UNDERSTANDING DEPRESSION
What is Depression?: Depression is a prolonged
emotional tone dominating an individual’s outlook and mood. Normal moods
of sadness, grief, and elation are typically short-lived and part of
everyday life, but these can progress into a depressed mental state.
Other symptoms often accompany depression but the most common symptoms
of major depression are:
- deep sadness or emptiness,
- apathy, loss of interest or pleasure in usual activities,
- agitation or restlessness, physical hyperactivity or inactivity,
- sleep disturbances,
- weight/appetite disturbances,
- diminished ability to think or concentrate,
- feelings of excessive guilt, self-reproach or worthlessness,
- feelings of fatigue or loss of energy, and
- morbid thoughts of death or suicide.
If a person experiences at least five of these symptoms for one month
they have major depression. Mild depression would typically be defined
as having two to four of these symptoms for over one month. Bipolar
disorder (manic depression) includes swings from deeply depressive moods
to wildly manic moods (elation, irritability, hostility, inflated
thoughts of self, boasting)—with many intensities and variations.
When asked “what brings you pleasure in life” most unsaved, depressed
people will look down and finally say something like “nothing.” The
saved are more guarded because they fear if they admit “nothing” they
will be thought unspiritual, so they say something like “being saved” or
“knowing Christ.” The saved, depressed person generally knows about
their eternal and heavenly blessings, for which they are thankful, but
they feel trapped now by inexplicable emotional tones and moods. Consider this man trapped by depression’s grip.
“I am now the most miserable man living. If what I feel
were equally distributed to the whole human family, there would be not
one cheerful face on earth. Whether I shall ever be better, I cannot
tell. I awfully (regretfully) forebode (foretell) I shall not. To remain
as I am is impossible. I must die or be better it appears to
me.”—Abraham Lincoln
Biblical Occurrences: Depression is the ascendancy and tyranny of our emotions over our lives. Thus, Proverbs 15:13 says, “A merry heart maketh a cheerful countenance; but by sorrow of the heart the spirit is broken.”
Often an initiating discouragement leads to sadness, which leads to
prolonged grief, and then into a downhill spiral to depression.
Depression is a universal problem, but no one really knows if Biblical
characters had what we call depression, or if it would be more
appropriate to say they suffered emotionally. However, Paul in I
Corinthians 10:13 says, “There hath no temptation taken you but such
as is common to man; but God is faithful who will not suffer you to be
tempted above that ye are able…”. Temptation can mean trial,
calamity, or affliction. Accordingly, we should understand that our
present day afflictions were also common to the great Bible characters.
David was overwhelmed with grief and sadness, his heart was desolate,
and his tears fell all night (Psa. 61:2, 77:2-3, 142:4, and 143:4).
Jonah, Jeremiah (Jer. 15), Job, and Elijah (I Kings 19) are other
examples. Whenever characters express rejection, loneliness, self-pity,
hopelessness, overwhelming grief, and wish they had not been born, it
seems they are expressing more than temporary sadness but classic
symptoms of major depression. Paul had classic symptoms: his flesh had
no rest, he was troubled on all sides, he was cast down, he had fears
within, and he despaired of life (II Cor. 1:8 & 7:5-6). Hannah (I
Samuel 1) had many of the symptoms of depression and her spiritual
leader instantly and incorrectly accused her of a spiritual problem.
It seems there is a universal truth concerning depression, that is,
the non-depressed rarely understand the unrelenting pain involved, the
feelings of hopelessness (in this life, not once delivered from this
body), and think the person should just pick themselves up and get over
it. It is not that easy. In fact, when that part of the brain that
mediates emotions is not functioning properly, medical help (not
criticism) is often needed.
Depression Considerations: Each year depression
strikes ten million people in the United States. Older Christians have
more depression than younger; does this mean that spiritual maturity is
of no avail? No, what this indicates is that older people have more
biochemical and brain malfunctions as they age; depression is a natural
consequence. Similarly, more women (two to three times) have depression
than men. Women do not have more spiritual problems than men, but they
do process adverse events differently than men, and, they have a complex
body chemistry that can get out of balance, both leading to depression.
Women tend to take adverse events and internalize them and take the
blame—this is a thought-processing problem. Men tend to react to the
same events with escapism (sports, TV, sexual obsessions, alcohol);
which can later result in heart disease, hypertension, diabetes,
etc.—again, a thought-processing problem but with different results.
