Yes, with December 1 just over the page, it’s that time of year again when I roll out the old faithful SAD video.

Are you SAD? from Puritan Reformed on Vimeo.

A large 40 year study, by the American Heart Association, of over 80,000 women in the USA  has found that those with a history of depression had a 29% increased risk of stroke.

 The researchers also found that women who had used anti-depressants particularly SSRIs (selective serotonin reuptake inhibitors) at any point in the two years prior to the study, was 39% higher.

And here’s where our prejudices and presuppositions immediately kick in.

Those who are against anti-depressants will read this as further evidence of “the cure is worse than the disease.” 

Those who see a role for anti-depressants in the treatment of serious depression will try to find other explanations for the facts. 

For example, in this report on the findings, the BBC found public health and stroke experts to argue against any direct link between strokes and anti-depressant medication. 

Dr Kathryn Rexrode, who led the research, said the medicines were more likely to be an indication someone was more seriously ill, rather than a cause of the stroke. She said: “I don’t think the medications themselves are the primary cause of the risk. This study does not suggest that people should stop their medications to reduce the risk of stroke.”

She added: “Depression can prevent individuals from controlling other medical problems such as diabetes and hypertension, from taking medications regularly or pursuing other healthy lifestyle measures such as exercise. All these factors could contribute to increased risk.”

That was echoed by Dr Peter Coleman, deputy director of research at the UK’s Stroke Association: “This research appears to indicate that women suffering from depression may be less motivated to maintain good health or control other medical conditions such as diabetes and high blood pressure, which have an associated increased risk of stroke.”

My takeaways from the research are: 

1. View depression as a serious condition with many damaging consequences. 

Don’t dismiss depressed people as if they were merely suffering from a common cold, allergy, or a passing bad mood. Wherever depression starts – in the heart, in the brain, or in devastating providences – its ripple (tsunami?) effects are extensive and often life-threatening. Take this seriously, and get help early.

2. Medication alone is never the answer.  

Much research into the benefits and drawbacks of anti-depressants take no account of the impact of social support, spiritual counseling, lifestyle coaching, etc. 

Some research (usually funded by by talking-therapy advocates) shows that anti-depressants do little better than placebos. Other research (usually funded by drug companies) highlights  a drug’s statistical success.  But what help are any of these “facts” without knowing much more about the background and situations of these sufferers. 

I have never seen anti-depressants work where there has not been a serious commitment to receiving  and acting upon counsel about lifestyle, decision-making, social interaction, and spiritual needs. If you think that the sole answer to depression is a pill, you are in for a very long and dark journey – and possibly a stroke!

Having said that, sometimes, in really serious depression, unless there is a willingness to take medication, all the counsel in the world is going to go in one ear and out the other. The information cannot be received or successfully processed. 

3. Be aware of our own prejudices and presuppositions when analyzing research.

When we read something that supports our existing conclusions, we are much more likely to believe it as true without any further analysis.

When we read something that challenges our faith, our reason, or our previously adopted public positions, out come our sharpened critical faculties to find the weaknesses and inconsistencies. 

Sometimes, our response to research reveals more about ourselves than anything else.

Deeply rooted self-doubt and self-criticism will often emerge and strengthen during a depression. Depressed people often feel useless and worthless. They have low self-esteem. What should we do to address this?

Some Christians are reluctant to give people any praise or encouragement because of the risk of making a person proud. However, it is safe to say that pride is one of the least risky vices for someone who is depressed. Pride results from having an overinflated view of oneself. Depression usually results in the opposite.

Other Christians misconstrue the doctrine of original sin and total depravity to mean that there is no kind of good in anyone and fail to say anything positive to the depressed person. However, without minimizing the wickedness of the human heart and without denying our inability to do anything pleasing to God apart from faith in Christ, we should feel free to encourage depressed people to have a more realistic view of themselves by highlighting their God-given gifts, their contributions to the lives of others, their usefulness in society, and, if they are Christians, their value to the church.

For example, a depressed young mother may feel like a total failure in every area of her life because she doesn’t have a perfect home or perfect children. We can help such a person see that she achieves a lot in a day, even though she might not manage to do everything she would like. We might remind her of all the meals she makes, clothes she washes and irons, and the shopping she manages, helping her see herself and her life in a more accurate and realistic light. Arie Elshout comments:

It is wrong to pat ourselves on the back when something has been accomplished as a result of our initiative. It is equally wrong, however, to focus on what we have not accomplished. In 1 Corinthians 15:10 we have a clear example of humility accompanied with a healthy opinion of one’s accomplishments: “But by the grace of God I am what I am: and his grace which was bestowed upon me was not in vain; but I labored more abundantly than they all: yet not I, but the grace of God which was with me.”

