Philippians 3:19-21 Updated American Standard Version (UASV)

Timothy and Epaphroditus

19 But I hope in the Lord Jesus to send Timothy to you shortly, so that I also may be encouraged when I know the things concerning you. 20 For I have no one else like-minded who will genuinely care for your concerns. 21 For they all seek their own interests, not the things of Jesus Christ. 22 But you know his proven character, because he has served with me in the gospel ministry like a child with a father. 23 Therefore, I hope to send him as soon as I see how things go with me; 24 and I trust in the Lord that I myself also will be coming shortly.

Epaphroditus’ Mission

25 But I thought it necessary to send to you Epaphroditus my brother and fellow worker and fellow soldier, and your messenger and minister to my need; 26 since he has been longing for all[1] of you and was distressed because you had heard that he was sick. 27 For indeed he was sick to the point of death, but God had mercy on him, and not on him only but also on me, so that I would not have sorrow upon sorrow. 28 Therefore I am sending him all the more eagerly so that when you see him again you may rejoice and that I may be less anxious. 29 Therefore receive him in the Lord with all joy, and hold men like him in high regard; 30 because he came close to death for the work of Christ, risking his life to complete what was lacking in your service to me.

A little known Bible character named Epaphroditus became depressed. He had been charged with going to attend and comfort the seriously ill apostle Paul in Rome, some 600 miles away.  However, Epaphroditus fell sick, and needed to be comforted. He may have thought the Philippian congregation that sent him would believe he had failed them. On the other hand, he might just have felt extreme guilt, and longed to see them, to know they understood his circumstances. Paul used the Greek word, ademoneo, “to be distressed,” “to be in anxiety,” “to feel dejected,” “sorrow troubled [i.e., depressed],” to define Epaphroditus’ circumstance. Bible scholar J. B. Lightfoot wrote that this word can designate “the confused, restless, half-distracted state, which is produced by physical derangement, or by mental distress, as grief, shame, disappointment, etc.” ademoneo “to be troubled, much distressed,” is used of the Lord’s sorrow in Gethsemane, Matt. 26:37; Mark 14:33. (Vine 1996, 299)

The circumstances of Epaphroditus, the historical setting, what exactly brought on his distress can help us today better appreciate how anxiety and stress can contribute to a depressive bout. A devastating sickness may be a basis of depression or guilt feelings of someone in the congregation, or a Christian that is visiting a counselor. This one might have been very active in the congregation prior to an illness, or getting older, and now is very limited to what he can do. This could be very distressing! The pastor or counselor can use Epaphroditus to teach a lesson, or at least a lesson on the effects of extreme or misplaced guilt. The counselor would ask, “Can Epaphroditus be blamed because he fell ill?” The counselee would respond, “Definitely not!” Then, the counselor briefly explains what they already know to be true about our fallen condition. (Genesis 3:17-19; Romans 5:12) Then, the counselor asks the counselee, “Epaphroditus wanted to serve God and his congregation, but sickness restricted him to some degree did it not? The counselee answers, “Yes.” How did Paul and his congregation feel about Epaphroditus? Were they angry because of what happened, the counselor asks. “No,” says the counselee, “in fact, he praised him.”

The Feeling of Depression

“As you wake in the morning, you know, just before you come into consciousness, you feel very sad, very emotional, to the point that you do not want to rise to face the day, you just keep forcing yourself back to sleep,” says Julie. She goes on to say that you do not want to face the day; there is this feeling of impending doom, a sense of worthlessness, wondering why you have to go on like this.”

James remembers, “I was always in a state of nervousness, feeling guilty over everything, and fearing the worst was just ahead, and that life was over when it had only just begun. My fear of losing my job actually pushed me to quit it before the embarrassment of going through the rejection. I worried day and night about everything, my mind racing from one thing to the next, as a beat myself up with my negative self-talk (“man am I dumb!” “I will never amount to anything!” “My life is hopeless!” “Even when I do my best I fail.”). I felt as though I failed God, and would never be in his good graces.”

All of us have been sad from time to time, which can give us that misplaced belief that we can relate to a person who suffers from clinical depression. This could not be further from the truth. The sad truth is, what we may do to remove our feelings of sadness, if recommended to a depressive person, will only enhance their depression. Take a moment to fill out Dr. Burn’s Depression Checklist below.

