Depression: Is Depression Real?

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Christ Alone and the Hope of Salvation

People are tired of hearing nothing but doom and despair on the radio. The message of Christianity is that salvation is found in Christ alone, and any who reject Christ therefore forfeit any hope of salvation, any hope of heaven.

The issue is that humanity is in sin, and the wrath of almighty God is hanging over our heads. They will hear his words, they will not act upon them, and when the floods of divine judgment, when the fires of wrath come, they will be consumed and they will perish.

God wrapped himself in flesh, condescended and became a man, died on the cross for sin, was resurrected on the third day, has ascended to the right hand of the Father, where he sits now to make intercession for us.

Jesus is saying there is a group of people who will hear his words, they will act upon them, and when the floods of divine judgment come in that final day, their house will stand.

Whether Depression Is Real and What It Means

Welcome to Bible Bashed, where we aim to equip the saints for the works of ministry by answering the questions you're not allowed to ask. We're your hosts, Harrison Kerrig and Pastor Tim Mullett, and today we seek to answer the age-old question, is depression real?

So Tim, why don't you start us off by answering that title question, is depression real or is this just some boogeyman that we've all made up in our own minds?

Yeah, well this is definitely one of those questions that I get on a regular basis, and normally it's coming from maybe a church member if I've been speaking to issues related to psychology or speaking to issues related to sanctification in general on some of these topics like this that are off limits.

And so if I'm trying to give some sort of biblical response to ADD and telling people how to glorify God and honor Him with their actions or something along those lines, with many of these psychological disorders, people will come up to me and they'll basically say, so you don't think depression's real, do you?

That kind of thing. And so that's the common question I get, basically. So you're trying to say it's not real.

You think we're all just making this up, right?

Yeah, pretty much. And it's one of those questions that's pretty interesting because it's the type of question that I don't really know how to respond to. So they say, you don't think it's real, do you?

And then my follow-up question to that is, well, what's it? What are we talking about? So they're saying depression, you don't think, is depression real? And the problem there is that essentially what that question reveals is there's a different question that they're actually asking.

And so when someone asks a question along those lines to someone like me, what they're asking is essentially, and they're not wording it this way, but what I'm typically trying to do is I'm trying to encourage people to take responsibility for their depression.

And so whenever I'm trying to get people to take responsibility for that and to turn from these feelings of despair or hopelessness or try to give them some sort of biblical answer to that, essentially this question comes about, and the assumption behind it is essentially, so you're saying that there's no such thing as a medical problem called depression which functionally isn't the person's fault and they can't do anything about, essentially.

Does that make sense?

Yeah, yeah.

So what they're trying to ask me when they're asking a question like that is they're basically somewhat scandalized by the fact that I don't believe that there is like a quasi-medical illness called depression, which is totally not their fault.

But what I'm not trying to deny is the reality that essentially people are, they do have crippling despair or hopelessness. I mean there's obviously a lot of people out in the world who have despair and who are hopeless and they are hopeless or they despair to such a degree that it becomes crippling and they refuse to take care of the basic issues of life.

So there's no disagreement on the reality that there are people who are dominated by despair and there are people who are dominated by hopelessness and excessive guilt and shame and everything else to such an extent that they are unable to function in life.

And those people obviously exist. I mean one in five women right now are taking antidepressants in order to deal with life. There's obviously many people who have despair problems who have hopeless problems.

But then the issue is where does it come from? Does that make sense? What's causing it? So what is the cause of these feelings of despair or hopelessness or guilt and shame and everything else? And that's, you know, psychology does have an answer to that.

And then I think the Bible has a different answer to the source of that. And that's where the discussion is. Like what is the source of this despair that characterizes so many people, if that makes sense.

Yeah.

Defining Depression: Clinical Criteria and a Biblical Definition

Now we're going to be talking about depression a lot in this episode, obviously. And so it might be helpful, Tim, just to kind of give us a solid definition for depression.

What are we talking about?

Yeah, so we're all kind of on the same page. Because I think this is kind of a word that really just gets thrown around in so many different ways. And probably even in ways that most secular people might disagree with.