Paul knew very well that he daily offended in many things (James 3:2; cf. Rom. 7; Phil. 3:12), and yet he did not go so far as to cast out all his accomplishments. I do not believe that this is God’s will. In contrast to sinful forms of self-confidence and self-respect, there are also those that are good, necessary, and useful.

Without a healthy sense of these, human beings cannot function well. We may pray for an appropriate sense of self-confidence and self-respect, clothed in true humility, and we must oppose everything that impedes a healthy development of these things (be it in ourselves or others) with the Word of God (Overcoming Spiritual Depression, 32–33).

Edited extract from Christians get depressed too. Available at RHB and Ligonier. Kindle version here.

Thoughtful and prayerful study of depression should naturally and automatically increase our sympathy for those who suffer from it. By sympathy, I mean an ability to communicate that we truly understand the problem and the symptoms, that we are deeply concerned, and that we will do all that we can to help. In many cases such sympathy can have a powerful therapeutic effect on the sufferer. The lack of it can only multiply the pain and deepen the darkness. Consider the following quote from Russell Hampton, who suffered from depression:

It will greatly help you to sympathize if you always remember that you could just as easily be in the same position, suffering the same sorrow (1 Cor. 4:7). If you treat depressed people with impatient contempt, you may, like many others before you, have to learn sympathy the hard way.

Edited extract from Christians get depressed too. Available at RHB and Ligonier. Kindle version here

A depressed Christian’s family and friends, and fellow Christians, will be involved to one degree or another in helping a depressed person get better. Usually these caregivers have no medical training, and often they have limited or incorrect knowledge of depression or anxiety. However, they have a critical role in helping a depressed person get better. Research has shown that depressed people get better much quicker if they can confide in and get support from someone close to them. Over the next few days we will consider ten areas for caregivers to consider when they are trying to help a depressed person get better.

The first requirement is study. As Christians, we surely want to be the person to whom our loved ones turn in time of need. And when they do turn to us, we want to be able to help them and not hurt them further. It is imperative, therefore, that we learn about depression in order to avoid the common mistakes that laypeople often make when dealing with the depressed and in order to be of maximum benefit to those who are suffering.

Along with studying how Jesus dealt with the ill, the weak, and the distressed, you might want to read some of the helpful books, written from a Christian perspective, that are now available. The following are listed in order of readability and usefulness:

• I’m Not Supposed to Feel Like This by Chris Williams, Paul Richards, and Ingrid Whitton
• D is for Depression by Michael Lawson
• Overcoming Spiritual Depression by Arie Elshout
• When the darkness won’t lift by John Piper
• Broken Minds by Steve and Robyn Bloem
• A Practical Workbook for the Depressed Christian by Dr. John Lockley (you can safely ignore chapter 19)

Another book, of course, is the well-known Spiritual Depression by Dr. Martyn Lloyd-Jones. However, you should be aware that in that book Dr. Lloyd-Jones does not deal with every aspect of depression as an illness but rather focuses on some of the spiritual consequences of depression. In some ways, the book is more about spiritual discouragement than depression, but it is helpful nevertheless.

A book written from a non-Christian perspective, but which is still useful for changing unhelpful thought patterns and behavior, is Mind over Mood by Dennis Greenberger and Christine Padesky.

I would also cautiously recommend Ed Welch’s Blame It on the Brain? and Depression: A Stubborn Darkness. Dr. Welch exhibits a sensitive balance when dealing with depression, and his books have a lot of excellent and helpful material. He seems to be open to non-spiritual causes of depression, although at times he still seems to revert to the “medicine only alleviates symptoms” model. A Stubborn Darkness is also helpful for exploring possible spiritual causes or contributors to depression. However, I would hesitate to put this book directly into the hands of depressed Christians, as they will often draw the worst possible conclusions about themselves, regardless of objective reality. It is better that a committed and understanding pastor or family member gently and wisely guide a depressed person through the relevant parts of the book.

It is important to remember that reading these books will not turn you into a mental health expert, but it will make you more useful and helpful to loved ones in distress. It will also help you to know your limitations so that you make the right decision about when to advise someone to see a more experienced Christian, a doctor, or a mental health professional. I would recommend that pastors build a database of local doctors and mental health professionals who share their Christian principles. Phone around, speak to people, visit hospitals, speak to the staff, and build relationships so that when you are facing a situation that is beyond your competence, you will know to whom you should turn.

