1 Kings 19 · Debate · Despair and Depression
Can a Christian Be Depressed?
Elijah, Jeremiah, Job and the psalmist of Psalm 42 each voiced a sorrow that wished for death or questioned God.
Two English pastors of the seventeenth century wrote whole books for readers afflicted in mind, in body or in both.
while he himself traveled on a day’s journey into the wilderness. He sat down under a broom tree and prayed that he might die. “I have had enough, LORD,” he said. “Take my life, for I am no better than my fathers.”
- The question
- Is a believer's deep and lasting sorrow a sin to confess, a suffering to bear, an illness to treat, or more than one of these?
Summary
The church's teachers, from Thomas Aquinas to Charles Spurgeon, have read the deep sorrow of a faithful believer in four ways. They have called it sin or the fruit of sin, a suffering borne under God's hand, an illness of body and mind, or a trouble with causes in body, soul and circumstance together.
- Thomas Aquinas counted sloth and despair among the sins and defined despair as distrust of God's pardon.
- Richard Baxter and Timothy Rogers held that melancholy often starts in the body, and they sent the sufferer to a physician as well as to prayer.
- Charles Spurgeon, who suffered fits of depression himself, held that physician and minister may both be needed for one sufferer.
The Texts Every Reading Uses
Five passages from the prophets, the Psalms and Job carry the weight of the question.
The question is whether a Christian can sink into a darkness of mind that lasts and deepens. It belongs to the trial of despair and depression, because every answer to it shapes how a church treats the believer who cannot lift his own head.
This study gives the texts every reading uses, the four readings in their holders' own words with the strongest objection to each, and four peer-reviewed studies set beside them. It also gives the history of the question, plain words on getting help and the great books.
Then he lay down under the broom tree and fell asleep. Suddenly an angel touched him and said, “Get up and eat.” And he looked around, and there by his head was a cake of bread baked over hot coals, and a jar of water. So he ate and drank and lay down again. A second time the angel of the LORD returned and touched him, saying, “Get up and eat, or the journey will be too much for you.” So he got up and ate and drank. And strengthened by that food, he walked forty days and forty nights until he reached Horeb, the mountain of God.Every reading has to account for these verses, which hold God's first answer to Elijah's prayer to die.
Cursed be the day I was born! May the day my mother bore me never be blessed. Cursed be the man who brought my father the news, saying, “A son is born to you,” bringing him great joy. May that man be like the cities that the LORD overthrew without compassion. May he hear an outcry in the morning and a battle cry at noon, because he did not kill me in the womb so that my mother might have been my grave, and her womb forever enlarged. Why did I come out of the womb to see only trouble and sorrow, and to end my days in shame?These are the words of a prophet God had called, so every reading must find room for such sorrow in a faithful servant.
Why are you downcast, O my soul? Why the unease within me? Put your hope in God, for I will yet praise Him for the salvation of His presence.Each of the four readings claims this verse as its own pattern.
I sigh when food is put before me, and my groans pour out like water. For the thing I feared has overtaken me, and what I dreaded has befallen me. I am not at ease or quiet; I have no rest, for trouble has come.”Every reading counts Job a righteous man whose sorrow came from a cause beyond his own sin.
When I kept silent, my bones became brittle from my groaning all day long. For day and night Your hand was heavy upon me; my strength was drained as in the summer heat. SelahThe reading that traces such sorrow to sin points to this psalm.
The refrain of Psalms 42 and 43 has its own study.
Psalm 42:5, Job 3:24 to 26, Psalm 32:3 to 4
Four Readings of One Sorrow
Timothy Rogers and Charles Spurgeon each hold two of the four readings.
The four readings part over the source of the sorrow, and so over the help that should come first.
| The reading | What the sorrow is | What the believer should do | Held by |
|---|---|---|---|
| Sin or its fruit | A sorrow that turns from spiritual good, or a despair that doubts God's pardon | Confess sin and hope in God's mercy | Thomas Aquinas, Summa Theologiae |
| A suffering under God's hand | A trial God permits, which humbles the servant and fits him to comfort others | Bear it in faith, rest, and wait for God to lift it | Charles Spurgeon, Lectures to My Students; Timothy Rogers, Discourse |
| An illness of body and mind | A disease that often begins in the body and reaches the mind | Take a skilled physician's care beside prayer | Richard Baxter, Preservatives against Melancholy; Timothy Rogers, Discourse; Thomas Aquinas, Summa Theologiae |
| Body, soul and circumstance together | A trouble with causes in the body, the soul and the life around it | Join the physician's skill to the minister's counsel | Greenham, as Rogers quotes him; Charles Spurgeon, Lectures to My Students |
Each Reading in Its Holders' Words
Each reading rests on its own account of where the sorrow comes from.