Burns Depression Checklist

Instructions: Put the corresponding number in the last cell of the chart row to indicate how much you have experienced each symptom during the past week, including today. Please answer all 25 items.[2]

0―Not At All
1―Somewhat
2―Moderately
4―A Lot
5―Extremely
Thoughts and Feelings
1. Feeling sad or down in the dumps
2. Feeling unhappy or blue
3. Crying spells or tearfulness
4. Feeling discouraged
5. Feeling hopeless
6. Low self-esteem
7. Feeling worthless or inadequate
8. Guilt or shame
9. Criticizing yourself or blaming yourself
10. Difficulty making decisions
Activities and Personal Relationships
11. Loss of interest in family, friends or colleagues
12. Loneliness
13. Spending less time with family or friends
14. Loss of motivation
15. Loss of interest in work or other activities
16. Avoiding work or other activities
17. Loss of pleasure or satisfaction in life
Physical Symptoms
18. Feeling tired
19. Difficulty sleeping or sleeping too much
20. Decreased or increased appetite
21. Loss of interest in sex
22. Worrying about your health
Physical Symptoms
23. Do you have any suicidal thoughts?
24. Would you like to end your life?
25 Do you have a plan for harming yourself?

Interpreting the Burns Depression Checklist

   0-5                      no depression

  6-10                     normal but unhappy

 11-25                     mild depression

 26-50                    moderate depression

 51-75                    severe depression

76-100                  extreme depression

The Cruelty of Depression

Even moderate depression can take its toll on you, as the suffering can be very intense at times. If symptoms such as persistent feelings of hopelessness, dejection, poor concentration, lack of energy, inability to sleep, and so on persist for a few weeks, you should seek help. This is more than a short period of sad blues, as clinical depression is a serious disturbance that repeatedly hampers a person from doing everyday activities.

If your depression seems to be severe in the extreme, you should not way, but seek help. If the suffering that you are going through seems intolerable, it is time to reach out. This is not to be trifled with, as because intense feelings of hopelessness and despair can lead to suicidal thoughts. These extreme moods can creep up on you out of nowhere.

The Range of Sadness to Depression
Sadness to Mild Depression Moderate to Major Depression
Sadness, normal grief Overwhelming hopelessness
Self-pity, discouragement Feeling of worthlessness
Self-blame and guilt Destructive guilt and self-blame
Able to find some pleasure Find no pleasure, no longer care
Thoughts Going Through Your Mind
Feeling of guilt and regret Thoughts of suicide
Sorrow Hard to concentrate
Length of Time
A few days to a week More than two weeks
Physical Symptoms
Normal functioning Constant fatigue; unexplained aches
Slight temporary physical problems Changes in eating and sleeping habits
Somewhat tired Inability to sit still, pacing, hand-wringing
Some trouble sleeping Slowed speech or body motions

Types of Depression

According to the Diagnostic and Statistical Manual of Mental Disorders, there are two main categories of depression, major depressive disorder and dysthymia, and a grouping of other, less common types. There are also a number of other mood disorders that can cause depression symptoms.

Depression is set apart into two different categories: (1) those that are the result of tragic life events (like the loss of a loved one), and (2) and those that are biological (like bipolar). However, most cases are a combination of both. Nevertheless, it is best for the purpose of recovery; the diagnoses should be divided into event-related or biological-related.

The biological-related is a lifelong commitment at maintaining and caring for the mental disorder, which can mean a very normal life. However, the event-related have no long-term effect on the brain. Therefore, in time, they will work themselves out with some cognitive therapy, some rest, good eating habits, and some light exercise.

Biological depressions take place within the brain cells, which results in damage to the cells of the brain. However, it may be a stressful event, which triggers the depressive episode. In this case, the duration may not just be a few days to a week, like event-related, but two weeks or more, and treat may very well involve medication, as well as cognitive therapy. Each time a person suffers from a depressive episode, it alters the structure of brain cells, which in turn increases the likelihood of further depressive episodes. However, the tools given in cognitive therapy alter the structure of brain cells as well, which can prevent future depressive episodes.

Event-Related

  • Normal Grief: great sadness, especially as a result of some tragic event
  • Adjustment Disorder: when an individual is unable to adjust to or cope with a particular stressor, like a major life event.

