In Part 1 we explained how negative thoughts influence depressive symptoms and how depression is due to a brain health issue (a weakened frontal lobe) which can influence behavior and impulsivity. Impulsivity leads to bad habits such as alcohol and drug abuse alongside poor food choices, decreased exercise, increased screen time and decreased social interaction. This creates a negative cycle where bad habits and depressive symptoms influence each other. This downward cycle occurred with Millennials during the COVID-19 quarantine.
Part 2 now discusses how treatment plans for depression often do not incorporate a patientâ€™s faith background and how the Bible guides Christians through a positive upward cycle in hopeful thinking and spiritual health.
The current treatment for depression relies heavily on using antidepressants. However, over 50 percent of antidepressants are not producing the long-lasting effects as expected. Furthermore, one-third of individuals still feel depressed even after using four different antidepressants (Wiles, 2014). This raises the question of why antidepressants are not solving the problem if depression is only a biological brain issue.
To tackle this issue, Ayhan and Budak researched a potential link regarding depression, automatic negative thoughts and mindfulness. They found that individuals suffering from depression are more likely to experience automatic negative thoughts and feelings such as hopelessness. There is also a positive correlation between depressive symptoms and automatic negative thoughts (Ayhan, 2021). Therefore, research raises questions about moving forward with a purely biological treatment option for these individuals. Although many treatment plans do include a psychological component to retrain the thought patterns of the patient along with the biological aspect, this still does not provide a holistic approach to the individual.
A biopsychosocial and spiritual approach needs to be utilized during treatment to address the whole person. However, spirituality is often ignored in treating the depressed individual. If spirituality is addressed, it is often a â€œthin spiritualityâ€ which is the lowest common denominator of what all religions agree on.Â For instance, the therapist may help to find a patientâ€™s purpose in life without tapping into the power of scripture.Â Thin spirituality is used as an all-inclusive umbrella of faith and does not consider the individualâ€™s specific faith background. Therefore, it does not incorporate a holistic view of people (Swinton, 2020).
Christianity provides hope and purpose for an individualâ€™s life, which is exactly what people are looking for. Drawing from a Christianâ€™s faith during treatment is a â€œthick spiritualityâ€ that develops a patientâ€™s deep and personal connection to Christ. This idea of a deeply rooted faith has been supported by research studies that demonstrated a positive correlation of religious spirituality with the alleviation of depressive symptoms (Swinton, 2020).
Swinton emphasizes the importance of incorporating â€œthick spiritualityâ€ in therapy. This includes encouraging practices such as worshiping and praying with others as well as reading and reflecting on the promises found in the Bible (Swinton 2020). Examples of thick spirituality have been demonstrated by historical church leaders during their times of depression.Â Martin Luther King, Jr. found hope from positive words in the spiritual songs such as â€œThe Pilgrimâ€™s Songâ€ and â€œNo Never Alone.â€ Charles Spurgeon clung to Godâ€™s promises in scripture and was reminded of what was true in spite of his own feelings (Gruver, 2020). Similarly, the theologian Henri Nouwen said, â€œI have personally found much help in . . . repeating in my mind a sacred text such as a prayer of Saint Francis. . . When I let these words enter deeply into my consciousness, something new in me happens and I am moved beyond the places where exultation or depression dwell.â€œÂ (Nouwen, 2017). These practices utilize the personâ€™s faith foundation to pull them closer to God during their suffering.
Our thoughts and feelings affect the biology of our body.Â For example, anger is associated with increased blood pressure and the development of heart disease (Suls, 2013). Another example is broken heart syndrome, a condition which mimics a heart attack. It is induced by stressful environments or extreme emotions, such as those that occur with the death of a loved one (Mahajani, 2016). Just as feelings such as anger or grief affect the biology, negative thoughts that occur in depression also affect the personâ€™s biology (Feldman, 1999).
The Bible provides guidance for developing optimistic thought pathways in the brain. In Philippians 4:8 it states, â€œFinally, brethren, whatever things are true, whatever things are noble, whatever things are just, whatever things are pure, whatever things are lovely, whatever things are of good report, if there is any virtue and if there is anything praiseworthyâ€”meditate on these things (NKJV).â€Â This optimistic thinking is correlated with improved physical health (Rasmussen, 2009).
