"I HAVE had enough, Lord. Take my life; I am no better than my
ancestors," Elijah says, in the first book of Kings. Elijah's
depressive lament is just one from several biblical characters that
show depression is not a modern malaise, especially among people of
Sad moods, physical exhaustion, a sense of hopelessness, and a
loss of perspective are some of the symptoms of a devastating
illness whose worst outcome can be suicide. For some, it is
triggered by life events: trauma, stress, loss, or burnout. For
others, depression can be what is known as "endogenous" - it is a
The Mental Health Foundation says that one in four adults
experience at least one diagnosable mental-health problem in any
one year. Anxiety and depression is the most common mental disorder
in the UK: between eight and 12 per cent of the population are
depressed in any one year (The Office for National Statistics
Psychiatric Morbidity Report, 2001).
As scripture shows, people of faith are not immune to
depression. And at a General Synod fringe-meeting on mental health
in February 2012, the former Archbishop of Canterbury Lord Williams
signed the "Time to Change" pledge, a campaign run by Mind, and
Rethink Mental Illness, to end the discrimination and stigma
against people with mental-health illness.
The Ven. Arthur Hawes, Archdeacon Emeritus of Lincoln and Canon
of Lincoln Cathedral, has held various senior and advisory
positions on mental health in the Church of England and the NHS. He
says that the stigma arises out of fear. "People are afraid,
particularly of what they can't see. Unless you're a professional,
and you know what you're looking for, you can't see mental
In the Church, there can be an added problem, he says. "There
are still some Christians who see it as linked to sin in one way or
another. And even if they don't do that, they can be made to feel
guilty about it."
A senior consultant in psychiatry, spirituality, and ethics at a
Christian clinic in Switzerland, Dr Samuel Pfeifer has written
widely on Christianity and depression. He says that stigma
concerning depression among Christians often comes down to a wrong
understanding of faith: that Christians should be happy all the
"It is very hard when we think that faith just means enjoying
the Lord, enjoying prayer, enjoying praise, to come into a
situation or mood where this isn't possible any longer," he
"Then people think that this is antagonistic to their faith,
because it is antagonistic to their emotion. . . [They can think]
it's also antagonistic to God's plan for their lives. I think
that's a wrong connection."
Sue Atkinson, a Christian author, wrote Climbing out of
Depression in 1993. More than 20 years later, misconceptions
about depression are still prevalent, she says. "Some people are
clearly more up to date, but there's still a huge number of people
who think that real Christians don't have these kind of
Not understanding depression can lead to simplistic responses
that require the sufferer to try harder, or pray harder, to beat
their symptoms. "When you have a significant bereavement, most
people wouldn't dream of saying 'Pull yourself together.' But they
do with depression."
And, she says, among some wings of the Church, "there tends to
be the attitude: 'If you just pray, you'll be fine; so clearly it's
your fault,' -which, of course, it isn't."
Mrs Atkinson has found the best support outside the Church,
through the charity Depression Alliance. "It's a lot of people who
are depressed, supporting each other. I've found that hugely
helpful - sometimes more than the church community. There's no
blame, no shame."
CLERGY are not immune from depression. Figures quoted by St
Luke's Healthcare for the Clergy show that 30 per cent of clergy
say that they have suffered from depression since becoming an
ordained priest, and 18 to 25 per cent of all clergy are depressed
at any one time.
The Anglican Association of Advisors in Pastoral Care and
Counselling (AAAPC) is a network of pastoral-care advisers and
other professionals for the dioceses, providing training,
counselling, and support for clergy. Last year, it surveyed all of
its advisers to determine what the key pressures were for clergy.
Stress, relationships, depression, and having to be a financial
manager, came out on top.
"Clergy often feel that they have to be on duty 24/7, and that
they live in something of a goldfish bowl," the secretary of AAAPC,
Heather Vernon, says. "The expectations that people have of them
can be huge."
Sue Clements-Jewery is a consultant to the Churches' Ministerial
Counselling Service (CMCS), and chairs its steering group. The CMCS
is an ecumenical counselling service that also provides counselling
to clergy in Southwark diocese. She says that conflict can be a
significant source of stress for clergy.
"Congregations are declining, so change is very necessary, and
that's stressful and threatening for everybody," she says. "Often
the person who is the initiator of change is a target for negative
feelings, and that leads to clergy getting stressed and
The Revd Paul Brown (not his real name) took early retirement at
the age of 45, after three breakdowns while in ministry. He feels
that his situation could have been avoided if he had had more
"It was only after my breakdown that a mentor was put in place
for me. This was a retired, experienced member of the clergy, who
gave me his card. Had this been in place from when I was made
vicar, rather than after the horse had bolted from the stable,
things may have been different" (see panel, opposite).
