How to Care for a Loved One with Depression
Admitting Our Feelings
At first, I told myself I could shrug off the gloom. Perhaps I’m just not getting enough sleep, I would say when I struggled to crawl out of bed. Maybe I’m just having a few bad days, I would think when sunshine and my kids’ laughter suddenly lost their luster. Yet after days turned into weeks and the fog didn’t lift, I couldn’t ignore the truth.
“Love, I think I’m dealing with depression again,” I finally admitted to my husband one night, my voice cracking. When he asked how he could help, I avoided his eyes and a flush of shame crept across my cheeks. How could I advise him when I didn’t know the answer myself? Why was I going through this again? “Please just be patient with me,” I finally said.
When I met his gaze, tears swam in his eyes, and he offered me the most helpful response I could have imagined. “I love you and I’m here for you,” he said. “Let’s pray about this.” As we bowed our heads, a welcomed whisper of relief swept over me, as if for a fleeting moment Christ’s light had broken through the darkness in my mind.
What Does Depression Mean for My Faith?
Kathryn Butler, MD
In this concise booklet, author and physician Kathryn Butler addresses common misconceptions about clinical depression within the church, offers encouragement for believers who suffer, and equips church leaders with the tools to provide spiritual support.
When Darkness Descends
Clinical depression is a devastating disorder with far-reaching effects. Sufferers struggle with despair, an inability to feel pleasure, and impairments in nearly every domain of life, with concentration, sleep, eating patterns, motivation, and thoughts all disrupted. In the worst cases, depression is life-threatening; all-cause mortality1 is up to 100 percent greater, and suicide2 incidence twenty-seven times greater in depression than in the general population.
Such statistics are dismaying given the prevalence of depression worldwide. The disorder afflicts three hundred million adults3—approximately 4 percent of the global population—and in the US the numbers are even higher, with a lifetime prevalence of 21 percent across the country4. Such statistics hint that no matter where in the world you live, at some point you’ll interface with someone who’s grappling in the darkness.
How can we respond when depression strikes a loved one? Oftentimes, the intricacies of depression anguish and baffle us. We watch helplessly as those we cherish retreat into themselves, losing interest in all the pursuits that once brought joy. We yearn to draw them back into the light, but the practical advice we offer only seems to drive them away. Conversely, we worry we’ll say the wrong thing, and so remain silent, unsure of what to do.
Despite our misgivings, the call to love our neighbors is clear (Mark 12:31; John 13:34–35). Scripture guides us to have special concern for the downtrodden and afflicted and to bear one another’s burdens (Micah 6:8; Matt. 5:7; Gal. 6:2, 9–10; Phil. 2:4). Although the task may seem daunting, as stewards of the greatest message of hope in history, Christians are uniquely positioned to minister to those grappling with depression. Sufferers need gospel hope and reminders of God’s love more than ever.
How can we help those we love struggling in the darkness? How can we offer them the guiding light of God’s word graciously, compassionately, and steadfastly? The following encouragements can equip you to support the depressed, love them, and remind them of their hope in Christ in their dire need.
Stay Connected
Shame, exhaustion, and the presumption that few understand can drive those with depression into isolation. This tendency can entrench sufferers in misery, leaving them feeling more alone, forgotten, and unloved.
If you learn a loved one is battling depression, show him or her the face of Christ by staying connected. Don’t wait for depressed individuals to reach out for help; odds are they won’t, even if they desperately need support. Instead, offer to visit, pray over the phone, or bring groceries or a meal. Invite them out for a walk or over for dinner.
Check in regularly. Show them that they’re not alone, they’re loved, and they have dignity and value.
If you learn a loved one is battling depression, show him or her the face of Christ by staying connected.
Practice Compassion
If a sufferer confides in you, it’s crucial to recognize the difficulty of that admission and to respond gently, patiently, and without reproach. Practice empathy and compassion. Don’t prejudge depression as a sign of spiritual weakness, and don’t dismiss their struggles by suggesting simplistic remedies.
Instead, listen and focus on a ministry of presence, following the sufferer’s lead as to what helps and what doesn’t. Some will welcome speaking openly about their ordeal with someone who listens and withholds condemnation. Others will relish diversion, a return to the activities and topics that once brought them joy. Still more will value being seen and esteemed as worthy of time and attention. Approach depression as a common reality in this sin-sickened world rather than as a problem unique to the sufferer alone.
