Ever since my early 20s, I’ve struggled on and off with anxiety and depression. In the last few years, the struggle has become particularly acute. I often wake at 4:30 am and pretend that it’s just the call of my bladder, but I know it isn’t. I know that as soon as I wake, I won’t go to sleep again. My body feels tired—like I’ve been running in my sleep—and my brain whirs away like the hard drive on my computer. I wake up with a thousand questions in my head—none of which seem solvable—and, at times, I’ve been so exhausted, I’ve just curled up in a ball on the floor and cried, wondering if the emptiness will go away soon. I have suffered mainly from anxiety, with periods of very low mood thrown in for good measure.
From talking to others, I know that my experience is both common and unique. It’s unique in that the symptoms of depression and anxiety vary from person to person—some sleep too much, rather than too little; some stop eating; some eat too much; some become suicidal, and some don’t. And yet I know my experience is common because the statistics say that the general incidence of depression and anxiety (D&A) has grown out of control in our society over the last 50 years or so.1
The question God’s people need to ask is “What do the Scriptures have to say to those who are depressed and anxious?” It’s an important question—both for those who struggle with D&A and for those who wish to love their brothers and sisters who struggle. My aim in this article is to explore what the Bible has to say to those who have D&A. But before I do, I want to acknowledge some of the complexities involved.
Talking about D&A raises the issue of the interrelationship between our psychology and physiology. We know that our minds and our bodies are connected. How we think directly affects our biochemistry, and our biochemistry has an impact on the way we think. But our biochemistry is not just affected by how we think; exercise, sleep and diet all have an impact as well.
So the debate continues to rage about how much D&A are illnesses (hormonal/chemical imbalances that lead to distorted thinking and feeling) and how much our thinking and feeling lead to the hormonal/chemical imbalance that marks D&A. The reality is our biochemistry and psychology affect each other in complex but profound ways. For some people, the issues are largely cognitive; for others, they have a much larger biochemical component. For this reason, it is vitally important that if you are someone struggling with D&A, you seek medical help. This article is no substitute for a professional diagnosis.
However, I think that it is equally important to point out that D&A can’t be sealed off in a medical compartment from which God is absent. Because God addresses all people, the word of God applies just as much to those who are depressed and anxious as those who are ‘healthy’. So how are we to approach D&A biblically?
What follows is not a complete biblical or theological study of the problem, but a set of scripturally informed reflections on being depressed and anxious in light of my own experience. I’m not saying anything here about the importance of diet, sleep and exercise—all of which I have found important in controlling my tendencies towards anxiety and depression. My concern here is to talk about some of the fundamental issues of D&A and how they relate to living the Christian life. I pray that they will be useful to you.
The same gospel for all
I want to begin by observing that the gospel applies to the depressed and anxious person the same way it applies to the emotionally healthy person. We are all sinners in need of forgiveness who find our only hope in the life, death, resurrection and ascension of the Lord Jesus Christ. True life for all is found through repentance and faith in Jesus (cf. Acts 20:21; Rom 10:9-10).
This is important because it sets the framework for thinking well about responding to D&A. You can’t have Jesus as Lord without having Jesus as saviour, and you cannot have Jesus as saviour without having Jesus as Lord. So as we think about struggling to live the Christian life as someone who experiences D&A, or about encouraging and supporting those we know who suffer in this way, we will only think rightly when we think in light of the one true gospel, which saves all people.
Let me explain why this is important. When we see our friends and family members wrestling with the guilt and deep sense of responsibility that nearly always accompany D&A, our instant reaction is to minimize their pain. There are lots of ways we can do this, but one of the crucial ones involves minimizing God’s expectations of the depressed and anxious Christian. When they feel cut to the heart by something that was said in a sermon, we feel tempted to say things like, “Oh, that doesn’t really apply to you in your current condition”. We say this out of good intentions, but it is ultimately unhelpful.
When the depressed and anxious person reads, “Owe no one anything, except to love each other, for the one who loves another has fulfilled the law” (Rom 13:8), they know full well that these words apply to them. These words apply to all who belong to Jesus. What they need at that moment is not to be told something that is patently false (i.e. “God’s word doesn’t apply to you”), but to be encouraged to think about how these words really apply to them in the light of the fullness of God’s revelation in Christ.
This approach helps us in two ways. Firstly, it permits the healthy acknowledgement that our depressed and anxious brothers and sisters also sin. They need to keep hearing about the fullness of the forgiveness available in Christ. Secondly, it helps us find good biblical reasons why their understanding of how to apply particular verses may be wrong. It is true that they will sometimes feel guilty for things they are not guilty of, but the way to deal with that is not by giving glib answers, but by explaining the word of God prayerfully. False ways of dealing with sin and guilt will never truly help or heal.
