Interview with a Psychotherapist: How to Help Depressed Believers?

Psychological and mental anxiety
Psychological and mental anxiety
By CCD contributor: Xiao BinOctober 7th, 2020

According to the latest data from the World Health Organization (WHO) in 2019, there are more than 350 million people globally who suffer from depression, while it is estimated that there are already over 100 million people suffering from depression in China. These figures illustrate the prevalence of depression in the population, and churches also face the challenge of caring for this group in their pastoral work. As Christians, how do we react when we suffer from depression, or if brothers and sisters around us suffer from depression. Explanation and assistance also need to be performed from the perspective of faith.

Recently, China Christian Daily invited Mr Xiao, who has been engaged in counseling for 30 years in the United States and Hong Kong, to answer questions about depression groups and how the church can provide effective help.

China Christian Daily: For most non-professionals, it is very important to quickly identify patients who are depressed, so as to provide timely help. So how do you identify persons who have depression? What are the common symptoms?

Mr Xiao: The following may be the signs that believers are prone to depression, which can be used for reference. Depression is primarily diagnosed by a psychiatrist, so don't trust too much in just guessing if someone is suffering from depression.

Some people might say: "Please pray for me, I am not confident, I am weak in spirit, I often feel very anxious, very afraid, very scared, and I have insomnia." Some people may say, “Oh, I have lost interest in life, and I am very pessimistic. I even don't want to eat.” Another situation is that some people are very sensitive. When others have different opinions, they will react quickly and lose their temper.

Some people wonder that God has promised us peace, but why do they still often feel uneasy?  Sometimes they can't sleep all night. Even though they pray, it doesn't seem to work. In addition, some people will feel great pressure. Sometimes they will feel their heart beating very fast. They will sweat. They’ll have pain, and the doctors cannot find the reason.

Some people feel that they have sinned, and they have sinned against God. They cannot meet his demands, and they are afraid to face him. Others are tired of serving in the church. In fact, the exhaustion is not from the job or service, but from relationships. These can be relationships with the leaders, which can make one feel tired and trapped by the relationship.

There is also the possibility that they are very enthusiastic about participating in the work of the church, but their personalities are very withdrawn. They have few friends, and they do not know how to be open with others. It is difficult for anyone to know how to care for them. Some people have also found that they are workaholics. They always think they are very spiritual, because they are active in serving others. They does not know how to rest, or how to have fun. They think these are not worth their time.

When you help someone who is depressed, you can ask them questions such as: When do you feel low? Have you ever doubted God? Do you think God is being unfair to you? Ask several questions, one or two at a time, and listen to the answers.

China Christian Daily: Do you deal with the many Christians who face depression in your daily counseling? As far as you know, what are the actual problems and difficulties faced by the community of people in the church who face depression?

Mr Xiao: I think the number of believers in China who suffer from depression and the number of their family and friends is huge. Because depression has only been given special attention in China in the last decade, ordinary people, including Christians, had no basic understanding of mental health. They did not know how to recognize depression so when situations became serious, pastors had little experience or resources to address the difficulties individuals were facing.   

I believe that all the pastors are good shepherds, and all hope that believers will become people acceptable to God and learn to be as holy as Jesus. Just as Jesus said, "Be ye therefore perfect, even as your Father which is in heaven is perfect."(Matthew 5:48) But by "perfect," Jesus did not mean that the whole law must be kept without blemish, but that the body, soul, and spirit of the whole person should be healthy and mature.

General discipleship now emphasizes “spiritual” manifestations such as reading the Bible, praying, attending church meetings, preaching the Gospel, and serving others. These are important, but emotional health and the maturity of the believers' lives are also important indicators of spirituality. If the church fails to teach believers to think positively, does not give them the space to express emotions of grief, and does not deal with their inner lives, when the believers face struggles and temptation, they not only have no power to respond, but also will they be disappointed with their own behavior again and again. Because of stress and the contradictions of life, when the condition is serious, depression occurs. Some people even suffer from serious depression.

