Rethinking Depression: Not a Sickness Not a Sin

by Daniel R. Berger II

Diagnoses of depressive and bipolar disorders have reached epidemic proportions. The current psychiatric theories, approaches, and suggested remedies have together failed to resolve these human struggles despite technological advances and continued claims of validity and reliability. In fact, since its introduction in the early 1960s, the current humanistic paradigm has worsened both individuals and society as a whole. Suicidal ideation and completions are also rapidly increasing within the church and even among church leadership. There clearly exists an urgent need to rethink the widespread human struggle known today as depression. In this book, Dr. Berger proposes from both Scripture and scientific evidence that the root of our mental struggles lies in our metaphysical souls rather than in our physical bodies. As the reader will discover, the solution is not to endlessly invent new theories and alleged physical remedies that inevitably fail, but to return to understanding humanity's true nature as God declares it to be from the beginning of time. Only by realizing and accepting this important perspective does our own human fragility and depravity begin to make sense. At the same time, this is not a book that suggests that those who struggle should simply pray and read their Bible more and that all of their problems will vanish. Rather, the book offers proven and practical answers to important questions.Rethinking Depression invites the Christian who seeks answers and desires to help others struggling or diagnosed within the psychiatric system to re-examine the current ways of understanding and treating depression and to consider the gracious perspective that in all of our mental suffering, sorrow, and hopelessness-no matter how severe, we are not abnormal or different from one another at our core. In truth, what we all desperately need is sure hope and genuine healing for our souls that is only found in the person and work of Jesus Christ.

Genres: Psychology, Health

256 pages, Paperback

Published February 5, 2019

About the author

Dr. Daniel R. Berger II is the founder and direct of Alethia International Ministries (AIM), where he continues to speak around the country at various conferences and ministries. He is also an experienced pastor, counselor, school administrator, and the author of numerous books on Christian counseling, practical theology, education, and the history and philosophy of the mental health construct. Daniel attended Bob Jones University and Florida International University, where he earned four degrees in counseling and theology. He is also a certified member of the International Association of Biblical Counselors (IABC). When he is not speaking, he and his wife Oriana live in Greenville South Carolina with their three children.

Reviews

[Blake · Rating 5 out of 5]

In the counseling world many voices have, and continue, to speak into the discussion about depression, bipolar, and standards of normalcy. In this gracious, well-documented, thought provoking book, Dr. Daniel Berger II enters the discussion, giving voice to a much over-looked philosophy of counseling. All counselors would do well to read Dr. Berger's book and give pause to ponder this well-reasoned, hope-filled approach to handling a common to man struggle. I was greatly blessed by the content of this book. This book, as well other books by Dr. Berger are available at the Grace Resource Center here at Grace Bible Church.

[Chad · Rating 4 out of 5]

A much-needed exploration of depression from a Christian perspective. The first part is a bit difficult to get through because it gives a lot of details about the secular philosophy of psychology and the medical treatment of depression, but it’s worth reading. The second part, about a biblical understanding of depression, is very good. The book is applicable not only to depression, but also to all forms of hopelessness and sadness.

Summary: It's to be expected that people experience sorrow, hopelessness, and guilt due to the Fall. Depression is primarily spiritual, not physical, but it causes physical symptoms. "Antidepressants" work by blunting feelings and giving hope, but studies show placebos work just as well because they, too, give hope. "Antidepressants" and other treatments may provide temporary relief, but the only true, lasting treatment comes from repenting and believing in Jesus, finding hope in His forgiveness of our sins and the promise of His return. Although Christians will still experience sorrow due to the Fall, we have hope in Christ to help us through it.

Notes
Understanding Depression
Depression can be described as inability to experience pleasure.

Depression has no known pathology (underlying physical cause) and no biological markers to serve as diagnostic tools. It can't be measured with objective tests or scans as biological diseases and illnesses can.

It is a mistake to view depressed feelings or even severely depressed feelings as a 'disease.' Depression, remember, is an emotional response to life. It is a feeling of unhappiness—a particular kind of unhappiness that involves helpless self-blame and guilt, a sense of not deserving happiness, and a loss of interest in life. —Peter Breggin, former professor of psychiatry and NIMH consultant

Feelings of sorrow, hopelessness, and guilt aren't abnormalities, but expected, normal reactions to the fallen nature of life and our unfulfilled desires.

Sorrow, hopelessness, and guilt aren't primarily physical illnesses or caused by physical disfunction; they're immaterial/metaphysical/spiritual. They have no physical quality, and can't be measured scientifically.

