The Heart of Depression: The Role of Internal Response in Recovering from Depression

I remember the moment when I thought it might be a good idea to end it all. I was in my mid-twenties, experiencing what I now know as PTSD symptoms, had little hope for the future, and couldn’t experience happiness no matter what I tried. These thoughts had been on loop for months with no sign of relenting. I hated the anxiety, the heightened nerves, the racing mind, and the loss of interest in nearly everything in life.

I had given up on the potential benefits of therapy after only a couple of sessions. I was using my PhD studies to distract myself but that wasn’t working. Prayer and meditation weren’t working. Talking to people wasn’t working. Nothing was working. So, briefly, as I lay awake at night, unable to sleep, I thought about what it would be like to end it all. Luckily, I never seriously considered ending my life. And fortunately, somehow, I pulled out of my depression a few years later.

During my second, more recent, experience of depression, I had no thoughts of suicide, but I felt similarly hopeless and helpless. During both periods, my depression was a manipulative liar, telling me regularly was that I had no hope for a happy and fulfilled life. I’d been depressed for so long that I’d forgotten what normalcy felt like. I thought my mental and emotional state was permanent and that recovery was impossible.

During my more recent period of depression, I recovered much more quickly and comprehensively because I reached out for external help; I received EMDR and other treatments for my PTSD. With those symptoms minimized, I was able to turn inward and thus recover in a more transformative manner by taking an inventory of my heart. 

My Internal Response to Depression

As I have summarized in this article, depression has many causes, some of them external and others internal. For the purposes of this article, we will focus on the internal response to depression. Depression is never so simple as, “Some bad things happened to me and caused my depression” or “I have a chemical imbalance.” Our depression is always affected by our interpretation of external events. We filter the meaning and significance of those events through our view of God, others, the world, and our self. Even chemical imbalances often need an interpretive push to send us over the line into the dark hole of depression. Indeed, our internal response generally makes quite a difference with regard to our experience of depression.

The Hebrew Bible and Christian New Testament speak about our internal response to life in terms of the “heart.” The Bible refers to the heart upwards of nine hundred times. “The heart,” theologian Gordon Spykman writes:

represents the unifying center of man’s entire existence, the spiritual concentration point of our total selfhood, the inner reflective core which sets the direction for all of our life relationships. It is the wellspring of all our willing, thinking, feeling, acting, and every other life utterance. It is the fountainhead from which flows every movement of man’s intellect, emotions, and will, as well as any other ‘faculty’ or mode of our existence. In short, the heart is the ‘mini-me.’”

Gordon Spykman

All men and women live from their hearts, and direct their heartfelt worship toward God, the true source of joy and recovery, or toward false gods who will never fail to disappoint.

In other words, while molecular biology explains humanity at a cellular level, and while neuroscience explains humanity in terms of circuitry, the Christian Scriptures explain humanity at the spiritual level. At the core of who we are—at the “heart” level—we are spiritual beings who respond spiritually to life. Consider these passages:

Keep your heart with all diligence,
For out of it spring the issues of life.

Prov 4:23

Out of the abundance of the heart the mouth speaks.

Mt 12:34

A good man out of the good treasure of his heart brings forth good; and an evil man out of the evil treasure of his heart brings forth evil. For out of the abundance of the heart his mouth speaks.

Lk 6:45

At rock bottom, our lives center around God or false gods. This allegiance—either to God or to counterfeit gods—shapes our desires, imagination, and motives, which in turn shape our thoughts, feelings, and actions. Our connection or disconnection with God makes all the difference.

Thus at all times, and perhaps especially when we find ourselves depressed, we benefit immensely from undertaking a spiritual inventory.

Taking an Inventory of My Heart

One of the greatest challenges in life is to know our own heart. Although we find it easy to enumerate our circumstances or catalogue our current feelings, we face a more formidable challenge when it comes to understanding the depths of our own hearts. In our heart of hearts, we can deceive even ourselves. Fortunately, our depression can be of great help in unveiling our hearts.

In Depression: Looking Up from the Stubborn Darkness, psychologist and Christian counselor Ed Welch lists a number of diagnostic questions that can help us to get to the bottom of things:

• Who or what do I trust, love, and obey more than any other person or thing?
• What are my greatest hopes?
• What are my greatest fears?
• What causes me the most anxiety?
• What do I “need” the most?
• What defines success and failure?
• What do I pray for most often?
• What do I talk about most often?
• What circumstances or people trigger me to doubt God’s goodness or Scripture’s reliability?
• What makes me the most bitter?
• Which people or things do I avoid?

Suffering can reveal who we really are. It peels away our masks, opens the doors to our hiding places, and forces us into the open. The way we respond to suffering reveals a great deal about who we are. God uses hardship to reveal our hearts to ourselves and to others. This is good because we must know what is in our heart before we can set forth on the path of spiritual progress.

Unfortunately, many of us try to medicate our hardships with substances or pleasurable experiences. During my last period of depression, I chose to medicate with alcohol (a depressant!) which made things worse. Yet, if we are wise, we will determine to weather the storm without pseudo-medications and will choose to walk forward on the path of spiritual progress, rather than backward on the path of regress.

When we respond in spiritually unhealthy ways to our depression—in effect, turning our backs on God—we expose our wound to the Evil One’s rusted knife. But when we respond in faith by patiently waiting on God, we expose our wound to the Great Physician’s healing scalpel.

Reshaping My Heart

Depressed people list various things that helped them to break out of the slump: they began preaching the gospel to themselves instead of listening to their skewed minds, stopped saying “it won’t work,” had a friend or pastor who “interrupted” by giving wise counsel, encountered somebody else who is going through a catastrophic time, piggybacked on the faith of a friend, realized their egocentrism, stopped being a martyr, realized they were in a battle and started to fight, started a good medication, built structure into their days, or started a gratitude list.

In one way or another, each of these responses involved a “reset” of their internal response, a reshaping and redirecting of their hearts. Indeed, when we find ourselves in a depressive condition, the most powerful thing we can do is to cultivate healthy hearts. An evaluation of the heart is an introspection at the deepest level possible.

As I explain in this article, my spiritual recovery during depression involved remembering God’s faithfulness in the past, creating healthy daily habits that help us live constructively even in the midst of emotional turmoil, and perseverance through the toughest days. By doing so, we are “renarrating” our lives with God as the main actor, and God as the main actor is actively loving us even—and especially—in the midst of our darkest moments. We are remembering to be grateful for the many good gifts he has given us. And we are actively clinging to his promises for the future.

Which brings me back to the darkest days of my early depression. Briefly, I had considered that it might be better not to live. Yet, during that episode, and in the years that ensued, I was reminded in many ways of God’s goodness. I pulled out of the depression and experienced joy in many ways. During my more recent episode of depression, I learned the spiritual lessons of depression-recovery in a deeper and more enduring manner.

On the backdrop of those depressive episodes and having seen God actively loving me in the midst of them, I can declare even more confidently with the Psalmist:

One thing I have desired of the Lord,
That will I seek:
That I may dwell in the house of the Lord
All the days of my life,
To behold the beauty of the Lord,
And to inquire in His temple.

Ps 27:4

Indeed, I must have faith in God’s good will for my life. I must resist telling my story as if he were not actively loving me in the midst of it. And I must place my hope in him, no matter hard times may come.