An Evangelical Free Church in Cary, NC

Book Review- The Suppression of Depression

A pastor friend of mine, Maurice Wright told me that his brother, an MD from UNC-Chapel Hill, wrote a book on depression. Since depression is part of my personal story and I am interested in helping people through depression from a Christian perspective, I got the book and read it in a couple of hours. (it is only 55 pages)

Marion Wright, Jr., MD wrote The Suppression of Depression in order to help Christians talk about depression in a constructive way in the church, rather than sweeping it under the rug or saying that it is simply a “faith issue”. He identifies the two main reasons people of faith, specifically people in Christian churches, tend to avoid addressing the issue of depression.

First, Christian people tend to ascribe depression to a “character flaw” or some kind of spiritual weakness on the part of the individual struggling with depression. This thinking can confuse a psychological, emotional, or physical problem with a spiritual one. Granted, there is a “faith” element involved when Christians struggle with depression, but telling someone who is in the midst of clinical depression they simply need to “have more joy” or “pray more” is overly simplistic.

Second, Wright identifies another reason people of faith don’t talk about depression: some people view depression as a God-ordained discipline or even punishment. Their thinking is that God has assigned them to this trial and that they should wait until the Lord takes it away from them. This approach misrepresents God’s motives (as if he intends to do us harm), and it also prevents someone from seeking help, because they may mistakenly think the solution is “all up to God”.

Add to these two reasons that Christians have an expectation, as well as scriptural teaching, which says we are to “be joyful always” , “hope in the Lord”, and the “joy of the Lord is our strength”, and you have a recipe for someone to slide into depressive thinking, “What is wrong with me? I should be happy and joyful!”

Wright is a physician who has seen people in a wide variety of circumstances and treatment, so he is quick to admit that depression is a multi-factor illness. That is, there is no one single reason or cause why certain individuals become depressed. Some may become depressed after the loss of a loved one or the loss of a job. Others may go through a traumatic event that can trigger depression. Some people may develop depression gradually over time due to a combination of high expectations of themselves, low-self esteem, expectations from parents, or other circumstances. Some may develop depression after the birth of a child (postpartum depression). No matter what the circumstances, here are the common symptoms of clinical depression: (more than 2 weeks long)

  1. Depressed mood most of the day, every day (also irritability in children)
  2. Loss of interest or pleasure in activities one previously enjoyed
  3. Weight loss or weight gain- major changes in appetite
  4. Lack of sleep, or too much sleep
  5. Overall loss of energy, slowing down every day
  6. Feeling of worthlessness, hopelessness, or excessive guilt
  7. Inability to concentrate and make decisions
  8. Recurrent thoughts of death or thoughts of suicide

So how is depression treated? For some people, simply changing their habits with regard to diet, exercise, and sleep, can be effective. But for most people, effectively treating longer-term depression involves a combination spiritual support, talk-therapy, and/or medication. God has made us whole beings, and therefore when treating any problem, it is useful to consider our soul, our body, and our mind.

For me, reading the bible and praying was much harder when I was in times of depression. I found a small book entitled, “Reading the Psalms in times of Depression” that helped a great deal. Another way I sought the Lord during times of depression was to make daily or weekly “thankfulness” lists of positive things or people I was thankful for. John Piper’s book, “When I Don’t Desire God” is a longer manual on how to “fight for joy” in times of depression, and was a useful resource. Although seeking God is more difficult in times of depression, I found that even if I did just five minutes a day of reading or prayer on a regular basis, it helped me through.

Talk therapy- either informal counseling, psychotherapy, or group therapy can help people in depression. There are various approaches, but the main goal of talk-therapy is to help someone express their thoughts and feelings, re-evaluate their circumstances and their thinking patterns, and then help them see their situation in a different light so that they are motivated to make a behavioral change. The challenge with someone who is depressed is that most or all of their thoughts tend to be a negative distortion of reality. Therefore, helping someone re-frame their situation and focus on positive steps is the goal of a good counselor. An emotional benefit of talk-therapy is that the person who is depressed feels less alone- he or she has an advocate, a safe person to confide in- which can lift some of the depressive feelings.

I appreciated how Dr. Wright addresses the issue of medication. For various reasons, people of faith seem hesitant to use medications for mental illness. Some may be afraid that medication will “make me less like myself”; others may have concerns over side effects. One common objection I hear to medication is this: since medications for depression target the brain, it is wrong for a Christian to use medication because we are to “take every thought captive to obey Christ” (2 Corinthians 10:5), therefore taking anything that alters our mental state inhibits our faith.

In response to that objection, I would say that we need to remember that our bodies are in decay because of sin, and every person’s body has parts that don’t work quite right. For the diabetic, their body doesn’t produce enough insulin. For someone with heart disease, their heart doesn’t pump as effectively. For someone with Chron’s disease, their digestive system is flawed and they may need supplements. Therefore, as a Christian I can certainly ask God to heal various parts of my body, but I also can make use of what God has provided in order to help certain organs function more effectively.

Dr. Marion Wright gives a simple illustration about the rational for treating depression with medication: on a wintry day when he was in medical school, his car would not start. The cold temperature had frozen the remaining fuel in his gas tank. His first thought was to pray- hoping that God would miraculously start his car so that he could make it to the nearest gas station. After a few minutes of not seeing his prayer answered, he heard a voice tell him, “You need to put gas in your car.” So, he hiked home, grabbed an empty juice bottle, and walked to the gas station to get enough gas to start the car. His point is this: It is not ridiculous faith to believe that God could start his car with only a small trace of gas in the tank, but the lesson he learned that day was that he needed to make use of what God had already provided in order to start his car. In the same way, he says, Christians can ask God for miraculous healing from depression. But they should also feel the freedom to seek out medical attention for any physical problem in which their body is not functioning correctly. (Wright says that it is unfortunate these medications are referred to as mind-altering or mood-altering drugs because that label tends to have negative perception.)

I’ll close with this paragraph from Wright’s book, which summarizes his basic point:

“The main point in all these examples is that God can utilize various methods of healing. Healing can occur with or without the intervention of medical professionals. Notice that Jesus did not scold the woman with the issue of blood for seeking help from physicians. Likewise, I believe today that people of faith should not be scolded for going to doctors no more than people should for seeking help from financial advisors or lawyers. After reading this chapter, I would hope that at least some readers would not be as quick to bring accusation against those that seek help for any health-related reason.” The Suppression of Depression, pg. 27