It was 11:00 a.m. on a weekday morning and the pastor was having difficulty
finding the energy to get out of bed. He wasn’t feeling very "pastoral," and
the guilt was overwhelming. He had phone calls to make, people to visit, sermons
to work on, and family obligations were mounting. But all he really wanted to
do was get in his car, drive to anywhere but here and forget about everything.
Thirty minutes later he finally mustered
the energy to get up and go into the bathroom. On the way, his wife met him.
She had a look in her eyes he had never seen before. With a soft voice, but
filled with tension, she looked him and said, "For the last few months, you
have looked like a walking dead man. I’m worried about you and I don’t know
what to do." That was the straw that broke the camel’s back. He knew something
was very wrong, and he had to get help.
That was many years ago. The pastor
did get help, and today his depression is under control. I know, because I was
that pastor.
I’m still a pastor, but now I’m also
a professional counselor and therapist, and my years of professional experience
have shown me that depression is far from unique among Christians. Many pastors
and parishioners feel that no matter how much they get involved and how much
time they sacrifice, they just can’t shed the gloominess that seems to follow
them everywhere. So they work harder and give more with the hope that this will
make the gloom go away. They try Bible study, but they can’t seem to focus.
They try prayer, but they don’t know what to say.
Even worse, they don’t feel like being
around people anymore, whether at church or at home. They’re not as patient
as they used to be. They get frustrated and angry more easily. Little things
that never used to bother them now do. And guilt sets in; they get angry at
themselves, try to set new schedules and goals to make themselves do what they
know they should, only to be disappointed at their seemingly endless lack of
"character" to follow through. Their tempers get shorter and shorter, or they
escape to the isolation of their beds, not having the energy to even start the
day.
This scenario is a textbook case of
clinical depression. Oh no—surely not. Christians, of all people, born again
with a new life in Christ, shouldn’t get depressed, should they?
Should Christians get depressed?
As a pastor and professional counselor,
this is one of the questions I am asked most often. Christians feel guilty about
being depressed. They feel they should "know better." This leads to denial,
which only makes matters worse. Well-meaning friends, and even pastors, who
don’t understand what is going on, encourage them to "snap out of it," and offer
advice on "getting their Christian act back together."
But depression isn’t something a person
can "snap out of."
In the late 1990s and early 2000s
several groundbreaking studies brought significant insight into the biology
behind depression. In laymen’s terms, these studies showed that some people’s
brains simply do not have the capacity to recover from the biological effects
of stress and crisis (Kramer, p. 131). This in turn literally shrinks a part
of the brain that controls feelings.
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When you finally see a
counselor, be honest. The more you tell them, the more they can help.
Sometimes, when you talk with someone who has an objective perspective,
it can make the gloom begin to lift.
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The cause of depression is rooted
in brain chemistry. The chemicals necessary to maintain this particular area
of the brain are not sufficient. As a result, one’s mood is affected, and depression
eventually can set in. Genetics has a strong impact on a person’s tendency to
become depressed. It isn’t a matter of being Christian or not Christian, converted
or not converted or saved or not saved. As Dr. Peter Kramer states in his book,
Against Depression, when talking about a study focused on twins:
"Even bleak environments elicit depression
only in the vulnerable. That a shared environment rarely shows up in the chain
of what causes depression pushes a good deal of what we call environment into
the background" (ibid., 135).
We all accept the fact that our bodies
wear out and run down and are susceptible to disease. We can even accept the
fact that our brains can be ravaged by diseases such as Alzheimer’s. But some
Christians will not accept the fact that clinical depression also has specific
biological causes. They’d rather categorize depression as a "bad attitude" or
"lack of faith."
What should you do?
If you suffer from depression, there
are some things you can do.
First, find a good professional who
can help you, someone who is licensed by the state where you live. They will
have credentials like LPC (Licensed Professional Counselor), LCSW (Licensed
Clinical Social Worker), a Ph.D. in clinical psychology, or a Psy.D. (Psychological
Doctorate). When you contact them, ask if they have a specialty. If they don’t,
ask if they will work with someone who is challenged with depression. If they
answer yes, ask whether they refer their clients for medication evaluations,
or use counseling only. If you happen to have a history of trauma or abuse (many
do, so don’t feel alone), make sure you ask whether the therapist is trained
in such areas. It’s important for you that they are.
Finding a counselor may feel like
an overwhelming task, but it’s extremely important. Admitting that you can’t
carry this load on your own is a huge step toward feeling better.
If you want a Christian counselor,
you can check websites such as "The American Association of Christian Counselors"
(AACC). They have a search option that will help you find a counselor in your
area. Again, make sure they are state licensed, and don’t be afraid to ask questions.
You do have the right to find a counselor you’re comfortable with, but realize
you will have to eventually make a decision; it may never feel "perfect."
When you finally see the counselor,
be honest. They are there to help, not condemn. The more you tell them, the
more they can help. Sometimes, when you talk with someone who has an objective
perspective, it can make the gloom begin to lift.
Some come to me and say, "I’ve tried
talking with my family, and it doesn’t seem to be getting any better." Their
attempts at trying to talk with their family, especially a husband or wife,
have actually added to their gloominess or depression. This makes them feel
even worse. What they don’t realize is that depression affects not just the
victim, but also everyone close to them. People who try to help can end up taking
the inevitable rejection personally and become upset. It’s not their fault;
they simply don’t understand the dynamics of what’s going on. But their reactions
can actually make your depression worse. That’s why it’s so important you get
a professional, objective perspective.
