Is Depression Sin? A Biblical Analysis Of Depression
Through the Eyes of Biblically-based Medicine
Introduction: this series: Biblical Analysis of Depression and Feelings States is long overdue. The culture, both churched and non-churched are under the spell of a psychologized mindset. In addition, the term depression and feelings states are everywhere. How is a believer to think about this common occurrence and explanation? For a number of reasons which will become clear I embarked on the series: Biblical Analysis of depression and feelings states. I as well as the Church needed clarity on the subject and I suspect believers, pastors, physicians, and counselors do so as well. Let’s begin and see what you think. We go to Scripture and move out from there in order to perform a proper biblical analysis of depression and feeling states.
Life is characterized by change such that all people are “becomers.” All people are and will change. This includes physical and spiritual changes. Generally they are two groups of people: those who are true believers – Christians – and those who are. Both are believers because every person is a faith-based and hope-based being. Both groups are theologians because they have beliefs about God and are in relationship to Him whether denies or not. Moreover, they are image bearers of God and as such every person lives in God’s world as a dependent being.
No person stays the same in his thoughts, desires, and actions. Change is of the essence for all people. Unbelievers are members of Satan’s family and kingdom and as such are conforming (changing) more and more into his image (John 8:44; 1 John 3:8-12). In contrast, believers have been changed from the inside out by what theologians call regeneration (John 3:3-8; 6:60-64). As a result, they are in the process of becoming more like Christ.
They develop a mindset and lifestyle that the Bible calls walking according to the Spirit, in fear of the Lord, loving God and neighbor, and growing in the grace and knowledge of the Lord Jesus Christ. These concepts are radical to the mindset of the world – that system of thinking, wanting, and acting that is opposed to biblical truth. The Bible refers to this mindset and lifestyle by a variety of terms such as according to the flesh, walking by sight, being wise in one’s own eyes and strength, trusting-in-self, and self-pleasing.
In order to conduct a biblical analysis of depression and feelings states, we go back to the beginning: God created the heavens and the earth and created man, male and female in His image, and breathed into him the breath of life (Genesis 1:1, 26-28; 2:7). He became a living being. But animals were also living beings (1:20, 21, 24, 30). Man was placed in the Garden and he received counsel from God. He was able to think God’s thoughts, desire what God desired, and act accordingly. Notice I did not mention feelings. The Bible does not emotion them until after sin and the Fall. It is important to link thoughts, desires, actions, and feelings because God did and does. Feelings, their origin and presence are related to how man thinks, desires, and acts. We must understand this fact if we are going to have a proper biblical analysis of depression and future states.
Pleasing God was Adam’s motivation until he sinned. He chose to accept and follow the counsel of Satan while at the same time rejecting God’s counsel. After he proved covenantally unfaithful he was judged and all mankind in and with him. A cascade of realities follow. Thinking became distorted due to the noetic effect of sin; man’s ability to think was intact but thinking was man-centered and not God-centered. Desires became self-centered motivated by the I wants.
As a result, \bad feelings entered into the picture as documented in Genesis 3. Instead of joy, peace, and contentment – a quietness of the soul and whole person there was sinful fear. They now sought to distanced themselves from God. They hid hoping against hope to hide themselves with their heir guilt and shame from God, each other, and probably themselves. So much futile energy was expended on self. They may well have received any number of psychiatric labels such as panic attack or an anxiety disorder. We are not told that they wept or stopping functioning. The focus of Adam and Eve turned from God to self. Pain now entered into the world. Romans 5:12-14 described sin, misery, and death entered into the world. bad feelings were everywhere!
Man was created a rational, reasoning being – a thinker; he was created a relational being both in relation to self, others, and God; he was created a revelational being – he was a revelation receiver, interpreter, and implementer; he was created a religious being – a worshipper; and he created a morally-responsible being;. These nouns help indicate that man was created the image of God. Pre-Fall, he had one goal: to glorify God. God created man a faith-based and hope-based being. Man was given the capacity to think God’s thoughts, to desire what God desires, and the capacity to act desires for God and to God for His honor. He was prophet, priest, and king. This anthropology is important for a proper biblical analysis of depression and feelings states.
The fall did not change God’s creational design or purpose for man. But sin and God’s judgment of Adam at the first sin on earth placed man in a precarious and deadly position. He was guilty and condemned before God. He lost – forfeited – his original righteousness defined as his right standing before God. There was deadness and darkness within his whole person but primarily manifested in his heart – his inner-man. His nature was corrupt and he was at enmity with God, others, and self.
This fact does not seem to manifest itself in Genesis 3 and 4 but Genesis 5 picks up the reality of living as God’s enemies: and he died is the refrain throughout the chapter as a result of enmity with God. Self took center stage as God declared in Genesis 6. Unsaved, fallen man had no desire or ability to please God. Rather, mankind lived from the mindset of “what is in it for me.”
As I have practiced medicine and counsel I meet people who have been given various psychological labels. The people have problems as well as labels. The issue before us is this: how do we minister to these people? Do the labels help or hinder? One of my goals in writing is to help Christian physicians and biblical counselors minister to people with psychological labels. Thus was born the series: a biblical analysis of depression and feeling states.
I think it is important that you know how I arrived at my conclusions. So I begin with a personal note. I was an unbeliever when I became a physician. My worldview was horizontally focused for my gain. I would not have believed that about me if someone told me! I was doing the best I thought could as I lived according to my standard, goal, and motive. I perceived life through the senses and interpreted what I took in by my own reasoning and feelings. You could not have convinced me that I was wrong. All my training in medicine only reinforced my approach.
I was an unbeliever in medical school and early in the practice of rheumatology both at the university level and in private practice for some three decades. I considered myself a scientist. However, there was uneasiness about me and what I did. I did not understand it then. I know now that I was the problem. When I became a believer, “life looked better” but my practice of medicine did not change much. Patients were still problems to be solved and biblical truth had no role in the practice of medicine and problem-solving.
A second radical change occurred when I was introduced to the use of the Bible as a way of life for me as well as for others. Not only did I begin to change individually I changed my view of medicine and how I practiced. I continue in the “change process” as I grow in my understanding of biblical truth and its application in my life and in the lives of those that God brings to me in His providence. Eve though recently retired, I practiced and would medicine the way I counsel. Ask questions that move from the inside-out focusing on thinking, wanting, and actions. I spell out the results of the change process in my life greater detail in four of my books, Pain the Plight of Fallen Man, Being Christian in Your Medical Practice, True Competence in Medicine: Practicing Biblically-Based Medicine in a Fallen World, and How to be A Godly Patient. I have added three books that address these areas: Depression: Through a Biblical Lens: A Whole-Person Approach, Joy in Grief: God’s Answer for Hard Times; Endurance: What It is and How it Looks in the Believer’s Life).
This present work: A biblical analysis of depression and feeling states is a culmination of thoughts based on my increasing understanding of biblical truth as applied to the practice of medicine and counseling as a true theologian. I have written a book: Depression: Through a Biblical Lens: A Whole-Person Approach. In it I give biblical rationale for how I arrived at my conclusions regarding a biblical analysis of depression and feeling states. I hope to stimulate your thinking and move you to a radically different perspective regarding “feeling states.” Please pray that all Christian physicians, pastors, and biblical counselors develop and nourish a heart for God’s people, God’s way, for His glory in the context of physical problems.
A Biblical Analysis of Depression: Feelings States
First, consider a word about feeling states. People – patients and counselees – don’t complain about good feelings when they come to the office – medical or counseling. Rather, they present with the complaints of bad feelings and the expectation and even demand for relief. For reasons that will become apparent I consider the bad “feeling states” (so-called psychological disorders and mental health disorders) such as worry – “Anxiety disorder”, fear – “Panic Attack”, anger, and depression as thinking and wanting problems. At the heart of the issue is control – theirs and God’s.
Patients, when questioned according to biblical data-gathering principles, will always associate their feeling states with two main elements: their thinking and wanting about control and resources, or lack thereof. Bad-feeling states involve whole-person activities of wanting, thinking, and doing often as a patterned way of life and a mindset of letting their feelings be their guide.