Establishing Normalcy
Individual degenerationism: philosophy that when something is mentally, emotionally, or behaviorally wrong with a person, and impairment or distress persists, the problem isn't part of human nature, but is due to person's environment or experiences, or due to biological causes.

Real illnesses are quite homogenous in origins, etiology (causes), course, outcome, treatment. Causes of psychological problems are quite heterogenous, so it's unrealistic to expect same treatment to work for them (i.e., no single treatment will work for all cases of depression).

Psychology's theory of mental disorder is based on evolutionary theory and individual degenerationism, which are subjective and have no objective definition of normality, so it's illogical for psychology to define abnormalities.

The more people see life as God sees it and accept the human condition as it truly is [due to Fall, full of sorrow, hopelessness, guilt], the more they will be able to accept and endure the sorrows of this life and the joy that is to come.

Responding to Sorrow
2 destructive responses to sorrow
• Seek false hopes for deliverance
• Give up on pursuing hopes; become inattentive, catatonic, unmotivated, apathetic, suicidal

Life is predominantly sorrowful, with moments of pleasure (Pro 14:13; Ecc).

What secularists label bipolar is described in Bible as normal, failed attempt by people to escape their fallen condition (Ecc 1-2).

Depression is most often diagnosed among poor; bipolar is most often diagnosed among wealthier. The more resources people have, the greater the tendency to turn to their own resources and be proud.

[H]umanity's true condition is sorrow and there is nothing a person can pursue apart from Christ that can bring about happiness or provide hope. [Ecc 1-2]

Accepting the bad news about their broken, vexed, condemned reality puts people in a position to receive the gospel that transform sadness into gladness. If sorrow leads to self-reliance, it crushes the spirit; if sorrow leads to reliance on God, it gladdens the heart (Ecc 7:2-4).

Discerning False Perspectives
Secular understanding of depression syndrome (that depression is a disease or product of physical disease) is based on construct of mental illness; that is based on individual degenerationism, biodeterminism, and evolutionary theory (which is based on materialism); all 3 of those are based on humanism. All these philosophies are unbiblical.

Biodeterminism is idea that people's ideas and actions are predetermined by their biology; this undermines personal responsibility.

Contemporary neuroscience research has failed to confirm any serotonergic lesion in any mental disorder, and has in fact provided significant counterevidence to the explanation of a simple neurotransmitter deficiency. … to propose that researchers can objectively identify a "chemical imbalance" at the molecular level is not compatible with extant science. In fact, there is no scientifically established ideal "chemical balance" of serotonin, let alone an identifiable pathological imbalance. —Jeffrey Lacasse and Jonathan Leo, PLOS Medicine

No one denies that somatic changes occur related to depression; disagreement is about whether physical changes cause mental distress or are vice versa.

Depression is simply the normal impairing and destructive state of being apart from God's wisdom, and the good news—the hope of the gospel—is the metaphysical medicine that heals. Of course, until a person sees Christ face to face, the full dosage—which fully remedies the human condition—will not be realized.

There's no evidence that there are 2 types of depression (depression caused by a spiritual struggle, including sin, and depression caused by physical disease).

Depression can cause physical disease and make one more vulnerable to illness (diabetes, heart disease, heart attack, cancer, stroke).

Physical diseases don't directly cause depression, but they force people to see that humans are weak and dying, which triggers spiritual response of sorrow and hopelessness.

Struggling with hopelessness, guilt, or especially sorrow isn't necessarily sinful or caused by one's own sin.

Sorrow isn't inherently sinful; sinless Jesus was sad, and Rom 12:15 tells us to weep with those who weep.

Bible never tells us to help people get over sadness.

From a scriptural view, depression (a pained and crushed spirit) is a distressing spiritual reality of normal human nature that negatively alters the physical nature, but which God in His mercy can use to lead people out of their fallen condition and into faith in the hope of Jesus Christ.

Reconsidering Emotions
Bible teaches spiritual heart produces affections/emotions.

Bible teaches emotions reveal heart's desires/treasures (Mt 12:33-35).

If biodeterminism were true, morality and guilt wouldn't exist, because biodeterminism means people simply follow their physical "programming."

Discovering God's Remedies
Vast majority of pharmaceutical studies show that in clinical trials, placebos are just as effective as "antidepressants" in helping people with depression. Many of these studies were submitted to the FDA but deliberately not published.

Both placebos and "antidepressants" work by providing hope (promise of relief from distress).

False, temporal hope can come from establishing goals and purpose, authoritative and caring relationships, therapeutic promises, and patient expectations, but these eventually, inevitably fail and cause greater damage.

