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Dealing with the black dog
Full article: Church Times November 17th 2006
Celebrities speak out in public about their battles with depression. Chris Williams explains why church people may go to the opposite extreme
PLENTY of biblical characters suffered bouts of depression. But it's rare to hear a sermon about it — even though it is a common experience. Take a row of five worshippers in church on a Sunday. At least one will, on average, experience a serious depressive illness at some stage in his or her life. Two will suffer significant anxiety or depression.
Christians can find depression difficult to admit to. Celebrities who talk about their experience of it are helping to dissolve the stigma of depression in wider society, but connections between depression and faith can make it harder for church people to seek help.
Among the many expectations Christians have about how they should behave and react, they may feel that, because they have a faith, life should be happy and fulfilled, with little room for depression, struggle, or times of doubt. If they say to themselves, "I'm not supposed to feel like this," and put on a front of "being fine", they may delay getting access to help within the church and possibly through the National Health Service.
MOST PEOPLE feel low from time to time. Usually, we are able to work through these feelings and bounce back — be it over a few minutes, a few hours, or a few days. Sometimes, however, our mood can drop and stay low day after day, so that we lose all sense of enjoyment in things.
Causes of depression vary. There can be a single obvious cause, such as a bereavement, or there can be an ongoing problem, such as debt, which grinds us down.
Sometimes, smaller things accumulate, so that relationships, practical problems, and difficult life challenges — such as debt, unemployment, struggles with child-care — can build up to affect how we feel in the longer term.
Our coping strategies, past history of loss and trauma, and biological, genetic, or physical problems, such as thyroid problems, undiagnosed diabetes, anaemia, alcoholism, drug use, and so on, can also affect us. Whatever the original cause, we can experience depression when our ability to cope seems overwhelmed by the challenges we face, and we lose any sense of joy in life.
Clinical depression is diagnosed when these feelings have lasted more than two weeks, and where the changes don't just affect our emotions. A depressive illness affects our whole being — emotionally, spiritually, and physically — as well as our thinking, relationships, and activity levels.
LOW MOOD and a loss of feelings of pleasure, achievement, or closeness to others can be very distressing, particularly for women with post-natal depression, who may find they feel nothing for their children. Former passions and hobbies — even relaxing things such as gardening, walking, or reading — can also lose all appeal. People's sense of God often becomes numb, too, so that he seems to be distant or absent.
With depression, one's thinking often becomes extreme. Sufferers can look back on the week and remember things they haven't done, or things that have gone wrong, rather than any successes. The future can seem bleak, and they may jump to the worst conclusions (catastrophic thinking). Sometimes, sufferers become forgetful or unable to focus concentration as usual.
Christians can be liable to dwell on mistakes and sins from the past, leading to self-condemnation and guilt. They can fear they have committed the "unforgivable sin", or come to believe that they have displeased God, and that is why they no longer feel his presence. They can fear that if they say how they are feeling, others in the church will think badly of them and be critical of their faith.
DEPRESSION has a strong physical impact, too. Sufferers may feel exhausted and tired, or on edge, agitated, and fidgety. They may struggle to get off to sleep, sleep fitfully, and then awake early and unrested. They may pick at food, or over eat (comfort-eat), with weight changes as a result. And their sex drive may be lost, possibly causing added distress to a spouse.
Activity levels and responses are usually affected by depression. If we feel depressed, with low energy and poor motivation, it's likely we will struggle to maintain our usual activity levels.
Most people at first force themselves to do things they "must/ should/ought" to do, such as going to work or looking after children. But hobbies, going for walks, meeting friends, and so on, can be squeezed out. If Christians stop reading the Bible, meeting other Christians, going to church or praying, this will also undermine how they feel.
ANXIETY occurs in about 70 per cent of people experiencing a depressive illness. These feelings may cause the person to avoid people, places, or situations that seem scary. Losing confidence in relating to others can mean they go to church less or attend fewer mid-week meetings. The result is growing isolation.
STRATEGIES used to cope with depression can backfire, and become part of the problem. Blocking out feelings through drinking to excess, spending one's way out with a new dress or gadget, or eating more cakes and biscuits to soothe oneself can all exacerbate the problem.
Sometimes people push others away, or test how much they really care. They may lash out verbally or physically at those at home or in church. Self-harming or risk-taking — doing things they usually wouldn't do, such as having an affair — are also all ways some people respond to feelings of depression.
While some people will feel far away from or angry at God, others throw themselves into church or other activities, in order to run away from reality and avoid stopping, thinking, and reflecting.
Christians with depression need an atmosphere of acceptance to deal healthily with mental-health issues. With many examples in both the Old and the New Testament to preach from, the clergy need to speak more about Christian responses to depression, anxiety, and struggle. Congregations need to be able to admit that their week — or weeks —have been tough.
It is important for churches and Christians to make positive statements about mental-health services. Sometimes they can be there as partners in the recovery process for Christians struggling with depression.
Dr Williams is a senior lecturer in psychiatry at the University of Glasgow, and a session clerk in Killearn Kirk, Glasgow. He is a past president of the British Association for Behavioural and Cognitive Psychotherapies (BABCP).
He is the co-author of I'm not supposed to feel like this: A Christian self-help approach to depression and anxiety (Hodder and Stoughton, £7.99 (CT Bookshop £7.20); 0-340-78639-6). He has also written Overcoming depression and low mood: A five areas approach (Hodder Arnold, £19.99 (CT Bookshop £18); 0-340-90586-7).
www.livinglifetothefull.com A Christian response to depression:
• Keep active. A short walk each day can help, and some GPs can refer patients for exercise to help boost their mood.
• Make a choice not to withdraw from things that would normally bring a sense of pleasure, achievement, or closeness to others. Face fears by meeting people at a place you can cope with.
• Try to keep hold of God's promises in the Bible. Even if God feels distant, he isn't — it's a feeling caused by the depression. He is present, and still cares and forgives.
• Re-read a personal faith diary, if you have kept one, and think back to times when you have had a sense of closeness to God.
• Read encouraging psalms and Bible verses. A list is available at
www.feelinglikethis.com. • Keep a routine of prayer, even if this is really short.
• Keep some contact with your church, if you can. This may include going to smaller and quieter services, or turning up late and leaving early so that it doesn't feel too much.
• Pray with trusted others, even if it's just for a short time. Ask them to pray for you.
• Seek medical help. Ask your GP what help might be available locally.
• Live healthily. Fitness, food, and sleep matter, and can often be overlooked when we feel low.
• Say "no" to some things. Balance demands that you have space to recover.
The Association for Christian Counsellors (ACC) will look at Christian approaches to depression as part of its national conference on 25-28 January 2007 in Swanwick.
www.acc-uk.org Last Updated ( Friday, 17 November 2006 )
