For the longest time I didn’t want to admit to myself, or to anyone else, that I struggled with depression. My mother suffered with it the majority of her adult life. Her mother and her sister succumbed to it for years as well, although they didn’t recognize it for what it was or call it depression.
Growing up, I lived in a home where depression abounded, yet I never heard that term. It was as if depression was a way of life. My mother suffered from depression, yet I chalked up her way of interacting to her personality, thinking to myself, “That’s just the way she is.” So when depression reared its ugly head in my own life, I didn’t initially recognize it for what it was. Denial doesn’t mitigate the experience; it just dampens our ability or our willingness to proactively seek change or get help. Sadly, it prolongs our misery.
What Is Depression?
In psychiatry, depression falls under the classification of a “mood disorder.” It’s considered a condition of general emotional dejection and withdrawal during which one experiences a greater degree of sadness or sadness that lasts longer than what is reasonably warranted given the circumstances. It often results in decreased energy, stamina, or functional activity. Depression can present in a wide range of severities and is expressed in different ways depending on the age, gender, ethnicity, personality, upbringing, and circumstances of the person suffering.
In any given year, approximately 18.8 million American adults suffer from a depressive disorder,1 and at some point in their lives, about one out of four Americans will experience depression.2 If we broaden the scope, at least 350 million people globally live with depression.3 In the United States, only 29 percent of all persons with depression reported contacting a mental health professional last year,4 and in some countries, as few as one out of ten receive effective treatment.5 Nearly twice as many women as men are estimated to be affected by a depressive disorder each year.6 These figures translate to more than 9 million women in the United States each year suffering from this devastating condition.7 If you are not one of them, you know one of them! Depression is the leading cause of disability worldwide.8
The incidence of depression is increasing. Depression often begins in the early middle-age years and is also fairly common among the elderly. It’s sometimes a reversible cause of cognitive changes in seniors. It’s also increasingly common in children and youth. Over half of youth diagnosed with depression experience a recurrence within seven years.
Everyone experiences feelings of sadness at times, but generally this is a fleeting emotion that resolves itself relatively quickly. Depression, however, interferes with daily functioning for weeks or longer.
Symptoms of Depression
Some of the most common symptoms of depression include:
feeling sad, blue, down, or numb
irritability or agitation
difficulty concentrating
feeling worthless, helpless, and/or hopeless
feeling guilty
indecisiveness
decreased energy or motivation
decreased interest in previously enjoyed activities
decreased social interaction
crying
sleep disturbance
appetite disturbance
unintentional weight gain or loss
aches and pains that do not improve with treatment
excessive use of alcohol or other substances (including prescription medication)
thoughts of suicide
There are a myriad of other associated symptoms. Most sufferers will experience a subset of symptoms, and the severity varies from person to person. Depression affects people in different ways. Men and women display symptoms of depression differently. Children with depression present much differently than adults with the same condition. Older adults suffering from depression also present differently and often with less obvious symptoms. They may be reticent to admit to sadness or grief, and their presentation may be masked by other medical conditions.
How depression is experienced and the degree to which it affects one’s functioning is very personal in nature. Consider it like this: you and I could both see a physician and receive a diagnosis of allergies, yet your symptoms may include congestion and cough while mine might entail a runny nose, itchy eyes, and hives. While our symptoms vary, our diagnosis is the same. The same is true with depression in that we can both suffer but present with different symptoms. If not treated effectively, depression can result in devastating life consequences such as broken relationships, divorce, job loss, physical illness, personal injury, or suicide.
Often symptoms of depression are masked by external behaviors used to cope with internal feelings. For example, addictive behaviors such as drinking, overeating, or excessive spending can begin as an effort to cope with the underlying symptoms of depression, including sadness, loneliness, or irritability. Angry outbursts can mask feelings of rejection or embarrassment frequently experienced during a depressive episode. Even traits that appear to be more socially desirable, like perfectionism, drivenness, people pleasing, or peacekeeping, can be subconscious coping styles for managing the discomfort depression produces.
As a medical professional, I’ve found that many misunderstand depression. Those who don’t suffer from it or haven’t had a loved one deal with the ache from it have a hard time grasping the personal depth to which depression cuts or the devastating sense of loss and sadness that accompany it. Those who have not experienced it for themselves will frequently be either ignorant of depression’s presence or in denial of it.
The majority of books written on the subject, as well as many treating practitioners, ignore the spiritual side of depression. The spiritual battle is the reason more people aren’t effectively treated and why individuals frequently experience recurrence after treatment. Treatment, then, if it’s to be truly helpful, cannot ignore this aspect. I endeavor to shed light on this spiritual battle to equip you to fight this war more effectively.
Now that you have a better understanding of what depression is, the next chapter discusses one of the biggest secrets impacting the church today.
Your Rx
Reread the list of the most common symptoms of depression. Put a check mark next to each one you’ve experienced for more than two weeks to determine if depression may be a factor in this current season for you. If you aren’t sure, do not fret. Only a physician, psychologist, or therapist can diagnose with certainty, yet reviewing the list will give you an indication and start you in the right direction.
