Nothing will stretch your theology quite as much as trying to understand depression, in your own life, as well as in the lives of those to whom you minister. When I preach on depression, the title is never “Overcoming Depression,” or “Victory Over Depression.” Instead, the title is “Understanding Depression,” or “Living with Depression.” It is not that I doubt God’s ability to heal. I believe that a theology of healing must be held in tension with a theology of suffering.

It is a lot about understanding why even the most spiritual of people may live with depression. It is also about understanding why even godly leaders may sometimes take their own lives in suicide. It is about understanding what causes depression, about what are predisposing genetic factors and the contribution of early trauma. It is about how and why medications and psychotherapy may help in its management. It’s about offering understanding to sufferers about where God is in the midst of their depressions, and what he is up to in their lives when such afflictions are permitted, and when they are not healed in this “now but not yet” phase of the kingdom of our ascended Lord.

Here are some guidelines for preaching about depression.

Two Things to Avoid

Avoid triumphalism at all costs; avoid judging people who are depressed, and do not tell them to “pick themselves up by the bootstraps,” or to “get over it,” for they cannot.

Avoid telling depressed people to read more of the Bible, and to pray more, for they cannot. Read the Bible and pray with them. Wise Puritan pastors of the 17th and 18th centuries in England knew these things very well.[1]

Develop a Theology of Depression

Think deeply about your theology of depression. Treat your preaching on depression as an opportunity to teach a proper theological anthropology; this involves both the wonder that all human persons are made in the image of God, and that all human persons face the challenges of being fallen in every area of our lives.

Seek to overcome the dualism of the chemistry of the brain and the chemistry of the body. This will guide what you think about openness to the taking of antidepressants when they are properly prescribed. Using the comparison between taking insulin for diabetes and antidepressants for the illness of depression, can be helpful.

It is important, especially in more charismatic settings, for people who have been prayed for with respect to their depression to be both open and receptive to healing, but also to stay accountable to their medical carers (and their spouses or friends), so that if they believe they are healed, they will come off their antidepressants slowly under medical supervision.

Demonic Origin

Great discernment is needed about whether depression may be demonic in its origin. Psychiatrists and psychotherapists and pastors need to consult together on this. What may look like demonization can simply be a severe mental illness like schizophrenia. Responsiveness to medication can help discernment in this regard.

In Ephesians 4:26-27, Paul makes a clear distinction between the root causes of anger, for example, and the demonic manipulation of those roots if they are not probed and processed: “‘In your anger do not sin’: Do not let the sun go down while you are still angry, and do not give the devil a foothold.” Addressing the roots will remove the stronghold.

Medical Perspective

It is important to know from a medical perspective, both the causes of depression, and its various types, including bipolar type 1 (manic depression), bipolar type 2 (recurrent unipolar depressions with hypomanic phases), unipolar depression, reactive depressions (usually a “one-off,” and responsive to medication and therapy), and also the relationship between anxiety and depression, which can be complex.

Theology of Suffering and Healing

Develop for the congregation a theology of suffering, alongside of a theology of healing.

Find examples of well-known preachers and theologians who have struggled with depression: C.H. Spurgeon, Mother Teresa, Richard Baxter, Timothy Rogers, William Cowper (who wrote the hymn “God Moves in a Mysterious Way”), the latter who attempted suicide.

Psalms of Lament

An important resource for scriptural exposition is the Psalms of Lament, which constitute forty percent of the Psalter, some of which have no resolution in the Psalm (e.g. Psalms 77, 88).

Creating space in church for lament runs counter to the popular desire for upbeat, “happy” services, but given the number of psalms in what ought to be one the most important prayer and praise sources, surely suggests such spaces should be created.

Psalms 42 and 43 are particularly helpful on depression, both it’s possible causes and coping mechanisms, and also for normalizing its occurrence even among the most godly of saints. Second Corinthians 12, though it doesn’t mention depression specifically is an example of a theology of suffering written by Paul, one that involves experiencing God’s sufficient grace no matter how long the affliction persists.

Benefits of Depression

Highlight some of the surprising benefits of having depression, or even being a long-term depressive. Seeing the cup half empty, as depressives tend to do, often means imagining what may make the cup full, when others don’t even see that the cup is half empty.

Some visionary leaders may be like this, and their visionary dreams may thus be intermingled with depression. Theologians and pastors and very thoughtful, spiritual people may often see heights and depths that others don’t, and these benefits may sometimes be shaded by depression.

There are also spiritual depths and heights which the depressed people may experience that those on an even keel may never plumb. Going through counselling can also result in affective, relational and spiritual growth through deep catharsis and the processing of emotions, sometimes very old emotions. This results in greater self-knowledge, which when coupled with the knowledge of God, and the avoidance of self-obsession, is a desirable thing.

John Calvin in his Institutes makes it clear that knowledge of God and knowledge of self are deeply interdependent. My own experience of skilled and insightful therapy for depression not only facilitated emotional healing and awareness, but it made me a pastor able to enter the brokenness of others. It made me more than just a purveyor of theological and biblical knowledge. It made me more fully human.

Lack of emotional intelligence is one of the reasons for the lack of resilience in pastors.

Reassure Our People

Above all, reassure your people, whatever their afflictions, that God is at work in them.

In 2 Corinthians 12, Paul exemplifies what it is like to have an affliction that won’t go away. His desire to be rid of it is clear—he prays three times on different occasions for it to be taken away. It is something to do with the body. It is something that brings him down to earth and earthy living after some great heavenly experiences. It keeps him humble. But above all, in the ongoing daily grind of it, he is assured that God’s grace is sufficient for him, that in God’s economy, our weaknesses become our strengths.

Give People Both Space and Community

While it is true that people in depression need community, one of the symptoms is isolating from people (see Elijah in 1 Kings 19). This takes great sensitivity. Giving people space is appropriate at times. But when people are seriously depressed and ideating and talking about suicide, pastors and friends need to be emphatic about urging people like this to get medical help, and best of all, to take them for help.

This needs to be taught when preaching on depression. When the person becomes open to community, this can be a very significant part of their healing and return to some level of normality. Not all healing needs to happen in therapy. Larry Crabb’s book on Connecting [2] is a superb resource for how the community of Christ can minister to each other as people of the new covenant.

Don’t Cast Judgment

When Christians take their lives by suicide, and this will probably happen at least once in the life of a pastor, it is important for the pastor not to cast judgment, and not to speculate about whether said person is in heaven or not, for only God knows that. For a person who has believed in Jesus, and has lived the Christian life faithfully, there seems to be little doubt that they are in heaven.

Suicide is not the unpardonable sin. Suicide that is the result of mental illness is usually the act of someone who has lost touch with reality, and I personally do not think they will be judged for it.[3] Our hope is always in the vicarious life, reconciling death, triumphant resurrection, and glorious ascension of Jesus for us!

[1] See for example, Timothy Rogers, Trouble of Mind and the Disease of Melancholy: Written for the Use of Such As Are or Have Been Exercised by the Same (Grand Rapids, MI.: Soli Deo Gloria, 2002); William Bridge, A Lifting Up For The Downcast (Louisville, KY.: GLH Publishing, 2014).

[2] Larry Crabb, Connecting: Healing Ourselves and Our Relationships (Nashville, TN.: W Pub. Group, 1997).

[3] Such suicide is not ethically the same as the deliberate decision of sane persons who are ill and who ask a doctor to end their lives, as in physician-assisted suicide. PAS is distinctly difference from palliation which does not cause death but rather allows the patient to die with as little pain as possible.