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DEPRESSION: FINDING HELP IN THE STRUGGLE

Depression is one of the most common mental disorders in the US and is an illness that can affect anyone regardless of age, race, income, culture, or education. As Christians, we are not immune to depression. As we explore the Bible, we see many of its heroes experienced symptoms of depression.

Although the Bible does not overtly use the term depression, we see many biblical figures who encountered its effects. We know David suffered many traumas in his life and lamented in several verses.

In Psalm 38:6 and 8, David wrote, “I am bowed down and brought very low; all day long I go about mourning. … I am feeble and utterly crushed; I groan in anguish of heart” (NIV). In Psalm 42:5, he asked, “Why, my soul, are you downcast? Why so disturbed within me?” He cried out to God for help and prayed, “Answer me quickly, Lord; my spirit fails. Do not hide your face from me or I will be like those who go down to the pit” (Psalm 143:7).

Other examples include Job, Jeremiah, and Elijah, who all journeyed through emotional distress with symptoms such as loss of hope, immense despair, lingering sadness, shame, and even passively suicidal events.

In 2021, the Boston University School of Public Health reported elevated rates of depression have worsened, climbing to 32.8 percent and affecting one in every three American adults. Current research suggests depression is caused by a combination of genetic, biological, environmental, and psychological factors. For example, per the National Institute of Mental Health, risk factors may include a family history of depression, a major life change, experiencing trauma, and stress factors. It may even occur with serious medical conditions or be a side effect from medications.

SYMPTOMS

Sadness is a part of normal life and can be attributed to events and experiences, but it is important to differentiate between sadness and depression. Depressive features include feelings of sadness that become prolonged and intense, last from months to years, and elapse into depression. Generalized feelings of worthlessness, apathy, and physical changes with sleep, appetite, and decreased energy also may occur. Symptoms caused by major depression can vary from person to person and may be dependent upon age. Other indicators include the following:

  • “Empty” mood, pessimism, irritability
  • Feelings of guilt, helplessness
  • Loss of interest or pleasure in hobbies and activities
  • Moving or talking more slowly
  • Feeling restless or having trouble sitting still
  • Difficulty concentrating, remembering, or making decisions
  • Early-morning awakening or oversleeping
  • Weight changes
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment
  • Thoughts of death or suicide or suicide attempt

DIAGNOSIS

A doctor may determine a diagnosis of depression based on physical exams, lab tests, psychiatric evaluations, and utilizing the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, published by the American Psychiatric Association.

The two common forms of depression include major depression and persistent depressive disorder (dysthymia). Major depression causes serious, persistent feelings of sadness and other symptoms that make functioning or enjoying life very difficult. Persistent depressive disorder is a milder but more chronic and lasting form of depression.

Criteria for the diagnosis include experiencing five depressive symptoms every day for at least two weeks, and one of the symptoms must be a depressed mood or loss of interest or pleasure in almost all activities. Other forms of depression include perinatal and/or postpartum, seasonal affective disorder, and depression with symptoms of psychosis. Individuals experiencing bipolar disorder also experience depression.

TREATMENT

Depression is a common mental health disorder, yet some people may experience shame, fearfulness, and loneliness, and they may avoid seeking help even though depression is highly treatable, especially when treatment is provided early and consistently. As a result, they can manage symptoms and return to feelings of control and enjoyment.

Treatment is typically a combination of psychotherapy, medications, social support, and education. Antidepressants are often used to treat depression, along with cognitive behavioral modalities and interpersonal therapy. Treatment plans are developed with a professional mental health provider and are individualized based on the person’s needs, such as the type of depression and intensity of symptoms. Identifying personal preferences and goals is important as there is no one-size-fits-all treatment.

WAYS TO SUPPORT

Receiving support from loved ones is crucial for those experiencing depressive symptoms.

  • Listen with understanding, with patience, and without judgment.
  • Offer encouragement through prayer, assist with positive thoughts through sharing happy memories, and remind them of their capability to feel enjoyment again.
  • Provide practical support—help with meals, chores, and appointments.
  • Encourage physical activity and social interactions.
  • Avoid trying to “cheer them up” or stating “snap out of it.”
  • Encourage professional help.
  • Don’t give up on them.

Dr. Pam Whitaker serves as senior vice president of program development at One More Child, a ministry that provides Christ-centered services to vulnerable children and struggling families. As a Licensed Mental Health Counselor serving children and families for many years, she has witnessed the value of sound mental health that has provided helpful navigation through the stressors of life, resulting in personal growth and spiritual development.

Disclaimer: The information shared on this page is not meant to diagnose or treat a mental health condition. We encourage you to follow up with your health-care provider and seek a mental health professional for individual consultation and care.