At this point, it might be helpful to explain what this looks like in practice. Take a friend of mine who suffered from bipolar disorder. In his worst moments, he would say and do completely socially unacceptable things. Those around him understood that he wasn’t entirely in his right mind, and they made allowances. For example, they didn’t take everything he said seriously. But they didn’t just let him do whatever he wanted to do; they challenged him to control his behaviour, and asked him to do what was right. Later, when his conditioned improved, he needed to acknowledge the wrong things he had done, and try and deal with some of the relational damage he had created.
I think these principles are generally applicable for most depressed and anxious people. Their condition doesn’t absolve them of all responsibility for their actions, even though those around them will make allowances for their reduced capacity at times. Exactly what this means in each individual case requires a great deal of wisdom from God, and we won’t always get it right. But I think the principle is important. Much of what we know about D&A tells us that in spite of the reduced capacity of the sufferers, their cognitive processes still have a significant effect on their functioning.
For example, it is an accepted fact that religious involvement significantly decreases the likelihood of suicide. A recent Canadian study suggests that this decrease isn’t just because of the increased social support resulting from being part of a community.2 Even when a person’s depression is at its worst, their character and beliefs affect how they act. A depressed person still has the capacity to accept responsibility and to act in light of their beliefs. This is not to ignore the fact that depression affects people’s thinking, but rather to point out that depressed and anxious people are still responsible for their actions, and that their thinking still affects their decision-making.
A conversation with another Christian leader a few years ago highlighted this for me. I was aware from a number of personal conversations with him that he had struggled deeply with depression, although he has never told me so explicitly. With tears in my eyes (I was struggling quite a bit at the time), I asked him how he managed to persevere in public ministry, despite his struggle. His answer (also with tears in his eyes) was “sheer stubbornness”. The more I go through life, the more I understand what he was saying: he was determined, by the strength the Spirit provided, to cling to the goodness of God and to do what was right, no matter how uncomfortable or painful his own emotional state.
So the gospel speaks to the depressed and anxious person about their personal responsibility and about the nature of life in God’s world. But it is also the key to dealing with their feelings of guilt and failure.
Guilt, failure, self-understanding and the gospel
One of the most widely experienced aspects of D&A is a profound sense of guilt and failure. Again, the gospel speaks deeply to us here. The assurance of God’s love is grounded in the objective reality of the cross, not in religious performance. Without trivializing the condition or being flippant, the depressed and anxious person, their friends and their family need to work at wrestling with the goodness of God in the gospel sensitively and carefully. The gospel is the answer to guilt and failure because it is the only way we can experience forgiveness and cleansing for all our sin and guilt, and because it provides a healthy framework for self-understanding.
Firstly, the gospel is the only way to perfect forgiveness. We know that God forgives us and loves us because of Jesus’ death for us, and we know that his forgiveness is complete and total. If there was any other way that sins could be forgiven, would God have sent his Son to die for us? God loved us so much that he sent his one and only Son to die on the cross to forgive his enemies (John 3:16; Rom 5:8, 10). That is why there is no condemnation for those who are in Christ Jesus (Rom 8:1).
The problem for the depressed and anxious person is that these truths feel like they’re a million miles away. What the person who has never struggled with D&A often finds hard to appreciate is the level of mental and emotional effort required to think about these truths in relation to your own problems. In the depths of D&A, just fighting to believe that Jesus’ death is enough can feel like more than we are capable of. And while we know in theory that God works in us, often we feel like our prayers bounce back off the ceiling.
But I want to encourage those who are depressed and anxious to persevere with the spiritual discipline of believing God’s word. While it can sound a little stark putting it like this, there is an element of unbelief involved in clinging to our guilt in the face of God’s declaration that we have been forgiven. One part of repentance and faith is accepting the truth of the word God speaks to us. So when God says, “There is therefore now no condemnation …”, our job is to accept that that is true, even if our hearts cry out against it. It is in the gospel of Jesus, not through our circumstances and emotions, that we know the love of God. One of the challenges for the depressed and anxious person is to grapple with the reality of God’s love, even when it feels unbelievable.
Similarly, friends and family will best serve the depressed and anxious person by reminding them graciously and patiently of the fullness of God’s love revealed in the death and resurrection of Christ. However, it is important not to be doctrinaire, authoritarian or glib. This is best achieved by showing them that you can see and appreciate their pain and their sense that the gospel doesn’t really apply to them. That said, we must not minimize the gospel out of fear of appearing pious; God has promised that in Christ, we find all we need for life and godliness (2 Pet 1:3).
