Understanding and Counseling Depression

 


I.   Looking at the state of the depressed person

II.  Consider root problems which cause deep depression

III. Biblical approach to anger to share in counseling

IV.   Faulty thinking patterns often cause depression

·         Thinking and depression

·         Attitudes and depression

·         Guilt and depression

·         Physiology and depression

V.  Some experience depression because of negative emotions

VI. Negative feelings are not to be ignored

 

 

The problem of Depression

 

Once thought to be a singularly adult problem, depression is a regular state for many teens and preteens. “Researchers and clinicians now concede that depression frequently occurs in children (Evans, Reinhart, & Succop, 1980; French & Berbin, 1979) and adolescents (Friedrich, Reams, & Jacobs, 1982; Seigel & Griffin, 1984; Teri 1982b).

 

While it is difficult to measure how many teens suffer depression, the findings suggest that a substantial proportion of young people are suffering from strong feelings of unhappiness and despair.

 

It is a complex and dangerous condition that often seems to defy description and definition. This is partly because people use the term depression to refer to different things; a general sadness, the blues, humiliation following failure, or a period of stress and emotional volatility.


I. LOOKING AT THE STATE OF THE DEPRESSED PERSON

 

A. A truly depressed person does not snap back when things take place, rather they -- gradually cease to function,

 

1. They withdraw from life and retreat into crushing dejection, guilt, and unworthiness.
2. They carry the world on their shoulders and find it very difficult to make simple decisions.
3. The attentions span narrows and they find it difficult to concentrate.
4. They cannot assimilate what others are telling them. They may be so preoccupied with self and personal problems they cannot give full attention to anyone.

 

B. At one moment he may be so depressed he may experience exaggerated mood swings and the slightest movement may agitate him, at other times he may laugh at anything hilariously. This outburst of laughter is really a facade or cover up for the inner true feelings. He may come to what some call manic depression.

C. The depressed person is often irritable and touchy and the least little thing annoys him. So taken up with self that outside interferences disturb him. This can degenerate to the place that he is totally unaware of what is happening around him. He also generally loses interest in his environment, possibly in his wife and children and idly sit. He may even sleep all week end, or contemplate suicide because life appears meaningless.

D. David described feelings of depression as:
A broken heart and the terrors of death, fearfulness and trembling, a crushing feeling of horror. He desired to fly away like a dove and be at rest. (Study Psalm 38.) God comforted David when depressed over the hatred of a friend. He comforted David, in time of sin, and used it to drive him to seek repentance and forgiveness. (Psa. 32, 38)

A person may be depressed because of the loss of a job, loss of a loved one, or financial or marital problems. But these are not the roots of the problem. They are contributing factors.

Physiological problems are not included in root problems, though they may exist. These contributing elements are merely predisposing factors and may help pave the way for depression which is actually brought about by the root problems.
Depression may be anywhere from slight at one end of the spectrum to very severe at the other end. Almost every person has at times been depressed to some degree. For many Christians it has been only minor or for a short period of time. As they applied Biblical truth their depression problem was cared for.

Back to the Top ^ 

II. CONSIDER ROOT PROBLEMS WHICH CAUSE DEEP DEPRESSION

 

A. Depression Is Often Caused By Internalized Anger. This is anger held inside the heart and thoughts.

 

1. Maybe the person has never verbally shared his anger but it is there. As anger is suppressed and thus internalized is grows until the person may be on the verge of exploding.

2. Anger destroys as it erupts in some

   a. physical problem (like shingles, colitis, heart-attack, etc.) ,
   b. personal reaction (like beating children, slapping wife, etc.),

c. ruining personal relationships or bringing physical disease or major personal problems.

 

B. The direction anger takes determines its rightness or wrongness, its hurt or damage or, felt or expressed.

 

1. Christ (Matt 23) was angry and used anger to drive them to repent and face sin.
2. Not all anger is wrong, every emotion is a gift from God to be under His  control for His glory. Damaging emotions are a result of sin.
3. It is not a sin to feel anger, maybe its the only thing that will cause us to do something about a problem.
4. Suppressing anger brings depression, destroys relationships, and brings psychosomatic disorders and suffering..

 

III. BIBLICAL APPROACH TO ANGER TO SHARE IN COUNSELING:

 

A. Anger is not sin, (Psa. 7:11 God is angry with the wicked every day.) Anger is not sin in itself, but can lead to sinful action. It is not wrong to be angry at sin.