In addition, each feeling-state carries with it the idea that something outside of the person “made” him feel – and think and desire – the way he does. In other words he functions as if he is a victim to that which is outside of him. However, that which outside of him is best termed God’s providence. I hope you see the significance of the so-called psychological mindset. A little later I define the duplexity of man and the effect of the inner-man (wanting and thinking) on the outer-man and vice versa.
There are several set of questions that you need to answer and points for you to please ponder as we engage in a biblical analysis of depression and feeling states. These include:
One: Please write out your answer to the question: is depression sin? In one or two sentences, please include:
• Your knee-jerk reaction and the reasons for your answer
• Your definition of depression
• How you arrived at your definition
• Is there non-sinful depression?
Two: when speaking of depression, generally described as bad feelings, what do you think? As you answer the question consider:
• Where do you go to find information about depression?
• What is your bias about depression (every one presupposes some belief and acts upon it)?
• What standard do you use in giving and accepting the label of depression?
• What standard do you use for responding to a person with that label?
• What place does biblical truth have in helping people with that label?
• How do you define help and what is your standard for defining it?
Three: have you engaged in a biblical analysis of depression and feeling states? If so what was your results and the basis for it? If not why not?
These questions need answers. The present work is designed to help Christian physicians and biblical counselors answer them and function as God’s kind of doctor and counselor. A corollary purpose is to help all believers whether patients or counselees to properly understand and respond to their “feeling” (so-called “emotional”) states. Together we will look at the condition called depression and other feeling states through the lens of Scripture in order to perform a proper biblical analysis of depression and feeling states. One goal of the series is to honor God and bless His people.
Based on my study of the Bible as applied to the care of patients and counselees over the years, it is my conclusion that depression, as I define it, is sin. I make distinctions: between depression as a noun and depressed as a verb. I also know that body problems can cause bad feelings. We need to be careful how we interpret that fact when addressing the subject of so-called mental health. If depression is a sin, there are far-reaching implications as you read the Bible and consider such people as Jesus, Paul, David, and Job. Please stay with me as we “walk” through how I arrived at my conclusion, in part, based on the following five premises.
A Biblical Analysis of Depression: First Premise: the necessity of a proper starting point
In our series, a Biblical Analysis of Depression we must begin at the beginning. A proper starting point is essential for developing a proper biblical perspective regarding bad-feeling states labeled as mental illness. As a disclaimer, I did not begin with a definition of a certain mental illness or even the term in general. Many have done that. I begin in the office with a real person sitting across from me.
Consider this first question: when faced with a person labeled as having depression do you begin with the Bible applying its truth to the person in terms of his wanting, thinking, feeling, and doing (everyone thinks, wants, feels, and does something!)? Or do you accept, and therefore, begin with and impose a secular (or worldly) definition and the culture’s worldview onto the Bible in an attempt to help hurting people? Both approaches are purported to “help” hurting people. Notice that there are now two definitions that must be agreed upon: that of depression and that of help.
It is increasingly evident to me that most Christians, both lay people and leaders, have accepted the definition of depression provided by the secular, medical community. Following the culture, Christians bring/import feeling language into the Bible. As a result I propose that there is a conflict between biblical truth and its application and the culture’s approach and “solution” to bad-feeling states.
I suspect many biblical counselors, pastors, and Christian physicians would reject my proposal. However, when they are face to face with people who complain of bad feelings AND feeling-directed thinking, wanting, and behavior, it is easy to accept the medical diagnosis of depression. There are several reasons for this:
• Almost everyone has experienced or is acquainted with someone who has experienced bad feelings in varying degrees. These may be reported by a variety of terms: sadness, discouragement, blueness, and feeling down;
• Bad feelings however defined are common occurrences in a fallen world; they are a variety reasons but all are related to God’s judgment on Adam’s first sin and the resultant misery. Sadness and sorrow are part of the human experience for both believers and unbelievers. But even though true, both have an origin, content, duration, and flow from a proper or improper relationship to God and others;
• While the Bible does not give a definition of depression the Bible describes the whole spectrum of human experience both from God’s perspective and the perspective of people who may be so-called innocent and guilty sufferers. It is easy to forget that they are still sinful individuals;
• The presumed “safety” of following recent, traditional, medical practice;
• Whoever speaks the most, defines the problem and the solution from their perspective. Starting with secular definitions actually defines God out of the problem and the solution.
Definition of terms is critical for a proper analysis of depression and feelings states. When the terms depression and help are not defined, the Bible will not be used in addressing the whole person or the Bible will be used in ways that God did not intend. For instance, some in biblical counseling would say that Paul and Jesus were depressed (Paul: 2 Corinthians 1:8-10; 4:8-10; Jesus: when He was in the Garden of Gethsemane; please see my website series entitled: Was Jesus Depressed?). If Jesus was depressed or had depression, then it is OK for all believers.
Others may use the Bible in a supporting role much like one would use an antidepressant. A personal vignette highlights this. A patient was complaining of pain and feeling bad. When she awakened at night hurting she prayed to God. I asked her the nature of her prayer. She told me relief. Her response to my “what happened then” was: “I took a Xanax.” I asked her if that was a proper response to God’s “no.” She said getting relief was the most important thing at that moment. I asked her to think about her relationship to God in Christ and the impact that being in Christ had in terms of her wanting, thinking, feeling, and doing especially when things weren’t going her way. She told me her relationship with Christ was no better, or even was less effective, than a Xanax. She did not want to examine her thought and desire-life. She only wanted relief and taking a Xanax was quite simple and effective.
One may interject: because depression and other bad-feeling states are “physical” problems, medications are to be used as God’s gift. One might even say, “God gave us medication to help the body. So why shouldn’t I take any drug that makes me feel better, and good, such as antidepressants?” For now, suffice it to say, following the medical model of disease, the discipline of medicine would like us to believe that these bad-feeling states are physical in nature, and therefore, are fair game for medication. Further, there may be a time when a physician who does not give certain medications could be accused of practicing “bad medicine.” My conclusion in premise five answers question for me and I hope for you.
Pragmatically, does the label “depression” really help? I submit that it actually detracts and hinders the use of biblical truth in the care of people. How, you ask? Let me preface my answer with a personal experience. At presbytery following a presentation regarding biblical counseling I was asked if I had ever met a “good” psychiatrist. I failed miserably in my response. I failed to have the questioner define “good” and psychiatry. Now we have four terms that need clarity: depression, help, good, and psychiatry and even psychology. If we include psychology we would need to define which one. There are more than 250 psychologies. I had failed to do a proper biblical analysis of depression and feelings states! I have since repented!
Jesus defined “good” in response to the rich young ruler’s question regarding inheriting eternal life (Matthew 19:1-2; Mark 10:17-18; Luke 18:18-19). Jesus began with a proper vertical reference: only God is good. Since God is good and He is truth, only biblical truth rightly applied is good and sets the person free (John 14:6, 17:17; 8:31-32). Untruth or partial truth is counterfeit and holds a person in bondage.
In terms of defining help or better, each must be defined according to biblical truth. Truth moves a person to become more like Christ and function as a “Christian oyster” which is using the unpleasantness of a situation to make the pearl of Christlikeness (2 Corinthians 5:9 So we make it our goal to please Him whether we are at home in the body or away from it.). The only way to please God is by growth in Christlikeness thereby imitating Christ. True help must be judged on the biblical standard such as given in 2 Corinthians 5:9.
Going back to presbytery, I would ask my questioner if he had done a biblical analysis of depression and feeling states. I would ask him if psychiatry as a discipline is rooted in non-biblical truth and if it ever helps a person become more like Christ. Rather, only biblical truth rightly applied by a changed heart and illumined by the Holy Spirit motivates the believer to become more like Christ (Philippians 2:12-13: Therefore my dear friends as you have always obeyed – not only in my presence but now much more in my absence – continue to work out your salvation with fear and trembling, for it is God who works in you to will and to act according to his good purpose; 2 Peter 3:18: But grow in the grace and knowledge of our Lord and Savior Jesus Christ. To him be glory both now and forever. Amen).
