David Powlison presents a talk on Depression & Anxiety: How Can Churches Help? at the 2018 Bethlehem Conference
To be depressed is to be entangled by death. That’s why I hate depression. Its victims have found themselves in death’s long shadow and there seems to be no escape. Pain, hopelessness, hellish torments, thoughts of suicide—these are the death rattles that inevitably accompany depression.
But depression never tells the entire story. It is, at least, myopic. It cannot see hope, so it claims that hope is absent, and it is wrong. Jesus has come and has conquered this enemy by facing death and then rising from the dead. We, by faith in him, join him in that resurrection. As such, we are people who can look ahead with hope. The challenge is this: if we are going to be people of hope, we have no choice but to humble ourselves before the Lord and believe what he says more than believe the myths attached to depression.
A few passages from Hebrews, not typically keyed to depression, can send us in the direction of life.
God saves from death.
In the days of his flesh, Jesus offered up prayers and supplications, with loud cries and tears, to him who was able to save him from death (Heb. 5:7).
Jesus, our high priest, who is able to sympathize with our weaknesses, is showing us that our God is close and can rescue us from death and anything that has become entangled with death. We can approach him with confidence in the same way Jesus did (Heb. 4:15-16). We talk to our Lord. We speak from our hearts with tears, and, in that, we are walking with Jesus, even imitating him.
By faith, we see deeper realities.
By faith we understand that the universe was created by the word of God, so that what is seen was not made out of things that are visible (Heb. 11:3).
This verse reminds us that there is much more happening than we can see with unaided vision, and anyone who experiences chronic suffering must catch glimpses of those deeper realities. Faith is a way of seeing—or sensing—the invisible realities that stand behind the visible. Depression, when it is being yanked in death’s direction, sees misery; depression when coupled with faith, sees much more.
By faith we discover that, when we turn to Jesus, we are forgiven, we are brought into fellowship with him, which will be all the richer when we see him face to face. If you are depressed, ask for help to see the invisible God who is closer and different than you might think.
Our spiritual efforts will be fruitful.
Whoever would draw near to God must believe that he exists and that he rewards those who seek him (Heb. 11:6).
This passage asks us to open our faith-eyes. With this aided vision we see that God initiates, pursues, makes promises, keeps promises, loves with grace and mercy, and says so much to us. We, in response, can’t be inert or indifferent. We can say amen to all he says and does: we can believe him and believe in him. A concrete expression of this belief is to say, “Lord, I believe that you exist, and I believe that you give me strength to seek you and you even bless me as I seek you.”
Somehow, in that gradual descent into depression, death comes alongside and agrees with depression’s assessment that life is vanity and hopeless. If we are to ascend, we must take a stand against the intruder Death, and see with the aid of the Spirit and the Word. We must elicit the help of others, who might be able to see more clearly than we can, and fix our eyes on Jesus.
This is an earlier version of a blog that appeared on the Biblical Counseling Coalition website on April 9, 2015.
If you are a big-time confessor of sin when you are depressed—and there are a few of you—then please skip this. But if you are prone to depression, and confession is not high on your list, this might help.
The misery of depression is in its apathy. That’s what makes you feel dead. You feel nothing, so you do nothing. Or you feel agitated, but agitation is not the same as passion. Passion wants to do something; agitation is aimless. The skills to take a stand against such inertia certainly are not intrinsic to us.
So you look for something within your reach that might contribute a smidgeon of vitality. Confession is especially suitable for this because confession, in itself, is a sign of life. It is evidence of the Spirit working in us. And it comes with the assurance of forgiveness of sins. If you have no idea where to start, you could begin with the Confession of Sin from The Book of Common Prayer, some of the prayers from The Valley of Vision, or Prone to Wander. You could also try more specific confession.
Are you holding something against God? “Lord, my questions to you about “why?” and “how long?” have become accusations. At times I have stood over you in judgment rather than under you in humility. Please forgive me.”
Do you complain? Scripture has much to say about complaining. In an especially pointed passage, the Lord sees through our complaints and identifies them as holding him in contempt (Num. 14:11). Most of us can make room for confession and repentance with this one. “Father, I am much better at complaining than I am at thankfulness.”
