Running head: THE BATTLE OF DEPRESSION 1
Joyce Noble
Liberty University
Christian Counseling for Women CCOU 304
12/20/2017
The Battle of Depression from a Biblical Worldview
THE BATTLE OF DEPRESSION 2
Abstract
An overview of what is frequently referred to as the common cold of mental illness, this paper
examines the escalating problem of depression in American society from a Biblical Worldview.
Traditional secular counseling which ignores the spiritual issues needed for true transformation
has resulted in rising levels of depression which experts now classify as a major public health
problem that affects 16-17% of Americans at any given time. As the number one cause of
disability in the United States, depression is a serious issue in society today that needs to be
addressed not only from a clinical perspective, but by the body of the church as well. An
examination of the definition of depression, as well as its symptoms, possible causes, and options
for treatments through the lens of sound scriptural doctrine clearly reveals the need for the
integration of psychological and spiritual methods for true healing and lasting transformation to
take place.
Keywords: depression, public health, Biblical worldview, Christian counseling,
secular counseling,
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The Battle of Depression from a Biblical Worldview
Regardless of one’s worldview, depression is recognized on a global scale as an illness
with major health, social, and economic consequences. It is an acute and overwhelming sense of
despair that infiltrates the entire body system; adversely affecting the cognitive, physical, and
spiritual functions of its victim (Hislop, 2010). Viewing depression through a Biblical
Worldview, it is obvious that a holistic approach which integrates spiritually therapy is needed
for true healing to occur.
What is Depression?
Depression is listed among the most common, and yet the most underdiagnosed,
misunderstood and undertreated mood disorders among people today. Known as the “common
cold” of psychological disorders, it is defined by clinicians as “a serious mental health condition
that affects an estimated 19 million Americans, regardless of age, race, or gender” (Randolph,
2016, p.1). Depression is much more than an occasional bout of sadness; it is a period of such
intense despair, the ability to function on a healthy level is paralyzed. (Shulz, 2015). Whether
defined as a medical illness or a psychological disorder, it is an ambiguous condition, that
continues to plague society despite continued medical advancements to arrest it.
In the Natural Realm
Due to frequent misdiagnosis (Jancin, 2003) and the resulting lack of proper treatment,
the severity and reoccurrence of depression continues to rise at an alarming rate, signifying the
need for alternate avenues of therapy (Lamba, & Ellison, 2012). Recent studies confirm that it is
a growing public health and economic concern on a global level (Freeman, Tyrovolas &
Koyanagi, 2016) despite advancements in secular counseling and treatment. As symptoms grow
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more severe, the difficulty of those suffering from depression to effectively communicate in
social settings (Hislop, B., 2010) affects both private and social life, as well as job performance
and economic stability. According to Pratt & Brody (2014), up to 88% of those suffering from
depression reported having difficulties functioning on the job, causing approximately 200 million
days of lost work every year, with annual costs to employers rising as high as forty-four billion
dollars (Randolph, 2016). Therefore, it is no surprise that recent research classifies depression as
the leading cause of disability worldwide (Freeman et al., 2016).
In the Spiritual Realm
Defining depression from a Biblical Worldview requires a Scriptural understanding of
God’s original intent for man at the time of his creation and the fallen condition of humankind.
As spiritual beings created in the image of God (Genesis 1:27), humanity is instilled with a deep
longing for a relationship with the Creator (Tan, 2011), yet tainted by the atrophy of inherited sin
(Romans 5:12). Although some may be resistant to God as the source of these “deep longings in
the human heart for relationship and impact” (Crabb, as cited by Tan, 2011), the need for self-
transcendence has been established by behavioral theorists as a human need. In his model, the
hierarchy of needs, humanistic psychologist, Abraham Maslow affirms that human behavior is
not always driven by basic survival needs, but motivated by “a higher level need to connect to
something beyond the self” (Nevid, 2015). Failure to fulfill this supernaturally instilled human
need will ultimately lead to substitute or subsistent living (Moore, 2003), both of which only
exacerbate the problem. Consequently, a Biblical worldview defines depression as neither
biological or cognitive, but spiritual. It is a disconnection of God’s creation from the creator; a
state of “spiritual famine” that torments the unsatisfied heart with the need to be filled with
something more; something that cannot be seen, or touched, described or defined, but is greatly
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needed. “God made our souls to long for Him, and we are not fully satisfied without His
presence in our lives” (Moore,2013, p.7).
