Depression: When a Member of the Flock Needs Special Care - Lesson 4
The Elephant in the Room
In this lesson, you'll gain a comprehensive understanding of the complexity of depression, its various causes, and the importance of considering a balanced approach to treatment. Recognizing that depression is not solely spiritual, physical, or emotional, you'll explore the role of the church and prayer in addressing mental health issues and the consequences of delayed treatment. The lesson also discusses the importance of accurate diagnosis and evaluation using self-assessment tools, addressing the physical aspects of depression through an understanding of neurotransmitters and antidepressants, and the interconnected nature of depression with aspects of your life such as sleep, relationships, and spirituality. By adopting a balanced approach, you can begin to navigate the complexities of depression more effectively.
The Elephant in the Room
I. The Complexity of Depression and Its Causes
A. Polarization and strong feelings about depression
B. Spiritual ramifications and treatment approaches
II. The Role of the Church and Prayer
A. Misconceptions about mental illness and prayer
B. Consequences of delayed treatment
III. Diagnosis and Evaluation
A. Overlapping symptoms of different disorders
B. Self-assessment tools
IV. Addressing the Physical Aspects of Depression
A. Neurotransmitters and antidepressants
B. Genetic mutations and the need for vitamins
V. The Interconnected Nature of Depression
A. The role of sleep, relationships, and spirituality
B. The need for a balanced approach
- In the first lecture of the course "Depression: When a Member of the Flock Needs Special Care," you will gain insight into what depression is, how it affects people, and what causes it, as well as learn about the difference between depression and normal sadness, and how to recognize signs of depression.
- This lesson teaches you to view depression as a warning sign, and helps you understand the various causes and risk factors, including predisposing biological factors and neurotransmitters, for a more balanced approach to addressing and managing depression.
- In this lesson, you learn about the spiritual aspects that influence our understanding of the heart of God, examining misconceptions and stereotypes, as well as how depression affects Christians. Through biblical examples, you gain insight into God's compassionate response to those who struggle and his desire for a relationship with his followers.
- In this lesson, you learn about the complex nature of depression and the need for a balanced approach to treatment, considering spiritual, physical, and emotional aspects while debunking misconceptions about mental illness and prayer.
- In this lesson you will discover the importance of adjusting the focus of our thought life as part of the process of overcoming depression. You will also learn about the importance of having an open discussion about depression in the context of a church community. And finally, two common mistakes we make often make; trying to control things we don’t have control over and not controlling things we do have control over.
- In this lesson you will learn about the importance of dealing with anger appropriately and hear suggested strategies for doing it. This lesson also covers the importance of an accurate self-concept and how scripture informs us in this area.
The primary subject of this course is depression. In much of the Christian world this topic has been taboo, misunderstood and rejected out of hand. If that is your perspective, let me encourage you to take another look. In 2005 I almost lost the ministry God had gifted me for and called me to because of depression. Dr. Gregory Knopf, my medical doctor at the time treated me with skillful, tender, compassionate Christ-centered care and saved my ministry. Dr. Gary Lovejoy brings a pastoral heart to his profession and to this issue. If you are a leader in a church, this course will give you insights into people’s lives that will be productive. If you are struggling yourself with discouragement you will be encouraged and challenged.
In Lecture 4, The Elephant in the Room, Dr. Lovejoy mentions some self-assessment forms. You can find them in his book, Light on the Fringe: Finding Hope in the Darkness of Depression.
Feeling sad, anxious, hopeless or depressed is mystifying because there seems to be so many confusing explanations for what is causing a person to feel so bad. Instant...
A Christian's Guide To Depression & Antidepressants
This book defines depression and its' basic causes, provides the criteria for determining whether one is depressed or not, and then outlines the basic options for...
A Pastor's Guide for the Shadow of Depression (Light in the Darkness)
Pastors face unique challenges and unrealistic expectations that can lead to feelings of failure, deep sadness, and depression. Too often they feel no one understands, as if...
Strands of Light: Seeing Hope in the Fog of Depression
Having a strong Christian faith is certainly no guarantee against depression. But what if depression has a good purpose in Godâs plan? Strands of Light challenges readers...
Light on the Fringe: Finding Hope in the Darkness of Depression
"Light on the Fringe: Finding Hope in the Darkness of Depression" addresses the difficulty that many depressed Christians often have in understanding their...