Sin or its fruitThomas Aquinas
Thomas Aquinas, in the Summa Theologiae, II-II, question 35, article 1, defines sloth after John Damascene as “an oppressive sorrow, which, to wit, so weighs upon man's mind, that he wants to do nothing”. He judges it a sin because it is sorrow about spiritual good.
In question 20, article 1, he calls despair sinful because it rests on the false opinion that God refuses pardon to the repentant sinner.
A suffering under God's handCharles Spurgeon, Timothy Rogers
Charles Spurgeon, in his lecture “The Minister's Fainting Fits”, asked why “the children of light sometimes walk in the thick darkness”, and his first answer was that they are men. He held that God is glorified “by all the castings down of his servants”, because they praise Him when He sets them on their feet again.
Timothy Rogers, who had suffered the disease himself, warned his readers not to judge or censure people under spiritual trouble. He told them to wait until they saw what God would build from the ruins.
An illness of body and mindRichard Baxter, Timothy Rogers, Thomas Aquinas
Richard Baxter preached on Paul's counsel that the penitent at Corinth be comforted, so that he would not be overwhelmed by excessive sorrow (2 Corinthians 2:7). He taught that sorrow, even for sin, may be overmuch, and that with many people a great part of its cause lies in a weak and diseased body.
Baxter told the sufferer who could find an experienced physician not to neglect him, and he wrote that “the Soul and Body are wonderfully Co-partners in their Diseases and Cure”.
Timothy Rogers wrote in the preface to his Discourse, “It does generally indeed first begin at the Body, and then conveys its venom to the Mind”. He left the choice of medicines to those learned in physic.
Thomas Aquinas had already asked whether sorrow is assuaged by sleep and baths, and he answered that “sorrow is assuaged by such like bodily remedies”.
Body, soul and circumstance togetherGreenham, Charles Spurgeon
Rogers quoted an older minister named Greenham, who warned that a minister may look only to the soul and a physician only to the body. Greenham held that the soul is cured by the Word and by prayer, and that the body must be brought into temper by physic and diet.
Of the sorrow that comes without a cause, Spurgeon said, “The physician and the divine may unite their skill in such cases, and both find their hands full, and more than full.”
What the Studies Show
Four peer-reviewed studies measure where major depression comes from and how it answers to treatment.
The studies trace major depression to inheritance and experience together, and find that treatment helps many patients and not all.
| Study | Journal and year | What it gathered | What it found |
|---|---|---|---|
| Sullivan, Neale and Kendler | American Journal of Psychiatry, 2000 | Family, adoption and twin studies, five of them twin studies | The heritability of liability was estimated at 37 percent, with 63 percent from each person's own environment and error of measurement |
| Rush and others, the STAR*D trial | American Journal of Psychiatry, 2006 | 3,671 outpatients given up to four treatment steps in turn | 36.8 percent reached remission at the first step and 67 percent over all four, and those who needed more steps relapsed more often |
| Cuijpers and others | World Psychiatry, 2013 | 67 trials of 5,993 patients comparing talking therapy with medicine | No significant difference overall between the two treatments |
| Cipriani and others | The Lancet, 2018 | 522 trials of 116,477 adults taking 21 antidepressants | Every drug did better than placebo, and the certainty of the evidence ranged from moderate to very low |
The studies agree with what Baxter and Rogers saw in their own day, that the body has a part in this sorrow. They measure risk and recovery across groups of patients, and they leave the questions of sin and faith to Scripture.
The studies of hope and hopelessness have their own page.
How the Question Came Down
The question passed from the pastors of the seventeenth century to the hymn writers and the Victorian pulpit.
Three of the four writers on this timeline suffered the sorrow they wrote about.
- 1692Timothy RogersA Discourse concerning Trouble of Mind and the Disease of Melancholy, in the London edition of that year.
- 1713Richard BaxterPreservatives against Melancholy and Overmuch Sorrow, printed with the note that it was written above thirty years before.
- 1779William CowperOlney Hymns, with his hymn “Light shining out of darkness”.
- 1875Charles SpurgeonLectures to My Students, First Series, with “The Minister's Fainting Fits”.
A timeline of four dated works, each row naming the writer and the work.
