Healthy Depression

By Kenyon C. Knapp

Depression is the most common mental health struggle on earth, but before we treat it, it helps to determine if it is the illness or the symptom. There are some depressions that are biologically based, and others that are situational, and some that are based on a lack of meaning and purpose in life. This book will help you figure out if you have the sufficient meaning and purpose in your life that serves as a protective factor when the hard times inevitably come. We will examine how depression can be a sign of health and how you can find meaning and purpose in your life.

• Language: English
• Publisher: Wipf and Stock
• Release date: May 25, 2023
• ISBN: 9781666722116

Kenyon C. Knapp

Kenyon C. Knapp, Ph.D., LPC is the Dean for the School of Behavioral Sciences at Liberty University. He has had a private practice for over 20 years, worked in numerous counseling settings, been a counseling professor for over 25 years, and served as a board member for CACREP (the national counseling accreditation board). He has conducted crisis counseling trainings in India, Israel & the West Bank, Uganda, Haiti, Colombia, and many other places around the world. However, his greatest accomplishment comes in the form of his wife and 4 children who keep him multitasking and grateful.

Book preview

Healthy Depression

Kenyon C. Knapp

Healthy Depression

Copyright ©

2023

Kenyon C. Knapp. All rights reserved. Except for brief quotations in critical publications or reviews, no part of this book may be reproduced in any manner without prior written permission from the publisher. Write: Permissions, Wipf and Stock Publishers,

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Wipf & Stock

An Imprint of Wipf and Stock Publishers

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paperback isbn: 978-1-6667-3049-4

hardcover isbn: 978-1-6667-2210-9

ebook isbn: 978-1-6667-2211-6

05/23/23

All Scripture quotations, unless otherwise indicated, are taken from the Holy Bible, New International Version®, NIV®. Copyright ©

1973

,

1978

,

1984

,

2011

by Biblica, Inc.™ Used by permission of Zondervan. All rights reserved worldwide. www.zondervan.com.

English Standard Version (ESV) copyright ©

2001

by Crossway Bibles, a division of Good News Publishers.

Easy-to-Read Version (ERV) International Edition ©

2013

,

2016

Bible League International.

The New King James Version of the Bible (NKJV), copyright ©

1982

by Thomas Nelson, Inc.

Table of Contents

Title Page

Chapter 1: Introduction

Chapter 2: The Scope and Scale of Depression

Chapter 3: Essential Questions for All People

Chapter 4: Group 1: Those Who Are Depressed, but Should Not Be

Chapter 5: Group 2: Those Who Are Not Depressed, and Should Not Be

Chapter 6: Group 3: Those Who Are Depressed, and Should Be

Chapter 7: Group 4: Those Who Are Not Depressed, but Should Be

Chapter 8: Evidence-Based Treatments for Depression

Chapter 10: Author’s Coping Mechanisms—Christian Existential Stance

Chapter 10: Conclusion

Bibliography

Dedicated to Beautiful, my wife, Ginger, who divides my burdens and multiplies my joys.

chapter 1

Introduction

Illness is bad, but symptoms are good.

I

deas have consequences. Ideas

and perspectives can be detrimental or beneficial in regards to our mental health as well. The consequences of these ideas are seen in fairly predictable patterns by mental health professionals. Depression is the most common mental health struggle across the globe. According to the World Health Organization (

2017

), depression is the leading cause of disability worldwide, affecting over

322

million people.¹ Over

800

,

000

people commit suicide every year, which is twice the number that die from homicides, and

1

.

4

% (as high as

5

% in some countries) of global deaths were from suicide in

2017.

² In

2017

, the National Institute of Mental Health (NIMH) noted that

7

.

1

% of the US population (or

17

.

3

million US adults) had at least one major depressive episode in their lifetime.³

Depression is increasingly being treated as mainly a medical condition, but what if the depression is not the illness, but rather the symptom? What if much of current psychological treatment efforts are merely putting a Band-Aid on a tumor? The causes of depression are truly varied, and this book is not an attempt to oversimplify them. Rather, this book was written to encourage readers to examine their own lives and to find crucial answers to some basic yet puzzling questions about life.

For instance, imagine a woman in her thirties went to her family practice physician and described pain in her chest and left arm, light-headedness, and large rashes. The physician listened intently, empathically reflected back how she was feeling, said they were sorry for the way she was feeling, and then gave her a prescription for a painkiller, saying that it would take effect in about twenty minutes and that she should feel fine after that.

