Many individuals find themselves asking that question. Depression is, unfortunately, a growing problem. In the midst of the COVID-19 pandemic, there has been an enormous spike in depression and associated mental issues. According to the Centers for Disease Control and Prevention, “The prevalence of symptoms of anxiety disorder was approximately three times those reported in the second quarter of 2019 (25.5% versus 8.1%), and prevalence of depressive disorder was approximately four times that reported in the second quarter of 2019 (24.3% versus 6.5%) (2).”[1] In Japan, for example, deaths from suicide outweigh deaths related to COVID-19.[2]

Outside of COVID-19 and the accompanying difficulties of social distancing, closed businesses and houses of worship, and limited interactions, depression is still an enormous problem for many individuals, ranging from children to elderly adults.[3] We will peruse a few of these contributing factors briefly.

Physical Causes of and Contributions to Depression

So, why are we depressed? There are many factors that can contribute to depression. At times, an individual’s physical problems can lead to depression. In a paper written by Guy M. Goodwin, he presents several physical factors that can lead to depression.[4] These include chronic pain, the effects of a stroke, and heart disease. A lack of sleep can increase depression as well.[5]

Poor diets can also factor in depression. Though there may be a cyclical effect of depression and poor eating habits, research has shown that an unhealthy diet can contribute to depression.[6]

Mental Contributions to Depression

Other contributing factors include stressful life situations. A rocky marriage, problems with children, a failing career, financial issues, and similar circumstances may also contribute to depression.[7]

Medicative Contributions to Depression

There are also medicative causes of depression.[8] Interestingly, many of the prescribed medications for depression can have the opposite effect of increasing depression.[9] The struggles with opioid addiction also have the potential to affect one’s struggles with depression.[10]

Spiritual Contributions to Depression

Though not always addressed as much, the spiritual aspects of human beings can contribute to depression. Sin, the concept of offending the requirements of a deity, can lead to guilt and increased depression. The fear of the afterlife also can interact and increase depression.

Biblical Counseling and the Causes of Depression

As a biblical counselor, I seek to examine the Scriptures and apply them to the various challenges of life that afflict us all. Depression is one of those challenges, and upon which the Scriptures have much to say. We will deal with the above contributing factors in reverse order.

Biblical Counseling and Spiritual Contributions to Depression

One example of an individual who experienced depression is David. During his time of kingship of Israel, he engaged in adultery with the wife of one of his soldiers (see 2 Samuel 11:1-5). Through the course of events, David had Uriah murdered as well as engaging in deceptive actions (2 Sam. 11:6-21). Though we do not know the period of time that elapsed between David’s sins and his repentance, we do have a record of what was going on in David’s heart. Psalm 32:3-5 records David’s struggles,

“For when I kept silent, my bones wasted away through my groaning all day long. For day and night your hand was heavy upon me; my strength was dried up as by the heat of summer. Selah.” (ESV)

David’s spiritual battle with lust, adultery, and murder and his failure to repent brought about depression. One of the common marks of an individual who is depressed is their inability and unwillingness to engage in daily activities.

Another example we could examine is Cain (see Genesis 4:1-6). Though God’s discussion of sacrifices is not covered in Genesis, we can conclude that both Cain and Abel knew what God expected. Cain offered the work of his farming to God, but God rejected Cain’s offering, though God accepted Abel’s (Gen. 4:3-5). In God’s description of Cain, He states “your face [has] fallen.” (Gen. 3:6, ESV)

Though not always, often people who struggle with depression manifest it in their eyes and facial expressions. In Cain’s instance, he was depressed because of God’s rejection of his offering.

Biblical Counseling and Medicative Contributions to Depression

Does the Bible address medicine and depression? It does. Proverbs 23:29-30 offers a glimpse into such a situation.

“Who has woe? Who has sorrow? Who has strife? Who has complaints? Who has needless bruises? Who has bloodshot eyes? Those who linger over wine, who go to sample bowls of mixed wine.” (NIV)

Now, there are many issues presented here: threats, sorrow (uneasiness, depressiveness), division, ingratitude/difficult situations, unknown injuries, and affected physical appearances. That is, there is a host of issues related to alcohol abuse. Interestingly, however, is the appearance of “sorrow.” There is another proverb that encourages the use of alcohol in a medicinal manner. In Proverbs 31:6-7 we find these interesting statements, “Let beer be for those who are perishing, wine for those who are in anguish! Let them drink and forget their poverty and remember their misery no more.” (NIV)

In these two proverbs, we see both the use and misuse of alcohol. The use is to aid someone in intense pain and/or suffering (31:6-7). The misuse is the abuse of alcohol to the detriment of the individual (23:29-30).