Edited extract from Christians get depressed too at RHB and Ligonier. Kindle version here

One reason for the dramatic surge of depression in our Western culture is the stressful lifestyle that so many are living for extended periods of time. Addressing this is not the whole answer in recovering from depression, but it is often a large part of the answer. It is vital to lead a balanced lifestyle in order to relieve the “stretch” that threatens our physical, mental, emotional, and spiritual well-being.

1. Routine
One of the keys to a balanced lifestyle is regular routine. This is also one of the first things to fall by the wayside when someone becomes depressed. Depressed people often find it difficult to resist being guided by their feelings. When a person feels down he will often do only what he feels like doing and avoid what he doesn’t feel like doing. For example, if you are depressed and you don’t feel like getting up, you won’t. If you don’t feel like working, you won’t. If you don’t feel like doing the laundry, you won’t. If you feel you want to drink or eat to excess, you do it. A positive step in recovering from depression is to restore order and discipline in your life. Regular and orderly sleeping, eating, and working patterns will rebuild a sense of usefulness and healthy “self-esteem.” It is also glorifying to God who is a God of order, not of confusion (1 Cor. 14:33).

2. Relaxation
We need to build times of relaxation into our lives. This may involve finding a quiet spot at various times throughout the day to simply pause, calm down, and seek the peace of God in our lives. Jesus recognized and provided for this need in His disciples when He took them “apart into a desert place, and rest[ed] a while” (Mark 6:31).

Another helpful area to explore is whether you are breathing properly. It is common for depressed and anxious people to be extremely tense, which often leads to hyperventilation or over-breathing and then to inevitable weakness of body and brain. There are many helpful books and Web sites that, without straying into “New Age” ideas, give good basic advice on re-learning how to relax and breathe properly.

3. Re-creation
Moderate physical exercise helps to expel unhelpful chemicals from our system and stimulates the production of helpful chemicals. Outdoor exercise has the added benefit of the sun’s healing rays.

4. Rest
A Christian psychologist recently said to me that he starts most depressed people on three pills: “Good exercise, good diet, and good sleep!” That’s great advice, so I would encourage you to make use of the plentiful resources available today on these subjects.

As regular sleep patterns enable the body and mind to repair and re-charge, set fixed times for going to bed and getting up, and try to get at least eight hours of sleep. Avoid caffeine, vigorous exercise, phone calls, TV, and Internet use within three hours of sleeping. Get into a set routine for going to bed, and try to secure cooperation from others in the house. And remember God’s gift of weekly rest. The Lord’s Day was graciously made for us (Mark 2:27), partly to ease the tension of our busy, overstretched lives.

5. Re-prioritize
Examine your life and see what you can do to reduce your commitments and obligations. Areas to consider are your family, your work, your church, your neighbors, and travel. Once you are better you may be able to pick up some of these activities again. But the priority is to get better.

6. Repentance
We may also need to look at the reasons for choosing such stressful and damaging lifestyles. What is driving us? What is motivating us? What are our aims and ambitions? What are we living for? Above all, who are we living for?

Christians get depressed too at Reformation Heritage Books, Ligonier, and Amazon.

When I start counseling a depressed person, I’m looking for answers to five questions at an early stage in the conversation. I don’t ask them in a checklist or condemning manner, but I try to probe sympathetically to get a sense of where they are at.

1. Do you accept you have a problem?
Don’t assume that just because a person has come for counseling, that he accepts he has a problem. Family pressure rather than personal choice may have put him there. It is very common for a depressed person to be in denial about the existence, the nature, or the extent of the problem. Sometimes this denial is wilful pride, but sometimes it is because depression can creep over a person so slowly that they do not realize that it has happened. And, of course, part of depression is an inability to see oneself in a true and realistic light.

2. Are you willing to explore all the possible dimensions of this problem?
Once a person has accepted that he has a problem, I want to know how open they are to looking at the problem from a number of angles. Some people will only want to look at the spiritual dimension, and are looking for bible verses; others only want to talk about the physical dimension, and are looking for a pill; still others are only interested in looking back to find all the people and events that have contributed to their problems. But, unless a person is willing to explore all the possible dimensions of depression – physical, spiritual, mental, social, etc., – most counseling effort will be frustratingly handicapped. 

