By Rev. Dr Simon Jooste
The Christian is not to be conformed to the world’s pattern of thinking (Romans 12:2). But it is particularly tempting to bow the knee to the pharmacological fruits for therapeutic narcissism and its pragmatic ethics, particularly when the billows of suffering roll in. Prozac can be a tempting easy fix. So where does the depressed Christian look for restoration? In contrast to evangelicalism and Protestant liberalism, rooted in pietistic tendencies towards moralistic subjectivism and social activism, confessional Reformed piety has centred Christian vitality around churchly ordinances administered publicly on the Lord’s Day. In addition to providing sustenance for weary pilgrims, the official ministry of the Word provides essential wisdom in making use of God-given common medical care.
Ministry of Word and sacrament in the covenant community
Historically, Reformed believers have believed and confessed that through Christ’s ordinances, particularly the Word and sacraments, God communicates the benefits of redemption to his afflicted people. Chiefly by the Word preached, the depressed are persevered and perfected through faith unto salvation. This ministry of proclamation should include the whole counsel of God, both law and gospel, command and promise. For example, through the preaching of the law, the sinner who is downcast at failed attempts at self-justification “bottoms out” and finds new life and joy in the gospel. The command to abstain from sexual immorality rouses the fornicating covenant child to flee to Christ for cleansing and power to fight temptation, and the depressing weight of guilt lifts. The slothful teen enveloped by a cloud of melancholy finds some sunshine after being convicted of his self-abuse through poor eating, sleeping and exercise habits. The retrenched father of four finds renewed resilience and joy after hearing a sermon on Job. This enables him to pray, meditate and look for employment again. Ideally, through the ministry of the law, the masks of sin and self-reliance are removed. And in turn through the gospel, the saints find their new identity and happiness in Christ.
Knowing our weakness, God has also given his church tangible signs and seals to assure us of the Word of promise proclaimed to our ears. In baptism, the depressed are assured of their in grafting into Christ, which includes a lifetime of suffering, but followed by glory. Through participation in the Eucharist, the depressed feed unto spiritual nourishment and growth in grace.
Having received God’s gifts of grace, the covenant community now serves by becoming a balm of comfort to the distressed – each member doing his and her part. In accordance with the Word, the elders are to pray over the depressed (James 5:14–15). The minister, as the trained physician of the soul, is to be sought out for private counsel and prayer. The community of saints is called to show compassion and carry the burdens of the weak (Galatians 6:2; 2 Corinthians 1:4).
In short, the Christian community, both in its official ministerial capacity and in its broader fellowship, provides cruciform wisdom for approaching suffering and the alleviation of it. While incorporating the moral reflection of the medical establishment servicing humanity at large, the Christian will nevertheless also take into consideration unique angles on life, health and death, provided by Scripture. In other words, redemption in Jesus Christ adds vital contours to the believer’s moral reflection on depression and ways of treating it. In keeping with the counter-cultural layer of ethical responsibility set forth in the likes of the Beatitudes, which includes turning the cheek when wronged (Matthew 5:38–42), Christian identity reinterprets suffering of all kinds, including depression, in a new salvific light. Hence, Christians must wrestle with treatment options for depression accordingly.
Some who avail themselves of the spiritual means offered by the church may invariably emerge from the pit of depression. Through the ministry of the Word, roots of sinful thinking and behaviour are exposed, helpful wisdom is imparted or the season of spiritual testing passes. However, others, no matter how pious, may continue to linger in the valley, thereby suggesting ongoing underlying neurochemical causes and/or effects.
At this point, to deny a believer the possibility of anti-depressant treatment is to deny that a given case of depression may have a cause in and/or effect on brain chemistry. It is imperative that the church does not unwittingly exacerbate the suffering of the depressed under the guise of a hyper-supernaturalism or spirituality that treats all physio-chemical problems as spiritual maladies to be treated with spiritual solutions. The Christian is to avoid both materialist reductionism and spiritual reductionism when it comes to the treatment of depression.
Simon Jooste is the pastor of Reformed Church Southern Suburbs.
This is an edited version of an essay that was first published in the Stellenbosch Theological Journal 2018, volume 4, number 1.