“You can’t hope to understand someone’s struggle with depression by diagnosing it; you must listen to it.” Scott Mehl discusses how to listen and administer care to those struggling with depression.
The CDC reports that at any given moment, 8% of the population in the United States is suffering from depression. In fact, it is said that one in four Americans (almost 80 million people) will meet the criteria for major depression in their lifetime. I have sat with countless people who are depressed in my role as a pastor and a counselor and even have a significant history of it in my own family as well. With an issue of such epidemic proportions, it begs the question how we, as Christians, ought to understand depression and how we might be a part of helping those who struggle in such incredible pain because of it.
How does the Bible conceptualize depression? How are we to understand the diagnosis of depression? How can we seek to understand depression in a way that is both biblically rooted and accurate to a person’s experience? Is this even Scripture’s territory? These are just some of the questions that Christians ask when they know someone who is struggling with depression, or are struggling with it themselves.
The most significant problem in answering these questions is in the defining of “depression” itself. There are, in fact, an incredible number of issues that can all be categorized as depression. The Diagnostic and Statistical Manual of Mental Disorders (DSM) lists at least sixteen different symptoms that include everything from insomnia to weight loss to guilt to worthlessness to indecisiveness. Of these sixteen symptoms, only three need to be present to be diagnosed with a “Persistent Depressive Disorder” and only five need to be present to be diagnosed with a “Major Depressive Disorder.” And this doesn’t even include the vast majority of people who self-diagnose or peer-diagnose depression based on a different criteria than that laid out in the DSM.
What we need to realize is that no two peoples’ experience of depression are ever the same. In fact, oftentimes the same person’s different bouts of depression aren’t even the same. Because of this incredible diversity, the label “depression” may be helpful for the sake of gathering statistics or for pursuing treatment in a medical context, but it’s not very helpful in seeking to understand the specific struggle the person sitting in front of you is experiencing. Everyone fills the word “depression” with different meaning. The question that must be asked isn’t simply “Do you have depression or not?” but “What do you fill the word ‘depression’ with?” In this way, you can’t hope to understand someone’s struggle with depression by diagnosing it; you must listen to it.
When you lean heavily on the diagnosis of depression, you can feel ill-equipped to be used by God in helping someone deal with their struggle. However, when you listen intently to a person’s struggle, understanding the ways in which they are uniquely and particularly suffering, you may find that you’re more equipped than you ever realized. “Depression” can seem intimidating and confusing. But, when you listen for more than just the label, you end up hearing struggles like hopelessness, guilt, shame, coping, sadness, joylessness, worthlessness, etc. These may not seem like issues that are any less complicated to deal with, but they are issues that we see repeatedly addressed throughout the Scriptures. Is this even Scripture’s territory? Absolutely.
How does Scripture conceptualize depression? Well, that depends greatly on what exactly the person’s struggle with depression entails. Generally, though, Scripture gives us two macro-categories to help us conceptualize all of our problems in living. First, the suffering we experience greatly contributes to our problems, and it is undoubtedly a contributor to our depression as well. This includes everything from living in a fallen body to living among other fallen, sinful people. Second the sin in our hearts also greatly contributes to our problems, and is also usually a contributor to our depression as well. This isn’t to over simplify things and say that “we’re depressed because of the sin we committed” as some have mistakenly taught in the past, but to recognize that whenever anything or anyone other than God is the focal point of our worship and desire, that kind of idolatry impacts not only our behavior and our thoughts, but also our emotions as well.
But, while the overwhelming number of different forms these contributors can take may tempt us to discouragement, there is nothing more hopeful than beginning to understand how our suffering and our sin contribute to our depression. If suffering and sin are the cause of the problem, we’re in a great place…because it is exactly those two things that Christ came to redeem us from. He came to give us hope and joy in the midst of our suffering and he came to give us redemption and freedom in the midst of our sin.
People have a lot to say as we seek to understand their own unique struggle with depression, and Scripture has a lot to say as we seek to understand how the gospel powerfully applies to their specific struggle. In both of areas, we just need to listen.