Biological-Related

  • Clinical or major depression is so severest that life is disrupted.
  • Dysthymia is persistent depression that has symptoms such as fatigue, low self-esteem, insomnia, and appetite disturbances but is not severe enough to amount to a mental illness.
  • Bipolar Disorder is a psychiatric disorder characterized by extreme mood swings, ranging between episodes of acute euphoria mania and severe depression
  • Seasonal Effective Disorder (SAD) is winter depression: medical depression associated with the onset of winter and thought to be caused by decreasing amounts of daylight.

Can God Help Depressed Ones?

God is very much aware of his servants that suffer from depression. Isaiah 57:15 says, “The high and lofty one who lives in eternity, the Holy One, says this: ‘I live in the high and holy place with those whose spirits are contrite and humble. I restore the crushed spirit of the humble and revive the courage of those with repentant hearts.’” We can draw a measure of comfort from the fact that God “is near to the brokenhearted and saves the crushed in spirit.” – Psalm 34:18.

There is little doubt that our taking the time to open our heart to the One who ‘hears prayers,” it can enable us to be able to cope better with disturbing moods and situations. (Psalm 65:2) The apostle Paul exhorts us, “do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.” – Philippians 4:6-7.

Some of the more severe forms of depression can cause us to have an intense sense of worthlessness, which can lead us to believe that God has abandoned us, no longer hearing our cries for help. However, this is irrational thinking gone out of control, because “he knows how weak we are; he remembers we are only dust.” (Psa. 103:14) While our human imperfections, we need to know that while “our heart condemns us, God is greater than our heart, and he knows everything.” (1 John 3:19-20) Yes, we need to pray similarly as the Psalmist, who said that God “is a stronghold for the oppressed, a stronghold in times of trouble.” – Psalm 9:9, 10; 10:12, 14, 17; and 25:17.

Even when our depression has the better of us, inhibiting us from being able clearly to state what we want, we should never give up. We just need to express ourselves as best we can, even if it is mumbling to “the God and Father of our Lord Jesus Christ, the Father of mercies and God of all comfort.” (2 Cor. 1:3) The Spirit knows what is in our hearts. The question is how does God answer our prayers?

Proverbs 3:25-26 Lexham English Bible (LEB)

25 Do not be afraid of sudden panic,
or the storm of wickedness that will come.
26 [Jehovah] will be your confidence
and guard your foot from capture.

Before delving into what verses 25-26 means, let us take a moment to establish what it does not mean. Should we understand these verses, or any other in Scripture that because we are wisely walking with Jehovah God that he will miraculously step in to protect each Christian personally from diseases, mental disorders, injury or death? These sorts of miracles are the extreme exception to the rule. Of the 4,000 plus years of Bible history, from Adam to Jesus, with tens of millions of people living and dying, we have but a few dozen miracles that we know of in Scripture. Even in Bible times, miracles were not common, far from it. Hundreds of years may pass with no historical record of a miracle happening at all.

If we are wisely walking with God, we can be confident that bodily disease, mental disorders, injury or early death is far less likely than if we were not. Moreover, we can draw on the resurrection hope. Does God miraculously move events to save us out of difficult times or miraculously heal us? Yes he certainly can, but it is an extreme exception to the rule. He miraculously heals those who are going to play a major role in his settling of the issues that were raised in the Garden of Eden.

What these verses and the rest of Scripture teach us is this, if we walk by using biblical discernment and exercising biblically sound judgment unless time and an unforeseen occurrence befall us, we can be confident that we will not stumble into the difficulties that the world of mankind alienated from God faces every day. Conversely, the wicked do not have this protection. In other words, Christians live by the moral values of Scripture, which gives them an advantage over those that do not. Therefore, God answers our prayers by our faithfully acting in behalf of those prayers, by applying Scripture in a balanced manner. If we have not taken in a deep knowledge of God’s Word, how can we have the Spirit-inspired wisdom, the very knowledge of God to guide and direct us in our ways?

