Churches and Mental Illness: Time To Change

When The Gospel Coalition published an article regarding Pastors and Suicide, it caught my attention.  I served in full-time church ministry for 15 years, first as a youth pastor, then as a pastor, and finally as a church planter.  Throughout that time, my life-long issues with depression and anxiety intensified.  Unfortunately, I was always afraid to tell anyone.  After all, pastors are not supposed to have these kind of problems.

I do not know if it was age, a church planting failure, or a combination of the two, but after 15 years, I reached my breaking point.  After I spent 5 days in a psychiatric hospital, I came to a conclusion:  I have to start telling my story.

I decided that 15 years of pretending everything was find did not help anyone.  It was not healthy for me, my family, or the people I served.  So, if the Lord wills, I plan to spend the next half of my career telling my story.

I have been around enough ministry leaders to know I am not alone.  I can see the signs in others.  However, seeing The Gospel Coalition claim that pastor suicides are increasing really hit home.
It made me wonder, why do ministry leaders not get help?  The famous Lifeway study proves that the fear is real.  48% of evangelicals believe that prayer and Bible study alone are enough to treat mental illnesses like depression, bipolar disorder, and schizophrenia.  If one in two church members see reaching beyond Bible study and prayer as unnecessary, the fear that many pastors have about getting help is well founded.

Do not get me wrong.  I am all for prayer and Bible study.  I know of people who have been healed of all sorts of calamities through prayer alone.  However, when a person comes down with cancer, do we not pray AND seek medical help?  Do we not see the great advances in medical knowledge and technology as something that God gives and uses?  The Bible never speaks against medicine and doctors, so why do we treat mental illness differently?

I can think of two primary reasons.  First, we think the Bible does address depression and anxiety and that these are not illnesses.  Second, we fear that the psychiatric community will be hostile to the Christian faith.  There are other reasons but I will address these two.  These two reasons are myths that are keeping many from getting the help they need.

​Myth #1  The Bible speaks of depression and anxiety and these are not illnesses.
The Bible does talk about sadness, grief, and worry.  However, a clinical definition of depression and anxiety is not simply being sad and worrying.  A person diagnosed with major depressive disorder is not just sad.  

In fact, in order to be diagnosed with Major Depressive Disorder, the patient must have at least 5 or more of these symptoms in the same 2 week period:

1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.)
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation.)
3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

Also, those symptoms cannot be the result of a diagnosed physiological effect or other medical condition.  Further, the symptoms must be causing significant impairment either in the patients social life, employment, etc.

A person that is clinically depressed is not just sad.  A person that is has generalized anxiety disorder or “panic attacks” is not just worried. In fact I am not much of worrier at all.  My anxiety shows up as anger.  A pastor friend of mine had knee pain as a result of anxiety.

In my case, there is a real illness in my brain that prevents me from being happy even when I should.  That is not an excuse, any more than getting the flu is an excuse for anything.  It is up to me to learn to live with this problem and to honor God anyway.  However, if all it took was prayer and Bible study, I would have been healed long ago.  I have not given up on prayer and Bible study, but I thank God everyday for the doctors and the medicine that He has sent my way.

Myth #2:  The psychiatric and psychological community will be hostile to Christianity.

Psychiatry is a medical specialty.  Doctors are people and they have a wide range of thoughts and opinions about faith.  However, it is an error to assume that they will always be anti-Christian.  The American Psychological Association has a code of ethics that prohibits practitioners from degrading a patient’s faith. (it would contradict point 3.03 in the APA ethics code)

I can say that from my own personal experience, I have never met a mental health professional that was against my faith.  When I went to the hospital I dealt with a psychiatrist, a general practitioner, a psychologist, and a social worker.  They were not opposed to my faith.  In fact, they encouraged it.  The psychologist talked to me about Cognitive Behavioral Therapy, and then said, “You know, Pastor, that’s in the Bible.  Didn’t the apostle Paul say to take every thought captive?”  The social worker asked me before I was discharged if I had a church.  She was prepared to recommend one if I did not.  The hospital chaplain visited the unit and my pastor was welcomed to visit me even though any other visits were tightly regulated.  Were all the people running the unit Christians?  I think some were and some were not, but they were hardly hostile to my faith.  If anything, even the most secular practitioners I encountered saw a value in faith.

It is time to change the way we as Christians think about mental health.  Pastors need to know that they are not alone and that there is no shame in trying to be healthy.  Churches need to be ready to meet the needs of those that are suffering.  A healthy church will encourage healthy people.

Aaron Davis is an author and speaker.  He is the author of the novel “Street Preacher” and the memoir, "Baggage Claim: One Minister's Journey Through Depression to Peace" .  Click here for information about having Aaron speak to your church or group.

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