For over a year, churches around the world have navigated new terrain involving a fair degree of isolation and disconnection. The challenge of recognizing and responding to someone struggling with depression has certainly been amplified. The routine ways we used to sense the needs of others are now more elusive. So how can we recognize when someone in our church family is struggling with depression, and how can we helpfully respond?
What Are We Noticing?
Sometimes knowing what to look for can make the difference between overlooking someone’s suffering and moving toward them in love. Here are some broad indicators of depression as captured by the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition (lightly paraphrased). This list is a compilation of the experiences and observations of people who have struggled with deep discouragement.
Five or more or the following symptoms, with at least one of the symptoms being either depressed mood (persistent feelings of sadness, hopelessness) or loss of interest/pleasure; symptoms are present for at least two weeks and are causing significant distress or impairment:
- Depressed mood (feeling sad, empty, hopeless)
- Diminished interest or pleasure in all or most activities
- Change in weight (an increase or decrease of more than 5% of body weight in a month) or change in appetite
- Noticeable slowness in physical movement and slowing down of thought
- Fatigue, loss of energy
- Feeling worthless or feeling excessive guilt
- Decreased ability to think and make decisions
- Frequent thoughts of death or suicide
Here’s the problem: unless a person is verbally sharing these struggles or you are able to personally interact with them in order to observe or ask questions, it can be difficult to know if these signs are present. Nevertheless, there are some practical steps you can take.
The first step is to pay attention. You might observe some of the following:
- A small-group member gradually stops attending Zoom gatherings.
- A church friend doesn’t answer or return your calls.
- You know someone from church who has experienced a miscarriage or the death of a family member or friend; perhaps they are making hard decisions about their children’s schooling or wading through financial struggles.
- A fellow church member hasn’t returned to gathering with the church and their absence isn’t related to health concerns.
The experience of depression often moves people to avoid others and to isolate themselves. When hardship is combined with isolation, our desire to care for others should accelerate.
If you have noticed someone’s absence or you know about a hardship in their lives, you have taken the first step toward caring for them. Next, take steps to build the relationship. Call them and keep calling them, not to pressure them to attend an event or to serve but simply to check on them. Express your care and concern. Pray with them. Tell them they aren’t alone and that God is with them and is working for their good (conforming them to Christ). Write them a note or an email or send them a text. Try to connect weekly and remember that it may take time for someone to open up.
Building a foundation of care (by steadily pursuing others in love) often opens the door for a deeper relationship where more personal questions are welcomed and answered. If you know someone who has a stressful situation in their life, you can start by asking, “What’s the hardest part of this for you? What’s the biggest struggle for you today?” You’ll also want to ask them how they are doing spiritually and relationally. Listen for the following:
- Is God’s Word encouraging them in any way? Are they able to read the Bible and glean hope from it? (Reassure them that all believers experience seasons when the Bible doesn’t seem vivid or especially nourishing.)
- Do they feel numb and empty when they pray or hear a sermon?
- Are they avoiding or maybe even refusing to fulfill certain responsibilities in their lives? You may hear about the fall-out from avoiding work, avoiding relationships, and avoiding daily care for themselves and their families.
- Have anger and frustration about circumstances turned into hopelessness or numb resignation? Do you hear defeat that says, “Nothing will ever be different”? Do they sound exhausted and overwhelmed?
- Do they mention dying or death? Pay attention to dark jokes that hint around death.
- Do you hear a lack of purpose? It may sound like, “Why bother? It doesn’t matter any way.”
- Is there interest in spiritual things—or in any activity?
You might get pushback as you move toward someone who is depressed. Don’t stop caring, but be sure to give them some options: remind them that they don’t have to talk to you but you want to make sure they are talking to someone who will point them to the hope and purpose we have as followers of Jesus. As the body of Christ, we are called to exhort (urge, persuade, help) each other to follow and cling to the Lord every day (Hebrews 3:13). We need others to pray that we will be “strengthened with all power, according to God’s glorious might, for all endurance and patience with joy” (Col. 1:11). Depression is certainly a “stubborn darkness,” but we can serve and encourage our fellow church members by coming alongside them and noticing their struggles, building relationships, and asking gentle questions.
Remind those who are suffering that God is doing his steady work of conforming them into the image of his Son (Romans 8:29) and that you will help them walk this path toward Christ until they “look upon the goodness of the Lord in the land of the living” (Psalm 27:13–14).
For more information and tools related to helping those with depression, I highly recommend the following resources:
- Depression: The Way Up When You are Down by Ed Welch (booklet)
- Depression: Looking Up from the Stubborn Darkness by Ed Welch (book)
- When the Darkness Will Not Lift by John Piper (book)
- I’m Praying for You by Nancy Guthrie (book; biblical prayers for those who are suffering)
It’s very important to ask more questions if the person mentions death or dying. Depression may include thoughts of suicide, and it is essential to ask questions and involve others if there is a risk of self-harm. For more help on counseling those who are suicidal, please read Nine Guidelines for Counseling Suicidal People.