. Paul himself said he was striving for that conformity, and yet I'm sure he knew that on this side of the grave he would never fully attain it. I'm suspicious of people who say they are Christlike, but I understand those who say they want to be Christlike. There's an important distinction between the two.
Having the desire to be Christlike doesn't mean you rule out the possibility of having a reactive depression. There will be losses, and you'll find yourself grieving these losses through your depression.
Further, when you set goals within the context of this direction, they need to be realistic. It's not realistic to have a mind-set that you must never be depressed. You should strive to minimize the impact of losses, however, especially materialistic ones, as you come to understand the mind of Christ.
Another important element here is that you need to develop a healthy "theology of failure." Some people's theology won't allow them to think in terms of failure. They only see God in their successes. But we are human beings simply striving to be Christlike. We will fail.
Satan uses failure more destructively than he should be able to because we don't know how to receive it from the hand of God. We need to see failures as stepping stones to growth. They are "to grow by." I'm not suggesting you should
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encourage failure so you can grow, but when failure does occur — when you fail to reach a goal you've set for yourself — you must consider setting more-realistic goals (if that's a problem), and you must make sure that feeling of failure does not become destructive.
IS IT TRUE THAT DEPRESSED PEOPLE SEE RATIONALIZATIONS MORE THAN SOLUTIONS?
Since the purpose of depression is to remove people from the race, there's a loss of energy, of drive and ambition. There's also a tendency, therefore, to feel helpless and not to seek solutions. Depressed people often retreat into rationalization as a way of justifying their failure to do anything.
I recall a patient who was in a severe depression and as a consequence could not do his work properly. Instead of finding solutions, he sat there giving me elaborate explanations for why he couldn't get his work done. When I pressed him to write out four or five action steps that would help him be productive, he resisted strongly. Such resistance is a natural result of the depression. One just lacks the energy and drive to be action oriented.
TO WHAT EXTENT SHOULD A DEPRESSED PERSON TAKE RESPONSIBILITY FOR THE DEPRESSION?
You don't need to take responsibility for a depression before you can resolve it. The depression itself doesn't restore the loss. But you do have to take responsibility for dealing with the depression. It's probably not easy to do at the deepest time of your depression, but as you begin to "bottom out" and put the loss in perspective, you're responsible to deal with the consequences of the loss.
For instance, if you have lost your job, sooner or later you're going to have to do something about finding another. A time comes in the experience of depression when your energy starts to return and you can speed up your recovery by taking action.
IS THERE A TIME IN DEPRESSION WHEN IT'S IMPOSSIBLE TO HELP YOURSELF?
In some depressions (the less-severe ones), you can help yourself right through the depression. You're not that incapacitated. In the deeper depressions, however, there is a time early in the experience when it's impossible to help yourself. During that time, the best thing you can do is to remove yourself from
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your environment. Take some time off to be alone and allow yourself to do your grieving. Some depressives are afraid to do this because they're afraid they'll lose control if they give up, but it's the best thing to do when you're really low.
IS THERE A POSSIBILITY THAT "GIVING IN" TO YOUR DEPRESSION WILL FURTHER DEEPEN IT?
What will deepen a depression is to resist it, at least in the common, reactive depressions. When you experience a significant loss, you need a period of grieving. It may take a day or two, perhaps even a week or two or much longer, but it takes time. There comes a time when your energy begins to return, however. At that point, if you just get on that wave, you can speed up your recovery.
I must qualify this answer by stressing that I'm talking about the common, reactive depressions. If your depression is endogenous, it doesn't help to "give in" to it; that will only perpetuate it. Because it has its cause in the body's biochemical system, that balance must be restored before healing can occur. Withdrawing and giving in to this type of depression will not help. You should do whatever you can to minimize the impact of this depression.
Sometimes it helps to say to yourself, "Look. Cheer up. This is going to be over soon." Then go on about your normal routine. By talking to yourself this way, you can help to put your depression in better perspective. But avoid any self-talk that robs you of the right to be depressed; it will only aggravate the depression.
WHAT ARE THE KEY SCRIPTURAL PRINCIPLES INVOLVED IN COPING EFFECTIVELY WITH DEPRESSION?