You know, I know so many people who just flippantly kind of say, oh, I'm just depressed. You know, but then they're not even really facing depression in the way that the secular person might define depression.

So it seems like there's just not a uniform use of the word in our society. So maybe just give us a definition so that we all know what we're talking about throughout this episode.

Yeah, I think that's the very difficult thing to do is to try to define a word like this. Because there's a sense in which everyone and I say it's difficult, but there's different approaches. And I'm going to try to explain why it's difficult.

Because this is the type of word that I think everyone in some sense intuitively at the very least knows what depression is. So everyone knows what we're talking about. Everyone has some experience with these ideas of sorrow or despair or hopelessness or guilt or shame.

Everyone knows what you're talking about. And then at the same time, the problem is the word itself. It describes such a wide range of phenomenon that it's hard to nail down what an individual is talking about when they say that they're depressed.

I mean, I don't go into that kind of when I hear someone say that, I basically kind of assume I have no idea what they're talking about. In order to make myself ask more questions to figure out what they're talking about, I mean, I have a good idea, but I don't want to read my understanding of that word into what they're saying, actually.

But then part of what you're saying is that there is this it relates to just kind of it's become this pop psychology kind of word that people can use for a wide range of phenomenon, right? So, like, let's say that you're going to Taco Bell or something like that.

And the nacho fries have been taken off the menu, right?

Right.

That triggers my depression.

You get to the drive-thru.

All right, man, it's just some fries.

Menu change, right? But then, you know, you're just you're so depressed because, you know, you're tired. So, I mean, you can it could be used in as trivial of a way as that, right? I mean, it could be used as the menu item that you have been dreaming about and fantasizing about for the past few days or whatever is just gone.

You know, they took it away. They didn't even notify you. But that kind of thing. So, I mean, it can be something like that. You know, it could be an individual whose you know, her parent died recently.

And so they're having trouble moving on. You know, they're having trouble knowing how to function. They're in, you know, that dazed, disoriented, shell-shocked kind of state. And they describe it as they're depressed.

You know, now that would be that wouldn't be, you know, a clinical definition of the word as far as that goes. But then what I'm trying to say, though, is in common usage, you have a word like this that is in common usage could describe a whole lot a lot of range of different things.

Does that make sense?

Yeah.

But then go ahead.

No, no.

I was just going to ask you now that we have that, what is the what is your definition of depression that you're operating on?

Yeah.

Well, I guess, you know, maybe I have a definition of depression, but maybe it's helpful just to talk about the clinical one first.

Okay.

And then contrast mine with that, okay?

Okay, yeah.

So, when you think about, like, what the clinical method of diagnosing depression essentially, you have basically a list of criteria in the DSM that is going to be used to evaluate a person's thoughts and behaviors.

And so, essentially, you know, in order for someone to be categorized as having depression, essentially, in a clinical sense, basically what you need is you need five or more of the following symptoms to be present during the same two-week period and represent a change from previous functioning, okay?

So, five symptoms. You need five of the following, essentially, to be categorized as having depression, okay?

All right.

So, of these, you need a depressed mood or loss of interest and pleasure. Like, at least one of them has to be a depressed mood or loss of interest and pleasure. But then here are the, essentially, eight criteria, and you need five, okay?

Okay.

So, basically, you need depressed mood most of the day, nearly every day, as indicated by your subjective report, meaning you feel sad or empty or made by other people's observation of you, if that makes sense.

So, like in children, you know, they can have an irritable mood, and you can look at that and observe that. They may not be able to communicate that, but that can count, essentially. So, depressed mood every day for a two-week period.

Does that make sense?

All right.

Marked diminished interest and pleasure at all or almost all activities most of the day, nearly every day. And this can also be indicated by, you know, your own subjective account or someone else looking on the outside.

So, depressed mood, diminished interest and pleasure. The third is either weight loss when not dieting or weight gain, okay? So, fourth, either you sleep too much, you sleep too little. Five, psychomotor agitation, meaning you look slow.

You know, you look and this has to be observed by other people, that you appear to be moving slower, you appear to be, you know, weighed down, that kind of thing. And then you have, like, fatigue or loss of energy nearly every day.

