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Psalm 38: a man with major depression

Published online by Cambridge University Press:  02 January 2018

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Abstract

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Copyright © Royal College of Psychiatrists, 2010 

One of the many purposes the psalms served was to console the sick. These are known as the sickness psalms. There are only six such psalms and two describe quite severe depression (Psalms 38 and 88). Psalm 38 is a good example, but for reasons of space only those verses which describe key depressive symptoms are included here.

6 ‘I am utterly bowed down and prostrate, all day long I go around mourning’ – depressed mood.

8 ‘I am utterly spent and crushed: I groan because of the tumult in my heart’ – despair, anxiety.

10 ‘My heart throbs, my strength fails me: as for the light of my eyes – it has gone from me’ – tachycardia due to anxiety, anergy, anhedonia?

13 ‘But I am like the deaf I do not hear: like the mute who cannot speak

14 ‘Truly I am like one who does not hear and in whose mouth there is no retort’ – sensory inattention, inability to concentrate, with depressive mutism or psychomotor retardation.

18 ‘I confess my iniquity; I am sorry for my sin’ – guilt.

The person may be experiencing an episode of psychotic depression as additional five verses describe enemies who are plotting his end: 12 ‘Those who seek my life lay their snares, Those who seek to hurt me speak of ruin, and mediate treachery all day long’ – they may be real enemies or conspiracy theories with auditory hallucinations and thoughts of death through murder.

There is probably sufficient depressive symptomatology here to diagnose a DSM–IV major depression (five key symptoms, one of which is depressed mood). Such a combination of symptoms in this psalm may suggest that the author had had major depression himself, as it is unlikely that he would be able to render them so faithfully otherwise.

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