Recently, I did a memorial service for a man who took his own life after a long struggle with depression. It was the second such service I’d done in about two years. Both men were successful in their own way, competent at their professions. Both had friends and family who cared.
But in the end, each died alone.
Of all the psychiatric ailments, depression is the most common worldwide. Estimates of the prevalence of depression vary, but the National Institute of Mental Health (NIMH) recently reported that in 2012, “an estimated 16 million adults aged 18 or older in the U.S. had at least one major depressive episode in the past year. This represented 6.9 percent of all U.S. adults.”
Think about it. In any given year, about 7 percent of American adults will experience one or more episodes of major depression. Seven percent. If it’s not you, it’s someone you know: a friend, a co-worker, a loved one. And it’s not just adults: depression can afflict children, teenagers, and the elderly.
Depression is more than simply feeling a bit blue; true clinical depression is an illness that gets in the way of normal life. It’s characterized by such symptoms as these: persistent and intrusive feelings of sadness or hopelessness, worthlessness or guilt; fatigue; a loss of interest in what used to be pleasurable activities; a disruption to normal habits of eating, sleeping, and self-care; and of course, thoughts of suicide. Depressive episodes typically pass. But they may recur, and some people experience chronic symptoms that are experienced as a crushing burden, an ever-present weight.
The statistics indicate that women are more frequently diagnosed as depressed than men. But men may also be more reluctant to admit it to themselves or others, with the illness going unrecognized or untreated. Men are also more likely to show symptoms of irritability and anger, sometimes to the point of verbal and physical abuse. And here is the saddest gender difference of all: more women may attempt suicide each year than men, but men are more likely to succeed, in part because of the methods they choose. (For more information, please see this free NIMH booklet.)
The good news is that depression is treatable, through the careful use of medication, psychotherapy, or best of all, both. Not everyone, of course, will experience the same degree of relief, but the research on the effectiveness of treatment is both clear and encouraging. Consulting with your family physician may be a good place to start. Be aware of the fact, however, that not all physicians are equally knowledgeable about antidepressant medication, and getting the medication and dosage right is essential. Don’t give up; just recognize that in some cases, a qualified psychiatrist or psychologist may be a better bet than the family doctor.
Why am I saying all this, here, on a seminary blog?
In our culture at large, there is enough of a stigma surrounding any form of mental illness that it becomes more difficult for sufferers to find the support and understanding they need. This can be particularly true of local congregations, in which we often follow the tacit rule that Christians should have it all together emotionally. It’s true that the scientific community has yet to come to universal agreement on the nature and causes of depression. Nevertheless, the general consensus is that depression is, in part at least, a medical condition, and not a personal or spiritual failure.
Seven percent. Some estimates are higher. In a church of 200 adults, for example, 7 percent translates into more than a dozen people. If in any given congregation, that many men and women began suffering the same malady, others would be both alarmed and supportive. But where a perceived stigma exists, those who are depressed feel compelled to suffer in silence, stuck in an endless loop of self-recrimination and worthlessness.
It needn’t be that way. We must examine ourselves and our communities. Do we, implicitly or explicitly, give the impression that anyone who decides to follow Jesus is supposed to have perfect mental health and flawless relationships? Can we accept the fact that this side of the resurrection, we may suffer from a variety of ailments, depression among them? Can we break the barriers that threaten to keep sufferers isolated and alone?
This is less a matter of cure than care. I suspect that the day will come when I’ll be asked to do another memorial service like these two. But I want to be able to say, Here were those who struggled with depression, and yet remained in the grip of God’s grace. Why? Because they were loved by a community of people who helped them cling to a crimson thread of resurrection hope, to a vision of the future in which a loving and gracious God would dry every tear and wipe away every sorrow.
By God’s mercy, may it be so in all our congregations.
Cameron Lee is Professor of Marriage and Family Studies at Fuller Theological Seminary. He is a licensed Family Wellness Trainer and a member of the National Council on Family Relations. Lee is also a teaching pastor and licensed minister in the congregation where he is a member.
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