There is another difference: women tend to feel their depression
(sadness/guilt) while men act it out in their behavior (rage, hostility
and frustration).
Causes: Understanding the causes of depression is
very helpful to finding the solution. It is rare that there is only one
causative agent, generally there are several at work. Listed below (no specific order) are some factors known to contribute to depression:
- nutrient deficiency or excess
- drugs (prescription, illicit, caffeine)
- hypoglycemia (low blood sugar)
- hormonal imbalances
- allergies
- heavy metals
- sexual abuse as a child
- microbial overgrowths/toxins
- medical conditions (stroke, heart disease, cancer, Parkinson’s, diabetes, thyroid)
- natural light deprivation
- psychological factors (generally poor thought-processing)
- spiritual factors
Depression can have its source in our body, soul or spirit. Our body
can affect our soul and spirit and vice versa. For example: if one has a
low thyroid function it may affect the soul (for example the emotions)
leading to depression which then affects one’s spiritual life. Affecting
our spiritual life does not mean it changes our standing or position in
Christ, it means things like a less productive outreach/ministry and a
more self-oriented prayer life.
Research since the 1990’s has helped clarify this whole issue and
there is now better understanding on the causes and solutions. The
brain’s frontal lobe (behind the forehead) is now known to be intimately
involved in emotional well-being. It is recognized that one of the
characteristics of virtually all depressed people is a significant decrease in the frontal lobe’s blood flow and activity. The main cause of impaired frontal lobe function is a harmful lifestyle—the same cause of most of our physical diseases.
There is now no question that reductions in frontal lobe function lie
at the core of depression. Complimenting this research is the finding
that depressed children have significantly smaller frontal lobes than
non-depressed children. The evidence indicates that frontal lobe
problems are the cause and not the effect. The frontal lobe’s proper
function requires adequate blood flow and nerve chemistry.
As fog veils a beautiful meadow, so depression clouds life itself;
existence becomes dreary and dark. It has been described as darkness
visible. One can go to bed feeling fine only to wake with an
overwhelming gloom that cannot be explained or escaped. With proper
nutrition, lifestyle changes and a renewed way of processing the events
of our lives we can break through that fog into a sunny day.
“A merry heart doeth good like a medicine; but a broken spirit drieth the bones” (Proverbs 17:21).
Consequences: Now that it is clear that depression
is related to many factors, primarily to frontal lobe malfunction, let’s
consider the consequences of depression. Depression weakens the immune
system’s power to attack cancer cells, increases the risk of fatal
stroke by 50%, increases the risk of sudden cardiac death in heart
attack survivors by 250%, and increases the complications of pneumonia.
It has been found that depression increase stress hormone levels,
hypertension, and headaches; it complicates diabetes and is the leading
cause of suicide (its close relative). The point is clear, depression
should be addressed early or it may lead to fatal consequences. However,
because of their illness depressed persons have diminished ability to
combat their own disease, so help is often needed to lift them out of
the pit of despair.
How the Brain Works: By God’s design, all brain
activity (every thought, feeling and emotion, every order the brain
sends to the organs and cells) is the product of electrochemical
signals. The brain’s electrical signals require a chemical to carry the
signal across a small opening (synapse) between cells. The chemicals
used to do this are called neurotransmitters. To have a properly
functioning system we need an adequate amount of neurotransmitters. The
neurotransmitter most commonly associated with depression is serotonin.
Depressed people have low serotonin levels. Thus, they have impaired
brain message sending, especially relating to emotions and mood.
Serotonin is produced in the brain from tryptophan (a protein), which is
converted into 5-HTP, and then into serotonin. Some serotonin is
converted into melatonin, the hormone needed for proper sleep (thus the
connection between depression and sleep disorders). One cause of low
serotonin is the lack of an enzyme that converts tryptophan to 5-HTP.
Before proceeding, just think how unfair it would be to tell a
depressed person that is missing this needed enzyme that they have a
spiritual problem. As a doctor told a dear sister in Christ who just
could not understand why she could not get over her depression, “quit
beating yourself up about it, your body just does not produce enough
serotonin.”
