A Christian primer on anxiety and depression

Both in and out of the church, you’ve probably heard many clichés surrounding mental health in general, and perhaps anxiety and depression in particular:

“You just need more God. Read your Bible and pray more!”

“The Bible says to rejoice and not be anxious… there must be some sin in your life that is causing your issue.”

“Depression is just brain chemistry. You need medication.”

There are probably more, but these are common ones.

I’m excited to see Christians talking about mental health more. But I’d also like to see us develop our understanding of it from a Christian perspective so that we can be part of bringing healing to people who are not only physical, mental, and emotional beings, but spiritual beings as well.

What is depression, really?

Depression in particular can be hard to pin down. Is it just extended melancholy? It seems to be more than that, but perhaps inclusive of it. The Diagnostic and Statistical Manual (DSM-5) lays out the criteria for it to be considered a disorder: at least two weeks of any of a slew of symptoms, depressed mood or loss of interest or pleasure in things being the foremost.

I won’t go further into the definitions – you can google the DSM-5 on depression or anxiety for that. What’s important to understand is that there are differences between a disorder and a mood. Someone can be sad or melancholic in temperament without experiencing a depressive disorder or episode. Likewise with anxiety disorders. Everyone experiences anxiety, but not everyone has a more pervasive disorder.

Furthermore, disorders themselves are still being understood from a clinical point of view. We don’t fully know what’s going on in someone’s brain biologically, nor do we fully understand all of the mental and emotional factors either.

We need a comprehensive view

I believe that a comprehensive understanding of mental health concerns (and many other things) will help keep us from oversimplifications like the above clichés.

Jesus’ Great Commandment to us in the Gospel of Luke says to love God with all of our “heart, soul, strength, and mind.” A lot of people today find this four-part approach to a person helpful, and in my research on depression in particular I would agree. Briefly, let’s look at each one of these four components of a person.

The Mental: This refers to our cognitions, our thoughts. These aren’t so much how we feel but what we are thinking, whether intentionally or unintentionally, consciously or subconsciously.

The Emotional/Social: This includes our relationships with others as well as our general emotional state and stability. Relationships and emotional health are deeply interconnected.

I think this is one area the church has underestimated and left somewhat unaddressed in an increasingly individualistic Western culture. We have lost something important as we’ve focused in so deeply on the individual. In particular, we’ve perhaps not realized that disconnecting from people breeds loneliness and restricts our ability to accomplish the second part of the Great Commandment: to love our neighbour as ourselves. Thus, those who posit the “you just need to love God more” response sadly ignore the fullness of the Great Commandment, and fail to realize that we are not meant merely for God, but for others. Simply “loving God more” is not, then, by his own design, “enough” to satisfy the emotional needs of each human.

The Physical: This is our biology and physiology. This tends to be where modern western medicine focuses, and Christians who know the Scriptures shouldn’t deny its significance. Clearly, Jesus coming down in physical form and God creating us as physical beings means we are inherently and meaningfully physical. The Gnostics, who argued for the inherent “evilness” of the physical world, were condemned as heretics by the early church.

The Spiritual: This refers to our deepest values and sources of meaning and purpose in life. This also includes our integrity and our relationship with God.

Typically, Western medicine focuses on physical health. This focus has been incredibly helpful for dealing with things like bacterial and viral diseases. But we are finding more and more that we cannot see humans as merely biological entities, and that our biology interacts significantly with the other parts of ourselves.

When it comes to anxiety and depression disorders, Western medicine has understandably focused on the physical, with some degree of success (from medication to other interventions like using exercise). The church, on the other hand, perhaps skeptical at the confusion surrounding mental health in general, has at times tended to over-spiritualize the issue. After all, the Bible teaches that Christians should choose joy, right? Therefore maybe someone is depressed because there’s unrepentant sin in that person’s life, or they are simply not praying enough, reading their Bible enough, or maybe they are experiencing spiritual attack.

Finding a balance

Unfortunately, both these reactions to mental health are, at times, as oversimplified as they are unsympathetic. The pendulum can easily swing too far in either direction, focusing too much either on purely the physical side, or too much on the spiritual side.

Since this post is just a starting point to the discussion, I’d like to simply propose a more holistic approach to anxiety and depression. A holistic approach understands the complex fullness of a human being as physical and spiritual, mental and emotional/social, and that these categories naturally overlap and interact with each other. So what would it mean to take a more holistic approach to anxiety and depression?

It means we must be open to “unspiritual” help and interventions. Christians must remember that we are not spiritual beings only – brain chemistry and other biological issues exist in a broken world. Western medicine must understand the limitations of the merely physical and that medication may only treat symptoms while leaving underlying causal problems untreated. All the while, we see more and more evidence of the overlapping of the cognitive, emotional, and physical parts of the person. Symptoms could appear in one area but be caused or influenced by problems in another. Cognitive and emotional therapy has been employed and enjoyed by Christians to the alleviation of symptoms and other issues. Employing biblically allowed methods from secular psychology to biblical (and biblically informed) counselling could prove quite fruitful to the church, both to bless with and be blessed by.

It also means that, at risk of giving weight to some of the clichés, we do need to be open to the idea that sin could be affecting our mental health. Whether it’s a lack of mental self control, ongoing drug or pornography use (physical), willful isolation from community (emotional/social), or other habitual sin which always leads to death and isolation, it is more than possible that we are part of the problem in a willful sense. I think it’s possible to accept this idea without wandering into hurtful and unempathetic oversimplification. For me, it meant being real about my disposition towards worry. Worry is a sin – this disposition, therefore, needed tempering by God’s help and grace, and I needed to work at keeping worry at bay. I needed to start facing fears that I was developing so that they would not control me anymore. What I need from others is empathy, because it’s hard for me, and grace, because others aren’t perfect either. But I also need others to be honest when they think I might just be giving in to worry, and notice me trying to blame it on a disorder.

We must continue our pursuit of joy and develop our understanding of suffering and a theology of depression and anxiety. The Scriptures give the clear command to rejoice in God, always. Even in sufferings! Spiritual leaders have gone through forms of depression, even writing about it at times (great men like Charles Spurgeon, Martin Luther). Jesus’ own suffering and sorrow has given great depth to the Christian idea of joy. I’ll paraphrase John Piper: joy is a good feeling of the soul given by God’s Spirit as we understand Christ and his work. Note that this joy is not dependant on circumstance, but on God who is unchanging. In light of unchanging reality, then, we can explore what meaning and joy could be found in even the darkest of depressive symptoms, and develop our understanding of what it means to take joy even when bodily symptoms seem to be out of control.

Lead others into joy

Let’s lead others into joy also, and aim to bring healing as best we can. One of the ways we can do that is by boldly preaching the gospel. It can’t be denied the power ultimate meaning and purpose in life, from God himself, can give, namely through the person and work of Jesus. The gospel indeed does answer the dark depths of depression and the cold bite of anxiety. Healing can also come through community, and namely the love of Christian community. What if we allowed people to be in our friend groups, come to our churches and find support that they need for emotional healing? What if we gave generously to provide counseling and other help for those who can’t afford it for themselves? Could we bring healing and show the love of Christ with the hope that they and others embrace it eternally as they see what the power of that love?

Once again, this post is not meant to be extensive, but to move the conversation along. A lot of these ideas only scrape the surface of the discussion. It’s my prayer that it will help us dig deeper and understand anxiety and depression in the context of biblical Christianity, and hopefully alleviate the suffering of our believing and non-believing friends who suffer in this way.