 

1. It is wrong when it grows out of pride, and hurt feelings, etc.
2. It is wrong when it is expressed in sinful ways. (selfish desires)
3. It is wrong when it is destructive to others.

 

B. Anger is an emotion and every emotion God has given to mankind is good, however the emotion may be misused. Anger is an emotion designed to mobilize force to care for something. Energies of this emotion should be directed at the problem and not the person.


C. Anger should not be released hastily. (James 1:19; Eph. 4:26,27) But anger should not be held in for it will lead to wrath, bitterness, malice, desire for revenge, and then directly and indirectly it will produce depression.

We should release anger in accordance to Matthew 18:15-10. Be willing to forgive, and to forget. If we are wrong we must be willing to confess, forsake and reconcile. If anger is held inside it brings guilt, depression, ruins personal relationship which triggers more depression. It will bring physical disorders, and ruin the spiritual life.

D. Resolving anger can free us to resolve the problem that occasioned the anger in the first place.

E. Don’t try to resolve anger by ventilation, (punching a pillow, etc.).

 

1. It is much better to aim the response at the problem involved rather than to attack a person or an object.
2. Some counselors suggest getting it off your chest! Some people have ulcers and some give them.

 

F. Don’t be angry with the person -- but, if angry, may it be with his attitudes or deeds. And be very quick and willing to recognize your own shortcomings, sins, faults, and not just your brothers. Forgive quickly and fully!

G. Realize that many differences can be and should be overlooked. “Discretion of a man defers his anger, his glory is to pass over a transgression!”  (Prov. 19:11; 30:33; 15:1)

H. Any anger problem should be short lived, dealt with daily, immediately, if at all possible. (Eph. 4:26,27)

 

IV. FAULTY THINKING PATTERNS OFTEN CAUSE DEPRESSION.

 Is there hope for the depressed person? Is it something merely to be endured? Is it a result of sin or a trial to be put up with or an ailment like some sicknesses? Many feel that depression is a disease and seek to treat it as such.


NO, depression is not something to be endured or to be put up with as some chronic illness or sickness that has no answer. Rather it is something that can and must be conquered.

 

THINKING AND DEPRESSION 

 

A. Thinking is internalized sentences.

 

1. A person’s internal thought process will determine how a person will act and how a person will feel.
2. Events do not causes positive or negative feelings. Rather it is the attitude toward the event that will determine how a person feels and responds.
3. Actually it is our self-talk and belief system that determines our response to events, circumstances, and people.
4. The writer of Proverbs said, “As a man thinketh in his heart, so is he.” (Prov. 23:7). What is in the thoughts comes out in words and actions.
5. Renewal of the mind precedes behavior changes. Behavioral change will not last unless it is preceded by mind change. (Eph. 4:23; Rom. 12:2)

 

B. Problems must be dealt with on two levels -- behavior and thinking.

 

1. Tackling a problem only on the behavior level will only prove fruitless.
2. Thinking must be consistent with the Scripture.
3. Behavior will be an outgrowth of thinking.
4. If a person judges himself to be a failure, he (may) will perform on the  level of a failure and feel as a failure. This in turn can bring depression.

A man was passed over in a promotion and a position. He indulged in self-pity and introspection. He became very depressed as his thinking and attitudes brought depression into his life. Change or renewal does not take place or begin in the emotional or behavior center, but in the mental center.

5. The Christian counselor must challenge thinking as well as behavior.

   a. Wrong reasoning must be cast out.
   b. Wrong beliefs also must be challenged.

6. Proper behavioral patterns must be put on. This new pattern of living should be consistent with new thinking patterns.

 

ATTITUDES AND DEPRESSION

 

A. We must build positive attitudes.

 

1. Faulty thinking patterns must be identified for they build our attitudes.
2. Unless the counselee can see the wrongness of these attitudes and the devastating consequences, the counselee will not be motivated to change.
3. The counselor should take great pains in building a Biblical case for change.

 

B. Development of proper attitudes.

 

1. Build an attitude of praise. Phil. 4:4 Mental sins lead to physical problems. Proper thoughts lead to a healthy countenance, a relaxed mind and a merry heart. (Prov. 17:22; Phil. 4:8)

2. Build a practice of right praying. Phil. 4:6 We need to teach the counselee to pray biblically, how to pray, and the importance of a good prayer life.