To address the need for support, some dioceses, such as
Salisbury, Worcester, and Exeter, are running "reflective practice"
groups: confidential groups, facilitated by a pastoral-care adviser
who is a qualified counsellor or therapist, where eight to ten
clergy from a diocese meet monthly to provide peer support.
Pastoral-care advisers can also get involved in offering
preventive support, such as resilience training, to help deal with
stress and adversity. "Resilience is essentially helping clergy to
reflect, become more self-aware, to recognise in themselves stress,
negative thinking, and how to combat it. It's aimed to catch
problems before they arrive," Mrs Vernon says.
St Luke's Healthcare for the Clergy is also offering help. Last
autumn, it announced plans to offer a range of new "well-being"
services. To help dioceses gain an accurate picture of clergy
mental health,and then to plan appropriate support for dioceses, it
is offering an anonymous online clergy questionnaire.
It has been used "in at least four dioceses so far", and there
are "about half a dozen more" planning to use it, the chair of
trustees, Edward Martineau, says.
St Luke's can also provide reflective-practice workshops and
resilience training, and will part-fund these services if all three
elements (questionnaire, reflective-practice groups, and resilience
workshops) are taken together. "We are hoping to be at the
forefront of mental well-being for the clergy," Mr Martineau
RACHAEL COSTA suffered from depression throughout her teens. She
set up the charity Think Twice to challenge the stigma of
depression and mental illness, and now runs courses for churches on
Miss Costa understands that it can be difficult to be open about
depression in church. "There's a perception you have to be OK,
because you have to be a good witness, and if you're crying all the
time you're not being a good witness."
But this perception can be damaging, she says. "Not only does it
force people to hide how they're feeling, but it can really push
people away from church, because they can't be themselves. They
can't say to people: 'Actually I'm having a really hard time
today.' Depression is very isolating. Often it makes you somebody
who is not very nice to be around."
It is just at this time of isolation, however, that church
congregations can respond, and become places of healing, she says.
"To have a community around you who are willing to sit with you
when you can't be entertaining, and to help you do things that you
can't do. We need to make it more normal to reach out in the same
way that we would when someone's physically unwell."
Dr Christopher Findlay, who sits on the Executive of the
Spirituality and Psychiatry Special Interest Group of the Royal
College of Psychiatrists, says that relationship is essential in
helping a depressed person out of his or her isolation.
"Mental ill-health and depression can be a change process
whichcan lead to positive developments. Often, people can get
caught in the pain - it's kind of a switching down, because it's
too painful to face whatever the issues might be.
"Part of the therapeutic relationship, whether it's through a
friend, a professional person, or clergy person, is to 'warm up'
the distress so people can express it more freely. Then they can
Churches that can foster openness and support can play a keypart
in helping to support people with depression, an ordinand inthe
Church of England, Haydon Spenceley, says (see panel
opposite). Last year, he felt prompted, when leading worship
at his church, to speak out about his own battle with depression
and suicidal thoughts.
He was overwhelmed by the response from people, many of whom
said afterwards: "It's amazing you said that, because I feel just
In response to what he shared in the service, Mr Spenceley says
that people began to come forward to pray. "There were people there
who'd been depressed or suicidal for years, and had never mentioned
it to people at church, and they were suddenly praying with each
other, or offering to help each other, or offering to share
"I think there's been a shift in the Church: we're actually
talking about stuff, now. One of the ways the Church can be
Kingdom-focused, and show something alternative to the world, is by
offering a welcome to people regardless."
The Revd Eva McIntyre is co-ordinator of Mental
Health Matters, a new website set up for the Church of England to share resources, best practice, and advice on
how churches can deal with mental-health issues. She agrees
that the Church is in a unique position to help remove stigma and
"Time to Change's research shows
that faith communities come out in a very good light, by and
large, in terms of welcoming people. I think we could, potentially,
be funded to be in the position of encouraging people towards
self-referral and preventing escalation. Not doing huge amounts,
but by being a welcoming, supporting community.
"We've got all these buildings; we've got people who
care, and who are motivated. It would be quite simple to increase
the input we have into making it less likely that people end up in
A&E and secondary services."
Speaking out is the only way to take
the fear and stigma out of
depression, she says. "We must talk: we must gently say it's
there, and find creative ways to allow other people to say 'This is
me, is it OK, and can I have some help, please?'"
Other support structures may soon
come into place. Mental Health Matters evolved out of fringe
meetings at the Church of England General Synod, and is
part of the work of the Committee of and among Deaf and Disabled
People in Ministry Division. The Bishop of Salisbury, the Rt Revd
Nicholas Holtam, who chairs the committee, acknowledges the work
going on at national, diocesan, and congregational level.