The use of various psychological labels hinders the use of biblical truth for the following reasons (see my article entitled Lists and Labels on my website under the heading psychology):
1. The mindset of the culture permeates the counseling room and doctor’s office. Relief is the major therapeutic goal. Self takes center stage. The person is a victim of his feelings, the desire for relief, and to that which is around him. The person also takes on the identity of the label – “I am that label.”
All people live out of an identity. This is God’s creational design. Adam was created a dependent creature in covenant with God by design. God entered into a covenant with him. He was to function as a covenant keeper for the purpose of serving and glorifying God. That was his identity, and because he represented all mankind, every person was designed to be a covenant keeper. he failed to function as a godly covenant head as sin entered into the world.
We must remember that people label themselves and are labeled by others. A person receives and is motivated by the label; thoughts, desires, and actions follow in accordance with the label. Labels, too often, are used to explain thinking, wanting, and doing. They may very well become a person’s refuge, strength, and source of comfort. One’s identity leads to agenda-setting and pursuit of it. In bad-feeling states, relief is not only the goal but also it is the reason for thinking, doing and not doing. The person uses feelings rather than biblical truth as his guide.
To counter the relief-is-everything mindset I ask the person how something outside of him makes him feel the way he does. Most people (patients and counselees) have no idea how to answer. Since he presented with the complaint of bad feelings, I meet him at the feeling level. By my data gathering I move to his thoughts and wants. Many people understand the implication: nothing touched them physically yet they feel bad. The very presence of another person or a situation seems to have caused bad feelings. The person begins to see that his response is driven by thoughts and unfilled desires.
Then I have the person reflect on the situation as a context and not the cause of his feelings, thoughts, and desires. I also determine his patterned thinking and wanting. My goal is to help him realize that by God’s design he is not a victim to that which is outside of him. Some people appreciate this insight while others are threatened by it. People trained themselves to react from a victim and label mentality. It is “easier” (less effort is involved) to react than to respond from a biblically-controlled mindset.
2. The secular community, both medical and non-medical, has “liberalized” its definition of depression. As a consequence, there is a high frequency of finding depressed people. Medical personnel are looking for and diagnosing people as “depressed.” There are many reasons for this.
3. What is being taught is that depression, even for a believer, is an expected and normal response to life. The term life is so often misused by Christians. The term actually refers to God’s providence – His good and purposeful control. This is an important fact. Words do matte! Following the secular mindset and taken to its logical conclusion, God is considered to be responsible for the person’s bad feelings. Such a conclusion leads to and is part of a mindset of trust in self, hopelessness, and misery. The person is considered a victim to both his nature and nurture; both of these are under God’s sovereign control. He is living the lie!
4. The psychological diagnosis of depression (and any feeling state that falls under the category of a psychological disorder) should lead any person to conclude that depression is characterized by bad feelings and feeling-directed behavior. The medical community usually denies the fact that bad feelings have an origin unless they uncover some clearly defined physical problem through abnormal blood tests with or without other examinations.
They also deny the fact that behavior is driven by feelings. However, as discussed below and in premise two, the Bible teaches that people live out of their heart and behavior is driven by feelings, wants, and thoughts. Behavior is not subjective; because it is observable and observer-dependent and interpreted. However, in relation to psychological conditions subjectivity rules. Bad feelings, verbalized in some form, are the major criteria for the diagnosis of depression which is summed by answers to two questions (see footnote 14, pages 47-48 in Depression Through A Biblical Lens: A Whole Person Approach). Moreover, even though depression is considered a physical problem, a physical examination is not needed for the diagnosis. I repeat: the person’s behavior is influenced by how he feels.
Contrast the subjectivity-rules approach (feelings reign supreme and are the criteria for diagnosis and treatment success or failure) with one in which you gather appropriate data. You do this by asking questions regarding thinking, wanting, and motivation – from the “inside-out.” Let me explain. God has made us inside out people (Proverbs 4:23: Above else, guard your heart; for it is the wellspring of life; Matthew 12:33-36, 15:7-9, 16-20; Mark 7:6-8, 18-23). Attitudes and beliefs originate in the heart (inner-man) and give rise to actions and behavior (these are whole-person activities – both inner-man and outer-man activities). I discuss this in premises two through four.
When I spend time with patients and counselees who have been diagnosed with depression, what stands out is the connection between wanting, thinking, feeling, and doing. Proper data gathering as described above should lead to the inevitable conclusion that people with label of depression are thinkers and wanters. That is part of the reason I think the term depressed is misleading. Verbs denote action. I had one patient tell me she did not need anyone or anything else to depress her. She could do that herself. And she did!
Rather, depression is usually viewed as something happening to someone or in someone. The person considers himself acted upon. In that sense depression is passive. However, biblically speaking, when feelings are a person’s authority and guide, he actively gives up on God, His promises, and the application of biblical principles. He is living the lie. His theology interprets reality differently than God does in His Word. As a consequence he neglects some or many of his responsibilities in varying degrees. Initially, those in biblical counseling accepted this concept and definition.
The person cognitively and willfully gives up even though he may deny that fact or explain it away by the burden of bad feelings, his right to give up, the difficulty of being responsible including exercising his body. He shrinks his world based on feelings and his interpretation of God, self, others, and life. It takes energy and effort to give up. A sedentary person has much activity in terms of thinking and wanting. He is still a chooser! He chooses to think God’s thoughts properly and worshipfully or he chooses to rely on satanic logic and his own feeling-based and -directed reasoning.
I believe that many, if not most, people labeled as depressed have trained themselves – inner and outer man – to rely on feelings. They have patterned thinking and wanting. This mindset has been developing over time. It is patterned response to God’s providence. They have developed a form of learned helplessness. I would agree that there is action on the person’s part, but it is giving in to feelings while ignoring biblical truth. The person’s proper vertical (to God) and horizontal (to others) references are replaced by an inordinate self-focus.
I often hear that depression (a noun) just is and I can’t help myself. Depression is often presented as an uncontrollable feeling: I just feel down and out so I don’t do anything. However the verb depressed confirms what some people say: “I can depress myself any time I want about anything.” Psalms 42-43 give insight into this fact (see my discussion on my website under the headings psychology and Psalms). Thrice the psalmist asks himself why he was downcast and disturbed within – why he had depressed himself (42:5: Why are you downcast O my soul? Why so disturbed within me? Put your hope in the Lord; 42:11 and 43:5: Why are you downcast O my soul? Why are you so disturbed within? Put your hope in God, for I will yet praise him, my Savior and my God).
The term downcast in the original language indicates trouble on the outside and a churning within – turmoil and sorrow. He was unsettled in his soul (the Hebrew mindset often considered soul as the whole person). His turmoil was connected with his view of himself, his circumstances, and the God of those circumstances. He understood the seriousness of his wrong thinking. He came to his senses!
In the verses above, he wrote that he counseled himself to change his hope from false hope to true hope. He was to hope in the Lord implying that his hope had been in something else. He acknowledged the reality of hard times but also the God of them and of him! The “of him” is critical. The psalmist applied correct thinking and wanting. He stilled himself before God. He ceased striving, basically against God now applying what he had known: God is God and he was not (Psalm 46:10: Be still and know that I am God. I will be exalted among the nations. I will be exalted in the earth).
He encouraged himself by these facts. He changed his thoughts and desires about God, His presence and control, himself, and his circumstances. His control and resources were no longer issues. He set his hope on God and praised Him. The Psalmist got busy doing something but the specifics of his actions are not described. Make no mistake: wanting, thinking, feeling, and doing are related. They can’t be divorced when ministering to God’s people. God didn’t separate them and we must not. This point is critical for a proper biblical analyses of depression and feeling states.
