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Depression: When It’s Time to Get Help

depressed man
To know if you're depressed, you first have to know what depression is.

“Since a true Christian has eternal life to be thankful for, the joy of Jesus in their hearts, and is a ‘new creation’ in Christ,” the deacon uttered rather condescendingly as several men stood outside the church in the parking lot, “he or she should never get depressed.” Mr. Deacon didn’t know I was a licensed professional counselor as well as an ordained minister.

“OK then,” I mused, “since the same ‘true’ Christian has the helmet of salvation as part of the armor of God, he or she should never get a concussion or traumatic brain injury either, right? Both are ‘just in your head.’ Right?”

No response. I expected that.

Clearing the Fog

Depress de-pres (verb); compound word; de = not, down, against, negative; press= press, push, force against.

Mood mood (noun); a state of mind that is expressed in emotions such as: feeling sad, despondent, dejected, disheartened and/or gloomy.

Disorder dis-or-der (verb); compound word; dis = not, no; order = organized, operating the way it was designed, lacking confusion and chaos.

Depression de-pres-sion (noun); the state of being depressed.

So we can say depression is when the brain is pressed down by force … to the point where it becomes out of order … and ends up operating below the normal level of its ability.

What Is Depression?

Clinical depression is not “feeling moody.” Nor is it an indication of a wavering walk with God. It’s a medically substantiated brain condition. For clinical depression to be formally diagnosed, there has to be a number of specific physical and physiological symptoms collectively present for a period of time: Diminished interest in things normally interesting, insomnia or desiring to sleep too much/all the time, diminished ability to think clearly and concentrate, just to name a few.

Once you brain is pressed down to the level for it to be formally diagnosed with depression you can’t “pull yourself up by your bootstraps” and get better. Besides, you most likely won’t know it and won’t have the energy to fight it even if you did know. Outside assistance is necessary in the form of a medical evaluation, lifestyle changes, getting out of a bad or harmful relationship or circumstance, therapy, and/or medication.

It’s in Your Brain

The brain is heavily laden with layers of interconnections that depend on a dynamic balance of hormones and neuro-transmitters to function smoothly. Any number of things can press down on the brain to cause an imbalance.

A simplified way to look at depression is in terms of: Is it situational or life-long?
Situational depression can be caused by any number of events: Living in a domestic violent relationship, overworking the brain to the point where the chemical and neuro-transmitter levels get out of balance, or the cumulative effect of stressors that becomes overwhelming. This kind of depression is brought on by a specific situation or at a specific time where circumstances become overbearing. It can be intense and debilitating. It will end — if treated — and sometimes even if it’s not.

Life-long depression is what it says it is: life-long. And it may be caused by deficiencies in the brain from birth, experiencing physical or mental trauma — especially trauma to the head (concussions, traumatic brain injuries, closed head injuries, etc.) or the effects of abuse of drugs (illegal or prescription) to name a few.

The brain is functioning below the normal level it’s designed to and is genetic, brought on by a medical complication or some situation that leaves a permanent damaged impact on the brain and its ability to function fully.

So you tell me how a consistent devotional time will restore the chemical out of balance that’s in your brain.

It won’t, and unless God miraculously heals your brain, life-long depression has no end and must be looked at differently. Your goal is to “manage” the depression rather than trying to “get over” it. Lifestyle changes, a healthy diet and exercise are parts of the management plan. Therapy may also be beneficial. Often medications are needed for a chronic state of depression — augmenting the brain with the chemicals, neuro-transmitters and/or hormones that are permanently lacking.

“So can a true Christian suffer from depression?”

Well, can a true Christian suffer from a traumatic brain injury? Yes.

“Well, can depression be a psychological and a spiritual ‘state of mind’?”

Also, yes.

Active sin may be the situation that pressed down on the brain causing depression. Repentance is what will heal the strained relationship you have with God; it does not, however, heal the pressed down, imbalance of neuro-chemicals, out of order brain.

To summarize, you can have spiritual problems without having depression, depression without having spiritual problems, or depression and spiritual problems together. Discernment and an accurate assessment are critical to determine which it is.

Don’t trust online quizzes to accurately diagnose depression. Don’t ignore friends’ concerned comments to get a medical evaluation. Don’t try to “get over it” on your own. And don’t trust your own ability to assess whether you’re depressed or not.

Be clued in. Be alert to depression if you: have a family history of depression, are more introverted, creative or perfectionistic in personality, or are left-handed (yes, really). Take any head injury seriously. Make sure you’re getting enough sleep. Be aware of how you’re feeling if you’ve had three or more major life-changing circumstances in a 12-month timeframe. Get help early if you suspect you may be depressed.

Action Steps

1. Start with talking openly to a friend, a family member or a minister about what and how you’re feeling. This is also a good time to do a spiritual inventory of your walk with God and research depression and its symptoms.

2. Next, get an evaluation from a medical doctor.

3. If medication is suggested, consider it and/or seek a second opinion from a psychiatrist since they specialize in mental health issues.

4. Finally, if the second opinion suggests a medication regime, consider cooperating and get into therapy with a clinical professional.

Medication for situational depression is designed to help your brain become un-pressed down and un-out of order so you can address the “issue(s)” that generated the depressed state in the first place. This is the time and place to confront any issues that arose from your spiritual inventory. The goal is to get your brain well again to handle life’s situations on its own. Then you can consider getting off the medication and/or ending therapy. reports about 70 percent of persons with clinical depression recover fully with effective therapy.

Medication is necessary to assist the brain’s ability to keep the chemicals in order and balanced thereby managing the life-long depressed state. In this case, therapy helps address the frustrations, disappointments and emotions around the permanency of the depression and teach skills that assist in managing it in order to maintain as normal of a life as possible.

You can be involved in therapy without being on medication. If you are on medication, however, it’s extremely important to also be in therapy. Be forewarned: What oftentimes happens is when the medication begins to work you think, Oh! I’m better and don’t follow through on therapy. Add in the fact that therapy is expensive, time consuming, sometimes awkward and takes effort, you may be tempted to pick the medication-only path, which will work. It will ensure your dependency on the medication indefinitely.

Yes, it is all in your physical biological head. So do both: Take care of your spiritual soul and be sure to take care of your biological brain as well.

Copyright 2014 Focus on the Family. All rights reserved.

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About the Author

Tim Sanford

Tim Sanford is a licensed professional counselor with over 20 experience as a clinician.  He is an author and a member of the Focus on the Family counseling team.

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