I am assuming the reader understands and accepts that there must be a basic foundation of salvation in Christ and the indwelling power of the Holy Spirit.
Beyond that, there are at least three scriptural principles I have found tremendously helpful.
First, both loss and gain are part of our Christian experience. We should not expect everything to be gain.
In Philippians 3:7-8, Paul said that the things that were once gain to him, he now counted as loss for Christ. He meant there is no loss we can experience that exceeds what we gain in Christ. He also said, in effect, "Everything I'm going to lose in the future, I will contrast with what I gain in Jesus Christ. That will help me to bear the loss and get over my grieving more quickly."
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The principle of seeing what we gain in Christ can revolutionize our value systems. It can help us put our losses, whatever they are, in the perspective of eternity.
That doesn't mean depression won't bother us in the future. Even though Paul said he counted all his losses as gains, I don't think he was implying he never felt sorrow over some particular loss. It's a process, something we call to remembrance every day to help us cope with the losses of life. In fact, it's a healthy spiritual exercise to begin each day by taking all the losses you anticipate and, in advance, offsetting them by reminding yourself of your gains in Christ.
Second, we are called to forgive those who hurt us.
The principle of forgiveness is stated most clearly in the Sermon on the Mount (see Matthew 6:14-15). I cannot stress strongly enough how much I feel that many of our depressions are the by-product of our inability or unwillingness to forgive. We don't seem to be, by nature, very willing to do it. We prefer taking revenge. We harbor grudges. We savor resentments. Since most losses in life come to us at the hand of some other person, the principle of forgiveness is absolutely essential to the avoidance and healing of depression.
Third, we're instructed to "renew our minds."
As a Christian psychologist, I greatly appreciate Romans 12:2. Paul reminded us there that we are to be "transformed by the renewing" of our minds. Not only does that verse legitimate some of the things I try to do professionally, but it's also a broad concept essential to coping with depression. Part of what God offers us in Christ is a renewed mind. That includes a new way of thinking, new values, new beliefs, and new attitudes. All are necessary if we're to cope with depression in a healthy way.
WHAT UNIQUE RESOURCES DO WE HAVE AS CHRISTIANS IN COUNTERING DEPRESSION?
God gives us a fantastic supply of resources in the gospel. He not only gives us His power directly through the indwelling Holy Spirit, but He also gives us the resources of His Word and prayer. All of these are directly beneficial in dealing with our depressions.
One of the most direct benefits these resources provide is a unique perspective on this life, especially that it's temporary and transitional. We are just "passing through," as the spiritual says. This perspective gives us a set of values that greatly help us cope with depression, because they change our
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perception of what is and isn't loss.
Christianity also teaches us not to be attached to the things of this world.
The first step in the process of healing, therefore, is really a spiritual exercise. We need to examine our hearts periodically to determine the extent of our attachments to our jobs, our families, our loved ones, our reputations, our ambitions, our dreams, and even ourselves. Too many of us leave those attachments unexamined, and an unexamined life is an unhappy life. Then, with God's help, we can reorder them so they're within the normal bounds of attachment.
Let me give you a concrete example. I love my family very much. At times I honestly believe I'm overattached to each of them. Whenever I realize that, I ask for God's help to put my relationship with them in a more balanced place. I honestly acknowledge my overattachment, and then, by reflecting on His role in my life, I realize He is the only one to whom I should be "overattached." This slowly brings my feelings under control and allows my love for my family to be put into better perspective.
Such periodic readjusting of attachments can also help us in preparing to face the losses that will eventually occur with even the most precious of the persons or objects we have.
ARE THERE STAGES IN THE PROCESS OF RESOLVING DEPRESSION?
Yes, there are three: protest, despair, and detachment. These stages are similar for all forms of loss. As we examine our spiritual resources for dealing with depression, it will be helpful to tie them in to each stage.
The first stage is protest. This occurs when we discover a loss has occurred. It's the natural reaction of our minds and bodies and is probably designed to help us overcome the loss. When the young wife hears her husband is leaving her, she immediately begins to protest, even deny it. That mobilizes her to deal with the threat, and in some instances it may even help to prevent the loss from occurring. For most of us, however, the protest phase doesn't help at all. It makes us angry and often intensifies the pain we experience over the loss.
