Thursday, June 30, 2011

Toward a Biblical Perspective on Depression: Case Study #4

There are many examples of depression from the life of David, who may have had a tendency toward depression that many of God's children have experienced over the years. Many of his psalms deal with this very issue in one way or another, but we will limit our focus to just two of them.
NKJ Psalm 6:1-10 “O LORD, do not rebuke me in Your anger, nor chasten me in Your hot displeasure. 2 Have mercy on me, O LORD, for I am weak; O LORD, heal me, for my bones are troubled. 3 My soul also is greatly troubled; but You, O LORD – how long? 4 Return, O LORD, deliver me! Oh, save me for Your mercies' sake! 5 For in death there is no remembrance of You; in the grave who will give You thanks? 6 I am weary with my groaning; all night I make my bed swim; I drench my couch with my tears. 7 My eye wastes away because of grief; it grows old because of all my enemies. 8 Depart from me, all you workers of iniquity; for the LORD has heard the voice of my weeping. 9 The LORD has heard my supplication; the LORD will receive my prayer. 10 Let all my enemies be ashamed and greatly troubled; let them turn back and be ashamed suddenly.”
Here we see that the cause for David's depression in this instance was mainly the bad treatment he was receiving from others. He refers to those who are abusing him as “workers of iniquity” (vs. 8) and “enemies” (vs. 10). He doesn't tell us what they were doing to make his life so miserable, but miserable he surely was (vs. 3)! In fact, we have here not only the typical weeping that comes with depression (vss. 6-8), but also the physical symptoms that may accompany it (vs. 2).

This psalm really hit home with me because a great deal of the depression I had experienced early in my life had to do with the mistreatment I received from others. But, sadly, I did not discover what David knew until I was twenty years old, namely that I could find help from God through praise and prayer. But this is what David discovered, isn't it? For isn't this psalm both praise and prayer? In it David calls out to God for help and also expresses confidence that God will indeed answer him (vss. 8-9). So here again we have the most basic answer for depression – simple trust in the Lord, a trust in Him that gives us confidence to open our hearts to Him.

This psalm also shows us the importance of sharing our troubles with other people. After all, this psalm was written by David to be sung by others. How sad it is, then, when believers keep their depression all bottled up inside, instead of sharing it with God and His people.

Let's turn our attention next to Psalm 32:
NKJ Psalm 32:1-5 “Blessed is he whose transgression is forgiven, whose sin is covered. 2 Blessed is the man to whom the LORD does not impute iniquity, and in whose spirit there is no deceit. 3 When I kept silent, my bones grew old through my groaning [שְׁאָגָה, sheagah, literally roaring as of a lion, but here with the sense of bawling or groaning] all the day long. 4 For day and night Your hand was heavy upon me; my vitality was turned into the drought of summer. Selah 5 I acknowledged my sin to You, and my iniquity I have not hidden. I said, 'I will confess my transgressions to the LORD,' and You forgave the iniquity of my sin. Selah”
Here the obvious reason for David's depression was guilt due to unconfessed sin. Notice several effects of this guilt in verses 3-4.

First, David had not only emotional effects (“groaning,” vs. 3), but also physical effects (“my bones grew old,” vs. 3; “my vitality was turned into the drought of summer,” vs. 4b) from unconfessed sin.

Second, David was continually plagued by the unconfessed sin and the accompanying symptoms (“day and night,” vs. 4a).

Third, David had these ailments and depression as a result of God's discipline (“Your hand was heavy upon me,” vs.4a).