Site Leader Resources

WARNING SIGNS: WHAT TO DO WHEN YOU ARE CONCERNED ABOUT ANOTHER’S MENTAL HEALTH

I often receive phone calls from caring individuals concerned about a friend’s mental health. They are seeing signs of depression or anxiety in their friend. They see worrying symptoms of isolation, lack of enjoyment in activities, and even just a shell of the friend he or she used to be. It is hard to watch someone suffer and not know how to best support him or her during a mental health struggle.

The National Alliance on Mental Illness reports one in five adults struggled with mental illness in 2020, but only 45 percent of those struggling seek help.¹ With statistics like this, you likely are concerned about someone in your life. Whether it is depression, anxiety, or another mental health disorder, knowing how to support and point the person in the direction of help can make all the difference.

HAVE A PLAN AND EDUCATE YOURSELF

When you first approach a friend with your concerns, have a plan of what you want to say. Write it out, and be simple and concrete. Make sure you are approaching others with compassion and understanding, not with shame or guilt about their struggles. What they need most is an available, empathetic listener who can gently guide them to whatever help they need.

Additionally, become familiar with the signs and symptoms of someone struggling with his or her mental health. Look for changes in mood, appetite, or social engagements or seeming to be restless or fidgety. You also want to pay attention to unexplained physical symptoms someone may be reporting, such as nausea, shortness of breath, or feeling fatigued. Let them know you see they are struggling and you want to be with them and help them find the resources they need to feel better. Often, when people are struggling with mental health, it is difficult for them to recognize how poorly they are feeling.

As an outsider looking in, you can help them see the bigger picture. You can help them put into words what they are experiencing. This is a helpful step as they explore different resources, such as meeting with a minister, getting professional counseling, seeking psychiatric help, or visiting their doctor. Offer to attend an appointment with them to help paint a picture of what you see. You can also point friends to skills that could improve their ability to cope, such as moving their bodies, keeping a journal, spending time with loved ones, or meditating on Scripture passages.

BE PATIENT

Most importantly, be patient. Ephesians 4:2 says, “Be completely humble and gentle; be patient, bearing with one another in love.” This verse sums up what it means to come alongside those who are struggling with mental health. Be humble and gentle as you discuss what is happening with your friend, and be patient as you allow him or her time to utilize resources you discover together. Help bear your friend’s burden by sharing the weight of what he or she is experiencing.

Not all individuals will be ready to act on all you have to offer. Your job is not to fix them but rather to gently offer resources and a listening ear. Remember, if people are struggling with mental health issues, something that may seem simple for you might feel like climbing Mount Everest to them. Make sure to look for realistic goals and align your expectations with those goals.

CARING FOR YOURSELF

Because you cannot give what you do not have, you must make sure you are caring well for yourself as you care for others. Your soul needs to be strengthened so you can bear the weight of these burdens. For this reason, you must make sure you are engaging in self-care.

One of the best pictures in Scripture of our need to care for our bodies is in 1 Kings 19. In this chapter, Elijah was fleeing a terrifying situation. He was emotionally desperate, and it is obvious his body needed care. He first lay down under a tree to sleep, then he ate food and drank water the angel brought, and finally he slept again. Verses 7 and 8 say, “The angel of the Lord came back a second time and touched him and said, ‘Get up and eat, for the journey is too much for you.’ So he got up and ate and drank.” Without nourishment or sleep, Elijah could not have continued on his journey. We, too, cannot function or care for others if we are not doing the same.

Managing your emotions and setting boundaries for yourself is also a vital step. It is OK to know your limits and know you cannot be available all the time. Make sure to communicate your availability and when you need to take a step back. Be willing to add in other social supports, such as pastors, friends, and family, for yourself too. Remember, it is OK for you to ask for help if you begin to notice yourself struggling.

Without doing these things, you could be on the road to caregiver burnout. The Cleveland Clinic describes caregiver burnout as the following:

  • Withdrawal from friends, family, and other loved ones
  • Loss of interest in activities previously enjoyed
  • Feeling blue, irritable, hopeless, and helpless
  • Changes in appetite, weight, or both
  • Changes in sleep patterns
  • Getting sick more often than usual
  • Feelings of wanting to hurt yourself or the person for whom you are caring
  • Emotional and physical exhaustion
  • Irritability²

It is a sacred space to walk alongside someone struggling with mental health. But it takes energy and can take a toll if you are not also caring for yourself. Scriptures call us to care for one another and support one another. But we must do what we can to ensure we care for ourselves along the way.

