"Why doesn't the church know what to do with depression?" That's the question I've been asking myself since the almost unbearably sad news broke that Robin Williams had taken his own life last week. There were a plethora of responses. Some touching. Some naive. More than a few lacking the nuances and gentleness of grace. 

What was undeniably clear is that we still don't know what to do with people struggling deeply with depression. Like Job's counselors, we often move too quickly to either a cause, or a quick cure. We don't know how to simply sit with people in sadness, much less know how to take their hand and walk with them through it. 

The temptation is to situate depression in one place, as if the roots of depression were singular and not varied. But Scripture won't let us do that. David got depressed because he was slow to confess his lust to God and kept it to himself (Psalm 32:3-4). Hannah got depressed because it seemed like she was the only one of her friends who couldn't get pregnant (1 Samuel 1:7-8). Elijah got so depressed he wanted to kill himself because he felt like such a failure and couldn't bear the burden of life anymore (1 Kings 19:4). Scripture is clear that we get depressed. It is much less clear on exactly why we get depressed. 

Or perhaps it would be better to say that in Scripture there are a diversity of reasons why people get depressed. Sometimes it seems to be more spiritually related, like in David's case. Other times it seems to be rooted in crushingly disappointing circumstances, like in Hannah's case. For some it seems to get so bad they can't bear the thought of having to live another day, like in Elijah's case.  

And then there are the personalities in Scripture that seem more prone to sadness, like Jeremiah. Or those more prone to despair, like Jonah. Not all are born with a cheerful disposition. It seems some are born with storm clouds constantly gathering over their heads. 

Charles Spurgeon, who himself wrestled throughout his life with depression, described it well: "Causeless depression cannot be reasoned with, nor can David's harp charm it away by sweet discoursings. As well fight with the mist as with this shapeless, undefinable, yet all-beclouding hopelessness ... The iron bolt which so mysteriously fastens the door of hope and holds our spirits in gloomy prison, needs a heavenly hand to push it back." He had a category for causeless depression, depression that shows up through no fault of one's own. 

So did Martyn Lloyd Jones. He preached a series that later became a book on the topic, known to us as Spiritual Depression (Eerdmans, 1965). He warned Christians of the temptation to over-spiritualize conditions like depression, writing, "Many Christian people, in fact, are in utter ignorance concerning this realm where the borderlines between the physical, psychological and spiritual meet. Frequently I have found that such [church] leaders had treated those whose trouble was obviously mainly physical or psychological, in a purely spiritual manner; and if you do so, you not only don't help. You aggravate the problem." 

It seems Martin Luther had a similar category too. Speaking of his own struggle with depression (and the use of medicine in his own day) he said, "When I was ill...the physicians made me take as much medicine as though I had been a great bull...I do not deny that medicine is a gift of God, nor do I refuse to acknowledge science in the skill of many physicians. But take the best of them, how far are they from perfection?...When I feel indisposed, by observing a strict diet and going to bed early, I generally manage to get round again, that is, if I can keep my mind tolerably at rest. I have no objection to the doctors acting upon certain theories, but, at the same time, they must not expect us to be the slaves to their fancies." Luther had a category for depression that is mostly physical in cause and cure. 

Then there's John Cassian, writing in the fourth century, who said, "Of dejection there are two kinds: one, that which springs up when anger has died down, or is the result of some loss we have incurred or of some purpose which has been hindered and interfered with; the other, that which comes from unreasonable anxiety of mind or from despair." Cassian had a category for depression that is circumstantial, and that which is clinical. 

In other words, Christians with much less understanding of mental health than we have seemed to have a better grasp of it than we do. They knew what we often forget, that, in the words of David Murray, Christians get depressed too. And not because they're bad Christians, rather because they're broken human beings, living in a broken world, tempted to put their hope in broken cisterns. That brokenness includes our bodies, those bodies include our brains, and those brains help determine (or undermine) healthy or unhealthy patterns of behavior. Biblically speaking, our hearts determine our patterns of behavior.

What Scripture and these men refuse to do is to deal simplistically with a complex issue. We are souls with bodies who have pasts. While sickness may be located in any one of those, the whole person is always affected. So who do you go see when you're depressed? A pastor, a counselor, or a doctor? The answer is, "Yes." Whether that depression is more circumstantial (a death in the family, a break up, etc.), or more clinical (I myself come from a long line of depressives), we need all three to learn how to live well with depression.  