Others deny their self-depressing capacity (which is a result of the Fall) saying they don’t know why they are depressed; rather they only feel. These facts alone should lead you to the biblical conclusion that thinking, wanting, feeling, and doing (or not doing in the case of depression) are linked. Therefore, the whole person, both inner and outer man, not simply feelings, must be addressed in the “diagnosis” and care of people who are labeled as being depressed. Even the secular mindset gives credence to this when they recommend psychotherapy, mindfulness meditation, or cognitive behavioral therapy as treatment for depression. Changed thinking improves feelings. Moreover, such activities as yoga and deep breathing exercises change thinking through changed feelings.
A non-jaundiced look at psychological labels and people so labeled shows that the emphasis on helping people should be on changing their wanting and thinking rather than changing feelings and behavior. The connection between wanting, thinking, feeling, and doing are whole-person activities and need to be addressed in every person especially those with psychological labels. Knowledge of this fact is a must for a proper analysis of depression and feeling states. Biblical truth is God’s tool for doing that and should be ours. Psychological labels are not based on abnormal genes, molecules, or neurotransmitters. Psychiatry would like us to believe that all these play a causative role in depression. To the chagrin of their colleagues, many in the field think that psychiatry fails to make its case regarding science.
On the other hand, if psychiatry did prove itself a science and that depression was a physical problem, where would that leave biblical counselors and Christian physicians? In my book: Depression: Through a Biblical Lens – A Whole-Person Approach, I mentioned a “depression-causing gene” (page 68, footnote 24). If one could be found would we then blame God for the person living the lie as a response to life – His providence? I think not. The person would need to increase his scrutiny of his thoughts and desires much the way a person with sensitive diabetes needs to watch his food intake.
I think no matter what so-called medical science finds, it would leave us right where we are. In fact, God has us right where He wants us. Biblical principles are applicable for every person irrespective of their body. The application of them may change given a true body problem (for example, a person with a closed head injury and even dementia). One of our grandsons who has died had severe cerebral palsy. It was interesting to see my son, his dad, minister to him and the boy’s response.
I agree that man is a psychologist. The work has to do with knowledge of the soul ands sometimes people say mind. Those terms refer to the inner man which is the Holy Spirit’s territory! As true psychologists we must imitate Jesus Christ because He is the only true Psychologist! The Greek term psuche is used some 104 times in the New Testament. It refers to the inner man and the whole person. True psychology is the study of the whole person God’s way for His glory using His self-revelation – the Bible. These facts are fundamental to gaining a proper biblical analysis of depression and feeling states.
We must follow Isaiah’s proclamation, to the law and testimony (Isaiah 8:20: To the law and to the testimony! If they do not speak according to this word, they have no light of dawn). In doing so, we turn to the Bible and glean its truth especially before we begin with the secular culture’s definitions and culture’s me first and victim approach to life and people. No fact is neutral or mute. They sing out theology and call for a proper interpretation! All facts including those discovered by the social sciences are designed by God to be re-interpreted His way; they must be evaluated and interpreted through the grid of biblical truth. Nothing less will truly serve our God. nothing else will enable to make a proper biblical analysis of depression and feeling states.
If you don’t agree that wanting, thinking, feeling, and doing are involved in bad-feeling states, please follow this suggestion. Go back and gather data (determine the person’s thinking, wanting, feeling, and doing at the time of the problem and his pattern of thinking and wanting before the event) from the last ten people labeled with depression that you have encountered. In some way, each one will relate to you that feelings are his authority and guide and are linked to thinking and wanting. In some way the thinking and wanting will be out of sync with biblical truth. Feeling-directed behavior always follows. Once you have determined this is the case, you are in a better position to bring biblical truth, rightly applied, to the person where he is. Try it!
Biblical Analysis of Depression: Second premise: the necessity of a proper anthropology
A second premise is the necessity of a proper understanding of man’s duplex nature, of man’s physical and ‘spiritual” anatomy regarding thinking and wanting, and of the difference between symptoms and signs.
Man’s duplex nature and wholeness
Sound anthropology (knowledge of man) is necessary in order to carry out a proper biblical analysis of depression and feeling states. The Bible’s view of man begins at his creation. The word for create is bara which emphasizes God’s supernatural divine activity and never man’s activity (Genesis 1:1. 21, 27; 2:3) Man was created a duplex unit. He was created a material, physical being – “out of the dust of the ground” (Genesis 2:7). Man is body and has a body, but he is not only body. Man was also created a spiritual being. Adam was formed out of the dust of the ground, but it was only when the breath of life was breathed into him that man became a living soul/being. The uniqueness of man was not in him being a living soul (see Genesis 1:20, 24), but in the manner in which God brought about His results. God’s personal, direct in-breathing was a separate act on God’s part that distinguished man from animals. God interposed himself and man became a living being.
As a duplex unit man is a whole person including body (outer man) and soul (inner man: James 2:26; Ecclesiastes 3:21; 12:7). Because of man’s duplexity, his outer- and inner-man are linked. Each influences the other. For example, physical or bodily problems can influence how and what a person thinks, desires, and does (Elijah in 1 Kings 18-19). Just how that happens is open to question. Some say that their body made them do it meaning their feelings and function of their body was so poor that their heart/inner-man activity followed. An example may be the person with cancer or rheumatoid arthritis especially if the disease is active getting angry because someone did something the person did not like it. Similarly inner-man problems such as the consequence of David’s unconfessed sins (see Psalms 32 and 38) affects how one feels and functions (Proverbs 28;1). Similarly Proverbs 12:25; 14:30; 15:13, 30; 16:24; 17:22 speak to the state of the inner man and its affect of the body I terms of feelings and physiological changes.
Man’s whole-person activities include thinking, desires or wants, and actions. The Bible uses various terms to describe the inner man which is the immaterial side of man (heart, mind, spirit, soul, will, and conscience; heart is the most commonly used term). Biblically speaking man thinks, hopes, fears, purposes, doubts, considers and decides courses of action in his heart. These activities become patterned and habitual. Since the Fall, man is born a sinner as a whole person. He sins as a whole person in thought, desire, and action. Feelings take on more prominence as a guide for man. So often feelings take on a life of their own. They become one aspect of the person’s interpretative grid by which he measures reality and life – God, himself, others, and God’s providence. These facts are vital to a proper biblical analysis of depression and feeling states.
The inner man is the site of man’s motivational and belief systems; it is where the Holy Spirit resides in the believer. The Spirit does not coexist with Satan (1 John 5:18). .God does not share His glory with another especially Satan (Isaiah 42:8; 48:8-11) The Spirit’s workshop is the believer’s heart which is connected to the outer man including the brain. There is no word in the original texts for brain. it is part of the body. This connection is not neural. There is no nerve pathway or circuits between the two. Neurochemicals are present in the body that influence function but the inner man is untouched by them. So the inner and outer linkage is mysterious but it is a reality because man is a whole person. Man sins as a whole person and he loves God as a whole person. These fact are also vital for a proper biblical analysis of depression and feeling states.
Inner-man activities may be invisible to others and known only to the “performer” (for instance, Matthew 5:22-23, 28-29). As mentioned above, there is a non-anatomic connection between the inner and outer man so that thinking, wanting, and acting are present in both. Again I did not mention feelings. They are integrally related to thoughts and desires. Jesus Christ was a whole person – inner and outer man. These two were in perfect synchrony throughout His life as well as now. His grid for interpreting facts and what was real was biblical truth. He thought and desired in both his inner and outer man. The result was a whole-person activity that pleased God. He thought God’s thoughts, desired what God desired, and acted accordingly. Post-Fall, the previous synchrony of the inner and outer man in Adam was lost. Fallen man, as a whole person, thinks, desires, and acts as God’s enemy because he is. He remains so until regeneration (salvation). This Holy Spirit-derived activity enables the now-believer to bring his whole person into Christlike synchrony. He begins to think, desire, and act as did Christ in all areas of life.
