The Bible is plumb full of commentary on depression. King David experienced intermittent times of intense depression. He was a man who had to work through a great deal of it, and we can see that he succeeded in breaking through into freedom.
Would David today be treated with antidepressants? Could he have been treated at a mental hospital? (I honestly think the answer is “yes” to these questions. He was definitely devastated by depression at certain times.)
There is no question he experienced both spiritual and physical depression. But I believe that David teaches us that depression has a spiritual component in our fallenness. It has to be treated holistically, covering both the physical and the spiritual. It’s like having two hands injured but only treating just one of them.
We need to discern the difference between:
depression caused by guilt (sin)
depression caused by a medical issue (organic)
depression as a reaction to a trauma or loss (reaction)
This is key. These all can be working at the same time (and very often do). But there will only be a partial release if there is only a partial solution. The three can overlap each other. Any of the three can be the predominant kind of depression.
The points below deal primarily with “guilt” or “sin depression.” (I’m not qualified to speak out on the othe1) Confession of sin may free us from certain issues of depression.r two.)
13″If you don’t confess your sins, you will be a failure. But God will be merciful if you confess your sins and give them up.” Proverbs 28:13 (CEV)
2) The story of Cain and Abel reveals the issue of “angry depression” taking over a person’s actions.
“6The LORD said to Cain:
What’s wrong with you? Why do you have such an angry look on your face? 7If you had done the right thing, you would be smiling. But you did the wrong thing, and now sin is waiting to attack you like a lion. Sin wants to destroy you, but don’t let it!”
3) David was depressed until he confessed his sin of adultery with Bathsheba.
3“When I refused to confess my sin, my body wasted away, and I groaned all day long. 4 Day and night your hand of discipline was heavy on me. My strength evaporated like water in the summer heat.” Psalm 32:3-4 (NLT)
4) The way out of depression caused by guilt is confession and seeking God’s forgiveness.
5 “Finally, I confessed all my sins to you and stopped trying to hide my guilt. I said to myself, “I will confess my rebellion to the Lord.” And you forgave me! All my guilt is gone.
1 Oh, what joy for those whose disobedience is forgiven, whose sin is put out of sight! 2 Yes, what joy for those whose record the Lord has cleared of guilt, whose lives are lived in complete honesty!”
Psalm 32:5 , 1-2
5) If you are a Christian and are experiencing “moderate-to-heavy” depression, I would encourage you to seek out medical help. Medication may be helpful to get through this rough time, and talk therapy can be a life-saver. If your depression is caused from guilt, it will NOT get better, until you deal with it in the presence of God.
Now I’m not a physician, nor is this post medical advice.If you are experiencing thoughts of depression and suicide seek out help immediately. Call 911 right now.
Your regular doctor can guide you to a good psychiatrist which may help.
3 “For the enemy has pursued my soul; he has crushed my life to the ground; he has made me sit in darkness like those long dead.”
Some time ago, I was hospitalized for my mental illness. (Actually seven times.) And though each time was bitter, but the Lord carried me. They would take from me my shoelaces, and belts, and fingernail clippers. Basically, I was stripped of everything, anything that I might use to harm myself. But I was creative, I took a clock off the wall and rolled it in a blanket, I smashed it and used the shards of glass to cut my wrists.The nurses were exceptionally observant, and within moments they intervened.
I had already been stripped, searched, and then brought into a ward full of very sick people. Much of all of this is a terrible glazed blur. There was a real awareness of unreality. I was quite confused, and it would take several weeks before I could reconnect. Things were no longer ‘reasonable’ and I could discern nothing. But I didn’t know I was so confused (but I did suspect it). The staff were quite aware and accommodating. They let me be, so time could take care of the rest. I needed to unravel things
Besides, Jesus knew exactly where I was if I didn’t.
Days rolled by, quite slowly. The tedium of a mental hospital is the worst— much more difficult than jail or prison. You walk in a very limited corridor, back and forth. You wait for your shrink, and wait, and wait. You pace, and pace. You pray, stupidly. The other patients were equally disturbed. There was a great variety among them. One guy would urinate in any corner. Once he jumped up on the nurses station, and took a “whizz.” It was hysterical. He almost shorted out their computer.
In all of this, there was a very bleak and strange awareness, of being incredibly ‘detached,’ and only remotely aware that something was not right with me. I tried to get well, but I was mentally lost. I paced, and I remained confused. I was most definitely in an ugly place. Desperate and increasingly bewildered, I knew I had no place to go. A fine place for someone who used to pastor, and teach at a Bible college.