Symptoms
The symptoms of depression range from mild to severe, situational to seasonal, and
impact all areas of daily life. Since the frequency, duration, and severity vary based on the
specific type of depression (Randolph, 2016), there is a wide scope of symptoms which manifest
in different ways in different people, and at different times. The most common symptoms of
depression have been categorized by the Center for Disease Control into three groups; mood,
cognitive, and physical (Pratt &, Brody,2014).
In the Natural Realm
Symptoms of depression in the natural world tend to be grounded in that which affects
the relationship with self. Feeling sad, irritable, guilty or worthless are obviously mood
symptoms, as well as a general loss of interest in those things that used to be a source of
happiness and pleasure, such as social events or engaging in a favorite hobby. Cognitive
symptoms include problems with memory, concentration, and increasing difficulty in making
decisions or adhering to decisions already made. The physical effects of depression range from
extreme fatigue to manic energy and restlessness, as well as a plethora of common ailments not
specifically linked to but impacted by depression, like headaches, digestive issues, and
observable changes in eating or sleeping habits (Pratt &, Brody,2014).
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In the Spiritual Realm
A Biblical Worldview sees the spiritual symptoms of depression not only as that which
affects self but, more importantly, that which affects the connection between God and self.
Although the spiritual symptoms of depression were excluded from the CDC’s categorization,
those who adhere to a Biblical Worldview are not immune to its negative impact. With respect
for the 75% of Americans who claim that religious beliefs are imperative to their worldview and
are a part of their daily lives (Hagedorn & Gutierrez, as cited by Johnson, 2013), “the spiritual
component must not be forgotten” (Hislop, 2010, p. 71). Depression can significantly impair the
believer’s relationship with God in many ways. Feelings of worthlessness make it very difficult
to accept the Father’s unconditional love. Shame impedes the ability to ask for and to receive His
unfailing mercy and forgiveness, and the overwhelming spirit of fear rooted in depression
conflicts with the faith necessary for the victorious life of the Christian. “And without faith it is
impossible to please him, for whoever would draw near to God must believe that he exists and
that he rewards those who seek him” (Hebrews 11:6, English Standard Version). Recognizing the
spiritual symptoms of depression can bring a new awareness to the ways in which the Godly
principles of a Biblical Worldview can be applied in the healing process (Johnson, 2013).
Causes
Depression is caused by a combination of biological, cognitive, environmental, and
spiritual factors. Although it is exclusively attributed to either physiological or psychological in
some instances, the scope of this debilitating condition is often rooted in both physical and
mental factors.
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Ranging from temporary situational stressors (like divorce or a death in the family), to
disruptions in the limbic system: the part of the brain that helps to regulate moods and emotions
(Nevid, 2015), the cause of depressive disorders is not always easily recognized or medically
defined (Hislop, 2010).
In the Natural Realm
Clarifying the cause of depression is influenced by which school of thought is believed
in. For instance, a psychoanalytic approach may claim the cause of depression stems from past
childhood experiences, while a cognitive theorist would be prone to identifying erroneous
thoughts patterns as the root cause (Cashion, Shriner, & Mossler, 2016), but then, it is possible
that both could be applicable and overlapping causes. Since there are many factors that
contribute to depressive mood disorders, identifying the cause, or causes, is often a complex and
time-consuming process that requires extensive knowledge, proper diagnostic testing, and critical
thinking combined with compassionate, attentive listening skills.