This means that depression accompanied by physical symptoms, or in combination with physical ailments, whether they are experienced together – as in David's case – or not, can be due to the discipline of the Lord. For other Scriptural examples of God's discipline, consider the following passages:
NKJ 1 Corinthians 11:26-30 “For as often as you eat this bread and drink this cup, you proclaim the Lord's death till He comes. 27 Therefore whoever eats this bread or drinks this cup of the Lord in an unworthy manner will be guilty of the body and blood of the Lord. 28 But let a man examine himself, and so let him eat of the bread and drink of the cup. 29 For he who eats and drinks in an unworthy manner eats and drinks judgment to himself, not discerning the Lord's body. 30 For this reason many are weak and sick among you, and many sleep.”
If God can discipline through sickness, weakness, and even death, then He can certainly do so through depression, can't He? I believe so. In fact, I think this was the very thing David experienced due to unconfessed sin.
NKJ James 5:14-15 “Is anyone among you sick? Let him call for the elders of the church, and let them pray over him, anointing him with oil in the name of the Lord. 15 And the prayer of faith will save the sick, and the Lord will raise him up. And if he has committed sins, he will be forgiven.”
Notice that James assumes that sickness may be due to sin in a person's life. But if this is so, then it should be seen as discipline from the Lord, shouldn't it? This is certainly what David discovered. In fact, his unconfessed sin led to both physical ailment and depression. And this may be true of many depressed people today as well. If so, then they should also be encouraged that this is a sign of God's love for them, as the author of Hebrews teaches:
NKJ Hebrews 12:5-8 “And you have forgotten the exhortation which speaks to you as to sons: 'My son, do not despise the chastening of the LORD, nor be discouraged when you are rebuked by Him; 6 For whom the LORD loves He chastens, and scourges every son whom He receives.' [Prov. 3:11-12] 7 If you endure chastening, God deals with you as with sons; for what son is there whom a father does not chasten? 8 But if you are without chastening, of which all have become partakers, then you are illegitimate and not sons.”
If you are experiencing depression because of unconfessed sin or due to God's discipline, then you need to remember not to get discouraged and think that it is a sign that God does not love you. Actually, it is a sign of the very opposite! It is a sign of His great Fatherly love, because of which He will apply the discipline you need.

I wonder how many of us may be struggling with depression or some physical ailment due to a stubborn refusal to deal with our sins by confessing them to the Lord and receiving His Forgiveness. And I wonder how many of us in such a condition can deny that it is pride that keeps us from calling out to Him in repentance as we should? So again we see that depression is often bound up with pride.

Wednesday, June 15, 2011

Toward a Biblical Perspective on Depression: Case Study #3

There are perhaps several examples from the life of Moses that we could examine, but one clear instance of depression in his life can be found in Numbers 11, which relates the account of the Israelites complaining about having to eat manna every day:
NKJ Numbers 11:10-15 “Then Moses heard the people weeping throughout their families, everyone at the door of his tent; and the anger of the LORD was greatly aroused; Moses also was displeased. 11 So Moses said to the LORD, 'Why have You afflicted Your servant? And why have I not found favor in Your sight, that You have laid the burden of all these people on me? 12 Did I conceive all these people? Did I beget them, that You should say to me, “Carry them in your bosom, as a guardian carries a nursing child,” to the land which You swore to their fathers? 13 Where am I to get meat to give to all these people? For they weep all over me, saying, “Give us meat, that we may eat.” 14 I am not able to bear all these people alone, because the burden is too heavy for me. 15 If You treat me like this, please kill me here and now – if I have found favor in Your sight – and do not let me see my wretchedness!'”
Here I think we can see that the primary reason for Moses' depression was stress. He had to deal with the stress of people that constantly complained and of having to look after them all the time. Moses was simply overwhelmed! And he was so depressed that he wanted to die! This is the kind of despair he related in verse 15, where he said, “please kill me here and now … and do not let me see my wretchedness.” The Hebrew term translated wretchedness can indicate evil or perverseness on the one hand, or it can indicate misery or trouble on the other. And I think that perhaps Moses used the term because it carried both of these connotations. That is, I think that Moses did not want to see either his own misery or his own evil reactions to it any longer. So I like the way the KJV, NKJV, ESV, and NASB have translated the term as wretchedness, because this English word can carry both of these basic connotations as well. For example, the Merriam-Webster Online Dictionary gives the following definition for wretchedness:
1 : deeply afflicted, dejected, or distressed in body or mind
2 : extremely or deplorably bad or distressing
3 : a : being or appearing mean, miserable, or contemptible

     b : very poor in quality or ability : inferior
The first two senses listed overlap nicely with the semantic range of the Hebrew term used by Moses. It helps us to see that Moses may have been distressed both at his own continual misery and at his own deplorably bad reaction to it. Perhaps he was just sick and tired not only of the stress and depression stemming from all the Israelites' constant complaining and weeping, but also from the trial of being mad at them and disappointed in them all the time.