If you have been in this place, you will recognize the ‘lostness’ of being on a ward of a mental hospital. It is confusion mixed with despair, and without a part of very strong drugs, and there is nothing you can do to be released. And really until you come to this fact, they will never let you go. They wait for you to snap out of your confusion, unfortunately that takes time. Sometimes many weeks and whole months. Sometimes never.
It’s worse when you have a family. In my case it was my wife, and two small children. This at times, would twist my heart. I would get a very short phone call, once a week. But this was quite difficult. I gained very little from those calls, and I found myself quite disturbed after each call. Being on this ward tinged me completely. It was like being dipped into darkness. I was very much affected. Now on the outside, I admit I was quite disturbed, but at the time I honestly did not understand a way out.
Dear friend, having a mental illness is cruel and disturbing. And being committed to a mental hospital is a desperate thing. Having passed through its locked doors is something you will never forget. The way I figure these seven hospitalizations have stolen over six months of my life. Its work is irrevocable, its fingerprints will be on your life, for as long as you live.But God will bring good out of this. This I know.
“Do not gloat over me, my enemy! Though I have fallen, I will rise. Though I sit in darkness, the Lord will be my light.”
“In my search for a counselor, I visited a secular psychologist, read books written by extremist biblical counselors, and had tearful talks with my own general practitioner. I wish I had known then what TYPES of Christian counselors were out there and how on earth I could find help I could trust and afford.”
Why Educate Yourself about Christian Counseling?
Perhaps you do not suffer from depression, have a great marriage, kids seem to be doing okay, everything is fine. Why should you look into various types of Christian counsel?
1) Think of a Christian counselor as an invaluable resource, much like the family lawyer, pediatrician, or accountant. When problems arise, wouldn’t it be nice to already have the information you need regarding local counseling services?
2) It’s always a good idea to have information at hand so that you can guide distraught friends and family members to a trusted counselor who can offer biblical guidance and support.
If you are a believing Christian, I MUST recommend seeking a Christian counselor.
“Consequently, you are no longer foreigners and aliens, but fellow citizens with God’s people and members of God’s household.”
The Problem with Secular Counsel
Many secular counselors will take your faith into consideration when treating you. However, as citizens of heaven,seeking counsel from a non-Christian is much like seeking counsel from someone who doesn’t speak your language…and he or she does not speak yours. Progress and inroads could be made, but in the long run, little will be accomplished.
There is wisdom and truth from godly counsel:
“The godly offer good counsel; they know what is right from wrong.”
Find a Christian who is a professional counselor. There are a number of directories on the internet. Each individual counselor is different from the next, however, and you will need to interview any counselor before you decide to use his or her services.
If Possible, Find a Specialist
You may wish to choose a counselor who specializes in a specific area. There a number of issues for which people seek counsel, including:
Coping with Stress
Major life changes
Religious doubt/ confusion
Sexual/ intimacy difficulties
The first thing to consider when choosing a Christian counselor is whether or not they are capable or qualified to handle the particular issue you seek counsel for. A marriage counselor may not be the best person to go to if your thirteen year old daughter is battling anorexia. This seems like a given; however, be sure your counselor has experience handling your specific issue.
Decide whether or not you would feel more comfortable seeing a man or a woman for your particular problem.
Seek a Licensed Professional
Also, if you seek counsel outside of your church, make sure your counselor is a licensed professional. I suggest finding a professional who holds a minimum of a master’s degree in their field of study, who has completed the required number of supervised hours, and who has passed your state’s examination to become a licensed counselor.
Remember that most counselors employed by churches are Professional counselors, but few are not. A church counselor should be qualified through their educational experience, should have some sort of license or certification that enables them to counsel (generally they have a Christian counseling certification awarded from various Christian counseling training programs or colleges.)
Interview Your Prospective Counselor BEFORE Your First Session
Going into a counseling session before you know where your counselor is coming from can be dangerous, especially when you are in a vulnerable emotional position unable to clearly think or discern the counsel you receive.
Before your first session, make the counselor shares your faith and concerns about the issue at hand. If possible, bring a trusted companion along to get their opinion about the practice you are considering.
Some questions to ask your potential counselor are:
What is your Christian counseling approach?
Do they adhere strictly to biblical counseling or do they consider psychological approaches as well?