Feelings of worthlessness or excessive or inappropriate guilt. And then, diminished ability to think or concentrate, indecisiveness nearly every day, you know, either made by you or others, and then reoccurring thoughts of death or suicide.

So, basically, you need, like, five or eight of you need five of these symptoms for a two-week period, you know, at least every day. Does that make sense? And so, it has to be a change from how you normally function.

So, that's kind of a clinical diagnosis that and one of the things you'll notice about that is that nothing medical is happening at all in that kind of diagnosis. You're just asking people questions about their thoughts and behavior, right?

Yeah, it kind of sounds like the, you know, when you're talking to kids, they get hurt and you ask them, how bad it hurts on a scale of one to ten.

Right, right, right, right.

Very subjective.

Right.

Now, what that tells you, though so, you're asking me what my view of depression is. Well, you kind of have to deal with, like, psychology's view. So, psychology's view I mean, this is described as a mental illness, right?

So, and the way it's determined is by talking to people about, you know, their subjective impressions of their thoughts and feelings, as far as that goes. And then some of them have some sort of check on it.

You know, it has to be observable by others. But, I mean, like, it's like, there's nothing scientific that just happened there, right?

Right.

But then the end result of that is that this is considered, basically, a mental disorder. And in the minds of most people, it's basically considered a, you know, quasi-medical illness, right?

Mm-hmm.

So, when someone says they have depression, essentially what they're saying is that It's almost like as if they're saying that they suffer from or they're suffering from depression. I mean, it sounds very much like the same kind of medical language as someone would say, I'm suffering from cancer or something along those lines.

Right, right.

So, basically, you have this quasi-medical category that feels like it as if it's representing some kind of organic problem in a certain way that basically has to do with guilt, despair, and hopelessness.

Does that make sense?

Mm-hmm.

Right.

So, but then, you know, what the way I would describe it, you know, what do I I'm going to look at these same things and try to give a biblical definition of this or give some sort of put that language into biblical terms, right, as far as that goes.

And so, I would describe depression as a debilitating mood, feeling, or attitude of hopelessness, which becomes a person's reason for not handling the most important issues of life. Does that make sense?

So, notice how that kind of definition puts personal responsibility on the person itself. So, it's a debilitating mood, feeling, attitude of hopelessness, which becomes the person's reason for not handling the most important issues of life.

So, when a person is so, I'm describing clinical depression in that way as a decision to give in to this despair or hopelessness or give in to these debilitating moods to the point where you just refuse to handle life anymore.

Does that make sense?

Mm-hmm.

So, that would be my understanding of what depression actually is.

So, like, something that basically causes you or, I guess, maybe tempts you to just say or shirk all of your regular responsibilities. Is that what you mean?

I would just say whenever a person, like, is so dominated by guilt, shame, hopelessness, or despair that they choose to quit handling life, I would say that, okay, you know, you might That's what people are describing as depression.

Does that make sense?

That's what people are describing as depression or you are describing as depression?

Well, depression is not a biblical term. So, I don't have any vested interest in

Yeah, there's no. Thou shalt not be depressed.

Right, right. So, it's not a biblical term, but so, you can't just say, well, here's what the Bible says, you know, depression is. What I'm trying to say is, like, what that clinical definition of depression is describing is describing the kind of situation where a person is so weighed down by guilt, hopelessness, and shame that they refuse to deal with life.

And so, like, the classic depressed person in the clinical sense is the person who, you know, they haven't taken a shower for three weeks or something like that. They're laying in bed all day long, right?

They are they, you know, they're just curled up in a fetal position, unable to move, don't want to they stop going to work. They stop taking care of themselves. They stop so, basically, they basically just wave the white flag of surrender and said, I give, uncle, right?

Right.

And so, that's the classic depressed person. But so, what I'm trying to say is, you know, how I understand what's happening is that, like, depression is the excuse that the person gives for not handling their life, right?

So, they're blaming their decision to not move on with life on this word depression, right, itself instead of, you know, actually handling their life as far as that goes.

Okay.

So, in other words, the secular world is kind of using this term depression to sort of recategorize certain aspects that the Bible does actually talk about, but then try to, I guess, maybe repurpose the words to almost be something else that essentially takes the responsibility away from the individual?