The reason we don't know what to do with depression is twofold. We don't like complexity, and we don't know what to do with sadness. We want things to be simple, and we want things to be happy. Depression is neither. There's typically no quick fix, no magic formula. 

There's a scene in Lars and the Real Girl where Lars has just lost his "girlfriend" Bianca, a mannequin that he's been treating like a real person. His church community, who's been playing along, doesn't know what to do. Do they keep playing along and mourn her "death," or do they finally tell him how ridiculous he's being? They decide to play along for his sake. They have a funeral. Afterwards the women of the church bring food back to the house, and one of them says, "We brought casseroles...We came over to sit. That's what people do when tragedy strikes."  

When you handle complex issues simplistically it steals hope from the people who desperately need it. Hope for the sufferer isn't found in solving their suffering. If that were the case Jesus would have climbed down from the cross. No, hope for the sufferer is in learning to entrust themselves to God in the midst of their suffering, believing somehow that He is working good, working resurrection. The sadness of the cross becomes our joy. That's always been the strange paradox of Christianity. We sit with one another in sadness as we wait to see what God will do.

Of all the people who should be leading the way in a careful handling of depression, the church should be foremost, both in affirming it's complexity, and in bringing hope to those in its clutches. We of all people should know there isn't always a tidy explanation for our suffering. We follow a Savior who himself was familiar with the anxiety of entrusting himself to God in the midst of perplexingly painful circumstances. The sweat on Jesus' brow in the garden of Gethsemane comforts those whose hearts are filled with anxiety. The garden tells us he knows something of the sadness of life. The Prince of Peace is also a "man of sorrows, and acquainted with grief" (Isa 53:4). 

For the past couple of years I've had the privilege of teaching a seminar for college students on anxiety and depression, and I've loved it, not because I love depressing people (my wife might disagree), but because depression has been such a huge part of my own story. There have been times when hope feels eclipsed by despair, and everything in me wants to tap out of life because I feel utterly defeated. 

The best description I've ever read about how depression feels is in Jeffery Eugenides' recent book The Marriage Plot (Picador, 2012). A character is describing the difference between depression and addiction, and she says, "One thing I learned, between addiction and depression? Depression a lot worse. Depression ain't something you just get off of. You can't get clean from depression. Depression be like a bruise that never goes away. A bruise in your mind. You just got to be careful not to touch where it hurts. It always be there, though (pp. 259-60)." 

The image of a bruise is the perfect image for depression. Because sometimes you know how a bruise got there, and sometimes you genuinely don't. Sometimes it's pretty clear why you are depressed, and other times depression shows up out of the blue (pun intended) and next thing you know, to quote Bob Dylan, you're tangled up in blue to the point where it's hard to breathe. 

The question I've asked myself a lot over the years as I've contemplated my own struggle with depression is this: am I depressed because I'm making bad choices, or am I making bad choices because I'm depressed? The answer is, "Yes." Sometimes I'm depressed because of sin in my life. The Westminster Confession of Faith 18:4 wisely reminds us of this: 

But sometimes depression may show up through no fault of my own. This is the kind of depression we don't know what to do with. The kind that can't be repented of. The kind that can't be explained. The kind that gets passed down in families, that seems to be much more the result of imbalances in the body or brain. The kind that Jesus, instead of taking away, asks us to learn to live with faithfully as we trust and follow him. 

The reality is that all of us will experience the sadness of depression at some point in our lives. Others of us will experience it more consistently throughout our lives, like a dark passenger, always lurking. Our hope isn't in solving it, but in entrusting ourselves to Jesus, who is gentle with us in the very places where we are often hardest on ourselves. In fact, He promises not to break a reed that is badly bruised (Isa 42:3), but instead to gently restore it until it is strong enough to stand again. If depression is like a bruise, then God's love is like a balm, which soothes and restores. It's not a quick fix, but something you gently apply over the course of a lifetime.  

The bad news is that most times our depression won't ever just go away. The good news is that no matter how bad our depression gets, we're in the care of a Great Physician who promises to never go away.

Sammy Rhodes (@sammyrhodes) is a campus minister with Reformed University Fellowship at the University of South Carolina. He blogs at Embracing Awkward.