But at least Moses didn't continue to try to deal with it all on his own. Instead, he turned to the Lord and honestly communicated the despair that was in his heart. And he found comfort in the Lord as well as help, for the Lord gave him seventy elders to help him in looking after the people and to ease his burden:
NKJ Numbers 11:16-17 “So the LORD said to Moses: 'Gather to Me seventy men of the elders of Israel, whom you know to be the elders of the people and officers over them; bring them to the tabernacle of meeting, that they may stand there with you. 17 Then I will come down and talk with you there. I will take of the Spirit that is upon you and will put the same upon them; and they shall bear the burden of the people with you, that you may not bear it yourself alone.'”
Notice how graciously God helped Moses by giving him a way to minimize the stress he was under through sharing the burden with others. We can learn a lesson from this, namely that, when we are struggling with depression due to stress, we need to share our burdens with the Lord and with fellow believers when they become too heavy to bear alone.

Sadly, too many of us fail to open up to others about our troubles when we should. And, even worse, we fail to open up even to God about our troubles, either because we don't think He will listen or because we don't really trust Him. But Moses' example teaches us that we can always count on God to care, so we need to tell Him all our struggles. I think he would agree with Peter's admonition to us when he writes:
NKJ 1 Peter 5:6-7 “Therefore humble yourselves under the mighty hand of God, that He may exalt you in due time, 7 casting all your care upon Him, for He cares for you.”
I am reminded in this regard of the important teaching of Hebrews about the High Priestly ministry of Jesus and the implications of this ministry for believers. For example:
NKJ Hebrews 2:17-18 “Therefore, in all things He had to be made like His brethren, that He might be a merciful and faithful High Priest in things pertaining to God, to make propitiation for the sins of the people. 18 For in that He Himself has suffered, being tempted, He is able to aid those who are tempted."

NKJ Hebrews 4:14-16 “Seeing then that we have a great High Priest who has passed through the heavens, Jesus the Son of God, let us hold fast our confession. 15 For we do not have a High Priest who cannot sympathize with our weaknesses, but was in all points tempted as we are, yet without sin. 16 Let us therefore come boldly [parrēsía] to the throne of grace, that we may obtain mercy and find grace to help in time of need.”
It is significant that the Greek word translated boldly in 4:16 (or with confidence as in ESV and NASB) can literally mean “speaking all things” (Linguistic Key to the Greek New Testament, p. 677). Thus it can refer to “a use of speech that conceals nothing and passes over nothing, outspokenness, frankness, plainness” (BAGD3 # 5720, BibleWorks). This is why it could also be used of the boldness the Apostles had in sharing the Gospel (e.g. Acts 4:29, 31; 28:31) and could even be used to refer to “a state of boldness and confidence, courage, confidence, boldness, fearlessness, esp. in the presence of persons of high rank” (BAGD3 # 5720, BibleWorks).

You see, the Greek word refers to the confidence or boldness that one has to speak openly, even in the presence of someone great. And I think this connotation is to be understood in Hebrews 4:16 with respect to the way we come before God in prayer. We need to know that, because Jesus understands all that we are going through, we can truly pour out our hearts before Him and find the grace we need.

Perhaps a brief illustration may help to get the point across. I recall that in my Navy days I could not just go up to the captain of my ship and speak to him whenever I wished. I had to have permission to do so. And even when I was called to stand before him and speak with him, I could not simply say whatever I wished. For that I had to ask permission to “speak freely,” and could only speak freely if such permission were granted to me. Well, in Hebrews 4 we are given permission not only to come before God, but to speak freely when we do so. We are invited to come boldly – to speak what is on our hearts in prayer – before His throne of grace, encouraged by the fact that Jesus, our Great High Priest, sympathizes with us in all our weaknesses, including when we struggle with depression (more on this in a later, when we do a case study of Jesus Himself as one who knew the depths of depression).