 

  • Too often our prayers are nothing but a selfish pity party (for me, myself and I).
  • Paul gives the content for Biblical praying. (Phil. 1: 9-1; Col. 1:9-11)
  • Pray about everything and build a spirit of prayer (I Thess. 5:17).
  • We must supplicate and direct prayer toward God to resolve the problem for this will help us drain off damaging, wrong emotions.
  • Prayer should be aimed at resolving problems. Let God change you.
  • Pray with thanksgiving, for everything, for this will guard against self- pity.

    3. Build a practice of right thinking. (Phil. 4:8) We must learn to think Biblically. Maybe the person needs to make a think list of all that God has done. Go over that list daily, study why and the benefits of right thinking.

    4. Build a practice of positive living. (Phil. 2:13; 4:19; Rom. 8:28) Anchored in Christ we can be an overcomer. By living a positive life, resting in the Lord and His promises we can overcome. An overcomer is one whose fellowship with Christ is real.

    Right thinking leads to right attitudes, actions, behavior, and emotions.


 The counselor must help the person to identify the faulty thinking patterns that led to depression. We must expose these attitudes as sin, and inconsistent with Biblical Christianity. Unless the counselee can see the wrongness of the attitudes and devastating consequences he will not be properly motivated to change.

We must build a Biblical case for change. Consider Psalm chapters 73, 42, and 43. God requires the believer to battle the wrong thoughts (II Cor. 10:3-5) and requires right thoughts of the believer. Proper thoughts (Psa. 50:23) glorify God. Mental sins such as worry, complaining, etc., lead to physical problems and can bring depression as well.
Rejoicing in the Lord, and a practice of praise does make a big difference. Christian counselors should help counselees make thanksgiving a habit of life, and not live under the circumstances as a way of life.
God has everything in control; He is sovereign and will do right. Help the person to make a thanksgiving list for which to praise and rejoice.

 

GUILT AND DEPRESSION

 

A. Guilt is an emotion we experience when we violate our value system.

 

1. Our value system consists of those things we have come to accept as being true.

a. things from school, b. things from home training,
c. things from the impact of society, (Rom. 2:14-15)
d. things from Scripture as God’s Word convicts us.

Guilt comes from that written law that has been written on our hearts, or imposed on our hearts. Conscience gives assent to that written law. All people, no matter their culture, know guilt. Gentiles did not have God’s law, but had a law written on the heart!

 

B. Guilt is an attitude of condemnation and punishment.

 

    1. When the conscience is violated, guilt steps forth like a prosecuting  attorney, saying “guilty, guilty, guilty.”
    2. In several of the Psalms, David characterized his state well.  (Psa. 32:4; 38:3, 7, 8, 10)
    3. Guilt rises up in the mind screaming words of accusation.
    4. Guilt can be merciful or a destroyer. Guilt sent David to his knees and Judas to his death. After Judas acknowledged that he had betrayed innocent blood, he “went out and hanged himself.” (Matt. 27:4) His inner depression, guilt and pressure of wrong overwhelmed him as he did not seek forgiveness and reconciliation.

 

C. Guilt may manifest itself in a myriad of forms.

 

1. unconscious pay-off:


Guilt originally meant the payment of a fine for an offense with a desire to make personal atonement. It was to offer something in return for a wrong. It made the person no closer to God’s forgiveness though they may have felt they had a part in personal atoning for wrong. It was conscience money -- for example.

2. Blame shifting: As a counterfeit of real reason, the guilty one hides and shifts blame, such as Adam. “The excuse is a lie wrapped in the skin of a reason.”

3. Defensive aggression - Possible action of a teen as a smoke screen to cover guilt.

4. Attitudes of persecution

5. Extreme cleanliness -- such as continual washing or bathing

6. Free-floating guilt -- In this aspect a person has a lot of guilt and may not even know why... the result of many unresolved sin habits, sinful actions and practices.

Consider:

 

  • When a person violates his conscience or value system he experiences guilt!

  • Guilt is usually a major cause of depression.

  • Many Christians even feel they must offer a psychological offering that consists of frustration, anxiety, and guilt before they can accept God’s forgiveness or feel forgiven. They think that they’d feel better if they suffer some for sin.

  • They may well believe they must have feelings of depression as a result of their sin and wrong.

  • Depressed feeling of sorrow, anxiety over life-style, and fear about the future are often all associated with ongoing depression. Often this takes place because of the poor way the person has dealt with sin and wrong.
    A woman in apathy and depression did not desire to study the Word of God, or pray and did not enjoy spiritual things. She was resentful and bitter toward God for she felt God did not answer her prayers. She harbored resentment toward a family member (not shouting, etc., but fuming within). The faulty relationships with others destroyed her relationship with God.

