For many teenagers and young adults, depression and anxiety are a very real part of their daily lives. 25% of teenagers (age 13-18) and 30% of young adults (age 18-29) report having struggled with an anxiety disorder at some point in their lives. The average age an anxiety disorder starts is 11 years old. For depression, 12.5% of adolescents (age 12-17) and 10.3% of young adults (age 18-25) have experienced a major depressive episode within the past year. In fact, among college students, depression is the most common health problem.
If you struggle with depression or anxiety, the good news is that you are not alone. There is help available. The best news, though, is that there is a God who knows what you are going through and loves you and cares about you more than you can even know.
How should Christians approach the subjects of anxiety and depression?
Before we can delve into these subjects, we need to address the tension that often arises in the minds of many Christians between psychology and scripture.
Christians are divided on whether to deal with these issues from a scientific point of view by using psychology and psychotherapy or from a spiritual point of view by using scripture and prayer as a basis for diagnosis and treatment. Those in the church have had a tendency to only want to address the spiritual side of things or believe that anxiety and depression are caused only by spiritual forces. They have become distrusting of the psychological establishment due to organizations like the American Psychological Association promoting homosexuality as a healthy and normal lifestyle when the Bible labels such actions as sinful and unnatural (Romans 1:26-27). In addition, many in the psychological establishment will often ignore or dismiss the spiritual aspects of a person. It also doesn’t help that psychology usually can’t give universal, cookie-cutter answers that are easily understood and applied to everyone. Therefore, many in the church have become dismissive of psychology and just call it, “a bunch of mumbo-jumbo.”
However, we shouldn’t throw away the baby with the bath water. There is a lot of good that comes from psychology. Millions of people every year (including many Christians) are helped by professionals in psychological and therapeutic occupations (many of whom are Christians themselves). We cannot deny the way God uses these people to accomplish his will any more than we can deny God using a medical doctor to accomplish his will in healing a person. Even though God can heal diseases supernaturally, we don’t dismiss the need for medical doctors to help us with our bodies. Similarly, even though God can heal our minds supernaturally, we shouldn’t dismiss the need for psychologists and therapists to help us with our minds.
The truth is that anxiety and depression need to be understood from both perspectives because there are many potential root causes that can be addressed only from someone trained in the science of psychology and other root causes that are spiritual in nature and need to be addressed by someone who understands the Word of God. Either way, we shouldn’t oversimplify these subjects into being only a spiritual issue or only a scientific issue. The truth of the matter is that the diagnosis and treatment will depend on the individual and their needs.
With that being said, this article will attempt to approach the subjects of depression and anxiety from both perspectives.
What are anxiety and depression? How do I know if I have an anxiety or depressive disorder?
It’s important to be able to identify whether you have an anxiety or depressive disorder. Everyone experiences feelings of nervousness or fear, whether it’s about a big test in school, speaking in public, or asking someone to prom. Similarly, everyone experiences feelings of sadness if a family member has passed away, you broke up with your boyfriend or girlfriend, or if a friend is diagnosed with cancer. These are all normal human emotions that everyone has. There’s nothing wrong or defective about you for feeling this way. In fact, it would be strange if you didn’t have these emotions when challenging circumstances arise.
If these emotions are normal, though, what makes a person have a diagnosable anxiety or depression disorder? The answer is in the frequency (how often) and intensity (how much) of these emotions. Think of it like you are driving a car on the freeway, where anxiety is like driving a car faster, and depression is like driving a car slower. It’s normal to temporarily speed up if you are trying to pass a car that is going slow, and it’s normal to slow down if there’s traffic. These are like the typical human emotions that we experience in response to life’s changing circumstances. However, if we are going 25mph when everyone else is going 70mph or you are constantly driving 110 mph and swerving around cars, this is abnormal and can endanger yourself or others. Similarly, if you are feeling down or anxious for weeks or months on end and seem to be unable to get back to a normal, healthy frame of mind, then you could be suffering from a disorder.