3. Do you want to be made whole?
This was the question Jesus asked of the lame man at the pool of Bethesda (John 5:6). At first glance it may seem like a silly question. Surely every sick person wants to be made whole! Surely everyone with problems wants them solved! However, Christ’s challenging question seems to imply that this man had settled into the role of “victim” and no longer wanted to get better. Sometimes a depressed person can also adopt this mindset. Perhaps they are frightened of all the responsibilities of life that might come upon them should they be viewed as well again. Perhaps they would miss the attention and sympathy that being ill often generates. So, we gently ask, “Do you really want to be made whole?” And that leads us to the next question.

4. Are you willing to do what you can to contribute to the healing process
Doctors and pastors are often faced with the frustrating situation of people who need their help, yet are not taking the steps required to benefit from this help: practical suggestions are not followed through, Scripture is not read, necessary medication is not taken, friendships are shunned, etc. Depressed people often need to be encouraged out of passivity and into taking some responsibility.

5. Do you trust me when I tell you that you have good hope of recovery?
As hope is such an important part of recovering from depression, I’d like to ask “Do you have hope of getting better?” However, as depression usually involves a general sense of hopelessness, initially I ask them to trust me that there is hope, rather than have that hope themselves. I encourage them with statistics (the vast majority of depressed people do eventually recover), and with stories of other people I’ve seen get better. After a few meetings I usually see people beginning to adopt the hope themselves, and that is such an accelerator of healing.

Again, I want to emphasize that this questioning is to be done in a caring and compassionate way. And I’m not saying, “Unless you get the right answers right away, you might as well not even start.” However, I’ve found that these questions usually reveal enough to indicate how fruitful any future counseling will be.

Christians get depressed too at Reformation Heritage Books, Ligonier, and Amazon.

I was really delighted to see David Powlison’s careful, balanced, loving response to the question: “Do you believe that there is a biological basis for depression which may endure, despite the fact that heart issues have been successfully addressed through biblical counseling? If so, is there a place for long-term use of medication?”

David calls this “one of the defining questions of our age.”

I agree.

And this video goes a long way towards answering it.

Last year a student and I put together a short video about SAD (Seasonal Affective Disorder). With yesterday being the shortest day of the year, I thought this might be an opportune time to make it available again.

And if videos are not your thing, here is a really helpful article about how physiological and seasonal factors can contribute to depression. It is written in simple language, includes great illustrations, and some practical how-to’s (and how not-to’s)

The focus is on two potentially problematic areas: the importance of sleep and the effect of nutrition. Here are a few extracts:

The importance of sleep
“Sleep to a human is like refueling the car. You can’t drive a car 60 miles everyday without refilling the gas tank. The same is true with body and sleep. Adult humans need seven to nine hours of sleep per night to function optimally.”

“Fatigue from sleep deprivation has many of the same symptoms as depression. Dr. Edward Welsh of the Christian Counseling Education Foundation here in Philadelphia explained that sometimes clients who feel depressed are actually sleep deprived.

This is not to say that all depression is merely sleep deprivation. But rather, certain symptoms may develop without proper sleep. Furthermore, a sleep-deprived brain can’t handle stressors like a fully rested brain. Between Thanksgiving and Christmas many people log long stressful days without balancing it with necessary sleep.”

The effect of nutrition
“Giving your body proper nutrition is like keeping all of your car’s fluids full and clean. Let me say from personal experience, if you don’t have coolant in your radiator, you will find smoke billowing out of your car’s hood.”

“If we were to put butter in the radiator fluid, it may function OK, but not optimally. If we continue to put butter into the mix, the car will eventually be nothing more than a fancy cigarette lighter. The same goes with our bodies. We treat them badly, then wonder why the feel so run down. Furthermore, when we are not giving our brains the nutrients they need to perform well, then stressors will seem all the more overwhelming. 

Every time you feed your body food devoid of nutritional value, you place the task of food digestion on your body, but give it none of the tools (vitamins, fiber, protein, and whatnot) that it needs to do the job done. This leaves your systems weakened instead of bolstered, leaving you open for attack by viruses and bacteria. Whether we end up getting sick or not, the brain is also harmed. And, when the brain is harmed we may feel depressed.”

Read the whole article here.

I’ve been subscribing to the Postpartum Progress Blog for quite a while now. It is the most widely-read blog on postpartum depression & other mental illnesses related to childbirth. I’m not sure if I’m the only man on the list (!), but I’d definitely encourage other Christian men to join. Pastors would find it especially helpful in building a sympathetic understanding of oh-so-common postpartum depression and other associated childbirth complications flowing from Genesis 3:16a.

