Depression and the missionary life
Depression and its closely-related cousin, anxiety, are complex and controversial topics in church circles even without the complication of international missions work. Yet it's a conversation we need to have, because our people are suffering, usually in silence.
Simply defined, depression is a severe, on-going sense of sadness and/or hopelessness. It's a paralytic, causing the person suffering from depression to withdraw. Physical symptoms can include excessive tiredness and difficulty accomplishing everyday tasks.
Anxiety, the flip side of the same coin, is the inability to manage normal emotions like fear or worry, or to cope with unexpected problems or setbacks. A person struggling with anxiety often has severe mood swings (with or without provocation) and can have panic attacks. Physical signs often include shortness of breath, digestive issues, tension headaches, and insomnia.
One of the reasons depression and anxiety is so difficult to treat is the complexity of the human mind, as well as contributing factors. For some people, depression/anxiety is sparked by traumatic events or life stresses. For others, it's a result of spiritual struggles or emotional strain. Depression/anxiety can be caused by chemical or hormonal imbalances in the body, often around seasons of physical change like menopause. Usually, depression/anxiety stems from several or all of these causes, in varying degrees.
I experienced my first (and worst) season of depression the year after graduating university. I went on a missions internship to Papua New Guinea and endured two months of vicious team conflict, food poisoning, kidney stones - you name it, I probably had it.
For the following six months, I was very sick from an undiagnosed illness that turned out to be re-occuring malaria. A hard relationship break-up sent me spiraling into a season of depression for about two years.
Since recovering from that dark period, I've experienced depression several times while serving on the mission field. Close team members have also struggled with anxiety/depression.
At times, I've felt like I'm treading water and holding everyone else's heads above the waves.
If that's you, painting on the happy Christian face, trying to serve God and love people and make it through the day - I understand. I've been there. And you're not alone.
If you're struggling to hold your friend, teammate, or family member's head above water and have never felt so helpless in all your life - I understand. I've been there too. You are not alone.
You are not helpless, you are not alone, and there is hope.
The hidden face of depression/anxiety
One of the reasons depression/anxiety is not identified and treated in overseas missions workers is because of shame and ignorance.
Since Christians are supposed to be filled with hope and joy, a missionary suffering from depression/anxiety can feel ashamed to share their feelings with their teammates or supporters in their home country. Or missionaries may not identify it as a valid problem.
On the other hand, often teammates, friends, family, or supporters who've not experienced depression/anxiety do not recognize the signs or may even deny the problem. I've been shocked by genuine believers I've encountered who suggested that people suffering from depression/anxiety need to "think more positively," study the Bible more, or "trust God more."
These generic Band-Aids, while helpful principles, oversimplify the issues.
The reality is people are hurting and staying silent. Until we learn to understand their struggle, we won't be able to soothe the real issues and bring lasting hope and healing.
The way forward
Jesus met us where we were at, but He didn't leave us there. The struggle is real. The dark place you or your friend are in right now is real. It shouldn't be ignored.
But you don't have to stay there. Even David, the "man after God's own heart," suffered periods of depression and anxiety, recorded for us in the Psalms. But David also demonstrates for us a healthy perspective for moving through the valleys instead of setting up camp.
1) He expressed his pain. David never pretended he wasn't hurt, confused, or plagued by doubt. He told God exactly how he felt. And it wasn't pretty.
If you or your friend have experienced pain or trauma, those feelings need to be expressed, not ignored or denied. David processed trauma through writing and music. For other people, they may need to talk to a friend, paint, or work on a project or hobby.
2) He took time to rest. Sometimes, depression/anxiety is a direct result of over-commitment or burn-out. Taking some time away to find some green pastures and "restore your soul" may be just what the doctor ordered. Step back, refocus, re-evaluate, and reduce responsibilities. Learn to say "no."
God loves to use you to impact others, but He doesn't need your ministry accomplishments.
3) He listened to others. Especially in cases where depression/anxiety is triggered by spiritual attack or emotional struggles, it's important to be listening to people who speak truth from a Biblical perspective. A pastor or counselor might be needed to work through issues in a healthy way.
4) He took responsibility. When David sinned or made mistakes that led to severe consequences in his life, he asked forgiveness from God, forgave others who wronged him, and moved on. This enabled him to neither be bound by the past or by the self-pitying mindset that can hold captive people struggling with depression/anxiety.
Key to achieving long-term victory over depression/anxiety is taking responsibility for your own emotions (people can't "make" you feel anything), setting good boundaries for yourself and others, and taking practical responsibility for life.
5) He set his hope on the character of God. We live in a broken world, and David understood that very well. He expressed the pain of living in a broken world, but he also continually came back to the good character of God and His love for us.
For some people, depression/anxiety is a season they are able to process, deal with, and walk through into complete healing. For others, depression/anxiety is an on-going struggle throughout their life (see Charles Spurgeon).
Either way, God is willing and able to bring practical hope and healing into your life or the life of your friend through many different means.
Take courage, knowing that it can get better.
You can get through this.
On the good days and the dark days, He will walk with you every step of the way. And, speaking on behalf of your brothers and sisters in Christ, so will we.