Lisa Keane is a licensed professional counselor supervisor in Birmingham, Alabama, and a national board-certified counselor. For more than 15 years, Lisa has worked to help individuals and families seek hope and healing through counseling. She has been a speaker at national and local events on topics such as mental health, parenting, marriage, and many other issues. Lisa believes everyone deserves to live a full, meaningful life. She loves to work with individuals and families to help them discover how to do just that.

¹National Alliance on Mental Illness, “Mental Health By the Numbers,” https://www.nami.org/mhstats.

²Cleveland Clinic, “Caregiver Burnout,” https://my.clevelandclinic.org/health/diseases/9225-caregiver-burnout.

Disclaimer: The information shared on this page is not meant to diagnose or treat a mental health condition. We encourage you to follow up with your health-care provider and seek a mental health professional for individual consultation and care.

Site Leader Resources

OPENING OUR MINDS: THE CHURCH AND MENTAL HEALTH

Admitting our vulnerability can be uncomfortable. But if we take an honest look at Scripture, we discover God motivates vulnerable people like you and me to love other vulnerable people by becoming vulnerable for them. Vulnerability is not a curse but rather the key to connection and community.

In Genesis 2:18, God declared, “It is not good for the man to be alone.” God created humans with an innate need for one another. Community is an invitation to participate in life together, complete with all the differences that make us who we are as unique beings. Though many in the local church can appreciate community in theory, its implementation and practice are often a different story. Many people living with mental illness can testify to this fact.

Mental illness is simultaneously overlooked and often stigmatized in local church settings. According to Scott McConnell, executive director of Lifeway Research, a 2021 survey showed that “While preaching on mental illness is the norm and even more pastors feel their church is responsible to help the mentally ill, still 37% of pastors rarely or never bring it up from the pulpit.”¹ This culture of silence must change for us to experience the community and connection God desires for us in the local church.

FOUR WAYS WE CAN CHANGE THE CONVERSATION ABOUT MENTAL ILLNESS IN THE CHURCH

1. Normalize discussion about mental health.

If a particular church is not discussing mental health or mental illness, the congregation will assume it is not a high priority for those in leadership. Encourage your pastor to find opportunities to talk about it from the pulpit regularly. Plan to have systematic studies about it in your small groups. Offer training on mental health, abuse, and becoming trauma-informed for those who would like to learn more. Create and provide a list of mental health resources and services available in your area. By addressing mental illness from the pulpit and in groups, you give the congregation multiple connection points to enter the conversation.

2. Reach out to local nonprofits and social services in your community.

You don’t have to do this work alone. There are likely many organizations and service providers in your community you can contact. Google “mental health” plus “nonprofits” and your zip code. Set up a meeting to learn more. Invite the organization or service provider to offer training at your church.

3. Offer counseling in your church.

Though talking to your church and your community is a start, confidential mental health services are also crucial. Reach out to local counseling centers, establish a relationship with them, and refer people to them.

4. Embrace your vulnerability.

It’s difficult to discuss the mental health of others when we neglect our own. By addressing our issues, we are better poised to engage with others. Choosing to process through your brokenness, pain, anxiety, and disillusionment will lead to self-awareness. As we become acquainted with our frailty, the boundary between “us” and “them” will fade, and we will realize that it’s just us. We’re all living with the tangible effects from the Fall. Understanding what we bring to the conversation helps provide an equal footing as we talk to others in our communities.

OUR WORDS MATTER

The words we say matter. In many cases, we hurt people around us without even knowing. Here are a few things we should avoid saying and what we can say instead:

  • Avoid saying the phrases “suffering from” or “battling” mental illness, which convey a negative connotation. Instead, you can say “living with a mental illness” to unlock empathy, compassion, and many other positive things.
  • Avoid using words like crazynuts, or schizophrenic in conversation to describe things that do not pertain to mental health. Though these statements may be casual to you, they can send a stigmatized message to someone living with a mental illness.
  • Avoid saying things like “pray harder” or “if only your faith were stronger, you wouldn’t struggle with [fill in the blank].” This statement is shame-inducing and accuses rather than heals. Instead, if you have built the relational capital with the person, offer to pray with him or her. Remind others of how Christ lived, died, and rose in their place. Focus on what was done for them rather than what you feel they should do.
  • The Bible tells us to be quick to listen and slow to speak. Being thoughtful about the words we say can make the difference between someone engaging further with the church or feeling rejected.

Raleigh Sadler founded and serves as the executive director of Let My People Go, a national ministry focused on empowering the local church to address human trafficking. He is the author of two books, Vulnerable: Rethinking Human Trafficking and The Let My People Go Handbook.