How can God help us in this protest stage? Christians I've tried to help through it tend to blame God, themselves, and anyone else who might get in the way. There's a high level of hostility, and it's even possible that they will try to take their own lives or harm the people responsible for their losses.
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Recently there has been a spate of reports in the news of men who were fired from their jobs and returned within a few days to take revenge on their fellow workers and those responsible for their dismissal. This is the protest stage of depression. It can be traumatic for some. But for most of us, who only have to deal with ordinary losses and separations, the protest stage may go no further than a high level of irritability and aggravation.
It's extremely difficult at this stage to implement spiritual disciplines such as prayer and scripture reading. However, every effort should be made to focus back on God as being in control of our lives and to avoid feeling totally helpless. Scripture can provide a solid foundation. We can focus on the greatness of God (e.g., Psalm 77:13; 95:3; 104:1) or on His power (e.g., 1 Chronicles 29:12; 2 Chronicles 25:8; Psalm 65:6; Romans 16:25). We can also focus on the strength God makes available to His children (e.g., 2 Samuel 22:40; Isaiah 40:31; 41:10; Ephesians 3:16), or on the theme of endurance (e.g., 2 Timothy 2:3-4; 4:5; Hebrews 12:6-8; James 1:12).
Scripture can also be extremely important in helping us control feelings of hostility toward those who may be causing our loss. Above all else, we must pray for the strength and courage to forgive those who might be responsible for what we're feeling. We also have to forgive ourselves for what we've done and how we're reacting. Scriptural verses about forgiveness can help to focus our minds and energy on more-constructive actions (e.g., Psalm 103:10-12; 130:3-4; Colossians 1:12-13; 1 John 1:9).
During this protest stage, there's also a deep sense of injury and a groping to hold on to the lost object. Particularly in cases where the separation was not expected, there can be an exaggerated cry of alarm, panic, protest, and anger. God can help us with each of those reactions.
The task we have to accomplish during this stage is to become fully aware of the loss and not engage in denial. We must face up to the pain. The more effectively we can do that, the quicker will be our recovery. We may find we lack interest in establishing an attachment to a new object. In some cases, we might run out and try to replace the object as quickly as possible.
Sadly, this often happens in divorce situations, where the one who was rejected almost immediately searches for another partner. This is done for several reasons, including the need to punish the one who has walked away or to replace the loss so there is less sense of abandonment.
Obviously, lots of mistakes can be made in this stage, so we need to ask God to keep our minds focused on the grieving process and not allow us to rush out
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and do something foolish. Grief never works itself out through substitution. We can't just replace our losses. If we do, we may find ourselves with a delayed grief response at a later time in life.
WHAT IS THE DESPAIR STAGE?
The protest stage finally gives way to the second stage in the grieving process, despair. As soon as our losses or separations become realistic to us, the depression may intensify. In this despair, we lose interest in all other people or things. We want to hibernate and not be disturbed, and we become silent and sullen. We need our space; we need to be feeling our sadness and reflecting upon our loss.
During this stage, the real work of healing begins. And it's here that we need to turn to God and be renewed in our spirits. We cannot find comfort in people that is as enduring or meaningful as the comfort that comes from God. The theme of comfort, therefore, may be very helpful to those in the despairing stage of depression. They might appreciate such passages as Psalm 23, 2 Corinthians 1:3-4, Philippians 2:1, and 1 Thessalonians 4:18.
During this period, however, it's extremely difficult to strengthen or even maintain our spiritual lives. But we can take comfort in the fact that this is the work of the Holy Spirit and that God can maintain our spiritual lives without much effort or motivation from us. If we live in total surrender and dependence on the Holy Spirit, we can trust Him to heal our infirmities and strengthen our spirits even though we may not be very cooperative (see Matthew 9:28-29; Ephesians 3:20; Philippians 1:6; 2 Timothy 1:12).
If you're a friend or loved one of others who are in the despair stage of depression, don't talk too much, but focus on listening. Read Scripture to them without judging or condemning, and pray for them, because they most likely won't be able to pray for themselves. You can be extremely helpful in putting into words what they feel, even though they're not able to muster the strength or interest to do it for themselves. (For more on how to help a friend, see chapter 9.)
HOW DO WE REACH THE FINAL STAGE OF DETACHMENT?