In your preferred version of the Bible, look up the following verses: Psalms 31:7; 34:17–18; 54:4. Then write them on index cards and place them where you will see them frequently. I encourage you to read each of these passages aloud three times daily, committing them to memory. The Bible tells us that faith comes by hearing, and at this point in your journey through depression, it will help for you to hear God’s promises as you recite them aloud to yourself.
My Prayer for You
Father, you know the battle I’ve fought. You recall the days when the only prayer I could offer for myself was a whispered, feeble “Help.” During those days, I depended on the prayers of others to carry my needs to your throne. It is my privilege and honor to come before your presence now, Father, on behalf of the one reading these words. You know every unspoken need. You know there is fear you won’t hear or answer because the pain hurts too bad or has gone on so long. Father, lift up this precious one. Your Word tells us in Psalm 18:30 that your way is perfect and that you are a shield to all who trust in you. Sometimes, Father, we have to borrow on the faith and trust of others who are just a step or two ahead of us in the journey. I trust you that your way is perfect and that you will show your love, your perfect way, to this one you love. Father, you will do as you promised in Isaiah 41:13. I trust you will take this one by the hand and lovingly say, “Do not be afraid. I will help you.” Thank you, Father, for your great love for us, that you care for us, and that you hear and long to answer every prayer.
In Jesus’s name, amen.
Recommended Playlist
“Need You Now,” Plumb, © 2012 by Curb Records
“Hold On,” MercyMe, © 2012 by Fair Trade
“Healing Has Begun,” Matthew West, © 2010 by Sparrow Records
“Walls,” Cody Carnes, © 2012 by Gateway Create Publishing
“Song of Solomon,” Jesus Culture, © 2012 by Jesus Culture Music
“Steady My Heart,” Kari Jobe, © 2012 by Sparrow Records
“Hands of the Healer,” John Waller, © 2009 by Reunion Records
“Always Enough,” Casting Crowns, © 2009 by Reunion Records
“Because He Lives,” Matt Maher, © 2015 by Essential Records
“Everything Falls,” Fee, © 2009 by Ino/Columbia
“You Stand,” Gateway Devotions, © 2014 by Gateway Create Publishing
2
You Are Not Alone
For I wrote you out of great distress and anguish of heart and with many tears, not to grieve you but to let you know the depth of my love for you.
2 Corinthians 2:4
Alone we can do so little; together we can do so much.
Helen Keller
I’m here to tell you the secret is out: even Christians get depressed. Unfortunately, Christians are often the ones who most feel they must hide their pain and pretend that nothing is wrong. We go to church each weekend with a smile plastered on our faces and an “I’m fine” on the tip of our tongues. All the while we tell ourselves:
“If they knew the truth, they would think I’m pathetic.”
“If they knew how much I really do not have my act together, they would think I’m incompetent.”
“If they knew how desperately alone and unhappy I really feel, they would think something is wrong with me.”
This line of thinking can make depression worse and more difficult to overcome.
When you experience despair daily, and it seems no matter what you try, things don’t get better, it becomes easier for you to accept that your feelings are “normal,” that this is your fate.
But hope prevails! I say this not just because I am a doctor but because I’ve been there. The thoughts suggested above mirror my experience through multiple bouts of depression. I hope and sincerely pray that by reading these pages you will feel comforted and you will know you are not alone.
Depression does not have to become a permanent way of life. There is hope. Jesus has offered “inexpressible joy” (1 Peter 1:8 NKJV), which must be the absolute opposite of depression. The Bible offers a wealth of promises for those who suffer through the torrent of depression. Matthew 5:4 promises, “Blessed are those who mourn, for they will be comforted.” Psalm 126:5 promises, “They who sow with tears will reap with songs of joy.” We have access to the God of all comfort (see 2 Cor. 1:3–4).
During my darkest days, when I truly could not fathom a time in the future when I would not suffer the gut-wrenching despair of my depression, I clung to the promises found in Scripture. Verses such as Isaiah 51:11 provided me with the hope that no one else could offer: “Those who have been ransomed by the LORD will return. They will enter Jerusalem singing, crowned with everlasting joy. Sorrow and mourning will disappear, and they will be filled with joy and gladness” (NLT). Oh, how I wanted to be overcome with joy and gladness.
Can you relate? Is that how you feel?
After a particularly devastating period in my life, when depression clung to me like a spider web that you just can’t shake loose, I could appreciate the value of the trial. I remember telling a friend, “I don’t ever want to go through anything that painful again. Honestly, I wouldn’t voluntarily choose to endure such pain, nor would I wish it on anyone. But now that I’m on the other side, I can see how even in the midst of such pain God was there. And truly, he used even pain for my good. For that I am thankful.”
Still, there were days I wasn’t sure I could go on. Or that I even wanted to. Days when I begged God to take the depression from me. Days when I literally could not pray anything other than a tearfully whispered, “Help.” But after the sorrow and mourning disappeared, I had a new appreciation for 1 Peter 4:12–13, which says, “Dear friends, don’t be surprised at the fiery trials you are going through. . . . Instead, be very glad—for these trials make you partners with Christ in his suffering, so that you will have the wonderful joy of seeing his glory” (NLT).
