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By Dr. Lisa Steiner
When I initially accepted Jesus as my Lord and Savior, I did not believe that a Christian could suffer from depression. After all, the Bible is filled with many scriptures on joy: “But the fruit of the spirit is…joy” (Galatians 5:22, NKJV); “in your presence is fullness of joy” (Psalm 16:11); and “my soul shall be joyful in the Lord” (Psalm 35:9).
Scripture clearly supports that God’s desire for His children is to experience joy. However, in reality, many Christians do battle and suffer from depression. One just needs to continue reading in the book of Psalms and ponder passages such as Psalm 69:20: “Reproach has broken my heart, and I am full of heaviness; I looked for someone to take pity, but there was none; and for comforters, but I found none.”
As the director of a New Jersey and New York-based counseling center leading a team of 18 licensed clinicians trained at integrating the Christian faith into professional counseling, I am hoping to begin to demystify depression in the Christian community.
In the fifth edition of the Diagnostic and Statistical Manual (2013), the American Psychiatric Association explains that a major depressive episode occurs when there are symptoms that “cause clinically significant distress or impairment in social, occupational or other important areas of functioning” that are “not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).” Furthermore, depression consists of at least five of the following nine symptoms that “have been present during the same two-week period and represent a change from previous functioning” where “at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure:”
- Depressed mood most of the day, nearly every day for adults. For children and adolescents, it can be an irritable mood instead.
- Significant reduction of interest or pleasure in nearly all activities, most of the day, almost every day
- Substantial weight gain or weight loss (when not dieting), or a substantial change in appetite almost every day. For children, it could instead be a failure to reach expected weight gains.
- Difficulty sleeping or too much sleep almost every day
- Observable feelings of restlessness or being slowed down
- Energy loss or fatigue almost every day
- Feelings of worthlessness or excessive or inappropriate guilt
- Indecisiveness or reduced ability to concentrate almost every day
- Recurrent thoughts of death and/or suicide either with or without a specific plan or prior attempt (Paraphrased from APA, 2013)
What can a Christian do when he or she or a loved one suffers from depression? Seeking God first through prayer and Scripture is always a wise strategy. After all, God is omniscient and omnipotent; He can provide direction and/or divine intervention. Second, if the symptoms are moderate (e.g., affecting functioning in social and/or occupational settings) or severe (e.g., suicidal thoughts with or without a specific plan), seeking professional help is essential. A collaborative working relationship with a licensed therapist (e.g. psychologist, counselor, social worker) might be all that is needed to alleviate the depression. Licensed therapists must meet rigorous state-approved educational and experiential requirements; therefore, they have been trained to facilitate the treatment of depression. For example, they can help the individual: (a) cope with the feelings of depression; (b) recognize and improve thought patterns and beliefs that might be contributing to the depressed mood; (c) set firmer boundaries with unhealthy relationships and situations; (d) seek connections with emotionally safer people; (e) improve interpersonal approaches; (f) reduce relational conflict; and/or (g) appropriately grieve a loss.
When the depressive symptoms are more severe, a psychiatric evaluation (conducted by a psychiatrist or psychiatric nurse practitioner) is necessary to further evaluate the individuals’ mental health needs and determine if and what medication should be a part of the treatment plan. Unfortunately, many Christians fear and/or reject the possibility of medication. However, we need to remember that our earthly bodies are mortal. Sometimes a season of medication may help replenish the depleted brain chemicals (neurotransmitters) in our mortal bodies that affect our moods. However, because there is no readily available blood test to accurately measure the level of neurotransmitters in the brain, medical doctors (MDs) have to prescribe based on a patient’s symptoms. This unfortunately has created a stigma and misunderstanding regarding the medication used to replenish neurotransmitters.
Meanwhile, if an individual had been suffering from an underactive thyroid (hypothyroidism) where his/her thyroid gland was not producing enough chemicals (known as hormones), the corresponding symptoms could mimic many of those associated with depression. However, there is a blood test to determine if the thyroid chemicals are depleted, and then the MD prescribes a medication to elevate them. There is no stigma because the diagnosis was based on a blood test. Yet unfortunately, there is not a blood test to diagnose depression, and many Christians do suffer from it. Not only do they have to battle with the corresponding mood disorder, but they often have to overcome the fear and stigma associated with pursuing the treatment needed to get the relief they so desperately deserve.
Dr. Lisa Steiner, Ph.D., LPC, LMHC is the director of Wellsprings Counseling Center, LLC (www.wellsprings.org), leading a team of 18 licensed counselors in Northern NJ, New York City, and Orange County, NY.