“There is no soundness in my flesh…there is no health in my bones…My wounds stink and fester…I am utterly bowed down and prostrate; all day I go about mourning. For my sides are filled with burning, and there is no soundness in my flesh. I am feeble and crushed; I groan because of the tumult of my heart. O Lord, all my longing is before you; my sighing is not hidden from you. My heart throbs; my strength fails me, and the light of my eyes—it also has gone from me.”—David (Psalm 38:2-10, ESV)
Many people, upon reading David’s words, would assume that he has depression. In fact, if a doctor heard these words, they would probably start filling out a prescription for antidepressants. In fact, in one study, researchers at the National Center for Health Statistics (NCHS) found that “the rate of antidepressant use in this country among teens and adults (people ages 12 and older) increased by almost 400% between 1988-1994 and 2005-2008).”
While I am not against medication, I think it is unfortunate that many people simply assume it is a physical problem without addressing any other potential issues. This is a failure on part of our physicians and pastors (and, believers in general). What do I mean by that?
We have been discussing depression, and our last discussion focused on physical issues related to depression. Science and Scripture, rather than disagreeing with one another, actually demonstrate the affects our bodies can have on our emotions. But this does not address the whole issue, because human beings are more than simply physical bodies.
In this post, we will introduce the spiritual aspect of depression. We covered this briefly in another post, but for now I want to describe the spiritual make up of humanity, because it has enormous ramifications for how we understand and “treat” depression.
Back to the Beginning
We read about the creation of the first man, Adam, in Genesis 2:5-7. God used “the dust of the ground” and “breathed into his nostrils the breath of life,” and as a result, “the man became a living creature” (Gen. 2:7, ESV). We see that human beings are comprised of body (physical) and soul (spiritual).
There are, then, two sources of depression to the human being: physical and spiritual. In other words, we fail to address depression fully if we neglect the spiritual. Turning our attention back to David, we fill in the dots and find an interesting addition to our understanding.
2 For your arrows have sunk into me,
and your hand has come down on me.
3 There is no soundness in my flesh
because of your indignation;
there is no health in my bones
because of my sin.
4 For my iniquities have gone over my head;
like a heavy burden, they are too heavy for me.
5 My wounds stink and fester
because of my foolishness,
6 I am utterly bowed down and prostrate;
all the day I go about mourning.
7 For my sides are filled with burning,
and there is no soundness in my flesh.
8 I am feeble and crushed;
I groan because of the tumult of my heart.
9 O Lord, all my longing is before you;
my sighing is not hidden from you.
10 My heart throbs; my strength fails me,
and the light of my eyes—it also has gone from me.
Do you see the difference? While it is not always the source of the depression, in many cases, sin lies at the root of human depression. In David’s case, he committed adultery with Bathsheba, lied to his friend Uriah, and ultimately had Uriah murdered (see 2 Sam. 11-12). His sin brought about this severe depression. I agree with Adams’ sentiments when he writes, “Sin leads to guilt and depression, sinful handling of sin further complicates matters leading to greater guilt and deeper depression, ad infinitum.”
Depression can definitively be spiritual. In our next post, we will discuss sin in greater detail. We will examine what sin is and then look at how to address it. Finally, we will look at the way sin brings about and contributes to depression specifically.
 On a personal level, my wife, who was taking antidepressants at the time, went to talk with her doctor about weaning herself off the medication. When my wife began telling the doctor about her struggles with depression the doctor interrupted her and said she could prescribe her some antidepressants. She would be wise to review Proverbs 18:13 (the doctor, not my wife!).
 Peter Wehrwein, “Astounding increase in antidepressant use by Americans, Harvard Health Blog, 20 October 2011, https://www.health.harvard.edu/blog/astounding-increase-in-antidepressant-use-by-americans-201110203624, accessed 17 March 2021.
 I disagree with Jay Adams at this point. He writes, “The hope for depressed persons, as elsewhere, lies in this: the depression is the result of the counselee’s sin.” See Jay E. Adams, The Christian Counselor’s Manual: The Practice of Nouthetic Counseling (Grand Rapids, MI: Zondervan, 1973), 378. I believe that Adams fails to consider the fallen aspects of the human body, with the resulting corruption of our emotional states. Though not exhaustive, a pastor friend of mine, Ryan Davidson, has written on this topic. See J. Ryan Davidson, Thinking Through Anxiety: A Brief Christian Look (Warrendale, PA: Ichthus Publications, 2017). I also found Dan Wickert’s comments helpful, “A second question I consider is, ‘How are you handling life on the medication?’ Are they handling the normal problems of life in a biblical, God-honoring way while they are on the medication? If not, then taking them off the medication usually will not help the counselee to please God.” See Dan Wickert, “’Mary’ and Paralyzing Fear,” in Stuart Scott and Heath Lambert, Counseling the Hard Cases: True Stories Illustrating the Sufficiency of God’s Resources in Scripture (Nashville, TN: B&H Publishing, 2015), 121.
 For a brief discussion of the division of human beings (i.e., dichotomy or trichotomy), see Adams, The Christian Counselor’s Manual, 9, footnote 2.
 Ibid., 377.