Dr. Gregory Knopf and Dr. Gary Lovejoy
Depression: When a Member of the Flock Needs Special Care
The Elephant in the Room
Dr. Greg Knopf [00:00:06] Well, thank you. We're starting our next session here talking about depression and the complexity and the factors that are involved for all of us in our professions, in our churches, in our lives. And I'd like to just probably talk a little about the elephant in the room, and that is that, frankly, there's a lot of polarization and strong feelings as to how people perceive depression and what its causes are and what is treatment is appropriate and and what the spiritual ramifications are. I think I'd like to start by reading an article that was just recently sent out by church leader AECOM, and it's written by a woman who contributes to Christianity Today. And she she's title's it's evangelical. Why You're wrong on Mental illness. So I thought I would just to read it and then we can talk a little bit more about it. It says among evangelical fundamentalist or born again Christians recently surveyed, 64% believe churches should do more to prevent suicide. At the same time, 48% believe serious mental illness can be cured by prayer alone. So if you believe churches should do more to help prevent suicide, here's one tangible and quick way to help right now. Stop telling people they can cure their mental illness with only prayer. That got some good comments. I'll tell you, although seeking treatment is not condemned in a wholesale manner. Prayer and Bible study are prescribed as the first step to try to avoid treatment. And this, for many people, has the same effect as discouraging treatment. It certainly has. The effect of delaying treatment and delay increases the likelihood that mental illness will become more severe, cause serious disruption and functioning, and potentially cost a person his or her life. I'd like to just add to that that from the medical standpoint that if depression is allowed to exist and go untreated for years and years, studies have shown that it actually causes a shrinkage of the brain cells in the hippocampus and actually increases your risk of having Alzheimer's disease later in life. So this is not a benign condition. So it says one sure way to drive people closer to despair is to tell them their mental illness is simply a spiritual problem. Tell them to pray it away. And when it doesn't work, just tell them to pray harder. Laying a heavy spiritual burden on people suffering from serious mental illness is a way to encourage suicide, not to prevent it. It is easy for most to see that if you told people with cancer, diabetes or kidney failure that prayer was the best way to treat their life threatening illness. And because of your counsel, they refused medical treatment. You would be contributing to their death. Do you realize serious mental illness is also a life threatening condition for anyone to self-righteously tell some people they do not have a medical condition that requires treatment and that more rigorous religious activity is all they need. It is and it is inexcusable. Your faulty advice doesn't just doesn't work and condemns the person to suffer with feelings of spiritual inadequacy or abandonment. How can they conclude that their prayers aren't good enough or that God has walked away from them? Now God can heal anyone, and sometimes He does so miraculously, but most of the time he doesn't. Such an acknowledgment does not undermine God's greatness or his goodness. He has placed us in a world where we live within the boundaries of the very natural laws he created and with the presence of disease, decay and death. Mental illness, like other diseases, is a reality of the world. Excuse me, is a reality of life in a world where parts of our body, including our brains, get sick and malfunction. We don't consider it acceptable to prescribe prayer alone for a disease to livers, hearts or pancreases. So why prescribe it for disordered brains? Prayer is critical to a healthy spiritual life. Whether or not we are suffering from serious disease, but it is not a responsible replacement for medical treatment. So one of the things that I think is helpful and what we're arguing for and trying to present is a balanced approach. Again, to see the depression as a symptom, as a warning sign, as an alarm system to enter into a process of evaluation. And one of the things that I use in my office when someone comes in are three self assessment tools, because I sit down and I explain to them, and this is listed in my book called Demystifying Depression for Christians. That there's a lot of overlapping of the symptoms of major depressive disorder, generalized anxiety disorder, and a subtypes bipolar disorder and attention deficit disorder. In other words, anxiety can be one of the symptoms of all four of those. So in order for me to sort of diagnose accurately and treat appropriately, it's helpful to confirm not just the symptom but the underlying issue going on. So all the tools that I use is number one called the Hamilton Survey for Emotional and Physical Wellness. And these are available on our websites, which you will receive that these are free download and it's 25 questions and it helps people to quantify some of their symptoms. It has listed here thoughts of