Depression is often described like being in a dark tunnel. It is a complicated disease affecting more women than men. While you may have heard that depression results from chemical imbalance, it’s not quite that simple. It involves faulty brain regulation that impacts mood, genetic vulnerability, stress and life events, medications and medical problems. In other words, a combination of many factors can lead to depression.

In my experience, people often fail to understand this complexity. For example, one of my patients was told by fellow believers that she was depressed because she lacked faith. Actually, her depression stemmed from cancer treatments and the side effects of the drugs. Another was questioned about demonic oppression. When in fact, this patient had a terrible and rare reaction to a new medication prescribed for a medical condition. Her reaction to the medication looked like someone with psychosis. Avoid a quick move to judgment when you have no full understanding of the person’s life.

That said, not all depression can be traced to biochemical causes either. I have treated depressed Christians whose spiritual and relational lives were not in order.  They opposed good counsel.  They had unrepentant hearts and character problems that needed repair. I think of the Biblical story of Naomi, a woman who suffered personal loss, felt God turned away from her and so turned away from Him. She asked to be called “Mara” (bitter).  Change came when she was reminded of the personal covenant God had with her.

For some, medication is not the answer. New choices, renewed thinking and coping can help. But for others, medication clearly makes a difference. Certain medications can be life saving or lift the darkness enough to work through other issues.

So how should we respond to those who suffer from clinical depression?  Here are 10 things you can do to help someone who might be depressed:

• Acknowledge the depression. Don’t avoid talking about it. You may feel uncomfortable and not know what to say.  Proverbs 12:25 says heaviness in the heart causes depression but a good word makes it glad (paraphrased).  Provide empathy and a listening ear.
• Get them help. Depression is a serious illness that can lead to suicide, especially if there is no treatment. So, refer them to a licensed Christian mental health provider who will address mind, body and spirit. Reassure the person that getting help does not mean failure. It is a step towards healing.
• Talk to the person about their spiritual life. The person may feel like God has abandoned them. Yet, we know, God is ever present. In the middle of difficulty, God doesn’t leave us even though it can feel that way. Also, provide hope. The Bible reassures us there are better things ahead–a plan and a future. However, be careful not to use Scriptures as platitudes. Rather use Scripture to encourage and provide hope for a better day. Pray for the person.
• Support someone who wants to try an antidepressant. It may be just what they need. And remember that many antidepressants take weeks to get at therapeutic dose and be effective.
• Encourage realistic expectations. God does heal, but healing can be progressive. Change may be gradual and not immediate. In the meantime, stay hopeful and try different treatments if need be.
• Provide unconditional love and support. Let the person know that being depressed won’t push you away.  You will pray and support their treatment. You will love and care for them even in dark times.
• Suggest a daily routine even though the person won’t feel like doing anything. Get out of bed, dress and go about the day regardless of how you feel.
• Suggest exercise and positive activities. The benefits are both physical and emotional. Exercise releases important brain chemicals that are mood enhancing. Invite them to a Bible study, dinner or to go for a walk.
• Listen. No one is asking you to be a therapist but people often need to process feelings.  We benefit from talking with a friend. Be a friend and listen.
• Most of all, let the person know they can get better. My mother-in-law used to say, “This too shall pass.” A reminder that in God’s kingdom there is always a way of escape can bring hope for a better day. This present darkness will one day give way to light.

When you encounter someone with depression, examine your attitude towards this illness.  Do you stigmatize people who suffer? Do you think of them as failed Christians?  Or do you show compassion and grace?

What would happen if we made it more acceptable to talk about depression? After all, so many people struggle with depression in and out of the church. To encourage you to ask someone how they are doing, here is what happened at a Bible study I attended. One woman bravely stated that she needed prayer for depression.  A silence fell over the group. Five minutes passed and no one spoke or responded.  She glanced at the floor.  All I did was offer a word of support and encouragement.  To my surprise, three other women talked about their depression as well.  Others informed the group they were on medication.  Everyone breathed a huge sigh of relief and we got down to some serious prayer. Be ready.  Today may be your day to help encourage a friend in pain.