Wednesday, May 9, 2018

Gospel Hope for Common Struggles Part 2 of 2: Depression

The Boston Center for Biblical Counseling hosted their inaugural event – Anxiety & Depression: Gospel Hope for Common Struggles  Saturday, May 5, 2018 at Lortimer Hall, 88 Tremont Street, Boston

Here is the link to the previous post focused on anxiety:

Alasdair Groves of CCEF New England was joined by Jeffrey Monk, Ph.D., Jennifer Huang Harris, M.D., and Executive Director of the BCBC and City on a Hill Pastor Fletcher Lang, for this first seminar hosted by The Boston Center for Biblical Counseling (BCBC)The goal of the BCBC is to work with churches and people throughout the greater Boston area to answer:

+ How do we develop and foster a culture of care among people in our cities? 
+ How do we equip local churches to counsel each other and the people in the places where they live, work, and rest? 
+ How do we continue to grow and develop counseling services that are Gospel-centered, clinically-informed, and connected with the people who Jesus is moving in and through?

The notes in the following post will focus on Alasdair's morning session related to an introduction to depression and a glimpse of how God responds to us in our depression in the Scriptures.

The Boston Center for Biblical Counseling Gospel Hope for Common Struggles Part 2 of 2: Depression with Alasdair Groves

Anxiety and depression are some of the most universal human experiences.

Depression is a dark, fairly misunderstood, mysterious, and foreboding word that is often put on us. Whether someone follows Jesus or not, the experience of depression can result in the person feeling guilty. In fact, more often than not, guilt is a component of depression.

There is a great breadth to what it means for someone to be depressed as depression relates differently to different people.

How do we recognize depression?

The Diagnostic and Statistic Manuel of Mental Disorders (DSM 5th Edition) is a key resource for therapists in relation to categorizing mental health conditions. The DSM refers to depression as:

" ... a depressed mood, loss of pleasure, change of eating patterns, diet and weight, shift in sleep patterns, feelings of worthlessness and meaninglessness, excessive guilt, suicidal considerations ... "

As a counselor (not a psychiatrist), we don't have to work in the realm of labels. We can recognize symptoms when we think or feel that:

+ Something dramatic in my life has happened and it's dragging me down each day. 
+ Everything is dark and heavy; there seems to be no light. 
+ Life seems helpless; I can't imagine anything good right now.
+ I can't get out of bed and there's nothing in my tank; I'm drained day after day. 
+ Everything feels overwhelming and I'm constantly confused and disoriented. 
+ Nothing really matters to me. 
+ If I start to care, it feels like anguish, so I'd rather return to a state of being numb. 
+ I'm regularly angry, and I fear that I'm stuck in this pattern and there's nowhere to go for help.

What is your depression saying? What are you saying in response? How might your anxiety and depression be related?

It's a long, difficult process to listen to depression. But your depression is always telling you something, so it's important to listen.

In determining the relation between anxiety and depression:

Anxiety says, "It could go wrong and I'm afraid." 
Depression says, "It will go wrong and nothing can be made right again."

Anxiety and depression flow into each other sometimes. Ultimately, depression is anxiety that has lost hope. 

What is the relationship of medication to depression?

Medications can help you address some of the chemical, mental, and physical complications that may be fueling the depression. 

There are two important considerations in relation to medication that can help you continue to listen to your depression as well as listen to God:

+ Don't say, "If I just believe enough rightly, I won't need my medications anymore." 
+ Don't say, "My medications are what I really need more than anything (which means I kind of have an excuse for my sinful responses and don't need to uncover some of the heart issues that fuel my responses)."

Medications can be a helpful tool, but they are not your Savior.

How does sin interact with depression?

Sin is turning away from life to death. Sin is insanity and calling it logic. Our sin twists our thoughts and action to move (or run) away from the living God and His Kingdom of peace, justice, and mercy. 

Depression can be a response to what's wrong in the world or in us that can turn us to God. Depression can also be self indulgent, bitter, and self-destructive which results in a sinful response.

Whether or not depression turns us to God or we allow it to stir up sinful responses in us, it is always a suffering we endure. But we do not have to endure it alone.

What are examples of good responses to depression?