What license or certification do you have? Is it from an accredited college? A Christian college? A training program?
Are you affiliated with any particular Christian counseling organization?
How do you integrate the bible into your counseling sessions?
How do your incorporate prayer into your counseling practice?
Do you have experience counseling people with (insert the issue for which you seek counsel)?
What is your payment structure?
Will my insurance cover my sessions with you?
What is your view on psychoanalysis, medication treatments for psychological ailments, and other scientific approaches to mental illness?
If you have an opportunity to interview your potential counselor in his or her office, take a good look at the books on the bookshelves. The types of books displayed give you an excellent indication of the types of counsel you will receive.
Before you make your final decision, pray on it, consult your Bible, and if possible, talk to your trusted general practitioner before seeking therapy.
Educate yourself about the various types of Christian counselors. When finding a Christian counselor, remember to find a licensed, experienced CHRISTIAN professional capable of addressing your specific issue. Interview your prospective counselor before attending your first session. Go prepared with a series of questions that will help your gain knowledge about the kind of counsel you will be receiving. Prayerfully consider whether or not you and the counselor are a good fit.
Taken from a great website for believers with issues:
“I’m sure about this: the one who started a good work in you will stay with you to complete the job by the day of Christ Jesus.”
Philippians 1:6, CEB
I was ‘saved’ in my early twenties. With that salvation came a sense of what really was true. And perhaps a real hope of what life could become. I’m now 55, I can only shake my head. It certainly has not been as rosy as I first thought. I blame myself, and go on to understand that maybe this is the way it was supposed to turn out.
But my walk with Jesus has been real. I haven’t given up on my pitiful faith and I haven’t apostatized. And yet I am aware of a confusion, and a disconnectedness that is a bit odd. I sort of realize that my soul has been hunted, and that I’m vulnerable.
But I can’t let go of Him who I call Savior. It certainly has not been easy. Sometimes it seems that I am perhaps the most troubled of all His followers. I’m sure some of you might understand.
You see, I have a disease called “loving Jesus” from which know I will never recover.
The promises that have been given to me can’t be diminished or revoked. He has dedicated Himself to reaching me. I’ve been told that He not only plucks me out of my darkness, but His intention is to heal and balance me. My confusion is not enough to sidetrack His will.
I don’t know what my future holds. But to be honest, I don’t anticipate anything magical, or some fantastically creative spirituality. I do not think things will suddenly get bright all of a sudden. But I can tell you this much, that I will never turn from His grace or goodness. I hang on them as a shipwrecked man clings to a log, out in the middle of the ocean.
I am most unorthodox, I know. I do not fit the mold of the average believer. I am too blunt, direct and disconnected. I have considerable issues, compounded by my mental illness. But I do know Jesus. He has come to save the broken-hearted, and come as a physician to a very sick soul. I trust Him to fix me. In 2 Timothy 1:7, Paul writes us:
“For God has not given us a spirit of fear, but of power and of love and of a sound mind.”
It seems we stand on the threshold of a real and authentic life. For some, we must work especially hard to understand this walk of authentic discipleship. Unquestionably, we must trust in His love. But being stable and established will not save us. (Although, it would be nice). Salvation has always been by grace through faith.
My dysfunctional life doesn’t incur His rejection, the opposite is true. He loves losers, and looks especially on losers who know they are very lost.
I especially want to encourage my brothers and sisters who struggle with a mental illness. You’ve been dealt a severe blow. Others will never understand your “limp.” But Jesus does. You have a gift to bring to the table. He can pour much more grace into you. Don’t be discouraged by the resistance coming out of your thinking. You are especially His. He holds you with a transforming love.
This should supply direction and dialogue on the issues faced by every church member. It is a great opportunity we have been given— to minister to every person in the Body of Christ. —Bryan
by Ken Camp, Associated Baptist Press —
Living with depression — or any other form of mental illness — is like viewing life “through a glass darkly,” according to Jessy Grondin, a student in Vanderbilt University’s Divinity School. “It distorts how you see things.”
Like one in four Americans, Grondin wrestles with mental illness, having struggled with severe bouts of depression since her elementary-school days. Depression is one of the most common types of mental illness, along with bipolar disorder, another mood-altering malady. Other forms of mental illness include schizophrenia and disorders related to anxiety, eating, substance abuse and attention deficit/hyperactivity.