Do you ever simply speak to the Lord about the hardness of what you experience? “Lord, there are too many times when I am like ancient Israel. I do not cry out to you from my heart but wail upon my bed (Hos. 7:14). I live like a silent spouse, with my back turned to you. Please forgive me.”
Are you angry with other people? Anger can take different forms: complaining, resentment, envy—to name a few. If we have never really known God’s love and forgiveness, then our anger makes sense. After all, we tend to treat others in the way we ourselves have been treated. But if we have been loved and forgiven, our anger is arrogance before God and others. “Father, forgive me for standing in judgment over others rather than considering how to love them.”
This is not a case of kicking a depressed person who is already down. Confession is how we turn from things associated with death and turn to Christ and life itself. It is a way we have communion with him. It is a gift, and it is met with God’s forgiveness and joy.
“If you, O Lord, kept a record of sins, O Lord, who could stand? But with you there is forgiveness; therefore you are feared” (Ps. 130:3-4). And fear, in this passage, suggests that we are controlled more by the God of life than by anyone or anything else.
Simply end your confession with “thank you,” then look around and see if you notice a hint of life.
Depression: The Way Up When You Are Down. Lost ambition. Emotional numbness. Fear and withdrawal. Fatigue. Marks of what is commonly called depression. If you are one of the many people suffering from depression, there is hope and there is help–a way up when you are down. Even if you don’t feel like doing anything, this booklet provides manageable steps for getting started on the path that leads out of depression.
Edward T. Welch helps us understand the spiritual issues involved, whether one’s depression is caused by physical problems or results in them. Getting to the heart of what depression says and means, Welch guides us through a process of dealing with it biblically and effectively.
Good counsel for those who struggle: hear the gospel of Christ, know and act on your purpose. This minibook suggests 11 practical steps of love and obedience.
Publisher: P & R
Publication Date: 2000
I will never forget the first time suicide came close to me. I met with a young woman who was leaving her mission work in Eastern Europe. She was haunted by an experience but could not even talk about it—my guess was that she was burdened by an inappropriate relationship with a young man who lived there.
Two months later I received a letter from her parents. “We want to thank you for your kindness toward our daughter and let you know that her misery is now over. She took her own life two weeks ago.” The letter was full of faith, grace, hope and grief. I kept it in the top drawer of my desk for over a decade, though I did not need either the reminder that those we care about can take their own lives or the added injection of guilt and endless “what if’s.” They were already inscribed in me. The only reason my regrets from her death don’t linger is that they have been replaced by other suicides.
Suicide has come close to most of us. We have read of the recent suicide of a beloved pastor’s son. We know that military veterans take their own lives every day, and even children can speak about an internal darkness that once was only found in those with accumulated years of trouble and pain.
What have we learned?
Lord have mercy on those besieged by depression. Don’t let the darkness talk to them. May they hear words of a deeper reality and the genuine hope we have because Jesus is alive.
Is it abnormal to feel saddened by the lovelessness and wrongness of much that happens in life? No. “Every little thing that happens” often contains sorrows. Even with lovely things, there is often a worm in the apple. At minimum, good things do not last—“Pleasures pass but sorrows stay,” as an old saying put it. And many everyday things are plain wrong: backbiting in the workplace, gossip and factions in church, arguing and indifference at home, deceptive dealings in money matters, ill health, friendships that drift apart or turn sour. If we are honest—and not cynical—the things that happen often leave us grieved and aggrieved. (And even cynical people have a history of grief and grievance, but got tired of investing energy into sorrow and mourning.)
But what goes into the particular sadnesses that beset this letter writer? The questions she poses capture some of her difficulties. In responding, I will have to make some assumptions. That’s particularly obvious in a letter, but a version of it occurs in every face to face counseling relationship as well. We never know another person fully, so we always respond out of partial knowing. A good conversation or correspondence often contains a fair bit of correcting the ways we misconstrue each other.
