Dr. Welch’s description of the “stubborn darkness” of depression presses at the pain contemporary Christendom often seeks to avoid admitting exists within the church. Christians are those who have been born again and in-filled with the Holy Spirit. Subsequently they are to be “more than conquerors” (Rom. 8:37) given “victory through our Lord Jesus Christ” (1 Cor. 15:57) and are those who are to continually “rejoice in the Lord” (Phil. 3:2; 4:4). Feeling anything less, acting dourly, joylessly, or not using the correct affirmative Christianese catch phrases can often ostracize one from the pack of “victorious” believers. This stigma provokes many to question not only their own salvation but also the existence of the very God they claim to worship.
Contrary to the shallowness of the positive-thinking Christian subculture, Welch rightly identifies that depression plays an integral role in the Scriptures. “God doesn’t prescribe a happy life. Look at the Psalms” (p. 5). The Psalmist though is not the lone voice of depression (what Welch strikingly describes metaphorically as “hell”). The depression recorded there seems meager to that set down by the mature Christian preacher who penned the book of Ecclesiastes (p. 68). There the preacher dissects the ultimate seeming vanity of life. We’re in situations we can’t control with death looming not far off for each of us. None of it appears to make any sense, and God’s ways often don’t appear to be that of a beneficent providence. That’s hardly the message the church expects to hear from a seasoned ordained preacher. In fact, it’s depressing!
Welch doesn’t leave his readers stumbling around in despair. Rather, a depressed Christian (and someone involved with that person) actually has a unique opportunity to probe the very existential depths of the Christian faith. As Welch explains, all depression has a sense in which it is “always and profoundly spiritual” because it involves questioning the core area of our very being: “Who is God? Do we trust him? Why is he allowing this to happen to me? How can I trust him when he seems so remote and unresponsive?” (p.20). Welch insightfully points out such questions scrutinize our very identities as human beings. Depression is ultimately a “why” question (p.4) because by deconstructing it, one embarks on a journey back to God. “At its very roots, life is about God” (p. 34).
The book though isn’t simply a regurgitated tome of Kierkegaard-esque melancholic introspection. Welch is concerned with providing a cogent worldview that places a depressed person in reach of understanding, relief, and spiritual growth. He’s not so narrow-minded to discount the different types of depression categorized by secular psychology (p. 16). On the other hand, he’s not so quick to hand out pills for Bipolar disorder (p. 18). The temporary relief provided by medication is just that: a temporary relief (p. 21). Rather, the solution to depression is concerned with placing it within a Biblical worldview so to analyze it, experience it, and be sanctified through it.
Welch outlines basic stimuli for depression: culture (chapter 12), other people, our mental state, our physical nature, diabolic spiritual forces, and finally God Himself (pp. 27-28). In some cases the roots of the depressed state can be discovered. Other times, the only response may be “I don’t know” (p. 29). The first major section of the book tackles the pain and suffering in its relationship to depression. While some may be tempted to explore the former less controversial stimuli behind suffering, Welch begins with the most troublesome cause: God Himself.
Since God has infinite attributes and exists in perfection, one should not expect to always be thinking correctly about God and his ways (p. 35). For instance, Scripture does reveal that God is intimately connected to suffering, particular through His Son, Jesus Christ. If it is true that the life of Jesus shows a suffering theology of the cross, someone who claims to walk with that suffering man should not expect a carefree theology of glory. If the suffering savior was loved by God, Christians likewise should see the truth that God’s love and suffering are not incompatible. If they were, the life of Jesus would be in contradiction to God’s love.
Welch helpfully tackles the solution of the “trite answer” of pointing out the positives to those who are suffering from depression (Chapter 8). While trite answers focusing on the temporalities of life may at times sound good and helpful, if depression really is ultimately a spiritual issue, only the remembrance of God’s truth will serve as any sort of lasting solution. Quoting Scripture as a depressed person (or to a depressed person) may at times be similar to force-feeding the soul, but spiritual health depends on it (p. 66). Is there a purpose for suffering depression? If depression truly is a spiritual issue as Welch contends, each Christian serves a teleological divine purpose. That purpose may not be revealed in a glorious supernatural parting of the clouds, but it still needs to be spoon fed to each believer on a daily basis with such particular basics as: fearing and loving God, keeping the commandments, and serving the neighbor, all to the glory of God. It will be God which carries the depressed person through to final perseverance (Chapter 10). A purposeful faith will be the only nutrition that feeds a depressed soul.
The second major section of the book seeks to unravel the former listed causes of depression in order to “listen to it.” Welch sees our past troubled interactions with other people as more valuable because in God’s providence “what happened to us was not a series of random, unrelated events” (p. 93). Rather than offering solutions to human life under the curse of sin and attacks by diabolic forces, Welch simply identifies them as the enemy they are. He also explores common causes of depression: fear, anger, dashed hopes, failure, shame, guilt, legalism, and ultimately, the fear of death. Welch’s point is not to solve these issues as to why they lead some to depression, but rather to provoke people to uncover them as possible reasons for their depression. Here the point is to learn about ourselves and the experiences that have made us who we are and why we interpret our lives the way we do. By listening to depression, clues as to its cure may be revealed (p. 108).
