Depression - Part I
Although depression can be caused directly by physical problems like side effects from drugs, thyroid, hypoglycemia, sleep loss, poor nutrition, or hormonal imbalances, it can also be a result of spiritual
problems. It can result from hopelessness, lack of purpose, grief, or guilt that leads to disappointment, discouragement, despondency, and depression.
The Diagnostic and Statistical Manual (Fifth Edition) outlines the following criterion to make a diagnosis of depression. The individual must be experiencing five or more symptoms during the same two-week period and at least one of the symptoms should be either (1) depressed mood, or (2) loss of interest or pleasure:
- Depressed mood most of the day, nearly every day.
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
- Significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day.
- A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
- Fatigue or loss of energy nearly every day.
- Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
- Diminished ability to think or concentrate, or indecisiveness, nearly every day.
- Recurrent thoughts of death, recurrent suicidal ideation without specific plan, or a suicide attempt or a specific plan for committing suicide. 1
When people reach a point of helplessness, they believe they have exhausted all of their resources, or come to the end of themselves, and have two options. Many turn to hopelessness which is believing circumstances are impossible or having no expectation of good or success. It is a sinful attitude that is the ultimate end of hoping in anything less than God (Rom. 5:1-5).
In The Christian Counselor’s Manual, Jay E. Adams lists several types of people who may have reached the point of hopelessness:
The other option is hope, which is the favorable and confident expectation about things that are not seen (Rom. 8:24-25), and for the future. Biblical hope is twofold because it includes hope for abundant life now (John 10:10), and hope for eternity. This hope is based on God’s promises and His faithfulness to fulfill them, and not on people, possessions, or circumstances. This is why God is the God of hope (Rom. 15:13).
God provides the following hope for believers:
- People, like the man in John 9 who was born blind, with long-standing problems
- People, like the woman in Matthew 9 with the issue of blood, with peculiarly difficult problems
- People who have a problem that has been labeled incorrectly
- People who have been harassed by fear
- Persons whose hopes have been dashed repeatedly
- Those who have tried repeatedly and failed like Paul in Romans 7:18
- Those who do the right thing but give up too quickly.
- Older people who often need hope because they believe they have passed the point where change is possible
- Depressed people need hope
- Suicidal people need hope
- People who have suffered life-shattering losses like death, moving, adultery, divorce, possessions, or position need hope
- Those who are without Christ need hope because they “have no hope” (Eph. 2:12). 2
These hopes that counteract hopelessness are received by a person believing he is a sinner and receiving Jesus Christ as his Savior and Lord.
- Salvation (Rom. 8:20-25; 15:4, 13; I Thess. 5:8; II Thess. 2:16; I Pet. 1:3).
- Righteousness (Gal. 5:5).
- God’s calling (Eph. 1:18; 4:4).
- Eternal inheritance (Eph. 1:11-18; Col. 1:5; Heb. 9:15; I Pet. 1:4).
- God’s glory (Rom. 5:1-5; Col. 1:27).
- Resurrection (Acts 23:6; 24:15; I Thess. 4:13; Titus 2:13; I John 3:3).
- Eternal life (I Cor. 13:13; 15:19; Eph. 2:12; Col. 1:23; Titus 1:2; 3:7; Heb. 3:6; 6:11, 18-19; 7:19; I Pet. 1:3-13).
- Safety in heaven (I Thess. 2:19).
- Joy (Rom. 5:2; 12:12; 15:13; Ps. 146:5; Jer. 17:7).
- Peace (Rom. 15:13).
- Encouragement (Rom. 15:4).
- Perseverance in any situation (Rom. 8:24-25; Heb. 6:9-12)
- Confident steadfastness (Col. 1:21-23; I Thess. 1:2-3; Heb. 3:5-6).
- Dependence on God (II Cor. 1:8-10).
- Disciplined life and faithfulness (I Tim. 4:7-10).
- Purity (I John 3:3).
- Endurance (Rom. 5:5; I Thess. 1:3).
1 American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5). Arlington, VA: American Psychiatric Publishing, 2013.
2 Adams, Jay E., The Christian Counselor’s M