Assessing Depression
This is the 4th post in my series on Depression, Burnout & Ministry, and it is the one where I hope to provide some critieria of symptoms that might help us out if we are wondering about this issue.
There are a variety of factors and tools that one may use in assessing if someone has depression. In ministry, there were usually a few questions I may have asked a student to better assess what was going on. I still ask those questions of people in ministry, as well as in my clinical work. In my work as a Marriage and Family Therapist one of the main tools that we use is the DSM-IV (i.e. Diagnostic and Statistical Manual for Mental Disorders). Whether or not one believes in diagnosing individuals, some of the criteria they provide is very helpful in getting a sense of the symptoms that one is exhibiting.
As a pastor, leader, or volunteer in the Church you most likely will not look at the criteria in the DSM-IV, but it’s important to have a baseline of criteria that one’s symptoms can be measured against. A book that I have found really helpful is Depression and Hope: New Insights for Pastoral Counseling by Howard W. Stone. In this great book Stone says the following:
Criteria for Depression
Depression, or melancholia, is known in psychiatric terminology as major depression to distniguish it from the normal low periods that many people go through. The psychiatric diagnostic criteria for major depression lists nine symptoms, as follows:
- Depressed mood, sadeness, irritability part of each day, nearly every day
- Diminished pleasure or interest in daily activities
- Considerable weight loss or gain, change in appetite
- Significant change in sleeping patterns (The most common result is early waking.)
- Marked increase or decrease in movement (Most commonly the person physically slows down.)
- Fatigue and loss of energy
- Feelings of worthlessness or guilt (The feelings are beyond the scope of how people would usually feel.)
- Difficulty in concentration
- Ideas of suicide or death
To be diagnosed with major depression according to the American Psychiatric Assocation criteria, persons must exhibit at least five symptoms for a minimum of two weeks, and have either depressed mood or diminished pleasure or interest on most days for at least part of the day (APA 1994). These criteria are a good basis for determining if someone really is depressed. The certainly are not exhaustive but signal that a person’s story may be one of melancholia. (pp. 65-66)
How Does Depression Manifest in Ministry
I think there are many ways that depression manifests itself in ministry, but what I would like to do is mention how in a few different areas I think it has manifested for me on occasion, and I’m curious to hear from you. The tricky thing with depression and burnout is that we can experience symptoms along the spectrum without being considered clinically depressed. Here is how I experienced it at some levels, even though I have never been clinically diagnosed myself.
Emotionally: Not being able to enter into, or handle anymore conversations, meetings, encounters with people in ministry. My fuse was short and I was unable to pay attention at a certain level. It’s an emotional exhaustion. Often this mosts manifests itself at home with the people we love. We give all we have at work, but have little energy for home.
Spiritually: Not being able to pray or read Scripture. In fact, most of that was masked by ministry prayer (in meetings, services, etc.), but little of my own prayer life. Also, most of my Scripture reading was for sermon preparation, but very little of my own prayer devotion and meditation. I think this is very common in ministry, where pastors spend hours upon hours in sermon preparation and consider that to be part of their devotion and meditation.
Physically: Being so exhausted that you don’t have the energy for one more event or meeting. In fact, when you are doing your yearly calendar, your relief comes from looking at the date about 9 months out when you can rest. That is depressing.
I would love to hear from you. How have you experienced depression in ministry? Can you share some examples?
The next post in this series I will be taking a look at the history of depression in the Church and spiritual writings. But for now, don’t forget to check out the three previous posts:
Depression, Burnout & Ministry: Deciding to Get Honest About Our Journeys
Depression, Burnout & Ministry: Anne Jackson Interview, Part 1
Depression, Burnout & Ministry: Anne Jackson Interview, Part 2
Disclaimer: This blog post is not to be a substitute for professional help or advice. Please consider seeking out professional help if you consider yourself to be at risk for depression.
{ 7 comments… read them below or add one }
Rhett,
Would you give a range of time that might help distinguish between a bad day and an major depressive episode? I’ve heard that two weeks with the above criteria is a good rule of thumb. It’s certainly been true for me.
John,
That is tough, only cause I would have to really sit with a person to get a better assessment. But I think you are right…the episode has to be longer than a day here and there….two weeks, with other indicating factors.
rhett
I am a pastor of a new church and i became so depressed after they evaluated my work (in all areas as a pastor) and they gave me a very very low score. I’m almost 20 years in the ministry, planted 3 healthy growing churches. But this one really made me so depressed after they gave me the lowest score I can ever get. Now I feel that I am inadequate in the service. I feel like quitting and consider change of career or go back to a seminary. What do you think is the best option I have? I need some professional advise… thanks.
Get in touch with PastorCare. They have pastors that will walk with you through this. Pastorcare.org is their web site. Contact info for all regions is on the web site.
I recently stepped away from a job I loved to become a youth minister. I did this in part because it afforded my wife the opportunity to stay home with our two kids. I wanted this to happen as much as she did. I would have preferred to stay in my previous role but we couldn’t survive financially. Here is the problem: I do not really find joy in what I am doing. In fact, I experience a lot of stress, overwhelm and frustration. At times, I have a lot of depression, yesterday I even had flashing thoughts of my death.
I feel bad for the church (especially the youth) that I currently serve because I do not sense that I am connecting with them. I have been here approximately 3 months and am already looking for another job. I noticed one at a nearby university, this job would be very similar to what I was doing previously, it contains the ministry aspect I desire combined with the higher education component that I dearly love. Do you have any suggestions?
Soon I will be 68 years young. I have been serving in church ministry since age 12. Many people considered me too young at 12, now too old at 68.
I don’t feel old. I have served my latest pastorate for five years, since 2005. I do get tired and weary. I preach quite a lot in churches, prisons, schools, and hospitals. Depression is the common cold of mental illness. We all get it sometime.
I think I’ll keep active in service until my last day on this earth.
Prayer, appreciation from others, support from family, keeping creative with new sermons, books, and communication opportunities help keep the muscles of faith and happiness moving.
I keep in touch with young people by offering counseling at a substance abuse treatment center and in our church. For more thasn 12 years I have also served as campus minister for a community college. I wrote a book called Passionate Joy: Building a Wealth of Joy in a World Starved for Love.
Norman Vincent Peale anonited me “minister of joy to the world” during one of his Schools of Practical Christianity. Those video tapes in my brain of the joyful times help during the valleys of life.
ok I left a youth ministry I loved to join a church I felt led to volunteer in. after couple of weeks in the choir, i feel so overwhelmed by the new system . I usually have been leading or directly affecting lives but due to the new church protocols, I am very limited. I feel tied and not enjoying everything . I cant go back coz God did not ask me too. I cant force my style on others as well. prayer /Bible study has significantly dropped. any advice.