But here is where the Christian can encounter a great deal of spiritual warfare, especially since the devil and his minions do not what us to come confidently before the Lord with our troubles. This is exactly the problem Peter deals with in the passage cited above, when he writes:
NKJ 1 Peter 5:5-9 “Likewise you younger people, submit yourselves to your elders. Yes, all of you be submissive to one another, and be clothed with humility, for 'God resists the proud, but gives grace to the humble.' [Prov. 3:34] 6 Therefore humble yourselves under the mighty hand of God, that He may exalt you in due time, 7 casting all your care upon Him, for He cares for you. 8 Be sober, be vigilant; because your adversary the devil walks about like a roaring lion, seeking whom he may devour. 9 Resist him, steadfast in the faith, knowing that the same sufferings are experienced by your brotherhood in the world.”
So the person with depression is going to struggle with opening up to God and is going to encounter spiritual warfare that will make this even harder. But notice that Peter sees the real trouble as being pride. And he teaches that we will never find the grace we need if we do not humble ourselves before the Lord. Sadly, however, far too many depressed people struggle with pride that will not let them truly surrender their problems to the Lord. Far too many of them believe the devil's lie that God does not care and that if He did they wouldn't struggle with depression in the first place. I hope we have seen, however, that this is far from the truth and that God not only cares, but that He cares so much that He gave His one and only Son to be our High Priest and to allow us to come boldly before His throne of grace, where we may obtain “grace to help in time of need” (Heb. 14:16). But this boldness is not brashness; it is rather a deep humility that trusts in the Lord and in His grace.

Now, many of you may think, “Wait a minute! Isn't the depressed person the very epitome of humility? Isn't he typically the person whose real struggle is with low self-esteem, the very opposite of pride?” Well, to be quite frank, in my own experience with depression, and in my experience dealing with depressed people, thinking that the problem is “low self-esteem” is usually just a way of masking the real problem – pride! In fact, as I observed in an earlier post, some of the most depressed people I have ever known are also some of the most prideful people I have ever known, and their battle with depression is actually rooted in their pride in one way or another. Perhaps it is pride that keeps them from trusting the Lord to overcome their depression, or perhaps God's purpose in allowing the depression is to deal with their pride, but pride is very often at the bottom of things, and the way they very often seek to avoid this conclusion is by relabeling their pride as something else, such as “low self-esteem.”

But one thing Moses' example – the example of the most humble of all men in his day (Num. 12:3) – teaches us is that we must be humble enough to trust the Lord to help us, and we must be confident enough in His love for us that we will truly open up to Him. And when He provides a means to help us through the aid of our fellow believers, we must be humble enough to accept this as well.

Thursday, June 09, 2011

Toward a Biblical Perspective on Depression: Case Study #2

In our first case study, we saw that depression can be the result of unresolved sin, but in this case study we will see an example of depression that doesn't stem from sin, even though it leads to sin. In fact, we will see that even the most righteous man on the earth in his day succumbed to a sinful attitude in the midst of a terrible depression. In this case study we will focus our attention upon the account of Job.

Job is perhaps one of the first people we think of when we think of Biblical examples of depression. And we are given some very good reasons for why he was depressed. For example, we know that God at first allowed Satan to destroy Job's family (except for his wife) and all of his property (1:13-19). But we are told that Job's initial reaction to these terrible events was one of godly worship, even in the midst of such deep pain and anguish.

NKJ Job 1:20-22Then Job arose, tore his robe, and shaved his head; and he fell to the ground and worshiped. 21 And he said: 'Naked I came from my mother's womb, and naked shall I return there. The LORD gave, and the LORD has taken away; blessed be the name of the LORD.' 22 In all this Job did not sin nor charge God with wrong.”

So, Job found refuge in his knowledge that God was sovereign over all things, even over the terrible things that had happened to him and his wife, when they lost all their children and all their possessions.

However, as Job himself was attacked with physical infirmities (2:1-7), as his wife began to nag him (2:9-10), as his depression got deeper and deeper, and he received no comfort from his friends, he began to become more and more bitter and angry. In fact, he even began to get angry at God and to accuse Him of wronging him. Let's take a further look at his situation and examine some of his own descriptions of his depression:

NKJ Job 3:1-3 “After this Job opened his mouth and cursed the day of his birth. 2 And Job spoke, and said: 3 'May the day perish on which I was born, and the night in which it was said, “A male child is conceived.”'”

NKJ Job 3:24-26For my sighing comes before I eat, and my groanings pour out like water. 25 For the thing I greatly feared has come upon me, and what I dreaded has happened to me. 26 I am not at ease, nor am I quiet; I have no rest, for trouble comes.”

NKJ Job 6:26 “Do you intend to rebuke my words, and the speeches of a desperate one, which are as wind?”

