Is depression a sin?

I’ve been sent a couple of questions on depression. One was in response to my book, You Can Change, asking if I think depression is a sin. The other is from David Wayne, a pastor in Maryland, in response to my series on communities of grace. Here’s what David wrote:

Here in the US, the therapeutic culture defines and narrates the story of depression.  The psychologists, psychiatrists and other therapists are the great high priests on these issues, high priests to whose wisdom we ill-informed pastors must bow. I do know and understand that, by and large, the church and many of us pastors are given to flippant and pious platitudes in response to depression.  On the other hand, since the therapeutic culture gets to narrate the story of depression, when we pastors seek to frame a biblical story of depression we are usually ruled out of line and hurtful.  For the most part, depressed people in my congregation, or others who are under the influence of any kind of counsellor simply will not listen to me.  They will tell me what their counsellor says about how I am to help them and it is my job to receive instruction from them and to never contradict the authority of the counsellor.

Here’s my response to these two questions.

A medical view of depression is not enough

I don’t think that depression is simply a medical condition like breaking a leg. But nor do I think it is a consequence of a particular sin. I think it is more complicated than both of those statements allow. I don’t want to provide a ‘yes’ or ‘no’ answer to the question is depression a sin.

I think a better analogy than breaking a leg might be something like anxiety. An anxious person is failing to trust the sovereign care of their heavenly Father. Jesus tells us worry arises from little faith (Luke 12). Does that mean I condemn an anxious person? Of course not. I sympathize with them. First, because what is causing them to be anxious is real. And, second, because I, too, struggle day by day to have faith in God in a thousand ways. We all do. We are all sinners dependent on God’s grace. So I sympathize with them and I love them. But, because I love them, I also call on them to trust God rather than be anxious. This is where hope is found. This is good news for the anxious person. So I call on them to have faith in God, just as they call on me to have faith in God’s goodness rather than seek pleasure in ungodly ways or to have faith in God’s grace rather than seek to prove myself or to have faith in God’s glory rather than fear people and so on.

The same is true of depression. Depression can have a number of underlying causes – guilt, disappointment, trauma, bereavement, betrayal and so on. (Depression is sometimes linked to chemical imbalances in the brain, but medical science is unclear which is cause and which is effect. In my experience and the experience of others pastors to whom I’ve talked, chemical imbalances are never the only cause. You have to remember that medical practitioners look at all problems in medical terms because that is what they are trained to deal with – they almost inevitably ignore the spiritual dimension.)

We are not responsible for most of those causes. But we are responsible for how we respond to them. We all at different points in our life have to respond to adverse circumstances. Those circumstances may be external (bereavement, failure, disappointment, relational difficulties). They may be internal (illness, chemical imbalances). They may involve both external and internal factors. But we are responsible for how we respond and we will respond with different degrees of faith. Where we are not trusting God’s grace or God’s care or God’s goodness then that response will be expressed in ungodly ways.

The word ‘depression’ covers so much that it is impossible to say depression is a sin or not a sin. Many of those causes (guilt, disappointment, trauma and so on) will make us sad. They may sap our energy and our zest for life. They may feel like an overwhelming darkness. All these are classic symptoms of what people call depression. All of them are, I think, natural and often quite proper responses. But God also tells us to rejoice in the Lord. So in some people features of their depression can reflect a failure to have faith in God in some sense. They may doubt God’s grace and so be consumed by guilt. They may doubt God’s goodness and so be consumed by disappointment. They may doubt God’s care are so be consumed by fear. For some people their depression becomes an identity that enables them to avoid taking responsibility in life.

Does that mean I condemn them? Of course not. I sympathize with them. First, because what is causing them to be depressed is real. And, second, because I, too, struggle day by day to have faith in God. We all do. We are all sinners dependent on God’s grace. So I sympathize with them and I love them. But because I love them I also call on them to trust God and find joy in him. I will do this gently, patiently, persistently. I don’t expect instant change – the Bible does not promise instant change and I know from my own life that change takes a lifetime. But I also want to offer hope. There is good news for the person who is depressed. So I call on them to have faith in God, just as they call on me to have faith in God for the issues with which I struggle.

