1. Depression affects every aspect of a person's existence and can have biological, situational, developmental, or spiritual causes. It is characterized by symptoms like sadness, fatigue, loss of interest in activities, changes in appetite or sleep, feelings of worthlessness, and thoughts of death or suicide. 2. While early Christian thinkers condemned suicide as sinful, more recent perspectives view it as reflecting mental illness rather than moral failure, and do not see it as automatically resulting in damnation. 3. The church can help address stigma around depression and suicide by fostering communities, remembering God's promises, providing hope through future possibilities, and embracing life's challenges alongside faith in God.

1. Depression and Suicide: Theological Reflections for Christian Ministry Kyle A. Roberts Bethel Seminary Transforming Church Initiative

2. Depression: A Definition “Depression is a disease that affects, to one degree or another, every arena of an affected person’s state of existence.” – Biebel and Koenig, New Light on Depression

3. Causes of Depressive Disorder Situational Depression Developmental Depression Biological Depression Spiritual Depression

4. What Depression Looks Like Difficulty in relationships Irritability Problems sleeping A broad search for causes and cures Fear of losing one’s mind Complex of new physical ailments Loss of energy Diminished libido Impaired memory / thinking Change in eating patterns Feelings of worthlessness

5. Diagnosis of Depression Persistent sadness, unhappiness, irritability, anger Lethargy or fatigue Loss of interest in previously enjoyable activities Sudden change in appetite Disruption of normal sleep pattern Feeling guilty or worthless Moving about more slowly or sluggishly Difficulty thinking or concentrating Recurrent thoughts of suicide or death

6. Severity of Depression Clinical (major) depression: at least five of those symptoms have been present for at least 2 weeks or longer and are significantly interfering with functioning in social settings

7. The Problem of Suicide 3rd leading cause of death for age 15-24 (5,000 each year) 2nd leading cause of death among college-age youth 6th leading cause of death for children 5-15 10-15% of people with the illness of depression (the brain is sick, impaired, muddled) commit suicide

8. Misconceptions of Depression “Many people still think of depression not as a treatable sickness, but as a personal weakness, a lack of willpower, a failure of one’s religious faith, or a shameful failure of family upbringing.” – Dr. Bill Nichols

9. “Christian” Myths About Depression “Real Christians” aren’t susceptible to major depression Depression is solely a spiritual disorder or moral failure Depression = “the Dark Night of the Soul” A depressed person cannot be a “good witness” Depression is caused by God Depressed persons should avoid medicine (psychotropic, mood stabilizers, etc.) and/or psychotherapy and should let their depression “sanctify” them Prayer and Bible reading are sufficient to end or minimize depression

10. The Stigma of Suicide in Christianity “Don’t All Suicides Go to Hell?” “Doesn’t Suicide Reflect a Loss of Faith?”

11. Augustine of Hippo (354-430)

12. Augustine Suicide is a ‘detestable crime and a damnable sin’ (1.27). Based on his interpretation of Deut. 5:17: ‘Thou shalt not kill’ (1:20). There is no legitimate reason to commit suicide (whether magnanimity, because of physical violation of chastity, or to avoid future sin. (p. 60) - Kaplan and Schwartz, A Psychology of Hope

13. Early Church Councils Council of Orleans (533) “produced the church’s first official disapproval of suicide by denying funeral rites to suicides who were accused of crimes.” Council of Braga (563) extended this ban to all suicides. Council of Antisidor (590) forbade the church to accept offerings for the souls of suicides. “ - Kaplan and Schwartz, p. 61

14. Thomas Aquinas (1225-1274)

15. Thomas Aquinas (1225-1274) “First, suicide is unnatural: everyone bears an instinctive charity toward himself and should thus desire to do himself no harm. Suicide, being both unnatural and uncharitable, is a mortal sin.” Second, “an individual is a member of a social unit….suicide is antisocial.” Third, “life is the gift of God: though it is given, it remains God’s property,; therefore, only God can pronounce the sentence of life and death: ‘I will kill and I will make to live” (Deut 32:39) - Kaplan and Schwartz, 61

16. Dante’s (1265-1321) Inferno Dante placed suicides in a lower circle of hell than murderers (the middle ring of the seventh circle) Transformed into bushes and trees Their bodies will not be resurrected after the final judgment

17. Undoing the Stigma Why do depressed people turn to suicide? They have somehow convinced themselves (or their minds have tricked them into believing) that there is no other way out of their despair They have somehow convinced themselves (or their minds have tricked them into believing) that they have become a burden to others (and would not be missed) Suicide reflects a sickness of the brain/mind, not a deficiency of the soul Suicide is not a one-way ticket to Hell

18. “The person who considers suicide truly believes it to be the only way out of his pain. It is counterintuitive to those who are not suicidal, but death feels to the sufferer like a measure of freedom in an otherwise imprisoned life, a light at the end of an interminable tunnel. Maybe I can’t get better, but at least I can get out.” - Barbara Cawthorne Crafton, Jesus Wept

19. “The pain of despair is the agony of being responsible for the loss of the meaning of one’s existence and of being unable to recover it. One is shut up in one’s self and in the conflict with one’s self. One cannot escape, because one cannot escape from one’s self. It is out of this situation that the question arises whether suicide may be a ay of getting rid of one’s self.” - Paul Tillich, Systematic Theology, II

20. The Soul is Not Sick “The soul is not the seat of sickness in the mentally ill; it is the brain, its synapses and receptors and so on, that render the mind broken. The soul, as the self in relation to God, continues healthy in anyone as long as that person is in Christ, relating to and witnessing to God.” - Kathryn Greene-McCreight

