Key Points on Depression:
- Depression=self focused, hopeless, emotional pain; an introverted form of suffering that totally obscures hope
- “Causes” of depression are multiple and sometimes complex. Depression is a pneuma-bio-social phenomenon. Depression always has significant spiritual components. Spurgon, Rainer, and Carey all struggled with depression
- Suffering invariably reveals that allegiance of our hearts. Depression is more than just a feeling. It is something we “do.” Depression speaks; it says something.
- Key spiritual foci when counseling depression: excessive self-focus and hopelessness
- Initial counseling strategies:
Lead with mercy and compassion (Jms. )
Provide biblical hope and encouragement (Rms. )
Understand and assess
Explicitly commit yourself to counsel/disciple them as long as necessary
- Develop and elicit commitment to initial steps of trust and obedience: assign direct, simple, achievable homework/goals
- Diagnose heart condition/spiritual/God-related issues.
- Invite the counselee to examine their own heart
- Identify hopelessness and self-focus
- What is the depression saying?
- Renew the mind (Rom 12:2; Eph. , Phil 4:8)
- Take the soul to task; “you must preach to yourself (M. Lloyd Jones); the depressed person must talk to themselves rather than just letting their depression talk to and beguile them into staying in the pit (Ps. 42, 43)
- “Watch how you muse and what you choose when you lose” (Jim Berg)
- Deal with passivity and lack of motivation
- increase pleasure activities
- increase competency activities
- increase altruism/love others
- attack procrastination
- Practice RX: put off/putt on – from/to
- spiritual disciplines
- Discipline of Grace, Jerry Bridges is a great book and has great examples. Many Christians just put it on cruise control
- 2 Tim. 4 (The Race and The Fight) War is going on in her heart. Remind her over and over again who she is in Christ. Sin is not stronger than she is.
- Must get that following God is not passive, there is no shortcuts in holiness. No book can do it for her, she needs to fight, fight, fight.
- Many women describe depression as a pain that is crippling, a room, a black hole that they just cannot get out of. Ask them what they mean! It is a form of suffering (Prob. ) and women are 2 times more likely to become depressed than men. It is not simply hormones, it is very complex.
- Premenstrual Disphoric Disorder (PDD)--- This is severe king and it a deeper level of depression for 1 to 2 weeks before cycle (3-5%) all women
- Post Partum Depression --- 10-20% of first time mom have some version Baby Blues (see counseling manual) 1 week after birth, massive hormone changes.
- S.A.D. (Seasonal) women or 3 times more likely than men. Not a lot of exposure to sun
- Bipolar, most all insurances will cover this one so sometimes over diagnosed
- Dysthemia, mild to moderate depression for 1-2 years.
- Major Depression, suicidal! Lost touch with reality, nothing is good, cannot get out of bed for anything, her body is heavy. Having these symptoms for t least 2 weeks. 50% have recurrences especial if they struggle with it early on in life.
Could be many biological factors even chronic stress, lack of sleep, overworking
What are your goals when counseling (Big Picture)
- For God to be glorified in her life and be sanctified
- to know Him and trust hum
- her faith to be purified
- grow in the fear of God
- mind of Christ
- love others
- her heart reveals who/what she is living for