This is how Steve Timmis put it to me in an email: “I think the most significant issue with depression is that people actually ‘feel’ sad, down, lifeless, disinterested, apathetic and it won’t disappear. There is nothing imaginary about it; that’s the way it is. But I have yet to find someone whose depression is non-circumstantial. In my experience it is always in some way responsive. However, because the incident or situation invariably strikes at the core of who I am and what I cherish or worship, the emotions will not disappear at the wave of a wand, or the reciting of a text or the rehearsal of a truth. But the texts and truths are salient to my circumstances and response to it, so they need to be massaged deep into my heart by me, my brothers and sisters, and through prayer.”

Depression in a community of grace

Let me add – and this brings more directly to David’s email – that I am always surprised that people are so reluctant to say that sin might be involved in depression. People seem to think this is cruel. But it should not be shocking to evangelicals to discover that we are sinners, and that our sin affects us in profound and significant ways. And seeing the sin that is involved also offers profound and significant hope because we have a Saviour who rescues us from the penalty and power of sin. Often the process of change is slow. Complete change takes a lifetime. But change is always possible because of Christ’s work for us and the Spirit’s work in us. That is not cruel. That is good news.

We have two people in our congregation who have been on medication for depression. These are the truths that have brought hope and change to their lives.

I don’t think it is ever a case of repent of your sin and all will be well – if by that you mean that change can be instantaneous or easy. Change is is a daily struggle and a lifelong struggle.

On the subject of medication, I’m not a medical doctor so I am always reluctant to give advice. I fear medication is too often seen as a quick and easy way for the medical services to mask the problem and avoid the time involved in addressing the underlying issues. But I also think medication can alleviate the symptoms of depression and create space to tackle the real issues. Therefore it can play a welcome role. So follow the advice of a medical doctor when it comes to medication, but also seek to address the underlying issues through the gospel care of the Christian community.

The telling statement in the email from the person who asked whether depression is a sin was one in which they said that someone with depression is viewed in the church as ‘less a Christian’; that there is a stigma attached to it. I am really sorry if this has been people’s experience. Really sorry. It is simply not true that Christians with depression are in any way lesser Christians. In fact it’s a horribly, ugly distortion of the gospel. But the issue is not whether some people think depression is a sin or not (as if Christians without depression are not sinners in a myriad of others ways?!). The issue is people believing anything we might do could make us more or less a Christian. That is the lie. I guess it’s a lie many people operate with, but it is a lie. Our identity is entirely based on God’s electing love, Christ’s finished work and the Spirit’s regenerating power. I can’t add to that and I can’t take away from that.

So the real problem, I suspect, are performance-oriented churches where people pretend to be okay because their standing within the church depends on it. A ‘sorted’ person is seen as the standard or the norm, and anyone who is struggling is seen as sub-standard or sub-Christian. I can see that in that kind of environment that to acknowledge that you are a sinner is difficult and distressing. But this is the opposite of grace. Grace acknowledges that we are all sinners, we are all messed up people, all struggling, all doubting at a functional level. But grace also affirms that in Christ we all belong, all make the grade, all are welcome, all are Christians (there are no lesser Christians). Imagine such a church for a moment. Here is Andrew: he sometimes uses pom because he struggles to find refuge in God. Here’s Pauline: she sometimes has panic attacks because she struggles to believe in the care of her heavenly Father. Here’s Abdul: he sometimes looses his temper because he struggles to believe that God is in control. Here’s Georgina: she sometimes has bouts of depression because she struggles to believe God’s grace. When they come together they accept one another and celebrate God’s grace towards each other. They rejoice that they are all children of God through the work of Christ. And they remind one another of the truths each of them needs to keep going and to change. It’s a community of grace, a community of hope, a community of change. ‘Blessed are the broken people for theirs is the kingdom of heaven’ (Matthew 5:3).