So the first thing I say is that feeling life’s sadness is not abnormal. Our Savior is pointedly a man of sorrows, well-acquainted with grief, and aggrieved by what is grievous. The psalms express Jesus’ experience, and many psalms are in the “minor key” emotionally—more dysphoric than euphoric, more sorrowful or anxious or aggrieved than cheerful. But it is a sorrow that continually reckons with specific promises of God: his lovingkindness, his watchful care, his forgiveness, the reality that he is our only true refuge. This experience of sorrows in search of the God who willingly makes himself known can become increasingly our own. Psalms take us by the hand. We learn how to honestly face trouble, how to give voice to deep internal struggles… and how this can often segue into a “major key” sense of confidence, safety, and even (on occasion) exultant joy.
The second half of that last sentence might have surprised you. Life is full of broken things that aim to break you. Yet we learn the humanity of faith, looking troubles in the eye, giving voice to our distress, looking God in the eye. And the Lord restores your soul. He is with you. He has a way of modulating the key in which life plays.
What about the phenomena of other people who appear to be “completely happy”? I think it largely bears witness to shallowness in the fellowship, in the friendships and acquaintances, in the family and neighborhood. People wear masks, putting a good face on things. Perhaps our letter writer is being taken in by the personal p.r., propaganda, and spin? Eliphaz misinterpreted Job’s struggle and gave him poor counsel, but some of his observations were on target: “Man is born to trouble as the sparks fly upward” (Job 5:7).
Even more important, Christian faith roots in the humility that honestly reckons with our need. The first four beatitudes stress the right kind of poverty, sorrow, neediness, hunger, and thirst (Matthew 5:3–6). The wise know that they are weak: 2 Corinthians 12:8–10, Hebrews 5:2 and 5:7. Fools are self-confident, think they need nothing, and do not know that they are wretched, pitiable, poor, blind, and naked (Revelation 3:17). True self-awareness begins with understanding these things. True understanding reckons with our mortality—“So teach us to number our days that we may get a heart of wisdom” (Psalm 90:12).
Henry David Thoreau was no Christian, but he was a close observer: “The mass of men lead lives of quiet desperation.” So the appearance—unruffled competency? self-satisfaction? the onward-and-upward of successful living?—is most likely an illusion. Consider the good show to be a product of denial, staying busy, self-promotion, dishonesty (with oneself, even). It’s delusional, a case of believing one’s own spin, of being afraid to stop and look. Also, consider that perception to be a misperception, partly a product of not looking deeply enough, lovingly enough, at others. We live in a world full of darkness, brokenness, hurt, disappointment, sin and death. Life is not the way it’s meant to be. The happy veneer is a veneer.
But this doesn’t mean we are called to be depressives, swallowed up in sorrows. Consider a case study in subtly contrasting responses. The same set of life experiences underlies both “the blues” and “Negro spirituals.” Both give voice to the black community’s experience of living under slavery, injustice, oppression, poverty, and racism. Here is an archetypal expression of that experience given voice in an old “Jewish spiritual”:
My heart is wounded. I mourn. Dismay has gripped me. Is there no balm in Gilead? If my head were water and my eyes a spring of tears, I would weep day and night. (Jeremiah 8:21–9:1)
The blues takes the experience of pain and grieves honestly, movingly. Some emotional relief comes through honest catharsis, through musical expression, through shared experience. But there is no hope in the blues. The faith expressed in a spiritual takes the same experience of pain, and grieves honestly, movingly, but with hope. We might say that the old spirituals took the question mark of Jeremiah 8:22—Is there no balm?—and turned it into an exclamation point: “There is a balm in Gilead that makes the wounded whole! There is a balm in Gilead that heals the sin-sick soul!” Jesus is the difference-maker between the blues and the spiritual. Sadness and loss do not get last say.
This sounds way too simple.
When someone has a problem, most of us would prefer to offer help that intrigues, surprises or at least sounds somewhat intelligent. Philippians 4:6 seems to fall short of these goals.
Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God.
Or, to paraphrase: “Are you ready for this one? It is super important, really helpful. You are going to love it. Ready? Don’t be anxious… pray.” To which the anxious person might respond: “Wow, just a second. Could you say that again? I want to write it down!” Or, the person might brush you off as trite and simplistic.
Have you tried it when you are anxious?
