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What is Depression?

with Ed Welch, Leslie Vernick | July 11, 2011

Depression feels terrifying, dark, numb, heavy, and painful. Ed Welch, counselor at the Christian Counseling and Educational Foundation, and Leslie Vernick, a licensed clinical social worker who maintains a private Christian counseling practice in Pennsylvania, help us understand what depression really is.

Depression feels terrifying, dark, numb, heavy, and painful. Ed Welch, counselor at the Christian Counseling and Educational Foundation, and Leslie Vernick, a licensed clinical social worker who maintains a private Christian counseling practice in Pennsylvania, help us understand what depression really is.

What is Depression?

With Ed Welch, Leslie Vernick
|
July 11, 2011
| Download Transcript PDF

 Bob:  Alan is a man in his 50s.  He is very bright, very talented, a good

 husband, a good father, and he has dealt for many years with depression.

Alan:  I think depression is such a difficult emotion or condition because you do lose perspective; and there's a feeling of hopelessness and despondency

that, "This is never going to get better."

You have this rational part of your mind that you're trying to tell yourself something so that you won't feel this way, and nothing works.  When I'm depressed, the glass is not even close to half empty.  It's 99-percent empty.

Bob:  This is FamilyLife Today for Monday, July 11th.  Our host is the President of FamilyLife, Dennis Rainey; and I'm Bob Lepine.  What do you do if it feels like the emotional cup of your life is drained dry?  How do you respond to depression? 

And welcome to FamilyLife Today.  Thanks for joining us on the Monday edition.  I can imagine there are a lot of our listeners who just moved closer to the radio, turned it up, and are paying careful attention because what they just heard described, they either go, "That's me," or "I know someone like that"—someone who is in the throes of depression and may have been there for an extended period of time.

Dennis:  You know, Bob, one of the problems with depression is we don't know how to address it from a Christian perspective.  Some people label it "sin of the soul," and they just want to put a blanket statement around it.  Others just want to say it's a medical problem and it doesn't relate to our spiritual condition.  What's the Christian community supposed to think, and how is it supposed to act toward those people who struggle with depression? 

I think the broadcasts this week, here on FamilyLife Today, are going to be very encouraging and instructive as to how individuals can cope with depression in their own lives but also know better how to live with those who also struggle with it.  We have a couple of professionals here in the studio that join us on FamilyLife Today—Dr. Ed Welch and Leslie Vernick.  Welcome to the broadcast.

Ed:  Thanks, Dennis.

Leslie:  Thanks for having us.

Dennis:  Leslie is a licensed clinical social worker from Pennsylvania.  She has written a book called Getting Over the Blues: A Woman's Guide to Fighting Depression.  Leslie, I really enjoyed your book.  I felt like it was a warm, practical, heart-to-heart conversation of a woman who had a story to share with other women and really desired to bring a biblical perspective to this all-important subject.  I really appreciate your writing the book.

Leslie:  Thank you.  I really enjoyed writing it.  I just sensed God needed to use me to say some things to other women, and I certainly have had to learn these lessons myself.

Dennis:  Well, it was a great book.  Dr. Ed Welch is no stranger to our listeners.  He has been on FamilyLife Today before.  He is a counselor and director of the School of Biblical Counseling at Christian Counseling and Education Foundation; also a professor at Westminster Theological Seminary; and he has written a book on depression, as well, called Depression:  A Stubborn Darkness, Light for the Path.  Ed, I really enjoyed your book, as well.  I felt like it was a great biblical look at depression.

Let's define depression.  Ed, how would you put a working laymen's definition to this subject?

Ed:  Let me put images on it, even though that's not the technical definition.  Images capture it for people—“emptiness" is one of the things you're going to hear.  “Weight" is another thing you're going to hear—people simply feel weighted down.  They actually feel like they weigh more than they did before.  Something is just pulling them down to the ground in a way they've never been pulled down before.

I think another feature of it is this “darkness;” and you heard it, I think, in one of the excerpts before the show began—this sense of being in a tunnel, enclosed in this tunnel with darkness all around.  Those are some of the images that you hear over and over when people describe the experience.

Bob:  And it's not a single experience.  There are kind of levels.  Here is one woman who says the difference between sadness and depression is duration; and yet there are levels of melancholy, if you will.  Some people can't get out of bed and other people just kind of drag around during the day.  Leslie, is there a way to diagnose and say, "Oh, you've got medium depression, and she's got extreme depression?"