Man’s Inside-Out-ness and Man is the Image of God
Again, sound anthropology (knowledge of man) is a must in order to carry out a proper biblical analysis of depression and feeling states. The Bible teaches that man lives out of his heart (Matthew 12:33-36; 15:16-20; Mark 7:18-20; Luke 6:43-45; Proverbs 4:23). The Bible does not view man’s behavior as isolated. It can be only inner-man activity or it can be associated with outer-man activity. The Bible does not present man as only heart or only body. Rather man is a whole person who thinks, desires, and acts in both his inner and outer man. Man, as a duplex unit, thinks in both his brain (outer man) and his inner man.
The functional capacity and its expression of the inner man can be compared to a sponge or pitcher. Only what is inside will come out when the sponge is squeezed or the pitcher is tipped over. The squeezing or pouring represents pressure – God’s providential ordering of a person’s life. The person’s circumstances are the context, not the cause of the outpouring of his inner man including depression. Sometimes a person just feels bad. No physical cause can be found and even if it was (thyroid problems are usually used as an example) correlation and causation are not synonymous.
Man is the image of God. Which part you say? All of man is in terms of thoughts, desires or affections, and actions. According to Ephesians 4:24; Colossians 3:10; 2 Corinthians 3:18; Romans 8:29, the believer is re-created in the image of God:
• In knowledge: man is to be a truth-thinker and truth-teller as a whole person not simply in his outer or inner man. But whose truth? It is God’s truth so that man as a prophet thinks God’s thoughts. Otherwise he thinks Satan’s thoughts.
• In righteousness: man as a whole person is aware of his unrighteousness, distrust of God, and disobedience. Guilt is a common aspect of his life. As priest and spurred by feelings that are controlled by proper thinking and wanting, he is aware of his need for the Triune God. He confesses sin and offers himself as a sacrifice pleasing to God.
• In holiness: man is aware that different actions flow from his position as king. He willfully consecrates himself as a whole person in thought, desire, and action to be pleasing God. As king, he subdues and disciplines himself for the purpose of godliness.
Moreover, man was created a faith-based and hope-based being. Both faith and hope have content. They are relational, rational, and motivating. There is true faith (saving faith) and false faith. There is true hope and false hope.
Man is also a sensual being. He was designed to see, taste, touch, hear, and smell as a sensual experience. The information he “takes in” requires interpretation. God designed man as an interpreter, chooser, and a concluder. Initially, pre-fall man correctly and receptively reevaluated (re-interpreted) God’s initial revelation about God, man, and creation as true. Adam and Eve had sensual experiences. They saw creation and heard God. They smelled the vegetation. They agreed with God: God saw that all he made and it was good (Genesis 1:31).
Initially they took in information – facts – through their senses and rightly processed them because their interpretative grid- biblical truth – paralleled God’s revealed thoughts and desires. An unanswerable question is this: why did Adam choose the way he did? He was not deceived (1 Timothy 2:14). His inner man was untainted by sin. He had the potential to sin – to choose self – but he had a relationship with God and Eve unmarred by sin and God’s judgment. He had no indwelling sin. We know he chose to please self by accepting and acting upon satanic counsel blaming God for giving him Eve! .
After the fall, Adam and all men creaturely interpreted facts following autonomous human reasoning. Reason was not guided by biblical truth. An unbeliever continues to have an improper interpretative grid. He is for self by self, and to self. These are predominantly inner-man activities but man does think and desire in his outer man. Such is the result of the curse of sin and its noetic effect (nous is the Greek word for thinking and perception. noetic means the effects of sin upon thought and thinking. As a result of sin, there is distortion of the facts that includes description, definitional, and direction). These facts are vital for a proper biblical analysis for depression and feeling states.
Post-fall, man continues to be a sensual being but thinking, feelings, and desires are unchecked by biblical truth, totally in the unbeliever and far too frequently in the believer. The believer continues, in varying degrees, to function according to his feelings and wants resulting in feeling-directed behavior. There is a “link” (as I have mentioned, little understood is an understatement) between the inner and outer man; this link is not anatomic.
As mentioned previously, what occurs in the inner man influences activity in the outer man and vice versa. One aspect of the inner-man outer-man connection is pictured in Romans 6:6 (For we know that our old self was crucified with Him so that the body of sin might be done away with that we should no longer be slaves to sin.). Among other truths, Romans 6 (also see Romans 7:14-25) teaches that because of previous membership in Satan’s family and kingdom, believers continue to demonstrate in varying degrees, rebellion and self pleasing. This is related to habituation and remaining sinfulness in the whole person. The remaining sinfulness and habituation is present in both the inner-man and the outer man (Matthew 5:22-23, 28-29).
In Romans 6, Paul is teaching that with salvation, here expressed as being crucified with Christ, there has been a transfer out of Satan’s family and kingdom into God’s family and kingdom (Colossians 1:13: For he has rescued us from the dominion of darkness and brought us into a kingdom of the Son he loves). Importantly, the believer has a new nature with the capacity for re-habituation. The believer has been changed. The Holy Spirit worked in him but not for him or against him. He continues to work in and with him. The initial work of salvation was 100% God and 0% the believer. Unlike salvation, the work of growth in Christ is 100 % the Holy Spirit and 100% the believer. As a result the believer is called to be what he is in Christ and indwelt by the Holy Spirit. He is to put on a new patterned lifestyle of thinking, wanting, and doing in his whole person. What was done to his whole person gives rise to God’s command to get busy acting as one saved (Romans 6:9-19; Ephesians 4:22-24; Colossians 3:8-10).
Paul speaks of whole-person renewal in 2 Corinthians 5:17: Therefore, if anyone is in Christ, he is a new creation, the old has gone, the new has come. The believer has a radically new orientation, bent, and inclination (i.e. a new nature) to please God rather than self. As the believer grows in maturity, the activity and function of his inner and outer man will be increasingly in sync thus imitating Christ. The change at salvation is in his inner man (Romans 6:6). But since man is a whole person, the believer’s heart change will be reflected in his body and outer-man activities. We rejoice with Paul that the believer is no longer a slave to sin, self, and Satan in his whole person (Romans 6:16-19). Thus, the believer puts off – replaces – satanic engendered and -practiced thoughts, desires, and actions as he puts on godly thoughts, desires, and actions. He does this as a whole person – inner and outer man.
This process of re-habituation and renewal is of the whole person made possible by the radical change in the inner man. The put-off and put-on dynamic involves thoughts, desires, and actions. The whole person changes which is most evident in changes in the outer man. Again the biblical truth surfaces: the believer is a whole person, a duplex unit such that thinking and wanting influence feeling and doing and vice versa. Again this truth is necessary for a proper biblical analysis of depression and feelings states.
As noted previously, man and desires thinks in both his brain (at least, in the frontal lobe and perhaps in the limbic system) and in his inner man. The brain is part of the body – soma. At birth the whole person in the womb at least for some time, has been affected by sin. he is a sinner in his whole person: thoughts, desires, and actions. David documents these truths in Psalm 51. As mentioned, there is no term for brain in the original languages.
The culture’s view of man’s “anatomy” is incorrect. Biblically and in contrast to the culture’s view, thinking and wanting are inner-man and outer-man activities. The brain is part of the body that receives, interprets, and acts on messages received from various parts of the body as well as from the inner man. it is appealing to think that the brain has a direct connection to the heart – inner man but that is only speculative. In the believer, the inner man is the place where the Holy Spirit dwells and is active. It is His place of residence. But the whole person is involved.
The Holy Spirit through His Word enables the believer to think God’s thoughts and desire God’s desires in any circumstance. In that way the believer brings his inner and outer man – his whole person – together. It is as if the two are members of an orchestra and each must be in sync for the proper functioning of the whole!
As a result of the Holy Spirit’s activity, the believer is able to respond in any situation according to biblical truth – he can please God because of his whole-person change (Philippians 2:12-13: Therefore my dear friends as you have always obeyed – not only in my presence but now in my absence – continue to work our your salvation with fear and trembling, for it is God who works in you to will and to act according to his good purpose; 4:13: I can do everything through him who gives me strength).