The question about depression that really matters

In summary: Is depression a sin? The question only matters if you are part of a performance-based community. If you are part of a community of grace then the question that matters is: What gospel truths do we need to remind you of as we love you?

David ends by saying:

Frankly I think it is often hard for the depressed and “psychologized” person to avail themselves of what a true community of grace might offer. The story they are told by their therapists is that their sufferings are unique and they are fragile and the church community will very likely be harmful to them since the church community probably can’t offer them what they need nor understand them.  Because of that they often can’t come in as participants in the community of grace – they often have to stay at arms length because of the harm that may come to them from others … I deeply long for the kind of community you are describing, but have been terribly frustrated at the fact that many expect the community and it’s leaders to submit to the conventional wisdoms of the therapeutic culture.

Recommended books on depression

If you want to follow this up further here are my top book recommendations:

Dr Martyn Lloyd-Jones, Spiritual Depression: Its Causes and Cures

Edward Welch, Depression: A Stubborn Darkness

John Piper, When the Darkness Will Not Lift

15 thoughts on “Is depression a sin?

  1. Thanks Tim. An interesting post which I think I’ll need to chew over more.

    I’d also recommend “A Practical Wokbook for the Depressed Christian” by John Lockley. This is the book I found most helpful when I was depressed and other friends with depression have also recommended it. It’s especially helpful as it’s written by an evangelical Christian doctor who also struggled with depression for about 6 years.

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  3. Very good post Tim.
    As someone who has experienced and been treated for depression in the past I can only echo what you have said here. I can also echo that the analysis given in the quotation from Steve Timmis is spot on and that most depressions are the result of a wrong reaction to adverse circumstances threatening something we are wrongly treasuring as important to our self identity.
    There are a couple of comments I would like to add from my own experience:
    1. Your comment about medication is spot on. Medication IS prescribed way too freely by GPs as a ‘one solution fits all’ strategy. But, as you rightly say, sometimes medication is necessary in order to stop the daily downward spiral and to create the space in which you can start to hear or to listen to God’s truth and start to rebuild your thinking patterns.
    2. The ONLY way out of depression is by a renewing of your thought patterns associated with how you understand your identity as a person. However, YOU have to become fully persuaded of God’s truth YOURSELF, not just accept it because someone else tells you it is true. Being able to tell yourself the truth is the only answer, but it can take time to get to this stage. I have seen too many well meaning counsellors get frustrated with a depressed person because of their seeming inability to believe the truths they have told them. Often it is NOT a case that the depressed person does not acknowledge the truth of what they have been told, but it is that it can take some considerable time for them to assimilate those truths to the extent that they believe them thoroughly and can tell themselves those truths.

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  5. Obviously a difficult topic. I cringe most of the time it comes up in a Christian setting. Very few people deny that antidepressants are overprescribed, but don’t throw the baby out with the bathwater. There are people out there who quite simply need medication in order to function properly. It isn’t a stop gap, something to tide you over until the real problem is fixed, it is the problem. It is disingenuous and hurtful to deny this. This may be the minority of cases, and I do think it’s wrong to prescribe antidepressants without also requiring the patient to seek out some sort of therapy. I also think care must be taken in discussing the topic so as not to alienate and hurt the crowd of people who truly rely on their medication.