Like many Americans with mental illness, Grondin and her family looked to the church for help. And she found the response generally less-than-helpful. “When I was in the ninth grade and hospitalized for depression, only a couple of people even visited me, and that was kind of awkward. I guess they didn’t know what to say,” said Grondin, who grew up in a Southern Baptist church in Alabama.
Generally, most Christians she knew dealt with her mood disorder by ignoring it, she said. “It was just nonexistent, like it never happened,” she said. “They never acknowledged it.” When she was an adolescent, many church members just thought of her as a troublemaker, not a person dealing with an illness, she recalled. A few who acknowledged her diagnosed mood disorder responded with comments Grondin still finds hurtful. “When dealing with people in the church … some see mental illness as a weakness — a sign you don’t have enough faith,” she said. “They said: ‘It’s a problem of the heart. You need to straighten things out with God.’ They make depression out to be a sin, because you don’t have the joy in your life a Christian is supposed to have.”
A Baylor University study revealed that among Christians who approached their local church for help in response to a personal or family member’s diagnosed mental illness, more than 30 percent were told by a minister that they or their loved one did not really have a mental illness. And 57 percent of the Christians who were told by a minister that they were not mentally ill quit taking their medication.
That troubles neuroscientist Matthew Stanford. “It’s not a sin to be sick,” he insists. Stanford, professor of psychology and neuroscience and director of the doctoral program in psychology at Baylor, acknowledges religion’s longstanding tense relationship with behavioral science. And he believes that conflict destroys lives. “Men and women with diagnosed mental illness are told they need to pray more and turn from their sin. Mental illness is equated with demon possession, weak faith and generational sin,”
Stanford writes in his recently released book, Grace for the Afflicted. “The underlying cause of this stain on the church is a lack of knowledge, both of basic brain function and of scriptural truth.” As an evangelical Christian who attends Antioch Community Church in Waco, Texas, Stanford understands underlying reasons why many Christians view psychology and psychiatry with suspicion. “When it comes to the behavioral sciences, many of the early fathers were no friends of religion. That’s certainly true of Freud and Jung,” he noted in an interview.
Many conservative Christians also believe the behavioral sciences tend to justify sin, he added, pointing particularly to homosexual behavior. In 1973, the American Psychiatric Association famously removed homosexuality from its revised edition of its Diagnostic and Statistical Manual of Mental Disorders. As a theologically conservative Christian, Stanford stressed that scripture, not the Diagnostic and Statistical Manual, constitutes the highest authority.
But that doesn’t mean the Bible is an encyclopedia of knowledge in all areas, and all people benefit from scientific insights into brain chemistry and the interplay of biological and environmental factors that shape personality. Furthermore, while he does not presume to diagnose with certainty cases of mental illness millennia after the fact, Stanford believes biblical figures — Job, King Saul of Israel and King Nebuchadnezzar of Babylon, among others — demonstrated symptoms of some types of mental illness. “Mental disorders do not discriminate according to faith,” he said.
Regardless of their feelings about some psychological or psychiatric approaches, Christians need to recognize mental illnesses are genuine disorders that originate in faulty biological processes, Stanford insisted. “It’s appropriate for Christians to be careful about approaches to treatment, but they need to understand these are real people dealing with real suffering,” he said. Richard Brake, director of counseling and psychological services for Texas Baptist Child & Family Services, agrees. “The personal connection is important. Church leaders need to be open to the idea that there are some real mental-health issues in their congregation,” Brake said.
Ministers often have training in pastoral counseling to help people successfully work through normal grief after a loss, but may lack the expertise to recognize persistent mental-health problems stemming from deeper life issues or biochemical imbalances, he noted. Internet resources are available through national mental-health organizations and associations of Christian mental-health providers. But the best way to learn about available mental health treatment — and to determine whether ministers would be comfortable referring people to them — is through personal contact, Brake and Stanford agreed. “Get to know counselors in the community,” Brake suggested. “Find out how they work, what their belief systems are and how they integrate them into their practices.”
Mental-health providers include school counselors and case managers with state agencies, as well as psychiatrists and psychologists in private practice or associated with secular or faith-related treatment facilities, he noted. Stanford and Brake emphasized the vital importance of making referrals to qualified mental-health professionals, but they also stressed the role of churches in creating a supportive and spiritually nurturing environment for people with mental-health disorders. Mental illness does not illustrate lack of faith, but it does have spiritual effects, they agreed. “Research indicates people with an active faith life who are involved in congregational life get through these problems more smoothly,” Brake said.