You may be reading this and thinking, “That’s all well and good for her, but she doesn’t know what I’ve gone through.” Or perhaps you are reading this and thinking, “If one more person tells me another Bible verse and thinks that will make me feel better, I’ll scream.” Can I tell you something? I thought those very same things! I was tired of even trying, and I was sick of crying. I tried to smile on the outside, but on the inside I felt like I was dying. And I just wanted it to stop.
I had been a Christian since I was seven years old. I had memorized hundreds of verses by the time I graduated from high school. When I was in the throes of depression, a friend said I needed to “snap out of it.” As if it was yesterday, I remember thinking, “She has no idea what I’ve been through. If she did, she would understand why I feel the way I do and why I can’t just snap out of it.” And I remember getting frustrated to the point of being angry when fellow Christians would quote Bible verses to try to make me feel better. I felt like all they were doing was giving me platitudes, which, in my mind, just proved to me they had no idea what I was going through.
Time to Be Honest
If you are reading this book right now, I suspect one of two things is true. Either you struggle with depression, or you love someone who does. I wish I could sit right beside you and hold your hand. Sometimes when we hurt so badly, we don’t necessarily want anyone to say anything; we just need a warm embrace or a knowing touch that speaks more than words. Quite possibly, if we were sitting together right now, if I put my hand on your shoulder and gave you a glance that conveyed, “I understand,” tears might start to flow. Maybe as you read this you are trying to hold back the tears. Let them come. Don’t try to hold them back. You don’t need to pretend anymore.
Do you remember the questions I asked you in chapter 1? I wanted you to feel free to give answers that rang true in your deepest core. If you want freedom from depression, you have to decide you are ready to dispel some myths and lies and replace them with truth—God’s truth. That includes the lies you unknowingly allowed yourself to believe about yourself, the lies you may have believed about others, and those you’ve let others believe about you. So if you read something in these pages that causes a tear, let it run. Feel it. Ask yourself, “What prompted that?”
You might also think, “I’m afraid if I let myself cry I might never stop.” Those were once my exact words to a therapist. I promise that healing your hurts will dry your tears. Don’t deny yourself the feeling and pretend it doesn’t exist. If you do, it will resurface later only stronger and probably at a less opportune time.
So often, unfortunately, we feel shame attached to our plunge into depression, as if the devastation of that period of darkness isn’t enough suffering. I experienced that too on multiple levels. I felt ashamed because I was the doctor who was “supposed to have all the answers.” If I had the answers for other people, why couldn’t I prevent myself from falling down the slippery slope into the valley? I have friends who are always cheerful and peppy, while for years it seemed like a black cloud followed me everywhere. I didn’t want to be like that, and I repeatedly asked the question, “What is wrong with me?” I tried so many of the treatment suggestions I prescribed for my own patients, and yet they weren’t enough to stop up the flood of tears or produce a rainbow that I could appreciate.
I’m going to be honest with you. I never found one magical cure-all. I did, however, through my years of professional practice and years of personal struggle, come to realize that there are several factors at play during bouts of depression that affect us spiritually and perpetuate our ord
eal. Once I became aware of the spiritual aspects of depression, the curtain was pulled back and I found new ammunition to fight the battle. Then, just like with a good deal at a favorite store or restaurant, I couldn’t keep it to myself. I don’t want anyone to suffer one more minute if I can offer help.
The circumstances that led to our struggles with depression may be different, but there is hope. There are things that depression does to us on a spiritual level, but by the grace of God, there are also things that God will not allow depression to do. We will explore some of the lies and myths that influence our experience of depression. “Then you will know the truth, and the truth will set you free” (John 8:32).
Often we lose perspective and need the guidance of someone who can understand our situation and knows the appropriate course of action. Especially when traversing the valley of depression, we can struggle with indecision and decreased drive and motivation. If you were to see a doctor for a physical illness, they might prescribe a medication to help you. If you came to see me in my office for depression, I would give you a prescription of treatment suggestions. Just as your physician can’t force you to take the prescribed medication, I can’t force you to take my recommendations. Jesus didn’t force the lame man by the pool to follow his commands (see John 5:1–15). The man wanted healing badly enough to do as Jesus suggested. That was the implied question Jesus asked. It was not so much “Do you want to get well?” but rather “Are you willing to do what it will take to get well and stay well?”
Are you ready to exchange your despair for an abundant and full life? Are you ready to get well? In the next chapter, we will discuss where depression comes from. Once we know where depression comes from, we can be strategic in avoiding the traps that have previously lured us in.
Your Rx
Prayerfully consider and answer the question, “Have I allowed myself to feel shame because I’ve suffered with depression?” Then take that shame to God in prayer, telling him you want to exchange it for his perfect perspective of you. You are not your depression, and shame does not come from God. It comes from the enemy, who wants to keep you stuck in the valley.
Hope Prevails Page 3