Depression: A Stubborn Darkness [Paperback]

Welch's book on depression is helpful on a number of levels. It presents both a clear-headed use of descriptive psychology, while providing an instructive example of how to apply biblical teaching about the nature of sin to a particular struggle in the Christian life. The church would do well to learn from his work.

Throughout Chapter 3, Welch makes it clear that we should be willing to learn from psychology at least as a descriptive discipline. This is an important point that we ought to observe and appreciate. The tendency of many in "Christian counseling" circles is to react against the misuse of psychology, claiming that it has no use whatsoever. But Welch clearly demonstrates that a method that recognizes the central authority of Scripture may still make use of insights gleaned from the discipline of psychology. One of the observations that we gain from psychology is that there are various conditions labeled "depression," resulting in a continuum of severity (28). These things are important to recognize; "depression" is not a word with a definite denotation. We should be careful in our response to those who claim to suffer from it, being careful to diagnosis what, precisely, is going on.

Furthermore, Welch grants the theoretical possibility of medical causes of depression, but is careful to point out that "chemical imbalances" are nearly impossible to detect. Even if they were detected, it remains to be proven whether the chemical imbalance caused or was caused by the depression. For all of these reasons, we should be wary of a premature medical diagnosis (30-31). This is even more the case when we realize that such a diagnosis can have a negative effect on the effort to address other contributing factors and issues. The temptation will be for a medical diagnosis to make all else seem superfluous. It will feel like "prescribing physical exercise for baldness" (31). This would then preclude efforts to discover any other causes that Scripture may speak to, whether they be directly sin-related or environmental.

As the beginnings of a biblical way of dealing with depression, part one develops the thesis that depression is suffering (37-100). This is revolutionary; it provides us with a perspective from which to view and approach depression, as Scripture has much to say about suffering. Appropriately, though not facilely, Welch quotes James 1:2-4 at this point (38). Already from this one verse, it is clear that suffering - including depression - has purpose. What's more, Scripture teaches us a number of the causes of suffering: others, ourselves, our bodies, Satan, and God can all play a role as the source of suffering. This, then, should color our approach to the problem of depression.

At this point, knowing that God is in control of our suffering and even uses it for our good, we may be tempted to respond with faithless rebellion. But Welch encourages us with two important biblical principles: 1.) Jesus shared in our suffering; and 2.) God is gracious and generous (47-52). What are we to do, then? The key is not to wait on God to magically strengthen out faith, but to exercise faith by calling upon the Lord (55-61).

Throughout his discussion, Welch is not afraid to point out the places where sin is a hindrance to defeating depression or even a cause of depression. He warns that if a particular passage of Scripture is not speaking to the one who is suffering from depression, it may very well be the result of a willful disregard for the truth that God is speaking to him at that point. (Consider his question, for instance, on page 72: "Do you want to change?") He even presents a fairly detailed exploration of one's over-all view of sin (75-78). But such admonitions are never in the direction of works-righteousness. Far from it. Indeed, they are exhortations to faith. So, when we struggle with depression, we should seek the heart of it in pride, in a desire for autonomy, and in the idolatry of self and self-indulgence (127-129). And even when we do find sin, we must be careful that we not too readily assume that sin is the only - or even the primary - cause of our depression (131).

For all he says of sin and the importance of faith, Welch does not neglect the external factors that may cause depression. We must recognize that we are involved in spiritual warfare (63). He discusses specifics, encouraging those who struggle with depression to list what they suspect to be their main causes. He also discusses general cultural trends that contribute to depression (113-122). In my estimation, this latter discussion is supremely valuable. His diagnoses of individualism, obsession with novelty, and the idolatry of happiness as sources of depression are absolutely correct. Welch's work here is useful for all Christians, not just those who have particular struggles with depression. But this stands to reason. He has diagnosed depression as at least having an element of sin as its cause; that being the case, it is only natural that we would all benefit from the solution, as it is clearly the case that we all struggle with sin.

All in all, even in the context of his discussions of the problem of sin, Welch is consistently Christ-centered. Ultimately, it is only the suffering of Christ that allows us to make sense of our own suffering. "Since Jesus came, suffering is redemptive. When we keep Jesus in view, the `one who learned obedience from what he suffered,' we can begin to understand how James could encourage us to have joy in the desert trek" (139).

If there is one serious criticism of Welch's book, it is that he doesn't seem to make sufficient use of the biblical motif of eschatology. To be sure, he refers to life as a "desert trek" (139), and he reminds us that an important motif for the Christian life is that of pilgrimage (16). In a brilliant chapter, Welch argues that a biblical sense of purpose is important in the fight against depression (90). Traveling, pilgrimage, purpose - all of these are important concepts, and Welch should be commended for making use of them. But it seems to me that he insufficiently develops the idea that on one level, we should all be discontent and dissatisfied with life in this world as we know it. John Calvin develops this theme heavily. A biblically-informed Christian spirituality will be dissatisfied with this life, longing for the life to come. It seems appropriate, then, to encourage those who struggle with depression to recognize where they may in fact be on to something. Their diagnosis of life in the here and now may not be that far off. But the key is to be faithful in what they do in response to that diagnosis. They must look to the hope that is ours in Christ, to the fact that God is making all things new. On that basis, then, even the present life is to be lived in joyful expectation of what is to come. What's more, the Lord provides us foretastes of that life to come in the life of the church - in worship on the Lord's Day, in the Lord's Supper, and in fellowship with God's people.