Does there seem to be something wrong with this picture? Shouldn’t the physician do further testing, try to figure out the causes for these symptoms, and offer some type of intervention besides pain management? It may seem bizarre, but a version of this happens daily in the lives of many people where their therapists believe that feelings matter more than facts. We must always remember that illness is bad, but symptoms are good. Symptoms notify us something is wrong and needs intervention. Symptoms are often a winding road map to the true issue causing them. If we medicate symptoms and ignore the illness, we will only get worse, regardless of what we blame the increased illness on, and no matter how much we medicate the symptoms.

Contrary to popular assumptions, depression could be a sign of health rather than sickness, letting people know that something is wrong and needs to be changed. Maybe depression is honest feelings about the logical consequences of thoughts and ideas in life. Perhaps instead of trying to change the way we feel, we need to make changes in our attitudes, expectation, and/or beliefs. Although an attractive quick fix in postmodernity, a pill can numb or skew the way a person feels, but ultimately, it does not change the deeper thoughts and presuppositions of most people. Ideas have consequences: they always have; and those consequences are not just philosophical. Sometimes, they are psychological.

As a licensed professional counselor for over twenty years, I have counseled hundreds of people with depression. Many depressed clients would agree with client Ned Vizzini, who said, I didn’t want to wake up. I was having a much better time asleep. And that’s really sad. It was almost like a reverse nightmare, like when you wake up from a nightmare you’re so relieved. I woke up into a nightmare.⁴ People like Ned exist worldwide, feeling thoroughly confused about the origins of their depression, and subsequently finding it easier to just medicate the feelings rather than dig for the cause of the depression. In my practice observations, important trends and themes have emerged. Many clients whom I have met over the years have expressed their feelings of depression, only to speak of numerous difficult life circumstances and experiences—along with an embrace of a nihilistic (the belief that life is meaningless) or fatalistic (the belief that things will turn out poorly regardless of what you do) worldview. The flip side of this is that certain themes toward healthy coping also became obvious with some clients, such as having close trusting relationships, an active spiritual/religious life, and a perspective of learning/growing from challenges in life.

Nihilism is a philosophy that denies the existence of authentic moral truths or values, rejects the possibility of knowledge or communication, and asserts the ultimate meaninglessness or purposelessness of life or of the universe.⁵ Nihilism as an organized idea came from Russian literature in the early

1800

s, and was popularized in philosophy discussions by people such as Søren Kierkegaard, Friedrich Nietzsche, and Albert Camus. What has struck me as ironic over the years is that many proponents of nihilism or fatalism have vehemently said their idea is true or accurate, while denying the existence of truth at the same time, yet they seem oblivious to the contradiction.

Fatalism is the belief that events are predetermined by fate or destiny, and that people can’t do anything to change them—everything is inevitable. This idea has been around for a long time, even during the time of Aristotle (

384

–

322

BC), whose work De Interpretatione, particularly in chapter

9

, created an argument for fatalism.⁶ Fatalism can lead to multiple and opposite reactions in people—some choosing to accept the inevitable, and some resigning themselves to the horror. Most often though, fatalism is a viewpoint that leads to increased depression, as it assumes life to be unpleasant and negative outcomes. Sometimes people will say, Crap happens and then you die, which is a clearly fatalistic viewpoint. It seems self-evident that if people hold to either nihilistic or fatalistic ideas, depression is a logical consequence, and this is what I have seen in decades of therapy with clients. It is not that the beliefs of these clients is their reality, it is that these beliefs become self-fulfilling prophesies.

Existentialism has always had parts that made sense and seemed healthy to the general population such as the idea that we all have personal freedom to make choices, and that we are responsible for those choices. Jean-Paul Sartre once said, Freedom is what you do with what’s been done to you,⁷ and that certainly rings true for many people. However, Sartre has also made other controversial statements, such as, Every existing thing is born without reason, prolongs itself out of weakness, and dies by chance,⁸ which is essentially nihilism. This may have been Sartre’s life experience, but it is not common to most people I have met in life. Still, I suggest the Christian existential stance brings many benefits, which will be elaborated on in chapter

9

.

When you hear life stories from clients with a morbid outlook in life, it only makes sense that they would be hopeless and depressed. However, when these same clients present their worldviews to the typical mental health professional, there is often a knee-jerk reaction on the part of the therapist that the depression is a horrible thing—a strange and inappropriate invader that must be attacked. Without deep consideration of contributing factors, depression is often dealt with in isolation, being treated as the bad guy in the life of a good person. However, there are timeless philosophical questions that we must all answer,