“Malignant sadness” is the horridly vivid description of depression given by Lewis Wolpert in his book of that title. It often takes such poetic language to express the reality of a form of suffering that is so hard to understand. How can we make sense of it?
This difficulty is seen in the various and sometimes conflicting explanations for depression. For example, a neuroscientist may explain that ‘major depression’ is 60% heritable and involves characteristic brain circuitry changes. A cognitive psychologist might point to the irrational thought patterns depressed people have about themselves and their world. A psychoanalyst would seek to unearth subconscious scars from early relational difficulties. A sociologist could demonstrate the statistical link between traumatic life events and the onset of depression. A Christian counsellor might urge us not to forget the impact of guilt about moral choices or the disappointment when things we have idolised fail us.
With so many explanations it is no surprise there is confusion, even conflict among Christians about depression. If we suffer we long to make sense of it. If we’re an onlooker, we’d like to understand so we can help. I’m convinced there are no easy answers. For a start the term depression encompasses a wide spectrum of ‘mood disorders’. It’s not a simple phenomenon. But I would like to encourage us about how the Bible can help.
This is not to advocate viewing the bible as a pseudo-medical text. Neither is it to suggest that reproducing some favourite verses offers the magical solution. Of course individual passages can be a great comfort; but I want to suggest that we can also find help from grasping the bible’s overarching narrative. The story of creation, fall, redemption and new creation gives a framework both for making sense of the various causes of depression and also solid hope for an ultimate solution.
A good place to start is the opening chapters of Genesis. I outlined above possible biological, psychological, social and spiritual explanations of depression. When we look at Genesis what we find is a description of humanity that includes these elements. We are created as ‘bio-psycho-socio-spiritual’ beings. But the human rebellion and consequent curses of God recorded in Genesis 3 mean that each of these faculties is damaged.
Let’s consider biology first. Genesis describes humanity as physical beings made of the dust of the earth. But since Genesis 3 we are cursed with thorns and thistles, increased pain in childbirth and death. Hence there is a theological basis for biological disorder.
Secondly psychology: in creation we are uniquely God’s ‘image bearers.’ This seems to entail being stewards of his earth. We have both an identity and a function. This gives a basis for a healthy psychology. But since our rebellion we would rather be kings than stewards; and we no longer pursue loving dominion of the earth rather imperial domination. Such distortion of identity and function is the seed-bed of psychological pathology.
Thirdly, we are made for trusting and freely giving relationships. But Genesis 3 records the onset of mistrust and power struggles. A world characterised by relational breakdown means ample material for psychoanalysts as well as epidemic sociological problems.
Finally of course Genesis gives the background to our spiritual problems; sin and God’s judgment, meaning we are alienated from our loving creator.
How do these observations help us? Well it gives us a theological basis for disorder in these four spheres. But also it means that these spheres are not disconnected. Traditionally mental healthcare has been characterised by competing theories with one of these areas considered the primary problem. But more recently there is growing recognition that a depressive episode is often caused not by one of these factors alone, but an interaction of several. The biblical narrative gives us the philosophical basis for a unifying theory including insights from all these areas.
But the bible’s narrative doesn’t just explain our problem. It also gives solid hope. Medical services may offer biological, psychological or social treatments. But the Bible however, not only incorporates all of these, it also sheds light on spiritual causes and offers spiritual help too. So as Christians we have not three, but a four part checklist for the understanding and treatment of depression. And the bible offers something none of these others can; an ultimate and eternal solution - the message of redemption, whether the sufferer might feel it or not. The Christian hope is for a new creation where biological, psychological, social and spiritual problems will be no more. Malignant sadness will be swallowed up by infinite joy.
This article was first published in the CEN on 4th November 2012
The Revd Dr Nick Weir was a practising Psychiatrist before ordination. He is now a Curate at St Mary’s, Basingstoke and a member of the Latimer Trust Theological work group.
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