suicide, issues of sleep, anxiety, fatigue. Then another of the four, the second one is called the GAD seven stands for Generalized Anxiety Disorder and is simply seven simple questions. And it helps to sort of quantify the degree of anxiety that they're experiencing and the severity. And then another one is called the Adult Self-report Scale as a symptom checklist. And this for people who may have adult attention deficit disorder. And then the last one is called the Q excuse me, the Mood Disorders questionnaire, the M.D.. Q And this is 13 questions, and it helps me to confirm whether a person could have bipolar disorder, which is a subtype of depression that can have more serious consequences and have more erratic symptoms and is usually genetically based. So once I evaluate people with these type of questionnaires, it helps me to say what is going on physically, How much of what is occurring in this person is related to their biochemistry. And then I will oftentimes sit down with them and use this analogy. It actually has a tank here. But I also will say to them, if I go into your house and it's wintertime and it's 50 degrees, either somebody left all the doors and windows open or your furnace is not working. So either you're losing these neurotransmitters because of stress and other factors and biology, or you're not able to make enough. So the major neurotransmitters, the serotonin, norepinephrine and dopamine. Your body makes this every day and your body breaks it down every day. So in order if your tank is low, then the only way to improve or to raise the level inside the tank is to either block the breakdown and conserve what you've already made or to make more. And there's a couple of ways to do that. Antidepressants simply help your body conserve what you've already made. They are not addicting. They are not Valium. They are not just putting a Band-Aid on the symptoms. And then there's also about 10% of people who can experience a genetic mutation. Add the methyl tetrahedra, folate reductase, enzyme. And these people need a vitamin to bypass that blockage, which allows their body to have the building blocks that it needs to manufacture and create more of the neurotransmitters that are necessary. So these are some of the principles that I use when it comes to addressing the physical aspects of a person who may be experiencing depression. And frankly, most of the time it's not 100% any one of these things. It's usually a combination because if I'm not sleeping well, it's going to affect my spiritual life. If my relationships are a problem, it's going to affect my sleep and my spiritual life and how I relate to God in my concepts of God. So as Gary was saying earlier, these are all interconnected and they are complex. Therefore, the solutions need to be well balanced. And so what we're advocating for is to say, okay, is all depression spiritual? No. Is all depression physical? No. Is all depression emotional? And because your parents messed up know it, all those factors can play a role, but each one experiences that differently. And this is, again, a warning sign of God's faithfulness in your life. Just saying there are some things that you need to understand in order to optimize your health physically, emotionally and spiritually. So I realize that some of these issues are controversial and a lot of people hold very, very rigid views to a particular viewpoint. And so what we're trying to to try to do is to try to open up a dialog and say, you know, let's let's have a conversation about what is best for the person, because I tell people I'm not here to. Put you on pills. I'm here to help you feel your best. And the studies have clearly shown in the medical literature that medication plus counseling together are better than either one alone. And that's why it's so important to be part of a community of faith and healing. Because I will oftentimes ask people, now I'm going to help to manage maybe your medication and help to see if we can find one that will be right for you. We'll set you up with a good counselor. Now, do you have a spiritual community or what do you do to nurture your spiritual life? What is going on in that area of your life? And to be able to say, yes, I really encourage you to to talk to your pastor or to visit a church if you're not going to one currently to enhance that area of your life, to give you a perspective that you may not have now. So those are some of the things that that we believe are important as we're trying to help people come to a more clear understanding of what's going on so that it's not simply a knee jerk reaction based on if you're feeling down, then just do this. And I've actually seen programs where actually a doctor, an M.D., said, you know, all depression is caused by yeast and it's all candida. And if you just take this thing I'm going to sell you, your depression will go away. Well, you know, this is charlatan and it's it's it's it's totally bogus. And so but sometimes people can be gullible into believing certain things about a variety of substances that people may be looking for, a quick miracle cure. And what we're trying to say is step back and just say, let's do a multi-disciplined evaluation and approach. So those are some of the thoughts that we have as we're moving forward.
