“Do you work wonders for the dead? Do the departed rise up to praise you? Selah… Are your wonders known in the darkness, or your righteousness in the land of forgetfulness? (ESV)”1 (Psalm 88:10, 12). This Psalm of the Sons of Korah captures the powerful emotions in the despair of the Christian who must travel through the dark paths and alleyways of depression. Does God remember? Is there love? Must I suffer on this lonely island of despair? Even the closing words of this beautiful psalm express these words of struggle and wrestling: “You have caused my beloved and my friend to shun me; my companions have become darkness.” (Psalm 88:18)
Dr. Edward T. Welch writes about the difficult matter of depression in his book Depression: A Stubborn Darkness. He brings the expertise of years as a Christian counselor and as a teacher at Christian Counseling Educational Foundation (CCEF) to the table. He is also an example of a mature family man, with a wife and two daughters. In this book, he focuses on the spiritual aspect to depression, while recognizing and encouraging his readers to see that there may also be medical and other factors at play as well. As a Christian counsellor, he ensures that the good news of Jesus Christ will play a prominent role in the wreckage and brokenness of the mind. As such, that gospel does not only provide hope in the middle of physical brokenness, but also lays out the path of healing and transformation from sinful patterns of the mind and the heart.
In the introduction, Dr. Welch does three things: he explains the path, the feeling of depression, and gives some definitions and causes. He paints a positive picture of the one who suffers depression as a pilgrim following the call of God and even shares the example of Psalm 88 as a prayer which one might speak to God along the way. The feeling of depression is often described as “Hell,” as a place of abandonment. The images are full of darkness, pain, meaninglessness, lifelessness, numbness sometimes leading to thoughts of suicide. The preacher, Charles Spurgeon, wrestled with episodes of depression and once said: “I could weep by the hour like a child, and yet I knew not what I wept for.”2 Dr. Welch also explains the types of depression. From less severe to more severe they are described as: discontent, dysthmic disorder, situational depression, hopelessness, major depressive disorder, clinical depression.3 It is important for the Christian to describe his/her feelings. Depression should also be approached carefully, and while medication might be one aspect to the answer, Dr. Welch does not want this to become the only plan of attack.
b. Part One: Depression is Suffering
Depression is suffering and we see many cases of suffering in the Scriptures and in the world with various causes including ourselves, other people, our bodies, Satan, and even God’s will brings us through suffering (most of these causes are unknown at the time). Often God is challenged and questioned during this time of suffering, and the one suffering should recall the sufferings of Christ for an unworthy people as well as the goodness of God at the cross of Jesus Christ. And so the response to suffering (like the men of Psalm 88) should be to cry out to God, after all, this is what Jesus Christ also did on the cross. We can put the words of these Psalms in the mouth of Jesus on the cross (like Psalm 22). While depression turns inward, the Christian response is to call out to God and make war in Christ. This is done by realizing the lies of Satan and speaking the truth of forgiveness and life in Scripture. The depressed individual must remind himself/herself of the promises of God daily. In those promises the Christian finds purpose in glorifying God and loving Him and keeping His commandments. And so, while depression is calling for complete surrender, the Scriptures are calling the Christian to persevere through the battle.
c. Part Two: Listening to Depression
There is a necessary self-honesty as the Christian listens to what his/her depression is saying: where does what my depression is saying to me depart from the truth revealed in Scripture? Here, Dr. Welch works with the various causes for depression while recognizing also how the fall of Adam has affected our physical bodies and not just our spiritual health. He speaks about how a culture of decisions, individualism, self-indulgence, the idolatry of happiness, and entertainment/boredom affects us as Christians. He then discusses the natural inclinations of the heart: pride, autonomy, various lusts, covetousness. In his discussion of the unveiling of the heart, he talks about the wilderness of depression, and finding joy in Christ in the wilderness. In chapters 15-20 he responds to a number of issues that might factor into causes for depression: fear, anger, dashed hopes, failure and shame, guilt and legalism, and also death. In all this, he returns to the central comfort of the Christian life. Even in times when the Christian turns to suicidal thoughts, the only comfort is Jesus Christ (HC, LD 1).
d. Part Three: Other Help and Advice
Here, Dr. Welch first deals with the matter of medical treatments. This is important for those who might feel threatened by his spiritual-oriented approach. He does indeed recognize the person in his/her entirety, including body and soul. He remarks that antidepressants have helped many people but not all people. He then admits that it is unclear whether medication or counseling works better. He cautions about long-term use, side-effects, and thinking that medication is the answer. Obviously, this might be linked to other medical problems, so medical examinations are important. He follows this with some encouragement for how to help as a community: including thoughtfulness, seeking help, and working on a positive lifestyle (I.e. structure in exercise and sleep). He then lays out some strategies and suggests that people should expect to be surprised by the power of love.