However, the believer has remaining sinfulness including the habituation of self-pleasing and rebellion as an aftermath and legacy of previous membership in Satan’s family and kingdom. This remaining sinfulness is in the whole person but is approached through the heart. Therefore, at times, he still functions as if he still in Satan’s kingdom. This patterned self-pleasing does not continue in the life of the believer but it may die slowly (1 John 1:8-10; 3:6-7).
Unfortunately, the culture and the social sciences (anthropology, psychology, sociology, and psychiatry) still hold to the pagan lies that feelings are the problem in depression and they must be changed. Medical science is enamored with:
• The idea that the brain is man’s moral compass. In other words, morality consists of hormones and chemicals in or out of place; it has nothing to do with God’s creational design of man – a duplex being and God’s image. In contrast to the secular model, the Bible teaches that man’s moral compass is not located in the brain but in the heart.
• The idea that the brain is not functioning correctly due to genetics, nurture, and environmental factors. Sophisticated neuroimaging techniques are studied in hopes of showing changes that elevate psychiatry’s importance.
• The fact that various chemicals (neurotransmitters) have been reported to be “awry” in patients diagnosed as having depression. Yet several questions are unanswered: what is a normal neurotransmitter level? In those diagnosed with depression, what is an abnormal neurotransmitter level? If it can be proved, is it cause or effect? If there is an imbalance, what is it? What is the role of diurnal variation – do neurotransmitter levels ebb and flow? Does the self report of “feeling better” correlate with changed or “improved” levels? If there is an “imbalance” is it correctible on its “own,” by faith, cognitive behavioral therapy, or medication?
• The reports that various areas of the brain apparently show different levels of “metabolic activity” on high tech magnetic resonance imaging and positive emission technical scans.
• The claims that purported changes in chemical levels and blood flow are touted as causative for bad feelings.
• The reports that various inflammatory mediators are abnormally high in those diagnosed with depression and the inflammatory state is alleged to cause changes in the nervous system.
• Following the medical model of disease. As a result medications are a mainstay of treatment for “depression” as well as any number of so-called “mental health diseases.”
I should add that not all those in psychiatry agree. The use of medication is subject to debate among psychiatrists. Moreover, at least two other models of “disease” have been postulated including the Biopsychosocial and the Bio-psycho-social-spiritual models of disease.
Symptoms and Signs
This section is not intended to be technical. Rather, a proper biblical analysis of depression and feeling states requires it! When considering the duplexity of man it is important, even mandatory, to distinguish between signs and symptoms. Both can be explained by genes, biology, molecule, biochemistry, neurotransmitters, etc. Following the medical model, changes in any and all of these are thought responsible for symptoms and signs. However, a person’s relationship with Christ and the indwelling Holy Spirit must be addressed. Regrettably, these latter truths are too often denied or considered improperly by the Christian physician and the biblical counselor (as well as the counselee and patient).
A sign is objective and can be measured. It can be quantified by some instrument other than self report. For instance, feverishness is a symptom that is not measurable by an objective tool. Fever is a sign with or without symptoms and is measured by a tool (thermometer). A symptom is subjective. There is nothing to measure and the amount and degree of a symptom rests solely on the person’s report.
Another helpful concept in understanding feelings states is the difference between something wrong with the body and in the body. Take the example of a patient-reported rapid heart rate. Patients may “feel” that their heart is racing (this is called palpitations). In fact, when measured, the heart rate and rhythm are normal. The sensation that the patient feels is a symptom. Usually there is no problem with the body. On the other hand, a measured rapid heart rate is a sign. Now physician and patient alike need to determine if the problem is with or in the body. A rapid heart rate may be due to a normally functioning heart influenced by fear, anger, and physical exertion in a de-conditioned person. All of these are examples of something wrong in the body. For clarification, a faster heart rate in a fit and normal person doing work or undergoing a stress test is a normal physiological activity. There is something happening in the body but nothing wrong with or in the body.
Examples of something wrong with the body include a rapid heart rate due to anemia, pneumonia, a hyperactive thyroid, or blood clots to the lung. Even though the heart is not the problem (it is working as God intended) the increased heart rate is a response to a pathological condition within the body. There is something wrong with the body but not necessarily with the heart. Another example of something wrong with the body is a rapid heart rate because the heart itself is affected such as in a patient who has had a “heart attack”. In the latter case, something is wrong with the body and it is primarily the heart.
It is quite striking how the culture is psychologized. Feelings, I remind you, are linked to thinking, wanting, and doing. To reiterate, thinking, wanting, and doing are the inner and outer man activities. This simple biblical truth seems to be ignored when ministering to people who are diagnosed with depression. It is so easy to make the quantum leap to consider depression as a physical problem, that is, something wrong with the body.
Rather, I propose the problem of depression is most likely a problem in the body (not with the body) – a whole-person activity involving thinking, wanting, and feeling. (See my definition of depression in premise five.) As I have said, proper definitions and terminology are critical for a proper solution. Regarding depression, proper thinking and wanting via biblically-controlled thinking is God’s antidote to psychologized thinking. Again, these facts are critical for a proper biblical analysis of depression and feeling states.
From the patient-counselee standpoint consider the following scenario:
• When most people speak of depression, they describe how they feel using terms such as “feeling down and blue, hopeless, depressed, discouraged, and overwhelmed.” Feeling-directed behavior follows (see footnote 5).
• They are not happy campers. They assume the problem is physical – that is with the body. However, they know that their laboratory tests are normal but still assume a chemical imbalance.
• Man was created a physical, sensual being. He takes in data via the senses (physical) and interprets it both in the inner man (heart) and outer man (brain). As a result feelings are generated in the inner and outer man.
• People must be taught about their feelings. They are not their feelings but they function as if they are.
• Christian physicians and biblical counselors must teach people the biblical truth that wanting and thinking – both inner- and outer-man activities – drive feelings and action.
From the physician’s standpoint consider these three scenarios:
• Many assume that a person diagnosed with depression has a physical problem. They are following the medical model of disease.
• Just as commonly, a person who presents with non-specific symptoms without an objective cause for them undoubtedly will be labeled as depressed and given medication. Doctors don’t like loose ends.
• Because patient complaints of bad feelings are so prominent and medications are so plentiful, medications seem to be an appropriate choice.
When I see a person who has been diagnosed with depression I assume nothing. I set aside the label of depression and the use of medications and focus on the person by gathering data. I ask: “What is the depression that you feel?” Usually he does not volunteer his thinking and wanting. I ask him to tell me his thinking and wanting currently and prior to the onset of his present bad feelings. Often I discover a long-standing pattern of wanting, thinking, feeling, and doing of which the person may or may not be aware. I may discover that the person noticed bad feelings developed or worsen after some event or circumstance.
I also inquire regarding the conclusions that he has drawn about himself, his situation, others, and the medications he may be taking. If he is a believer I include his thoughts about God and the cross. I want to know the person, his wanting and thinking so I am in a position to direct him to put off sinful thoughts, desires, and actions by putting on Christlikeness.
I can only do that if I begin and end with biblical truth. This can be trickery. Many believers will confess and repent of something in hopes of relieving symptoms. Or they will hold fast to their innocence and see no reason for a self- evaluation (Hebrews 3:13; 4:12; James 5:14-16).
As I move to a biblical perspective regarding feeling states, I ask: what is missing from the secular approach and definition of depression? The answer is multifaceted. What is missing is:
• The consideration that man is the image bearer of God and a whole person. He is a rational being and a prophet – he thinks and was designed to think God’s thoughts; he is a worshipping, religious being and has priest he was designed to desire what God desires; and he is an ethical, morally responsible being – as king, he was designed to act and conduct himself according to God’s truth.
• Man is more than feelings although he has them – he is not his feelings or emotions however defined.
• Wanting, thinking, feeling, and doing are integral parts of every person, both in his inner and outer man. Each is linked and related.
In contrast, the Bible is primary, sufficient, authoritative, and necessary when ministering to people with feeling states.
• The Bible describes real people in real historical contexts with real problems.
• The Bible sets out true anthropology and describes people who think, desire, feel, and act.