We discussed the importance of attachments in our lives in chapter 2. Let me add a few thoughts.
In every circumstance of loss or separation, the final goal of healing is to be no longer attached to the lost object but to become nonattached. This is the final stage of letting go.
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Let's say you were released from your job and that even though you now have a new job, it's not as prestigious or as satisfying as your previous work. This can easily prolong your depression, because you haven't fully replaced what was lost. Before you can begin to form an attachment to your new job, you have to release your old position and become nonattached to it.
For many, this is extremely difficult. Even when they begin to feel better about the new job, whenever some disappointment occurs, they revert to their previous state of dissatisfaction and begin to reconstruct their original loss all over again. This vacillation between feeling good and feeling bad can be debilitating and stressful.
To complete the grieving process, therefore, you have to achieve this state of non attachment. In my experience, that only comes about when you sincerely seek God's grace and ask for the power to help you release what was taken from you. Our natural instinct is to hold on to everything. Only God can gradually remove your fingers so that the object or person falls free from your grasp and you can get on with your life without it.
The portion of Scripture I've found most helpful in working with Christian patients is Philippians 3:7-12. In fact, the whole of Philippians 3 is extremely helpful in this regard. The central point of what Paul says is contained in verse 7: "But what things were gain to me, those I counted loss for Christ" (KJV).
The phrase "I counted loss" describes a decision on Paul's part. It was his intentional choice that everything he had counted gain, including being considered a righteous Jew who had zealously persecuted the church, was no longer important to him. And the reason he could count those things as loss was that he had found something far better. The" excellency of the knowledge of Christ Jesus my Lord" (v. 8) made the difference.
Paul had adjusted his values so that the only thing that mattered in life was God and His message to the world through Christ. With such a value system, it's no wonder he could rejoice even in the closing moments of his life, when he was about to lose everything.
To become a mature Christian, you have to be able to separate the essentials of life from the nonessentials. Think about your life and its many facets, and then ask yourself: Is this an essential facet or a nonessential? If you have God's perspective, only things of eternity will fall into the category of "essential." All other matters become nonessential.
Pray that God will constantly remind you of whether something is an essential
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or a nonessential issue of life. If you can do that, depression will certainly become less of a problem for you. You will be able to move quickly to the place of acceptance and nonattachment.
WHAT CAN I LEARN ABOUT DEPRESSION FROM PEOPLE IN THE BIBLE?
The most important lesson is that depression is the common experience of everyone, even great saints of God. No one is exempt. It's a process designed into us by an intelligent God as a healing experience. The study of people like Elijah and King David, whose emotions are vividly described, confirms this.
Second, while we have to live out the gospel in the context of our humanity, a study of biblical characters helps us come to terms with our limitations and discover how God can enable us to transcend them.
We have a strong tendency to idealize not only characters from the Bible, but also ministers. We need to realize that their acts of faith are in the context of a very normal humanity. Being reminded of that, we can accept ourselves and turn to God in our depression rather than turning to a state of despair.
Nothing causes more despair than the deep-seated fear that you're never going to make it or that everyone else is more spiritual than you. But that's not what the gospel is all about. Look at those Old Testament characters. See how human they were. Reflect on how exactly like you they were. But then see what they were able to do for God, and take courage from their victories.
HOW CAN I KEEP UP MY SPIRITUAL LIFE WHEN I FEEL SO LOW?
Never give in to the temptation to abandon your spiritual life when you're depressed: "Let me just set aside my walk with God and deal with my problems first. Then I'll get back to it." No, your spiritual life must be brought into harmony with the whole experience of depression. If you do that, you will find your spiritual life helps and complements the other.
To keep your spiritual life vital when you feel down, you must accept the depression. I don't mean you resign yourself to it, but you should accept your emotion for what it is — a symptom that something is wrong and needs attention.
You don't have to be preoccupied with it. A lot of depression can just be "set aside." You know it's there, but you don't have to dwell on it. Many people learn to disregard pain and live with it. In a sense, you need to disregard your depression
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in the same way. You also need to avoid allowing the feeling of depression to keep you from dealing with the cause of it. The resources of Christ will enable you to do that.