It’s also vital to understand that depression can mean more than just being sad, and anxiety can mean more than just being nervous or fearful. The NIMH lists several symptoms as possible indicators of depression, including sadness, emptiness, hopelessness, being angry or cranky, not caring about things or activities you used to enjoy, feeling tired with no energy, feeling worthless, thinking about dying or attempting suicide, etc. People who suffer from depression may experience many of these symptoms or only a few. With anxiety, the NIMH lists potential symptoms that include restlessness, feeling on edge, muscle tension, difficulty controlling feelings of worry, sleep problems, panic attacks and feeling out of control of your emotions, nervousness or feeling sick when speaking to others in normal everyday conversation, etc.
Again, many of these feelings are normal to have in everyday life, but are usually weak or don’t last very long. We don’t want to overexaggerate or underexaggerate how we are feeling. We don’t want to be the person who thinks they’re sick, goes on to WebMD.com, and comes out thinking they have a deadly Amazonian virus. But we don’t want to minimize or ignore our feelings either. If you have severe or persistent symptoms described above or suspect you may have a depression or anxiety disorder, then seek help. It’s better to err on the side of caution. The last thing you should do is try and go through it alone or ignore it because the symptoms probably won’t get better if you don’t reach out to someone, especially someone who has the wisdom and understanding to be able to help you.
What causes anxiety and depression?
According to the academic literature, there are multiple factors that can contribute to depression and anxiety. In general, for depression, they are categorized as genetic factors, biological factors, environmental factors, and psychological factors. Anxiety is mainly attributed to genetic and environmental factors. Genetic factors are inherited traits from family, biological factors are things like brain structure or chemical imbalances in the body, environmental factors are those such as changing life circumstances and relationships or traumas, and psychological factors are things such as self-perception.
As Christians, though, we also recognize the existence of the spiritual. We live in a fallen world ruled by Satan and his demons (2 Corinthians 4:4, 1 John 5:19). All men have sinned and fall short of the glory of God (Romans 3:23). Creation itself, including our bodies, is fallen and imperfect (Romans 8:21). Therefore, we should understand that from a Biblical perspective, anxiety and depression could have origins in demonic oppression, from sin in our own lives or from the lives of others (like environmental and psychological factors mentioned above), as well as physical origins in our fallen bodies (like the biological and genetic factors mentioned above).
Is it a sin to be depressed or anxious? What does the Bible say about anxiety and depression?
The Bible commands us not to be anxious (Matthew 6:25-34, Philippians 4:6-9) as well as to continually rejoice (Philippians 4:4, 1 Thessalonians 5:16). Does that mean that it is sinful to be anxious or depressed? In order to answer this question, we have to be able to distinguish between the temptation to be anxious or depressed and feeling anxious or depressed versus acting out on those feelings of anxiety or depression.
Let’s start with the first part. It is not a sin to be tempted to be anxious or depressed. Undergoing temptation is never a sin. Jesus himself was tempted by the devil (Luke 4:1-13) but was also sinless (1 Peter 2:22). Hebrews 4:15 tells us, ” For we do not have a high priest who is unable to sympathize with our weaknesses, but one who in every respect has been tempted as we are, yet without sin.”
It is also not a sin to feel anxious or depressed. Righteous and godly people in the Bible experienced feelings of depression or anxiety including Elijah (1 Kings 19:4), Nehemiah (Nehemiah 1:4), Job (Job 17:1), David (Psalms 6, 13, 55, 69), Solomon (Ecclesiastes 1:2), and Paul (2 Corinthians 1:8). Even Jesus, when he was about to pray in the garden the night before he went to the cross, said, ” My soul is very sorrowful, even to death”(Matthew 26:38, Mark 14:34). Having feelings of depression and anxiety is not sinful. Having these feelings or being tempted on a constant basis is also not sinful (although it is usually indicative that something is wrong and needs to be addressed). It is what we do with those feelings that determines whether we have sinned or not.
