But it can, and you need to know how to recognize it and what to do about it.

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.

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?

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.

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.

(Re-posted from Grace Communion International)

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