Remember that your body matters and the way it interacts with thoughts and emotions can reveal things that are wrong.

Depression can say: "This is not right, this is not the way the world is supposed to be." When we look to God when depressed, it is good to be troubled by what troubles Him. For example, in Acts 7:54-8:2, even though Stephen said he saw Jesus and forgave those who stoned him to death, it says in 8:2 that the people "mourned deeply for him." Mourning will come and there can be a temptation to wonder if anything will get better.

Depression will ask, "What's the point?" So good responses and actions in life will feel pointless. We can and should still do them in faith regardless of how we feel. 

Depression will say, "No one can help." Push back and don't go through life alone. Reach out and ask for help.

What are examples of good responses to someone who is suffering with depression?

+ Don't assume you need to have the answers as if that will be the best way to help someone. Be present. 
+ Don't be surprised about the length of time that the depression lasts; it can seem to reside very slowly. Be patient. 
+ Don't lose hope even when the person loses hope; with Jesus' help, hold onto hope for people. Be prayerful.

Between a good counselor and a good friend, I'd choose a faithful friend for those who suffer from depression.

Where does the Bible speak to people enduring depression and suffering?

Lamentations is a book in the Bible that gives us a glimpse of what it is like to walk on the outskirts of hell on this side of death, and yet still engage with God in the midst of anxiety, fear, and depression.

The people crying out are engaging in all kinds of mourning and a crushing loss of hope after facing murder, genocide, rape, cannibalism, judgment, and horror, and yet they are still talking to God, and He is still listening.

Somehow, even in one of the darkest chapters in the people of God's history, there is a glimmer of hope. It is in the middle of Lamentations that we hear them say the words: 

Because of the Lord’s great love we are not consumed, for His compassions never fail. They are new every morning; great is Your faithfulness. I say to myself, “The Lord is my portion; therefore I will wait for Him.” The Lord is good to those whose hope is in Him, to the one who seeks Him; it is good to wait quietly for the salvation of the Lord. (Lamentations 3:22-26).

If the people in Lamentations in their condition are still engaging a living God who knows and hears, then so can we when we face moments in life that can invite in depression.

What might God be saying to you (whether in the silence, or in the Scriptures, or by His Spirit) in the midst of your depression?

God does not ask us to know how much of our depression is spiritual, emotional, or physical; we will suffer and we will be tempted to respond sinfully, but we will also be invited to humbly bring our burdens to Him and to others He has placed in our lives.

What passages might we turn to in order to hear from God during our depression?

Sometimes we need revelation from God to understand our depression: 

Send me Your light and Your faithful care, let them lead me; let them bring me ... to the place where You dwell. Why, my soul, are you downcast? Why so disturbed within me? Put your hope in God, for I will yet praise Him, my Savior and my God (Psalm 43:3, 5).

Sometimes we need confession to God to engage with a sin that might have fueled the depression:

Have mercy on me, O God, according to Your unfailing love; according to your great compassion blot out my transgressions. Wash away all my iniquity and cleanse me from my sin. For I know my transgressions, and my sin is always before me. Create in me a pure heart, O God, and renew a steadfast spirit within me. Do not cast me from Your presence or take Your Holy Spirit from me. Restore to me the joy of Your salvation and grant me a willing spirit, to sustain me. My sacrifice, O God, is a broken spirit; a broken and contrite heart You, God, will not despise (Psalm 51:1-3, 10-12, 17).

We are always invited to remember God's presence, that we are never alone in our depression: 

The LORD is close to the brokenhearted and saves those who are crushed in spirit. ... I am with you always to the very end ...  (Psalm 34:18Matthew 28:20).

The promise that Jesus is with us to the end is an unparalleled gift for all who suffer from depression.

Three helpful resources for engaging more with the topic of depression and counseling are:

+ Depression: Looking Up from the Stubborn Darkness by Edward T. Welch 
+ Spurgeon's Sorrows: Realistic Hope for Those Who Suffer from Depression by Zack Eswine  
+ Instruments in the Redeemer's Hands: People in Need of Change Helping People in Need of Change by Paul David Tripp

Soli Jesu gloria.

Rev. Mike "Sully" Sullivan

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