Spurgeon's lecture and his own darkness after the Surrey Gardens disaster have their own page.
William Cowper's attacks of melancholy and the hymn he wrote between them have their own page.
Help in the Dark
A reader in danger needs help today, from the people and the care within reach.
If you are thinking of ending your life or fear that you may harm yourself, get help now. Call your local emergency number or a crisis line, and tell someone near you what you are facing.
Medical care belongs beside prayer, and the sufferer needs both. A doctor can judge what the body needs, and a pastor and a church can carry the sufferer in prayer and stay beside him.
The Readings Weighed
Each reading faces one objection that the others press hardest.
The objection to the sin reading1 paragraph
Baxter answered that the more such sorrow springs from the natural necessity of the body, the less sinful and the less dangerous it is to the soul. Job's friends traced his sorrow to his sin, and the LORD told Eliphaz, “you have not spoken about Me accurately, as My servant Job has” (Job 42:7).
The objection to the suffering reading1 paragraph
Psalm 32 shows a sorrow that came from sin David had kept silent, so a believer's darkness may call for confession as well as patience.
The objection to the illness reading1 paragraph
Treatment leaves some patients unwell even after several steps, as the STAR*D trial found, and a reading that sees only illness can leave the questions of guilt and faith unanswered.
The objection to reading the causes together1 paragraph
In a given case the cause is hard to find. Spurgeon granted that this sorrow sometimes comes “we know not why”, and then it is all the harder to drive away.
Books to Read Next
Aquinas, Rogers, Baxter and Spurgeon each left a book that a reader can open free today.
Summa Theologiae, I-II, question 38, and II-II, questions 20 and 35
Thomas Aquinas · English translation of 1920
Aquinas sets out the remedies of sorrow and the sins of despair and sloth.
READ IT FREE →A Discourse concerning Trouble of Mind and the Disease of Melancholy
Timothy Rogers · 1692 edition
Rogers wrote for those who suffered the disease and added letters from other ministers.
READ IT FREE →Preservatives against Melancholy and Overmuch Sorrow, or the Cure of Both by Faith and Physick
Richard Baxter · 1713 edition
The treatise sets out the signs, the causes and the remedies of overmuch sorrow in a pastor's plain words.
READ IT FREE →Lectures to My Students, First Series
Charles Spurgeon · 1875
Spurgeon's eleventh lecture gives the causes and the seasons of a minister's depression from his own experience.
READ IT FREE →The Question at Horeb
The LORD's question to Elijah at Horeb stands where every reading agrees.
When Elijah reached Horeb (1 Kings 19:9), the word of the LORD came to him, saying, “What are you doing here, Elijah?”
Sources
Scripture is the Berean Standard Bible.
- Thomas Aquinas, Summa Theologiae, II-II, question 35, article 1, translated by the Fathers of the English Dominican Province, second and revised edition (1920)
- Thomas Aquinas, Summa Theologiae, II-II, question 20, article 1, translated by the Fathers of the English Dominican Province, second and revised edition (1920)
- Thomas Aquinas, Summa Theologiae, I-II, question 38, article 5, translated by the Fathers of the English Dominican Province, second and revised edition (1920)
- Richard Baxter, Preservatives against Melancholy and Overmuch Sorrow, or the Cure of Both by Faith and Physick (London: printed by W. R., sold by William Hill, 1713), pages 1 to 2, the third question, and pages 82 to 86.
- Timothy Rogers, A Discourse concerning Trouble of Mind and the Disease of Melancholy (London: printed for Thomas Parkhurst and another, 1692), the preface and part 3, about pages 389 to 390.
- C. H. Spurgeon, Lectures to My Students, First Series (New York: Sheldon and Company, 1875), lecture 11, “The Minister's Fainting Fits”, pages 249 to 267.
- Olney Hymns, in Three Books (London: W. Oliver, 1779), book 3, hymn 15.
- Patrick F. Sullivan, Michael C. Neale and Kenneth S. Kendler, Genetic epidemiology of major depression: review and meta-analysis, American Journal of Psychiatry 157, no. 10 (2000): 1552 to 1562.
- A. John Rush and others, Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report, American Journal of Psychiatry 163, no. 11 (2006): 1905 to 1917.
- Pim Cuijpers and others, The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta-analysis of direct comparisons, World Psychiatry 12, no. 2 (2013): 137 to 148.
- Andrea Cipriani and others, Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis, The Lancet 391, no. 10128 (2018): 1357 to 1366.
Keep Studying
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In this trial7
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