Dimensions of depression
Two thirds of us will at some time experience symptoms of anxiety and depression of sufficient severity to disrupt our lives. No Christian is exempt from the possibility. One woman said she had lost the joy of the Lord and blamed herself for it. She got better, and recovered her joy. A younger woman fell among exorcists and had four hours of prayer and exorcism. She was extremely angry at what had been done to her. It had not helped. A prominent member of the well known evangelical chapel that I attended, a young man, killed himself. All I heard was a deafening silence. Perhaps one need is to obtain a better knowledge of the person who is ill - to know the background history, assess the personality, and so on, and all this done in a gentle way.
Detecting depression
But first, what are some of the symptoms of clinical depression? There may be loss of weight, appetite or pleasure in life or, in some cases, loss of interest in a previously good marriage. Difficulties with concentration and memory, problems with sleep and early waking in some distress, low mood with crying, irritability and general loss of interest may all be signs of depression. It is a distressing factor that often things like prayer, reading, worship and fellowship cannot be enjoyed.
Serious depression is often masked by smiles, physical symptoms of anxiety or concerns about imagined cancer or other serious illness. Some people say, ‘surely unhappiness is not an illness’. True, but anyone who is deeply unhappy, and is ill with his unhappiness, is certainly suffering from depression. Of course, we can use a symptom to avoid something. Even the wisest parent may be unsure whether their child is crying wolf or is really ill. And so it may be in the church fellowship.We all may either be part of the problem or also part of the solution.
Many a patient is told depression is because of sin. As a result, treatment may be refused. In every such case that I have seen, this has been entirely misguided. I am amazed that so many reject good medication. A patient may be told at church to pray more, but that is just what they find so difficult. Of course, for every horror story there are other accounts of prayerful support and sensible advice, and of being encouraged to accept proper treatment.
Related problems
Sometimes it becomes obvious that it is not just a question of illness, but of a bigger problem within the person who is ill. They may even have a personality disorder. At one extreme is the histrionic patient who makes ‘a drama out of every crisis’ and who may be a skilled manipulator of those around. At the other extreme may be a quiet, careful perfectionist, often good at camouflage. But let us remember that such obessional people are much more prone to severe anxieties (just think of the young Martin Luther or John Bunyan) and also suffer more easily from depression. Many of them are pillars in the church.
Some Christians share the common suspicion of psychiatry. They will say, ‘A miserable Christian is a contradiction in terms’. Slowly, this approach is changing - perhaps as slowly as global warming! I find most pastors recognise the vulnerable in their churches and seek to offer appropriate help. Like their mentor, Paul, they try to be gentle like a mother caring for her little children (1 Thessalonians 2:7) or as a father deals with his own children, encouraging, comforting and urging (1 Thessalonians 2:10). But when a person seems to be using depression to avoid clear Christian duties, what can be done ?
Pastors are as different, in temperament, as the members of their flock. Some seem to have been born with understanding and sympathy, and are intuitively able to sympathise with our weaknesses (Hebrews 4:15). Others are quite different - like sergeant majors they feel cross when one of their Christian soldiers seems to be dodging the column. One thing that should be emphasised is that a person who is depressed is often angry. Certainly he may be angry with himself (what is a suicide, if it is not anger turned inwards?). It may greatly help to realise that being so angry with others in the church as to seem quite paranoid is also part of depression. If such ‘bad feelings’ which are forced outwards (so called ‘projection’) are understood, it may be easier to manage the situations and to make progress out of the illness and back to more normal life.
Wider issues
The husband or wife of a depressed person suffers much, as do the parents of an anxious or depressed teenager. Families have many different stories too, and sometimes the stories reflect their basic beliefs. One young wife with two children told me that her mother said, ‘We don’t do depression’. As a result, it was many years before the patient received the help that her mother’s attitude had denied her. Another father said to his suffering son, ‘Our family just does not have depression’. Such denial in the face of the facts is unbelievable. A family’s concerns are usually ‘guilt-edged’ - Christian patients may feel guilty about seeking help.
Depression disrupts families, affects the partner and the children, and also the parents and grandparents of those in the extended family. The burden of chronic depression and anxiety upon other members of the family may be huge.
When the patient is older and the problems of old age are added, then more care is often needed. The same is true of adolescent depression which may cause mind-boggling problems to the parents and others in the family. A sympathy and understanding which is both wide and deep, and a willingness to care by visiting and helping with practical jobs has eased such heavy burdens for many families.