Destructive Self-Talk

It is not the troubles of this would that actually cause us to feel bad. It is what we tell ourselves that contributes to how we feel. Self-talk is what we tell ourselves in our thoughts. In fact, it is the words we tell ourselves about people, self, experiences, life in general, God, the future, the past, the present; it is specifically all the words we say to ourselves all the time. Destructive self-talk, even subconsciously, can be very harmful to our mood: mood slumps, our self-worth plummeting, our body feeling sluggish, our will to accomplish even the tiniest of things is not to be realized and our actions defeat us.

Intense negative thinking will always lead to our feeling blue, painful emotions or even a depressive state. Our thoughts based on a good mood will be entirely different from those based on our being upset. Negative thoughts that flood our mind are the actual contributors of our self-defeating emotions. These very thoughts are what keep us sluggish and contribute to our feeling worthless. Therefore, this thinking is the key to our relief.

Every time we feel down about something, attempt to locate the corresponding negative thought we had to this feeling down. Because it is these thoughts that have created our feelings of low self-worth, by learning to offset them and replace them with rational thoughts we can actually change our mood. Remember the thoughts that move through our mind, with no effort, is the easiest course to follow because we have developed a way of thinking, a pattern of thinking. It is so subconscious that they even go unnoticed because we are not searching for them.

The centerpiece to it all is the mind. Our moods, behaviors and body responses result from the way we view things. It is a proven fact that we cannot experience any event in any way, shape, or form unless we have processed it with our mind first. No event can depress us; it is your perception of that event that will. If we are only sad over an event, our thoughts will be rational; but if you are depressed or anxious over an event, our thinking will be bent and irrational, distorted and simply wrong.

It may be difficult for each of us to wrap our mind around the concept that we are responsible for our thinking that leads to most depressive episodes, but we are very good at telling ourselves outright lies and half-truths, repeatedly throughout each day. In fact, some of us are so good at it that it has become our reality and leads to depression and anxiety. Look at the statements below.

  • Self-degrading: I am so stupid or I never get anything right. Everything I do seem to fail. Even when I do all I can to make someone love me; they just end up rejecting me.
  • Situation degrading: Life is the same every day; I do not even know why I bother getting up! Life just kicks me in the face every day it stinks!
  • Future degrading: I am never going to make it in life; I do not know why I even try. It is a waste of time! I will never find happiness like everyone else. Hope, what is that!

We must appreciate that our thinking can deceive all of us, contributing to our belief that the negative mood, which has been created, because of our thinking, is reality, when it is not. If we have established a negative way of thinking, an irrational way of thinking, our mind will simply accept it as truth. Within a moment, we can alter our mood, and it is not even likely we notice it taking place. These negative feelings feel as though they are the real thing, which only reinforces to the deceptive thinking.

 If we are under mental distress, and we find ourselves having no depression to very mild, and are unhappy much of the time, we need to be in prayer for Holy Spirit. However, we need to act in behalf of our prayers as well. It is likely that we can combine our spiritual pursuits with some cognitive behavioral therapy.[3]

Romans 15:13 English Standard Version (ESV)

13 May the God of hope fill you with all joy and peace in believing, so that by the power of the Holy Spirit you may abound in hope.[4]

We know by now, having come this far in this publication, most of our minor to moderate mental distresses can be overcome by changing the way we think. We also know that the way we think has taken some time to become our pattern of thinking, and is deeply ingrained by now. However, if we are persistent about challenging our thinking every time we have an irrational thought, we can unhinge our irrationally, deep-seated ways of thinking.

At first, we will have to be alert to our thinking, because most of it is subconscious, and will go unnoticed otherwise. We could carry a small pocket tablet with us, to record the times of the day, or how many times in the day, we catch ourselves feeding ourselves irrational thoughts, and how successful we were at overcoming them. If we fail to take this exercise serious, it will be like a Christian, who lacks faith in the existence of Christ, which inevitably leads to spiritual shipwreck. The same is true of our mental distress, if we lack faith in the process, it will not be long before we have a major depressive shipwreck.

