One of the most dangerous attitudes I encounter is one which is almost intrinsic to depression: isolating self-pity. Now, most of us engage in this from time to time, and a little “licking of one’s own wounds,” so to speak, it not always a bad thing. But when it leads to the sort of isolation which defies the comfort extended by friends and family, it is a bad thing indeed. And when it goes further than that—and it regularly does—it can become implicitly (if unintentionally) blasphemous in quality.

Myth #1: It won’t happen to me.

As for me, I said in my prosperity,
“I shall never be moved.”
By your favor, O Lord,
you made my mountain stand strong;
you hid your face;
I was dismayed. (Psalm 30:6–7)

Overconfidence may not lead directly to a fall or to depression, but being overconfident hardly prepares one for either. David appears to have expected his spiritual “prosperity” to continue unbroken—the sort of “I’ve finally arrived” attitude that many of us may have experienced briefly before learning that, no, life usually doesn’t continue in an unbroken vista of “personal peace and affluence.”¹

Even the achieving of those dubious goals does not (thankfully) fully protect us from the “slings and arrows of outrageous fortune.”² It is better to expect what we are promised in Scripture in the form of unwanted and (hopefully) undeserved suffering. Otherwise, we risk being surprised by that very thing about which we have been repeatedly warned (1 Peter 4:12).

Depression can be quite as fiery a trial as any other, and will be if we imagine that we “shall never be moved.” The good news—outlined explicitly in this same Psalm—is that God does indeed hear the cry of the afflicted, and he does answer those cries with deliverance that ends with mourning turned into dancing and songs of praise. Even if I do not experience depression myself, thinking that I avoid it because it is impossibility does not equip me to be particularly sympathetic towards those who do suffer. In fact, very many people are significantly depressed at some point in life, sometimes as a result of serious medical illness, sad circumstances, or for no apparent reason at all. If we are led into the suffering which Scripture promises, we must trust God to lead us through it in ways of his choosing.

If we are led into the suffering which Scripture promises, we must trust God to lead us through it in ways of his choosing.

Myth #2: It’s all in my mind.

Well, if you happen to be a disembodied spirit, maybe so. I’m inclined to say that our minds are (presently) all in our bodies. Show me a mind without a body, and I’ll show you a body without a mind. Who we are is defined by what we are: living souls (1 Corinthians 15:14). While spirit and body may be distinguished, they cannot (at least in this life) be separated (James 2:26). References in Scripture to their separation (as opposed to emphasis on one aspect of ourselves) do, as far as I can make out, refer to the afterlife (e.g., 1 Samuel 28, which describes the unlawful summoning of Samuel from his “rest” after death by Saul). Now, there are synonymous as well as overlapping terms in Scripture for heart, soul, spirit, and mind, yet entire theologies have been based upon eisegetical renderings of that single verse in Scripture which references “spirit and soul and body” (1 Thessalonians 5:23) as if it were an anatomy lesson rather than the comprehensive benediction intended by Paul!

So what? Well, for starters, if you are depressed, it usually affects your body in terms of sleep, energy, appetite, and sense of well-being. On the other hand, sometimes depression is an effect of poor bodily health in one or more ways. A quick example is untreated obstructive sleep apnea. This condition, especially in severe forms, degrades sleep in terms of both quantity and quality. Much of the night is spent actually waking from sleep and falling asleep again and again, so that what is known as sleep efficiency is very low. In addition, the actual sleep itself is shallow and non-restorative. If you’ve ever gone without sleep for an extended period, you will realize how miserable it makes you in almost every way: concentration is poor, judgment is impaired, fatigue slows down action, and irritability rises. And this is for non-depressed individuals.

Our minds are “housed” in our bodies and not disconnected functionally or mechanically from them. We tend to “sense” ourselves as being centered in our “heads” but, when we face unexpectedly sorrowful news, our “hearts” ache and our center seems to have somehow shifted. Our brains and the other aspects of our selves that think and feel and know are all part of one body. The reason that Paul could use the body as a metaphor for unity as opposed to division when discussing the church is that the body really is a unity. One.

Myth #3: I definitely don’t need medication.

“That medication made me feel like a zombie!” is the most common complaint I receive from patients entering my care from treatment elsewhere. Undoing a bad experience with medications can be a challenge and my initial response is to offer assurances that my salary is not based on how much or even whether or not I prescribe medication, and that I do not own any pharmaceutical company’s stock.

I go on to say that medications are not always indicated, and that I have in my career done a substantial amount of un-prescribing of medications that were either a poor fit for a patient’s symptom profile or were prescribed in doses higher than necessary or in combination with such a large number of other medications as to make it difficult to know which was doing what, in terms of both intended effects as well as unwanted side effects. I advise that it is as important to avoid taking too little medication as it is to avoid too much. If none is indicated, then any is too much. However, it is also true that if any is indicated, then none is too little. “Just the right dose,” as my mentor³ used to say, is what is needed.

This book presents 17th-century pastor Richard Baxter’s wise, gentle advice to comfort and strengthen all who struggle with depression or know someone who does.

I continue by stating that medication is very often helpful and regularly necessary for recovery from depression, though it is not—alone—as often sufficient for it. Other interventions are commonly needed as well. For example, Cognitive Behavioral Therapy (CBT) is a formalized approach to identifying false assumptions, modifying them, and then testing the new assumptions through changes in behavior. As powerful as CBT has proven to be, properly undertaken, it is a rigorous and sometimes very difficult treatment. Many individuals require medication before they are able to engage successfully in CBT, in order to establish a platform of affective (i.e., emotional) stability which can be positively exploited via CBT.

But reluctance to taking medication is quite common and hardly new. I think it helpful to consider medication as one of the several means which God may use to bring about healing. Can God heal by direct intervention with no intermediary? Certainly. He does. Are we free do demand that he do so? Certainly not. There are too many Scriptural examples of God’s use of means to bring about healing, and while I do not imply that each is a form of medication, some are.

1. Francis A. Schaeffer, How Should We Then Live?: The Rise and Decline of Western Thought and Culture, L’Abri 50th Anniversary Edition (Wheaton, IL: Crossway, 2005), 11.
2. Hamlet by William Shakespeare.
3. George E. Burch, MD (1910–1986).

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