WHEN I'M DEPRESSED, I DON'T WANT TO READ MY BIBLE AND PRAY. IS THERE ANY HOPE FOR ME?
There's a lot more to spiritual devotion than just reading your Bible or praying. Even though your depression robs you of the energy of concentration to focus on some specific Bible study or a purposeful act of praying, there's still a lot you can do. Remember, God understands how you feel better than you do.
For example, you can meditate on God or Scripture just where you sit or lie. Quietly open yourself up to receive from Him whatever He wants to give you. Rather than trying to concentrate on giving out to Him in some specific devotional activity, relax and receive from Him. Meditation should be the natural consequence of being depressed. It doesn't take energy, you can do it when you're down, and it can be more meaningful than concentrated reading or even prayer at such times.
DOES DEPRESSION ARISING FROM SIN REQUIRE DIFFERENT TREATMENT FROM THAT ARISING FROM LOSS?
In some ways, yes. A depression arising from sinful behavior has to be treated by first dealing with the sin. While the sin continues to exist, there will be no relief from the depression. We deal with sin, of course, by repentance and confession, as set out in 1 John 1:9.
Many losses also arise secondary to the sin: loss of self-respect, of the peace of God, of His closeness, and so on. But the treatment must first involve recognition of the sin, confession of the sin, repentance, and the acceptance of forgiveness — the whole package. Even when you've gone through these steps and have received by faith the forgiveness of God through Christ, however, you may still find yourself feeling depressed. There are losses still to be grieved, and you must avoid becoming depressed over the fact that you still feel depressed.
IS PRAYER A PSYCHOTHERAPEUTIC PROCESS?
Prayer is much more than therapy. It's true that it produces growth and selfunderstanding, but we can't reduce prayer just to the therapeutic. Therapy is a process requiring another person, but that other person can be God just as well as
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another human being. God doesn't expect us to communicate only with Him, however. We need one another, and sharing with other human beings is also in God's plan for our wholeness. A great deal of emphasis ought to be put on the fellowship of believers, the dependence we have on one another in the body of Christ for emotional healing. Fellowship with God in prayer and fellowship with others in the body are both essential.
CAN I PRAY MY WAY OUT OF A DEPRESSION?
It depends on the depression, or more importantly on what's causing it. If it's caused by sin, yes, you can pray your way out of it. The act of prayer involves confession, repentance, and the receiving of forgiveness, so you remove the cause of the depression. You can get up from that kind of praying and really believe you've received forgiveness. Keep in mind what I've just mentioned, though, that the feeling of depression may not go away immediately.
Praying also helps to put things into perspective. It gets you in touch with the resources of God, too. But I don't want to give the impression that every time you're depressed, you can just pray and it will go away. It's not that easy. But prayer needs to be an integral part of your healing from depression.
CAN I PRAISE MY WAY OUT OF A DEPRESSION?
Some preachers have suggested you can praise yourself out of a depression. It's not that easy. If you're over the worst part of your depression, you can speed your recovery with acts of praise. But while you're heavy with the loss, it's difficult to praise. In fact, trying to praise at that point can intensify the depression. God wants us to have an attitude of praise, but an act of praising must come from an appropriate feeling.
Once you have come through the worst of the depression and are beginning to feel it lift, praising can speed up the recovery. One important aspect of praise is that it focuses your attention on positive things. You count your blessings. That in turn helps you to regain perspective on your losses. So praise at this stage can certainly help you to get over the final stage of your depression more quickly.
HOW CAN I THANK GOD FOR WHAT SEEMS TO BE A SENSELESS AND HOPELESS SITUATION?
Thanking God in a hopeless situation can only be meaningful if you really understand how things fit together in His kingdom. If you have His perspective
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on this life, you can thank God even though your circumstances seem hopeless, useless, and pointless.
Colossians 3:15-16 tells us we should "let the peace of Christ rule in your hearts . . .And be thankful. Let the word of Christ dwell in you richly." When God's Word dwells in you, you have a deeper understanding of the larger scheme of things. You know God's plan. You begin to see the essential nature of the eternal compared to the nonessential nature of temporal things. All of this put together gives you a perspective from which you can thank God even in the middle of the deepest depression, for behind that deep, low mood, you have the conviction that there's a plan and a purpose in it all, and you can thank God for it.
