In his book, The Loss of Sadness, Allan Horwitz pointed out that the Diagnostic and Statistical Manuals have taken more and more symptoms and classified them under the umbrella term of depression. Of course, given the name of the book, Horwitz’s main concern was the topic of sadness. His thesis, or observation, is that people are not allowed to be sad anymore. Instead, they are depressed. As I read I noticed that this is true not only for sadness, but for virtually all of the “symptoms” listed for making the diagnosis, depression. Here is a list I came across at the web site for the National Institute of Health (NIH):
Persistent sad, anxious, or “empty” feelings
Feelings of hopelessness or pessimism
Feelings of guilt, worthlessness, or helplessness
Loss of interest in activities or hobbies once pleasurable, including sex
Fatigue and decreased energy
Difficulty concentrating, remembering details, and making decisions
Insomnia, early-morning wakefulness, or excessive sleeping
Overeating, or appetite loss
Thoughts of suicide, suicide attempts
Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.
These are the symptoms they list as those that indicate that a person has the illness of depression. As you read through the list, notice that none of these things are out of the ordinary for the way life comes at us. In other words, we all experience these effects in various degrees throughout the course of our lives. Our dog dies, we feel sad. Our college finals are coming up and we can’t sleep. We are lack sleep and we feel irritable. So, my question, and Dr. Horwitz’s question is why can’t we just say we are sad? Or feeling hopeless? Or am really tired all the time? Or my life sucks and I think about suicide all the time?
To say that I am sad, or angry, or bitter, or sick, is to take the responsible route. We have to admit that we have played a part in why I feel the way I feel. As long as I can call the reason for my situation depression (which is a very in style word, like nervous breakdown in the 1960’s), I can say I am sick and need to take medication. Which is exactly what the NIH prescribes.
One problem with the label, Depression, is that we are lead to believe that we can’t do anything about the symptoms other than what those who give us the label tell us needs to be done. In this case, medication or electric shock treatment. Psychotherapy is recommended to help us live with the various symptoms. But notice that overcoming the symptoms is never discussed. I guess this is because if you have an illness, you’ll always have the illness. Also, notice that the medication apparently doesn’t do anything with the symptoms, it simply masks the effects of the symptoms so you can get on with your life.
How horrible is that? The Bible tells us that there are remedies for each of these symptoms. Taken one at a time, any one or all of these symptoms can be remedied, dealt with, and removed from our lives. Or if in the case of a real pathological malady, lived with in a gracious and sweet way (none of which are mentioned on the NIH list).
Another problem with the label, Depression, is that we feel justified in doing what the symptom has chased us into doing. I might have said, forced us into doing because by the time these symptoms are so strong that they interfere with the way we are living, they have taken over and are ruling us. When life gets to this point, we have already handled these events badly and have turned inward—making things even more difficult than they already were. When life gets hard and we don’t handle it the way the creator of life prescribes, we become ever more self-absorbed and feel more and more (okay I’ll say it) depressed. But when we call it depression instead of what it actually is, not only do we feel like we must have a disease, we are also justified in not responding properly. Having a diagnosis that justifies, or describes (it certainly doesn’t explain) what is going on, allows us to feel justified to be “ill.”
Following the logic, calling whatever is producing the diagnosis, depression, also causes us feel like we have a right to be angry with God for making us feel so bad. And, we feel justified in being angry with God for not taking the problem away. But in most, if not all of these instances, sin and not handling sin is the reason for the symptom in the first place.
Here’s what I propose. Instead of calling everything depression, let’s call it what it is. If we feel guilty and are under the conviction of sin, let’s call it that. If we call it depression, we’ll never come to God in confession. We’ll never make things right with our neighbor. We’ll just go on feeling bad, until our bitterness destroys us and everyone around us.
If we are sad, let’s call it sadness. Sadness is not necessarily sinful. It might be a part of a grieving process. It might be something else entirely, but whatever is causing our sadness, we can deal with is a whole lot better if we call it what it is. The psalmist said, “Why are you cast down, O my soul, and why are you disquieted within me? Hope in God; for I shall again praise him, my help and my God” (Psa. 42:11).
There isn’t a single symptom on this list that can’t be handled in a way that won’t either cause the symptom to go away entirely, or put it in a light that it can be lived with in a gracious way. We take our situation to God. He gives us a new heart and a new mind. We change our thoughts, emotions, actions in accord with our new heart. And everything falls into place.
Some may ask, isn’t there a kind of person who is depressed as part of their nature? Like someone who is outgoing, or always chipper? The Puritans thought there were some people who were just melancholy. That’s who they were. I don’t doubt that this is so. God is a wonderful God and he likes to mess with our theories. I know this might be true. So, here’s what I do when people come to me for counsel to deal with their depression: I ask them to tell me about their depression. When did it first start? Why did it start? What makes it go deeper or lighten up? Tell me about the symptoms. If they answer the question by giving me reasons for their depression and those reasons are similar or the same as these symptoms, I know that whether or not they are naturally depressed, they need to fix the symptoms by running to God. If, after, repairing these things, they are still depressed, then I might say, they have a depressed personality.
Incidentally, in some 30 years of counseling, I have not found anyone who after confessing their sin, living through the sadness, overcoming their anger, etc. was still a depressed personality. I’m not giving up hope. I’m only saying, let’s not call sin, or the results of sin, depression.
Here is a list I came up with before I found the list on the web. This is a list of things that feel and look a lot like depression, but can be dealt with in a Biblical way, if we will call them what they actually are.
Guilt, Conviction of sin, Sadness, Anger, Bitterness, Grief, Shame, Sickness, Exhaustion, Loneliness, Withdrawal from life, Heartache, Sorrow, Missing, Sober realization of the future, Denial of the truth, Persecution, Habitual Eeyore, Fear, Lack of faith, Lack of motivation, Lack of purpose, Pathological Issues (thyroid, vitamin D, etc.), Entitlement Attitude (Life isn’t fair, I don’t deserve this)
I hope this helps.