Physiological Causes of Depression. Although the complexities of possible genetic
causes of depression is still not fully understood, some studies have associated depression with
certain genes that can be inherited from parents. Research estimates people with first-degree
relatives who suffer from depression are up to three times more likely to develop it. Further
studies have proven that it can even be passed on from a mother to her developing fetus before
birth (Bembnowska & Josko-Ochojska, 2015). Depression can also be due to chemical
imbalances in the brain, caused by the improper production or functioning of certain
neurotransmitters: serotonin, norepinephrine, dopamine, gamma –aminobutyric acid (GABA),
and brain-derived neurotrophic factors. The influence of certain hormones, such as serotonin,
may be the reason why women are 70% more likely than men to experience depression at any
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given time (Randolph, 2016), although the amount of stress, how it is distributed between the
genders, and the different ways in which men and women cope with the stress must also be
considered. Because the hormonal changes in a woman’s life cycle change dramatically at certain
stages, the hormonal changes that take place during post- partum, premenstrual, and the various
stages of menopause are often found to be the cause of depression in women (Nevid, 2015).
Regardless of gender, a lower level of serotonin has been proven to cause depression, including
the onset of suicidal tendencies (Bembnowska & Josko-Ochojska, 2015). Due to its insidious
ability to coexist, overlap, or hide beneath other conditions, a clear, one size fits all explanation
for the cause of depression is simply impossible.
Psychological Causes of Depression. The psychological or cognitive causes of
depression are generally rooted in erroneous thought patterns; a distorted mental filter through
which life experiences are viewed in negative and exaggerated ways. Aaron Beck, the
psychiatrist who developed cognitive therapy, classifies several of these negative thinking
patterns as cognitive distortions that “increase vulnerability to depression following negative life
events” (as cited in Nevid, 2015, p. 506). Another example is the learned helplessness model
developed by Martin Seligman which suggests that continued exposure to uncontrollable
circumstances in which efforts to improve continue to fail will inevitably result in a defeatist
attitude which turns into depression (Nevid, 2015). Sifting through the possibilities to identify
the cause of depression in each individual case must be a combined effort of an effective
counselor, a competent clinician, and the client as well.
Environmental Influences. A simple explanation for depression remains a debatable
issue, depending on which side of the nature versus nurture debate one stands on. Studies
confirm both genetic and environmental influences contribute to the development of depression,
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and assert that environmental influences experienced throughout the life of an individual must be
viewed as a contributing factor (Nevid, 2015). For instance, research confirms a clear connection
between depression among women and a history of sexual abuse during childhood (Bembnowska
& Josko-Ochojska, 2015). Clearly, any traumatic experiences during childhood will adversely
affect an individual’s biological response to stress, impair cognitive coping abilities, and open the
door to the development of serious maladies in later life.
In evaluating the plethora of physiological and psychological causes for depression, the
prospect of sorting through such a wide range of possibilities may seem overwhelming, but there
is research that claims there are also instances when depression is simply caused by the
consequences of a person’s own bad choices or behavior (Bembnowska & Josko-Ochojska,
2015). According to some studies, there are even some people who become depressed “for no
apparent reason” (Mental Health America, n.d).
In the Spiritual Realm
Although some of the causes of depression in the spiritual realm resemble those based on
empirical evidence (distorted beliefs or thoughts), the supernatural causes seen through the lens
of a Biblical Worldview go far beyond what science can adequately explain, including the
indelible and oppressing presence of sin, as well as the engagement in spiritual warfare.
Although unrecognized and/or unrepentant sin can obviously be the root cause leading to
circumstantial or situational depression, the influence of sin goes beyond personal mistakes and
bad choices. It also refers to “our general state of brokenness and the consequences of living with
other broken people” (McMinn & Campbell, 2009, p.241). The atrophy of indwelling sin has,
unfortunately, become the natural state of nature and is a continuous and insidious influence
which causes distorted beliefs and spiritual misconceptions. A Biblical Worldview affirms that
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living in a fallen world is a perpetual state of battle; a spiritual warfare (Ephesians 6:12) that can
easily trigger a depressive episode. Attempting to steal the source of a believer’s strength; the joy
of the Lord (Nehemiah 8:10), depression is the enemy’s weapon of destruction (John 10:10).