Daily Battle of the Mind Schedule

Time Irrational Rational
8-9
9-10
10-11
11-12
12-1
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
9-12

Physical Health

Our physical health is directly related to our mental health. What we eat can affect our moods. Therefore, it is best to see a nutritionist, to discover a healthy eating schedule. In addition, we need to know what foods will be most beneficial in having a positive effect on our moods. In short, it is better to eat five small meals a day, as oppose to three larger meals. We would want to minimize our pasta and bread intake. We would wish to have at least two servings of fruit per day, and one desert of some sort that is not excessive. We would wish to drink half of our body weight in ounces of water. Therefore, if we weigh 150 lbs., our water intake for a day would be 75 ounces or 3.5 20 oz. bottles. We would also want to have some light form of exercise each day. Find a beautiful place where you live, and take a 15-30 minute walk each day, followed by three sets of pushups and three sets of dumbbell curls. Good mental health comes from our showing the appropriate balance in our social, physical, spiritual and emotional Christian life.

Spiritual Health

Spiritual health is one aspect that many let go of first in difficult times. It is in fact, the most important aspect of our wellbeing. The key to being and remaining spiritually mentally healthy is application and being regular at spiritual activities. We should be regular at our Christian meetings, attendance being even more important during the time of crisis. We should be regular about our personal Bible study and Bible reading program. We should be regular in our evangelism of others. When we talk about our faith, it builds our faith.

Supporting Depressed Ones

If we have a wife, husband, child, or parent that suffers from a mental disorder, we need to be aware of the symptoms. This will help you to deal with them in a more loving way. It would be very painful for a sufferer to be further tormented by an uninformed loved one that sees symptoms as hormonal changes. In addition, you may make comments that are not supporting, by saying “you are just sick, you will be fine in a couple of days.” Worse still, you may infer that what are mental health issues are simply spiritual weaknesses or personality flaws. When you see that your loved one is continuously sleeping in longer, having no energy, confused, not interested in eating, irritable, this may be more serious than moodiness. If you have a loved one, who suffers from depression, you need to buy out the time, to research their illness.

We can offer further support, by helping and reinforcing to our loved ones that they need to take an active role in their treatment. Some suffering from depression have been given false information that, “this is who you are, you have a chemical imbalance in your brain, and there is nothing you can do about it. When someone tries to tell you otherwise, they are the enemy, so you should not listen to them.” Wrong, almost all who suffer from mental disorders, even those of a long-term nature, can recover and live healthy lives.

Some may have to take medications and participate in cognitive therapy while others may just need some cognitive therapy. Moreover, those on medication may be able to take lower doses after some time in cognitive therapy.[5] The irony is, if you had symptoms of heart issues, you would seek out treatment, to avoid a heart attack. Even minor heart attacks cause damage to the heart, which can lead to a major heart attack. Some, who go years with minor depressive episodes, not seeking diagnoses, are doing damage to their brain cells, changing the structure of the brain cells, which can lead to major depression.

As a supporter, you need not place blame because a loved one suffers from a mental disorder. Scientists share that this is a very complex combination of genetic, environmental, and social issues. Those who live with the sufferer know that it can be trying at times for both parties, but it does little good to blame a person for an illness that is out of the hands of the sufferer. On the genetic level, it would be the same as faulting someone for having breast cancer, which they genetically inherited. On the event-based level, it would be like blaming a person who grew up in an abusive home. Your time and energy would be better directed at support as well as encouragement.

You need to have an outlook, which is realistic based in reality, not what you would like to see. If the sufferer has limits on what he or she can do, it can be disheartening if you raise the bar beyond those limits. Now, this does not negate the fact that the sufferer needs to be actively involved in their recovery, and improvement is always a goal. However, this should always flow through their counselor.

The best tool for a successful relationship with one suffering from a mental disorder is good communication. It may seem as though that the sufferer misconstrues what is said, but this can be part of the illness, viewing things in an irrational way. However, this is no excuse for giving up. Over time, if you do not allow the lines of communication to close, they will improve. You will learn how to communicate more effectively, and the sufferer will learn how to express himself or herself more effectively. As a supporter, you have to be concerned about more than the sufferer alone. If you are a husband or wife, you have to consider the children as well.

Being the foundation in a family with one who suffers from mental disorders, will over time wear you down. You need to be concerned about your wellbeing as well. You must make sure you eat well because the foods we consume affect our moods as well. You should implement some form of exercise three times a week. Getting enough sleep is crucial as well. Moreover, just because the sufferer cannot take part in social events at times, this does not mean that you should set them aside.