THERAPEUTIC CONSIDERATIONS
This article will consider botanical medicine, medications, proper
lifestyle, nutrition, thought processing, and spiritual direction—the
most common causes of depression. Some consider botanical or
pharmaceutical medications for depression to be “mind-numbing” or
“feel-good” drugs. This is unfortunate because such medications only
help a depressed person feel more “normal” (a non-depressed person would
feel worse or no change).
If depression were primarily spiritually induced, people should not
get better from medications because medications do nothing about the
spiritual problem. If the medications merely treat the symptoms and do
not get to the root spiritual cause then the depression should always
come back once the medications are stopped, which is not the case.
Botanical Medicines: The Scripture makes it clear
that because of sin the earth today is not yielding its strength (Gen.
4:12). As a result of this Romans 8:22 says, “For we know that the whole creation groaneth and travaileth in pain together until now.” Knowing this, the Lord has made special provisions for us. Psalms 104:14 says, “…and herb for the service of man:…”, which means the botanical (herbal) kingdom was designed for the many services of humans, including medicine.
Often herbal products are slower acting than pharmaceutical
medications, but the advantages of herbal supplements is that they can
often affect a cure (rather than just address symptoms) and the side
effects are minor compared to pharmaceutical drugs. Herbs can be
considered the medicine from God’s pharmacy. The most important and well tested herbs to consider in connection with depression are:
- St. John’s Wort (SJW): relieves depression, anxiety, apathy, sleep
disturbance, anorexia, and feeling of worthlessness. All these symptoms
are caused by low serotonin and SJW increases the level of serotonin in
the brain.
- Ginkgo biloba: improves blood flow and function of the frontal lobe.
Ginkgo increases the ability of serotonin to do its job in the brain.
- 5-HTP: a plant extract that is just one step from becoming
serotonin—the brain readily makes this conversion. It raises the level
of serotonin and other brain neurotransmitters. This product overcomes
the genetic problem that does not allow for the conversion of tryptophan
to 5-HTP.
Pharmaceutical Medications: There are times when
medications can save a person’s life. If botanical medicines do not work
(in conjunction with the lifestyle, thought processing, and
consideration of other causes) then medications are an option. A
short-term use of antidepressant drugs may be needed in order to get the
mind operating sufficiently well so that a person can function.
Medications generally work by keeping serotonin (or other
neurotransmitters) at adequate levels in the brain’s synapses. They do
not help create increased blood flow or frontal lobe function.
Nutrition: A deficiency of any single nutrient can
alter brain function and lead to depression, anxiety, and other mental
disorders. The most common deficiencies are folic acid, vitamin B12 and
B6. An insufficiency of Omega 3 fatty acids (oils) has been linked to
depression. Low Omega 3 oils result in cells throughout the body and
brain that do not function correctly, and the mind suffers. The needed
Omega 3 oils are found in fish oils and flaxseed oil.
The diet for helping to prevent and correct depression is based upon Biblical insights:
- Increase the consumption of fiber-rich plant foods (fruits, vegetables, grains, legumes, and raw nuts and seeds).
- Avoid alcohol, caffeine, and other stimulants; also avoid foods that cause allergic symptoms.
- A good diet is: low protein, high fiber, low-moderate fat, and high complex carbohydrates. Complex carbohydrates do not include
simple carbohydrates (processed foods, snack foods, white bread, soda).
Raw fruit has simple carbohydrates but is good because of the fiber,
enzymes and antioxidants.
- Atkins type diets are poor; they actually lead to depression since carbohydrates are needed to get tryptophan into the brain.
- Foods high in tryptophan should be consumed regularly: soy flour,
meats/poultry (turkey and chicken), tofu, pumpkin seeds, sesame seeds,
raw nuts, eggs, lentils, and garbanzo beans.
- A good snack before going to bed would be a turkey sandwich on whole
grain bread (there is tryptophan in the turkey and the whole grain
bread will help keep sugar levels stable and help get the tryptophan get
into the brain).
Rule to live by: Eat foods as close to the way God created them as possible: raw, whole, and unprocessed.
He created vegetables, fruit, nuts, seeds, etc. He did not create
processed foods or animal meat full of antibiotics and hormones. Humans cannot improve upon God’s bounty!
Lifestyle: Regular exercise and sleep are essential
to combat depression. Exercise at least 30 minutes four times a week.
