You're discouraged, and feel almost hopeless, because things aren't going well on the job ... or you can't find a job in the first place. As a born again Christian, you're experiencing a period of spiritual dryness, and feel somehow "cut off" from the Lord. You're disappointed because of a failed romance, or a broken friendship, or a bank loan being denied, or failing a crucial exam in school. It appears that your prayers aren't being answered, and reading the Bible seems to be a dull and uninteresting chore. In other words, you're miserable. That's the bad news. The good news? You're probably not suffering from Major Clinical Depression!
The sorrows and difficulties mentioned above are, sadly, a normal part of life - - - even the Christian life. We all go through feelings of gloom and hopelessness and discouragement at times; depending on our personalities, we may experience such things frequently, or very infrequently. This is part of the human condition. In the words of Shakespeare, quoted in an earlier post, these are "the thousand natural shocks that flesh is heir to." Eventually, these feelings pass: perhaps gradually, perhaps all at once: we wake up one morning and, to our astonishment, the world seems much brighter. If this is your experience, it's very unlikely that you're suffering from the disease of Major Depression. You are, in fact, what the experts call "normal!"
This series of posts, however, is aimed at people who have received Christ, according to John 1:12 and John 3:3-7, and who are afflicted with the physical illness of Major Clinical Depression. And for them (for us, really; I've been treated for this disease for twenty years), it's a far different story. (I highly
recommend that you go to the bottom of the post and read the first two
posts in the series, if you haven't already, before proceeding.) In today's post, we're going to discuss some of the symptoms of Major Depression. How can you tell whether you have it or not? Well, you can't, all by yourself: you'll probably need a professional diagnosis. (Your family doctor or a general practitioner can help; you don't need to go straight to a shrink.) But knowing the symptoms can tell you whether such a diagnosis is called for.
(Incidentally, I don't use the word "shrink" in an insulting or sarcastic fashion: psychiatrists and psychologists are professionals, and I afford them the respect I'd give any professional - - - but no more. They don't intimidate me, and I don't hold them in any great reverence. They're doctors [the psychiatrists are, anyway], and after being treated by several of them, I've earned the right to use shorthand or slang if I want to. If you want to see real sarcasm and disrespect, think about how people talk about preachers of the Gospel!)
As we've mentioned in previous posts, many Bible believing Christians are very skeptical about Depression, or any other mental illness, in the life of a genuinely saved Christian. (By the way, please check your own personal vocabulary: the terms "mentally ill" and "insane" or "crazy" are not the same things. If you suffer from Major Depression, you're not "crazy" at all; you simply have a problem with your brain chemistry, as we described in Part I of this series.) Very often, ignorant but well-meaning Christians will quote the verse, For God hath not given us the spirit of fear; but of power, and of love, and of a sound mind (2 Timothy 1:7). "If you were just 'right with God,'" they'll say, "You'd have a sound mind! You wouldn't have any mental illness at all!" But they misunderstand the verse. It's not a reference to mental illness, but to a way of thinking, the same as other verses. (In fact, the verse can be a great comfort to those of us whose thinking is clouded by illness.) Having a mental illness doesn't contradict the promises and declarations of scripture. For who hath known the mind of the Lord, that he may instruct him? But we have the mind of Christ (1 Corinthians 2:16). That's an absolute assurance for every Christian; but having the mind of Christ doesn't mean that our old, fallen natures have disappeared, or that our brain chemistry is always functioning perfectly. Christians need to be careful how they apply the scriptures - - - to others, and to themselves. Some of our brethren (or sistren, if that's a word) can become quite self-righteous about this. "Hmmmph!" they'll say. "I don't need a bottle of pills to help me deal with my problems!" If someone says that to you, the proper response is to smile and say, "Wonderful! How much time have you spent thanking God for that in the past week?"
What are the symptoms of genuine Major or Clinical Depression? (The terms are synonymous.) Let's see what the "experts" say. (I should say, emphatically, that I am not a fan of the American Psychiatric Association, which is simply another "professional organization," like the National Education Association, which is quite political, and which changes its positions on controversial subjects to suit the prevailing political winds. But they do publish the "DSM-IV," the Fourth Edition of the Diagnostic and Statistical Manual, which lists and describes psychiatric disorders. It is the authoritative guide to mental illness, at least among professionals, and it would be a mistake to toss it aside. [The Fifth Edition is currently under review.] Not all psychiatrists are quacks, and not all Christian pastors are money-grubbing hypocrites. Right? Right. Even the best shrinks, even the genuinely Christian shrinks, belong to the APA because it's almost a professional necessity, just as NEA membership is de rigeur for teachers.) According to experts, Major Depression affects about 19 million Americans, within any one year period, or approximately 9.5% of the population. (In other words, you probably don't have the disease, if you're in the other 90.5%!) Depression is so common that it has been called "the common cold of mental illness." As a Christian, do you feel sinful or ashamed when you get a cold? Then you shouldn't feel that way if you're diagnosed with Major Depression. It may be your "thorn in the flesh" (2 Corinthians 12:7-9), and you must remember God's words on the matter: My grace is sufficient for thee: for my strength is made perfect in weakness (2 Corinthians 12:9). We praise God for His love and grace: but that doesn't mean that God disapproves of us taking a decongestant when we have a cold, or seeking help if we have Depression.
