Last year I contributed to a short book called “The Pastor with a thorn in his side.” It’s a book which tells the stories of 7 pastors who have faced depression during their ministry. Steve Kneale edited the book and as well as telling his own story provides an introduction and a conclusion. In those chapters he seeks, briefly to draw out some common threads and to provide some practical observations. Each of the contributors were also asked to offer some commentary as well as tell their stories. However, all of this was intentionally brief. The aim was to provide a short and affordable read.
Reviews of the book have been warm and positive but quite a few have indicated that the reviewers would like to see more both in terms of practical suggestions and theological reflection. I agree that such things are needed but given that the book was never intended or able to do this, I think the best place for such content is in follow up blog articles. So since publication, I’ve attempted to return to the issue from time to time. Other contributors including Steve and Alistair Chalmers also blog and you may find that they interact with the subject as they see fit too.
So, here I wanted to highlight the theological foundations that we might need in place for any conversation about depression and its affects on those in ministry. So, what are some of the things we should include here? I would suggest the following.
We are made for joy
Some of us may remember that when John Piper’s book “Desiring God” came out, it was controversial because he talked about Christian Hedonism. Piper argued that hedonism -the seeking of pleasure and happiness was not itself wrong but rather the problem was that we seek happiness in the wrong places and things. The Christian hedonist discovers joy and pleasure in God. Joy, happiness and pleasure are things that belong to God, he glorifies and enjoys himself. WE are meant to find our happiness in him by enjoying and glorifying him for ever.
Whilst we still may not be comfortable with the language of hedonism, I think that the underlying premise is generally understood and acceptable. In broad brush terms we can see that in the story of creation, God makes a beautiful and good world to be enjoyed, God’s rest shows that the culmination of creation is joy, pleasure, enjoyment.
It comes through in specific Scriptures too. Psalm 37:4 says
“Delight yourself in the Lord and he will give you the desires of your heart.”
Then in the New Testament, there is a frequently expressed desire that the joy of believers will be completed. In John 15:10-11, Jesus says:
10 If you keep my commandments, you will abide in my love, just as I have kept my Father’s commandments and abide in his love. 11 These things I have spoken to you, that my joy may be in you, and that your joy may be full.
The Fall works against joy
If joy and happiness are good and central themes to creation and our relationship with God, then we should not be surprised to see that The Fall attacks joy. We have an enemy, the devil who wants to rob us of joy. This is seen in a variety of ways as the consequences of sin cause deep pain. Note, that here I’m not saying that depression is itself sin. I’m simply saying that we live in a world where there is grief and pain. Depression then is an aspect of that.
Indeed, I would want at this stage to say that when we describe depression, we are primarily describing symptoms not the root cause. We are describing an experience that includes sustained low moods, anxiety, severe loss of energy, tearfulness, hopelessness etc. The causes of such an experience can be numerous including:
- Physical causes whether that’s an organic illness directly affecting the mind and emotions or another illness that drains us of energy and leads to isolation
- Environmental factors -the world we live in and how it shapes our experience.
- The actions of others including bullying, abuse, betrayal, neglect.
- Our own actions including sinful decisions and responses leading to guilt.
Knowing the potential causes can be helpful in determining the right way to respond which might include one or more of the following:
- Treatment of a physical condition accompanied by rest.
- Medication to treat the specific causes and symptoms of depression (e.g. sertraline)
- Removal from an environment
- Challenging and correcting the actions of others
- Training and coaching in coping strategies and habits.
Counselling will include an element of diagnosis, talking with the person to help them identify potential causes but it will also include treatment such as the last example of training in coping strategies.
But the point I wanted to make here is that what we are really talking about when we talk about depression is a specific example of suffering.
We need a robust theology of Suffering
This provides the foundation for how we seek to understand and respond to depression as Christians. We know that as Christians we may expect to suffer in this life, even and particularly as we seek to live godly lives (see 2 Timothy 3:12).
When accounting for suffering we want to remember that God is sovereign and in control, that there are no surprises for him. We also need to talk about his love and goodness, that he works all things together for the good of those who love him, even suffering, even depression.
We need then a right understanding of now and eternity. Christians, including pastors experience depression along with other forms of suffering because we live in the now and the not yet. However, we look forward to eternity when death is swallowed up in victory and all tears are wiped away.
This is important because sometimes a prosperity gospel mindset can sneak in when it comes to depression. We can spot it with regards to other forms of suffering. We don’t think that someone is suffering cancer as a direct punishment for sin or that the cancer itself is sin (though even there we can look at ways in which their choices and behaviours, some of which may be sinful may have affected their health such as heavy drinking, smoking or poor diet). However, we are tempted to think that Christians and especially pastors should not be prone to depression, that depression is evidence of a lack of faith and/or that even if someone gets depressed that they should completely heal from it. Now, I don’t accept the assumption that once you have had depression you always will have depression. It is possible to recover to differing degrees. However, I would suggest that many people suffer either from chronic depression, helped by medication and therapy, or periods of relapse for much of their life. Even if you consider yourself recovered from the illness you tend to recognise that there are now weak and vulnerable points in your mental health. So, it is important to insist that just as with physical illness and other aspects of suffering that being a Christian doesn’t miraculously remove depression in this life. Just as I keep an asthma inhaler to hand, I might need to always have a box of sertraline ready too.
It is worth saying at this point then that faulty theology can itself be harmful and a significant factor in depression. That if I hear theology that loses the truth of God’s grace and encourages a culture of guilt, shame and condemnation then that will encourage me to believe lies bout God, His Creation, Humanity and New Creation. Good theology and faithful Bible teaching are surely part of the remedy we need.
We need to learn not just to survive but to be holy
This one of the challenges many of us learnt from Mike Ovey. This is so crucial as we think about pastoral counselling for people with depression and if we suffer ourselves, what it is that we should be looking for and praying for.
This is not to say that it is wrong to seek relief from suffering, or to desire healing. There are two reasons why I say this. First of all, we see the number of times in #Scripture where people pray and plead for healing, fertility, relief from suffering, escape from oppression. It is natural and right to cry out for God. It is a righteous thing to long for a day when suffering has ended. Further, whilst there are those who do argue we should simply accept suffering as part and parcel of the fall, reality soon cuts in against such claims. The same people tend to enjoy the benefits of technology and innovation which is intended to enable work to be less toilsome, childbirth less dangerous and ill health less scary. The frustration of the curse doesn’t remove the creation mandate to fill and subdue the world, it simply makes it more challenging.
However, we want to move beyond escape, relief and survival to see something deeper. Or to put it another way:
“we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope.”
This means that we learn to see how God is using our suffering, including depression for good. He uses it to teach and discipline us. This means that it should be at work to make us godlier. We are being pruned and refined for fruitfulness. It is right to ask whether, as I’ve progressed through an experience of mental illness whether I am now more gently, loving, kind, self-controlled, faithful (to God and others). Because if my symptoms are relieved and I’m happier, fitter, less anxious then I have simply survived. In that respect the suffering has not done its intended work.
There is nothing wrong with reaching for the pills when we are ill or sitting on the counsellor’s couch. However, the Christian response to mental illness, to depression and anxiety should be more than that. A deeper theological understanding of the reasons for and responses to depression will better equip, pastors and congregations, those suffering and those caring alike.
 Romans 5:3-4
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