SSRIs, SNRIs, and other "antidepressants" blunt feelings by suppressing awareness, offer hope of healing, and allow better sleep. These can relieve symptoms to an extent, but don't treat depression.

When people realize their "antidepressants" don't truly cure their depression, they become even more hopeless than before.

"Antidepressants" increase suicide ideation (see FDA black box warnings).

Christians still wrestle with sinful nature, so they set up false hopes that direct them away from Christ (1 Pet 1:13-15), and can still feel hopeless and condemned when they're not.

Temporal hopes aren't necessarily sinful, but they can shift our desires off Christ.

The only true hope is Christ, in His completed work on the cross and His promised return.

It's normal and right to sorrow over fallen condition of this life, but Christians must not sorrow as those who have no hope (1 Thess 4:13). Our hope doesn't remove sorrow in this life, but in life to come (Rom 8:17-24). We can rejoice while sorrowing (2 Cor 6:10).

Conclusion
Depression is primarily spiritual, but affects body. When person's thinking is godly, body responds in healing.

[Michelle · Rating 5 out of 5]

An outstanding book that may challenge presuppositions regarding depression and it’s remedy. In Rethinking Depression, Daniel Berger presents a diagnosis and remedy for depression from a Biblical Christian worldview and contrasts it with the acknowledged (many secular sources cited) theoretical and experimental nature of the most common medical and therapeutic treatments used in secular medicine and psychology to approach diagnosis of depressive, bipolar, and manic states.

The premise: This is a fallen world with sin, sickness, sorrow, disappointment, and calamity and therefore, sadness, sorrow, hopelessness, and depression at differing degrees and varying times are a very normal and expected result. The true remedy is not one that is theoretical, man-generated, and temporal, but instead is eternal, genuine, biblical, Christ-centered and sure.

An excerpt:
“The humanistic model is based on two faith agents: internal and external objects of faith. The first agent is faith in oneself- a faith that encourages people to look inward in order to find or create hope and obtain goals. This wrong perspective is used in most psychotherapies; it has created claims of reliability, and it is seen as a valid pathway to achieve happiness and discover meaning in life. This hope is limited to both the person’s abilities and to his/her temporal life…

The second agent of humanistic hope is an external faith in something that is temporal or allows a continuous pursuit in this life. These external mechanisms include countless self-help cures for depression which focus on the senses and physical health (e.g., take this pill, follow this diet, do this exercise, move your eyes back and forth, drink this mix, smell these scents, repeat these sayings, etc.). These and many other suggestions of external hope are at their core a hope in science (scientistism) and the medical model; they are practical applications of the gospel of humanism and materialism.” -page 202-203

Rethinking depression offers clarity and Gospel-centered hope for the human condition.

[Nathanael Price · Rating 3 out of 5]

I heard Dr. Berger speak last year and he was personable, compassionate, and engaging. He encouraged me personally in a difficult time of my life, and I am grateful to him for that. His book does not carry that same warmth. Cold, academic, and repetitive, the book feels mostly like a textbook. I think he pictures the book being read by cynics, psychiatrists, pastors, and professors alike; he didn’t really pick any one target audience. And I felt like I was missing the pastoral tone from his speaking.
It’s like each chapter is a separate academic research paper.

Philosophically, I think Dr. Bergers dualism is too extreme and does not allow for enough overlap between physical states and spiritual states. I did like how Dr. Berger pointed out that our subjective experience of sorrow cannot be contained in objective constructs of modern science. But just because the spiritual world exists does not mean that the physical world cannot impact it in any way.

I’m sure this book and the ideas in it will give many people hope and I am happy we have people trying to give alternate messages besides “your brain is just messed up.” Even if I disagree with parts of Dr. Berger’s philosophy of Christianity, I am still thankful he is pointing people to Jesus Christ in the midst of their desperation and sorrow. The book was challenging to read, but I do recommend it for anyone who needs a more hopeful perspective on depression- for anyone who thinks that depression is merely biochemically determined.

[Jodi Uplinger · Rating 4 out of 5]

This book was good with lots of information, but it took a long time to read it because it was written kind of like a textbook. I like that the author doesn't say depression isn't real but that there's a different way to look at it and help.

[Melissa]

Goodreads

[Travis Hall · Rating 5 out of 5]

Academic but practical.

[Warren G. · Rating 5 out of 5]

A refreshing and biblically sound look at "depression." Dr. Berger once again brings solid scholarship and concise articulation to bear on a matter that needs to be wrested back from the world of psychology.