We all want to be happy and experience enjoyable and rewarding lives. Physically, mentally, socially, and spiritually—we desire to have all our needs met and to lack nothing. But we don’t live in a perfect world, and until Paradise is restored, every son and daughter of Adam and Eve will suffer the pain of living broken lives in a broken world. We can indeed experience happiness and fulfillment, but sooner or later pain, lack, and want will surface in every person’s life. No one is exempt.
The opposite pole of happiness is despair and depression. We may experience depression when the discrepancy between what should be and what is becomes great, when what we were created for and truly need is not matched by what we have and get. When our souls and bodies are malnourished or injured physically, mentally, socially, or spiritually, painful feelings and the experience of emptiness may ensue.
Although there is much we can do to optimize health, many things are beyond our control.
Depression is one of the most widespread and debilitating disorders in our world today. The World Health Organization (WHO) states that depression is the leading cause of disability worldwide and a major contributor to the overall global burden of disease.
1 It’s so widespread that we are bound to encounter it in someone we know, or even in our own lives.
Depression is a range of disorders characterized by a depressed mood and a lack of interest and energy. Depression slows thinking, impoverishes feelings, and disturbs bodily functions such as sleep and appetite. Different types of depression may have various causes and require different approaches to treatment.
Women appear to experience depression more often than men. And depression is more prevalent in high-income countries than in low-income ones. Money does not protect from pain, emptiness, and despair. As many as one person in five will suffer clinical depression during their lifetime, and many more will experience symptoms of depression. If someone has dealt with depression once, there is an increased risk of having to do so again. Therefore, it’s important to assess what makes one vulnerable to depression, and counter that if possible.
In depression the brain gets stuck in vicious cycles of negative thoughts and emotions, each feeding the other and leaving little or no room for the positives. Negative thoughts and emotions take over the inner life and cram out optimism, energy, interests, pleasures, and hope. What provides meaning and enjoyment in life fades. In the depressed state the brain is sensitized to pick up on whatever is negative. A sad face, an unfortunate comment, the rain, bad news—whatever resonates with the depressed mood is noticed and amplified.
Meanwhile, a smile or small kindness, a wonderful dinner, beautiful flowers, an upcoming holiday or family reunion now lack luster. This negative bias makes it difficult for the depressed person to sense, feel, and think about what is or could be positive. The sense of life—all that gave life color, taste, meaning, and content—may feel like a thing of the past, never to be enjoyed again.
Many things can make us prone to suffering depression. Although there is much we can do to optimize health, many things are beyond our control.
Just as we accept that physical infirmities afflict everyone, however, we ought to understand and accept that mental infirmities are also part of being human in a broken world. Believing in God, accepting Jesus’ gift of salvation, and being filled with the Spirit do not necessarily spare us from mental pain and suffering. But we may find comfort and hope in knowing that we and our suffering are known by our loving Creator.
Genes, temperament, adverse life experiences, physical disorders, and an unhealthful lifestyle make us prone to depression. As with many physical disorders, depression may run in families, partly because of genes and partly because of learned patterns of dealing with emotions, thinking, behaving, and relating. People who are anxious, dogmatic, rigid, and hide feelings may have a higher risk of depression.
Trauma such as abuse, neglect, loss, and other negative life events, especially early in life, may increase vulnerability by causing us to become more sensitive to perceived threats and disappointments. Loneliness, dysfunctional relationships, or lack of meaningful and fulfilling content in life may lead to hollow feelings of emptiness. A range of physical disorders may result in depressive symptoms, making it important to identify and treat such disorders.
Currently, promising understanding is emerging on the influence on depression of immunologic disturbances, as well as the composition of the bacterial flora in the gut, the microbiome. Even a range of common medications have depression as a side effect; therefore, all prescriptions should be evaluated if one suffers from depressive symptoms. Prolonged stress causes hormones to be released that are neurotoxic and may change the architecture of the brain. This may lead to depression by adversely affecting concentration, memory, learning, planning, reflection, and feeling.
When the brain has changed, recovery will take time as it is not only the mood that needs to change but also the brain that produces the mood.
Finally, lifestyle may play a major role in the development of depression, as well as recovery from depression. In general, whatever is good for the body is good for the mind, and vice versa. We need sleep, wholesome food, regular exercise, sunshine, and rest. These things may help us to have not only longer but also happier lives. Contrary to this, when our bodies and minds do not get what they need or if we use harmful substances such as alcohol and drugs, our mental as well as our physical health may suffer. And even if we do everything right, many other aspects of life may hit us and throw us into depression.
Breaking the vicious cycle of negative thinking and feeling, getting unstuck, and making appropriate and necessary lifestyle changes may be hard work, but it’s worth it.
It’s always advisable to get help—external input—from someone who can interrupt and challenge the vicious cycles of feeling and thinking, be that friends, family, or a professional. Whenever depressive symptoms affect quality of life and functioning, professional help should be sought by having a thorough physical evaluation, as well as counseling or psychotherapy. In severe depressions, medication and other forms of treatment may be helpful in attempts to reboot thinking and feeling.
Many famous men and women have suffered depression. We find them in the Bible and in secular history. Great minds and devout believers are not spared from depression. Abraham Lincoln, before he was elected president of the United States, experienced deep depression, and he described his suffering eloquently: “I am now the most miserable man living. If what I feel were equally distributed to the whole human family, there would not be one cheerful face on the earth. Whether I shall ever be better I can not tell; I awfully forebode I shall not. To remain as I am is impossible; I must die or be better, it appears to me.”2
Anticipating staying forever in the depths of depression is nearly unbearable for the depressed. A common symptom in depression is thinking that it will never end. Like Abraham Lincoln, many depressed would rather die than continue to suffer the pain and emptiness of depression.
Still, that does not mean the depressed really want to die. They just want all the suffering to end. And when all other hope appears to be lost, the only escape may seem to be suicide. Hopelessness and isolation are major risk factors for giving up on the future and ending the suffering by ending life. The depressed therefore need connection with others—others who engage with them, nonjudgmentally listen to them, compassionately talk with them, and bear hope for them.
As Aaron and Hur held up the hands of Moses during the long hours of battle (see Ex. 17:12), the depressed may need others to hold up hope in their hour of battle. Most things in this world are transitory; fortunately, with the right help and support, oftentimes also is depression.
For the depressed, the challenge is to not give up at the bottom and miss out on the future they cannot see from the pit of depression. For the ones who do give up, who just cannot bear it anymore and end it, we may rest assured that we have a gracious God who knows the pain and suffering of every single creature. A God who is present and suffers with the sufferer.
In the cosmic battle between good and evil, even though we may not understand why, God often refrains from intervening in the present. However much He wants to, He cannot spare us from the consequences of living in a broken world. Whatever our burdens in life, we should still seek comfort and strength from God and fellow humans, and bear one another’s burdens (see Gal. 6:2).
For some, the experience of depression may be a turning point. Exploring our lives can motivate us to change for the better, helping us to learn from our mistakes, evaluate what we want and need, and determine what is really important. Dealing with depression may lead into a new, deeper, richer, and more meaningful experience of life.
Torben Bergland, M.D., a psychiatrist and psychotherapist, is health ministries director of the Trans-European Division. Helgi Jónsson, M.D., a psychiatrist and psychotherapist, is an elder at the Seventh-day Adventist church in Hafnarfjörður, Iceland.