In contrast to the enemy’s intent to use depression as means of harm, there is also the
possibility that the trials of battling depression may be allowed by God for spiritual growth.
According to Blazer (2007), the connection between depression, struggle, and spiritual growth is
ancient. Often referred to as “the dark night of the soul” these times of suffering can be a
supernatural catalyst for spiritual growth which draws the believer closer to God (Blazer, 2007),
and works all things out for good (Romans 8:28).
Treatments
The possible treatments for depression are as varied as its symptoms, and will ultimately
depend on several variables, including the type of depression being treated, the medical
condition of the sufferer and any personal preferences or spiritual beliefs. Recent statistics
published by the National Center for Health Statistics reveal a large gap between those suffering
from depression and those actively seeking help, which confirms the need to seek new avenues
to reach the hurting and oppressed (Luke 4:18). According to the data brief published in
December 2014, less than 20% of Americans with moderate depressive symptoms sought
professional help for their depression in the year prior to its publication. Even when it symptoms
worsened and became severe, the percentage of those seeking help was still only a little over one
third (Pratt &, Brody, 2014, p.5).
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In the Natural Realm.
Ranging from simple changes such as adjustments to diet and exercise (Nevid, 2015) to
hypnotherapy, the clinical goals for the treatment of depression are remission, a return to optimal
functioning, the prevention of relapse, and the management of any adverse effects of prescribed
medications (Schulz, 2015). Research confirms the most effective way to combat depression is a
combination of medication and therapy (Pratt & Brody, 2014). Hormonal therapy as well as the
use of antidepressants are often successful in alleviating the discomfort of the physical symptoms
of depression, while behavioral or solution-based therapies address cognitive and emotional
issues, such as distorted beliefs and inappropriate emotions (Nevid, 2015). Studies claim that
depression can be successfully treated, especially if treatment is started early and pursued
vigorously (Randolph, 2016) but, due to a high rate of recurrence, some studies also suggest the
need for “lifetime maintenance treatment” (Schulz, 2015).
In the Spiritual Realm
The most effective treatment of depression, from a Biblical Worldview, is a personal
encounter with Jesus Christ, Wonderful Counselor (Isaiah 9:6) and Master Healer (Exodus
15:26). Prayer, intercession, spiritual guidance, and involvement in church activities combined
with the knowledge gained from scientific research (Mckinn & Campbell, 2009) results in
Curative Theology; a holistic approach to treatment that promises lasting and transformative
change; a sense of spiritual well-being. Borrowing from the secular field of counseling,
Cognitive Behavioral Therapy is an effective method in changing erroneous though patterns and
can easily be incorporated into a Spiritual oriented mode of therapy (Hislop, 2010), aligning with
Scripture that clearly advises believers to abstain from the sinful patterns of the word and that the
way to transformation is by “changing the way you think” (Romans 12:2, New Living
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Translation). This of course is done by wielding the believer’s most powerful tool; the Sword of
the Spirit (Ephesians 6:17), which is the Word of God (Hebrews 4:12). Whether the cause of
depression is rooted in genetic anomalies, hormonal malfunctions, or mental incapacities, the
answer is found in Christ.
Conclusion
In conclusion, the battle against depression can only be won by addressing every aspect
of mankind as a created being; not only the physiological and psychological, but the spiritual as
well. The needs of almost 75% of depressed people are not being addressed by secular
counseling methods. According to Hislop (2010), one of the American Psychological Association
recommendations in the improvement of addressing the issue of depression in women is to
“include nontraditional interventions such as religious organizations” (p.309). Johnson (2013)
also states, “Spiritual, religious, and philosophical reflections, beliefs, and practices are
foundational to the human experience and, therefore, are an essential aspect to consider in
effective therapy”. As wounded healers walking in the newness of life, the goal of every
Christian Counselor should be to lead the brokenhearted to healing (Luke 4:18) by leading then
to a personal and transforming encounter with the Living Christ – “Wonderful Counselor” (Isaiah
9:6).
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