Churches cannot “fix” people with mental illness, but they can offer support to help them cope. “The church has a tremendous role to play. Research shows the benefits of a religious social support system,” Stanford said. They stressed the importance of creating a climate of unconditional love and acceptance for mentally ill people in church — a need Grondin echoed. “There needs to be an unconditional sense of community and relationships,” she said. She emphasized the importance of establishing relationships that may not be reciprocally satisfying all the time.
People with mental-health issues may not be as responsive or appreciative as some Christians would like them to be, she noted. “Others need to take the initiative and keep the relationship established. People don’t realize how hard it can be (for a person with a mood disorder) to summon the courage just to get out of bed,” Grondin said. Christians who seek to reach out to people with mental illness need to recognize “they are not able to see things clearly, and it’s not their fault,” Grondin added.
Mostly, Christians need to offer acceptance to people with mental illness — even if they don’t fully understand, she insisted. “Just be present. Offer support and love,” Grondin concluded. “You won’t always know what to say. Just speak words of support into a life of serious struggles. That means more than anything.”
(EDITOR’S NOTE — Camp is managing editor of the Texas Baptist Standard.)
For more information: National Alliance on Mental Illness (800) 950-6264 Anxiety Disorders Association of America (240) 485-1001 Depression & Bipolar Support Alliance (800) 826-3632 American Association of Christian Counselors (800) 526-8673 Stephen Ministries (314) 428-2600
Delusional disorder, (previously called paranoid disorder,) is a type of serious mental illness called a “psychosis“ in which a person cannot tell what is real from what is imagined. The main feature of this disorder is the presence of delusions, which are unshakable beliefs in something untrue.
People with delusional disorderexperience non-bizarre delusions, which involve situations that could occur in real life, such as being followed, poisoned, deceived, conspired against, or loved from a distance. These delusions usually involve the misinterpretation of perceptions or experiences. In reality, however, the situations are either not true at all or highly exaggerated.
People with delusional disorder often can continue to socialize and function normally, apart from the subject of their delusion, and generally do not behave in an obviously odd or in a bizarre manner. This is unlike people with other psychotic disorders, who also might have delusions as a symptom of their disorder. In some cases, however, people with delusional disorder might become so preoccupied with their delusions that their lives are disrupted.
Types of delusional disorder
There are different types of delusional disorder based on the main theme of the delusions experienced. The types of delusional disorder include:
Erotomanic — Someone with this type of delusional disorder believes that another person, often someone important or famous, is in love with him or her. The person might attempt to contact the object of the delusion, and stalking behavior is not uncommon.
Grandiose — A person with this type of delusional disorder has an over-inflated sense of worth, power, knowledge, or identity. The person might believe he or she has a great talent or has made an important discovery.
Jealous — A person with this type of delusional disorder believes that his or her spouse or sexual partner is unfaithful.
Persecutory — People with this type of delusional disorder believe that they (or someone close to them) are being mistreated, or that someone is spying on them or planning to harm them. It is not uncommon for people with this type of delusional disorder to make repeated complaints to legal authorities.
Somatic — A person with this type of delusional disorder believes that he or she has a physical defect or medical problem.
Mixed — People with this type of delusional disorder have two or more of the types of delusions listed above.
There are no systematic studies on treatment approaches and results in Delusional Disorder. The patient’s distrust and suspiciousness usually prevents any contact with a therapist.
Hospitalization is indicated if a potential for danger is present; otherwise outpatient management is advisable. Unfortunately, involuntary hospitalization may increase distrust and resentment and increase the patient’s persecutory delusions.
Antipsychotic medication may be useful, particularly for accompanying anxiety, agitation, and psychosis. Because patients may be suspicious of medication, depot forms may be helpful. Although antipsychotics may have a good response, they are often only marginally effective for specific forms of Delusional Disorder.
Other treatments have been tried (electroconvulsive therapy, insulin shock therapy, and psychosurgery), but these approaches are not recommended.
Copied materials. NO COPYRIGHT INFRINGEMENT INTENDED. All content belongs to its rightful owners. Not for monetary gain. For educational purposes only.
Professor Mitchell, what is the difference between being depressed and just feeling bad about yourself?
