Faculty View | Depression & the Puritans
How should a Christian view depression? There are a variety of perspectives, ranging from believing it to be sin to acknowledging it as a biological illness. How have Christians viewed depression in the past? The Puritans were surprisingly adept in the pastoral care of people with depression. Books like A Christian Directory by Richard Baxter, Trouble of Mind and the Disease of Melancholy by Timothy Rogers, and A Lifting Up of the Downcast by William Bridge testify to the importance of pastoral care for those so afflicted. Puritans recognized that such distress could originate from multiple sources. One was the disease of melancholy. Melancholy was acknowledged as genuine disease, very much like what we would describe as major depressive disorder. Richard Baxter understood that those afflicted with the disease of melancholy were “impaired in both brain and imagination and their reason is partly overthrown.” Similarly, Puritan Timothy Rogers advises, “look upon those who are under this woeful disease of melancholy with great pity and compassion . . . for they, alas, are wounded in both soul and body.”
The criteria for a diagnosis of major depression are strongly indicative of biological components. Symptoms include a depressed mood most days, sleep difficulties, psychomotor agitation or retardation, fatigue, feelings of worthlessness or guilt, diminished ability to concentrate, indecisiveness, recurrent thoughts of death and self-harm, and a loss of pleasure in once-pleasurable activities. Many of these symptoms suggest irregularities with brain chemicals that may resolve when medications that regulate these chemicals are introduced.
In some ways, depression is like diabetes. Both have psychological and behavioral components that can exacerbate the illnesses. Both may even be precipitated by specific behaviors. Persistent substance abuse or a pattern of pessimistic thinking may lead to depression, just as persistent overeating and inactivity may lead to type II diabetes. Psalm 32:3-4 reminds us of the connection between sin and physical distress: “For when I kept silent, my bones wasted away through my groaning all day long. For day and night your hand was heavy upon me; my strength was dried up as by the heat of summer.”
Research evidence demonstrates that medication and some forms of psychotherapy can effectively resolve depression. The Puritans’ remedies included meditation on the promises of pardon for sin in the Gospel, avoiding morbid and excessive preoccupation with sin and focusing instead on Christ, who rescues us from sin, and spending time in the company of “judicious, compassionate, and experienced Christians.” As a disease, depression can fully resolve or result in suicide. By acknowledging that depression has multiple facets and addressing each with the appropriate remedy, the Christian may rejoice in God’s provision of hope through so many channels.