In other words, Job is asking his friends why they are jumping all over him for venting in the midst of such pain. Don't they realize that the words of people in such a sad state cannot always be taken so seriously? On the other hand, Job will later regret having said much of what he said (40:3-4; 42:1-6)! But we will focus on Job's repentance later. For now, let's continue looking at the depths of his depression:

NKJ Job 9:27-31If I say, 'I will forget my complaint, I will put off my sad face and wear a smile,' 28 I am afraid of all my sufferings; I know that You will not hold me innocent. 29 If I am condemned, why then do I labor in vain? 30 If I wash myself with snow water, and cleanse my hands with soap, 31 yet You will plunge me into the pit, and my own clothes will abhor me.'”

NKJ Job 10:1-3 “My soul loathes my life; I will give free course to my complaint, I will speak in the bitterness of my soul. 2 I will say to God, 'Do not condemn me; show me why You contend with me. 3 Does it seem good to You that You should oppress, that You should despise the work of Your hands, and smile on the counsel of the wicked?'”

NKJ Job 19:6 “Know then that God has wronged me, and has surrounded me with His net.”

How sad what has happened to Job! After refusing either to curse God or accuse Him of any wrong (1:20; 2:10), he eventually succumbed to the pressure of his circumstances and the resulting despair and accused God of wrong. Such has been the temptation of many a depressed and sorrowful soul. Thankfully, though, Job never did curse God and turn away from Him, no matter how bitter and angry he became.

In the end, however, Job found solace in the same understanding of God's sovereignty that had at first enabled him to respond correctly. For, as a result of his suffering, Job had been given a clearer revelation of God that he had ever had before, and it was enough for him, even though he still had no answers for why all the terrible things had happened to him. Listen to what he says about it:

NKJ Job 42:1-6 “Then Job answered the LORD and said: 2 'I know that You can do everything, and that no purpose of Yours can be withheld from You. 3 You asked, “Who is this who hides counsel without knowledge?” Therefore I have uttered what I did not understand, things too wonderful for me, which I did not know. 4 Listen, please, and let me speak; You said, “I will question you, and you shall answer Me.” 5 I have heard of You by the hearing of the ear, but now my eye sees You. 6 Therefore I abhor myself, and repent in dust and ashes.'”

Notice that the first thing Job does, once he understands again the greatness of his sovereign God, is to repent. He repents of what he had said before about God, when he accused Him of treating him unfairly, and he admits that he never deserved to be treated well in the first place. Indeed, he hates what he has done. In light of who God is, he sees himself as small and insignificant and in need of God's mercy.

I think we may learn a valuable lesson from Job's example. You see, we will never have as clear a vision of God as we may have when we have been brought to the end of ourselves. And, when we have been brought to the very end of ourselves, to the end of our ability even to cope, we will discover that the clearer vision of God that we receive will be enough, even if it we don't get answers to our questions. To be sure, we should not expect to experience a theophany in which God appears to us in a whirlwind, as He did to Job, but we will nevertheless be able to ascertain like never before just how great He really is!

Do you want to know how great God truly is? If so, then you will have to discover how insignificant you truly are, and this means you will have to be brought low, perhaps to the deepest reaches of depression. But it will be worth it, and it will make you more useful to God as well, just as it did Job. Notice, for example, that at the beginning of the book we are told that Job offered sacrifices for his children and interceded for them (1:5). But at the end of the book Job's ministry was expanded to include his friends (42:7-9). Thus he found that he was able to minister to the very friends who had let him down, and he was able to do so in a way he never could have had he not gone through the trials he went through. We are also told that Job received more blessing from the Lord than ever, after he had gone through all of his trials (42:12a).

Perhaps we should consider that the kind of depression we all dread so much (3:25) may just be the best friend we could ever have! In my view, this is one of the great lessons to be learned from the example of Job. For even if we cannot see it clearly at the time, such calamity and depression may be the best thing for us in the end. But we need to trust God as Job did in order to see it. As Paul later teaches us, we need to remember that “all things work together for good to those who love God, to those who are the called according to His purpose” (Rom. 8:28).

I guess what I am trying to say from the teaching of Job, as well as from my own experience, is that depression could just be the best friend a person may ever have, but a person has to be willing to make friends with it. There has to be a willingness to see it in the context of God's larger plan. In fact, there has to be a willingness to see it as a an opportunity to know God better and to better make Him known. I believe this is what Job discovered in the end, and I hope we may discover it as well.