I have met many Chinese believers, and they all said that they were afraid to tell their real problems and struggles to the pastor, because they felt that the church is a very sacred place, and the pastor is mostly concerned about their spiritual problems. So if you let people know that you are weak and not in control of your life, people are bound to say that there is something wrong with your spiritual life, so everyone puts on a mask and hides their struggles. Some people even think that depression is the result of people's sins. Believers are depressed because they lack faith, worry too much and don't know how to trust God!

There are also pastors who only emphasize the importance of devotion to the Lord. They believe that Christians who are filled with the Holy Spirit will not be depressed, and are opposed to taking any antidepressants or electric therapy. Personally, I believe there is no conflict between taking medicine for depression and reading the Bible. If we don't take care of their physical needs, the situation is likely to get worse and worse.

China Christian Daily: How can depressed Christians properly accept and deal with their emotional problems?

Mr Xiao: Even Christians who have been believers for many years don't necessarily think that “life maturity” includes emotional health. In fact, one's definition of “life maturity” has a great deal to do with one's spiritual view. If a Christian's spiritual outlook is based only on how much one knows about the Bible and how long one has served, one will not even think about emotional health. Other Christians may think that a spiritual Christian "shouldn't" or "can't" have any negative emotions and therefore deny all negative emotions of their own.

The Bible also says about emotions, "Be ye angry, and sin not: let not the sun go down upon your wrath..."(Ephesians 4:26, 31) Paul accepted the existence of anger, but reminded Christians to be careful and reasonable in dealing with it, not to be angry all the time, not to be controlled by all kinds of negative emotions and do harm to themselves and others.

When someone asks you “How are you feeling today” or “How is your mood today”, many people's minds will probably go blank. They will say "good" or "not good" at best. Some Christians are aware of their own emotions, but not of how they process them. In fact, emotional awareness and processing skills can be learned. "Wherefore, my beloved brethren, let every man be swift to hear, slow to speak, slow to wrath."(James 1:19) Sometimes we react too quickly to what others say, so it's easy to get hurt. We should respond slowly and not be too sensitive, because a lot of people just say what they want and the next day they simply forget it. We don’t have to take it personally. 

We may be depressed because of physical problems, problems of sin in our lives, financial difficulties, etc. But when someone lets their depression take control of them, they cease to care about life, work, the people and things that they should be concerned about. They will just sit and wonder or stare blankly. When the individual feels that nothing has been accomplished, he or she will increase their own guilt and feel that there is no point in living. That way, we're less likely to do the things we should be doing, and the vicious cycle rolls on and turns into depression.

China Christian Daily: How can people stop the vicious circle of depression?

Mr Xiao: It's normal to first accept that you have low mood swings. Don't deny it, run from it, or blame others. If you feel guilty because you have sinned against God, ask God to forgive your sin and make peace with others. Start doing the work and things you need to do and take responsibility for your life. It takes time for a person to change habitual negative thinking patterns. So when you're feeling down, don't follow your own feelings but believe that God loves you. Make a schedule. No matter how you feel in your heart, you must live and work according to the schedule. Instead of sitting in a trance, get involved in more activities and refuse to talk about self-pity. Immediately repent from sin.

Change your mindset and refuse to use words like, “I have no expectations for the future!” or “I can't take it anymore!”

China Christian Daily: In terms of a church shepherd and fellow worker, how does the church care for people with depression? Which church workers need to be equipped for this task?

Mr Xiao: In order to help a believer with depression, church ministers and fellow workers can try to discuss depression with the patient from the perspective of faith. It may be more effective than telling the person directly that they have depression.

Step 1: Pray for yourself and the patients. The pastors of the church should first pray for those facing depression, then ask God's comprehensive healing on the patients. Ask God to cover you and your family with his precious blood, forbid the devil to attack you, and ask God to keep your heart from being dragged down by the negative emotions of others. Ask God to give you the wisdom to know how to help others. Find out where professional counsellors and psychiatrists are available and prepare for future referrals.

