I intended to write a comprehensive comment encompassing all the thoughts I had as I read your posts and subsequent comments. By the time I finished it was 5 pages, and I just couldn’t drop that into a comment here. So, I posted the diatribe in its entirety on my blog, http://www.calledoutinkansas.com/2011/03/24/conversations-on-depression/,
and will put an abbreviated version here. I will be making statements of opinion, but will go into minimal supportive/explanatory detail, so if anyone has concerns about what is said here, please read further at my site. So, here goes.
As far as I know I will be the third family practice doc to comment on this topic. My comment will not be as scholarly as many already posted, but hopefully will offer some insight.
1. I believe this topic is so incredibly complex, that any attempt to draw generalities risks alienating someone at some point. We will never have full understanding on the intricacies of the spirit, soul and body, so we will never fully understand this issue. Nevertheless, I will attempt to draw the most accurate generalities that I can, to explain my thoughts.
2. I believe that much of the mental illness we see today is environmental in nature, meaning that the sum total of past experiences makes us who we are today, for better or worse. Mental health is like a Rubik’s Cube, where the completed cube represents a life in total harmony and peace. The more insults we suffer, be it abuse as a child, death of a loved one, etc. (or even “non-traumatic life events like new jobs, moving, getting married, having children) the more times the dials on the cube turn, and the more complex and difficult the situation becomes. By the time the tiles are all jumbled, the person is jumbled as well: confused, hurting, lost, disoriented, etc.
3. I believe there may very well by a physical, or genetic, component to depression, but I think that it can be either trumped or revealed by environment. Again, this is not a catch-all concept, as certain mental illnesses seem to me more likely to have a physical or genetic component (Schizophrenia being one of them).
4. I have witnessed a trend in the last year or so for the field of Psychiatry to place a greater emphasis on diagnosis and pharmacologic treatment and much less of an emphasis on counseling. I see people being diagnosed with personality disorders or other things that, to me, can easily be explained by the overall context of the person’s life.
5. I strongly believe, as previously stated by Bobby, that the trend mentioned in #4 plays directly into the enemy’s hand by robbing us of the hope we may otherwise have for recovery/deliverance. This is one instance where further explanation will be held for sake of space, but my long version goes into greater detail on this.
6. I believe that it is possible to be delivered/healed from depression, especially for those of us in Christ. Again, in the short version, I will limit my discussion on this to the following:
a. Christians need to be honest with themselves, each other and God. One of the best things a person with any trouble can hear is “I have been there myself”.
b. Just as in other areas of life, those of us suffering with depression must keep our overall focus on Christ, to the best of our ability. We must keep the promises and truths of scripture before us. In my hard times I may have to remind myself of the truth in scripture continually for several days before it begins to take root in me, and some days are better than others. I will add as well that my current experience of depression is relatively rare, and by no means severe. So, I can see where those that have severe depression would struggle just to survive. These are the times when we simply have to stand on His sustaining power, and maybe not even think about His healing power.
c. Sometimes we just need a hand. There is nothing wrong with taking medication to help alleviate the symptoms enough to allow us to work on the issues at hand. When the depression gets so severe that we can’t even think straight or concentrate there is no way to gain ground. I am certainly not an advocate of medicating into oblivion, but a balance can be struck.
d. Counseling, especially by a trained professional who also has spiritual insight, can be a powerful tool. Even counseling with a skilled counselor without the scriptural background can be very helpful, but add in the appropriate application of biblical principles and the result can be astounding. “You shall know the truth and the truth will set you free”. When the Spirit of God reveals truth to the heart of man miracles can occur.
e. We must trust God to sustain us where we are, all the while looking ahead to the deliverance and healing that is promised in Christ. Just as Abraham waited 10 years (by my calculation) from the promise of a son to the actual birth of Isaac, so too must we be patient as the Holy Spirit works to grow the seed of Christ within us, until it chokes out every weed of the flesh and the enemy. We must seek Christ, and seek the present day expression of the eternal reality of our own death and resurrection.
7. When discussing the environmental and physical theories for the etiology of depression, I think we have to ask ourselves whether the chicken or the egg came first? Does the MRI show a change in the depressed person because the physical change caused their depression, or did the depression bring about chemical change which resulted in abnormalities on the imaging test? I lean towards the latter personally.
8. I agree with what another commenter wrote, that the world of medicine and Psychiatry operates on the assumption that there is no God. Therefore it has to find an explanation for all things in scientifically identifiable terms. In light of this, we can not take the wisdom that comes from this field as “gospel” truth, but rather must take it with a grain of salt, so to speak, in light of the greater truth of scripture.
9. I believe that there are people with severe depression that also suffer from spiritual oppression. There may be a tendency to lay fault for that oppression on the oppressed, but this would be misguided. I strongly believe that the enemy attacks the strongest when we are closest to significant breakthrough. He does NOT want us to reach our potential, and any steps towards reaching that scares him terribly.
In the end, no matter what we may say in this discussion, there is no “easy answer”. There is no cookie cutter solution. Even if we can identify the exact root of our problems, overcoming the subsequent effects of that takes time and effort, and often times a lot of pain. In the end it does come down to learning to trust, but with an understanding that it is okay to fail, and that He is faithful even if we are faithless. It is okay to be weak, and in reality it is preferable to be weak, as only then is His strength perfected in us.
I hope this comment helps. I welcome dialogue, as Dan has, as my own understanding is ever-evolving.