Leslie:  Well, yes, there is; and unfortunately there's no blood test.  A lot of people say, "I have a chemical imbalance;" but there is no blood test to determine whether you're depressed or not. 

There are some things that people would look at—some symptoms—physical symptoms like low energy; lack of sleep; a restless spirit; emotional symptoms like feeling sad or down, worthless, feeling no joy in life, an emptiness, a “lostness,” a darkness.  Mental symptoms—you can't think; you can't concentrate; you can't make decisions.  Spiritual symptoms—you feel guilty; you feel like God's abandoned you; you don't find yourself experiencing any joy of the Lord like you used to. 

Those would be some of the symptoms, and all of us experience some of these symptoms some of the time.  It doesn't mean you're depressed; it might mean that you're having a bad day or a depressed mood.  The difference between a depressed mood, or a depressed day, and depression is the severity of the symptoms and the length of time.  Someone who is experiencing these symptoms without a break for longer than two weeks would be considered, then, moving into a major depression.

Dennis:  You know, I've experienced times when I've gotten discouraged— circumstances; something somebody has said to me; maybe some of the behavior of my children when we were in the childrearing years; but everybody gets discouraged, Ed.  Does everybody get depressed, or are there some people who literally do not know what we're talking about when we're talking about depression—they've never experienced it?

Ed:  There are fewer and fewer people who don't know.  The statistics go somewhere around 25 percent of the population who are going to experience it at one time or another, which means you're going to experience it or you're going to be living closely with somebody who does experience it.  It should sound more and more familiar to the vast majority of your listeners.

Leslie:  Yes, statistics show that women are twice as vulnerable to depression than men and, also, about one in five women will experience major depression in her lifetime.  Right now, it's considered the No. 1 disability in women.  It's very prevalent; and it's very important that we, as Christians, recognize that we have that struggle and that we're going to know someone who has the struggle.

Bob:  Well, what do you think is up with that?  Why is it that women would be more likely—two to one—to experience depression?

Leslie:  Well, there are a lot of theories about it.  One is that women have different hormones than men do; women have different ways of processing stress than men do. 

One of my theories, and I think it supports it by some research, is that women are more closely in touch with their relationship needs and their relationship vulnerabilities.  God says we're all relational beings, but women especially get their self-esteem, their self-worth, through their interpersonal connections. 

Losses, stresses, and conflicts in relationships, or the lack of meaningful relationships, I think, affect women and their sense of self and their core identity more than it might a man, where he might pour himself into his work or his career.  For women—disruptions in her relationships affect her more deeply; and I think that makes her more vulnerable to depression.

Bob:  Ed, there is this increase in the incidence of depression among the population; and I know it's one of the things you've talked about in your book.  You see some reasons why you think there's more and more depression in our culture in our age today.

Ed:  People have speculated on and on.  I think one of the most interesting comments—observations—this is a person who is not a Christian and has no religious intent whatsoever.  He suggests that one reason there is more depression is because we live in a generation where there is nothing larger than ourselves. 

There is no national purpose; there is no family, essentially.  The family has been fragmented, and there is nothing bigger than ourselves to rely on.  He goes on to suggest that we just were not intended to rely exclusively on the self.  The self is not able to handle the freight.

Dennis:  We've turned inward more and more as a culture, and as a generation; and as a result, we've been disappointed more and more.  We're discouraged and disappointed with ourselves.  Is that what you're saying?

Ed:  We're on the heels of a few decades where people have tried to find some sort of identity within.  They've tried to somehow pump themselves up so they can feel better and have some kind of worth.  What we're finding is we're moving out of that stage where people are saying, "It didn't work."  They don't know what is available; but they're saying, "It didn't work."  We have to find someplace to put our hope, someplace to find purpose outside of ourselves.

Leslie:  That reminds me of the two greatest commandments that God gives us.  They have to do with connection—that we should be rightly-related to God.  We should love the Lord our God with all of our heart, soul, mind, and strength; and we should love others as much as ourselves and as God has loved us. 

We are commanded to be in relationship and be in connection.  That reminds me of an old Jewish proverb that says, "Sticks in the bundle are not easily broken, but sticks alone can be broken by a child."  When we're trying to live these independent, autonomous lives and finding self-satisfaction and self-fulfillment in self, we are easily broken because that's not how God intended it to be.