Step 2: Build a good relationship with those who are depressed. You can make someone trust you by talking to them, accompanying them, walking with them, etc. If the individual doesn't open up to you, don't force them. You can also be there from time to time and offer practical help. For example, go shopping, prepare food, help with transportation, etc. They may not want to interact with too many people because it will put too much pressure on them. But never make the person feel so lonely that they feel that they are bad, so no one wants to be with them. It's better to have the company of believers who are burdened by depression.

Step 3: Get to know those who are dealing with depression. You can ask some questions. You don't need to agree or disagree, because the main thing is to listen. Listen slowly, and don't express your opinion. For example, you can ask questions like: “How am I? What do you think will help  you the most in this situation? Do you feel like your heart is being crushed? Do you feel hopeless or want to die?” It doesn't matter what the answer is, you just listen. Don't debate with the patient or discuss theology, because the more you reason, the worse the results may be. Patients suffering from depression are usually very stubborn. When they suffer a seizure, and you debate with them or you scold the person, they will be uncontrolled in action becasue their mood is uncontrolled, and you may see them bang on the table. In some more serious cases, they may beat you.

Step 4: Read from the Psalms with them. I think reading the Psalm is a great way to express emotions. David was also a man of many afflictions and tribulations, and he often said in the Psalms, “Why is my soul cast down, and why is it agitated in me? We shall look up to God”? So God left the Psalms to help believers open their hearts. It doesn't matter because in front of God you can cry, you can shout, you can yell, you can tell God all the things you are unhappy about yourself, and you can talk about your anger and your complaints. There used to be a fellowship called the Naomi Fellowship, and it was full of divorced women. In this fellowship they would cry a lot and talk to God, and one of them said she was going to kill her ex-husband. They had such negative feelings.

Step 5: Suggest that the patient receive treatment. If they already trust you, tell them that the insomnia, loss of appetite, and negative emotions caused by depression can be treated with antidepressant medication. In order to deal with the pain of insomnia, they may be willing to see a doctor or have a physical examination. Don't speak directly to a psychiatrist to avoid his aversion.  Give the person time to think, and don't be too insistent. If they are unwilling to go, wait for another opportune moment. If there is no objections, get them to a doctor or a counselor  right away. You can use a referral you've already made. If you're not prepared, you'll miss the opportunity. If the person is desperate and has suicidal tendencies, talk to the family and insist on them seeing a doctor as soon as possible. Suicide is a serious problem for depressed patients and must be dealt with promptly.

China Christian Daily: What are some of the current misconceptions about depression?

Mr Xiao: Depression is not a sign of weakness. Although they are consumed by the melancholy mood most of their energy and motivation, they are definitely not lazy. On the contrary, some of them have to spend several times more energy than normal people to maintain their work and life.

Depression is not permanent. If people with depression have had the condition for many years, they have little confidence that they will get better. In fact, depression can now be controlled.

China Christian Daily: For those who are willing to serve people with depression, do they need to evaluate themselves? How do they maintain their spiritual and mental health in the process?

Mr Xiao: There are tests that can be used to assess a person's emotional and physical status, whether they are for a client or a helper, to see if they have anxiety, depression, fear of something or are overly sensitive in relationships. People who serve others need to have a healthy self-image and deal with their own past hurt feelings so they can help others more effectively. Love and patience are very important for people who serve because people with depression tend to make slow progress and are easily disappointed.

In the process of helping believers with depression, there is an important prerequisite for same-sex help, that is, male to male, female to female. Never try to help someone of the opposite sex, lest it causes an emotional shift that turns God's support into human support. Don't allow yourself to serve alone. You need to serve with co-workers or a team. Pray together and let the pressure go to God.

People who serve are content in their intimate relationship with God. Don't make serving others your satisfaction. Always be grateful, sensitive to the devil's deception and attacks, especially in your relationship with your family. Avoid the impulse to be easily offended, humble yourself before the Lord, and give glory to God.

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