DROWNING IN DEPRESSION
By Dr Hera Lukman
Depression is common in the Church but why are many reluctant to seek help?
Depression is a common mental ill-health. The debilitating effects of depression on health and functionality has robbed many from living life to the full and indeed, of life itself.In 2015, World Health Organisation (WHO) estimated that 322 million people in the world (an equivalent of 4.4 % of the world population) have depression.
In Malaysia, 3.8% of the population (more than one million) suffer from depression. Given that many with depressive symptoms may not have disclosed their condition, the figures are conservative estimates of the actual number of people struggling with depression.
Depression affects more people than we know.
The Christian community is not immune to depression and depressive symptoms. Depression consumes even the lives of faithful servants of God such as Matthew Warren (Rick Warren’s son), Pastor Phil Lineberger and more recently Pastor Bill Lenz whose journeys with depression have become public knowledge. The 2016 Schaeffer Institute study on the welfare of 8,150 evangelical and Reformed ministers in the US found that about one third of them battle depressive symptoms.
In Malaysia, the National Evangelical Christian Fellowship Malaysia reported in their 2006 Spiritual Formation Survey that depression is one of the main crises facing Christians from various evangelical churches. Clearly, depression is a prevalent condition and it does not discriminate. It afflicts anyone regardless of faith status.
Although depression is a condition that is treatable and manageable, WHO noted that approximately 50% of sufferers do not seek or get the necessary help. This unfortunate situation is due to lack of access to care and more importantly, the fear of being stigmatised. Consequently, a substantial number is suffering in silence and isolation. Based on various anecdotal observations and empirical studies relating to church health, the reluctance to seek help is also evident within Christian communities.
Urgent need for a safe community in Church
As depression is closely related to suicide, the reluctance to seek help needs to be urgently addressed. In October 2016, WHO started a global campaign entitled “Depression: Let’s Talk”. This initiative aims to reduce mental health related stigma and to encourageaffected individuals to seek help. The gist of the campaign is to create a safe space in as many communities as possible to talk about depression.If sufferers can share their struggles with another without fear of being judged, despised and rejected, the journey with depression will not be so isolating and hopeless. In dialogues, many unhelpful myths leading to prejudice and exacerbation of suffering can also be addressed. Talking about depression is a crucial step towards recovery.
I believe this is a long-overdue initiative that the Church should proactively support, not only within Christian communities but also in any community the Church is represented. If social justice, compassion and ministering to the marginalised are essential criteria of a missional Church, we must do more than preaching against stigma and prejudice of mental ill-health over the pulpit. The body of Christ must proactively make Church a place where those affected by mental ill-health can find a safe community. How might that look like in practical terms? May I suggest three starters.
1. Reevaluate the robustness of our theology of suffering
First, let’s examine why Christians are reluctant to talk about suffering.
In my opinion, this may be due to the common assumption that “a good testimony for God” or “a life blessed by God” should not include failures, defeats and illhealth. Such theological perspective not only lacks validity, it can create a severe sense of shame, rejection, disillusionment and alienation among Christians who find their lives falling short of being “exemplary” or “blessed”.
In fact, suffering among God’s people is evident throughout the Biblical text. For example, depressive symptoms are common experiences of faith giants such as David, Job, Jeremiah, Elijah and Paul. Even our Lord Jesus wrestled with despair and anguish prior to the cross. Should we therefore conclude that their lives had been dishonoring to God because they expressed weakness? As far as I understand, there is no Biblical support for such a perspective.
God did not disapprove of their sufferings nor did He miraculously remove despair from His people. Rather, God consistently provided their needs and enabled them to accomplish the purpose He had for them despite their struggles. We need to recognise that suffering is an inevitable mark of being a Christian and that God can be glorified in our suffering because “His strength is made perfect in our weakness”. A robust theology of suffering is necessary if “communal lamentation” is to be endorsed within the body of Christ.
2. Advocate evidence-based advice and support
It is widely known that the cause of depression is multifactorial. Depression develops and is maintained by a complex interaction of physical, psychological, social and spiritual problems. As such, the successful management of depression requires a multidisciplinary approach. While spiritual issues can contribute to depressive symptoms, spiritual discipline such as prayer, fasting and reading the Bible are not the panacea for every case of depression. The Church must avoid making simplistic conclusions regarding what causes and what can eliminate a person’s depressive symptoms.An erroneous assumption can have devastating implications for the welfare of the sufferer.
For example, other than psychological disorders, depressive symptoms can result from physical conditions such as diabetes, thyroid diseases, cancer or even hormonal imbalance after pregnancy and during menopause. In many cases, depressive symptoms are successfully alleviated with medication coupled with psychotherapy, but not all individuals experiencing symptoms need to be medicated.
A thorough assessment by qualified health professionals is paramount in making an informed decision for treatment. An advice to avoid conventional medical attention in favour of exclusive spiritual intervention is not onlypresumptuous, it is an irresponsiblecounsel. As a Church, we need to collaborate with health professionals to provide evidence-based advice and support for individuals with depression.
3. Engage in perspective taking
The world of a depressed individual is difficult to comprehend.Those with depression often perceive the world through dark tinted lenses while we see the world in all its colours. This explains why things are often perceived in shades of grey in the world of those with depression. It is important to understand that they do not chooseto live in a constantly gloomy existence as some may erroneously assume!If we were to see the world through the same dark tinted lenses, our world will also carry the same shades of grey.
Perspective taking is crucial if we want to support individuals with depression. Dismissing, denying or debating their perceived reality serves little to comfort the depressed. We must recognise, acknowledge and legitimise feelings because they are real. Only when we have done that can we offer an alternative perspective they can adopt, e.g. while feelings are real they are not necessarily reliable assessment of reality.
Church, we must talk more about depression in our community. The three suggestions noted above are practical steps the Church can do to provide a safe and informed community for those who are in despair. Anyone can take the first step. Indeed, it is everyone’s responsibility.
May the LORD work in and through His Church as we mourn with those who mourn and as we communicate His hope to the hopeless.