    You’ve admitted that you’re not psychologists or physicians, so instead of worrying about what those folks are doing wrong, I think the church would be better served to figure out what it is they’re doing that has led therapists to say such things about the church? The community of grace sounds wonderful, but it simply isn’t what most people experience. Why wouldn’t a therapist advise a client to stay away from the church if the church had been a source of pain and hurt? Why does the church see therapists as adversaries? Maybe clients listen to their therapist more than their pastor because they find what the therapist says to be more helpful? There are plenty of therapists out there, even those who aren’t believers, who do a wonderful job at helping people in ways that don’t necessarily strengthen their faith, but doesn’t really hurt it either. God can and does use these people. There are also plenty of pastors out there who do a terrible job of counseling and offering support to people who are truly hurting. The quote from David Wayne sheds some light on this, mocking therapists for acknowledging their clients fragile and unique state. No wonder his parishioners don’t exactly feel the love when they’re met with a message that basically says “you’re just like everybody else, now suck it up and go read your bible”

    My recommendation to churches is to seek out the counseling professionals in your area who are believers or who have received some biblically friendly training and establish a relationship with them. Find the guy with the PhD in clinical psychology that isn’t afraid to pray with his clients, they are out there!! Make more referrals, fund the counseling if you need to, and keep the actual pastoral counseling limited in scope. With all that pastors have on their plates, and the limited training they receive in terms of psychology and counseling, I think this is a much better approach to take.

  6. It may be helpful to strengthen your acknowledgement and explanation of the physiological effects of depression – so you don’t swing to the other extreme, but stay centered.

  7. Whoops, meant to add this:

    These are the figures I found: one in four women and one in ten men are likely to experience an episode of clinical depression in their lifetime. So I guess there will be a reasonable number of Christians who we will come in contact with who will be struggling with this. It could be helpful for us to educate ourselves in the area of depression so that we may be more effective in encouraging and building up the body of Christ.

    Depressed people do need to see a doctor; AND they need to be encouraged by the Christian community.

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  12. I think saying that medication is overprescribed is completely irrelevant and in conflict with living in a community of grace. First of all, I’ve never seen a relevant stat on how many people in the church are on anti-depressants. How could we possibly know whether or not they are being over-prescribed or prescribed too freely for people in the church?

    It is a moot point, and when it is continually brought up, it immediately alienates the people who are on medication. Because they will assume that this includes them. The evidence is anecdotal and my own anecdotal evidence is to the contrary.

    Christian leaders should be less concerned about what medication their parishioners are on and how long they’re on it and more concerned about comforting someone who is experiencing sorrow that seems to have no cause.

    The Lord knows the cause, He is ultimately the cause. And perhaps part of the reason He is inflicting the depression is to test those who are supposed to be the body of Christ to that person. How are we doing church???

  13. I wonder why no-one ever asks if diabetes is a sin?

    I once heard a Christian doctor make the comparison between diabetes and clinical depression (I’m not really sure here that this post adequately distinguishes clinical depression from what the lay person often thinks of as depression).

    Points of comparison include (this is not an exhaustive list) chemical imbalances within the organ concerned, the necessity of medication to counter these effects, the risk of death if the condition is not adequately treated.

    To suggest that clinical depression is a sin means that some suffering souls will not seek medical help early and their condition will deteriorate with possibly life-threatening consequences (possible suicide).

    Many people do experience low mood because of a lack of faith in God’s provision, doubting that they are worthy of His grace and forgiveness and so on. This is not the same as depression.

    I can only speak from experience, but when I have been clinically depressed these are the times when I have experienced the love and comfort of the Lord Jesus most powerfully. Never have I felt convicted by the Holy Spirit to repent of my depression, though I have felt condemned by other Christians who thought I should just pull myself together. The key difference between low mood and clinical depression is whether the individual concerned has the ability to do anything about it. Genuinely clinically depressed people do not have the ability to cheer themselves up or pull themselves together.

    In my darkest moments all I have wanted to do was die, the pain of the depression was an overwhelming, almost physical experience. My only comfort was the fellowship I experienced with the Lord Jesus Christ, the only way through the valley of the shadow of death was leaning on a staff of praise and worship, the only place I wanted to be was with my Master or with worshipping brothers and sisters.

    In short, my depression significantly increased by desire for God and the time I spent in worshipping Him. Does this sound like sin?

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