Sometimes it’s easy to tell the difference; sometimes you’re not certain. I look for clinical indicators of depressive illness: whether the person’s life is becoming impaired by these bad feelings, when it’s starting to interfere with people’s sleep, appetite and weight, when it’s interfering with their work and concentration, they’re having suicidal thoughts, they can’t buck up. Those symptoms help me to sort out whether it’s just life problems or whether it’s more.
So depression is an illness?
Yes. Even though there are both psychological and physical parts to it, it makes sense to think of severe depression as an illness. There are good medical and psychological treatments that can help people get out of it.
What proportion of the population is depressed?
Figures vary, but over a lifetime about 15% of the population are prone to getting depression on at least one occasion. So it’s relatively common. Some people only have one episode, but for at least half of those who suffer depression once, it is a recurring experience.
Is depression the sort of thing that certain personality types are likely to suffer?
I think that’s true. Anybody is vulnerable to becoming depressed, if things get difficult for them, but some personality types are more prone than others. For instance, if you tend to look for your own failings and weaknesses, if you expect disasters, you are prone to becoming depressed. People who have fragile self-esteems are prone; people who are excessively perfectionistic can be thrown when things don’t go quite right; people who have long-term high levels of anxiety.
Can you describe what it is like to be depressed?
Patients find it quite hard to describe. They often use analogies, like there is a ‘black cloud’ or a ‘weight’ on them. They say that they just can’t enjoy things any more, that they can’t get the drive to do anything; they stay in bed because they just have no energy or enthusiasm. They tend to ruminate and think about their failings, their hopeless situation. But many people find it hard to communicate the experience; even very articulate people have told me how difficult it is to communicate the experience to other people.
On the other side of the fence, what is it like to be close to someone who is depressed?
I think it’s very wearing. It never ceases to amaze me how couples stay together, particularly when it’s prolonged. Even with the best of good will and human kindness, long-term depression can be a very tiring experience for a spouse or close friend. You may get little response from a depressed person, little enthusiasm, withdrawal. They don’t want to interact socially and sometimes they can be quite irritable. Within a marriage, tension may be increased because the depressed person has no interest in sexual activity. So these things exacerbate the problem.
I sometimes hear it said that depressed people ought to just ‘snap out of it’. Can they do that?
Not when the depression is severe in the way we have been talking about. If someone can snap out of it, usually they have by that stage. In general, a depressed person doesn’t like the experience and if it was a matter of just getting on and doing something, they would have tried it. Sometimes people need to learn psychological ways of getting out of the depressed state. But sometimes there is a biochemical process going on that means the person isn’t physically able to snap out of it, without professional help.
Often there is a mixture of the physical and the psychological. It’s very rarely one or the other. The more I see depression, the more I see a complex interplay between personality, the biology of our brains and our life experience.
So depressed people can’t snap out of it, but they also can’t explain very easily what is actually troubling them. It’s a very frustrating illness!
Absolutely. It’s hard for people who haven’t dealt with it professionally to have any idea what it’s like to be depressed. So people have this difficulty understanding it, and this tendency to think that the person should be able to get out of it, and the depressed person has difficulty explaining the experience and feels frustrated and stigmatized when people are telling them to snap out of it, because they know they can’t snap out of it. There is enormous tension.
I suppose the big question is, for both the depressed person and those around them, can depression be cured?
Most people with depression can either be cured or significantly helped by available treatments. These days, we have very good treatments. We can’t help everybody, but we can help the vast majority of people we see.
Is it always a long-term cure, or can it happen quickly?
It varies. Often within a few weeks many people have benefited significantly. Some forms of depression require more long-term psychological treatment, others respond very quickly to medication. And there are grades in between.
Is depression like alcoholism, where you can get it under control but never really be beyond its reach?
For most people, that’s probably a realistic comparison. I tell people that they are always going to be prone to becoming depressed, so they need to be wary about relapses in the future. They need to be sensible about their medications, learn techniques to help them, think about whether there are aspects of their lives that they need to change. We can’t always prevent future episodes, but we can usually make them less likely.
The poet Les Murray recently has been very public about coming out of his depression. It’s interesting that some of the best poetry is written by people who have been depressed. Look at William Cowper, a Christian poet and hymn writer who wrote some of his most moving material during periods of profound depression. So depression can be both creative and destructive.
This raises an important issue for Christians. How do we connect our mental and our spiritual lives?