Dennis:  Is there a No. 1 cause of depression, generally speaking?  Specifically, I'm curious about women.  You said women are twice as likely to experience depression as men.  Would either one of you care to weigh in on that subject?

Ed:  Well, I would prefer to not think that there's a No. 1 cause. 

Leslie:  Yes.

Ed:  That doesn't answer your question; but what I want to do with somebody who is struggling with depression is, I want to listen as well as I possibly can.  I want to remove any stereotypes, as many theories, as possible.  I simply want to hear that person because every depression, even though you gather 100 people together and talk about their depression and the experience would be very similar, the roots of it, I think, are very unique.

Leslie:  But there are some common themes.  I think it would be dangerous to say that there's one root cause, but there are some common themes.  Physical themes would be—you know—certainly there's a physical component.  Your body is an important part of who you are.  When either we don't take care of our body so that it's run down, fatigued, or vulnerable; or just because of the fall, our bodies are imperfect.  Genetics, family history—all those kinds of things play a part in a person getting depressed. 

Also, there is the theme of our heart.  God’s Word talks about how we process things, how we think in our heart, how we interpret life.  When we interpret it consistently with a negative slant, or we interpret it with a slant toward self-pity or bitterness, we can be more vulnerable to depression.   Then there's life.  Life is hard.  There are stressors and losses in life.

Bob:  Well, both of you talk about loss.  Can you often trace depression back to some sense of profound loss?

Ed:  Well, it's a good question to ask.  I was reading a book the other day; and it started off by saying, "There is so much wanting out there."  That is a fine question to ask:  "What is it that I want that I haven't gotten?  What is it that I want that I've lost?" 

That is not necessarily going to drive us directly to the cause of depression, but it's a question that human beings should be asking themselves fairly consistently.

Dennis:  Well, you think about it, as a culture we want more…

Ed:  Absolutely.

Dennis:  than, maybe, any generation that's ever been alive.

Bob:  Well, there's more available to us—more choices, more option—so it stirs more wanting than we've ever had.

Dennis:  And our expectations are sky high.  When expectations aren't met, what do you call that?  Disappointment.

Leslie:  Right, and loss is common.  It is not usually a catastrophic loss for most people.  It might be a very small loss or something that we wouldn't even consider a loss—a loss of self-esteem; a loss of self-respect; being humiliated might be major for someone; a loss of a job; or loss of a pet. 

You know, I tell the story in my book about Elijah's loss.  We don't often look at Elijah's loss.  We know Elijah got depressed, and we usually attribute it to physical fatigue as a result of a spiritual experience.  Certainly, that played a component; but Elijah shifted slightly in what he expected and what he wanted.  What he wanted was Israel to repent. 

For Christians, so often what we want is not bad things.  We don't want sinful things.  We want good things—we want a good marriage; we want our child to repent; we want our children to love God with all of their heart; we want our mother to treat us well.  We don't want bad things.  We want to serve God; but when we don't get what we want, that is a loss.  Elijah wanted Israel to repent.  When he didn't get that—when Ahab and Jezebel did not repent; Israel did not repent—I think that contributed to his depression.

Dennis:  And certainly those in the ministry are not excluded… 

Leslie:  Not at all.

Dennis:  ...from depression.  Okay, I'm going to perform a little poll here in the studio.  There are four of us here.  How many of us at the table have experienced depression at some level?  Maybe it's not the chronic deep, deep depression but you have experienced depression at some level.  Hold your hands up.

Bob: Two out of four.

Dennis:  Two out of four.  Ed, you said you hadn't.  Bob you said you hadn't.

Bob: Right.

Dennis:  I raised my hand along with Leslie.  Now, you just blew my entire illustration here because I thought all of us were going to have something to say about this.  I guess Leslie and I are the only ones that can comment because what I was going to ask everybody to do was simply say, "For you, what is the cause or what has moved you toward a depressed state in your life?"

Bob: Well, I don’t think It’s not that Ed and I have never had times of being discouraged, or feeling alienated, or looking at life and going, “Gee, things aren’t working out the way we want to;” but if you are talking about a prolonged period of “funk,”...

Dennis:  I didn’t say prolonged.

Bob:  Well, then I guess that’s back to the difference between sadness and depression.  I was differentiating that way because...

Leslie:  A depressed mood and depression.

Bob:  Yes.  You said two weeks is kind of a bellwether; and I don’t know that I have beyond two weeks.