"The committee is well aware of the scale of need,
and also of the diverse ways in which churches and individuals do
amazing work in the area of mental health. It is at the heart of
the concerns of any active congregation.
"There is a need to connect up the many excellent
pieces of work and the many excellent individuals and groups who do
them. The committee is exploring ways of creating a stronger
network to support them."
The Revd Susan Bull and the Revd Michael Preston are
trustees of Love Me, Love My Mind, a small charity in Epsom that
provides support for people with mental-health issues. Part of its
work includes a weekly Monday drop-in at St Barnabas's, Epsom, for
people with mental-health issues.
"The drop-in was set up in 2006," Miss Bull says.
"It's open to everyone, especially for people with mental-health
issues, but we get semi-homeless people, people with drug and
alcohol issues, and people struggling financially.
"Every week, we have tea, coffee, and chat, sharing
the joys and sorrows of life. Volunteers cook a freshly made meal,
and we all sit down to eat together. We always celebrate
"The ethos is that we are human beings together -
it's not 'us and them' at all. We go on outings, and have speakers
chosen by any member of the group on topics we find helpful. The
church is open during the drop-in: people can go and pray if they
want to, light a candle, or just sit in silence in church."
Miss Bull would like to see other
churches run similar groups. "We are passionate that what we
is not rocket science, but that it saves lives. We have no special
"We are all on a spectrum of mental
health, and can all be kicked into touch in the blink of an eye.
When we are in that place, what actually helps is people to sit
alongside us, not to judge us, and even to sit in the mess with
THERE are good reasons for hope, Dr Pfeifer says.
"Depression in most cases is a self-limiting disorder. It can be
prevented and treated. With medication, with talk therapy, we can
really accomplish a very good improvement. Many, many people give
witness to that."
He says that churches can play a significant part in
helping someone with depression. "The fellowship in a church can be
very supportive. Also, there is comfort in one-to-one conversation;
or even a sermon can be very helpful for the depressed in a church,
especially when a pastor is thinking of the depressed people
Mr Hawes says: "We shouldn't duck the healing mission
of the Church, because the Church prays for people. Often, if I say
to people, 'I'm thinking about you in my prayers,' they're usually
very grateful - and people still are grateful, even in a secular
Mental Health Matters, in conjunction with Inclusive
Church, may soon be able to provide training courses for churches
on mental-health issues. And "Welcome Me As I Am", a not-for-profit
community-interest company, has a pack available, originally
created for Roman Catholic churches.
"We want to make mental health an OK subject to talk
about; and, secondly [provide] awareness training of what is and
isn't a mental-health issue," the charity's director, Ben Bano,
says. "There's a difference between normal loss and bereavement,
and something clinical called depression. We can make people aware
of those boundaries."
Churches also need to be clear on when to
suggest that someone seeks professional help, Mr Spenceley warns.
"Churches shouldn't try and completely solve the problem. . . If it
becomes a thing where someone needs to talk to a trained
counsellor, or take anti-depressants, or be sectioned, the Church
has no place doing something else. Signposting is the best thing to
"But the Church should be, in my view, a place where
everyone has a welcome, regardless of anything. You can disciple
people once they're in. . . But the first thing you should do is
let them in."
1. Accept the depressive
person in their illness and trouble, and show readiness to
accompany them through this difficult time.
2. Talk over the patient's
life-history. Explore with them the experiences that triggered the
depression. Give them the opportunity to empty their
3. Emphasise the outcome of
the condition. Most depressions improve after a time.
4. Explain treatment options,
and send those with a severe depression to their GP.
5. Encourage the person, and
speak about God's love, even when he or she feels little of it. Use
psalms, and scripture promises.
6. Prepare them for occasional
mood-swings: the road out of depression is lined with potholes, but
leads up to the light.
7. Set one goal at a time.
Depressed people are often so hemmed in that they can only take in
a little at a time.
Demanding: 'pull yourself together'
Depressed people are already placing themselves under a massive
burden of self-imposed obligations, and suffering as a result of
their supposed failure. It is of little help to add to this
Sending them on holiday/leave
Even in familiar surroundings, it is difficult for depressed
people to make contact with people, enjoy beauty, and fill their
day on their own initiative, which is what will be required of them
Allowing them to make big decisions
Often, a depressed person is not capable of properly evaluating
his or her situation. Decisions taken during a depressive phase
will often be recognised afterwards as wrong.