One does not have to jog: but walking, biking, tennis, swimming,
gardening, active house/yard work are great. Regular exercise takes time
for the effects to be felt, sometimes weeks.
We each have an internal clock that operates on a roughly 24-hour
schedule (circadian rhythm). Even mentally healthy people can become
depressed if the circadian rhythms are significantly disturbed. Seasonal
Affective Disorder is common in the winter months in northern climates
because the lack of natural sunlight disrupts these rhythms. Direct
exposure to bright full spectrum light can help, or, the serotonin
boosting botanical medicines.
A common factor leading to depression is hypoglycemia (low blood
sugar); the brain requires a constant supply of blood sugar to function
properly. Thyroid insufficiency also causes depression. Women with
post-partum depression and those approaching menopause (symptoms often
start by mid-30 age) are subject to hormonal disturbances that lead to
depression.
Biblical Thought-Processing: How we handle bad or
disappointing news has a profound effect upon our mental well-being. As
long as we believe we are victims, we are not able to achieve full
mental health.
Positive thinking is more important for overall health than almost
anything else. Negative thinking, on the contrary, can destroy the good
done by correct diet and lifestyle.
Many depressed people have a tendency to look at the down side of life.
It has been said that it is a positive duty to resist melancholy and
discontented thoughts as much as it is our duty to pray. Certainly there
will always be things in this imperfect world that give us cause to
complain. Often we are helpless to personally do anything about many of
these negative things. However, we can focus our mind on the enjoyable
and wonderful things of life; this is scriptural, uplifting and
therapeutic.
In the world of secular counseling there has been a shift away from
psychoanalysis which was aimed at uncovering “unconscious” reasons for
depression. Time was spent on how the individual was raised as a child,
and other past events that may have shaped a person’s feelings and
behavior. Going through the maze of a person’s past life was thought
helpful to present-day healing or identifying causative agents. This
therapy has proven less successful than desired. So, a shift has been
made toward cognitive behavioral therapy which focuses on the
interpretation of life’s events. This is mentioned because secular
therapy has, over time, become more closely aligned with what Paul
teaches about our thinking, that is:
- erroneous interpretations of events and negative automatic thoughts may initiate or perpetuate the depressed mood and
- our focus should not be on the past (finding circumstances or others to blame) but on what one can do differently.
The essential basics of cognitive behavioral therapy are shown below;
each person should provide their own verses to make them more personal
and meaningful. Whether in the natural world or in the realm of the
mind, science comes to the same conclusion as revealed in the Bible 2000
years ago.
- Locate and identify the negative thoughts or misbelief in your
self-talk. “I am no good because things are not like what I expect or
want.”
- Argue against the negative thoughts. “I am not a failure just
because I do not meet unrealistic expectations of myself or others.”
- Learn how to avoid rumination (the constant churning of thoughts in one’s mind) by immediately changing your thoughts.
- Replace the negative thoughts the very second they occur with the
truth and with empowering positive thoughts and beliefs. “In spite of
the sorrow, disappointments and feelings I experience the Lord will help
me carry on.”
Most depression-causing negative thoughts or misbeliefs enter the
flow of self-talk after some loss has occurred. Temporary disappointment
or sadness at loss is natural, but it cannot continue long-term without
consuming a person.
Don’t get caught in the trap of thinking that God has promised us
perfect peace at all times; that will come to those in the Kingdom (Isa.
26:1-3). The instruction and blessing of Philippians 4:6 & 7 are
applicable for today. Always understand these verses in light of Paul,
who had plenty of struggles and afflictions but God brought him through
and kept his heart and mind in the process.
Finally, Philippians 3:13 & 14 says, “…but this one thing I
do, forgetting those things which are behind, and reaching forth unto
those things which are before, I press toward the mark for the prize of
the high calling of God in Christ Jesus.” Paul is using a runner’s
analogy to put the past and future in their proper perspective. He says
that runners in a race cannot look back to see where the other runners
are, for if they do they may stumble or get out of their lane and be
disqualified. A runner can only look ahead and stretch forward, making
the focus the finish line, not what may be behind.