Yeah.

Let me give you an example of this. So, I mean, I did counsel. I counseled a guy. We're going to call him Richard, just for the sake of protecting the guilty. But, you know, he was a 28-year-old guy.

And this is not uncommon. I mean, I can give you plenty of stories like this, but this is just one I use on a regular basis. But, I mean, there's a guy, Richard, 28 years old. He's living in his parents' house.

And, you know, he spends all day long playing video games. You know, he doesn't have a job and everything else. You know, he says he doesn't have a job because of his ADD, okay? He can't hold down a job, but he can concentrate all day long on his video games and everything else.

But then, you know, he comes to counseling, and you say, well, why are you coming to counseling? And then the answer is because he's depressed. Does that make sense? And so then if you try to encourage him to, you know, read his Bible, if you try to encourage him to go out there and get a job, you know, he can't do that.

Because he's depressed. Do you see what I'm saying? So this label, in the way that people are using this label, this label becomes the excuse, the all-purpose excuse to not actually live a productive life.

So they blame it on the depression, right? But then, like, so then if I say, well, the Bible commands, the Bible basically says, you know, if a person doesn't work, don't let them eat. And then, you know, give them scriptures that apply to their situation.

They don't want those, and they say that they can't follow those things because they, I don't understand. You know, I just don't understand. What do you not get? I have depression. I can't do all this.

And so in that way, depression does become the club that's used to banish all personal responsibility. Does that make sense?

Yeah.

Yeah.

Medical Claims, Chemical Imbalance, and the Brain

Now, you talked a lot about people viewing depression as an illness. And you mentioned, you know, the doctors really sort of arbitrary. I don't know. Is it doctors or is it psychiatrists who you're going to, who are going to run those tests on you?

Yeah, there's significant overlap at this point. I mean, someone, we've been teaching this at the church. And someone came up to me today, essentially, and told me that they went to the doctor because they were experiencing some, you know, physical pain.

And, you know, when you go to the doctor, you have to fill out like a questionnaire, essentially. And, you know, of certain things that you've, your medical history as far as that goes. And one of the things you check on that is have you ever, you know, experienced depression or something like that.

And so this individual, they went to the doctor and they checked, you know, yes, I've experienced depression before. But then the doctor, essentially, they didn't run any medical tests on this person.

Zero medical tests were run. But then the doctor just assumed in some, I mean, they just asked him a few subjective questions about their thoughts and behavior. They didn't even go through the whole list, you know.

But then the doctor concluded without running any medical tests whatsoever that they had depression and that they were going to be put on antidepressants. And then, you know, the person from our church essentially saying, hey, I don't feel depressed.

I used to be depressed. I'm not depressed anymore. That's not happening. You know, but then they were basically, no, you are depressed. That's what's happening. And here's the antidepressants. I don't want the antidepressants.

But that's essentially, yes. So that's kind of what's happening. There's, like, these categories have been, you know, collapsed as far as that goes to where now doctors are prescribing antidepressants for everything.

I mean, that's part of why, you know, 20 of women are on antidepressants. And, I mean, if you're a person who doesn't know how to interact with that kind of discussion, and you have a doctor you're supposed to trust who's just telling you you have depression, and that sounds very much like you have some sort of medical problem.

It sounds like you have a medical illness. Then, you know, a person can go into that. I mean, I prepared church members to go into those situations and to know the kind of to have a thought process to understand what's actually happening.

But, I mean, you can imagine a person going into that and being told by a doctor, you have depression. Here's the antidepressant. They're like, well, I don't feel depressed. But the doctor knows best, right?

Here's your drugs, you know, as far as that goes. But there's yeah, I mean, on a regular basis, that's kind of how these things are worked out, and these diagnoses are being made without any medical tests being performed at all, you know?

Yeah, it seems like, you know, like if you break your arm, you're going to go in, and they're going to take an x-ray of your arm, and they'll either be able to see some kind of deformity in the bone, or they'll see that the bone is perfectly fine, and then they'll be able to tell either the arm is broken or it's not broken.

But then that doesn't really seem like what's really going on here. But then, you know, I have heard a lot of people say before, hey, so there are actual physical explanations for depression. One of the more popular ones being, you know, chemical imbalances in the brain being a cause of depression.

