When facing depression, there are four areas of life that need to be examined.
1. What are you thinking about?
The Bible confirms what we already know, how you think affects how you feel. Consider Prov. 23:7: As a man thinks in his heart so he is.
In Psalm 119:53 David says, When I think of your rules from of old, I take comfort, O Lord.
Again in Psalm 119:59-62, David says, When I think on my ways, I turn my feet to your testimonies; 60 I hasten and do not delay to keep your commandments. 61 Though the cords of the wicked ensnare me, I do not forget your law. 62 At midnight I rise to praise you, because of your righteous rules.
Notice the connection between how the writer thinks and how the writer feels. Throughout the Bible (and general observation in life confirms this) the role of thinking is a precursor to how one is feeling.
Therefore, when dealing with depression or depressed people, it is critical to realize the connection between thinking and feeling. If you see a person who is depressed it makes sense that the individual has thoughts that are depressing. If you see a person who is happy it makes sense that, at least at that moment, they are thinking “happy thoughts” (even the person who is acting “happy” yet is truly and profoundly feeling sad is doing so by governing their expression through concerted thinking. Therefore, the governing issue is, again, the thinking of the individual). We are physical beings that are impressed in every moment of every day by how we think concerning reality at any given moment. To complicate matters, we have the ability to call to our remembrance specific circumstances and situations from years ago at a moment’s notice and allow those memories to shape how we perceive reality. We even have latent thinking patterns (often formed in early childhood) that constantly act to shape our emotional outlook as well. Although poor English, the principle of “how you think is how you are” (even in regressed or latent thinking) is correct.
Whether you are an individual struggling with depression or a person who wants to help an individual who is struggling with depression, an exploration of the thinking pattern(s) is the fundamental starting point. This is exactly why a good counselor will ask questions and probe responses seeking to understand why a thought or a pattern of thought(s) are being interpreted with certain corresponding feelings and, eventually, in established behaviors.
Resource: David Powlison in his book: Seeing with New Eyes has an excellent listing of “X-Ray” questions to ask oneself on pg 132-140. Here are some questions you can ask of a person that you are seeking to help.
In seeking to determine if your depression is a result of sinful choices you must first examine your thoughts. Are you conforming how you think to the truth expressed in God’s Word? The mooring of truth in thinking is the starting point in rooting out what type of depression you are dealing with. Without an external source of truth (not just counseling gimmicks or medication or yelling “serenity now”), you cannot know if your depression is due to sinful choices. The role of how a person thinks can be compared to the way a painter transfers a beautiful mountainside landscape to the canvas. The mountainside shows definite lines and proportions that the painter must accurately translate to the canvas. The goal of the painter is to match what he sees on the mountainside onto the canvas. Similarly, we are to study God’s Word in order to translate the truths, guidelines, and discernment contained in God’s Word onto the thinking patterns of our lives. As we do this, the way we think will be changed and the way we feel (i.e. depression) will be addressed.
It is at this point that the Gospel becomes the primary force for shaping our immediate outlook and world-view in general. The Gospel stands at the center of how we are to process reality given that we are, at our core, worshiping something or someone. I will leave further explanation of what I mean for another post.
#2. What are you feeling? (feelings are the abode of depression)
Continuing with the metaphor of the painter and the mountain… feelings are to an individual the way colors serve the painter, they give depth and distinction to the painting. When you begin to feel depressed (or other emotions like anger, hate, bitterness, resentment, jealousy, envy, etc.), it is in response to something you are thinking. Feelings can also be seen as the flower of a plant while the thinking processes are like the root system. It is critical to dig-down to the root of the thinking pattern(s) that is flowering in a particular emotional expression. Remember, feelings do not just happen. Therefore, depression does not just happen.
If you are a follower of Jesus Christ, you must first deal with “Soul-Talk”. Again, applying the truth to what you are feeling is (for most people) the antidote for how you are feeling. This is often done with your pastor or counselor given the difficulty with performing a self-diagnostic when deep and long-term emotions are involved.
#3. What is your behavior?
If you are thinking wrongly it will contribute to wrong feelings that, in turn, will lead you to wrong behavior. Put another way, if you are thinking in a sinful way (“man-centered”), you will be interpret your feelings sinfully which will drive you into living sinfully. It is at this point that many people who deal with depression want to address the “flower” instead of the “root system.” The reasoning goes like this: if I stop doing “X” and start doing “X” or take medication “X” or change my relationship with “X” and so on and so on … then I will feel better. Notice that the thinking pattern is not being addressed just the behavior. Also, notice that the feelings are acting as THE motivator for change. Both of these dynamics guarantee that the individual who is caught in this dysfunction of diagnosis will never truly deal with their depression, they will just displace it or mask it. Often type of “remedy” is displayed in a change of relationships, the use of medication ( drugs or alcohol), avoidance of certain people, or other actions that help the individual feel better in the moment.
So, when you are in a situation that is bringing on feelings of depression (stress at work, disagreement with a friend, marital strife, etc.); can you pinpoint the focal point of your thinking? How does the way you are thinking relate to what the Word of God says? This is often where a skilled pastor, counselor, or even a wise church member can play a vital role in healing.
#4. What are your activities?
If there were no clear line or consistent pattern in the thinking, feeling, or behavior dynamic, I would then counsel the individual to begin to look at the activities of their life. This would focus on the physiological aspects of your life. This would include items such as your sleeping habits, work schedule, nutrition, exercise, emotional-load (death of a loves one, change in job, etc.) over the affected period of time. Since we are physical beings, depression may be remedied through a physical change and/or pace of how we live life.
When evaluating your activities it may be helpful to complete a blood test and/or other physiological tests in order to consider the range of components that are affecting mood and outlook.
Warning: The determination of physiological or “chemically-induced” depression should only be made after consulting with your pastor and/or biblical counselor. A hallmark of a physiological or a (truly) chemically induced depression is that there us (seemingly) no rhyme or reason for why you are feeling what you are feeling. If you are regularly feeling depressed, you SHOULD NOT seek to determine that this must be physiological or “chemical” on your own. With the help of your pastor and/or counselor, a determination can be explored when it is appropriate to seek medical attention. If you progress to this level of diagnosis, there should be a clear and objective standard when seeking confirmation regarding the need for medication. In this regard, I would recommend a psychiatrist or medical doctor (M.D.) who specializes in the area of psychological and physiological diagnosis. Regardless of who is ultimately involved in helping plot the course of action, the use of medication to address depression should be considered as a last resort. Only when imminent harm or risk has been determined or when it has been established that there is a clear inability to comprehend or process reality, that could be exhibited in the harming of others, would I be comfortable in the use of medication.