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.
