Previous article in this series: Salt Shakers Issue 70 (Jun 2023)
How should a Christian view treatment for depression?
Just as a person seeks treatment for bodily ailments, so should a person who suffers from depression seek appropriate treatment for ailments of the mind. I deliberately use the word “should”, because the first step of seeking help is often the most difficult. There may be mixed reasons – fear of stigma, anxiety, lack of energy , or pride. Many patients with depression wait until they are in crisis before seeking help, particularly those who are doing so for the first time. Some are practically dragged into the clinic by concerned loved ones, while others initially consult for physical symptoms such as insomnia or fatigue, with other depressive symptoms subsequently being revealed.
Therefore, the advice is – seek help early! It may not necessarily be from a trained professional, but a person who is feeling down should speak to someone whom they can trust or confide in as a first port of call.
Broadly, treatment for depression can be divided into 2 areas: pharmacological (with medications) and non-pharmacological. Antidepressants work by targeting the abnormal functioning of neurotransmitters, which in a complex way affect the brain’s chemistry. Non-pharmacological treatment comprises psychotherapy, counselling or supportive care such as regular exercise and relaxation techniques.
Antidepressants, though more readily accepted in recent years, draw some unfair strong criticism. They are not to be used only “as a last resort”, but work independently of or synergistically with other treatments. Medications are a means that God has provided to relieve the troubled mind, and should be viewed as such. Contrary to what some may think, antidepressants are not addictive, and while some may have side effects, these often improve over time. Sometimes the side effects are even desirable, such as a sedating type that helps those who have insomnia, or a more activating type that benefits those who lack energy. The medications take time to reach full effectiveness, up to six to twelve weeks. Sometimes switching is necessary, and this can be a real test of patience for both the patient and physician. I have had patients who respond poorly to not one, but two types of antidepressants, and after pushing through together on a third or combination of two, respond beautifully.
In my opinion, while not every person with depression requires antidepressants from the get-go, all should receive psychotherapy and/or counselling. This is because the negative thought patterns and false generalizations (and many others) in depression, which result in negative emotions and feelings, need to be recognized and gently re-directed. A biblical example of false generalization is Jacob’s declaration that because Joseph was dead and Simeon held hostage in Egypt, Benjamin would likewise be taken from him – “all these things are against me” (Genesis 42:36b). A valued member of the family and church may view his own life as worthless because of a distorted view of himself. A loving wife and mother may feel grossly inadequate and guilty because she can only focus on what she has not been able to do, but not the things she has done. Learning to identify and correct these unhelpful thought patterns is important, and good psychologists and counsellors can help guide a person through.
While there is yield in seeing a secular psychologist, I would encourage all Christians with depression to seek help from their pastors and elders. They watch over the spiritual well-being of the flock; and because of the effect depression has on a person’s spiritual life, spiritual “treatment” should accompany the physical. The depressed person needs to be assured time and time again that the sadness and emptiness he feels is not God’s abandonment of him, but his inability to see through the fog of darkness. He needs to be reminded that God’s love for him is not conditioned upon the strength of his faith, but bought by Christ’s blood and secured in the promises of the immutable God. If there are sins resulting from the consequences of depression, they need to be addressed as well.
How can I help a person who is depressed?
Helping a person going through depression is not restricted to professionals or their pastors and elders. As fellow brothers and sisters in Christ, we are called to bear one another’s burdens (Galatians 6:2).
The first step to help is to listen. The importance of this cannot be overstated; the tendency is to listen for a little while, pick out a few statements that require correction, unload some advice, and be on our way. In healthcare, this is called the “righting reflex”, where a healthcare worker dishes out advice to a patient about what they should do for their health, without taking the time to explore their ideas and motivations. Listening is far harder. It requires time and patience. It requires love and attention; in our hectic lives, it is difficult to fit in. Nevertheless, we are called to do so.
Listening is also active. Ask open questions like “tell me more”, clarify or summarize “what do you mean by…?”, or ask reflection questions like “why do you think…?” Remember that the answers must first come from the person himself or herself. Through active listening, we can understand the struggles of the depressed person, and identify areas to help or address. It is a privilege to be the confidant, as such sharing is often very personal. Bear in mind that not everyone who is depressed may be in the state to share or be willing to do so; but oftentimes, listening and being present with them is a good first step. It may even be all that is necessary.
By listening, we can identify areas that need attention. It could be the trigger for depression, such as a physical, emotional or spiritual stressor. It could be the impact of depression, such as withdrawal from fellowship, and inability to focus on prayer and bible reading. It could be predisposing or perpetuating unhealthy thought patterns that catastrophize negative experiences. It could even be an emergency that requires urgent medical attention such as active thoughts or plans of suicide.
Next comes action. A word of caution here – resist the “righting reflex” to prescribe what we think are solutions, but sensitively work with the person to identify what to address. However, at times a person can be so depressed that he or she is unable to make any suggestions. If so, the person helping could make suggestions on a single aspect to focus on. It is not possible to list all the areas, but some broad categories are:
- Work on the trigger(s) or cause(s): to identify and either work towards acceptance and submission to God’s will for events beyond our control or prayerfully make changes to address those which may be within.
- Work on the impact: how has it affected a person physically or spiritually? For example, spending 15 minutes a day reading the Bible or praying with a person who struggles to do so, simple companionship, providing a meal or encouraging a regular routine or sleep habits. This area is one that any person can help in, as it is immensely practical.
- Work on identifying false thought patterns that predispose to or perpetuate depression: talk through feelings and the process of how and why they reach there, or if there are alternative ways to perceive things. Point them to the Word of God.
Doing the above requires time, patience and love for the brother or sister. One may need to repeat the same process again and again, and experience rebuffs or advice that is not taken. There may seem little to no progress. Sometimes it may seem like the negativity is transferred to the person helping, and they too feel weighed down. However, bear in mind that helping in one’s capacity is synergistic with biblical counselling, and seeking professional help; therefore, the burden on the individual who is helping is not only theirs to bear.
One should also be equipped to help, and this comes through reading books and materials about mental health, Christian counselling and biblical psychology. Also, as with many things, the more times we practise a skill, the better we get – so seek opportunities to reach out to others who need help. For those who have previously experienced depression, or who have learnt to cope with it, they are in a unique position to understand and help a fellow sufferer.
Conclusion
In this article, I have written at length about depression, discussed biblical perspectives, how a Christian should view depression and its treatment, as well as some practical suggestions as to how fellow brothers and sisters in Christ can help one who suffers from depression. It is far from adequate to address the topic in its entirety, but I hope that it provides some perspective for readers to understand this complex disease of the fallen mind.
Written By: Matthias Wee
Salt Shakers 