One of the things God has used in my own struggles is the responsibility that I have had for ministering to others. For me, it is often much easier to see how the truth of the gospel applies to others than to me. I have found it helpful to ask myself (and to have good friends ask me), “What would you say to someone else if they were struggling with the things you’re struggling with?”
The gospel is the only grounds for finding forgiveness and acceptance with God. But it also helps us by giving us an external framework for healthy self-assessment. One of the things that I have observed both in myself and in many others who struggle with D&A is that the worse the condition becomes, the less objective our self-perception is. For example, in church, we might hear that a new baby has been born. Our first response may be to think about serving the new parents. And so, even though we have been unable to cook meals for our families over the last month, we still feel burdened by responsibility, and think, “If I don’t cook this family a meal this week, I will have failed in my obligations to God’s family. I will be the worst Christian in the world.” Our responses are completely out of proportion to the situation.
This is where the gospel framework for healthy self-evaluation becomes important.
Firstly, the gospel comes to us in the context of our createdness: God addresses us as his creatures when he calls on us to worship his son. God didn’t create us in such a way that we need to be superhuman to worship him appropriately; to love God with all your heart, soul, mind and strength (Mark 12:30) is not a call to become something you aren’t.
Understanding this helps us counteract the spiritual calculus many of us perform to assess our godliness. In a world where employers constantly seek a competitive edge, we are trained to think of the value of life in terms of productivity. But the kinds of personalities that are more naturally prone to D&A tend to turn this into an ideal for Christian living: we must squeeze more and more ‘value’ out of ourselves for Jesus’ sake. This is not biblical thinking; it’s the root of asceticism.3 If I skip lunch and dinner, and read my Bible 14 hours a day for the next three weeks, will I grow in godliness? I very much doubt it.
The gospel teaches us that we are not machines, we are creatures, and in our creatureliness, we cannot work out with any certainty the various values of individual actions. If we think we can identify and accurately calculate the fruit of our labours, we fool ourselves into thinking we are God. God knows what will happen tomorrow; we don’t. Do you know whether that encouraging thing you say to your friend will change his life or be forgotten five minutes later? Is laughing with your kids in the backyard in the 20 minutes before dinner more or less worthwhile than making another phone call to a Christian brother or sister in distress? Are you better off spending two hours a week reading the Bible with two people or half an hour a week reading the Bible with eight people?
God’s word teaches us that he has intentionally hidden much of the future from us (cf. Ecclesiastes). Why has he done this? To teach us to be humble before him (Eccl 3:9-14). God’s word critiques the perfectionism that goes hand in hand with much of D&A. As a creature, I am called to worship him with all that I am. But I am not called to become something I am not. We are relational beings made in the image of a relational God, and we dwell in his world. It’s a world full of singing, dancing and feasting, as well as labour in his service. God says very clearly that asceticism is not a Christian virtue (1 Tim 4:1-5). In fact, teaching asceticism is sin! The application of modern management practices to the Christian life ends in ungodliness because it results in the maximization of things that can be quantified—like hours spent, sales made or products produced. But godliness cannot be quantified in any absolute sense. At least in part, this is because it is a matter of the heart.
Secondly, one of the key words God uses to describe the Christian life in the New Testament is ‘freedom’ (2 Cor 3:17; Gal 5:1, 13; 1 Pet 2:16). Some of the implications of our freedom are worked out in places like Romans 14 and 1 Corinthians 8-10. In many areas of life, two different Christians, when facing the same set of circumstances, can make entirely different but equally God-honouring decisions. Paul’s words are particularly important here:
The one who observes the day, observes it in honor of the Lord. The one who eats, eats in honor of the Lord, since he gives thanks to God, while the one who abstains, abstains in honor of the Lord and gives thanks to God. (Rom 14:6).
God in his grace evaluates our use of our freedom according to our intent.
Let me illustrate the point. Sometimes I arrive home from work and am greeted at the door by one of my kids, who proudly shows me a picture they’ve drawn for me. What I never do is sit them down and explain the 10 things they could have done to make it a better drawing. Instead, I give them a hug and we enjoy the picture together. God is like that with us: as we prayerfully seek to serve him, through the death of Christ, he takes pleasure in our obedience. He does not sit in heaven calculating how we might have done more.
My instant response to this (especially when I am struggling) is “But I don’t want to be lazy”. This reasoning is almost impossible to rebut, because no sane Christian should counsel another to be lazy. But unfortunately my desire to avoid laziness often results in a distorted picture of godliness. When the desire to avoid laziness results in other forms of disobedience, I am still being ungodly. (My problem with responsibility, explained in the next section, is a prime example of this.)
