Many of us struggle with what to do when someone we know is depressed. We want to help but fear, confusion, or misunderstanding holds us back. So, let me suggest eight guidelines for helping depressed people.
1. Prepare for it.
Eventually, someone in your church or in your family is going to get depression. It is the third most common reason for people consulting the family doctor. In any one year, six percent of men and ten percent of women will suffer with depression.
Prepare by reading up on it. A couple of good books are Dealing with Depression by Sarah Collins and Jayne Haynes, a short book you will read it in an hour, and Grace for the Afflicted by Matthew S. Stanford, which is more demanding and more detailed.
Be prepared to be surprised by who gets it. Contrary to the caricatures, it is not just sad, lazy, pessimistic people that get depression. It’s also type-A personalities, it’s high achievers, it’s happy people, it’s people with everything going well in their life.
2. Don’t assume personal sin.
Don’t assume that depression has been caused by specific personal sin. That is a common reaction depressed people find in the church. You get cancer, or you get heart disease, and no one asks, “What did you do wrong?” You get depression, and they ask, “Who sinned, this man or his parents?”
In fact, I’ve found that sometimes it’s the most godly who are most likely to suffer with depression. That’s because they are much more sensitive to sin and to evil in themselves and their world. They are also the ones most overcommitted in their service of the Lord. And, of course, they are special targets for satanic attacks.
Just because there are spiritual symptoms does not mean there is a spiritual cause of a depression. Just because someone is feeling spiritually dark, spiritually desolate or spiritually abandoned, does not necessarily mean there is a spiritual cause of these spiritual feelings. These may be spiritual consequences of a physical or cognitive problem.
3. Measure the dimensions.
Check the width, depth, and length of the symptoms. Regarding width of symptoms, in most books or articles on depression, you’ll find a checklist of twelve to fifteen symptoms. You’re usually looking at checking off at least five or six of these before becoming too concerned.
In terms of depth, depression isn’t feeling a bit sad or a little anxious. There should be an unusual intensity in these feelings, so serious that it’s damaging a person’s life and beginning to incapacitate them.
As to length, you’re not looking for someone being sad for just a few days. Usually, it’s two or three weeks before you are thinking, “Hey, this person might have depression.” So, check the width, depth, and length of the symptoms. A medical doctor can help with this and other aspects of depression.
4. Don’t rush to or rule out medication.
Don’t rush to take antidepressants. Medication should rarely be the first option unless the situation is desperately bad. Often, people’s emotional upheaval is temporary and can be resolved with understanding, family support, pastoral care, counseling, addressing detrimental lifestyle choices, and repenting of any sinful habits. There are many other things we should do before resorting to medication.
Although we shouldn’t rush to medications, we shouldn't rule them out either. Ask yourself if your refusal to even consider them might be sinful pride, false presuppositions, or an unbiblical and over simplistic anthropology.
5. Be holistic.
One of the biggest mistakes people make is thinking that just popping a pill will cure depression. I’ve never seen anyone recover from depression by just taking medication. That’s because there’s usually a range of issues that need to be addressed. Medication can only work well when it’s part of a holistic package of care that addresses our whole humanity.
Be holistic in terms of causes and cure. Look at life events, look at lifestyle, look at bodily symptoms, look at thinking patterns, and look at how a person is feeling, look at social factors and spiritual factors. Look at all these realms and all these dimensions in terms of cause and cure.
6. Involve family and friends.
A counselor or pastor can’t stay with the depressed person every day of the week. But family and friends can be much more involved and are the key to a person’s long-term recovery. They can be especially helpful in encouraging a depressed person to build the four R’s into their lives: Routine, Relaxation, Recreation, and Rest.
7. Maintain spiritual disciplines.
An important part of a routine is maintaining spiritual disciplines. Due to the inability to focus and concentrate for long, Bible reading and prayer is often extremely difficult for the depressed person. That’s why they should keep reading and prayer short and simple. We can help by reading and praying with the person and encouraging them to tell God exactly how they feel and what they are thinking.
We must also point them to the objective truths of Scripture, rather than the subjective. Point them to the character of God, point them to the personal work of Christ, to justification, the cross, and the atonement. Let these objective truths really grab hold of their hearts and minds and the subjective will eventually come along in the wake.
Point them to the sympathy of Christ. He is the great high priest who himself has felt overwhelmed. He has known darkness, he has known fear. He is able to encourage us and support us in the midst of our deepest darkness and he eventually is able to take us out of it as well.
8. Give hope.
A depressed person feels hopeless. Give them hope. Help them to see this is a normal abnormality for a Christian living in a fallen world and a fallen body. The Bible and Church history reveal that many Christians have suffered with depression and almost all of them eventually get better. Give them hope that you will stick with them, that you won’t drop them.
Give them hope that they will actually be more useful after this than they were before it. Give them hope that they can glorify God in the darkness. And give them hope of the new heavens and the new earth in which God’s people will enjoy a new body, a new mind, a new heart, and new emotions.
Because we are body-soul unities, physical and spiritual issues intersect in ways that can't be easily pulled apart.