Friday, June 03, 2011

Toward a Biblical Perspective on Depression: Case Study #1

Cain may be the first clear example of depression in the Bible. Although Adam and Eve may well have been depressed after they sinned and then after they were driven from the Garden of Eden, the text does not explicitly address it. But it is clear that Cain was depressed, for God spoke to him about it:

NKJ Genesis 4:2b-7 “Now Abel was a keeper of sheep, but Cain was a tiller of the ground. 3 And in the process of time it came to pass that Cain brought an offering of the fruit of the ground to the LORD. 4 Abel also brought of the firstborn of his flock and of their fat. And the LORD respected Abel and his offering, 5 but He did not respect Cain and his offering. And Cain was very angry, and his countenance fell. 6 So the LORD said to Cain, 'Why are you angry? And why has your countenance fallen? 7 If you do well, will you not be accepted? And if you do not do well, sin lies at the door. And its desire is for you, but you should rule over it.'”
The Net Bible notes are correct in describing the meaning of the phrase that describes Cain's “countenance” [literally face] as having “fallen”:

16 tn Heb "And his face fell." The idiom means that the inner anger is reflected in Cain's facial expression. The fallen or downcast face expresses anger, dejection, or depression. Conversely, in Numbers 6 the high priestly blessing speaks of the LORD lifting up his face and giving peace. (e-Sword)

So the text indicates clearly that Cain was depressed and that his depression was connected to his anger, anger which the context leads us to believe was toward both God and Abel. He was clearly angry because God had not accepted his offering, which means that he was angry at God. But he was also clearly angry at Abel for having been accepted by God when he had not been, which is obvious from the fact that he murdered Abel (vss. 8-9).

So what can we learn from this example? I would suggest at least three lessons:
1) Depression can result from an unrepentant heart, such as when Cain refused to heed God's counsel and repent of his sinful heart. Cain wanted God to accept him, but only on his own terms. His prideful heart would not allow him to humble himself before the Lord. Instead of confessing his sin and seeking God's grace and forgiveness, he let his anger rule him until it led to murder.
2) Depression can result from unresolved anger. Cain became depressed because he was angry and refused to deal with his anger in the right way.
3) Depression can result from feelings of inadequacy and perhaps jealousy of someone else. In this case Cain felt he couldn't please God and was jealous of Abel's relationship with Him. But he could not see that the problem was not really his inadequacy; it was really his refusal to come to God on God's terms.
The cure for the depression Cain experienced is obvious from the causes, isn't it? All Cain had to do was confess his sin and ask for God's grace. But he refused to do so.

We can also learn from Cain's example that sometimes depression is a signal of pride and unresolved sin in a person's life. Sadly, most people today resent even the suggestion of this possibility when they seek help with depression. Yet, isn't this the very issue God Himself raised with Cain in response to his depression? Indeed it is, and it is the very issue many who struggle with depression need to confront in themselves as well. In fact, although I risk sounding insensitive to many, and even cruel to some, when I say this, nevertheless I must say that in my experience some of the most depressed people I have known are also some of the most prideful or angry people I have known. I include my own past struggles with depression in this assessment.

Now, I would of course never say that this is the only – or even the primary – reason for depression for many who struggle with it, but I do believe it is a far more common source of depression than many want to admit. And the reason they don't want to admit it is the very same reason that Cain didn't want to admit it, because they would rather blame God or some other person for their dilemma than take responsibility for themselves. This tendency toward refusal to take personal responsibility for one's actions or the state of one's own heart is a growing problem in our culture, and it has made significant inroads into the churches as well.

In addition, even where unresolved sin such as pride and anger are not readily identifiable as the source of one's struggle with depression, these sins are often present as a response to depression. I have dealt with many a person who responded to their struggle with depression by becoming angry at God, for example, and who have pridefully refused to let go of their anger, and it has only made their battle with depression even more difficult.

Therefore it is all the more important that we do not shirk from raising the issue of sin when dealing with depressed people. Although we may not know their hearts the way God knew Cain's heart, we do know that they were born sinners just as Cain was, and thus we also know that sin will likely be a crucial factor in their struggle with depression, whether as its source or as a complicating factor.