As mentioned in Part 1, humans tend to have a negativity bias (Vaish, 2008) and this is seen even more so in depressed individuals (Ayhan, 2021). In contrast, Philippians 4:8 instructs to practice encouraging thoughts. Having these positive thoughts can lead to dynamically increased synapse rates (interactions between nerve cells) and improved cognition and brain productivity (Subramaniam, 2009). Additionally, continued hopeful thinking will ingrain this thought pathway in the brain. So, practicing these pathways will allow individuals to come to positive conclusions about their situations more often than negative conclusions.
Reducing negative thoughts allows individuals to solve more problems (Subramaniam, 2009). Furthermore, optimistic and hopeful thoughts can decrease the stress hormone cortisol and increase the mood by elevating serotonin levels (Reynolds, 2011). Serotonin is an important neurotransmitter in the prefrontal cortex. Therefore, hopeful thinking as prescribed by Philippians 4:8 can strengthen the prefrontal cortex, which will allow for better cognitive ability, elevated mood and enhanced decision-making skills (Reynolds, 2011).
As stated earlier, one of the prominent feelings of depressed individuals is hopelessness. The Bible holds many themes and one of them is hope. Not simply hope in something better (â€œthin spiritualityâ€), but hope in God who is eternal and unchanging (â€œthick spiritualityâ€).
Romans 8:14-39 discusses this hope and describes it in two sections: hope in Christâ€™s faithfulness and hope through suffering. The first section discusses Christians as Godâ€™s children, implying that God is our spiritual father. Painting God in the image of a father describes the strength and security provided by a parent. This is true of God and his relationship with us. Trials and tribulations of depression are not faced alone, but with God who guides, comforts and supports his children throughout the process (ShÂÂÂÂrier, 2020). Deuteronomy 31:8 reminds us that God is faithful and will never leave us or forsake us.
The second area that Romans 8 addresses is hope through suffering. As children of God, we have hope that suffering will one day end. This hope is rooted in Jesus, because he overcame death. There is hope through suffering in knowing that Godâ€™s promises will be fulfilled. The Bible is not saying that suffering is easy or that it comes from God. Hope is the belief held by a suffering Christian that â€œGod is with them and is on their sideâ€ (Shrier, 2020). The passage in Romans provides those suffering with depression a hope rooted in Christ which draws them closer to Him. This is thick spirituality.
Treatment for depression is complex and involves psychotherapy, diet, exercise, antidepressant medications and sometimes neuromodulation interventions. Negative thoughts and negativity bias can lead to increased depressive symptoms (Vaish, 2008). Furthermore, some depressed individuals suffer from a weakened frontal lobe which is a brain health issue; this affects decision-making leading to the development of bad habits like substance abuse, overeating and others (SkÃ³ra, 2020). These bad habits will only further propagate the cycle that can lead to increased depressive symptoms (Moorman, 2018).
Just telling a depressed person to think positively is oversimplifying the situation and treatment needs to be approached holistically. An option to alleviate some of the symptoms is to strengthen the prefrontal cortex. Practicing Philippians 4:8 trains the brain and allows it to have a stronger, hopeful, default neural pathway. Instead of the brain working on negative thinking pathways, individuals with support from therapists or fellow Christians can apply hopeful thinking pathways grounded in Biblical teachings utilizing their â€œthick spiritualityâ€ anchor.
Joining alongside those that are suffering, the body of Christ serves as a social support.Â We can worship together, read Godâ€™s promises together and encourage one another. In addition, providing a safe place for everyone (including those suffering with depression) to testify (without judgment or blame) of what God is doing and not doing allows the body of Christ to empathize and support their fellow Christians (Swinton, 2020). A thick spirituality in Christ coupled with other treatments addresses the biopsychosocial and spiritual person, alleviates symptoms and provides hope for Millennials.
- Ayhan, Mehmet O. and Funda Kavak Budak. 2021. â€œThe Correlation between Mindfulness and Negative Automatic Thoughts in Depression Patients.â€ Perspectives in Psychiatric Care 57 (4): 1944â€“49. https://doi.org/10.1111/ppc.12770.
