I use the hashtag #theologyforpmads on Instagram to make it easy to find my posts on perinatal mood and anxiety disorders. This isn’t just to have a unique hashtag no one else is using. The application of theology to PMADs has been one of the greatest helps to me in understanding and recovering from perinatal depression, anxiety, PTSD, and OCD. Our understanding of God, His Word, providence, evil, man, sin, the person and work of Christ, the Holy Spirit, salvation, the church, and even eschatology informs how we suffer, how we interpret the world around us, and how we seek help.
My focus on theology is not intended downplay the importance of proper medical care. But there’s already a lot out there addressing PMADs from that angle, and that is also not where my training and education are.[1] What I want to do is bring theology to bear on PMADs for a distinctly Christian understanding of them, so that Christian women with PMADs and their support teams can be better equipped. Much of what I write will also hold true for general mood and anxiety disorder and other suffering we face.
Over the next few weeks, I’ll post about various topics of theology and how they apply to PMADs. Some of these doctrines can be controversial, but I’ll only be scratching the surface of them and will be trying to write in a way that won’t stir up needless controversy.
What does the doctrine of GOD have to do with PMADs?
Who do we think God is? What do we think He is like? How is He at work in the world? Books can’t fully explain God, so an Instagram post definitely can’t. Because of this, I’m just going to touch on three aspects of His nature here.
Transcendence.
God is the “other than King,” to borrow Ryan Lister’s phrase.[2] This points to His power, holiness, and authority, something that is terrifying outside of Christ, but comforting to His children. God is powerful enough to work in your suffering, even to remove it. He’s the Creator, not a creature, and doesn’t have the weaknesses and finite limitations we do. We won’t always (even usually) understand how He is working, because God doesn’t fit in our little boxes.
Immanence.
At the same time, God is the “with you King.” His transcendence doesn’t make Him standoffish; He manifests His nearness in Christ and in the Holy Spirit to help you in your time of need.[3] He is with you in your suffering, but can also rescue you from it.
Lovingkindness.
We may look at God’s transcendence and ask questions about evil and providence. But His immanent lovingkindness show that God’s work in the world and our in lives answers that problem.
If we truly believe that God is lavishly good, loving, and kind to those His Son has saved (as He demonstrated by giving up His Son for our adoption), it won’t remove our PMADs, but it will increase our courage and trust as we suffer.
In the comments: book recommendations on the character of God and two quotes highlighting how important our view of God is.
Book Recommendations:
“God Is” by Mark Jones
“In His Image” and “None Like Him” by Jen Wilkin
“When the surrender of ourselves seems too much to ask, it is first of all because our thoughts about God Himself are paltry. We have not really seen Him, we have hardly tested Him at all and learned how good He is. In our blindness we approach Him with suspicious reserve. We ask how much of our fun He intends to spoil, how much He will demand from us, how high is the price we must pay before He is placated. If we had the least notion of His lovingkindness and tender mercy, His fatherly care for His poor children, His generosity, His beautiful plans for us; if we knew how patiently He waits for our turning to Him, how gently He means to lead us to green pastures and still waters, how carefully He is preparing a place for us, how ceaselessly He is ordering and ordaining and engineering His Master Plan for our good – if we had any inkling of all this, could we be reluctant to let go of our smashed dandelions or whatever we clutch so fiercely in our sweaty little hands?”
Elisabeth Elliot, Loneliness, page 102
“Wimpy theology makes wimpy women… Wimpy theology simply does not give a woman a God that is big enough, strong enough, wise enough, and good enough to handle the realities of life in away that magnifies the infinite worth of Jesus Christ. Wimpy theology is plagued by woman-centeredness and man-centeredness. Wimpy theology doesn’t have the granite foundation of God’s sovereignty or the solid steel structure of a great God-centered purpose for all things.”
John Piper
What does the doctrine of SCRIPTURE have to do with PMADs?
This is a foundational doctrine. If we don’t view Scripture as the living and active Word of God, sufficient for faith and practice, then no other doctrine has a firm foundation—even the doctrine of God.
But my theology applied to PMADs didn’t start with Scripture, because thinking about the Bible can make new moms feel guilty. We can’t find the time to read it, or our foggy brains make it so difficult we give up. Depression may even block Scripture’s comfort. I’m not going to give you rules about how or how much to read. I hope rather to help you wonder at what a gift it is and encourage you to let it form your thoughts about PMADs.
- Scripture is a gift.