Have you ever countered anxiety with thoughtful, Scripture-led prayer? If so, you are in the minority. It turns out that this seemingly simplistic and available teaching is one of the hidden and under-used treasures of Scripture. It only sounds trite if you haven’t practiced it.
Okay, it is simple, but, like “love one another,” it takes a lifetime to master, and those who consistently respond to anxiety with prayer are the sages in our midst. Too often we brush off this passage and wait for something we think has more oomph to it. Meanwhile, this wonderfully compact teaching stands waiting for us.
The last twenty years of my life have been spent, in part, shortening the lag time between the appearance of anxiety and the onset of prayer. That gap has gone from two days down to one, then down to an hour or two. Occasionally, prayer comes even before my anxiety is full blown. When that happens, I marvel at the power of God that equips me to do what is counter-intuitive. Left to myself I can only spin out doomsday scenarios with the hope that, in my agitation, my frenetic mind will stumble onto some answers.
Have you tried it knowing that the Lord is near?
Prayer begins with the realized hope of the Old Testament: our God is near, very near (Phil.4:5). For the ancient Israelites, either the enemy was near or God was, and if God was near that, indeed, was good, but it was also a little risky. Maybe he would get too near, which might get dangerous (see Lev. 16:2, 1 Sam.6:19). The final sacrifice of Jesus removed those Old Testament fears when Jesus removed all barriers between the Father and ourselves, and he is now with us, even in us.
The God of the universe has come very near. Could there be a more profound answer to our anxiety?
Next time anxiety comes knocking, consider that the Lord is near. Then make petitions, surround them with thanksgiving, and finish with “not my will but yours.”
Have you tried it when you are depressed?
If it is unnatural to pray when you are anxious, it is much more so when you are depressed. Anxiety feels alone but still hopes that there is someone who might be near. Depression feels alone but has abandoned all hope of help.
Are you depressed? Pray. This is no guarantee that depression will immediately lighten, but it is sure to inspire hope as you witness the power of God in your life.
This may all sound too simple, but it is true. The Lord is near. If you are anxious, pray. If depressed, pray. Welcome to the deep wisdom of God.
Winston Smith talks about how a passage from C.S. Lewis’ The Chronicles of Narnia helped him through anxiety and depression in college and how counselors can use a variety of narratives in counseling.
I first noticed it when an up-and-coming executive was caught embezzling money. He knew the system. He didn’t need the money; he didn’t even care about money. And, he knew he would get caught. His embezzling had nothing to do with stealing and greed. Instead, he was moving quickly toward dizzying heights of success; hope was rising too—and he had to kill it. In the confusing world of fallen humanity, everything can be turned upside down and backwards. In his case, hope was a threat that had to be eliminated.
It happens more than you think. There are many hope saboteurs out there.
Beginner hope saboteurs are like Eeyore—pessimists. They forecast the worst. The pessimist says: “There are enough ups-and-downs in life, so let’s assume the worst—prepare for the worst—then the worst might not feel quite so bad.
Those who live with depression are the more advanced pessimists. Just try to speak words of encouragement to some depressed people and you will discover that they seem to become more depressed!
Here is one rule that hope saboteurs live by: success creates higher expectations, so undermine any gains before anyone notices. Some aren’t satisfied until they have hit a new bottom. There, they feel comfortable, safe and at home.
Odd, yes. But this makes complete sense in a godless world. Apart from God, things will indeed get worse. Why postpone the inevitable? Why pretend that all will be well? Ecclesiastes explores such a world and its natural conclusions.
But if we have come to know Jesus Christ, who died and is now the resurrected, living King, then hope-killers, along with their Eeyore brethren, are blind. Even in the midst of suffering, victimization and our own sin, the King will accomplish good and his reign of peace will be eternal.
So, a follower of Christ is a person who has hope. That, of course, takes a lot of explaining. After all…I might die today….the church that I attend might be gone in a year… I could lose my job. Uh oh, my inner Eeyore is coming out. But the church-at-large will grow in breadth and depth, Christ and his followers will be vindicated, and we will see the lover of our souls face-to-face.
We are people of hope, and this hope cannot be sabotaged. We must proclaim it well to a world that is almost persuaded that hope is a fantasy.