Who Should Treat Depression?
Clinical depression has been described as the common cold of mental illnesses. At times in my ministry I have wondered: who doesn’t suffer with depression or hasn’t at some point or other? The more open we are about discussing it, the less stigma we attach to it, the more we discover how common this ailment is. Unfortunately, its prevalence does not mitigate its pain.
The pain is not eased by those who see the ailment in a simplistic way as merely a spiritual problem with a spiritual cure. Even today there are Reformed believers who want to maintain the old view that a spiritual issue is the root cause of most (maybe even all) depression. This view insists that depression is directly caused by the sufferer’s sin and then the solution to depression rests in repentance. According to this perspective, pastors, elders, and regular believers, should call depression-sufferers to determine the sin which caused their anguish and turn from it.
Thankfully, other voices have been bringing a more balanced view. Among them is Dr. David Murray. His excellent book Christians Get Depressed Too (review here) proceeds on the basis that depression is a complex phenomenon often involving biological and medical realities. One might think that this is a contemporary approach, something only developed in the last few years. However, Murray points out that a nuanced view of clinical depression has been around for hundreds of years. William Perkins (1558-1602) recognized that depression requires medical treatment, and so did Jonathan Edwards (1703-1758).
Perkins and Edwards were not alone. I was recently paging through Peter Lewis’ The Genius of Puritanism. In chapter 3 (“The Puritan in Private”), Lewis has a discussion of mental depression. He notes that the Puritans distinguished spiritual depression (obviously caused by sin) from mental depression. They used the term “melancholy” for the latter. Lewis notes that Richard Baxter (1615-1691) and Thomas Brooks (1608-1680) both recognized melancholy as a medical phenomenon. I want to focus for a moment on Brooks and what he writes about this in The Crown and Glory of Christianity (found in volume 4 of The Complete Works of Thomas Brooks).
Brooks was addressing the question of why some Christians seem to be hard pressed with sadness, sorry, and grief. After all, shouldn’t Christians be joyful? Part of Brooks’ answer was to note that some of these issues arise from our bodies and the way we were constituted. Some people are constitutionally more inclined towards melancholy. He adds a vivid description of it:
Now there is no greater enemy to holy joy and gladness than melancholy, for this pestilent humour will raise such strange passions and imaginations, it will raise such groundless griefs, and fears, and frights, and such senseless surmises and jealousies, as will easily damp a Christian’s joy, and mightily vex, perplex, trouble, and turmoil, daunt, and discourage a Christian’s spirit (page 260).
He further says that this inclination towards melancholy can be used by Satan to his advantage. Moreover, it is a condition which afflicts both soul and body. There is definitely a spiritual aspect to the experience of depression, according to Thomas Brooks. In another book, he writes that this malady “tries the physician, grieves the minister, wounds relations, and makes sport for the Devil.” This surely sounds familiar!
Also familiar is the cure of which Brooks writes. He writes, “The cure of melancholy belongs rather to the physician than to the divine, to Galen than to Paul” (page 260). By “divine” here, Brooks means “theologian” or “pastor.” Galen (129-200 or 216) was one of the ancient pioneers of medical science. In our terms, Brooks was saying that depression needs to be treated by doctors, rather than by ministers. Certainly he would agree that ministers must be involved and can provide spiritual guidance as treatment is sought and provided, but at its roots this is a medical problem to be addressed by medical science. Did I mention that this was written in 1662? Yes, in those times they had a far different understanding of medical science, yet they were not averse to pinning a mood disorder on a biological cause.
If you were to encounter a brother or sister suffering from a brain tumour, you would encourage them rather than admonish them to examine themselves for the sin which caused their condition. Of course, we hold each other accountable for how we respond to medical ailments. Every Christian is responsible for how they respond to adversity in whatever form. Clinical depression should be dealt with in the same way. Those suffering from it need medical treatment — and Christian encouragement from office bearers and regular church members. In so doing, we reflect the heart and compassion of our Saviour Jesus.