We’re so used to our Bibles that we take them for granted. Having personal copies in our language is a privilege. But the existence of the Bible is an even greater privilege, because it is God’s communication to sinful men and women. He is reaching out to rebels. And that’s not just something He did long ago. According to Timothy Ward,
“Whenever we encounter… Scripture, we encounter God himself in action. The Father presents himself to us as a God who makes and keeps his covenant promises. The Son comes to us as the Word of God, knowable to us through his words. The Spirit ministers these words to us, illuminating our minds and hearts, so that in receiving, understanding and trusting them, we receive, know and trust God himself”
Timothy Ward, Words of Life, page 95
2. Scripture should shape how you think about PMADs.
The Bible should impact how we process and address PMADs—not just with specific verses, but with systematic and biblical theology. Scripture isn’t going to tell you what medication to take. But it will “thoroughly equip you for every good work,” and give you a worldview to understand your suffering and a framework for wisely seeking healing. Make use of God’s great gift!
(For more on the doctrine of Scripture, read Psalm 19, and look at R.C. Sproul’s free e-booklet “Can I Trust the Bible?”)
What does the doctrine of PROVIDENCE have to do with PMADs?
Providence: God’s direction of the world.
It’s often hotly debated. And it can make God seem dangerous—even evil—when divorced from an understanding of His goodness.
Christians disagree on exactly the role God plays in ordaining and governing our lives. Some say He only allows suffering in our lives, while others say He ordains it. But if God is God and there is none greater than Him, then everything comes back to Him, whether He ordains or merely allows.
This is why we ask God “why?” in our suffering. We know He has reasons for what we are going through, but we wonder how He can love us if He lets PMADs happen to us. He could have stopped them. He could have said “no.” Instead, He seems to say “no” to our prayers for relief.
Yet He permits—or ordains—what He hates to accomplish what He loves, to quote Joni Eareckson Tada.
This is terrifying, because it means that even our worst could happen. We don’t want to think anything good could ever come out of our worst. We don’t understand how blessing could ever come from PMADs.
I don’t know what good will come from your struggles. I can’t tell you how long it will take for you to be able to look back and say good did come (it took me a few years).
But we have to note the first part of the quote—God uses what He hates. What He hates. When God ordains or allows our suffering, He doesn’t do it glibly. He doesn’t rejoice in our pain. God using our PMADs doesn’t make them good.
But God is good. And it is because God is good that good can come from our trials and that we can trust Him to bring life from death, good from evil, and healing from pain.
I know that’s not always comforting when you’re suffering. His goodness and providence don’t always make sense from our perspective. That’s where lament comes in, where we can freely and honestly cry out to Him, asking why and waiting for His comfort.
Our sanctification is a part of His goodness. He is good—but that goodness may be seen in his prying your grip off your idols. He’s not “safe,” but He is good.
(Book recommendation: The Creaking on the Stairs, Mez McConnell.)
What does the doctrine of the TRINITY have to do with PMADs?
Disclaimer: There will be no shamrocks under this heading.
The mystery of the Three in One and One in Three can’t really be addressed in a couple hundred words. So instead, I’m going to share a few quotes from Fred Sanders’ book “The Deep Things of God,” that talk about how the Trinity impacts the gospel and how the gospel allows for us to be welcomed into the love and fellowship of the Triune God.
Quoting Rainsford, Sanders demonstrates how the Trinity is necessary for salvation: “Thanks be to God, I have them all, and I want them all—Father, Son, and Holy Ghost. I read that my Heavenly Father took my sins and laid them on Christ… Then I want the Son, who ‘His own self [bore] my sins in His own body on the tree.’ And I want the Holy Ghost: I should know nothing about this great salvation and care nothing for it if the Holy Ghost had not come and told me the story, and given me grace to believe it.”
The Trinity doesn’t just relate to how our salvation is accomplished, but also to its end:
“The good news of the gospel is that God has opened up the dynamics of his triune life and given us a share in that fellowship.”
“The eternal life of God in himself is something ‘even better than the good news.’”
“The triune God is a love infinitely high above you, eternally preceding you, and welcoming you in.”
“The living God binds himself to us and becomes our salvation, the life of God in the soul of man. We are saved by the gospel of God to worship the God of the gospel.”
Ponder today what love we receive, what help we have, and what fellowship we can partake in, even amidst PMADs!
(For more: “Delighting in the Trinity” by Michael Reeves or “The Deep Things of God” by Fred Sanders)
[1] See www.postpartum.net, Kristina Cowan’s book “When Postpartum Packs a Punch,” Karen Kleiman ‘s book “This Isn’t What I Expected,” and “The Postnatal Depletion Cure” by Oscar Serralach.
[2] Emblems of the Infinite King
[3] Immanence is an attribute; thus, He can’t be MORE immanent than He is, but it can be manifested or experienced differently, especially in relationship to His covenants. All of this on immanence/transcendence was heavily influenced by The Presence of God by Ryan Lister.
The Sorrows of Eve 
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