If you discern patterns of unrepentant sin or faulty theology contributing to a sufferer’s depression, address these gently. Partner and guide, rather than reprimand. Offer to go to a counselor with the sufferer. Rather than recommending exercise, invite the person out for a walk. Read and unpack pertinent Bible passages together, both of you stooped over the text, rather than suggesting that a sufferer study on his or her own. Come alongside the hurting, reinforcing that they are not alone, and reassuring them you come not to heap on guilt and shame but to help bear their burdens (Gal. 6:2).
Pray and Read Scripture Together
Sufferers may know the gospel, but oftentimes they can’t feel its import for their daily lives. They may recite the Lord’s Prayer, but the words have no effect when their hearts are heavy and awash in gray. Hopelessness and impaired concentration can cloud the mind, reducing prayers to just a single word or phrase.
Praying for and with the depressed can thus offer them a priceless gift. Bring them before the throne of grace in your personal devotions. When you visit with sufferers, offer to pray, and invite them to join you as they feel comfortable. Pray for their healing, for their perseverance, for the truth that nothing can wrench them from God’s love to penetrate their hearts.
To support sufferers, offer to read Scripture with them. Keep in mind that impaired concentration abounds in depression. This is not the time for extensive exegesis but for “slow listening” to God’s word to hear even one thing that could possibly be good for your soul. While I’ve lacked the clarity to study Scripture in depth during my depressive episodes, I’ve learned to earmark key psalms when I am well—especially the psalms of lament—so I know where to turn if I again sink into melancholy. For those waiting for the Lord “more than watchmen for the morning” (Ps. 130:6), guidance through the psalms can bring welcome encouragement. Passages that highlight Christ’s redeeming work and God’s promise of salvation can offer a lifeline when living feels like dying.
Encourage Professional Help
Misplaced guilt may compel sufferers to chastise themselves to “just get over it” on their own and to avoid seeking help, but the risks to well-being and even life itself are high without treatment. If a sufferer is meandering through an illness unguided, encourage him or her to seek professional assistance, through a counselor or a primary doctor who can guide them toward the right resources.
The road to treatment, as with so much else in depression, is tortuous. Many muster the courage to seek therapy, only to find an abundance of roadblocks: scarce providers, poor access to biblically-grounded counseling, inadequate insurance, long waiting lists, and troubling side effects to medication. If your loved one becomes tangled in such a course, offer to drive them to appointments and research counselors. Partner with them and aim to ease their burdens.
Recognize the Warning Signs for Suicide
In the worst cases of depression, suffering is so profound and seemingly inescapable that death seems the only possible relief. While the likelihood of suicide is notoriously hard to predict, certain changes in the behavior of a loved one should raise concern. If someone’s depression seems to worsen and you notice the person socially withdrawing and neglecting hygiene, lovingly invite him or her into a conversation. Agitation and reckless behavior, especially if it involves increased substance abuse, can also hint that someone is veering toward self-harm. Other sufferers may suddenly have a brightening of their mood and give away all their prized possessions; this may reflect sudden resolve to commit suicide. Most ominous are ruminations about death, threats to commit suicide, and the active seeking of the means to take one’s life. If you notice any of these behaviors, have a caring conversation immediately.
We may worry that asking someone about suicidal thoughts will put the idea in a sufferer’s head, but experts agree that the safest approach toward helping someone at risk for suicide is directly asking. If someone’s behavior concerns you, speak with him in private. Respect his privacy; however, if he admits to suicidal thoughts, kindly but firmly decline to keep his admission a secret. Instead, come alongside him and guide him toward professional help. Do not leave the person alone. Call or text the National Suicide Prevention Lifeline (NSPL) at 988 to connect to a crisis counselor for guidance, and if they so direct, escort the sufferer to the emergency room. Find further help at the NSPL website (www.suicidepreventionlifeline.org) or the Suicide Prevention Resource Center (www.sprc.org).
Notes:
- https://pubmed.ncbi.nlm.nih.gov/26773921/
- https://experts.umn.edu/en/publications/mortality-of-patients-with-mood-disorders-follow-up-over-34-38-ye
- https://www.who.int/publications/i/item/depression-global-health-estimates
- https://pubmed.ncbi.nlm.nih.gov/29450462/
Kathryn Butler, MD is the author of What Does Depression Mean for My Faith?.
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