It is not surprising, then, to see the many cautions and warnings against alcohol. I encourage you to read through the Scriptures (75 references, to be exact) on CrossTheology.[11]

Biblical Counseling and Mental Contributions to Depression

In Genesis chapter 21, we observe the account of the jealousy and subsequent harshness with which Sarah treats their servant, Hagar, and her son, Ishmael. Sarah, after watching Ishmael mock her son, Isaac, encourages Abraham to banish Hagar.

The Scriptures depict her mental stress in verse 16, “So she sat across from him [her son, Ishmael] and wept controllably.” (NET) There are several issues that would have increased Hagar’s mental stress. Having been banished by Abraham, she is now separated from her only source of food, shelter, and any protection. In addition, she has a son for whom she is unable to provide. Furthermore, she is sent out “wandering through the wilderness of Beer Sheba.” (Gen. 21:14, NET)

In her anguish and depression, she was unable to see a well water (cf. Gen. 21:19). Her depression prevented her from seeing something near. It took God (the NET renders it “God enabled Hagar to see a well of water,” 21:19) to anchor back to reality.

Biblical Counseling and Physical Causes of and Contributions to Depression

Elijah, the great prophet of the Old Testament, experienced physically related depression. After an incredible day of spiritual victory and exhaustion, followed by a lengthy run in which the prophet outruns a chariot (see 1 Kings 18), Elijah receives a threat from Queen Jezebel (1 Kings 19:1-2). In fear, he “went a day’s journey into the wilderness.” (1 Kings 19:4, NET)

It was only after those physically exhaustive events that Elijah undergoes depression. He seeks to be separated from people. He also desires death. These are both common manifestations of depression. After bemoaning his life, he falls asleep (1 Kings 19:5). An angel wakes him up and provides food, after which Elijah goes back to sleep (19:5-6).

It is interesting to note that God does not condemn Elijah for his depression (God’s response is found in 19:9-18).


In this post, we have examined the various contributing factors in relation to depression. This list is not exhaustive, but it does cover the wide gamut of issues related. In the first post, we acknowledge the complexities of depression.[12] In the next post, we will discuss how knowing these contributing factors can help us overcome depression.

[1] Mark E. Czeisler, et. al, “Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic—United States, June 24-30, 2020,” Centers for Disease Control and Prevention, 14 August 2020,, accessed 2 December 2020.

[2] Selina Wang, Rebecca Wright, and Yoko Wakatsuki, “In Japan, more people died from suicide last month than from Covid in all of 2020. And women have been impacted most,” 29 November 2020,, accessed 2 December 2020.

[3] “Teen Depression,” National Institute of Mental Health,, accessed 2 December 2020; and “Older Adults and Depression,” National Institute of Mental Health,,accessed 2 December 2020.

[4] Guy M. Goodwin, “Depression and Associated Physical Diseases and Symptoms,” Dialogues In Clinical Neuroscience, June 2006, 259-265.

[5] Harvard Mental Health, “Sleep and Mental Health,” updated 18 March 2019, published July 2009,, accessed 2 December 2020.

[6] Monique Tello, “Diet and Depression,” Harvard Health Blog, updated 29 January 2020, published 22 February 2018,, accessed 3 December 2020.

[7] Longfei Yang, et. al., “The Effects of Psychological Stress On Depression,” Current Neuropharmacology, July 2015,, accessed 2 December 2020.

[8] “What causes depression?” National Institute of Mental Health,, accessed 2 December 2020.

[9] Donald Rogers and Ronald Pies, “General Medical Drugs Associated with Depression,” Psychiatry MMC, December 2008, 28-41,, accessed 2 December 2020; Harvard Health Letter, “Is your medication making you depressed?” Harvard Medical School, October 2015,, accessed 2 December 2020.

[10] Alicia Grattan, et. al., “Depression and Prescription Opioid Misuse Among Chronic Opioid Therapy Recipients With No History of Substance Abuse,” Analysis of Family Medicine, vol. 10, no. 4, July 2012, 304-311,, accessed 3 December 2020.


[12] Here is that post:

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