So what are your thoughts on that?

Yeah, you know, the chemical imbalance theory is a theory that is essentially really being abandoned by the secular academy at this point. And it's one of those theories that really is almost impossible to prove.

And so it's the kind of thing that is basically when you think about this discussion in general, one of the things that you realize is that there's basically a chicken and egg problem that's happening as it relates to this discussion.

And so one of the things that you see when you read through the Bible is that David is, you know, David says when he keeps silent about his sin, his body wastes away, as far as that goes. And so the Bible also says that envy makes the bones rot.

And so one of the things that you realize is that there is a connection between the mind and the body, meaning our physical state at times does affect our mental state at times does affect us physically even.

So, you know, if you're weighed down by I mean, everyone knows what it's like to be weighed down by guilt and shame and condemnation. I mean, you could give yourself a stomach ulcer by worry and stress.

And, you know, stress manifests itself in very physical ways in the body itself and affects bodily processes and everything else. And so the question about depression is one of it's a chicken and egg kind of discussion.

It's, you know, what comes first. Related to like the chemical imbalance there, let's just assume for the sake of argument that there is some sort of chemical imbalance in the brain that is related to depression.

Well, one of the questions you might ask is, well, which comes first? The despair and the hopelessness or the so does despair and the hopelessness produce like a chemical reaction in the brain or is it vice versa?

And there's no way to really figure that out through science. Does that make sense? Now, that's one problem with it. But then another problem with it is I mean, there's many problems with the chemical imbalance theory, which is why people are chucking it.

But, you know, another problem with that is that no one who goes to the doctor is having the chemicals in their brain being tested to determine the appropriate amounts. Because they don't have some mechanism to drain all the chemicals out of the brain to figure out, you know, is there enough serotonin and everything and all that.

So no one's doing that. Like they're not running any medical test. And so there's no way to know what the appropriate amount of chemicals actually are. And there's no way to know how much chemicals are actually in the brain as far as that goes.

It's a theory, you know. And now it's a theory because and one of the reasons why this theory became popular is because one of the things you realize is that chemicals do affect us, obviously. So chemicals affect us.

So if you for instance, I mean, if you put a bunch of alcohol on a person, alcohol is going to affect a person's thoughts and behavior. So you can put chemicals in a person's body. You can put you know, give them hallucinogens and that's going to do something.

You can put alcohol in a person's body, which is depressant. That's going to do something. Like there's all caffeine's a stimulant. That's going to affect the way a person thinks. Like if you drink enough caffeine, you're going to feel jittery.

So the fact that chemicals influence us doesn't mean so like if I drink a lot of caffeine, no one would assume and then all of a sudden I feel jittery and I have more energy. Or something like that.

No one would assume that I have some sort of, you know, energy deficiency or something. Caffeine deficiency in my body or something along those lines, right? So no one would assume that. I mean, no one but then like the theory has been that if you basically give someone a tranquilizer with an antidepressant or something like that, the assumption is, well, then, you know, that has to correspond with some sort of deficiency in the brain.

But then I mean, obviously, yeah, you give someone a tranquilizer, that's going to affect them. That's going to tone down the feelings that they experience. But that doesn't mean that they were missing, you know, certain chemicals in the brain that they need.

It's just to say that that's going to affect them to some degree. But the thing is with the chemical imbalance theory, this is really largely like bad science at this point. I mean, it was bad science to begin with, but most people aren't really going there.

But then that hasn't really caught up to people in a popular level. But then one of the things that's happened, though, related to that kind of discussion is that people are starting to realize that these antidepressants don't work.

And that they don't perform in clinical trials statistically much better than a placebo. And that they have a lot of side effects. And then there's a lot of people who are just tired of being drug addicts, man.

And so, you know, a lot of the like people are still you still have 20 percent of the women who are on antidepressants. But we're turning to other things now like diet and nutrition because there's a lot of people who are just sick of it.

They're sick of being drug addicts. And it's really kind of a hopeless thing. I mean, you put someone on a pill, they're going to be on a pill forever. They're stuck on it. It's not like you're going to come off.