• The Bible describes people in particular situations via the providence of God and records God’s answer for bad feelings (see Psalms 6,13, 32,38, 42-43, 32; Job; 1 Samuel 30, Leviticus 10:1-3; 2 Corinthians 1:8-10; 4:8-10,16,18; 12:7-10). These are designed in part as a how-to manual for believers. See my website post: Feelings and Emotions; and Mental, Physical, Spiritual Heath: Feeling States).
• One non-negotiable biblical truth is that God is for the oppressed, downtrodden, and faint-hearted (Psalm 9:9-10; 10:12-14; 18:27; 34:18; 68:5-6; 69:33; 72:2-6,18-21; 146:5-9; 147:6; 149:4). This truth should be a source of comfort and courage for the believer no matter how he feels. if not one should ask why not.
• Because God is for the believer and the believer is united to Christ, Paul was convinced that the person himself in his circumstances of life would never be separated from God (Romans 8:37-39: No, in all these things we are more than conquerors through him who loved us. For I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers, neither height nor depth nor anything else in all creation will be able to separate us from the love of God that is in Christ Jesus our Lord). In this passage, Paul addresses the foundational issues of all feeling states: control and resources. However, so often this truth is minimized. The believer does not believe his status as victor because he thinks so little of Christ’s title of Victor and the road to it.
• God’s answer for those diagnosed with depression is to have the person change his thoughts and desires. Since the believer as a whole person is indwelt by the Holy Spirit he can think God’s thoughts and desire God’s desires no matter how he feels. Grace upon grace is lavished on the believer both saving and enabling-sanctifying grace. Not only that but the Triune God gives wisdom liberally (James 1;5-8). When the believer lives by trut rather than the lie does that is victory. He is following Christ who always lived according to truth. Thoughts and desires precede feelings. Feelings can train the whole person into a feeling-existence because of the influence on thoughts and desires of the whole person. It is the whole person who is acting. Especially in the feelings states, the above truths and their application have been set aside because of bad feelings. The person functions as if he is his feelings.
Third premise: Whole-person activity involves wanting, thinking, and doing based on Biblical Truth
Consider a third premise in our study: a biblical analysis of depression and feelings states. A person’s wanting, thinking, feeling, and doing are major subjects of the Bible. This truth follows because man was created and re-created to think God’s thoughts, desire what God desires and act accordingly. Therefore, when faced with bad-feeling states, the Bible must be consulted and used first and most. The Bible is not a medical textbook or a textbook for the diagnosis and treatment of physical problems. However, it does address and answer either explicitly or implicitly everything that a believer needs for life and godliness (2 Timothy 3:15-17; 2 Peter 1:3-4). Scripture is all a believer needs to properly respond to physical and non-physical problems. Without that confidence there will be no proper biblical analysis of depression and feeling sates.
The Bible speaks authoritatively about stewardship including taking care of the whole person. The Bible is our owner’s manual provided and preserved for every believer by God. It directs our paths (Psalm 119:105: Your word is a lamp to my feet and a light to my path). Jesus came into darkness and deadness – man’s heart – and as the Light He gave man truth as He is Truth and Light (John 1:3-5, 9-10; 3:17-21; 8:12, 31-32; 9:5; 14:6). He sent the Holy Spirit, the Spirit of truth to turn the light on in the believer (John 14:17, 25-26; 15:26-27; 16:13; Ephesians 1:17-19). As a result, believers minister to themselves! They turn from self and the culture’s mindset and ways. They rejoice. Change may occur slowly but it comes in and for the believer. It often occurs one thought, one desire, and one action at a time.
Believers minister to one another as well as themselves by reversing the paradigm so prevalent today. Instead of moving from the culture to the person and the Bible, believers must move from the Bible to the person. This sets all believers free! This requires a fundamental change in what you believe and why. Old patterns die hard. When faced with people complaining of bad feelings and feeling-directed behaviors, we must remember the person brings his whole self to the doctor and the counselor. He brings a mindset. Even believers bring a mindset that may or may not be steeped in biblical truth. Without this foundation, there will be no proper analysis of depression and feeling states.
Since the Bible is God’s powerful, purposeful self-revelation, the biblical counselor and Christian physician must begin and apply biblical truth to the whole person. Remember the one who speaks the loudest and most often gets the attention of people including believers. Jesus came in part to break that paradigm and set the prisoners free.
Biblical truth asserts that every person is a sensual (he takes in information through and by his senses), rational, and moral being. He interprets the data primarily in his inner man – his heart. As a result, he thinks, he desires, he feels, and he acts but in his whole person. Circumstances are the context for the expression of his whole person.
Considers these facts: every person is in relation to God properly or improperly and functions out of that relationship. Every person has some belief about God. God is Creator and man is creature, all of life is theological and every one is a theologian. The issue is what kind of theologian. Two main issues underlying depression are the person’s view of his lack of control and lack of sufficient resources. He has believed and acted upon his feelings rather than the Word of God. He is convinced that his feelings won’t let him. And why shouldn’t he? People have been persuaded that bad feelings “just are” and they preclude the regular and diligent application of biblical truth in their situation.
Biblical Analysis of Depression: Fourth premise: Progressive sanctification is a whole-person activity
A fourth premise for a proper biblical analysis of depression and feeling states answers the question: What does salvation and sanctification have to do with feelings, thinking, and behavior? Does the Bible speak about these topics? The answers are: EVERYTHING and YES. Biblical truth always and completely trumps man’s wisdom, especially that obtained by experience, feelings, and man’s autonomous human reasoning. Therefore, Christians, in order to appropriately minister to hurting, bad-feeling people, must use the Bible to correctly interpret what the culture has defined, described, and treats. The culture focuses on feelings and feeling-directed behavior. Ironically within the secular scientific community, the culture does not even agree on what an emotion is. And it does not tell us which emotions are broken in a so-called “emotional breakdowns”.
The Bible portrays real people with real problems. These include those with bad feelings. They are thinking and wanting people with resultant actions. As I have emphasized, it is vitally important to remember that thinking, wanting, and feeling are whole-person activities. In a so-called emotional breakdown truly emotions are not broken. If anything, the whole person and especially the inner person is full of activity. While it may be descriptive to say a person is emotional the term tells me that he is functioning based on his feelings. The term emotional doesn’t do justice to the Bible’s view of the whole-person. Rather it depicts the person as reacting according to his feelings. Those who take the emotional approach go to the Bible to “find” God’s emotions. I address this approach in various articles on website under psychology and medicine.
Moreover, when one takes the culture’s approach to so-called psychological problems, there is no real solution. There may be hope (but it is only a hope-so) that through drugs and psychotherapy of various sorts, people may feel better and therefore act better. But how are the terms better and help defined? Both are defined subjectively – by better feelings which may or may not lead to better function. Better is also define by the number of times the person uses medical facilities.
After taking medication, the person reports better feelings for whatever reason. He reports that he does not feel as if he is in a black hole; therefore he feels less depressed. The reality of his situation may not have changed but he has a different focus so he feels better. The same phenomenon may occur when the situation changes by God’s providence. The pressure or heat is off and therefore he feels better. In both cases, the person may act better because he feels better. The situations that were triggers for bad feelings and feeling-directed actions don’t seem to stimulate bad feelings.
However, the person has not changed; the situation has. He is still reacting to that which is outside of him. Both patients and counselees have told me that being on drugs lets them act the same way they did before taking the drug. However, they are not bothered by the situation or their reaction to it.