 

D. Removal of guilt

 

1. Do not minimize guilt for the person needs to face its reality.

2. Confess sin. (Psa.32:5; 38:18; I Jh. 1:7, 9) agree with God about the sin.


Confession must be as broad as the offense. Thank God for His forgiveness whether you feel it or not; God forgives and forgets. Instead of extending your energy in psychosomatic suffering, use that energy to forgive, give thanks and move toward positive action.

3. Realign conscience with Scripture.


(James 5:16) A woman, for sixteen years unfaithful in her marriage, had tried alcohol, and other therapy to relieve her guilt and depression. We need to help people to face guilt, for like pain, it is an early warning signal which will help to save the person from self-defeating behavior.

 

E. Guilt versus bad feelings

 

1. If a person violates his belief system, he is still guilty. (Rom. 14:23) The guilt he experienced is still real.

2. Uneasiness or awkwardness is not sin. Many things could be distinguished as bad feelings over something... that is not sin. Guilt come from the deliberate violation of one’s value system.

3. When in doubt, don’t do it.

After you have Biblically determined that a certain practice or action is proper and there will be no occasion for another stumbling, then go ahead and do it. If done in good faith and on the authority of the Word of God, good feelings will eventually follow.

 

PHYSIOLOGY AND DEPRESSION

 

A. Physical and spiritual depression are not the same.

 

    1. Physical depression generally has an “organic base” or reason.
    2. Spiritual depression lies in the area of faulty Biblical responses.

    a. Spiritual depression can occur as much from ignorance as it can from  a willful violation of Scripture.
    b. Many depressed people cannot tell you why they are depressed, but when their behavior and thinking patterns are  scripturally examined, sins of omission are often discovered.

 

B. Extensive and intensive data gathering will real the problem (s).

All problems fall into one of two areas -- organic or spiritual. Spiritual problems can be broken down into two areas -- behavior and thinking.
Extensive data gathering brings all component parts into focus. Intensive data gathering is more narrow and “hones in” on possible clues in one area.
Generally there is no need to consider the physical until the areas of the
spiritual have been thoroughly considered.

 

C. Possible areas of exploration

 

1. Anger and resentment
2. Wrong beliefs such as, “I can never do anything right,” or “everyone is against me,” or “all anger is sin.”
3. Habitual areas of sin -- practices, thoughts, etc. (Masturbation, adultery, fornication, and an improper thought life.)
4. Procrastination, poor scheduling, slothfulness.
5. Indebtedness, poor financial management
6. Bitterness, malice, and desire for revenge toward some person.
7. Anger with God, dislike of one’s lot in life
8. Battles in marriage, practicing scorn, contempt, etc.

 

D. Physical causes of depression


 Physical causes of depression can set the stage for spiritual depression. It is
very important that the Christian counselor understands some of the disorders the physical body can suffer.

 

       1. Thyroid deficiency
       2. Hypoglycemia or low blood sugar
       3. Vitamin deficiency (or some mineral lack)

 

V. SOME EXPERIENCE DEPRESSION BECAUSE OF NEGATIVE EMOTIONS.

 All of us are subject to feelings and are low at times or more calm at other times. Every day we come into contact with things that effect our emotions. We can experience restless nights, arguments, marital problems, etc., which can begin a path of inward depression. There are a host of things that may arouse our emotions to tension or relaxation, to excitement or depression, which extreme depends upon our attitude toward the or person(s) involved.

WE ARE EMOTIONAL BEINGS, SO

 

A. The things we say, the things we do, and the things we think about produce feelings or emotions.

B. They are a blessing; they make us human.

     1. The problems come when we allow negative feelings to dominate our attitudes and dictate our actions.

    2. If we are held by the cords of our own negative feelings and allow them to dominate the life -- we will probably have a self-fulfilling habit and life of depression made by the forging of our own chains.

Back to the Top ^ 

VI. NEGATIVE FEELINGS ARE NOT TO BE IGNORED

 

A. They indicate a hidden problem.

 

      1. We can invite depression. We control our choice of feelings by controlling our thoughts and actions.

     2. Basic law of psychology is -- you feel as you think and act.

 

B. We are never commanded to be happy, but to praise.

 

    1. All this is a choice we must make daily.

    2. Note: We build habits of continued response that then become the conditioning for our responses in future things that touch our lives.

 

C. To Help the Counselee:

 

     1. Root out wrong thinking; medication is not enough.

     2. To get to the bottom of any depression related problem, make two lists;

     a. On the first list have the person write down their faulty responses to life.
     b. On the second list have the person write down responses God commands us to put in the place of the first list.

