As we talk and think about the issue of depression in ministry one of the most important factors that we have in helping us determine what exactly we are dealing with is discernment.

the quality of being able to grasp and comprehend what is obscure

Discerning what type of help a person needs can be tricky. Should they see a therapist? A psychiatrist? Both? Is a recommendation for meds necessary? Are we dealing with depression, melancholy, burning out, etc? Maybe it’s all, maybe it’s some, maybe it’s none. But the act of discernment is a process and often involves multiple people helping one through their difficult journey.

In the book Depression and Hope: New Insights for Pastoral Counseling (which I mention quite a bit, is a great resource, and which I will reference and quote from heavily in this post), Howard W. Stone says:

Depression disturbs one’s most important relationships; for melancholics this may mean family members or close friends. For the mystic or hermit monk, and indeed for all faithful Christians, that most important relationship is with God. When people feel the absence of God, when they doubt, when religious ritual and service lose meaning, their experiences are very similar to the symptoms of depression.

Pastoral caregivers listen in a certain way to the words of those who are disconsolate, a way that is distinct from other helping professionals. To clergy and other professionals in ministry, despair, suffering, struggle, and adversity are laden with spiritual import, because reflection on the experience of melancholy and spiritual desolation can bring depth and meaning to those who are trying to be faithful to the call of Christ (Stone, 21).

When dealing with issues of such vital importance, you can see why discernment is key.  In fact, I would say that it’s quite rare for most people entering into ministry to have a decent understanding of mental health issues and the role of the pastor in pastoral caregiving.

In his book Stone talks about four experiences that “compare strongly to depression: the dark night of the soul, ‘accidie’, desolations, and Martin Luther’s understanding of ‘Anfechtungen'”. Fascinating stuff! Let me just mention them briefly here:

  1. Dark night of the soul: This term is in reference to the sixteenth-century spirituality, specifically that spoken of by John of the Cross. Often when this term is used the verse that is referenced is Psalm 63:1 “It is a ‘purgative stage in the contemplative journey during which worldly life loses all its attractiveness and even the life of prayer dries up so severely that the self feels utterly cut off from God’ (Bringle 1996, 333). It is a time of yearning for connection with the Other but with little perceived response. It is a period of aridity, and it ordinarily includes some flatness or darkening of emotion. ‘Dark night of the soul’ refers to the experience of being alone, of seeking closeness and a connection that is not there, of being vulnerable and recognizing one’s own finitude….But the dark night of the soul is part of the journey of faith” (Stone, 21-22).
  2. Accidie: “Early in the Christian church, the desert monks began writing of a condition they called ‘accidie’, one of the seven deadly sins. The term (also known as acedia or akedia) has gone through several transformations of meaning through the centuries. Evagrius of Pontus (fourth century C.E.) described accidie as a struggle with temptations, boredom, weariness, and difficulty maintaining attention or focus which lead to a physical and emotional exhaustion. At first ‘accidie’ was used to describe a state that afflicted the hermit monks; later, its meaning expanded to apply to all Christians. In English-speaking countries ‘accidie’ has been translated as ‘sloth’, which misses the mark. Today its real meaning seems to be a lost concept” (Stone, 23).
  3. Desolations: This concept derives from Ignatius of Loyola, who is the sixteenth century founder of the Society of Jesus. “In Spiritual Exercises, he explained his method of deepening one’s relationship with God. The Exercises were written and revised over a long period of time; his ideas for them germinated during his reading while he was in Pamplona convalescing from a war wound….In short, desolations are interior movements away from God. It is hard to read Ignatius’s description of desolations without noting the similarities to depression. Over the years various authors have disagreed with whether the two are the same. Most believe they are not identical, though the affective experience of spiritual desolations can be very similar to depression (Loftus 1983). According to Ignatius, the key theological distinction was that desolations signify a movement away from God. People can be depressed without experiencing religious desolations; they can experience religious desolations without depression; or they can experience both at the same time” (Stone, 25-26).
  4. Anfechtungen: “Anfechtungen has no English equivalent. Literally it means ‘to be fought at.’ The term refers to the despair, doubt, perplexity, and aloneness that humans experience. Anfechtungen is the recognition that God’s commands cannot be met. It includes trials and temptations that can lead to despair. For Luther, Anfechtungen was a part of his struggle over the righteousness of God and the sinfulness of humanity. Eric Gritsch suggests that Luther experienced periods of ‘anxiety ranging from simple doubts to deep depressions, which he labeled Anfechtungen’ (1983, 11). Luther contended with acute bouts of depression throughout his life. ‘I myself was offended more than once, and brought to the depth and abyss of despair, so that I wished that I had never been created a man’ (quoted in Gritsch & Jenson, 1976, 153).”

So what are we to do?

“One task of ministers, as they listen to depressed persons, is to discern what is what, and offer care accordingly. The pastoral caregiver must always listen carefully for the quiet murmurings of spirit within the words of those who are describing their depression. Is it a plaingsong? Is it a fugue? Is it a discordant cacophony? Pastoral caregivers listen to the words of the spiritually disconsolate and depressed in order to perceive which music they are hearing. And when helping them to make the cognitive, behavioral, interpersonal, or physiological changes necessary to address the depression, it is important not to forget those murmurings of the spirit, for they may indicate the sufferings of one on the path of faith. A sensitivity to those desolations, born of one’s own life in the spirit will make the pastoral caregiver more sensitive to both movements” (Stone, 30).

Our Task
You can see that our task is tricky indeed, not only as mental health professionals, but as pastoral caregivers. You may think to yourself that your are not in this role, but I would argue that every pastor, church leader, volunteer, etc. is in the role of pastoral caregiving, whether or not the title “pastor” is in your title or job description.

We are to be people who are attentive and discerning with those that God has blessed us to serve alongside with. That becomes extremely difficult when we function in a society and church culture that is moving very fast and in which we have little time to slow down and listen attentively to what others are both verbally and non-verbally saying to us.

Maybe that is why so many in the Church, go beyond the walls of the Church to seek help.

Most congregants cannot receive this personal attention in a pastor’s office, but they certainly will find it in the office of a therapist. I’m not asking that one person be totally responsible for the care of someone who is suffering from depression, but I am suggesting that we are just one member in the care team of others. Even mental health professionals approach depression from a team/collaborative effort, so why shouldn’t the Church? So what role can you play in the lives of those suffering from depression around you? Something for us to think about.


  1. Do you consider yourself in the role of a pastoral caregiver? Why or why not?
  2. Does your role as a pastor/church worker allow attentive, personal time for people? If not, how can you change that?
  3. Do you have any thoughts on the discernment process when it comes to depression?

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.