How to Comfort the Distressed with Words

Active Listening

Proverbs 20:5 English Standard Version (ESV)

The purpose in a man’s heart is like deep water,
but a man of understanding will draw it out

Proverbs 18:13 English Standard Version (ESV)

13 If one gives an answer before he hears,
it is his folly and shame.

We need to be able to hear the words that are spoken, as well as the way that it is said, the tone, the body language, so at to get the sense of what is being meant. A common complaint of wives to husbands is that they passively listen to them, blocking out much of what they do not want to hear, because they are opposed, or are not interested in what she is saying. Sadly, we tend to be less appreciative of those who are closest to us than total strangers. Active listening is a form of listening that results in both the speaker and listener having a full understand of what is meant. There are five points to keep in mind:

(1) Pay close attention to what is being said; listen for the ideas behind the words. Do not just hear, but also feel the words. Let the speaker know that you are listening, by leaning forward a little, looking at him, not staring, but having periodic eye contact.

(2) Look at facial expression, the tone of the voice, the inflection of the voice, the mood and body language. You want to get at the feelings behind the words. People generally do not say all that is on their mind, or convey their true feelings at times, so you have to pay close attention to the non-verbal.

(3)  Turn off your internal thinking as much as possible. In other words, do not be thinking of how to respond to certain points while he is still talking, because you are going to miss the whole of what he has said.

(4)  Let the speaker know you are paying attention by nodding from time to time, as well as acknowledging with verbal gestures.

(5) Reiterate is not a common word, but it means to repeat what you think the person meant by what they said, but in your own words, to see if you understood correctly. So, you mean … right?’

(6) The person you are speaking with will acknowledge either you are correct, or he will correct you, and will restate what they meant, and likely in a more comprehensive way since you misunderstood.

(7) When they have explained their message again, you must repeat your reiteration.

Be Empathetic

1 Peter 3:8 English Standard Version (ESV)

8 Finally, all of you, have unity of mind, sympathy, brotherly love, a tender heart, and a humble mind.

Romans 12:15 English Standard Version (ESV)

15 Rejoice with those who rejoice, weep with those who weep.

One of the ways to deal with a challenge is to have empathy. You in your heart must place yourself in their circumstances, getting their mindset. Just because a person comes across abrasively at times, this does not mean that you let them go. There may very well be a reason as to why they are not open to the conversation. This is where insightful, thought-provoking questions, can get at the significant part that has closed them down.

By employing active listening, allowing them to vent, you will understand whatever issues you need to overcome. You might ask, ‘tell me, what has you to the point where you are unable to talk this.’ This will let them know that you are open to listening. While they are expressing themselves, do not be tempted to resolve their issue, just listen as they fully explain. First, make sure you respond in a calm voice. Then reiterate what they said in a summary point, which will let them know you were listening, and it helps you to know you understand what it is. In the end, you may not agree, but you can empathetically understand in some way.

Be Patient

Psalm 103:14 New Living Translation (NLT)

14 For he knows how weak we are;
he remembers we are only dust.

Many times, one has to realize that not every conversation is going to reach a resolution. Therefore, one needs to be patient, and wait for a better time, as it will come up again. Another part of patience is being able to overlook the things the sufferer may say that is hurtful. Recognize that it is the illness speaking, and make allowances accordingly.

Use Your Words Wisely

Proverbs 25:11 Contemporary English Version (CEV)

11 The right word
at the right time
is like precious gold
set in silver.

Proverbs 15:23 Holman Christian Standard Bible (HCSB)

23 A man takes joy in giving an answer;
and a timely word—how good that is!

Use your words to strengthen the depressed one, help him or her to see their good qualities. Be specific in your praises. Let them know that the problems that you face together, the troubles of the past, and time when you both have fallen short are not reflective of the good person he or she is.

[1] One early MS reads “to see you all”

[2] If you believe your results indicate you are suffering from even mild depression, it is important to seek professional help.

http://www.echristiancounselor.org/

[3] http://www.echristiancounselor.org/

[4] God of hope. God is the source of eternal hope, life, and salvation, and He is the object of hope for every believer. The MacArthur Bible Commentary (Kindle Locations 52745-52747). Thomas Nelson. Kindle Edition.

[5] Your doctor, not implemented by you, should make any changes. Many have felt better for some time, and assumed they no longer needed their medication, so stopped it, only to suffer a major depressive episode.