21. Suicide is Not a One-Way Ticket to Hell God’s grace is not constrained by the depths of human despair “In all these things we are more than conquerors through him who loved us. For I am convinced that neither death, nor life, nor angels, nor rulers, nor things to come, nor powers, nor height, nor depth, nor anything else in all creation will be able to separate us from the love of God in Christ Jesus our Lord.” - Romans 8:37-39

22. Undoing the Stigma “The external act of suicide should not be singled out for special moral and religious condemnation. Such a practice is based on the superstitious idea that suicide definitively excludes the operation of saving grace. At the same time, the inner suicidal trends in everyone should be considered as an expression of human estrangement.” - Paul Tillich, Systematic Theology

23. What Can We Do? Facilitate communities of connectedness, vulnerability and acceptance Keep Memory alive: Scripture as Resource Provide hopeful “future stories” that are grounded in reality Encourage a “tearful embrace” of life within the challenge of despair: Embrace the Cross

24. Community as Resource For many who are depressed and suicidal, social systems have failed them (families, friends, support networks). The church can work at providing connectedness. Too often it rejects the depressed and suicidal either intentionally or unintentionally. The communion meal (Eucharist) symbolizes the unity of the body of Christ, including without respect of persons, the “weak” and the “strong”

25. A Challenge to the Church The church must help people to not be phobic or ashamed about dependence. Of all places, the church ought to create vulnerable places for vulnerable people to share with and lean on each other in times of crisis and loneliness. Instead, we too often create an environment that is only conducive to and welcoming of the healthy, happy and holy. We must remind others and ourselves that it is only human to need help and only human to seek help.

26. The Power of ‘Memory’ “What will allow for our survival is not how we feel but what we remember.” – Kathryn Greene-McCreight Memory of the past: All God has done Memory of the future: God’s promises

27. Feeling Is Not the Essence of Faith “If we really believed that feeling is the essence of the Christian faith, then depressed Christian would be given all the more ammunition for self-destruction...It is a good thing, then, that God does not look upon us according to our feelings but according to the faithfulness of Jesus Christ.” - Kathryn Greene-McCreight

28. Scripture as Resource Psalms of lament: 3, 5, 6, 7, 10, etc. (emerge from difficult, troubled times and express the fullness of suffering: Brueggemann, Hopeful Imagination) Jesus’ redirection of our hopes (The “Road to Emmaus”: Luke 24:13-25) Biblical eschatology and hope: Resurrection (1 Cor 15) and the new heaven and new earth (Rev. 20-21) The Cross validates the reality of suffering and shows that God has entered into the deepest of anguish (and that he will continue to do so)

29. There I will give her back her vineyards, and will make the Valley of Achor a door of hope. There she will sing as in the days of her youth, as in the day she came up out of Egypt. - Hosea 2:15

30. Scripture as Resource “Put your trust in god, for I will yet give thanks to him, who is the help of my countenance, and my God.” - Psalm 42:5

31. “Weeping may spend the night, but joy comes in the morning.” - Psalm 30:6

32. “You will forget your misery You will remember it as waters that have passed away And your life will be brighter than the noonday; Its darkness will be like the morning. And you will have confidence, because there is hope; You will be protected and take your rest in safety; You will lie down and no one will make you afraid. Many will entreat your favor. - Job 11:16-19

33. “Future Stories” as Resource

34. Finding “Transfinite” Hope “The sense of hope is: there is a way out. The sense of hopelessness is: there is no way out, no exit” –William Lynch, Images of Hope “Instead of keeping the finite hope connected to or in the context of ultimate hope in the character of God, a person can allow a finite hope to claim the status of ultimate hope.” - Hope in Pastoral Care and Counseling

35. Re-imagining the Future “Caring for persons who are feeling hopeless necessitates guiding them in the exercise of the imagination. Hoping is related to envisioning possibilities in both the present and the future…Since hope is future-oriented, we must be able to imagine ourselves and our environment being different” “one of our goals as caregivers is to help people suffering from hopelessness to change their assessment of the future. - Hope in Pastoral Care and Counseling

36. “A part of the professional competence of a pastoral counselor is to provide the creative kind of relationship in which innovations, inventions and the discovery of new alternatives is a daily event. In short, this creativity engenders hope. – Wayne E. Oates, Protestant Pastoral Counseling

37. “…a true story must be one that helps me to go on.” - Stanley Hauerwas

38. Encourage a Tearful Embrace of Life “There is no free lunch: either in life or in death” Despair can live with Christian faith

39. “Suicide is not painless, not for anybody. No, God won’t send you to hell for it—there’s more than enough hell to go around, right here on earth. But there is still no such thing as a free lunch.” - Barbara Cawthorne Crafton

40. “This is an exceedingly important lesson: despair can live with Christian faith. Indeed, having despair while knowing in your heart God has conquered even that is a great form of faith, for it is tried by fire.” – Kathryn Greene-McCreight

41. Clinging to the Cross The cross of Christ validates the reality of human suffering and shows that God is willing to enter into the deepest of our human anguish.

42. For Clergy / Friends Watch for signs (tears, erratic behavior, dramatic gaining or losing of weight, suicide talk, etc. Mania: watch for flamboyant behavior, dressing, hyper-sexuality) If serious, intervene (admit to hospital, 911) Be persistent in contact (but not overwhelming) Persevere in the relationship (be a friend) Pray, offer to read Scripture