 

Illustration:
Old Habits and Patterns: New Habits and Patterns:

1. not submitting to authority                           1. subjection to all authority
2. lying                                                          2. truth telling
3. constant gripping                                        3. giving thanks in everything
4. anger, resentments                                     4. solving problems daily, facing anger
5. continued introspection                               5. involvement in life, get busy giving everything to God.
6. slothfulness                                                6. scheduling, goal setting
7. misuse of the body                                     7. proper rest, diet, etc.
8. negativeness                                              8. study God’s Word, note His faithfulness


 Some Major Steps In Overcoming Depression.

 

1. Recognize that most things that lead up to depression are sin habits. Recognize that he needs a new life in Christ.

2. Realize that the habits he needs to break are habits of sin against God and against himself. Whether poorly   organized time, drinking, procrastination, etc., all are sinful.

3. He must acknowledge that depression is harmful, displeasing to God, wrong, debilitating. Motivation must be biblical or change will not last. Habits of life must be seen as God sees them. We must face the need of change, that we are not the product of our own environment.


Depression is never the will of God and to continue to be in that state is never the will of God.

4. Help the counselee to believe that he can change. He can succeed in change, that God can give grace to keep and grace to lift up. Only faith can make the difference! He must believe in the infinite ability of the Creator to sustain and to give grace and strength.

5. He must acknowledge that depression is often the result of the sin of unbelief, that it is the opposite of trusting and rejoicing. Only by faith can we have victory. (Heb. 11) Faith is the only thing by which there can be victory for the drug addict, prostitute, the homosexual, etc,. Only by faith can they be transformed from the kingdom of darkness into the family of God.  Only by faith can the person find the release from the bondage of depression and break the old habits that squeeze life from his inner person.

6. He needs others to pray for him and to provoke him to biblical obedience. He should stay away from people who give the wrong kind of sympathy and encourage his self-pity, excuse making, brooding, or the neglect of responsibilities.
(Study I Cor. 15:33; Prov. 22:24,25; Heb. 3:12,13; 10:24,25 concerning the kind of companions he needs.)

7. Help him make a “think and do list” of profitable things he can think about and do when he is tempted to be despondent. (Consider Phil. 4:8,9)

 

  • Profitable things in activity when tempted to be blue,
  • Profitable things to think upon when tempted to be despondent,
  • Profitable things he could do for others.

 

8. Help him (her) make a list of responsibilities. Note which ones he is fulfilling well and regularly and also note those he has been neglecting or is prone to neglect because he does not feel like doing them.

 

  • Plan a schedule which gives him time to do all that he really must do,
  • Get busy and seek to fulfill these responsibilities,
  • Don’t focus on how bad he feels, or how he dislikes the task,
  • Focus on God, and His will,
  • Focus on God’s promises, blessings and provisions,
  • Focus on the help God gives to do what should be done in obedience,
  • Focus on God’s presence, care and grace. (I Pet. 5:7; Heb. 13:5,6; Heb 4:14-16)

 

9. Help the counselee make a list of 30 - 50 blessings that God has bestowed upon him in every area of his life.

 

  • Spiritual blessings
  • Material, or physical blessings
  • Family and social blessings
  • Financial and work blessings
  • Possessions and environment blessings
  • Community and housing blessings
  • Opportunities and encouragements from others

  • Consider Psa. 103:1-10; 68:19. The blessings are there, we need to be in the habit of seeing them, recognizing them and thanking God for them. Make it a daily practice to give specific thanks for particular, specific things. (Phil. 4:8; Psa 34:1; Eph. 5:20)

10. Maintain a regular practice of daily Bible reading and study, prayer and meditation.

 

  • Help him to plan his procedure: schedule a regular time for devotions,  and put his plans into action,
  • Keep a written record of what he gets out of his devotional time,
  • Ask some mature Christians for help in making them more profitable and seek immediately to implement what he learns and to share it with other people.

 

11. He should be taught to serve God and others in practical ways for many depressed people are moody, blue, listless, and doing little to help their problem.

 

  • Make a list of abilities and gifts to use to serve others,
  • Ask others to evaluate strengths and gifts,
  • Read Romans 12 and see where he fits into the picture,
  • Make a list of specific ways in which he can and will serve others,
  • Begin immediately to put that list into practice,
  • Keep a record for a little while of how he is serving the Lord and others.

 

Back to the Top ^ 

 

Depression Quiz