But the clues typically don’t lead to pills and quick fixes. Rather, if one probes deep enough, once again one will come face to face with the problem of God (p. 109). Ultimately, such a probe uncovers how the human heart is misaligned (p. 112). It was intended to worship God, but rather shares its affections with a variety of idols. Ultimately, many depressed people struggle with pride, autonomy, indulgence, and selfishness. Here Welch leads many people to the ultimate cause of their depression: sin. If it is sin that corrupts life, one should expect to find it more often than not as the cause of depression.
Throughout the book, Welch has been careful not to shut the door on the advances of science in the treatment of depression. Section three therefore takes a practical look at the issues surrounding such a choice. Various other types of treatment are also discussed including such things as electroconvulsive therapy (p. 195). Related issues include weighing the side effects and long-term effects of medical treatment. A serious spiritual danger of medical treatments is alleviating symptoms through medication rather than the actual cause of the symptoms (p. 190). While medical treatments, in whatever form they take, may provide a certain amount of relief, one needs to be careful that hope is not placed in science in replacement of hope in God. From Welch’s reservations throughout the chapter, the underlying current appears to be that for the majority of sufferers, medical treatments of depression should be a last resort or only a temporary engagement. The true answers and relief to depression will be found only by recognizing and exploring our “spiritual core,” a place where no medication can reach (p. 196).
The final section of the book explores practical spiritual attitudes in escaping the despondency of depression. Welch reminds his readers that the fight against depression is not ultimately a lost battle. The Christian life does not end as a Shakespearean tragedy does. Rather, a Christian trusting in Jesus is enveloped by the savior’s eschatological end, which is glorious victory. On teleological level, a depressed Christian can have true hope. The story of God’s redemption, therefore, should be embraced as the personal story of each Christian. Other helpful strategies include the positive self-talk that many secularists would prescribe, but Welch grounds it in its rightful soil: the foundation of the promises of God recorded in sacred scripture. He recommends developing a sense of thankfulness, first and foremost to God. While revisiting the paradox of suffering and joy, he points out various small steps a depressed person can take to experience daily glimmers of joy until the life of a Christian consummates in eternal joy (p. 241).
One of the weaknesses of Welch’s overall treatment was a difficulty in synthesizing the non-spiritual causes of depression (alluded to throughout the book) into his overall presentation. It seemed Welch simply threw in the caveat that not all depression is based on spiritual causes simply as a way to cover himself on this current unsettled debate between medication therapy and counseling. At the beginning of the book, Welch boldly states, “So depression does not necessarily have a spiritual cause, if by spiritual, we mean that it is caused by our own sin. But there is a broader meaning to the word spiritual, and in this sense, your depression is always and profoundly spiritual.” (p. 20). Elsewhere he carefully explains that it might not be sin causing depression in every instance (p. 115). Later on in his section addressing medication, he needs to add the disclaimer “Most current thinking tends to miss the spiritual essence of depression. (Keep in mind that this doesn’t mean that there is always a spiritual cause of depression. It means that depression is always accompanied by questions about God, ourselves, hope and meaning)” (p. 190). The reader is left in the lurch as to exactly how to synthesize these statements. It appeared to me he wants to argue that all depression is indeed caused by spiritual issues but reluctantly had to add the disclaimer that in some instances spiritual concerns may only accompany depression. His entire section on medical treatments seemed more of a reluctant allowance.
At one point he states, “It is unclear whether medication is any more helpful than counseling. (And it is unclear whether counseling is any better, overall, than to talking with a wise friend). Even in cases of severe depression, careful analysis of the evidence does not always demonstrate the superior effectiveness of medication over secular counseling. You would expect at least similar results when you allow Scripture to guide you” (p. 192). He left me wondering exactly how cogent his presentation ultimately is if it’s only at least as successful as secular counseling or medication. The ultimate superiority of the Christian worldview must never be minimized. I’m sure Dr. Welch would agree that the Christian worldview is more than “at least” as successful as non-Christian approaches to any ultimately spiritual issue. It would be like arguing secular philosophers are at least as successful in explaining reality. The argument in either case should highlight the Christian worldview as the only basis by which to construct a truly cogent counseling or philosophic paradigm.
Despite these concerns, Dr. Welch presents a helpful discussion for Christians on the topic of depression. The strength of the book is its gentle and pastoral approach to the issues involved. Even when Welch probes the ultimate cause of depression having its roots in sin, one never gets the sense of condemnation. Rather, one finds understanding and encouragement.
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