As I have said, when the secular definition for the diagnosis of depression is followed, feelings are the major diagnostic criteria and are the medical person’s authority and guide. Feelings are the target for diagnosis, therapy, and determining the success or failure of treatment. The question for the Christian medical community and biblical counseling is this: how has taking the secular and psychologized approach to people presenting with bad feelings helped the person grow in Christlikeness? My contention is that it has not and will not. Therefore I proceeded with a biblical analysis of depression and feeling states
Biblical Analysis of Depression: Fifth premise: the requirement of a proper definition
In our study and series: a biblical analysis of depression and feeling states, we are ready for a working definition of depression. I reiterate that definitions are critical in almost every endeavor (see premise one) including ours. However, there is a problem. The medical community already has a definition for depression which uses individual criteria for a diagnosis. It assumes that if the person meets “enough” of the criteria (a numbers game if you will), the diagnosis of depression is given. I repeat, the criteria are based on self reports of “bad feelings” and observed behavior that is feeling directed. These diagnostic criteria are allegedly based on science. A question arises. Should we as biblical counselors and Christian physicians work with the diagnosis or do we derive a diagnosis of depression from Scripture? The truth of the matter is that Scripture gives no definition of depression. (It does not give a definition of panic attacks, anxiety disorder, and anger disorder).
The medical community would like us to believe that the whole (the person meeting a set number of criteria) is greater than the sum of the parts (each individual criterion). By that I mean, if a person meets enough individual criterion the diagnosis is made. For depression, the criteria are descriptive and deals mostly with feelings. Other psychological conditions have criteria based on observed behavior. While the Bible may not give a definition of depression, it certainly addresses every individual criterion that is used to for the diagnosis of a specific “psychological disorder” as given in the DSM.
Moreover, the Bible describes people as they experience life (God’s providential ordering of their circumstances and situation). The Bible covers the whole range of the human experience. Therefore, it is more than reasonable; it is demanded that biblical counselors and Christian physicians begin with the biblical truth that the person is a duplex unit as discussed previously. Therefore, a “diagnosis” and solution for any person labeled as depressed must include data gathering regarding his wanting, thinking, feeling, and doing. A proper biblical analysis of depression and feeling states demands this conclusion.
Viewed from a correct understanding of the Bible’s teaching regarding the whole person, depression is predominately an inner-man activity. The outer man follows including the brain. It is certainly possible that changes may be found in the brain as a result of inner-man problems. If true that fact does not prove that attention is to be first and foremost to the outer man. Often the approach has been to take care of the outer ma and hopefully the inner man will follow. That is not God’s way.
Further, depression is a feeling state in which the person’s focus is on God’s providence in an unbiblical way. While denied, depression is a learned, habituated whole-person activity in response to God’s providence (life). Often the response is a patterned one. Moreover, because a person’s desires and wants are not realized (met):
• He gives in to his feelings (they become his authority and guide), and
• He disregards and neglects thinking, desiring, and acting according to biblical principles in varying degrees
• He functions less than God would have him in whatever situation God has placed him,
• and he does not properly apply biblical principles in a way in his circumstances.
I repeat: depression, so-called a psychological condition, is a whole-person activity with outer-man manifestations. This concept is one key for a proper biblical analysis of depression. These activities include thinking, wanting, acting, and feeling in both the inner and outer man. Thinking and wanting are self-focused; actions are in keeping with self-focus; and feelings lead the parade. Any definition that fails to consider man as a whole person and an image bearer of God will not include man’s thinking, wanting, feeling, and doing as part of the definition. That definition and its approach are not valid biblically and must be discarded. .
Depression is more than just bad feelings and feeling-directed behavior. The person labeled as depressed considers himself resource-less. He believes that resources are unsatisfactory and/or insufficient for him in his situation. In other words, at the core of depression is the person’s view of his lack of control and resources.
Given his circumstances, the person thinks and feels as if he is “under the circumstances.” His focus is on the circumstances. He views them as bigger than him. He is overwhelmed. He considers himself alone and adrift. For the believer as he lives out the lie, bad feelings and feeling-directed behavior follow his wrong thinking and wanting. Once considered to be the “controller” he finds that “things” (God’s providential ordering of his life) are out of his control.
It is good to remember that when things are not to their liking, people can and do depress themselves. This truth is vital to a biblical analysis of depression and feeling states. Thinking and wanting influence feelings and vice versa. The person labeled with depression brings a patterned response of thinking, wanting, and acting to every situation.
I remind you that this me-first, self-pleasing habituation is a legacy from prior membership in Satan’s family and kingdom. Dr. Jay E Adams referred to this phenomenon by a term not in use: pre-conditioning. He was referring to a patterned lifestyle of wanting, thinking, and reacting based on feelings which is the person’s major instrument for interpreting circumstances. Please remember the terms life, circumstances, and situations actually are manifestations of God’s providential control in His world.
In fact, those people labeled as “being depressed” are in a theological battle that centers on simple truths: God IS, they are, and they are dependent on His good and purposeful control. However, when depression is considered a physical problem the significance of the battle will be denied. This is not to deny the fact that man is a sensual, physical being – he does “feel.” Two points are worth noting:
• The Bible brings clarity to man’s true nature (see previous discussion including premises two and three).
• Feelings are connected to thinking and wanting.
Functionally those diagnosed with depression reject the above truths. Too often those who care for them do likewise. The “depressed” person is in an I-don’t-like situation. If a sinful I-don’t-like response follows, bad feelings result. A response to God’s providential ordering of each person’s life is a response to God. For those diagnosed with depression, that response is based on a wrong view of God, His goodness and purpose, self, and life. As a consequence, he sees himself “under the circumstances” and “trying to hang on”. This only leads to misery and more bad feelings.
Yet, so many patients and counselees, when presented with their reaction and the explanation described above, take offense (as do many physicians and counselors). They deny their improper vertical reference to God often claiming that they are victims to bad feelings, people, and life. But in reality their claim is against God and His good, purposeful control. Some counselors who emphasize the person’s suffering (what I call the “suffering model” of biblical counseling) may well think that the reasoning and interpretation of the Bible outlined above is uncaring.
Yet people train themselves to live by their feelings and consequently feel when they really mean think and want. The Bible calls for biblically-controlled thinking and wanting – the two are linked (1 Corinthians 2:16; 2 Corinthians 10:5; Ephesians 4:22-24; Philippians 4:8). Preeminently Jesus taught and modeled the truth that thoughts and desires are linked (John 4:31-34).
• The person diagnosed with depression should be encouraged to (and he should desire to) repent of using his feelings as his authority and guide and the resultant feeling-directed behavior.
• He should be tenderly and yet firmly encouraged to examine his view of God, self, and his resources. Having done that, he is to get busy pleasing God using the bad feelings as his and God’s instrument to please God. The mountain may seem too high, the hole too deep, and the tunnel too long but Jesus walked the same path with a vertical, eternal perspective and mindset. The believer can and will imitate Christ.
• Since as I have defined depression, medications are not indicated. You don’t medicate people for sin. Yet so many people will be on medications when initially seen. It is not my responsibility to stop medications. I want believers to tell me the reasons that led to the use of medications. I learn by gathering data. Unless thinking, wanting, and action has changed God’s way for His glory, coming off medications will only lead to a return of or an increase of bad feelings. The person, physician, and counselor will assume that biblical truth has failed.
Biblical Analysis of Depression: Conclusion
I close the series: Biblical analysis of depression and feeling states with a summary conclusion. We have learned that man is an inside-out person because of his duplex nature. He is a whole person who thinks and desires in his inner and outer man. People who present with bad feelings and feeling-directed behavior and a diagnosis of “depression” must be evaluated based on a proper understanding of biblical anthropology. When that happens the person will not be divided. Feelings and people’s response to them will not be the major diagnostic criteria for depression or the target for treatment. Rather, wanting and thinking will be evaluated using the grid of biblical truth.
Biblically-controlled thought processing will replace wrong thoughts and desires. The truth sets people free as they apply it to their situation. Of course, a person will demur saying “he can’t” because he feels “so bad.” You and I as Christian physicians and biblical counselors have heard that refrain so often.
The same mindset is expressed in any situation in which problems are perceived as bigger than the person and God. Some of those problems may be a hard-to-live with-spouse, boss, or neighbor. God is not in his thinking and if He is, He is only perceived as a pain reliever/analgesic. The root of the problem is the person’s thinking and wanting as a whole person. These express and flow the significance that the person places on his relationship with Christ. Help him redefine victory other than relief and removal from the situation. Victory, God’s way, won’t come until we view depression from a biblical perspective.