By Toni Ridgaway -July 30, 2021

Back when I heard that Pastor Rick Warren had lost a son to mental illness, my heart broke, and I literally cried sitting in my car. I don’t know Pastor Warren personally, nor could I fully understand the certainly unending work that went into his son’s treatment. But I do feel a kindred spirit to his pain. As did Pastor Warren’s son, I spent much of my life battling mental illness—mine was diagnosed as major depressive disorder (commonly known as “depression”), and I know what it is to believe death is more tolerable than the illness. Yet when it comes to ministry and mental illness, there is abundant hope!
The National Institute of Mental Health says major depression afflicts more than six percent of the U.S. population, almost 15 million adults. The World Health Organization says clinical depression was the leading cause of disability in the U.S. for people ages 15–44. For every two homicides committed in the U.S., there are three suicides. Even with the best of intentions and attempts by the most loving of people, some patients will not recover and will take their own lives, as was the sad case for Pastor Warren’s son Matthew. It is a serious and dangerous disorder.
Depression has spiritually troubling symptoms: overwhelming feelings of sadness lasting two weeks or more, trouble eating and sleeping, decreased motivation, and decreased interest in activity (even activities the sufferer used to enjoy). It also can encompass and overwhelm everything in a person’s life, not just one situation or issue. The most severe cases deprive people of cognitive ability, hindering their concentration to where they can no longer form or hold a coherent thought.
I began my journey with Christ in unspeakable emotional darkness. It immobilized me like a cognitive assassin, poisoning my best intentions and expectations. In the deepest throes of the illness, I honestly believed that God wasted His time creating me and that the unbearable pain and sadness I felt all the time would never subside. My expectations of my abilities and my actual abilities were irreconcilable; I found it nearly impossible to hold a thought steady in my head. The idea that God valued me, just the way I was, was utterly ridiculous. In retrospect I often tell people, to their shock, that I understand how mothers suffering from postpartum depression can consider killing their children: They see it as a protective act. They honestly and truly believe their children would be better off dead than suffering through life with them for a mother.
One Sunday evening my husband, despondent and bitter as he helplessly tried to deal with me, put me in the car and drove to a prayer meeting at a local church. We walked in to a group of deeply committed Christians praying for wayward children, church budget concerns, ministry opportunities, employment possibilities and the like. When my turn came, I couldn’t speak at first; but after a moment, I burst into uncontrolled crying and begged for someone—anyone—to help me. After I finished, they all just stared at me for a moment, even the pastoral staff, and I considered bolting for the door. But then a pastor began to pray: “Father, I have no idea what’s wrong with this poor woman. Just heal her. She’s clearly in so much pain, so much…” His tears made him stutter at this point. “Just put Your hands on her and heal her, Lord. Right now. Please, Father…” The others chimed in at this point and began to lay their hands on me gently with genuine concern.
In retrospect, God had led me to that place of . Even though the church didn’t know exactly how to help at first with respect to ministry and mental illness, with their loving support my husband and I researched physicians and treatment plans that would work for me. Over a long period of time and by His grace, my worst spiritual crisis became a victory in the Name of a Father who is “mighty to save, takes great delight in you, quiets you with His love and rejoices over you with singing.”
As I continued in the long process of healing, I began to explore others’ experiences of ministry and mental illness while suffering depression in their faith communities. To my horror, many of these experiences resulted not in spiritual victory but in rejection and confusion. Delving deeper, I discovered that church leadership often sympathizes with the suffering person but when it came to ministry and mental illness they weren’t aware that the illness may not heal the way other spiritual struggles commonly do.
Clinically depressed people often struggle spiritually because they cannot perceive God’s goodness or see past the depth of the painful, unrelenting sadness. They often approach their pastors as I did, desperate to alleviate the dark feelings that overwhelm them and steal their joy for the things they once loved. But church leaders are often at a loss to deal with illnesses like depression that defy the typical methods of spiritual growth and healing. As a result, leaders may give their best advice of “repent,” “pray more,” “read more Scripture” or “grow in the disciplines.” After all, increased discipline brings people closer to God, and a Fruit of the Spirit is joy, right? Some have been even known to say, with the best intentions, “Christians don’t get depressed. How could they if they fully understood the redemptive value of the Cross?”
Unfortunately, spiritual discipline alone cannot heal a person with a major depressive disorder. Now don’t get me wrong: Naturally the value of increased prayer, Bible-study, meditation, etc. in a person’s life cannot be overestimated. And certainly issues of impurity, unacknowledged sin, lack of spiritual discipline, etc. can cause feelings of sadness and separation from God in a healthy person. But in a depressed person, these feelings can also stem from a biological source and therefore may not respond easily to discipline. In short, focused spiritual discipline requires a level of concentration that just isn’t possible when you’re clinically depressed. As such, telling a depressed person to “read more Scripture” or “pray more” is much like trying to turn on a lamp in your house as usual, but the bulb is burned out and will not light no matter how many times you bang on the switch.