Dr. Gary Lovejoy [00:11:56] Well, Greg, I you know, I was particularly appreciate you commenting about the whole idea that it's not all this or it's not all that and and that it's far more nuanced, nuanced than that, because there are so many complex variables. I think one of the things we're trying to communicate is that depression is a very complex disorder. It's not something it's very simple. It's not a 1 to 1 relationship. And so there are just as there are many factors that give rise to it, there are also many approaches that can be useful for it as well in terms of treatment. But one of the things I want to address and go back to this letter that you read earlier, Greg, about the issue of that, that all serious mental illness can be cured by prayer alone when and oftentimes people react very, very strongly to these kinds of articles. And I know you wrote an article that about medication and got a similar response. And you get you know, very few people fall in between. It's either very heavily in one direction or the other. But I'd like to address that because because I really grieve over the kind of of of of dissention that that can potentially cause in the church. It's not our desire, quite frankly, to to create more dissension or to create more conflict or more more difficulties, but rather to help us understand how these can be blended and understood. For example, it is not an issue. We certainly are the first to recognize the power of prayer. We would never say the power of prayer does not exist and that you must, you know, seek out these other alternatives. Prayer is a vital part, just as a biblical study is a vital part of the spiritual life of every person. And that spiritual life has an impact on the way they process their experience of depression. But, you know, even prayer itself is a complex experience. And we said, Well, what do you mean? Well, we often think about prayer as, you know, asking God to intervene in some way, especially when you're in adversity. I remember in the first chapter, James says, Carol, Joy, that you are suffering trials. I mean, is he talking that we need to be masochists, you know? Yeah, I love it. Give me more adversity. No, he's not talking about that. He's not talking about be happy. He says, I know it's not a happy experience, but be joyful because God is crafting in your person something new and different and better. And it may be a painful experience at times, may be a difficult process, but I don't believe that God creates adversity. I think what He does is he never wastes an experience. And so when adversity occurs, he then uses that adversity to grow us. But that I don't believe he's the author of it. I think that in this situation, you can see this in the nature of prayer as discussed by by James again, later in that same chapter one James, he says something quite counterintuitive. He says. You know how we see again if we pray, if we've got an illness or a loved one has an illness or some or they're depressed or they're have other problems, we cry out to God and say, please take this from us. Please heal this person. We have hope. Whole groups praying for the healing of different people, which is fine. But and that I'd say nothing negatively about that except to say this prayer is more complex because what James is saying is this is very counterintuitive. He says, pray such as this that you would ask God for the strength to remain under the endurance, to remain under the adversity until he has completed his work in you. Whoa. That is really counterintuitive. There is. I'm he's saying, have you ever stopped to consider that perhaps your prayer life can be made more effective if rather than pray that we get out of our adversity, that we pray that we're given strength to endure our entire city until God has complete his work in us? That's a whole different view of prayer. Sometimes I think prayer for many Christians is an escape hatch. It's a it's an escape route. You know, I'm in terrible situation. Get me out of this as fast as possible. But and many of those circumstances are our own doing as well. But God often in his wisdom, uses those experiences to craft something new in us, which is what will give us in the long, dry and long term joy and ultimately peace. And what is that Christ came to to when he came to probably say, I came to give you peace. I didn't come to give you an easy life and he'll give you a, you know, swimmingly smooth like I came to give you peace. A peace of is all understanding, which is what Paul said, which means a peace. It doesn't make any sense, given the circumstances. And I think and I often think of Chris own words about prayer when the disciples came to Jesus and they said, Teach us to pray. Now, I don't know about you, but if you stop and read that and you think about that for a moment, you think, Why on earth are they asking Jesus to how to pray? Don't they know how to pray? They've been raised in the synagogues, most of them had they'd heard the prayers of the rabbis for years. So why do they come and ask them how to pray? Because we could ask that same question a little differently. How do you pray? Because they recognize that Jesus prayed differently than the rabbis. They weren't the ritual prayers that they heard in the synagogue. They weren't the prayers, the almost distant kind of prayers they heard by the rabbinical authorities of their day. This was something deeply personal. There was something powerful about the way Jesus prayed and the disciples were saying, I want to pray like that. And so Jesus then commences to talk about a prayer, and he talks about petitions and other things. But actually, if you look at the model of prayer he provides, it's very little on petitioning. It's more on our spiritual life. It's more on forgiveness. It's more on our relationships with others. In the following chapter in Chapter seven of Matthew. Jesus gives the what I call the trilogy of prayer. He says, asking You shall