Dr Stephen Critchlow is a consultant psychiatrist and author. He is married with five adult daughters and lives in Northern Ireland. Over the last several years Stephen has travelled extensively giving talks on mental health and spiritual issues. He is the author of two books, Mindful of the Light and Finding the Yes in the Mess.
Stephen, there’s been much talk in the media recently about the importance of good mental health, but with our fast-paced society, pressurised lives and the tragedies that strike all of us at some point, could we be missing the signs when things begin to go wrong? For example, what are the symptoms of clinical depression?
There are common features of clinical depression that one would look for in seeking to establish a diagnosis.
Two weeks or more experiencing symptoms (1) or (2), plus at least four of the other symptoms (3-9) for most or all of the time.
1. Feeling low and down nearly all the time
2. No interests or pleasure in anything
3. Unable to sleep properly
4. Loss of weight (sometimes gain in weight)
5. Agitated or very slowed down
6. No energy, tired all the time
7. Feeling worthless or guilty
8. Unable to concentrate
9. Recurrent thoughts of death or suicide
Depression, as above, is not uncommon and between two and three percent of the population suffer from depression like this at any one time.
Do you believe that depression is spiritual in nature?
Some Christian teaching has given the impression that if you are depressed then the problem must be spiritual. You must have sinned or failed in some way in your Christian walk. This is usually incorrect, but unfortunately can lead to feelings of guilt which can compound the underlying depression. Spiritual factors may sometimes be involved, but we need to be very cautious in linking depression to them.
Are there any examples of depression in the Bible?
The Bible is very real about personal experience. We see people’s struggles as well as their joys and successes. In their low times, we may not necessarily say that they suffered from clinical depression, through lack of sufficient evidence, but it certainly seems likely in some cases.
Job was one of these. He was a leader of his city who sat in the gate giving judgement (Job 29:7). However, there came a fateful day when in quick succession he lost everything. All of his herds of animals and then all of his children were suddenly taken from him. His wife responded by turning against him and his health was broken in that he was sitting on the ground scratching his itching skin with a piece of broken pottery. In Job 3:3 and 3:21 we read: ‘May the day of my birth perish’ and ‘Why is light given to those in misery…who long for death that does not come?’
Job wants to die and wishes he had never been born. Job had lost so much that was precious to him and could not understand the reasons why. In my experience, many people with severe depression have been through similar losses which they may not understand. In Job’s situation, despite no material change in his circumstances and despite the poor advice of his friends, his faith shines through and in chapter 19 he exclaims,
‘I know that my redeemer lives!’ (Job 19:25) In difficulties that we may not understand our faith can still triumph. In the end, Job receives back double for all that he had lost, though clearly this does not happen for everyone.
Similarly, in the Old Testament, we read about Elijah (1 Kings 19:4) who had an episode of severe low mood, which may well have been related to near total exhaustion. Also in Psalms 6, 32 and 38 we read of many features of depression experienced by King David. Psalm 32 relates this to a sin issue in David’s life. When considering causes of depression, we should be aware that physical factors (Elijah) and sin issues (David) can be involved. Jeremiah the prophet suffered continual rejection from virtually everybody and became weary of life, wishing that he had never been born. (Jeremiah 20:7, 8, 14) It is most interesting to see the way God restored each individual in very different, yet loving ways.
Are there more recent examples you can tell us about, among famous Christian leaders?
Leadership brings additional responsibility and the possibility of increased isolation. Christian leadership may also bring attack and persecution, adding to the risks of depression.
Adoniram Judson was one of the first ‘modern’ missionaries who went to Burma in 1813. During his time in Burma he became profoundly depressed. It is not difficult, however, to track some of the factors that lay behind this. During war in the country he was severely mistreated and imprisoned. He then had to leave his wife and child behind to try and help out in the aftermath of the conflict. In his absence, sadly both his wife and child died. He could not forgive himself for not being with his wife and child when they had needed him most. He tried to bury his grief in his work of bible translation, but this did not help. Instead his grief became worse. He retreated into the jungle where he dug a grave and walked around it for several days in a suicidal state. He could not feel God’s presence with him. However, his fellow missionaries prayed constantly for him and he gradually recovered. Following recovery, whilst previously he had preached to little effect, now thousands embraced the Christian message.
The story of the depression endured by the famous preacher Charles Haddon Spurgeon is quite well known and he himself had considerable insight into some of the related factors.
How can the Church help those both inside and outside the fellowship who are suffering from depression?
Firstly, anyone suffering the symptoms of depression should go for a medical assessment. This helps to identify possible underlying factors, including physical factors, and enables the severity of the depression to be gauged and permits the formulation of a treatment plan. This can also help prevent us, both patient and others, from ‘over-spiritualising’ the condition.
How can we support and help someone we know suffering with depression?
We can try to encourage the depressed person to take regular meals, to try to keep to a normal sleep pattern, and remain socially involved. We should be compassionate and caring and seek to remain involved with the person. We can pray with them or for them as appropriate, and encourage Christian fellowship.
Accurate information about local support services and the precise nature of the condition can be very valuable. Booklets on all aspects of mental health are freely downloadable from the Royal College of Psychiatrists website.
Some churches, with help and advice, have started drop-in centres which can offer friendship, structure, support and practical help. Given the increasing awareness of mental health issues in society, it is important that Christians, both individually and collectively, learn how to respond appropriately so that we can meet the need of sufferers and carers alike with compassion and kindness.
When a preacher is downcast: www.haven.today.org/spurgeon-on-depression-gd-434.html