Cowper became very doubting at times, during his depression. One thing many Christian patients say is that God seems very distant during such periods. I’ve come to accept that as part of the depressive experience rather than a problem with their faith. I’ve seen people with a very deep faith, who yearn to be close to God, and who when depressed feel very barren and remote from God. For instance, J. B. Phillips, the Bible translator, was profoundly depressed for much of his adult life. He has described this sense of distance from God.
That is very distressing for Christians. They begin to worry that it is a lack of faith or lack of spiritual growth. But having seen it enough, I think it is just an expression of the depressive experience. Many Christians also feel that depression is a sign of weakness, of spiritual inadequacy, and they have a strong sense of guilt. Unfortunately, I think that often the church, explicitly or implicitly, has encouraged that—that if you have depression, it’s a reflection on your spiritual life. This adds an incredible burden to people who are already feeling guilty and self-critical. It’s a bit like Job’s encouragers, who basically made him feel worse.
Why does there seem to be a large number of depressed people in our churches?
It’s often the more sensitive people who become depressed, and there are often a lot of obsessional and sensitive people in churches. My experience is that there is a lot of depression in our congregations and that we don’t handle it at all well. We often infer, explicitly or implicitly, that the Christian shouldn’t have the experience of depression—that it’s not part of the victorious Christian life. And that causes enormous guilt and makes people less likely to talk about it. I think we have a lot of silent suffering going on in our churches. People just aren’t getting helped, because they feel guilty about having depression. We need to bring out into the open the fact that depression is a common experience, even within the church. And that being a Christian doesn’t stop you from getting depression. And that having depression is no more a failing than having diabetes.
In general, the church deals very badly with mental illness. In the middle ages, it was considered demon possession; in the late 20th century it’s considered a symptom of spiritual inadequacy. But it isn’t necessarily either of these things.
Are people in very demanding ministries especially prone?
They are prone; I don’t know about especially. They are in line for so many of the factors that contribute to depression: burn-out, demoralization, excessive demands, not looking after your own emotional needs, not having time to yourself. I see some of the casualties, and often by then it’s too late because someone has resigned from the ministry or become completely disillusioned. And it’s all too hidden, too hush-hush. We’re dealing with it no better than the secular world; in some ways we’re doing worse.
What then are the ways that a depressed person can be helped, both by individuals and by the church?
Well, especially in the early days, one can be supportive, help people get back into their lives—those normal things of friendship and support, being a sounding board, willing to listen to difficulties. These things might be sufficient to alleviate the early experience of depression.
But if we’re looking at a fully formed depression that’s been going on for a while, the person should be encouraged to seek proper professional help. That doesn’t always mean a psychiatrist; it might mean a GP or a counsellor. Just someone with the skills and training to help. So that’s the first thing, when the support networks have been stretched to the limit.
While that process is happening, it’s important to be around for the depressed person, accepting the fact that it might be a frustrating experience until that person picks up. Not feeling that you have to do everything yourself. There has to be a point where a friend accepts that they can’t provide everything the person needs. That point is usually indicated by signs like someone crying constantly, their work falling apart, withdrawing inexplicably, perhaps losing weight. These things indicate that the depression is getting severe.
Finally, do you think depression has become more of a problem today than it used to be?
It’s an area of debate. There’s no doubt that depression has always existed. The old Greek medical writers are clearly describing patients with depression. There was a book written in the 17th century called The Anatomy of Melancholy which described what we would call depressed patients. So it goes back through the ages; it’s part of the general human experience.
The issue is whether it has become more frequent. People have looked at the occurrence of depression in groups of people born in different decades in this century, and the frequency of occurrence seems to go up as the decades continue. People born in the 60s are more prone to depression than those at similar ages, but born in the 30s. Now, the significance of that is debated. It could be that people in recent decades simply have become more willing to admit to their depression, hence the higher rate of reports. Or it could be true that it is becoming a more common experience, and presumably that reflects changes in society. What those changes are is a very difficult question to answer.
So it’s hard to say whether the loneliness of urban living is a major factor?
Well yes, and it’s a very interesting area of debate. The World Health Organization has released predictions of the impact of different illnesses over the next century. They are saying that depression will be the 21st century’s most disabling condition, in terms of the impact on the individual, frequency and cost to society, on a worldwide basis. That survey included all medical conditions, including cancer and heart disease. So there is a recognition that it is a very prevalent condition, and that it is a very disabling condition to have. Whatever is causing it, we’re going to have to deal with it.
Philip Mitchell is a Professor at the School of Psychiatry, Prince Henry Hospital in Sydney, Australia.