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Spiritual depression

The easiest part of my job as a psychologist is science. Neurology, biochemistry and psychopharmacology. But in my experience life’s greatest heartaches are not biological but spiritual. 

Life is hard.

Dr. David Zuccolotto is a former pastor and clinical psychologist.
Dr. David Zuccolotto is a former pastor and clinical psychologist. | Courtesy of David Zuccolotto

As the Apostle Paul wrote, “Our struggle is not against flesh and blood but against the…spiritual forces of evil in the heavenly realms.” (Ephesians  6:12) Paul states the real battle is spiritual. The attack on our personal identity with God, the erosion of self-worth and the spiritual depression it causes in our life. 

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How erosive is sin? What is its impact? How does it affect the mind and body?

Imagine King David came to me for a psychological evaluation during one of his periods of depression. If we use Palms 38 as David’s reason for coming to my office, my clinical notes would look something like this:

Dr. Zuccolotto: Hi King David. Can you tell me why you are here today?

King David: I am full of anxiety because of my sin.

Dr. Zuccolotto: What about depression or feelings of sadness?

King David: Yes. God’s hand has come down on me. It is almost too heavy to bear.

Dr. Zuccolotto: How are your energy levels? Any tiredness or lethargy?

King David: It’s bad. It feels like there is no health in my body and my strength has failed me.

Dr. Zuccolotto: Any problems with guilt?

King David: It’s crushing me! It feels like wounds that are festering.

Dr. Zuccolotto: What about other people in your life? Any feelings of humiliation?

King David: Definitely. I feel bowed down and lower than anyone around me. As a matter of fact my friends avoid me because of this problem.

Dr. Zuccolotto: Any physical symptoms?

King David: Like I said, I don’t feel healthy in my body and my back is filled with pain.

Dr. Zuccolotto: Any anhedonia?

King David: What’s that?

Dr. Zuccolotto: A feeling of no pleasure in life.  Things feel hopeless.

King David: Well, I go about groaning most of the day, feeling feeble and utterly crushed. It’s like the light has gone from my eyes. Is that anhedonia?

Dr. Zuccolotto: That’s a yes.

DIAGNOSIS: Depression

What was the cause?

King David was decisive: “It is because of my sin.”

What can we learn from David’s experience of spiritual depression?

First, David’s depression wasn’t an isolated event. The psalms chronicle a long journey of King David’s highs and lows. Cycles of sin, anxiety and depression are a common theme. Life’s isn’t easy, even for the King of Israel and “man after God’s own heart.”

But whose to blame? 

David acknowledged and accepted that he was the problem. He made no attempts to minimize or rationalize his guilt:

“I have become like one… whose mouth can offer no reply.” (Psalm 38: 13-14)

And yet, King David did reply, “I confess my iniquity; I am troubled by my sin.” (Psalm 38:18)

The contrast highlights David’s spiritual poverty verses God’s sufficiency. A “mouth with no reply” acknowledges the incapacity for self-forgiveness. Instead, confession reaches out to God knowing He has the power to heal.  

But confession is not simply a judicial process of judgment. David is not saying, bring on the whips and chains of punishment. Instead David pleads, “Lord, do not rebuke me in your anger or discipline me in your wrath.” (Psalm 38:1) David is not denying the discipline of the Lord, but pleading it not be delivered in anger.

Once again David highlights God’s power verses his insufficiency. If God WAS angry who could stand? Self-justification provided no leverage or pathway to God. David wasn’t seeking self-worth from personal empowerment or his own ability to forgive himself.  Forgiveness and healing came from God.

David’s humility and God’s empowerment is what enabled David to survive his cycles of sin and spiritual depression. It is how he positioned himself and lived transparently before God.  

“My sighing is not hidden from you,” David acknowledged (Psalm 38;15). Transparency and God’s presence was assumed in all aspects of life: King, father, husband, warrior and servant. The thread of God’s grace woven into all aspects of life. The common thread to survive the cycles of sin and depression.

What was the process for King David’s healing? Waiting.

“Lord, I wait for you; you will answer, Lord my God.” (Psalm 38:15)

Waiting is the expectation of something and perception of how long before it happens.

In a doctor’s office you expect to see someone to treat your illness. While in the waiting room your perception can be altered by reading a magazine, diverting the anxiety of the wait.  

David’s expectation was God’s grace and forgiveness. While waiting David’s perception was strengthened by meditation on God’s law, prayer, confession, and changes to his life. It was what made waiting possible.

What can we learn from King David about spiritual depression?

Most importantly we must understand the pervasive nature of sin. It is not like a broken leg for an otherwise healthy person, but more like a terminal cancer unless treated. It is one thing to say, “I made a mistake.”  It is another to say, “I am a sinner.” The former implies the possibility of self-correction, the latter acknowledges the impossibility of life without God.  

King David realized that nothing of his own character, wit or strength could solve his spiritual depression. It was God who had to come to him, not David’s strengths and merits to come to God. David did not project his low self-worth and defeat onto God. David never assumed that how he felt about himself was how God felt about David.

That is our greatest challenge. Not only to accept our sinful nature and flawed character without God, but to refrain from projecting our fears and defeat onto him. As the Apostle John wrote, “If our hearts condemn us, we know that God is greater than our hearts and knows all things,” (1 John 3:20) Whereas we might condemn ourselves, God does not operate from our perspective or limitations. God knows and is empowered in all things to restore and love his children.   

So how do we handle spiritual depression?

Like King David, we wait.

Wait in God’s word.
Wait in daily prayer, confession and repentance.
Wait while loving one another.
Wait while loving your neighbor as yourself.
Wait with God in all roles of life.
Wait gazing at creation that declares His glory.  
Wait for Jesus:

The farmer waits for the land to yield its valuable crop, patiently waiting for the autumn and spring rains. You too, be patient and stand firm, because the Lord's coming is near. (James 5:7-8).

Dr. David Zuccolotto is a former pastor and clinical psychologist. For 35 years he has worked for hospitals, addiction treatment centers, outpatient clinics and private practice. He is the author of The Love of God: A 70 Day Journey of Forgiveness

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