The other day I was talking with a friend about how life was going. As I was telling her about the various highs and lows my husband and I had been facing, I started to see there was a massive gulf between my experience and her understanding. It shouldn’t have surprised me. She is not someone who has experienced her husband waking up regularly at 3 am because of his medication. She hasn’t had to cope with the extra responsibility of making sure her household keeps functioning because he hasn’t got the energy to cook, clean or take out the garbage. She hasn’t had to continually fight off the bug that’s kept him in bed for five weeks because his immune system is so low. She has never had to listen to him tell her how much he doesn’t want to live because death seems like the only way to stop him feeling the way he does. In short, she doesn’t have a husband who lives day to day with depression.
It occurred to me then that most of our Christian community is unequipped to deal with depression. They lack understanding of the disease and knowledge of how it affects Christians in particular. They want to help but they don’t know what to do, so sometimes their attempts to help are unhelpful. So this article is for Christians who know other Christians who have depression and want to love and care for them. Some of the things I say may be applicable to loving and caring for non-Christians with depression, but please bear in mind that I am focusing mainly on Christians. In addition, I am writing out of my own experience as a carer and a depression-sufferer, and so what I write will not necessarily apply to all depression-sufferers.
I don’t want to spend too much time talking about what depression is, what causes it and how to treat it, because there are plenty of books on that subject already. But it is important to say that depression is an illness; you just can’t snap out of it. Furthermore, it’s not like having the flu. If someone has the flu, you can usually tell. But if someone has depression, most of the time you can’t tell—unless they tell you. They may look healthy—they may be acting normal— but they may be having a major panic attack right in front of you.
Depression is different from other illnesses because it affects the mind. As Proverbs 18:14 says, “A man’s spirit will endure sickness, but a crushed spirit who can bear?” You can suffer through the flu and be fine emotionally, but when your emotions are tossing you this way and that, everything seems harder to weather.
Depression is also different from other illnesses because its symptoms become entangled with the spiritual life of the depressed person. Poor sleep (or even an increased amount of sleep) can lead to low energy and an inability to concentrate. This can make prayer, personal Bible reading, and going to church or Bible study hard. Low self-esteem can lead to feeling like no one cares—especially God—because you’re not worth caring about. (After all, why would God love someone who can’t pay attention to the sermon and finds it difficult to pray?) Low motivation can lead to a reluctance to make the effort to evangelize, encourage others or “run the good race”. Emotional flatness means the person takes no pleasure in the things they used to enjoy. All of the above can make a Christian feel guilty about any number of things (not attending church, not reading the Bible, sleeping too much, eating too much, not making the most of every opportunity, etc) and they may completely withdraw from Christian fellowship because of this.1
So what can other Christians do to help?
Firstly, recognize that the person does indeed have depression. They may look well but they aren’t. Don’t be fooled. Furthermore, don’t think that you can fix the way they feel. No matter what you say or do, you will not be able to make it all better for them. Ultimately that’s God’s role, and he may not choose to heal them in this life. So even though you feel completely helpless, acknowledge your limits.
Try to understand what the person is going through. They are the expert on how they’re going. What’s frustrating is that they may not have the energy or motivation or even the ability to explain it to you. Be patient and gentle. Don’t trivialize things, or tell them they’re sinful, or tell them it’s their fault, or imply that they shouldn’t be experiencing what they’re experiencing. Make sure you acknowledge that their feelings are real.
Recognize how depression affects their spiritual lives. They may not be able to read their Bible, they may find church really hard, they may stay away from Bible Study for weeks, and they may continually say that God could not possibly love them and that Jesus died for everyone’s sins but theirs, but that does not automatically make them a heretic, so don’t treat them like one. Don’t expect them to be able to do little things like making simple decisions, being on time, recalling birthdays or remembering to bring things (though encourage them if they can!). If the person is involved in ministry, pastors should discuss with them whether they should stop or at least reduce the level of responsibility they have (e.g. teaching Sunday school once a month instead of twice).
Recognize that the person has depression, but make sure you don’t take their problems onto yourself to the extent that you find yourself becoming depressed. You won’t be much good if this happens. Make sure you go easy on yourself and give yourself plenty of space and rest time. Don’t feel like you have to ask them how they’re going every week (they may get sick of answering!).