receive, seek, and you shall find and knock and it shall be open to you. What is he saying? He's saying, God is saying I'm in. I am calling you into an assertive relationship with me. An assertive relationship. Now, why is that important? Because assertiveness is the cornerstone of intimacy. There is no possibility of developing an intimate relationship between two people if if one or both are passive. Intimacy is built on assertiveness, and assertiveness is also what is at the stake of being able to share and openly communicate what's going on inside my skin. You don't have to guess what's going on inside of me, which is usually going to be wrong. I will tell you, I will share with you because I want us to have that kind of communication is open and functional and and fulfilling and and that's assertiveness. I respect you enough to know, to want to share my insides with you. And so here's God's saying. The first thing I want you to do. He says, I want you be assertive with me. Remember it says, And he was come boldly into the wrong grace, not come in like this, kind of saying, Oh, God, can I say something? No, he says, Come bold. It's like the child who comes up boldly to his father and tugs on his father's coat when he's talking to somebody. And that father or merely strong, say, what do you need, son? Because I have a special relationship and God is saying you have a special relationship with me. I want intimacy with you. And therefore, I want you to be assertive. And so he says, I want you to ask, But that's just if you just ask alone, it becomes passive. But he said, I want you to speak and I want you to know that God is calling us into a collaborative relationship with Him. Seeking is finding out what all your alternatives are, examining your options. Find out the alternate courses of action you might take. And then. And then knocking is experimenting, experiment with different things. And God says, I will open the doors. Trust me on that. I will open the doors. But I want you to open the door. Because why? Why did God give this responsibility to us? Because he's not an overprotective father. Remember? It says if you know how to give good things to your children, how much more than I can give good things to you? Well, one of the good things is I don't over protect you. I don't run around running interference for you all the time because you will be unable to handle adversity if you do. We know that from overprotective parents. How it cripples their children to be able to function in adult life. Do you think God is going to then take those dysfunctional principles and apply them in his own relationship to us? I don't think so. So in that kind of situation, he's saying, I want you to ask. I want you to seek and I want you to not. I'll open, I'll answer. I'll show you what you need to find. But I want you to take a collaborative relationship. You want that energy, that sort of relationship. So it revolutionizes the whole concept of prayer as a relationship. It's not just somebody asking somebody something. It is a relationship that is built on intimacy. And at times in that intimacy, we are asking for God to give us the strength to endure the adversity we're experiencing because we live in a fallen world where adversity happens. You know, I think oftentimes when it comes to when we do begin to succumb to to depression and so forth, there are certain spiritual stereotypes that have have sneaked into the into the vocabulary and lexicon of many Christians. One is that depression is sin. It's a sin. You shouldn't be depressed. And if you're depressed, then you're out of fellowship with God and you're in sin. But the fact is that emotional states are always not. Sometimes they are always morally neutral. The Apostle Paul pointed that out when he was talking about the issue of anger and he of all the emotional states, that's the one that's most problematic, is it not? And he says in Ephesians chapter 5 to 4, verse 26, he says, Be angry, but said not in other words, why you're angry, don't sin. And then he goes on to talk about what it looks like when you are sitting like when you're bitter and when you're outraged and lashing out in wrath, then you're in sin. But the emotional state of anger is not sinful. And yet we sometimes as Christians blend together in our process of oversimplification. Say, if you feel angry, then you're sinful. That's not true. And we have biblical evidence that it is not true. And so any emotional state and that includes depression is not sinful. But while it's not sin, depression can be the consequence, the emotional consequence of sin. And if we can sin, we can do things that are detrimental to our well-being and to the well-being of one another. And that is sin. And then I become depressed over its consequences. That's true. But itself, depression has never seen. A second stereotype is that depression is a lack of faith. If you just had more faith in God, you have more faith that he would pull you through, then you you wouldn't be depressed. But that's an interesting thing because most of the Old Testament prophets, if not all of that expressed and experienced a deep depression, sometimes even suicidal depression, It was not due to the lack of faith. These were men of faith. In fact, one of the people he got that got severely depressed was me because he had turned his anger inward. What? This was Jonah. But Jonah was not from a lack of faith. Remember when Jonah did not want the native eyes to repent because he knew that if they did that, God would relinquish his judgment of them and he hated them. And that's because the Nineveh sites were mortal enemies of Israel. And so he tried to run away. And of course, we know the story and eventually ends up back in an event he preaches never. And his worst case scenario occurs, then invites repent, and God relinquishes that to the judgment. And it says Jonah became very sullen and depressed. When God asked John A, Why are you