¹https://research.lifeway.com/2022/08/02/pastors-have-congregational-and-for-some-personal-experience-with-mental-illness/

For more information about national WMU’s focus on mental health, visit wmu.com/mentalhealth.

Disclaimer: The information shared on this page is not meant to diagnose or treat a mental health condition. We encourage you to follow up with your health-care provider and seek a mental health professional for individual consultation and care.

Site Leader Resources

MENTAL HEALTH AND THE CHURCH: A LOOK AT WAYS THE CHURCH CAN PROMOTE MENTAL HEALTH

A plethora of mental health definitions exist. There’s even a basic definition of “an absence of a mental disorder,” proving the one thing we can all agree on is it is difficult to define mental health. This speaks to the complexity of the Lord’s creation and how we are made in His image.

The American Psychiatric Association states mental health is “the effective functioning in daily activities resulting in productive activities (work, school, caregiving), healthy relationships, [and the] ability to adapt to change and cope with adversity.” In addition, a compilation of resources cite mental health as demonstrated through realizing one’s potential, feelings of self-worth, and community contributions as well as intellectual, emotional, and spiritual development. Mental health is the foundation of these characteristics and a crucial element for meaningful participation in society.

In contrast, the American Psychiatric Association defines mental illness as “changes in emotions, thinking, or behavior, or a combination of these.” Mental illnesses can be mild to severe and may take on many forms; however, to meet the criteria for a mental illness, the symptoms must cause significant distress in life domains and occur for an extended and specified amount of time. Significant mental illness may require hospitalization and varied treatment modalities, including medication.

Although we all experience the ups and downs of mental health, temporary valleys of mental health may be related to stressful events, such as the loss of a loved one or other life events. These do not require professional intervention. It is important to note there is no single cause of mental illness but more so a combination or range of variables, including biology, environmental exposure, genetics, and life experiences that may result in mental illness.

HOW DOES GOD SEE OUR MENTAL HEALTH?

The Bible speaks about mental health as it addresses our thoughts, feelings, and behaviors as well as our hearts and souls. The concept of mental health is integral in all of Scripture. In fact, Jesus said the greatest commandment states, “Love the Lord your God with all your heart and with all your soul and with all your mind” (Matt. 22:37).

The Lord cares about our mental health because we matter to Him, and He desires to be intimate with our thoughts and feelings through prayer. He provides for our mental health through the Holy Spirit, who is our comforter and counselor. The Lord provides hope through support systems, godly Christian mental health professionals, and medications as needed when our mental health suffers.

Scripture offers examples related to mental health that indicate self-care can be both physical and mental. Paul acknowledged physical exercise as profitable (1 Tim. 4:8) and encouraged Christ’s followers to maintain a positive thought life (Phil. 4:8), while Jesus took several respites from His demanding time on earth.

As a church body, it is important to promote positive mental health because it allows people to realize their full potential in their relationships with God, others, and their communities. Positive mental health allows individuals to serve, minister, and evangelize effectively.

THE CHURCH’S RESPONSE

As followers of Christ, we are to share the hope we have in the knowledge of the restoration of the world through Jesus Christ (Col. 1:19–20). God also commands us to love our neighbors. Those with mental health struggles require us to address the uncomfortableness of the often-perplexing nature of the mind, body, and soul. As Christians, there is a common propensity to fear when ministering to those experiencing mental health struggles, and if not thwarted, this attitude can exacerbate the marginalization of those with mental health struggles in and out of the church body.

The church can use the following practices to promote mental health:

  • Provide mental health education as a method to reduce stigmatization.
  • Become a trauma-informed care church by realizing the widespread impact of trauma, understanding the pathways to recovery, recognizing the signs and symptoms of trauma, responding by fully integrating knowledge into practices, and resisting re-traumatization.
  • Cultivate certified Mental Health First Aid practitioners in the church. Click here for information on Mental Health First Aid trainings offered through WMU.
  • Equip members to lead and champion mental health initiatives within the church.
  • Ensure the church provides a resource website for trustworthy mental health providers in the area who subscribe to sound Christian theology.

Dr. Pam Whitaker, EdD, LMHC, CCTP, serves as senior vice president of program development at One More Child. As a Licensed Mental Health Counselor serving children and families for many years, she has witnessed the value of sound mental health that has provided helpful navigation through the stressors of life, resulting in personal growth and spiritual development.

For more information about national WMU’s mental health focus, visit wmu.com/mentalhealth.

Disclaimer: The information shared on this page is not meant to diagnose or treat a mental health condition. We encourage you to follow up with your health-care provider and seek a mental health professional for individual consultation and care.