According to the DSM-IV, a "Depressive Episode" must involve at least five of the following symptoms, for two weeks or more, and this must be a change in one's normal state. If you only have three symptoms, or it lasts less than two weeks, it's not the real thing:
a. Depressed mood. For children and adolescents, this may be irritable mood.
b. A significantly reduced level of interest or pleasure in most or all activities.
c. A considerable loss or gain of weight (e.g., 5% or more change of weight in a month when not dieting). This may also be an increase or decrease in appetite. For children, they may not gain an expected amount of weight.
d. Difficulty falling or staying asleep (insomnia), or sleeping more than usual (hypersomnia).
e. Behavior that is agitated or slowed down. Others should be able to observe this.
f. Feeling fatigued, or diminished energy.
g. Thoughts of worthlessness or extreme guilt (not about being ill).
h. Ability to think, concentrate, or make decisions is reduced.
i. Frequent thoughts of death or suicide (with or without a specific plan), or attempt of suicide.
That's the definition of a Major Depressive "episode." To be diagnosed with ongoing Major Depressive Disorder, there must be at least one period of two months in which these symptoms are not present: in other words, you "get over it," but only temporarily. Then it returns. Like so many physical disorders, you experience the symptoms (say, pain in your chest), then they seem to go away for awhile - - - but the disease is still there, waiting to crop up again. Also, the symptoms must not be better explained by another problem: for example, a brain tumor.
Now, here's what's so interesting about this "mental illness." Did you notice how many of the symptoms are physical, and not emotional? Most people with Major Depression will experience both, at some point, to a greater or lesser degree. But that's what treatment is for, and that's why the disease is different from other mental disorders. Yes, some people with Depression are suicidal: but many never are. (And many suicidal people don't suffer from Depression.) What teenager, or man who's lost his job, hasn't had "feelings of worthlessness?" But that in itself doesn't indicate the presence of the disease; that's just part of life. Major Depression, however, affects the body, as well as the emotions. When the disease is being managed by medication or other means, the physical symptoms might the only symptoms: exhaustion, insomnia, changes in one's sex drive, changes in one's appetite, etc. Or, one might suffer the emotional feelings, without all of the physical symptoms. It's different in every case, as is true with any disease. But the physical symptoms point to a very important fact: Depression is a physical problem, caused by body chemistry, and not merely "the blues" or a "melancholy personality," if such a thing exists. That's why Christians shouldn't feel ashamed or apologetic about it. Would you feel that you'd "failed the Lord" if you had an attack of appendicitis, or breast cancer? No, you'd ask to be put on the prayer list at church. But we hesitate to do that with a mental illness, don't we?
That's because there are so many myths and misunderstandings about this disease, and that will be the subject of our next post. Until that time, however, we can only repeat what we've said before: the Bible believing Christian who suffers from Depression needs the attention of professionals, but his or her main help will come only from the Lord. David said, Give us help from trouble: for vain is the help of man (Psalm 60:11). If a Christian turns his or her back on God, and places his or her faith in the psychiatrist, they're only dealing with part of the problem: the body. But the soul and spirit are involved, too, and the shrinks, who can help the physical problems, can't address these things. The Christian needs medical attention and the understanding and counsel of brothers and sisters in Christ.
But, as Jesus said, those that are sick need a doctor (Mark 2:17). When the Good Samaritan found the man by the side of the road, he didn't ignore the man's physical wounds and bruises, or tell him that he "wasn't living right:" he dressed the wounds, and provided a place to rest. God sent the Good Samaritan to that suffering man, and He'll provide help to the Depressed Christian in whatever way He chooses. If this includes medication, so be it: God gave men and women the knowledge to create the medications in the first place.
You probably don't suffer from Major Depression. But if you do, don't be ashamed, or immobilized by guilt. Seek both spiritual and medical help, and stay in the Bible: that's where the eternal answers are!
For he hath not despised nor abhorred the affliction of the afflicted; neither hath he hid his face from him; but when he cried unto him, he heard (Psalm 22:24).
It is of the LORD'S mercies that we are not consumed, because his compassions fail not. They are new every morning: great is thy faithfulness (Lamentations 3:22, 23).
The LORD is good, a strong hold in the day of trouble; and he knoweth them that trust in him (Nahum 1:7).
Come unto me, all ye that labour and are heavy laden, and I will give you rest. Take my yoke upon you, and learn of me; for I am meek and lowly in heart: and ye shall find rest unto your souls. For my yoke is easy, and my burden is light (Matthew 11:28-30).
Thank God for His mercy and His wonderful compassion!