e. Part Four: Hope and Joy: Thinking God’s Thoughts
In this final section, Dr. Welch encourages the reader to develop specific virtues as they press forward in hope and joy. He offers the example of a comedy, where Jesus really does triumph in the end, which then gives cause for humility in the face of suffering. This humility also comes accompanied by hope in the final return of Jesus Christ after His triumph at the cross and resurrection. This hope and humility is accompanied by gratitude for what God is doing even in the difficult situations of life. Finally, Dr. Welch concludes with a warm note of encouragement to the reader as he expresses his love and desire that the grace of God would be with readers in their suffering and as they assist others in their suffering.
I would highly recommend the work of Dr. Welch to Christians who are wrestling with the various degrees and causes of depression. He recognizes the person as body and soul rather than reducing the matter of depression to one issue. Not only is he deeply aware of the human condition, but he also has a grasp of the gospel and how that applies to the human condition. He expresses an awareness of the thoughts and doubts that those going through depression have to wrestle with. He shows a sensitivity to the trials of those suffering depression and provides goals and hope in the middle of the intense suffering of depression.
I appreciated Dr. Welch’s focus on helping people work through the spiritual questions at play. After all, he is not a psychiatrist or a doctor, but a Christian Counselor. One of my concerns with the modern movement against depression is that there is a tendency to think of it as purely physical. The classic analogy that I have heard from Christians is that depression is akin to a broken arm. While this comparison works in the sense that the brain and an arm are both physical, the brain is also affected by things such as stress and fear in a way that an arm is not affected by stress and fear. The point is not to make the Christian feel guilt and shame as a result of physical things such as a lack of iron in the blood or a thyroid that is malfunctioning, but to help the Christian be self-honest with other factors that may be at play in this depression.
While Dr. Welch talks briefly about antidepressants towards the end of the book, as well as other matters on how to deal with the physical side of depression, I would encourage those who read this book to read broadly. This could include articles on the Gospel Coalition and Desiring God websites, but also to find resources on antidepressants, psychotropic drugs, and other ways of dealing with depression. This could include talking with doctors and nurses where possible. I appreciate that Dr. Welch brings out the fact that people are both positively and negatively affected by antidepressants, and that in spite of either effect, he wants to help them deal with whatever spiritual matters are at play.
While he does make remarks on goals to make in the middle of depression, I believe that there could be more practical advice in the area of not just thought patterns, but also lifestyle. Sleep, eating and exercise patterns are all very important things to think about in the area of depression. In this area, good friends are important as well. Finding friends who avoid both flattery and who refrain from harsh criticism, are also necessary for a positive approach to self-honesty. Finding time to walk in nature and good company to fellowship with, do amazing things to lift a heavy heart. I have found a lot of practical advice in this area in the Book of Proverbs, and I would suggest Proverbs as a good place to start in Scripture in examining the matter of depression. It gives clarity for how to live life in the middle of the fog and those who are committed to following its path will find clarity even in the brokenness of the mind.
A Brief Thought on Psalm 88:
Reading Psalm 88 can provide biblical expression for the pain that a depressed person is feeling. It also lays out the path to cry out to God in the midst of suffering. But without interpreting it with Christ at the center, it can be hard to understand. Christ suffered everything and worse than what the depressed person is going through. On the cross, He really was forsaken by His father. When Jesus finds Himself alone and when the Father turns His face away, these words could describe His state of mind: “O LORD, why do you cast my soul away? Why do you hide your face from me?” (Psalm 88:14) But because He rose from the dead, we now know that the end experience of the Christian life is not the cross, but the resurrection of the dead.
Depression: A Stubborn Darkness is an excellent book for Christians to read as they reflect on how the gospel applies to their suffering. It might be a long path ahead, with many twists and turns, through dark paths marshes which reek of death. But even during those times, we see an objective promise for the sufferer to cling to in Scripture. This promise is that the Great Shepherd will be with His faltering sheep: “Even though I walk through the valley of the shadow of death, I will fear no evil, for you are with me; your rod and your staff, they comfort me.” (Psalm 23:4) God is often at work in our darkest times, guiding us with His staff and disciplining us with His rod. This is the great comfort that Dr. Welch brings out in this book, and it is a comfort that every man and woman can experience.
1 All Bible references will be from ESV.org.
2 Edward T. Welch, Depression: A Stubborn Darkness (Greensboro: New Growth Press, 2004), 21.
3 Ibid., 28.