Secondly, pray for them. You may not know what to pray for so rely on the Holy Spirit (Rom 8:26). However some good things to pray for are strength, endurance and good health. (Good health is a good thing to pray for: 3 John 2.) Pray that they will know God’s comfort and love. Pray that they will be content in him even though they feel flat. Pray that he will teach them to cast all their anxieties upon him and instruct them on how to better deal with stress or sadness. Pray for the person’s family— especially their spouse who is usually the primary carer. Pray for yourself, that the Lord will equip you to help.
Thirdly, encourage them. Encourage them to seek help where appropriate (medical assistance, counselling, medication, therapies, etc.). Help them to think clearly and rightly about what doctors, psychiatrists and counsellors might be saying to them. Encourage them to keep track of their state of mind, how much they sleep and how much they exercise. Feed back to them about their moods (sometimes they need that external input). Celebrate little victories with them, like getting out of bed, reading a chapter of the Bible, or going for a walk in the park.
Reassure them that you love them, especially in tangible ways that they can come back to later: cards, little notes, a DVD of a short film by you, etc. Remember their self-esteem is usually quite low, and anxiety may lead them to think that you liked them yesterday but not today. Keep on reassuring them. And keep on inviting them to do things with you, even if they keep on saying no (you may not ask on a day when they are likely to say yes).
Remind them of the things that are true. Because depression skews things, sometimes they have trouble remembering simple things like the forgiveness we have through Jesus Christ or the all-surpassing goodness of God. I think doctrines like these bring the most consolation. One day when I was feeling really down, I heard a sermon on the transcendence and immanence of God, and I couldn’t help but feel comforted by the knowledge that my God is big and powerful but, at the same time, personal, intimate and aware of how I feel. Remind them of good theology, but make sure you get your own theology right first.
Fourthly, be patient with them. You might have the same conversation with them 20 times in an hour (“I’m so sinful. God can’t possibly love me”. “God has forgiven you for your sins in Christ. He loves you so much; that’s why he sent Jesus.”) but be patient and stick with them. They’re not trying to be perverse. They may actually need to hear what you say 10, 20, 50 or even 100 times. Be patient in listening to them. Remember, they may not be able to think straight, so they may not be able to express how they feel. But be patient and keep inviting them to tell you, even if you may not be able to make head or tail out of what they say, and you find having a conversation with them quite hard.
Be flexible with them. They may arrive late or they may have to cancel that lunch date with you at the last minute because things aren’t going so well at the moment and they need the time to rest. You may start to feel like they don’t appreciate you or care about you, but usually that’s not the case. They do appreciate you and care about you, but they cannot express it at the moment. Sometimes they may need to withdraw from fellowship because they have been having too much “people time”. Trust their judgement because it’s all part of the way they might be managing their depression. Don’t force them to go to things or put the guilt trip on them because you think that the evangelistic dinner at church is more important.
Fifthly, be ready to help practically. Be there for them. We had good friends who didn’t mind us waking them up at 3am to ask them to take us to the hospital. We had good friends who would come over and sit with my husband to help distract him from his thoughts. We had good friends who made us meals, vacuumed our house, cleaned our bathroom, lent us their cars when ours wasn’t working, took my husband out to do exercise, helped us pack boxes when we moved house, and had us over for nice meals.
Do things with them that you know they once enjoyed. A friend of mine whose wife suffers from depression used to take her out to sit in the sun to watch the kids play, because he knew that, in normal circumstances, she used to like that. Another friend of mine who was following up a girl from church would take her to the beach to build sandcastles instead of doing Bible study, because that was what this girl needed. Be proactive: don’t say, “When are you free?” Let them know when you’re free and give them the option of saying “Yes” or “No”. They may not be able to plan that far ahead, but let them know you are available at that particular time, even if they don’t take you up on your offer.
Sixthly, support the primary carer. Give them a listening ear, a shoulder to cry on and a helping hand. Reassure them that it’s not their fault that their loved one is depressed. Because my husband has depression, he is often not able to give me the emotional support I need when I am going through hard times. But I have been very blessed with good friends who let me lean on them, who bought me hot chocolate when I felt sad, and who prayed with me.
And finally, remember it’s all going to fade away. Depression is another aspect of the fallen state of creation. It is a temporary thing and we will leave it all behind when we pass into the next life. For there, “He will wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning nor crying nor pain anymore, for the former things have passed away” (Rev 21:4).
Endnote
1 Some of this material has been taken from John Lockley, A Practical Workbook for the Depressed Christian, Authentic Publishing, Milton Keynes, 1991.