Ultimately, life in the church is the indispensable key to fighting depression, for it is only in the church that we taste the hope that truly makes life livable. We must embrace the paradox: in order to appreciate and enjoy this life, we must first realize its utter deficiency compared to the glories that are to come. For apart from the church's eschatological hope, depression is the only sensible response.

Dr. Ed Welch has taken some "hits" even from within his own "camp" for this thoroughly balanced and biblical approach to understanding, facing, and dealing with depression. Welch is neither "gaga" over medical diagnoses nor "knee-jerk" reacting against the possibility of medical causes for some depression. In this, he follows in the train of the Church Fathers, the Reformers, and the Puritans who all recognized and even suggested the possibility of physical/medical causes for depression.

Welch writes with a rare combination of compassion and challenge, buttressed by his spiritual theology of suffering--a sufferology. This is perhaps the greatest contribution of the book.

Readers looking for a thought-provoking approach to depression that addresses spiritual, relational, rational, volitional, emotional, and physical issues, will not be disappointed by "Depression: A Stubborn Darkness--Light for the Path."

Reviewer: Bob Kellemen, Ph.D., is the author of "Soul Physicians," "Spiritual Friends," "Biblical Psychology," "Martin Luther's Pastoral Counseling," and "Beyond the Suffering: Embracing the Legacy of African American Soul Care and Spiritual Direction."

"When you are depressed, how can you take a step, let alone a journey? When all vital energy is devoted to staying alive and just making it to the next hour, how can you add anything else - like hope - to your day?" So begins this wise and compassionate book by Ed Welch. Whether you are a someone who struggles with depression yourself, or someone who desires to help those who do, Depression: A Stubborn Darkness will prove an informed and biblically-faithful resource.

The book is divided into an introduction and four parts.

Introduction. The first three chapters are introductory and begin with an empathetic note, describing "How Depression Feels" (chapter two) with a number of actual statements from those who have experienced depression. This chapter will help give understanding to someone who has never personally battled with severe depression. "Definitions and Causes" are described in chapter three, which differentiates between "situational depression" (less severe) and "clinical depression" (more severe), along with lists of possible symptoms for each.

Part One: Depression is Suffering. The seven chapters making up part one are Godward and hopeful, reminding us that depression is a form of suffering out which we can cry out to God for comfort and purpose. Welch doesn't try to make depression look less painful than it is. He faces it head-on. But neither does he let the lying voices of depression claim the day. Instead, he points the reader to God and Scripture (especially the Psalms), with gentle and hopeful reminders of God's love and sovereignty.

Part Two: Listen to Depression. Part two is especially helpful as the various contributing causes of depression are explored. These include other people, "Adam," Satan (chapter eleven), and culture (chapter twelve). Chapter thirteen gets to "The Heart of Depression" showing that depression is a result not simply of the "outside events" that "come at us," but also our "internal believes and interpretations . . . that come out of us" (p. 123). To deal with depression we must learn to address the "spiritual allegiances" of our hearts" which give rise to imaginations, desires, motives, thoughts, feelings, and actions. "The curious path to true life" says Welch, "is to grow in both the knowledge of God's love and your own sin" (p. 131). Chapter fourteen continues with "The Heart Unveiled," with following chapters exploring other causes of and collaborators with depression such as fear, anger, dashed hopes, failure and shame, guilt and legalism, and death. With each of these, the author walks the reader through the fog of confused feelings onto the sure-footed path of biblical truth about sin and grace.

Part Three: Other Help and Advice. In part three, Welch discusses medical treatments (chapter twenty-one) and gives helpful advice for the families and friends of those who are suffering from depression (chapter twenty-two). "To help a depressed person, you don't need expert knowledge. You do need an awareness of your own spiritual neediness, a growing knowledge of Jesus, and an eagerness to learn from others, including the person you would like to help" (p. 224). A particularly great chapter follows called "What Has Helped." It contains helpful insights from counselees about what first helped them begin to change, along with some specific strategies to try. The goal of the chapter is not to give an endless to-do list, but rather to "prime the pump" by giving ideas and strategies that have actually been helpful for depressed people. Chapter twenty-four is another honest, yet hopeful, look at "What to Expect" as one continues to battle against depression.

Part Four: Hope and Joy: Thinking God's Thoughts. The book finishes with two chapters on Humility and Hope (chapter twenty-five) and Thankfulness and Joy (chapter twenty-six). Potential readers should not feel daunted by the twenty-six chapters; each chapter is short and Ed Welch is an engaging writer with an easy prose. It is obvious that Welch has done his research, but the book isn't cluttered by clinical language. More than anything, reading this book feels like getting good advice from an kind and caring friend. As a pastor who sometimes struggles with discouragement and sometimes counsels those with more severe forms of depression, I found this a grace-filled book, loaded with hope and wisdom. I highly recommend it.

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