As far as I can tell, the writing is not usually from a Christian perspective. And sometimes the writing is unnecessarily “raw.” However, many of the articles offer lots of realistic, down-to-earth advice, which is particularly useful for us men who struggle to understand the emotional and mental sufferings some women have to endure.

For example, in this post Alexis Lesa give Four tips for supporting someone with postpartum depression. And here she writes on the benefits of postpartum depression. Obviously a Christian pastor would want to adjust and add to some of the material in these articles. However, they are a great starting point for understanding PPD and helping those suffering with it.

A couple of weeks ago I watched this video interview with Dr David Powlison, How does Biblical Counseling view Psychiatric Drugs?  I had some pastoral concerns about this video, and expressed them in this blog post, Who sinned? This man or his parents.

Last weekend I was privileged to receive a response from Dr Powlison. I asked him if he would mind me posting his response on my blog without further comment by me. Dr Powlison gave his OK, and said he had no problem with me responding. However, to let Dr Powlison’s words have their full weight and significance, I think it’s best to let them stand alone.

David M, I so appreciate your thoughtful response to my brief podcast. In fact I fully agree with your pastoral instincts. Depression per se is suffering, not sin, something many ministries miss. Symptomatic reliefs of many sorts are not to be despised, lightening burdens is a good. My mention of what each of us brings to suffering (“issues”), did not imply that sin is the underlying cause of depression, or that depression reduces to sin, or is cured by dealing with sin. To those who would merely medicalize depression, I meant to communicate “Don’t forget the person” by either over-medicalizing or over-situationalizing. On the other hand, I’d say to those who reduce depression to sin, “In your eagerness to deal with sin in light of Christ, don’t forget that people are physically-embodied and socially-embedded, and that both are vectors of sufferings,” some of which can be alleviated in part, some of which are intractable until the last day.

By “meaning and relationship” I intended the opposite of how you took my too-brief words. These things are good gifts we bring to sufferers (both personally and as bearers of Christ). My citing those words was not an allusion to strugglers’ personal failings. It was a reference to the potential for the church to enter in and care helpfully for strugglers. It describes a gift, not a diagnosis. In the context of Christian meaning and love, sufferers find encouragement, hope, and growth in grace, even as we all must endure through darkness.

Blessings, David P

I’m thankful to God for David Powlison, together with his predecessors and successors in the Biblical Counseling movement. By God’s grace, they have restored the pastor’s role in counseling, and led a wonderful reformation of church counseling practice. Their books have been blessed to me personally, and I use their materials extensively in our counseling classes at Puritan Seminary. Recently I was sent this video interview with Dr Powlison.

I agree with Dr Powlison:

1. Psychiatric drugs, like many drugs, are often prescribed to treat symptoms instead of dealing with the causes, the issues of meaning and relationship.

2. Psychiatric drugs, like most drugs to some extent, are often over-prescribed and overused.

3. Psychiatric drugs, like many other drugs, can have a placebo effect in some people.

However, I do have some pastoral concern with some of the emphases in this interview. It is difficult to comment on the paraphrase of the remarks attributed to the Director of the NIMH by Dr Powlison (if anyone can supply me with the exact words and larger context, I would be very grateful). But I’m a bit concerned lest by overreacting to over-use or abuse of medication, we end up with under-use or non-use, especially if it is a life-or-death situation. Also, though some studies do show a significant placebo effect with psychiatric drugs, I would not be quite so dismissive about alleviating the suffering of one third of millions of people with depression.

My major concern though is with Dr Powlison repeatedly describing psychiatric drugs, and the SSRI’s in particular, as only dealing with “symptom alleviation.” Implicitly and explicitly Dr Powlison says again and again that there are always underlying “issues” or causes. The issues are “meaning or relationship,” or “what you are living for and how you are living,” or “the two great commandments.” In other words, the default position in dealing with a depressed person is that their personal sin has caused it, they are responsible for it, and so they must repent and believe the Gospel. Of course, personal sin can and often does cause (or contribute to) depression and anxiety, just as personal sin can and often does cause (or contribute to) heart disease, or certain types of diabetes, or even blindness. But these same diseases and disabilities can also be the result, not of personal sin, but of living in a fallen body in a fallen world.

Just as the curse on this world and our bodies can cause mechanical, chemical and electrical problems in our hearts, our livers, our pancreas, our eyes, etc., so we can also have mechanical, chemical and electrical problems in our brains, which may affect the way we think, and even our personalities. I’m sure we have all seen loved ones with brain injuries, bleeds, or tumors dramatically and painfully change in this way. Nutritionists have also demonstrated how certain foods can affect our moods and thoughts, our feeling and thinking.

