Even though clinical depression has only been medically categorized and developed in the last few decades, the characters who populate our Scriptures were no strangers to it. In the book named for him, Job despairs: “I cannot eat for sighing; my groans pour out like water. What I always feared has happened to me. What I dreaded has come to be. I have no peace, no quietness. I have no rest; instead, only trouble comes …. I will never again experience pleasure … I would rather die of strangulation than go on and on like this. I hate my life” (Job 3:23-26, 7:11, 15-16, NLT).

King David was depressed. In the opening verses of Psalm 13 he writes, “How long, O Lord? Will you forget me forever? How long will you hide your face from me? How long must I wrestle with my thoughts and every day have sorrow in my heart?” And David’s son Solomon wrote, “I hated life, because the work that is done under the sun was grievous to me. All of it is meaningless, a chasing after the wind” (Ecclesiastes 2:17).

We can finally explain this disorder biologically; doctors have come to believe that clinical depression is caused by an imbalance of several chemicals in the brain, namely serotonin, dopamine and norepinephrine. Yet, we still have a tendency to see it as a personal or spiritual disorder. We hear about people with depression and think that they must just be lazy or unmotivated or self-pitying. Even seeing that biblical heroes might have been depressed doesn’t shake our instinct that real Christians just don’t get depressed. We explain those passages away and insist that Christians shouldn’t be depressed, because true joy is found in Jesus.

Unfortunately, the spiritual joy of salvation that comes with knowing Jesus does not always precipitate earthly health or happiness. Christians still get ill, and depression is a sickness—perhaps one of the most insidious ones. Depression inspires a worthlessness that undermines the love and mercy of God. Many Christians who suffer from depression find that their affliction makes it more difficult for them to go to church, pray or engage in acts of charity. The direction of causality here is crucial—depression causes spiritual withdrawal, not the other way around.

Some still say that depression is a result of sin in the depressive person’s life and they may be partially right. Guilt and shame can develop and persist because of secret or unconfessed sins in a person’s life and these perpetual feelings can trigger a depressive episode. This doesn’t mean that “eliminating” sin will cure depression, because sin will always be with us. We are all sinners and we’ll all disobey God’s will at some point—otherwise, what’s the point of grace? As Paul writes in Romans, “For in my inner being I delight in God’s law; but I see another law at work in the members of my body, waging war against the law of my mind and making me a prisoner of the law of sin at work within my members” (7:22-23). We are all, as Martin Luther would say, fully justified and yet fully sinners. An emphasis on the sin component of depression is basically blaming the victim.

Here it is helpful to look at depression the way we look at cancer. Some cancers are partially caused by the actions of the victim—they might have smoked cigarettes or suntanned too much. Yet there are many who have never taken even a drag off a smoke and those who use SPF 45 sun block and still get cancer. Carcinogens are all around us, and they are somewhat indiscriminate in their selection of victims. Similarly, sin is all around us. Dr. Fred Lee, a physician at Brigham and Women’s Hospital in Boston and a teaching fellow at Harvard University, put it this way, “The mortality rate of all people—believers and not—is 100 percent, because this is a fallen world. Sin begets disease, too, in the same way it begets death. From that perspective disease is our fault—in the sense that we are a fallen race. However, it is not directly the fault of the individual.”

A much more prevalent sin component of depression is the act of being sinned against. Experiences in our lives deeply scar us—something as simple as a popular kid making fun of our clothes or something as horrific as ongoing physical or sexual abuse. Perpetually being sinned against creates young men and women who believe that they deserve their sad state of fate, that they really aren’t good enough, and that no one, not even God, could possibly love them. Medical studies show that repeated traumatic experiences can permanently lower mood-regulating brain chemicals. This is the legacy of sin that exists in the lives of all of us.