- Feldman, P. J., S. Cohen, S. J. Lepore, K. A. Matthews, T. W. Kamarck, and A. L. Marsland. 1999. â€œNegative Emotions and Acute Physiological Responses to Stress.â€ Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine 21 (3): 216â€“22; discussion 223-226. https://doi.org/10.1007/BF02884836
- Gruver, Diana and Chuck DeGroat. 2020. â€œCompanions in the Darkness: Seven Saints Who Struggled with Depression and Doubt.â€ Intervarsity Press.
- Mahajani, V. and V. Suratkal. 2016. â€œBroken Heart Syndrome.â€ Journal of the Association of Physicians of India. 64(6):60-63. PMID: 27739268.
- Moorman, David E. 2018. â€œThe Role of the Orbitofrontal Cortex in Alcohol Use, Abuse and Dependence.â€ Progress in Neuro-Psychopharmacology & Biological Psychiatry 87 (Pt A): 85â€“107. https://doi.org/10.1016/j.pnpbp.2018.01.010.
- Nouwen, Henry JM. 2017. You are the Beloved: Daily Meditations for Spiritual Living. Compiled and edited by Gabrielle Earnshaw; Convergent books, New York; pg. 279.
- Rasmussen, H. N., Scheier, M. F., & Greenhouse, J. B. (2009). Optimism and Physical Health: A Meta-analytic Review. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine 37(3), 239â€“256. https://doi.org/10.1007/s12160-009-9111-x
- Reynolds, Susan. 2011. â€œHappy Brain, Happy Life: Happy brains are more creative, quicker, and more mentally alert.â€ Psychology Today. https://www.psychologytoday.com/us/blog/prime-your-gray-cells/201108/happy-brain-happy-life10.
- Shrier, Paul. 2020. â€œThick â€œReligious Spiritualityâ€ Needs to Replace the â€œThin Spiritualityâ€ of Psychology and the Behavior Sciences in Therapeutic Treatment.â€ Unpublished.
- SkÃ³ra, Maria Nalberczak, Tommy Pattij, Anna Beroun, Georgios Kogias, Dirk Mielenz, Taco de Vries, Kasia Radwanska and Christian P. MÃ¼ller. 2020. â€œPersonality Driven Alcohol and Drug Abuse: New Mechanisms Revealed.â€ Neuroscience & Biobehavioral Reviews 116 (September): 64â€“73. https://doi.org/10.1016/j.neubiorev.2020.06.023.
- Subramaniam, Karuna, John Kounios, Todd B. Parrish and Mark Jung-Beeman. 2009. â€œA Brain Mechanism for Facilitation of Insight by Positive Affect.â€ Journal of Cognitive Neuroscience 21 (3): 415â€“32. https://doi.org/10.1162/jocn.2009.21057.
- Suls, Jerry. (2013) Anger and the Heart: Perspectives on Cardiac Risk, Mechanisms and Interventions. Progress in Cardiovascular Disease 55(6):538-47. DOI: 10.1016/j.pcad.2013.03.002
- Swinton, John. 2020. Finding Jesus in the Storm: The Spiritual Lives of Christians with Mental Health Challenges. Wm. B. Eerdmans Publishing Co.
- Vaish, Amrisha, Tobias Grossmann and Amanda Woodward. 2008. â€œNot All Emotions Are Created Equal: The Negativity Bias in Social-Emotional Development.â€ Psychological Bulletin 134 (3): 383â€“403. https://doi.org/10.1037/0033-2909.134.3.383.
- Wiles, Nicola, Laura Thomas, Anna Abel, Maria Barnes, Fran Carroll, Nicola Ridgway, Sofie Sherlock, et al. 2014. â€œClinical Effectiveness and Cost-Effectiveness of Cognitive Behavioural Therapy as an Adjunct to Pharmacotherapy for Treatment-Resistant Depression in Primary Care: The CoBalT Randomised Controlled Trial.â€ Health Technology Assessment (Winchester, England) 18 (31): 1â€“167, viiâ€“viii. https://doi.org/10.3310/hta18310.