In ministry and mental illness, the improper handling of the clinically depressed has direct spiritual implications. Depressed people often hide their struggle from the faith community because they cannot explain it any better than their well-meaning leaders can identify it. A depressed person may work feverishly at spiritual discipline in an attempt to become “holy” enough or “spiritual” enough to alleviate their own suffering, often to no avail. Some faith communities even dismiss the person from their congregation, saying they can no longer help them if they will not “help themselves” or wholeheartedly work the methods offered. In the worst cases (and this is the true spiritual danger), sufferers leave the faith altogether, either because they feel guilty for failing to “work through” their pain, or they blame the spiritual organization (or even God) for a lack of mercy, understanding or interest in them. Some never return to Christ again, assuming that even He cannot (or doesn’t want to) help them.
I have personally experienced how a merciful church community can support the healing process, and I hope you will consider the following practical suggestions:
Ministry and Mental Illness:
1. Care for the depressed person’s physical needs.
In 1 Kings, Elijah sat down under a tree after a significant spiritual victory and told God he was ready to die. God answered Elijah by first providing for his immediate physical needs: hunger, thirst and exhaustion. Mother Teresa lived her life fulfilling the physically needy so she could reach their souls with the love of Jesus.
A depressed person may have no physical resources to deal with the struggle they’re facing because of their symptoms (poor eating habits, lack of sleep, etc.). Encourage an active lifestyle; tell them it will be difficult to maintain but can help ward off a serious episode. Make sure someone around them can account for them physically from day to day.
2. Help them pray, and pray for them.
Depressed people often cannot manage praying for themselves, and although the Spirit will intercede for them in their inexpressible groaning (Romans 8:26–27), the intercession of the Body will be vital to put a voice to the suffering. Encourage others to intercede who care for the person and can protect his/her confidentiality. Intercessory prayer will also allow the Body to express their compassion and desire to help their hurting brother or sister when the healing process seems long.
3. Encourage or assist them to accurately assess their issues.
When spiritual discipline does not alleviate the person’s symptoms, and you can confirm the person’s wholehearted attempt, encourage the sufferer to see a qualified physician, not just a general practitioner but someone trained to recognize mental illness. Assure them that clinical depression is very common; nearly 80 percent of the American population will experience at least one clinical depressive episode during their lifetime. Relieve them from the responsibility of analyzing their lives until a real diagnosis can be achieved. If a physician uncovers an actual issue, re-focus your efforts appropriately. Then encourage them to maintain their clinical treatment options as you work with them spiritually.
4. Assure them of God’s truth.
Depressed people can forget what joy feels like. Their unmet expectations and what they see as personal failures can immobilize them with guilt. Make sure they know the truth of God’s love, mercy and forgiveness; accurately depict His power and holiness and correct any wrong perceptions. Show them how God sees them: wiped clean by Christ’s sacrifice, holy and acceptable to Him as beloved children. Remind the person that these truths are independent of perception, i.e., the truth is such not because of who hears it, but because of Who declares it! Amen!
5. Give them specific spiritual steps to follow when a serious episode strikes.
Quality of life for the depressed can be cyclical, with good days and bad days. Bad days can occur unexpectedly and harshly. Give them a written list of spiritual activities in which to engage when their symptoms threaten their well-being. These activities might include reading specific Scripture passages, statements to populate their prayers, reminders of God’s truths, names and phone numbers of people to call, etc. Emphasize perseverance rather than achievement in these activities. Writing the list down will be crucial; a piece of paper in front of them will help them focus when their minds cannot do it alone, and holding it in their hands will tangibly remind them that someone cares and solutions exist.
6.Minister to those who care for them.
The families and loved ones of the mentally ill often suffer as much as the patient themselves, particularly if they have no experience with mental illness. They may feel out of control, angry, bitter, burdened, worried or depressed themselves. Offer to speak to relatives separately from the depressed person, and minister to their unique spiritual needs as you uncover them.
7. Be patient.
Depression is treatable, but it can be a long, complex road. Remedies are varied and must work for the individual. Treatment methods can take time to implement. Despite its high treatment success rate, two-thirds of people with depression do not seek treatment at all, and half of depressed people can be tempted to give up when they must wait for relief, especially since the illness can affect their level of motivation. They can also get frustrated if their first treatment method fails or needs adjustment.
Assure them that no matter how difficult it gets, you will always be willing to accompany them on their journey to wholeness. Don’t tire of doing good on their behalf, but reiterate the truth as they lose it in their personal darkness. As you persevere, so will they, and you’ll uncover all kinds of opportunities for spiritual growth.
8. Refer the severely ill.
Some clinical cases will be beyond your assistance. The best, most loving act in this instance is a referral to someone who truly can help them. Investigate local psychiatrists, psychologists, counselors and therapists in your area; take the time to call them and ask how they approach spiritual questions from patients. Keep names of appropriate professionals handy for reference, and direct lay leadership to refer mental illness issues to you.
When depression can be controlled, a spiritual light can result that burns brighter and longer than ever before; it’s a holy deliverance from a very personal sort of pain. John Ortberg said once, “Often it is the people closest to suffering who have the most powerful joy.” Truly, it is only when we experience profound darkness that we can fully revel in the light of Christ.
(This important article on ministry and mental illness originally appeared in 2018.)