depressed? He says, Well, he says, When I knew that if I went there and I preach and if they repented, I knew you were a gracious, loving, marvelous God and that you would forgive them. I, I laugh every time I read. That is as I knew you were going to do that because you're such a great guy. In fact, if God had not forgiven them, if he'd not relinquished his judgment, Jonah's opinion of God would have suffered. He said God was maybe not the most merciful God that I thought he was. He's not the God of grace that I thought he was. So. So it was not a lack of faith. It was. He had an abundance of faith, as did Moses. Moses had tremendous faith as well. But he was a people pleaser. And the people kept complaining. And maybe this is the worst case scenario for people pleaser. And they kept making demands on him. Even his own father. And I said, you know, what you're trying to do is not a good idea. Moses You're trying to take on everything. You're trying to please everybody. You can't do that. You've got to delegate. And of course, then later on in Chapter 11 of numbers, he's suicidal at that point. Take me. God, I want out of here. But it's not from a lack of faith. And I could go on on all the other all the other prophets and servants of God throughout the Old Testament and the new. And none of them were for a lack of faith. The third stereotype is depression is God's punishment. This is what I think probably the most cruel of all. And it really, really, I think, hones in on the dictator concept of God. But the depression isn't a lot. And we've said depression, Islam saying it's not punishment. It's not there's not a single case in the Bible that suggests that God uses to address the experience as punishment. I'm going to punish you by depressing you. That is not true. He is always, always makes those teachable moments, but he comes tenderly and guides his servants to a higher understanding of himself. But he doesn't. He doesn't use it as punishment. He will grow us. Yes. But he doesn't cause it in Jeremiah Chapter 29 versus 1112 is this for I know the plans to prosper you and what not harm you, plans to give you hope and a future. Does this sound like the statement of a God who seeks to punish you with depression? It is not the fourth Depression and fourth the stereotype of depression. Is it depression as demon possession? And it's interesting that this comes up because and some say, well, Christians can't be deemed possessed, but they can be oppressed. So maybe it's demon oppression. And I've had clients who have have had Christians come around them and say, you know, you must be oppressed by an evil spirit. So we're going to pray around you and annoy you with oil. And of course they did that. And the depression here, the Depression didn't lift and then they felt even worse. And they wow, I'm really in bad shape. This is what often happens when we apply these things. And then they and they don't get better. They may be scolded by those who say, well, you're not working hard enough. You're not you're not giving your heart enough to God or something. And so they work and work and work at it. And it and the more they work, the more depressed they become. Because then they become depressed about being depressed. That's worse, what I call secondary depression. And it's one thing to be depressed, but now I'm depressed because I'm depressed because that indicates what a moral attribute I am and a reprobate. And so I you know, I think it only worsens the depression. And I think the writer here indicated that. But, you know, it's interesting, even in the Bible, it disclaims that because in Matthew 424 distinguishes between demon possession and emotional disorder, it uses an archaic term emotional disorder, that kind of lunatic. And it comes from the idea that that certain tides in the moons and so forth, there were periods of time where they would would have emotional disorders and they linked those two together. So it came out an old term called lunatic, but it would really refer to emotional disorders in general. It could be severe depression, it could be psychotic behavior, it could be lots of different things. But it was a general term to apply to mental illness and demon possession. Now he makes a distinction. He said, there are those. There's demon possession and lunatics. In other words, he says they're different. So if God makes that distinction, shouldn't we? And then the other thing is, it's interesting that that that the Bible was written about a time that occurred almost directly in the center of the of a period of enlightenment about mental disorders, starting with about three in the fourth century B.C., three hundreds of B.C. with hypocrisies, who said by it, For my own part, I do not believe a body is ever befouled by a god. In other words, he was denying the idea that that mental disorders were the result of some sort of inhabitation of an evil God or an evil spirit. But he he argued instead for the natural causation of of depression and other mental disorders. And that and that led to much more humanitarian approaches to the treatment of people who struggled in one way or another. And so by the time of Christ in there were first rate sanatoriums in in in Egypt and elsewhere, where they treated them with music and with calmness and with quiet surroundings and beautiful gardens. And they had all a variety of things that they did. But all that ended in about 200 A.D. with the death of Galen, which suffered almost entire collapse of Eclipse of scientific activity and scientific research, and went through what we call the Dark Ages, which was really pretty much spanned the Middle Ages, in which the idea of demon possession for mental disorders rose to a vicious height and demon possession. Everyone was seen as that. That had problems were seen as demon possessed, and they had orders of which, you know, the witches and some of the even as late as the 19th century in this country in the Salem witch trials