We are on a track, running life’s race. The most incredible thing is
that each Christian is the only person on his/her track. One does not
have to be all that fast, but steady. The only thing that is behind us
on our track is our past (forgetting those things that are behind), with
its failures, abuses, hurts, regrets, accomplishments, or fame. If you
have your eye on the prize the past cannot hurt/catch you. The past
contains the thoughts that Paul says to forget about, certainly do not
ruminate about them, if you do you will stumble (have mental problems).
He implies a Christian’s greatest point of failure in running the race
is letting the past keep him/her from running well. Look ahead, stretch
forward toward a new day and thank God for all you have in Christ Jesus
our Lord.
Spiritual Direction: Depression can have a spiritual
source if we live in sin, harbor anger or resentment, etc. We have to
be willing to forgive (make the unnatural decision to let someone “off
the hook” even though they do not ask or deserve it) just as God for
Christ’s sake has forgiven us, Ephesians 4:32. (Note, we forgive because
we already have been forgiven, not to be forgiven as is the case in the
Gospels.)
Regular spiritual exercise (reading, studying, praying, meditation on
the Word) requires use of the frontal lobe of the brain and emphasizes
communion with God, thinking His thoughts, sensing His presence, and
knowing His will. This is active worship and produces the type of brain
waves in the frontal lobe that are very helpful for us all, including
the depressed. Hypnosis and the trance-like state of Eastern religious
meditation are very harmful; they produce the wrong type of brain waves
and information bypasses the frontal lobe, leading to possible mind
control.
Sometimes a believer is living for the Lord, serving and honoring Him
in all parts of his/her life. Over the years, the Lord blesses that
person and they are happy, enjoy good health, etc. Certainly there is
nothing wrong with enjoying the blessings of the Lord. But, it can all
be taken in a moment, not because of spiritual problems, but because it
may be that God is taking (or because of the situation He will take)
that person to the next level of maturity—it is perplexing and it hurts.
Often growth requires loss or brokenness. Paul says, “…I
count all things but loss for the excellency of the knowledge of Christ
Jesus my Lord for whom I have suffered the loss of all things…” (Phil. 3:8).
Romans 12:2 says, “And be not conformed to this world: but be ye
transformed by the renewing of your mind, that ye may prove what is that
good, and acceptable, and perfect, will of God.” Transformed in Greek is metamorphosis and means
a change in form; it implies a struggle like when a chrysalis morphs
into a butterfly. If we do not become changed from the inside-out—if we
do not morph—we will be tempted to find external things to satisfy our
needs. Transformation is not an instantaneous act of God, it is a life-long process (journey). One
does not get transformed by just praying, asking or believing; there is
no “microwave” (quick and easy) way to spiritual maturity.
The passive voice in Romans 12:2 means the Holy Spirit will do the transforming for us if we cooperate with Him (listening, yielding, relying…). Expect spiritual advancement, you can always mature more, Philippians
3:15-16. Your imperfections will be revealed by the Holy Spirit so that
you may continue to grow and become more complete (not sinless, but
well-rounded). Maturity versus infancy is the issue. God loves you just
the way you are, but refuses to leave you that way; He wants you to be
made conformable to Christ, II Corinthians 3:18.
Our Lord stripped himself of His glory and “…made himself of no
reputation, and took upon him the form of a servant, and was made in the
likeness of men…and became obedient unto death…” (Phil. 2:7 &
8). His life reminds us of our spiritual growth which often imposes
tough lessons, sometimes so tough we shrink back from learning them. It
seems we have to learn from actual experience that whatever we depend
upon in this life (for joy, comfort, acceptance, etc.), ends up
controlling us. God allows and uses life’s events to teach us about
misplaced dependencies, so that we finally grasp the concept that Christ is our one true sufficiency.
Disclaimer: This article is not intended to provide
medical diagnosis, offer prescriptive advice or substitute for a
personal health care provider. Anyone taking prescription medications,
or wishing to significantly change his/her lifestyle, is advised to
consult with a medical professional with appropriate expertise.
Steve Shober is a Naturopath (natural health practitioner) and a
member of the BBS Board of Directors. If you have questions about this
article, would like more information on the use of herbal products,
nutrition or lifestyle issues, or would like a presentation on
depression at your church, contact him at: Biblical Health Ministries,
7179 Clover Hill Dr., Waunakee, WI 53597; or shober@chorus.net. Biblical Health Ministries is a non-profit ministry dedicated to teaching God’s provisions for our health.