And then if you do try to come off, it's what happens is if you do try to come off of an antidepressant because your body is so chemically dependent upon it, then you feel crazy, right? And all that does is kind of reinforce in a person's mind that you need the drug.

But that's not actually what's happening. What's happening is you become chemically dependent on this substance now. And so now you can't even function without it. But they do mess with people in a very significant way.

I mean, to the overall question though, I mean, you know, is depression real? I mean, there is, you know, certainly people who are hopeless, who are given over to hopelessness, who are given over to despair, who are filled with guilt and shame.

The question though is one of, you know, etiology is one of origin, like what is causing it. And so is there some biological mechanism that is causing it or is it essentially a spiritual problem? And that's where the discussion needs to go.

And so, you know, I would say that by and large, most of what we're talking about when we're talking about depression is our spiritual issues essentially.

Why Christians Embrace the Medicalized View

Okay, so yeah, basically like moral issues that require us taking responsibility in some way. Is that what you mean?

Sure, yeah.

Okay.

So if that's the case then, why does it seem like even Christians are opposed to that idea and they subscribe more to the idea that depression is just something that we're left to deal with? You know, like it's a virus attacking the body as opposed to an actual moral issue that we need to take responsibility for.

Yeah, we all like to blame shift. So, I mean, if someone comes along and gives you an excuse to just give up, right? If you have a ready-made excuse just to roll over and not handle life anymore, a lot of people will take it.

So, I mean, I know many people who just, I mean, life's hard, you know. Life is difficult. It has challenges. And, you know, you got to work every day. You're underappreciated. Can't get that promotion.

You know, having trouble getting married. Want to get married. Want to move on. You're stuck in a dead-end job. You know, you look at your life. It's not what you want it to be. There's no hope. You know, maybe you're stuck in a bad marriage.

I mean, there's plenty of people. I mean, life's hard. It's difficult. It has challenges. And, you know, sin has infected the world. So, I mean, obviously, if someone comes along and tells you that you can just give up, there's a lot of people who will take them up on it.

So, I mean, part of it's that. I mean, it does provide an all-purpose excuse just to not only to just give in to despair, but to gain moral sympathy from everyone around you for giving in to despair and all that.

So, if you have some sort of—if you get that label, then everyone expects that that person will be shown sympathy and basically coddled at that point. And there's a lot of people who will take it. I say we have a stunted view of sanctification in the church, too, to where we haven't really taught on these things.

And so we really don't know how to deal with these kinds of issues from a biblical perspective. We don't know what the Bible says on that. We don't really have a whole lot of experience and or help when it comes from the church in actually dealing with what's going on in our heart as far as that goes.

And then you're living in a world that basically doesn't know—has a competing worldview with the Bible, which psychology is, which is basically just brainwashing everyone to think that this is a medical problem.

I mean, all the language we use to talk about this problem is medical language. I mean, you can watch infomercials on TV, are you suffering from depression? But if you say that enough, I mean, that's the way we—it's demanded in our society that you speak that way, right?

So it's demanded that you use that kind of language. And if you use it enough, people get brainwashed into thinking that this is an illness, because we're using the same kind of language we use for cancer, right?

I mean, one of the most offensive things I do, and it's really not very offensive, is if I'm dealing with someone who says that they're so depressed. And I think I may ask a question like, well, why do you think you're having so much trouble rejoicing in the Lord right now?

Or something like that.

What are you talking about? I didn't say I had a problem with rejoicing in the Lord. I said I was depressed.

Yeah, right.

Aren't you listening?

Well, why are you choosing to give in to your despair, you know? In this way, you know?

And then you get a two-star review on Yelp or something.

Yeah, I mean, it's just—but I mean, if you don't speak that language, if you just change the language in a simple way to language that's more related to moral accountability, I mean, you just—people are just incensed and enraged at you.

But, I mean, we have to speak about these things in moral categories. We can't just keep on using the victim language, but the more we use the victim language, the more it's reinforced in people's mind that this is an illness.

And so part of it's that. I mean, part of it is also that because one in five women are on antidepressants, everyone knows women who are on antidepressants right now. And so there's other problems in our society that you're not really allowed to confront a woman about anything.