In summary, the gospel teaches us that God is God and we are not. We will not grow in godliness by squeezing more productivity out of life, but by learning to obey the word of God in all its fullness. The gospel teaches us that we are free in Christ, and challenges our perfectionism at its heart.
But a healthy framework for self-reflection comes not just by reminding us of the fact that God is God and we are not, but also by inviting us to deal with the issues of our hearts. As uncomfortable as it is, God wants to know what is in our hearts, but often what is in our hearts drives us towards D&A.
A repeated pattern in my own life has been to delay rest and take on responsibility until I reach a point where I fall apart. When it gets to the stage when I can no longer function, then I have a legitimate excuse to say no to things and find space for recovery. Somewhat perversely, my external appearance of godliness (I was always doing good things) masked a deep ungodliness: I wanted to say yes in order to feel good about myself—partly because I just got a kick out of doing things (it made me feel useful), partly because I knew other people were watching (and I wanted to impress them), and partly because I wanted to make a name for myself. Of course, in saying yes to a number of publicly visible responsibilities, I wasn’t accepting all my God-given responsibilities: relationships with my immediate family suffered, my wider ministry also suffered when I got to the point of falling apart, and my godliness suffered at every point along the way.
But each of these issues is addressed by Jesus. What I needed (and, indeed, continue to need) is an understanding of who I am in Christ. I have found Matthew 6 profoundly helpful in this regard: Jesus’ teaching about prayer, giving and acts of righteousness are all directed at ensuring that we have right hearts, and the key to having a right heart is learning to play to an audience of one. The only good reason to act in righteousness is to please our Father in heaven. This is helpful because it reminds me that I am truly doing good when I am aware of all my responsibilities and am seeking to fulfil them, even if many of them remain unseen by others. God cares about whether I am being godly in all of my life; he knows whether I am chasing the pleasure of men or his good pleasure.
That is why I am now very wary about immediately answering anyone who asks me to undertake a significant commitment. I know that my overwhelming desire to please the one asking and to feel the pride that goes with undertaking a visible and important task drive me to say yes. But space for prayerful evaluation allows me to reflect on whether my commitment to the task will actually be good for my godliness and the godliness of others. Delaying my response nearly always results in a better decision.
In a world oriented towards personal pleasure and fulfilment, I need to understand that what is truly good is faithful service of God. In Christ, we see that our lives are for the glory of God. There is only one opinion that matters. The pride of my heart is humbled by the knowledge that I am not and cannot be God—that I cannot be superhuman—that I am reliant on God for his forgiveness and grace every day of my life—and that even what I achieve is achieved through the strength and action of God. Only the gospel can bring the required humility to assess ourselves rightly.
Your experience of D&A may well be different to mine. However, I am persuaded that these principles apply to us all. We must keep asking ourselves “What does the gospel say about who I am before God?”, “Where do I look for my significance and importance?” and “In what areas of my life do I need to repent in order to truly serve God with my life?”
I have been persuaded that while at times my thinking and behaviour have been outside my normal control, my D&A is largely rooted in who I think I am. And I know that before God, it is only through Jesus Christ that I will understand myself rightly and learn to serve him and others better. I expect that I will struggle on and off with my tendency towards D&A for the rest of my life, and there may well be times when I am not thinking as clearly as I am right now. But I pray that God will keep leading me back to Jesus so that I can find hope and the ability to change in the face of all that he brings to pass in my life.
1 I have decided to deal with depression and anxiety under the one heading in this article. This is mainly because these labels cover a range of symptoms and issues that I think are closely related. However, some people will be more depressed than anxious, and vice-versa. This will inevitably lead to individual differences, which will need to be considered prayerfully as you reflect on the big biblical principles in this article.
2 See http://bhascience.blogspot.com/2009/01/
how-does-religion-prevent-suicide.html (viewed 6 May 2009).
- List all the ways the gospel brings comfort to the depressed and anxious Christian.
- How does the Bible provide a framework for healthy self-evaluation?
- What are some of the issues of the heart that personally drive you towards ungodliness (whether or not you are depressed and anxious)? What are some biblical truths that challenge these issues?
- Ask God to help you to grow so that you will see the world through his eyes more and more. Ask him to forgive you for your ungodliness. Ask him to so work in you by his Spirit that you always take him at his word.
- Pray for friends and family members struggling with D&A. Ask God to work in them deeply so that they will see the truths of the gospel more clearly.