“For we struggle not against flesh and blood, but against principalities, against powers, against the rulers of the darkness of this world, against spiritual wickedness in high places.” Ephesians 6:12
In the diagnosis of clinical depression I’m including all of the mood disorders—the primary ones like Dysthymic Disorder, Bipolar Disorder and Major Depression, and the lesser ones like Seasonal Affective Disorder (SAD), Bereavement/Grief, Post-partum depression and PMS, etc.
All mood disorders are complex conditions that have biological (genetic) roots shaped by environmental factors such as unrelenting stress and loss (divorce, death, employment, etc). They are physical/behavioral problems but with profoundly spiritual consequences. Because of that they are fertile ground for the strongholds of helplessness, hopelessness and worthlessness—feelings that have been labeled the depressive triad. It’s likely that every Christian who has struggled with clinical depression has felt at some point as if they were being punished by God or abandoned by God. Even that paragon of Christ-like service and humility, Mother Theresa, struggled with feeling hopeless and abandoned. This was revealed in her diary published after her death.
Major Depression, Dysthymic Disorder and Bipolar Disorder
Severe clinical depression (Major Depressive Disorder) will impact nearly 20% of all people at some point over the course of their lifetime. Clinical depression is more than just feeling sad some of the time. It’s more than an occasional spell of the blues. It is feeling totally incapacitated (crying jags, low-energy, insomnia) for at least two weeks. Some will receive that diagnosis from psychiatrists but more from primary care physicians who they consult seeking medication.
In addition to Major Depression there is the sadness which seems to never go away. Dysthymic Disorder is a mild to moderate depression that in some cases is life-long. Many dysthymics get thru life undiagnosed. They are labeled as chronically sad, pessimistic, irritable, negative or lazy. Some end up as alcoholics, over-eaters or attempt to cope via some other addiction.
The extreme roller-coaster ride of energy and emotions that characterizes Bipolar Disorder (manic-depression) is a less frequent illness (1-2% of the population) than Major Depression or dysthymia, but untreated it can lead to a psychotic break with reality. During the manic phase they often engage in risky or anti-social behavior. A staggering 15% of those diagnosed with this illness will succeed in committing suicide. Bipolar Disorder, like dysthymia, is also a life-long condition.
All clinical depressions are potentially lethal conditions. Most of the 30,000 Americans who commit suicide this year will do so because of the feeling of hopelessness that accompanies clinical depression. In addition, the clinically depressed have higher mortality rates from cancer and heart disease.
Religiosity ~ Shooting the Wounded
There are strains of fundalmentalist, legalist and pentecostal believers who do not accept the fact that depression is every bit as much a physical illness as say diabetes or appendicitis. They cling to the notion that it all has to do with sin–and that therefore somehow its “cure” is repentance and prayer. Repentance and prayer are helpful, and important in the struggle with depression, but as hundreds of thousands of mood-disordered Christians will attest, it is hardly ever a cure.
I became aware of the naive attitudes of many believers, including noted Christian leaders and clergy, when I read Dr. Dwight Carlson’s Why Do Christians Shoot Their Wounded in 1995. Reading that book was the Holy Spirit’s first initiative in leading me toward a ministry for the mood-disordered. Dr. Carlson is a noted Christian psychiatrist and author, and sadly, I’ve found the clever title of his book to be all too true. Depressed Christians are wounded and far too often their reception in the body is akin to being shot. They are usually given cheap advice (read such and such a verse, etc), or ignored, or avoided as if depression could be caught like some virus. Reading that book and a serendipitous conversation with one of Northland Community Church’s pastors led me to teach a class there in 1998, called “Coping with Depression.” I taught the class ten times between 1998 and 2007. We changed the name of the class to “The Unwelcome Blessing” and in 2005, I published a book with that same title.
Depression and Biology
The physiological underpinning of mood disorders has been extensively researched and demonstrated. We know from studies of identical twins separated at birth that there is a genetic link. We also know that the stress hormone cortisol plays a role in susceptibility to clinical depression. It has also been clearly demonstrated that medication (antidepressants and mood regulators) are helpful in treating mood disorders. The physical basis of mood disorders is so evident that only those who are grossly ignorant, or psychologically invested in the notion that it all has to do with sin, refuse to acknowledge the facts.
Depression: A Thorn in the Flesh
Those who discount its physical basis naively and profoundly misunderstand both the illness, and why we are handed this illness (2 Cor. 12:7). It is Paul’s “thorn in the flesh.” Of course, we do not know what Paul’s particular thorn is—its opaqueness in scripture is deliberate. But hopefully, we all have some thorn in our flesh. I believe clinical depression is a God-allowed “thorn” which can lead those suffering it to dig deeper in their relationship with the Lord. Jesus is the suffering Messiah of Isaiah 53. We identify with Him in our wounded-ness. Drawing closer to God in our despair is pretty much the theme of the book of Job. This seeking God is particularly true because in addition to depression being a physical and behavioral illness, it is also a profoundly spiritual disorder.
Filling the Emptiness
It is my belief that most addictions have a mood disorder (or anxiety) as a root cause. The addictive substance (alcohol, drugs, food, money, etc) or behavior (shopping, codependency, religiosity, workaholism, etc) represents an attempt at self-medicating to deal with the hunger, the despair, the fear, the emptiness of clinical depression.
The other part of the problem with the mood-disordered is their susceptibility to spiritual warfare. I’m certain that demons do not cause mental illness, however, they most certainly exploit it. The monstrous evil that is Satan and his fallen angelic host is that they prey upon the most vulnerable—the unborn, the abused, the abandoned, the starving, the psychologically and spiritually ill. I believe that at least 50% of those suffering clinical depression either experienced abuse or felt abandoned in their childhood–and the demonic host are well aware of who is most susceptible to torment and temptation. The voice in our thoughts that tempts us and torments us—the one that provides a negative commentary on our behavior or our worth, the one that tells us we’re stupid or unlovable, is to me the “smoking gun” of spiritual warfare. It is the voice that says that we’re a piece of garbage, that the situation is hopeless and that things will never change.
Those believers not deeply grounded scripture or who lack an intimate relationship with Jesus are the most vulnerable to seeking worldly counsel or answers in pseudo-sciences or New Age credos like astrology, reiki, yoga, transcendental meditation, spiritualism, etc. Our struggle truly is not against “flesh and blood” but against hidden spiritual forces (Eph. 6:12). I explored the nexus of spiritual warfare and emotional illness in more detail in Satan’s Top Ten Tricks (2007). This book and The Unwelcome Blessing (2005) are both available from amazon.com. and “The Unwelcome Blessing” is also available in an e-book Kindle format. There are also related articles on my website: http://www.wellbless.com.