The brain is the most complex organ in our body, and so is liable to be the most affected of all our organs by the fall and the divine curse upon our bodies. And as processing our thoughts is the main activity of our brain, we can expect this area at times to fail and break, through no fault of our own, with subsequent emotional and behavioral problems. (And that’s not to deny that a person is responsible for how they respond to mechanical, chemical, or electrical failures and faults in any part of their body.)

In these cases, medication is not merely alleviating symptoms, but addressing the causes. It is no different to me giving my 8-year-old daughter one of her many daily injections of insulin for diabetes. I am not merely alleviating symptoms, but addressing the cause – depleted insulin due to dying or dead cells in her pancreas. And if she is lethargic, weepy, or irrational due to low sugar levels, I do not ask her what commandments she has broken or what “issues of meaning and relationship” she has in her life. I pity her, weep for her, and thank God for His gracious provision of medicine for her. 

If we come to the point that our default position in dealing with depression is “it’s sin until proven otherwise,” we are getting painfully close to the disciples position, “Who sinned? This man or his father?” (John 9:2). It is also getting worryingly close to the “health, wealth, and prosperity gospel,” in terms of diagnosis (personal sin) and prescription (more repentance and faith).

I realize that many in the biblical counseling movement have “moved” on the use of psychiatric drugs, and I welcome that. I also realize, as Dr Powlison said, that there are various views within the movement (see Ed Welch’s careful and sensitive Blame it on the brain?). We are all continuing to learn from God and from one another in the community of faith. I dread to think where we would be today without the courageous and wise leadership of the Biblical Counseling Movement.

But I started by saying that my concern was pastoral rather than polemical. And I mean that. Maybe it would help if I explained the particular pastoral context I’m thinking of. I was a pastor for 12 years on the west coast of the Scottish Highlands. Sadly, that beautiful area has one of the highest rates of depression in the western world, and I dealt with many Christians who endured years of mental suffering and spiritual darkness. Although initially, in my youthful zeal, I probed for the sin or “issues,” because I did not want just to “alleviate symptoms,” I came to realize that I was often (though not always) dealing with people whose problem was not “issues of meaning or relationship.” As I got to know them, I came to see that what they were living for and how they were living was not the problem; they were unquestionably living for Christ, and living like Christ.  In fact they were among the most godly Christians I have ever met. The Lord was everything to them and they would not let go of Him despite everything screaming from within and without, “There is no God.”

So, I would encourage pastors dealing with depression to fight strongly against adopting the default of “it’s sin until proven otherwise,” or as Dr Powlison says, “there are always issues, underlying issues”, or “it’s about what they are living for and how they are living,” or “its about the two great commandments.” It may well be. But let’s not begin there and so potentially damage some of the precious people of God in their moments of greatest weakness.

Many have attempted to describe the indescribable pain of depression. Numerous similes and metaphors have been used to convey depression’s deep, deep agonies. However, I don’t think I’ve seen anything come so close to describing the indescribable as this deeply moving poem by my Christian friend, Sue Lubbers.

Three things make this poem especially touching. First, it was written by a Christian, which actually adds another layer to the suffering.  The Christian with depression not only loses physical energy, intellectual ability, and emotional activity, but the most precious thing in their life feels lost – their spiritual relationship with their Lord and Savior, Jesus Christ.  

Second, the poem is breathtakingly honest. It does not attempt to gloss over or minimize the horrific thoughts and feelings that stalk and haunt the soul in this desolate valley. It is so far removed from the shallow and artificial triumphalism of so much of modern Christianity. It is much more reminiscent of the deep and realistic piety we find in many of the Psalms, in Job, and in Jeremiah.

Third, the poem holds out great hope for those still passing through these deep waters. To get maximum benefit, don’t read across the two columns. Rather, read the whole of the first column. Then start reading down the second column, comparing it as you go with the parallel line in the first column. What a transformation! The Lord has revolutionized this dear believer’s life. If you, or a loved one, are still in column one, then read column two and see what our almighty and gracious God can do in the most desperate of situations.

And if the Lord has spared you this affliction, then thank him for His undeserved favor towards you, and use the poem to cultivate sympathy and understanding for sufferers.

Picture: 2008 © Michele Piacqadio. Image from BigStockPhoto.com

Depression Poem.pdf
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“Antidepressants get to work immediately to lift mood, contrary to current belief, UK researchers say.”

Read the whole of this fascinating article on the BBC website.