But what if you see a counselor for
several sessions and the cloud doesn’t seem to be lifting?
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Clinical depression defined
The definition of clinical depression or a major
depressive episode as recognized by most clinicians is as follows:
"The essential feature of a Major Depressive Episode
is a period of at least 2 weeks during which there is either depressed
mood or the loss of interest or pleasure in nearly all activities"
(APA, DSM-IV-TR, pg. 349, 2005).
To further clarify this condition, one must experience
at least five or more of the following symptoms for at
least two weeks to meet the criteria for a Major Depressive
Episode. They are:
-
Depressed mood
most of the day, nearly every day, as indicated by either subjective
report (e.g., feels sad or empty), or observation made by others
(e.g., appears tearful). Note: In children and adolescents,
can be irritable mood.
Markedly
diminished interest or pleasure in all, or almost all, activities
most of the day, nearly every day (as indicated by either subjective
account or observation made by others).
Significant weight loss when not dieting or weight
gain (e.g., a change of more than 5 percent of body weight in
a month), or decrease or increase in appetite nearly every day.
Note: In children, consider failure to make expected weight
gains.
Insomnia or hypersomnia (can’t get out of bed)
nearly every day.
Psychomotor agitation or retardation nearly every
day (observable by others, not subjective feelings of restlessness
or being slowed down).
Fatigue or loss of energy nearly every day.
Feelings of worthlessness or excessive or
inappropriate guilt (which may be delusional) nearly every
day (not merely self-reproach or guilt about being sick).
Diminished ability to think or concentrate, or
indecisiveness nearly every day (either by subjective account
or as observed by others).
Recurrent thoughts of death (not just fear of
dying), recurrent suicidal ideation without a specific plan, or
suicide attempt or a specific plan for committing suicide (ibid.,
356).
Note: Many clinicians feel that if one has only
two or three of these characteristics for an extended period of
time, they are still at risk for becoming seriously depressed and
should seek help.
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To medicate or not medicate…
that is the question
When I went through my serious depression,
I believed that working harder, praying more, and serving more would make me
feel better. But that simply isn’t true. After weeks of therapy, my therapist
told me I was a good candidate for anti-depressant medication. At first I felt
like a total failure. Me…a Christian pastor…needed…happy pills!
So my therapist wisely explained to
me in understandable terms what was going on biologically in my brain, and how
the medications would help. It had nothing to do with demons, not being good
enough, or not being converted. I was able to understand that I was one of those
people who had a vulnerability to depression. In my case, my therapist had realized
that anti-depressant medication was not the first resort. But as he began to
understand my situation, he realized medication could help.
When I started thinking about it,
I realized I had probably been depressed several times in my life; I just didn’t
know what it was. But this time was worse than anything I had ever experienced.
I couldn’t get out of bed and I had constant shortness of breath. I was yawning
and sighing all the time. I felt a tremendous pressure in my chest and experienced
chest pains. My eyes felt like they were going to fall out of the back of my
head. I didn’t want to be around anybody, and I had developed a temper, especially
with my children. It felt like something had wrenched my soul from my body.
It was horrible! So, I decided to take the medication, and what a difference
it has made.
You have to be aware of something
regarding these medications. People are different, and our body chemistries
differ greatly. So, be patient! These medications take several weeks to show
results, and they may have side effects. Those can eventually go away; they
did for me. But if they don’t, there are other medications you can try. The
key is to find one that works for you and realize it may not be the first one
you try; so hang in there!
Antidepressant medications are not
happy pills. They certainly were not for me. But they did lift the cloud so
I could begin to talk about how I was thinking and feeling. Before taking the
medication, talking about my thoughts or feelings would only add to my depression.
The medications changed that. I still had to talk, and I stayed in counseling
for more than a year. I learned that I had been taught some pretty unhealthy
ways to think about people and situations. But, thanks to a great counselor,
a loving and supportive family, anti-depressant medication, and most importantly,
a loving and forgiving God, the cloud finally lifted.
What about personal spirituality?
In Matthew 11:28-30 Jesus said, "Come
to me, all you who are weary and burdened, and I will give you rest. Take my
yoke upon you and learn from me, for I am gentle and humble in heart, and you
will find rest for your souls. For my yoke is easy and my burden is light."
Jesus understands our dark feelings,
our doubt, our discouragement, and yes, even our depression; and his desire
is to help us. Sometimes, the help we need might include professional counseling
and antidepressant medication. After all, God created the minds that created
these medications, and it is not a sin to take them if you truly need them.
If you are depressed, there is help
for you. It is okay to admit it, and it is okay to get help. Life will still
have its ups and downs, but there are options for you if the "downs" last for
a long, long time.
If those around us are telling us
that something is wrong with us and they don’t know what to do for us, we need
to listen with a humble heart.
Mark Mounts has a Masters in
Professional Counseling from Liberty University and is a Licensed Professional
Counselor in the Houston area. Mark did his pre-graduate internship at Texas
Children’s Hospital in Houston and focused in the area of Early Childhood Intervention.
Mark now has a part-time counseling practice at the Houston Center for Christian
Counseling where he counsels children, teens, families, and individual adults.
He is also a full-time pastor for Community Christian Fellowship (a congregation
of Grace Communion International). Mark has been married to his wife Debra for
25 years and they have two teenagers, ages 14 and 15.
References:
• Peter D. Kramer, Against Depression. London:
Viking Penguin, 2005.
• Diagnostic and Statistical Manual of Mental Disorders, Fourth
Edition, Text Revision (DSM-IV-TR). American Psychiatric Association,
2005.