Dennis:  Well, if you hold to that strict definition...

Bob:  You’d have to take your hand down, too?

Dennis:  I’d have to take my hand down.

Bob:  Well, this blows all your illustration.  (laughter)

Dennis:  It does. It does.  That leaves only Leslie to be able to comment at this point. 

Ed:  I think Bob is making a good point.  That is one of the reasons I didn’t raise my hand.  I certainly have felt depressed in my life; but I know people who have felt depressed and the extreme nature of that—the thoughts of death that go through their mind moment after moment—I don’t want to put myself in that category.  It would somehow diminish the pain they have experienced.

Bob:  Did you have a season, Leslie, where it was an extended, prolonged, depressed—didn't want to get out of bed; didn't want to eat; all of those things?

Leslie:  It was, and it came after a severe loss in my life.  I tell the story of my husband and I planned to adopt a child.  We had one biological child, and we were planning to adopt another.  Through a series of miracles that we thought God had arranged for us to do a private adoption with a woman, she betrayed us at the last minute and gave the child to someone else. 

I have to say that I did, in that season of time, experience a profound sense of loss and sadness; but I was also angry.  I was very angry at the woman because she lied to us; but probably, if I was honest, and I am, I was angry at God.  "How dare He trick me," is how I put it.  “He led me to believe that He was going to give me the desires of my heart, and then He deceived me.” 

The experience exposed something in my heart that I was not aware of at the time.  Now, I can look back and see it.  At the time, I didn't see it.  I was just buried by it.  My relationship with God was rather superficial.  I was in this relationship with Him for what He could give me.  When He didn't give me what I thought I should get, what I thought I deserved after being so good as a Christian all those times that He was putting me through adversity.   “How dare He take that away from me?”

Dennis:  And so what did you do?  Did you literally crawl up in a ball and…

Leslie:  I sort of just crawled up in a ball, and I gave up.  I threw my Bible under my bed.  I said, "I'm done," and I just sort of just gave up for a while.  I don't remember how long "a while" was.  I didn't go to the doctor.  Nobody had to drag me out of bed.  I still functioned.  I took care of my other child; but I lost a sense of purpose; I lost a sense of direction; I lost a sense of joy; I didn't have any reason to do what I was doing other than I had to take care of my child.  I was just done.  I was done with life.  I think that, for me—I tend to be a somewhat melancholy, glass-half-empty kind of person.  I battle depressed moods regularly, but that was an experience of depression for me.

Bob: Well, then, help us out here because there are folks who are listening who are thinking, "I don't know if I'm just melancholy and I battle bad moods from time to time or if I'm depressed and need something more than just, ‘I'm in a bad mood from time to time.’" 

Is there a way to self-diagnose?  Is there a way to ask yourself these questions and determine:  "This is more than just a bad mood, and you need someone to help you through it,” or, "This is just a bad mood, and it will pass"?

Leslie:  Well, I think there are different kinds of depression, too.  Dysthymia is a low-level depression that's with someone for longer than two years.  How do they know whether that's just the way they are?  Some women just say, "I've always felt this way," or some men say, "I've always felt this way," and don't realize that this is actually called depression.

I think that I'm not sure self-diagnosis is necessarily the right approach.  I think what you need to do is recognize whether you're having a depressed mood or whether you're in a depression. 

First of all, if you're not functioning, like Elijah wasn't, if you're not able to get up out of your bed, if you're not eating, if you're not sleeping, you need some medical attention.  That would be the appropriate first step because you can't even hear anybody talking to you and you can't process anything if you're not sleeping and you're not eating.  You can't think.  That would be the first step.

Dennis:  And you're not thinking right when you do think about God, about yourself, about life, and about the Scriptures.

Leslie:  Right, especially if you are not sleeping.  It is really hard to process anything if you are up half the night, crying, if you are thinking of thoughts of suicide or those kinds of things.  It is really important to get the proper diagnosis to make sure that you are not having another medical condition or that you might need some medication for the short-term. 

Bob:  Go to a medical doctor first. That is what you did. 

Leslie:  That would be the first step.

Bob:  Ed?

Ed: I was going to say the Scripture doesn't seem to really focus on the magnitude of the depression.  It seems to suggest more that when hardships come your way in whatever form they may take, and certainly depression is a profound form of hardship, hardships are a time when we are going to be spiritually vulnerable. 