were a sad example of that. But but all through history, they they were what they were trying to do. They would beat the body, they would put them in scalding, were doing things all at the behest of the idea of making the body an unfit place for a soul, any self-respecting evil spirit to live. And so it led to a lot of unnecessary deaths. But that but in the intervening five, 500 years, between 300 and 202 hundred B.C. and 200 A.D., we find the the period of the scriptures. Directly in the middle of it in a lame period. Is it any surprise to you that one of God's inner or one of Jesus inner circle was Luke? Who was what? A physician who was undoubtedly familiar with all the latest, latest views of medicine in that day. And he would have understood the natural causation theory, and he would also have understood what Matthew wrote when he said there's a distinction between demon possession and emotional stress. The interesting thing is that while depression may accompany some cases of demon possession, that's true because that's one of the descriptors. It does not follow that depression is an expression of the in possession. That's where we run into the problem. So these are all stereotypes, whether it's we see depression, sin, or is a lack of faith or as God's punishment or as demon possession. All of these are stereotypes which only serve to increase the level of depression of a person who live by them. And as a matter of fact, they not only help. They exacerbate the problem. And and this leads us to one final concept. I know that people who argue against the idea of going to see a therapist or going to get an impressive medication or something, feel that that somehow of the devil I understand that I, I understand their and sympathize with their point of view, partly because I know that the history of psychology is, you know, one of the one of the founders of psychology was Sigmund Freud, who was an atheist. And and I know even to the present day, the American Psychological Association is a very liberal organization who espouses many, many positions that I repudiate and that you would repudiate. But but it's like throwing the baby out with the bathwater. If we reject everything that psychology has to offer, because many of the principles, the sound principles of the psychology also fit beautifully with Scripture. That's why I use a lot of Scripture in my in my counseling, because some of the most profound principles of good mental health are found in Scripture itself. And I liberally use it may even use it with non-Christians. And they accept it because they say, Well, yeah, the Bible says that, and they respect the Bible even though they don't believe it. And and they hear that and they are moved oftentimes by that, not realize. And many Christians I didn't realize the Bible said that. And and so one of the issues that triggers a lot of the controversy here is is the concept of self esteem. Some people who limit all help to prayer Bible say really become apoplectic at the mere mention of the concept of self esteem. They think, Oh, that's just narcissism. That's just a product of of a pagan culture. It's it's all about me, me, me. And I understand the misconception of self esteem. It's very common, not only in the Christian world, but in the non-Christian world as well. Most people don't even understand what it really means. But here is what self esteem. I'll define it. Then I'll describe what I'm talking about. Self esteem is valuing who you are as a person, as created in the image of God. You are an image bearer of God. And we read in First John, Chapter four that God is love. He's not just loving. He's not just having a loving characteristic. He is love. He is the embodiment of love. And then we read in Genesis one that he created us how in his own image. So that what that means is that we this sounds about hold with me for a moment. That means that we are inherently lovable as a person. Our behavior may be very quite unlovable at times, but our person before God is inherent level because we are created in the image of God. It's like this when we if we're going to have if we're going to have a child, my wife and I are going to have a child. Do you think we sat around and talked about, well, I wonder what we're going to have. You think we're going to have a squirrel chimpanzee monkey? You know, what do you think we're going to have? Of course not. We're going to have another human child. Why? Because we cannot produce that which is not in our own image. We can only produce that which is our own image, which is a physical baby. Human baby. And. And the same thing on. A spiritual realm with God. If God can only create that which when He creates that which is in his own image, you can only create that which is lovable because he is love. So somehow we lose that because we cannot make the distinction between person and behavior. We blend the two together. Behavior is the person. And that's not true. God loves us as a person, but he often rejects our behavior. This is the same thing as a parent. When you're a parent and your child misbehaves, you don't like that behavior. You will discipline that behavior. But you won't stop loving your child. Your child is a person. You still love them. You still gather them to you. You would be the first one to protect them if they were in harm's way. But you're sometimes are really angry with them when they misbehave. You don't like their behavior and you will punish them and see that ideas. And naturally, when we as parents, we know we function. And the distinction between person and behavior. We love the person, but we sure don't like that behavior. Well, when it comes to a love ability, that's the same idea that our person can be lovable, our behavior can be very unlovable and mask, quite frankly, the love ability of our person. You know, we hear from the pulpit oftentimes that we are to value what God values. Have you heard that many times? The messages we're to value, what God values to love, what God loves. Everybody goes, yes, that's true. Yes. Yes. Well, think about it for a moment. If we hate ourselves and we reject ourselves or we, you know, diminish ourselves and hate her and and and put ourselves down. Are we not violating this axiom? Because what does it say? It says God loves it. The whole point of Scripture. The whole point of Scripture is he loves us enough that he sent his own son to die in our place. That's the greatest expression of love there is. He says he loves us and there is. He values us. He says, I value so much, I'm willing to give everything in sacrifice to redeem you. That's how much I value. So if we really mean it when we say we should value what God values, we should love what God loves, and why is it that we say we should hate ourselves or that we should put ourselves down, or that we should view ourselves in dim fashion? Do we need to pay attention to our sinful nature? Absolutely. Do we need to decry our own simple behavior? Absolutely. But you know something? When you value yourself, when you value yourself, and then you are far more motivated to want to change the behaviors that are that are dishonoring to God. If you hate yourself, you figure, oh, well, I'm I'm worthless anyway. And I'll just I just go out and and behave accordingly. But when I when I value who I am, I want to behave in a way that reflects that value before God. I want to honor him. And so in that relationship, I love it with the Apostle Paul. In chapter seven of Romans, you read you read how his struggle with his sin nature does not show. He says, Oh, the very things I want to do or the things I don't do, and the very things I do or the things I, I wish I didn't do at all. And he talks about it goes on and on for an entire chapter. You really think, Wow, this guy's really struggling. But you don't see, by the way, he how honest he is, how self disclosing he is. I mean, he's the leader of the early church and he's disclosing his deep struggle. He's saying I really struggled back and forth the sin nature of mine and so forth. But in the end, what does he do? The most surprising thing about that passage is the end. He doesn't put himself down. Oh, I'm worthless. I'm no good. I'm going to He doesn't do any of that. At the end is a dark psychology on the grace of Lord Jesus Christ. That's what it is, Doctor. He's praises God because he realizes what that Hebrews passage is saying, that God still loves us and values us. And it's because of God's grace that we are in His presence. That we can enjoy his presence. So. So that's what self-esteem is really all about. That's the whole nature of what that means. It's a steamy with God esteem. I know. And people sometimes say, Well, yeah, but it says, deny yourself, take up your cross and follow me. Now what it means then. But see, denying self is very different than self-denial. Self-denial is putting yourself down. Living a life of self-imposed deprivation. Self-denial is the is the is the world's view of humility. This is this is the core of Eastern religion. Self-denial. Live in monastic conditions, live under self-imposed starvation, all the rest, all these kinds of things that are down to the centers of Eastern religion, self-denial at the core of it. But denying self what Jesus was talking about is deny are selfish aims. It's all about me. I got to go. I want what I want when I want it. That's what he's saying. Deny your selfish ambitions so that you might follow me. It has nothing to do with putting yourself down or devaluing yourself. And yet, as believers, we commonly develop these stereotypes of what God is teaching us and and what depression is. And. And what the ultimate goal is to is ultimately, hopefully, the goal is to feel better, to feel understanding, and to be able to work through what that depression is signaling so that I can come to a side of healing. But instead, what we do is we end up injuring ourselves still further and only makes depression more inevitable. So I appeal to those of you who may feel like, well, is prayer not important then? Absolutely. I'm not saying that. Prayer is powerful. It's important. That's why I took some time to describe how God is describing prayer, and Him intimately involved us as part of our own intimate relationship with God as a communion with Him. Is reading scripture important? Absolutely. And it holds all the marvelous principles of sound mental health. But you see, when you go to seek out professional help, it doesn't deny any of those things. It only brings those up to complete fruition so that you can begin to see the connections between the experiences you've had in your life that have damaged you and how you can get it, and how through God's love and his through your faith and through an understanding of the principles of Scripture and the principles that are sound psychological results, that I can maintain health for the first time, that I can be at peace. Once again, we come back to that promise that Christ so often gave us. I come to give you peace. I have not come to the press. You have come to give you peace and joy. So that is God's desire. That's the desire of God's heart. That's the God I know. That's the God I communicate to my patients. And when they do, they begin to see God an entirely different ways. And they began to appreciate their faith. Through their struggles of depression. So that actually is one pastor put it when I am I was working and he says bye and ends up that while it was the monster in my closet. It was my it was God's gift to me. And my gift to my people. What a beautiful statement and this is that comes from the words come from the same pastor who said before he started counting, says, I always believe prayer, my Bible, my counselor, I didn't mean anything else. And he says, I've learned differently. And he sees the holistic view of understanding who God is and how he can intervene on the everyday experiences of our life.