Superficially asserting: 'things are already
For a depressed person, things are the same, week after week. It
is better to affirm that they are still going through the "valley
of the shadows", and to affirm the presence of God in their
Casting doubt on delusional ideas
Many people suffer from the delusions of guilt and failure. Be
patient, and convince the sufferer they are valued. The promise in
1 John 3.19-20 is helpful: "We can set our hearts at rest in his
presence, whenever our hearts condemn us. For God is greater than
our hearts, and he knows everything." Close the conversation to
give time to digest.
Entering into the depressive condition
Avoid being drawn in and forgetting what they are still capable
of, and what gives them security. The balance is in Psalms: time
and again, the "nevertheless" breaks into the personal trouble of
the praying person, and directs their gaze above.
Making too many spiritual demands
Without reference to God's promises, pastoral care is reduced to
idle talk. But an abundance of scripture, which lacks relationship
to everyday life and to the depressed person's suffering, can leave
the person unable to receive God's word and feeling condemned.
When studying the Bible intensively, a severe depressive will
tend only to read the thoughts endorsed by their darkened
perspective. I advise depressed people to read just one verse each
day - preferably with an explanation in a devotional book.
Adapted, with permission, from Supporting the Weak:
Christian counselling and contemporary psychiatry (Paternoster
Press, 1994) by Samuel Pfeifer. www.samuealpfeifer.com
Haydon Spenceley will take up his first curacy this
summer. He has cerebral palsy, and is a wheelchair user, which he
links to his struggle with depression
WHEN I was 15, I woke up one day and thought: "I'm going to be
disabled my whole life." It dawned on me that this wasn't the kind
of condition you recover from. That started it for me, really.
I was in a conservative Evangelical church [which] kept talking
about how when you sin it's killing Jesus. I'd basically been a
good kid; it really messed with me for a while. It was like an
existential crisis. Most of my twenties was like that, even though
I did quite well academically, and I worked in churches and [did] a
few other things.
With the variant of cerebral palsy I have, tiredness is an
issue. I'd get tired, and spiral into negativity, thinking I wasn't
any good. I'd focus on all my mistakes, and on things from the past
that were long forgotten. It went unchecked because I thought
everyone was like that.
Then, a couple of years ago, it dawned on me that maybe it
wasn't necessary to be like that. I still sink occasionally, but
I'm trying to slow my life down, trying to manage things better,
and allow myself to be loved more. I think I'm still depressed, but
I know what I'm doing with it.
Between that, and being in a wheelchair, I have quite a clear
picture of my reliance on God, the thorn-in-the-flesh stuff that
Paul talks about. If I had everything together, and was able to
physically get around, I'd be a lot more arrogant. I wouldn't feel
like I needed anybody, and definitely not God.
[Having] grown up with lots of people helping me, I have a
picture of God who sustains me, and has healed me many times. If
you have a period when you want to die, basically, and you don't
feel like life's worth living, then you don't have that feeling any
more; that's kind of miraculous for me.
Paul Brown developed depression while he
worked as a priest. Now that he works in the NHS, he feels that his
condition can be a potential asset
IN MY first parish as a vicar, I
found myself in a united benefice of two parishes. They were very
different. Rightly or wrongly, I felt a pressure to
There were problems between the
parishes. People looked to me to solve the problems. But any talk
of change brought about such reactions from the congregation, and
the wider community in one parish, that I now understand what went
on as bullying. I experienced immense isolation as the only member
After two years, I had my first
breakdown. I was off work for about three months. I was to suffer
again within 12 months, with, again, about three months off
Three years after my second
breakdown, I moved into a team ministry. I was Team Vicar, with a
Team Rector over the whole team. The church had very able people, a
great PCC. It was very different. I had a curate as well. I enjoyed
working with him, and training him.
But I had another breakdown after
about 12 months. I then saw a psychiatrist through the NHS, and a
community psychiatric nurse. They said: "You need to imagine
yourself like an elastic band that's been stretched and under
stress. Now you've come into this new job, and that stress isn't
there. It's gone 'ba-doing' back into place. It's a reactive thing:
your body has now just collapsed."
I resigned because I was asked to.
The Bishop had no other means or tools to work with [me]. They
recognised that stress was a major contributing factor, because
they'd been told by a psychiatrist I had seen through St Luke's
Hospital for the Clergy, after my first breakdown.
It was said that: "We can't take the
stress away from the job; so we'll need to take you away from the
stress. The only way we have to do that is to offer you early
retirement due to ill health," which felt like a big
The Bishop said: "Think that we've
just pushed the pause
button. . . At the moment this is the only thing we can do. We're
releasing you to a new and creative ministry, free from the stress
of the parish.'
I have since been diagnosed as
having bipolar disorder, and now work two-and-a-half days a week as
a hospital chaplain. Recently, I worked with someone who tried to
commit suicide. I've shared part of my story with them, which they
found very helpful.