Our hearts are going to be revealed in new ways.  Questions about God are going to come screaming through our minds in the way they didn't in the past.  Also, we're going to be spiritually vulnerable.  It's as if Satan is just waiting for things like depression to knock on our door because we're already in the midst of depression, we're already saying, "Lord, where are you?  Do you hear us?"  Satan comes along and says, "Yes, they're great questions, and maybe He really doesn't hear you."

Scripture doesn't necessarily say you have to be really depressed.  It's just that sadness and hardships are always opportunities for us to consider, “What does God say to us now?”

Leslie:  Whether we're experiencing depression, like a clinical depression, or a major depression, or we're just in a depressed mood, I still have to practice this very same thing that I am teaching others to practice.  When I'm having a bad day, I have to:  listen to myself—listen to what I'm telling myself—listen to God—and ask myself if I'm really believing Him.  I have to do that in those moments, whether it's a mild bad day or whether I'm experiencing a more prolonged sense of loss and sadness.

Ed:  This goes back to Dennis' vote, where, from this perspective, all of us struggle with depression—every single human being struggles with depression.

Dennis:  Yes.  That's kind of where I was going with it because I think, at some level, whether or not you label it "clinically" depressed, we struggle with, as you said, the hardships of life that drag us down.  They may discourage us, they may neutralize us, they may cause us to become inward-focused on self and begin to believe lies about God, about the Scripture, and the promises of the Bible, and about ourselves. 

There's where the body of Christ comes in.  If you're married to someone who is struggling with depression, one of the most important roles you can play in that person's life is to not enter into their unbelief about themselves and about who God is. If you have a family member, or if you're going through a period like that, we all need others in our lives who remind us of the truth.  I'm going to keep going back to this, and we'll talk about it all week. 

It's the truth about God, it's the truth about the Scriptures—what the Scriptures say about who we are, what our identity is, who we are to be, and that we do have value, we do have worth, and that there are some things about us that need to be dealt with.  We don't always know what's taking place in our lives; and God may be trying to teach us a very, very important lesson through a time of hardship, a time of discouragement, or a time of depression.

Bob: In the course of a conversation like this on the radio, obviously, we can't deal with all of the issues that come up around the subject of depression; but in the books that the two of you have written, people can dive deeper and find out more and get more help. 

Ed’s book is called Depression:  A Stubborn Darkness.  Leslie has written a book called Defeating Depression.  We have both of these books in our FamilyLife TodayResource Center.  In fact, if you would like to get the two books together, we will send along, at no additional cost, the CD audio of the conversation we are having this week on this subject. 

Find out more when you go to FamilyLifeToday.com—that is our website—  FamilyLifeToday.com—again, the books are called Depression:  A Stubborn Darkness and Defeating Depression—or call 1-800-FLTODAY—

1-800-358-6329.  That is 1-800-“F” as in family, “L” as in life, and then the word “Today.”  You can ask about these books, and we will make arrangements to have either or both of them sent to you.

You know, one of the questions that comes up for many of us when we face situations like this, when we are dealing with things like depression or any kind of a trial or adversity is, “How can God be a good God and we still go through these prolonged seasons of difficulty and pain?” 

Our friend, Randy Alcorn, has written a very helpful booklet, 64 pages, dealing with the subject, “If God Is Good, Why Do We Hurt?”  This week, we want to make a copy of that booklet available to you at no cost if that is an issue you are wrestling with.  Perhaps you are a new listener to FamilyLife Today and this is an issue that has been a struggle for you.  Contact us, either online at FamilyLifeToday.com or call 1-800-FL-TODAY.  Request a copy of the booklet by Randy Alcorn, “If God Is Good, Why Do We Hurt?”  We will send it to you at no cost.  Again, you can order online at FamilyLifeToday.com or call

1-800-FL-TODAY.

Now, tomorrow, we want to talk about the biblical command for us to rejoice and the idea that joy is a fruit of the Spirit; and, “How does that fit in with the experience of depression in a Christian’s life?”  We will talk about that tomorrow.  Hope you can be with us for that.

I want to thank our engineer today, Keith Lynch, and our entire broadcast production team.  On behalf of our host, Dennis Rainey, I'm Bob Lepine.  We'll see you back tomorrow for another edition of FamilyLife Today.

FamilyLife Today is a production of FamilyLife of Little Rock, Arkansas. 

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