I remember one of my first visits to a counsellor very well. He had his office in his home so I had to park the car, cross the street and go in through his front door. Questions flooded my mind as I crossed the street—what if someone I knew saw me? What would they think? Did going to a counsellor mean that I was really in bad shape?
If I was really trusting God would I be making this walk? If someone stopped me and asked why I was going into the counsellor’s office, what would I say? How could I tell them I was a pastor and I was struggling with depression? It would be easiest to say, “I don’t want to talk about it.”
In his book on men and depression, Terrence Real captures what happens for men who are battling depression and many other emotional and psychological problems:
“One of the ironies about men’s depression is that the very forces that help create it keep us from seeing it. Men are not supposed to be vulnerable. Pain is something we are to rise above. He who has been brought down by it will most likely see himself as shameful, and so, too, may his family and friends, even the mental health profession. Yet I believe it is this secret pain that lies at the heart of many of the difficulties in men’s lives. Hidden depression drives several of the problems we think of as typically male: physical illness, alcohol and drug abuse, domestic violence, failures in intimacy, self-sabotage in careers.” (I Don’t Walk to Talk About It: Overcoming the Secret Legacy of Male Depression.Terrence Real, New York: Scribner, page 22.)
I wonder how many of us men are experiencing challenging physical illness or are battling a tendency to overuse alcohol or another kind of drug. I wonder how many of us are participating in domestic violence whether it is verbal, emotional or physical. I wonder how many of us are struggling to maintain a close relationship with either gender.
I wonder how many of us find ourselves failing in the workplace and blaming co-workers for our shortcomings while actually having a feeling that we are the authors of our problems. I wonder how many of us are battling depression and see its impact in various areas of our lives. Who do we tell? Who are our conversation partners? How many of us are living our lives with a loud, “I don’t want to talk about it?”
Even though we may not want to talk about depression, it is a poignant reality for many men. Keep in mind that depression is not a down day, or a fleeting feeling of sadness or melancholy. Most of us have these kinds of experiences and are able to move on from them. They are not debilitating and do not have an adverse affect on our daily functioning.
In being able to bounce back after a bad day or snap out of a sad experience, we are illustrating the exact opposite of depression. When someone is depressed they are exactly that— moving in a direction that is not high but low. People who are just having a down day are able to move to a higher level of energy and interest. People struggling with depression are not able to do this.
If you read the literature on clinical depression—the term most typically used to describe this problem—there are usually eight symptoms that are used diagnostically to determine if a person is depressed. The key is not to see these symptoms in isolation but to understand them in a broader context of what is going on in your life.
It’s also important to remember that these symptoms need to be present with regularity and consistency and a number of them need to be happening concurrently. One of the symptoms for a short period of time is not problematic or deserving of the diagnosis, but a significant number of the eight symptoms for an extended period of time would suggest that a competent professional should investigate for depression.
• Significant change in appetite, sexual drive and weight
• Significant change in sleep pattern
• Loss of energy and excessive fatigue
• Feelings of worthlessness, self-reproach and excessive guilt
• Difficulty concentrating, remembering and making decisions
• Loss of motivation and enjoyment of regular tasks
• General slowing down of all motor tasks
• Suicidal tendencies
Some of us who have problems with depression also struggle with a manic component as well. Within the psychiatric community, the diagnostic term—bipolar disorder—is used to describe these people who will have many of the symptoms described above as well as some or all of the following symptoms, again concentrated over an extended period of time:
• Significant elation and expansion of mood
• Irritability with impulsive anger
• Hyperactive, talkative and highly distractible
• Bad judgment leading to difficulties socially or at work
• Inflated self esteem
• Involvement in risky activities that can bring painful circumstances
• Diminished need for sleep
Those of us who have been involved in clinical work know that depression is not something that is confined to the non-Christian world. Some of the finest pastors, Christian leaders, preachers, teachers and counsellors that I have known, to say nothing of dedicated lay people and motivated church members, struggle with depression. On a given Sunday in any church, you can be quite confident that there are a significant number of people in the room that are, or have been, battling depression. Anecdotal evidence would suggest that spirituality and depression are not in opposition to one another.
We also have examples from history. Charles Haddon Spurgeon, recognized by many as one of the finest preachers over the past 200 years, struggled with depression that lasted for months at a time. At one particular point, after the church where he was serving was burned down, he went into a severe depression. Similar stories have been reported about such Christian notables as Martin Luther, John Bunyan and William Cowper. Their experiences would seem to illustrate that spiritual depth and commitment are no guarantee of protection from depression.
One could also look at the pages of Scripture to see some biblical characters going through depressive-like symptoms. Note the experience of Elijah in 1 Kings 19 after a spiritual triumph over the prophets of Baal. One would assume that after such a powerful experience with God, Elijah would be high and energetic. At the beginning of the chapter we see him receiving a message from Jezebel who threatens him. Elijah is afraid, runs away and goes out into the desert.
But he himself went a day’s journey into the wilderness, and came “and sat down under a solitary broom tree. He asked that he might die: “It is enough; now, O Lord, take away my life, for I am no better than my ancestors.” Then he lay down under the broom tree and fell asleep” (1 Kings 19:4-5).
It would appear that Elijah’s unique triumph over God’s enemies did not guarantee him a life that was free of depressive symptoms. Maybe you have been wondering whether you have been struggling with depression for some time and after reading this article you are more convinced that is the case. Can I encourage you to talk to a counsellor or doctor? Pastors and wise friends can provide you with support and care but because of the multifaceted nature of depression and because there is often a physiological and biochemical component, it is important that friends and family demonstrate care by having humility around their own abilities to help.
One of the dangers in Christian circles is that we can bring a spiritual paradigm to bear on the depressed person and forget the fact that other dimensions are playing a significant role. I have seen too many situations where genuinely depressed people experience backslapping and simplistically applied injunctions when what they need is competent help.
Help for people who are depressed needs to blend the spiritual, medical and psychological. Because psychiatrists and physicians have medical training, they are equipped to deal with issues around biochemistry, physiology, medication and, if needed, hospitalization. Counsellors, therapists and psychologists can be helpful on the psychological and spiritual side but it is important that a medical consultation be part of this process. To only deal with the psychological or spiritual component of depression is to potentially miss a key factor. And of course the corollary is also true. To stress the medical to the exclusion of the psychological and spiritual is also problematic.
It would be wonderful if as a result of reading this article even one man finally gave up on that unhelpful phrase— “I don’t want to talk about it.”