“It is important to discriminate between grief and depression”

Depression is a common issue in modern society. Its signs and symptoms may be different for men and women and in different cultures, and may take a number of forms.

According to Richard Winter, Professor Emeritus of Practical Theology and Counselling at Covenant Theological Seminary, “we all experience times of sadness [..] but it is important to discriminate between grief and depression”.

“We do not define it as major or clinical depression unless that happens for at least 2 weeks, almost everyday”, he explained in an interview recorded at the European Leadership Forum conference in Wisla (Poland), May 2017.

Winter pointed out that “depression is a complex thing, because it is a combination of many possibilities. If you want to think in biblical terms, we can think in the world, the flesh and the devil.”

Winter says it is important to know “which part of this is your responsibility, and which part it is just living in a very fallen, broken world, which you did not choose”.

“Wherever we are weak or vulnerable, the evil one comes and tells us lies about ourselves, to tell us how worthless and incompetent we are”, Winter adds.

The leader of the European Professional Counsellors Network talked about the experience of Biblical characters like Moses, Elijah, Job, Jonah, David or Jeremiah, who “in very different circumstances, got depressed.”

Read the full interview below.

Richard Winter. / FOCL

Question. What is depression?

Answer. Depression is an alteration of our mood, where we tend to feel sad, dejected or disappointed. It varies from person to person and from day to day.

For most of us, we experience times of sadness, of feeling down, feeling blue; but there are more serious forms of depression in this spectrum of severity.

In the other end we would put what we call major or clinical depression, where people feel sad all the time, and have other symptoms that relate to that.

But it is important that we recognize that there is a normal experience that we all have, when people feel up and down throughout the day. Not all those experiences of feeling sad are major depression.

Q. What is the difference between grief and depression?

A. It is important to discriminate between grief and depression, because there is much overlap.

Obviously, both of them involve feeling sad, and may involve crying and feeling worthless and useless. But grief is related very much to a specific event, the loss of someone, the loss of a job or a career opportunity. The person may feel sad, but it often comes in waves: they feel it for a little while, they feel better again, and hen they feel it again intensely.

But severe depression tends to be something that is prolong and stays the same, it does not come in such intense waves as grief comes, and often it is not clear what the cause is, it is a combination of causes.

About 10% of people going through grief of the loss of a loved one, will step in serious depression.

Q. What symptoms does someone suffering from clinical depression exhibit?

A. When depression becomes really severe, people are usually experiencing a number of different symptoms.

They may become very withdrawn, they may lose pleasure or interest in their life, and usually we do not define it as major or clinical depression unless that happens for at least 2 weeks, almost everyday.

Often, there are companying signs or symptoms that counsellors and doctors look for. For example, appetite: they lose their appetite, or they may eat too much just to comfort themselves.

They may sleep too much, or not be able to sleep at night, awake at 2 am, just ruminating of the day.

They may feel just very tired, fatigue. They may not be able to concentrate very well, find really difficult to make decisions, and, if it gets worse, they may experience thoughts of suicide, wanting to die, or perhaps even making plans of that.

For Christians, it is the sense that God is very far away, prayer is useless. The Bible seems like a death book, it becomes meaningless to them.

And then, occasionally, when people get into what we call psychotic depression, where they really are out of touch with reality, they may beginning to have delusions, where they believe things that are not true. It might be that someone with severe depression would believe they have cancer, or any other disease, when there is not medical evidence of that. They even might think develop paranoid delusions.

Q. Why do certain events and biological changes make people vulnerable to depression?

A. Depression is a complex thing, because it is a combination of many possibilities. If you want to think in biblical terms, we can think in the world, the flesh and the devil.

All the pressures of the world around are some of these events - the stress of work behind divorce rate, the pressure of pornography in marriages and sex life, the pressure of children at school, the political and economic strife, wars... All those things are not fault of our own but we, in a sense, are being sinned against by others. When there is domestic abuse or other form of emotional or physical violence.

But we also are sinners in how we respond to those things. So we have some responsibility but not all responsibility. In terms of the flesh, we can think of the way the Bible uses the expression “sinful nature”, as we are prone to pride, to self pity, to perfectionism, to uncontrolled anger, all those are part of our sinful flesh.

But the New Testament also uses the Greek word for flesh meaning our bodies. Our bodies can make us vulnerable to depression, some people are genetically more vulnerable, because they have a whole family history of depression.

Their brain chemistry may not work very well, because of past trauma, their brain may be shaped to be more vulnerable to depression.

And then we have have the devil, the evil one. Wherever we are weak or vulnerable, the evil one comes and tells us lies about ourselves, to tell us how worthless and incompetent we are. How we should blame others rather than take any responsibility ourselves for how we feel.

It is a complex mixture of different things, and with each person is different. That is why hearing the stories is so important, trying to tease out and helping them to tease out which part of this is your responsibility, and which part it is just living in a very fallen, broken world, which you did not choose, but you have inherited it.

Q. What can we learn from biblical characters who experienced depression?

A. When we look at the Bible, we find a number of people who obviously suffered depression.

It is hard to know how long it lasted, so in Psalms, when David talks about soaking his bead with tears, or darkness being his closest friend, at the end of Psalm 88, maybe this was just for a few days. Maybe it was for weeks and months, and some of them might have experienced serious depression.

Other characters as Moses, Elijah, or Jonah, who I call my “suicidal saints”, all of them got to a point where they experienced moments when they said: “God I have had enough, I want to die”.

Each of them, in very different circumstances, got angry and depressed. There are more, like Jeremiah, and, of course, Job and his intense grief, which at times verges on serious depression.

ABOUT RICHARD WINTER

Richard Winter is leader of the European Professional Counsellors Network. He is Professor Emeritus of Practical Theology and Counselling at Covenant Theological Seminary in St Louis, USA.

He is also a psychotherapist and counsellor who was trained in medicine and psychiatry in England before being on the staff and a director of the English branch of the L'Abri Fellowship for 14 years. 

Winter is the author of books on boredom, depression, perfectionism, and reproductive technologies. He is married, with four children and eight grandchildren.