When it does become sinful is when we choose to react to these emotions sinfully. What does that look like? With depression, people will often have a lot of negative “self-talk.” They will think to themselves, “It would be better if I didn’t exist,” or, “I’m never going to amount to anything,” or, “Nobody loves me.” Remember, it’s not wrong for those kinds of thoughts to pop into your mind, but how do you respond to them when they are there? Do you dwell on them? Do you affirm them or agree with them, even though they are lies? Or do you respond with the truth? “I am loved and wanted; my future is in God’s hands.”
The same goes for anxiety. People will often have thoughts like, “No one will like me if I talk to them,” or, “I don’t want to leave the house because it’s not safe,” or, “My stomach hurts. Am I going to die?” How do you respond? Do you never talk to anyone, try to do anything, and assume the worst with every situation? Or do you affirm the truths of God’s Word, do the things necessary to live your life, and look at life realistically, even though it may be difficult to do so.
More extreme examples of sin would be cutting, doing drugs, or attempting to commit suicide. Our bodies are temples of the Holy Spirit (1 Corinthians 3:16, 6:19-20) and we need to treat them with respect, honor, and in a way that glorifies God.
What should I do if I am struggling with anxiety or depression?
- Talk to someone about how you’re feeling and the kind of thoughts that are going through your mind. This is absolutely necessary for those of you who are contemplating hurting yourself or others. We weren’t meant to live life alone. Talk to your parents or to your pastor. They will be able to help you and get the resources you need. Asking for help is a sign of strength and humility. Don’t let pride stand in the way of getting better.
- Don’t be afraid to get professional counseling. They will give you mental tools to help you fight your unwanted thoughts and deal with your depression and anxiety in healthy ways. They can also recommend or prescribe medicine that would be helpful in reducing the intensity and frequency of your depression and anxiety if they believe there’s a biological component.
- Repeat the truth of God’s Word as often as the lies come into your head. The Bible talks about the difficulty of dealing with anxiety and depression (Proverbs 12:25, 15:13, 17:22). But, even more, it talks about the truths that refute the lies that depression and anxiety try and get you to believe. God loves you and nothing can change that (Romans 8:37-39). God is sovereign over your life and cares for you (Romans 8:28, 1 Peter 5:7). These are the truths we need to memorize and repeat to ourselves often. This is one part of what it means to take every thought captive and bring it before Christ (2 Corinthians 10:3-5).
- Don’t feel condemned or guilty for struggling with these emotions. We all have something that we struggle with. Remember, having these emotions is not wrong. It’s what you do with them that counts. Even if you do stumble and sin, do not let guilt and condemnation consume you. There is no condemnation for those in Christ Jesus (Romans 8:1). When we do sin, Jesus goes before us to the Father on our behalf to intercede for us (Romans 8:34, 1 John 2:1). We are seen as righteous and redeemed because of Christ’s sacrifice (2 Corinthians 5:21).
- Remember your identity in Christ. You are a son or daughter of the king of the universe (2 Corinthians 6:18, Romans 8:14-17, Galatians 4:6-7). Sin has no power over you since you belong to Jesus (Romans 6:11-14, 8:2). We have been made new creations in Christ (2 Corinthians 5:17) so that we can be transformed and sanctified by the Holy Spirit to become more like Jesus (John 17:17, Romans 8:29, 2 Corinthians 3:18).
- Realize that for the components of anxiety and depression related to sin, only God can change you and give you freedom. Trying to make yourself better through your own efforts will only lead to failure and disappointment. We need to submit ourselves to God (James 4:7-8) through prayer, Scripture, and other methods recommended to us by our pastors, psychologists, or other counselors.
- If you suspect your anxiety or depression is related to demonic activity, talk to your pastor. Above all, know that Jesus has all power and authority over the devil and his domain (Mark 1:27, Hebrews 2:14).
