Deny, defend, delay. That basically sums up my response to my own depression. I denied there was a problem, I defended myself with excuses when evidence of a problem mounted, and I delayed dealing with the problem even when I accepted there was one.
Looking back, I now see that I had low-grade depression for most of my adult life, but I had gotten so used to it that it just felt normal. However, the multiplication of major life stressors during a short space of time in my early fifties multiplied and deepened my depressive tendencies.
Even I could tell that I was in trouble, but when my wife, Shona, asked me from time to time, “Are you OK, David?” I continued to deny, defend, delay. Eventually, Shona pointed out that I was bringing her and the family down, too, and pleaded with me to see a doctor who gave a detailed mental health assessment. I couldn’t argue with his objective findings, which opened my mind to taking the problem seriously and doing something about it.
Having been someone who needed help but didn’t want help, I understand why so many people with mental illness, especially men, find it so hard to move from deny, defend, delay to agreement, acceptance, and action. Sometimes it’s because we view mental illness as a weakness, and we don’t want to be viewed as weak. Other times, it’s difficult talking about our struggles with others. It may be a reluctance to address painful wounds from the past, or a fear of having to change our lives and our lifestyle. Most often, it's simply a symptom of mental illness: a sense of helplessness and hopelessness about recovery.
So, with some understanding of why people who need help won’t seek it or take it, let’s identify some approaches that can help a person who doesn’t want help.
- Educate yourself about the causes and symptoms of mental illness so that you can deepen your sympathy and speak with some knowledge.
- Pray that God would give honesty, truthfulness, transparency, and courage to all concerned and that he would give you wisdom at every step of the way.
- Choose the right time. Don’t raise the subject first thing in the morning, last thing at night, or during busy times. Try to get privacy and quiet so that space, time, and quiet are available.
- Ask questions rather than make accusations. Don’t say, “You’re depressed,” or “I think you’re mentally ill.” Begin with assuring them of your love and then get permission to have a conversation about this. “Can I ask you some questions about a couple of concerns I have?”
- Remember, how we ask is perhaps even more important than what we ask. Keep the emotional temperature low and ask the questions in a gentle, caring, kind manner.
- If the sufferer begins to talk, don’t react with shock, fear, or tears, because that will only cause the person to bottle things up again.
- Highlight positives from the past and ask about their absence in the present. “Do you love your work as much as you used to? Why haven’t we connected with our friends for a while? Would you like to recover your energy and enthusiasm for sports again?”
- Be patient. They may not talk initially, but you’ve sown some seed-thoughts with your questions, and these can grow bigger in their minds over time, especially if they begin to notice what you asked about.
- If they won’t open up to you, perhaps ask one of their friends to come alongside them and ask them about what’s going on. Someone who’s had depression before can be an especially helpful ally because they can tell their story, making it easier for the sufferer to open up about their struggles.
- Ask if they’d be willing to read an article or listen to a podcast about mental illness. Choose something short and simple that takes a holistic approach to mental illness. This can then form the basis for further discussion.
- Offer re-assurances to prevent or overcome defenses. For example, “Mental illness doesn’t mean you’re a bad Christian or you lack faith.” “This does not mean you’re crazy.” “This is common in a fallen world and therefore you’re not weird.” “I don’t think less of you, in fact I admire your courage to accept this and act to change it. I will support you at every step.”
- Have some options ready if they do accept they need help. Explain what the first step would look like, usually a mental health assessment from a doctor or a professional counselor. Express your willingness to go with them or offer the option of an online consultation if that’s easier for them to begin with.
- Express your hope for the future and your belief that God can heal them if they get the right help.
- Point to examples of depressed Christians who have recovered and been more useful than before and express the hope that they will do the same by God’s grace (2 Cor. 1:4-6).
Ultimately, some may still refuse to admit they need help or seek the help that’s available. In such situations, we keep praying, assure them we are always ready to talk when they are, show them unconditional love, make some changes that can help their symptoms (diet, exercise, sleep, rest), look after ourselves so that we don’t get dragged down with them, and look to Christ.