- Draw close to God through prayer (Psalms 145:18, James 4:8) and reading the Word (2 Timothy 3:14-17). Be cautioned, though. These aren’t magical formulas that will instantly solve your depression and anxiety. Prayer and reading the Bible are ways for you to draw close to God, who is then able to provide healing. Make Jesus (rather than happy feelings) the object of your pursuit (John 5:39).
- Don’t expect change quickly or things to get easier overnight. Certainly, God is capable of doing that, but usually there are things in our lives that he is trying to change to be more like him. It may take weeks, months, or even years before that happens, but don’t be discouraged. Keep surrendering your thoughts and emotions to God and trust him to change you.
How can I help someone who is depressed or anxious?
- Avoid cliché responses when someone tells you they are struggling with anxiety or depression. Although well intentioned, saying things like, “Just have faith,” or, “Read the Bible and pray more,” or, “Is there unconfessed sin in your life?” can feel dismissive. Christians who struggle with this have usually already tried to read their Bible and pray more.
- Listen to them. If talking to someone about how they feel is the first step to healing, then they need people who will listen to them and not judge them or think any less of them.
- Be their friend, ask questions about their life, and show genuine interest. Many people who struggle with depression or anxiety will often isolate themselves because they feel uncomfortable around people. Seek them out; invite them to hang out; treat them like you would any other person.
- Let them know that they are loved, wanted, and appreciated even though they struggle with this issue. It goes a long way.
- Educate yourself. The better you understand what they are going through, the better you can minster to them.
- Work to eliminate the stigma surrounding mental health in the church. In 2013, Rick Warren, pastor of Saddleback Church, and Kay, his wife, lost their son Matthew to suicide. Since then, he has fought to reduce and eliminate that stigma surrounding mental health today in the church. It’s an unfortunate but true fact that there is still a level of shame attached to struggling with a mental health issue. Those of us in the church need to work to dispel this stigma and come alongside those who are struggling with anxiety and depression.
 “Any Anxiety Disorder Among Children,” National Institute of Mental Health, Accessed January 18, 2017, https://www.nimh.nih.gov/health/statistics/prevalence/any-anxiety-disorder-among-children.shtml.
 “Any Anxiety Disorder Among Adults,” National Institute of Mental Health, Accessed January 18, 2017, https://www.nimh.nih.gov/health/statistics/prevalence/any-anxiety-disorder-among-adults.shtml.
 “Major Depression Among Adolescents,” National Institute of Mental Health, Accessed January 18, 2017, https://www.nimh.nih.gov/health/statistics/prevalence/major-depression-among-adolescents.shtml.
 “Major Depression Among Adults,” National Institute of Mental Health, Accessed January 18, 2017, https://www.nimh.nih.gov/health/statistics/prevalence/major-depression-among-adults.shtml.
 “Depression and College Students,” National Institute of Mental Health, Accessed January 18, 2017, https://www.nimh.nih.gov/health/publications/depression-and-college-students/index.shtml.
 For depression, The National Institute of Mental Health (NIMH) says that symptoms experienced, “most of the day, nearly every day, for at least two weeks,” could potentially be diagnosed as a depression disorder. (https://www.nimh.nih.gov/health/topics/depression/index.shtml) For anxiety, the NIMH states, “For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The feelings can interfere with daily activities such as job performance, school work, and relationships.” These feelings can last for months on end. (https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml)
 For a full list of potential symptoms and types of depression, go to https://www.nimh.nih.gov/health/topics/depression/index.shtml.
 For a full list of potential symptoms and types of anxiety, go to https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml.
 “Depression,” National Institute of Mental Health, Accessed January 18, 2017, https://www.nimh.nih.gov/health/topics/depression/index.shtml
 “Anxiety Disorders,” National Institute of Mental Health, Accessed January 18, 2017, https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml