Responding to Depression as a Church (Session 2)

BCUK Conference (Edinburgh) 2019 - God and Depression - Part 2


Andrew Nicholls

Sept. 28, 2019


Disclaimer: this is an automatically generated machine transcription - there may be small errors or mistranscriptions. Please refer to the original audio if you are in any doubt.

[0:00] And if we had time, and perhaps you did have time in that lovely long coffee break to share something of your story with someone, perhaps an old friend, perhaps a new friend, and in that experience we begin to discover or rediscover some of what church can be.

[0:20] And we're thinking about that as we come into session two. How do we respond to depression as a church? And I want to split this session really into two bits.

[0:32] How does a person get depression, and then how does a person get help with depression? And in some ways this first bit belongs in the first talk, but I think put them together in the same one because the convictions you have about where depression comes from greatly impact what you think you need to do in response to depression.

[0:50] So if you think that depression simply arises because something goes wrong in your brain, then you'll be looking to put things right in the brain. If you think depression simply happens because something in your life has fallen apart, you'll be looking to try and repair that.

[1:04] The way you think people get depression has a huge impact on the way you think it's right to help. And so by putting them in the same talk I'm trying to help make some of these connections for us.

[1:15] And it's pretty important that we avoid simplistic explanations. I hope that'll be clear by the end of this. One of the things that I learned profoundly helpful for myself, and I try to remember it and I probably don't, and I need good friends to tell me when I've forgotten it, is that the word just is a pretty poisonous word when we're talking about anything important.

[1:35] That is, if I were to say, the thing with depression is it's just unbalanced neurochemistry, it's woefully simplistic.

[1:47] If I were to say, you just need to pray a bit more, that's woefully simplistic. If I say, you just need to take this medication, or it's just spiritual failings, you just need to repent and believe, that word just.

[2:04] Where there's an element of truth in it, it's buried in a whole load of stuff which is just not fit for purpose. And I would like to ban my own use of the word just, and you may find that a helpful thing to do for yourself.

[2:18] If I'm just saying, you just need to, or I just think, then before you articulate that, why not have a think about whether what's about to come out is perhaps a bit simplistic.

[2:29] And if you're someone that's been on the receiving end of simplicity, then the next time you get a chance to talk, you could share what it's like to feel just corrected.

[2:41] People are complicated. This is why simplistic solutions are no good. People are complicated because that's the way our creators made us. And you will recognize easily that we have these three parts, if you like, to our being.

[2:54] We have emotions. We'll felt some if we were connecting in any way with what Steph was just singing. Let there be light, Lord, is a thought.

[3:05] But it carries long emotion with it, that sense of longing, that sense of desire, that sense of not yet, but can I hang on? And in consequence of my thoughts and my emotions, I make decisions.

[3:17] And the way in which these three things interplay with each other is not straightforward. It's different at different times and different issues. And if you see the human being as basically a complex interplay of these three separate things, then you would begin to start addressing things to correcting thoughts, like cognitive behavioral therapy that's designed at addressing people through the window of their thoughts.

[3:42] If the problem is emotions, you might focus on providing emotionally supportive psychotherapy, or if it's about decisions, you might just tell them what to do.

[3:54] But in Bible thinking, although the thoughts and the emotions and decisions are all there, the language that the Bible uses is to tie them all together in a central idea.

[4:06] The Bible uses lots of words for that central idea. The one I think is most helpful and most sort of sticky is that word heart. The center of every human being has is a heart.

[4:18] The heart is that capacity I have to worship, to long, to desire. All human beings make something, our goal, our drive, our central thing.

[4:32] We can't be human without it. And that thing that is in my heart, or my soul, or my psyche, in my core, in the end has the main powerful determining effect on my emotional response to things, on the things that I think about myself and about life and on the decisions that I make.

[4:55] I make decisions in pursuit of what my heart wants. I'm happy if I get what my heart wants. I think about how to get what my heart has set itself on.

[5:07] So at the very center of the human being, at the center of each one of us, is this responsive, relational heart that has a capacity to control every other part of our being.

[5:26] But that heart lives in a body. We are embodied souls, and we are ensouled bodies.

[5:41] And for as long as I'm alive, part of what it means to be alive is that the only way you can relate to my heart is through my body. If you want to say something to my heart, you're going to have to use my ears, and you're going to have to do so in a language that my brain can process and connect with what's really going on in me.

[5:58] If I'm deaf, before you say anything, you're going to have to find a battery to my hearing aid. There's no way to access the heart except through the body or my eyes or my arms.

[6:10] You come and give me a hug. You're not just doing something with my body. You're doing something to my heart, but you have to use my body to get there. And both our heart and our body are great gifts of our creator, and they both matter deeply.

[6:28] He sustains our bodies with great care. He gives us tea and coffee. He gives us biscuits from M&S. He gives us whatever you just sustained yourself with in the break as part of his love and provision for us, because he cares about our bodies.

[6:43] Just as he cares about our souls, we are body and soul, and soul bodies, embodied souls. And there's one other bit to add to that picture, which is a bit in which we live, the world in which we live.

[6:56] So we're not only embodied, but also embedded in a culture, in a world. Things happen to us from outside. Things happened to us in our past because of the world we were living in.

[7:10] Right now we live in a cultural moment, and depression has a place in our culture, and we live in that world in which depression has that place in our culture. We can't escape that.

[7:20] We can't pretend that we live in another world. We don't. And in order to begin to think about how you respond to someone with any kind of issue, unless we are willing to take all three parts of what it means to be human, that is our heart, our soul, and our body, and the world in which we live, unless we're willing to take them seriously, then anything will end up being simplistic.

[7:48] Let's take a different kind of mental illness, because it's easier to see the connection sometimes. Let's take an illness like anorexia. Anorexia is much more common in the Western world, where Western culture has decided that the desirable way to be is to be thin.

[8:08] You don't get anorexia in cultures where it's healthy and desired to be fat. It's just unheard of. And even the word thin and fat is probably expressing my own distinct to which I've taken in a culture.

[8:23] But the point I'm making is that it's the cultural norms, which are the essential background without which anorexia doesn't develop. So that's the world. That's what it means to be embedded.

[8:34] But then there's a body involved in anorexia. If I'm desperately underweight, that is going to affect many, many things about my normal function.

[8:47] It's going to affect my mood. It's going to affect my... Almost every mechanism of my body, if I'm not getting enough nutrition, is going to start to fail.

[8:59] And that's going to spiral in on the way I feel about life in general. And it's not just because... Some of my thinking is wrong. It's because my body has become very unhealthy.

[9:11] But at the heart of that, there's a culture which is informing my thinking. Then there's a body which is affecting the way I experience the world every day.

[9:21] But somewhere at the heart of some of the anorexia is someone who's making choices. There is a soul living itself out in relationship with God and neighbor constantly.

[9:32] And so even though it's very important not to consider anorexia separate from culture and not to ignore the effects of a body, it's also important not to ignore what's going on in the soul or the heart of a person.

[9:43] And if that's obvious in something like anorexia, then it's no less important in something like depression. In depression, all three things matter. We're asking a question, how does someone get depression?

[9:55] The answer is we need to answer that question. My thinking about all three bits of what it means to be human. We need to think about what's going on around them in the world. What's come out at a person?

[10:06] If someone's just experienced a bereavement, if someone's just experienced a sudden redundancy, if someone has just experienced being stabbed in the back by a friend at work, if someone has just opened an envelope with terrible news in, that's going to affect everything about them.

[10:24] It's what comes at us as relevant depression as anything. But also, the way our body functions, I'm going to say a bit more about that in a moment.

[10:34] The way our body is functioning, the way our brains are functioning is hugely important in depression, the food we're eating, taking into our bodies is very important. The exercise we're getting is, Steph was saying, these things all have a big impact in us.

[10:48] Our bodies matter. They affect us deeply. And yes, in the heart of a person, decisions are being made too. Priorities are being lived out. One of the great simplifications that people make in responding to depression is to assume that it must in the end all tie to some great sin.

[11:12] And that's almost always wrong. It may be the most significant cause of depression, but almost always it's not just one thing. It's lots of things.

[11:23] Why did they do that particular thing? Almost certainly the culture in which they live worked out in their body will have had a big impact on the choice to do that particular thing, even if that was at the heart of it.

[11:35] We'll think a little bit more about that at the moment. The point I'm trying to make is that all three things are in a complex interrelationship in any human being all the time.

[11:48] And if we're trying to think then about how we get help with depression, it's important to think about all of those things rather than focusing on one.

[12:01] Now I say that before I come on to the very important question, which lots of your texts did in question so far have been about, which is the issue of medication. What about medication is one of those things which ties us up in lots of confuses.

[12:19] We get asked questions like, is it wrong for a Christian to go and take antidepressants? Hopefully you're beginning to think already in some of these ways.

[12:30] Let me describe this person. I'm not actually going to get you to discuss it where you are, but think about this person. Your friend Alice has been feeling low for four months, but more so recently.

[12:43] Her GP says she has a moderately severe depression and wants her to start on Prozac, classic common antidepressant. But Alice doesn't believe drugs can be the answer. It can't just be about brain chemicals.

[12:54] I want to know what caused this, she says. With her doctor urging her to start medication, she doesn't know what to do and turns to you for help. What will you say?

[13:04] Will you feel sympathetic to her refusal to put it all down to brain chemicals and say, well, I'm sure it's okay not to take them if you don't want to? Will you feel concerned that she may be on the point of rejecting the advice of a healthcare professional who may be offering her something very important, perhaps even a gift of God, to help?

[13:28] The simple version of what's often felt to be going on under medication is that one of the factors, or in some people's thinking, the problem at the root of depression is that there is a chemical imbalance in your brain.

[13:41] And if you push this too hard, it sounds like we're saying the cause is that your brain's not functioning properly. Here's a very oversimplified but still very complex picture of just one junction between the wires that make up your brain and your whole nervous system, of which there are billions.

[14:03] And one wire, neuron, doesn't join onto another wire with a kind of screw terminal. There's a little gap there. And if a signal comes down the top neuron, it doesn't automatically jump onto the next neuron.

[14:17] The way in which it's transmitted from one neuron to the next one is mediated through a very complex process of neuro-transmitters. And they get released from the end of the neuron that's firing and detected by the end of the neuron that's receiving the receptor.

[14:33] And if enough neurotransmitters of the right kind are detected, then the neuron will fire. But there are lots and lots of different neurotransmitters. One neurophysiology supervisor said this, the complexity of the central nervous system and the relative lack of specificity of our drug's means are efforts to treat people with psychotropic drugs, antidepressant medication included.

[14:57] It's a bit like trying to mend the engine of a car using only a hammer. If I take my car to a mechanic, I'm hoping they've got a rather more sophisticated set of tools than that.

[15:08] But that comment is that our understanding of how the brain works is not yet very advanced. You've got 86 billion neurons. So you've got 86 billion minus one connections between you.

[15:20] Actually, you've got more than that because one neuron collects too many more than one neuron. So you've got an incredibly complicated web. And at each junction, you may have more than 100 different neuro-transmitters being released, being taken up, modifying the connections from one to another.

[15:39] And the most of the common antidepressants that are prescribed these days are called SSRIs. And the first S is actually another name for what's on that slide as 5-ht.

[15:50] It's called serotonin. And the drug works in some way to increase the amount of serotonin in that space between neurons.

[16:03] Now, don't worry if you don't understand it. It doesn't please you. I just want to point out that we currently think there are at least seven different kinds of serotonin receptor. And those kinds have subtypes.

[16:13] And there's no way we yet reflect that complexity in the sophistication of the drugs we use. It is like trying to fix an engine with a hammer. We've got a drug. We know it does something, but it's nothing like a sophisticated as the anatomy and the neurophysiology that God has given us.

[16:27] It's very crude and understanding is still very basic. So then we have come back to that question. Is it true that antidepressants treat a chemical imbalance?

[16:38] And it's not a simple question to answer. I mean, they are certainly capable and almost certainly do work by adjusting the chemistry of the brain, but does that imply that they were imbalanced to start with?

[16:56] And if they were imbalanced, is that because they were the cause of the problem or because they had changed in response to something else that was wrong?

[17:10] One of the great problems with stuff in the brain is that you can't do a blood test for neurotransmitters like you can do a blood test for insulin in someone who has diabetes or glucose.

[17:21] Most people don't really enjoy having needles stuck into their brains in order to, and even if you could, you can't really see where you're putting it. It's a kind of mush and it's very difficult to do the research.

[17:32] But even underneath that, even if you could, that important question is there. Does my neurochemistry, does the balance of my brain transmitters, is that what makes me who I am?

[17:45] Is it my brain transmitters that make me put a smile on my face or make me feel a bit nervous in front of a crowd? Or is it the crowd that makes me feel nervous and you can see that in my brain chemistry?

[17:57] If I'm feeling joyful and you put me in a brain scanner, you'd see my joy on the scanner. Is that because of my brain or is it because of what I was thinking about under the scanner?

[18:10] And even if we could map all the chemical activity of the brain constantly and even if we had the drugs to manipulate it to within a very fine degree of accuracy, we still wouldn't be answering the question of what made them that way in the first place.

[18:30] And there's a way of understanding neurophysiology which is built on the assumption that we are essentially just a bag of chemicals. And to understand what it means to be human, you just have to understand those chemicals in the finest detail.

[18:44] And the Biblical understanding of human being is we are beings, relational beings created by God, given a body in which to live out our relationships with human people. And the quality of my relationship with God, if I'm thinking about singing how great thou art, you'll see that on a brain scanner.

[19:02] But that doesn't mean that God is a feature of my brain chemistry. So when your brain chemistry is recording that you're depressed, it may be helpful to correct the brain chemistry.

[19:19] But that doesn't mean I've found the cause of depression. You may well want to ask more questions about this when we get on to the question time. And I know we've had plenty of it.

[19:29] And certainly antidepressants are being used very heavily at the moment. In 1991, there were 9 million antidepressant prescriptions. By 2011, that had risen to 46.7 million antidepressant prescriptions.

[19:44] And currently 25% of all NHS prescriptions are for mental health problems, of which the largest proportion would be antidepressants. Now here are two helpful analogies, I think, which are not susceptible to the charge of being over-simplistic.

[19:58] And giving antidepressants can be a little bit like calming a sea. If there is some problem deep in the ocean and there is a raging storm, the dive boat has to stay in the port.

[20:10] Can't go and investigate what's going on because the storm is too great. But if you could find some way of just calming the waves down a bit, then you could take a boat out and go under the surface and see what was really going on and fix the oil rig or whatever the problem is.

[20:26] So antidepressants can function a bit like that, calming of the sea. That if there is a storm of emotions going on or my brain is completely fogged out by a depression which has overtaken me.

[20:39] For some people, for Steph's wife, for example, it may well be that taking antidepressants helps get to the place where it becomes possible to do some serious work under the surface of a person in counselling.

[20:53] So antidepressants may be of benefit on their own. They may create that capacity to investigate beneath the surface in a way that the rage of depression makes impossible because someone can't listen to a sentence because the depression is still storming.

[21:11] People can't find words to speak because the depression is still raging. If we could calm that down, then the things that need to be discovered and spoken about can be explored more successfully. Or another picture that might help is the provision of a walking aid.

[21:24] The idea that's very obvious when I have, my father's just had a new hip put in on Wednesday and it's very obvious that he needs a frame to walk with right now, a frame or crutches.

[21:35] He needs something. If a bit of your body is broken, it's great to have help with it. But sometimes when we injure our leg, we don't need a crutch.

[21:46] Sometimes we do, sometimes we don't. Sometimes I've stood on a bit of Lego, I probably don't need crutches for it. I just need to wait a few minutes and the pain will go. Sometimes the crutch gets in the way.

[21:57] If you've ever tried to watch for something crutches, it's very difficult to pick something up off the floor while using crutches, isn't it? Sometimes the crutch inhibits what you're doing. Now you just have to accept that if you need crutches, then you need them.

[22:08] But sometimes we could go on using the crutch for too long. And we get to the point where throwing the crutches away, something on which I've become independent, is difficult and walking hurts for a bit, but in the end, throwing it away will be good for me.

[22:22] Sometimes the injury is so bad we need the crutch for life. I'll never be able to walk again and I'm just going to have to get used to life with crutches. But still we know that the best way to walk is to be able to walk without one, if I could.

[22:36] And the best way to live is to be able to live unmedicated in the presence of God, responding to Him and to other people in the way that I was made to do.

[22:47] And we're looking forward to that day. But it may be that some of us are greatly helped by God's provision, just as He's provided opiates for pain in poppies and digioxin in fox gloves and aspirin in willows.

[23:05] God's provided antidepressants as a crutch to help us for a time until we don't need them anymore.

[23:16] And it's a matter of wisdom and medical expertise to work out if I need them, whether I need one or two, and how long I need them for, and when's the right time to start putting them away.

[23:28] I don't know if you find that a helpful picture. It helps me. You can't have that kind of interaction if you think that it's all to do with brain chemistry because if it's all to do with brain chemistry, then I might as well just take the pills to keep the brain chemistry sweet.

[23:44] But if it's not all to do with brain chemistry, then I can maybe use the pills to help me get in a place where I can address some of the other factors that may be going on. If I can get a bit better antidepressants and get out of bed and have some exercise, that may really help my body.

[23:58] If I can have antidepressants and get into a serious counseling relationship, that may really help my soul. If I can take antidepressants and read the Bible or listen while someone reads the Bible to me, that might be the beginning of growth in a relationship of the most important kind of all.

[24:14] Now, if that's how a person gets depression, it's something to do with the soul, something lived out about me and the decisions I'm making and the commitments I'm making.

[24:24] If it's something to do with the body and the way that my brain functions, the way my nerves fire, and if it's something to do with the stuff that's going on around me that impacts me, that I have no control over but is firing at me all the time, then we're in a position to begin to ask, well, how can a person with depression be helped by the church?

[24:42] And the thing I want to begin answering this question with is saying very simply, that church must know Jesus.

[24:52] That is the distinctive help that a church can give in the end in its highest and purest form, in its most powerful and distinctive is the way that we help each other grow in our relationship with God.

[25:08] That's the most important thing about any human being. The most important thing about any human being is not whether I can walk into heaven. The most important thing is whether I'll be welcomed when I get there.

[25:22] And that means that I need to be forgiven by the blood of Jesus Christ. And that means that the most important thing about me now is my relationship with God revealed in Jesus Christ.

[25:36] So for a church to be as helpful as church needs to be, first we must know Jesus. And what we must know about Jesus is that he knows our struggles and speaks into our struggles and even uses our struggles.

[25:54] We're not yet thinking about what we say to someone with depression. We're thinking about what a church needs to know in caring for people with depression. And the first thing a church needs to know is Jesus.

[26:06] Our relationship with Jesus is going to be the foundation of all the help that we give. So first of all, Jesus knows our struggles.

[26:17] As we know Jesus, we need to know that he is someone who knows our struggles. Jesus is interested in us and suffering people. He deeply understands us as suffering people. And the reason is because the world over which God and the Lord Jesus are sovereign is a world in which there is a kind of a built in brokenness right now.

[26:34] Here's from Ecclesiastes. What has a man from all the toil and striving of heart with which he toys beneath the sun for all his days are full of sorrow and his work is a vexation?

[26:45] Even in the night his heart does not rest. That's part of what it means to live in the world that Jesus understands so well. Or to add Psalm 102 to the Psalms we were looking at earlier on this morning.

[26:55] My days vanished like smoke, my bones burned like glowing embers, my heart is blighted and withered like grass. If yours is the kind of church or the kind of Christianity that seems to give the impression all the time that the world is already being fixed, then we won't be any help to people with depression.

[27:13] This is what the world is still like. We're still waiting for the return of Jesus. So we must know that Christ knows that is our situation now. And that is the world he sends us to help before it gets fixed.

[27:28] So he knows our struggles. Secondly, he speaks into our struggles. You can take each of those pictures that Manel used in that book when darkness is my closest friend, and you can match the truth from Scripture to each of them.

[27:45] Again, I'm not saying that what you do when you're talking to someone with depression, as soon as you've heard them talking about despair, you find the verse in which Christ brings hope and it's fixed. I'm not saying that. But this is a conviction that church needs to have.

[27:57] In Christ are the things that will make a difference because they do change our sense of reality in the deepest possible way. Make it possible to write songs like Steph just sang.

[28:10] Where we are despairing, it is not our despair that has the last word. It is Christ who has the last word. And he says there is no unhappy ending for any one of his children, and it will end with him in glory.

[28:24] We must know that. It may be months before we can say it in any form. But we must know that's true so that when we see someone struggling with depression, we are not despairing, that there is no hope for them.

[28:39] Doesn't mean we tell them to stop despairing. This is what we must know. There is an answer in the Gospel. How we bring it, I'll get to in a minute.

[28:49] Shame. When people feel ashamed, we need to know that Christ accept us, but we don't just say, oh, it's okay, Jesus accept you, I don't know why he feels so ashamed. Jesus interrupted a very important journey to go and raise a girl who was dying.

[29:04] In fact, he let her die because he was delayed by a woman who was bleeding and in a sense dying of shame. And he took time not just to heal her, which the lovely way the story is told, it was kind of accidentally that he just felt his power go from him.

[29:22] Of course he knew, but he stops and he turns and he says, who touched me? And he wakes everything wait and delay and eventually she comes forward so that he can say to her daughter, your faith has healed you.

[29:34] And so it's not just that she stopped bleeding, it's that the fact that she was an outcast and damaging in shame, Christ is over her, that as far as he's concerned, his relationship with her is now daughter.

[29:47] And he takes the time to deal with her shame. Christ accepts all of us, whatever our shame, but it sometimes takes time.

[29:58] A great deal longer than it took Jesus sometimes to be effective in helping people understand what that means, especially if their brains aren't working very well because they're in a deep depression. They can't just see that it's them, they can't just see it's personal, they can't just see that it's real.

[30:13] Christ speaks into our guilt with forgiveness. The relationship between depression and sin is one we're so prone to draw in wrong places.

[30:23] Depression is usually not simply caused by sin. It may be, as I've said, if someone has done something terribly wrong and never faced up to the guilt of what they've done, then it may be that the first other people become aware of this is that there's a depression taking over their life.

[30:47] But usually, depression is much more complicated and complex than that, and it's not possible to drive it back to one thing that they've done in the past.

[31:02] Depression is never a cure for sin. So just because someone has depression and taking the tablets to prove it, it doesn't mean that in their souls they aren't still living out a life which is as affected by sin as everybody else.

[31:15] Now, the way that you address the sin of people suffering from depression must be governed by love and gentleness and patience and all the other things which are enjoined on all of us as people in a church.

[31:27] But if we don't help people by labelling all depression is caused by sin, we similarly don't help people by pretending that people have depression have got no one going sin.

[31:37] We are, in fact, all alike, rescued from our sin and continuing to sin, unloved anyway. So exploring people's relationship with guilt and sin must be part of what we know and part of what we try and address with people over time.

[31:52] Jesus Christ declares your sins are forgiven, and as we work out what those sins are, we need to go on rejoicing in His forgiveness.

[32:03] Now as I've tried to say throughout this bit, what you know and what you say will be very different. These are convictions that we must hold and rediscover and keep coming back to because the experience of depression and understanding what's going on in the depression and the life of other people are likely to make us question some of these things.

[32:26] We need to know the God of Scripture and know the truth in order to be able then to think about what would be a next step to take in helping someone who's suffering with depression in discovering more of that for themselves.

[32:42] Now here's another thing that we need to know but be very careful about using. Jesus Christ uses our struggles. He does. Here is James chapter one. Count it all, join my brothers, when you meet trials of various kinds.

[32:53] But you know that the testing of your faith produces steadfastness and lets steadfastness have its full effect that you may be perfect and complete lacking in nothing. You can imagine how desperately wrong it could go if you try and use that verse quickly with someone struggling with depression to count it all joy.

[33:09] That's the answer. Yes, the Bible knows that we go through troubles of various kinds but here's the answer. James chapter one verse two, count it all joy. Off you go, job done.

[33:21] James isn't expecting us to start speaking in those kinds of ways when he writes it like this. There's a much more complicated thing going on here. First of all, the word count it all joy is not the same thing as saying cheer up.

[33:35] Count it all joy is about saying those things, you know in your life at your moment you've got all these things going wrong and it hurts so much and it's so difficult and they function to you as indicators that life is falling apart.

[33:46] You're facing trials of various kinds and you feel like you're drowning. You know you feel that those are all the things that are wrong with life and that despair and doom and disaster lies down that way. Do you know it's possible if you know that God is sovereign and that he loves you more than anything, it's possible, it's possible to begin to move some of those things away from the category of disaster the world is about to end to fulfilling a purpose of God.

[34:10] That I don't have to only respond to the kind of disasters that which I feel my life surrounded by feeling that this must end up in the grave separated from God forever.

[34:22] In fact, a life of faith is about learning to grow in the capacity to move those things which seem like problems over into the category of things over which God is sovereign and which God is using to fulfill his purposes.

[34:34] And you know it's a very hard thing to grow steadfastness in me. It's a very hard thing to grow steadfastness in you because I'm wobbly and fragile and actually I won't become more steadfast just like a tree won't become more steadfast and as the wind blows and makes its grow its roots I won't become more steadfast unless someone who really knows what they're doing allows winds to blow over my life so that I become more and more dependent and more and more certain of the things that God tells me are true.

[35:01] It doesn't happen just because someone says, cheer up. It happens because the things that are contained in verses like that gradually seep through and they mean more and more.

[35:12] And as my life goes on I find it possibly in ways I didn't know that the things that would hit me like a disaster, I can begin to see glimmers of hope that I can have confidence that a God who is sovereign and a God who loves me may be working out for something else.

[35:27] Christ does use our struggles. There are lots of other passages in the Bible that talk about that but they're very dangerous ones to use with people in depression. And Job and his friends ought to be a great warning to us in that.

[35:42] And the real reason is because we have no idea what's going, we have no idea what God is doing. We have no idea what God is doing behind the scenes. Eliphaz is the first of Job's counsellors to speak.

[35:54] After their days of silence, Job's life, I mean if anyone was entitled to be in mourning and grief, Job was because he's lost his children and his wealth and he is desperately, desperately sorrowful and with every justification.

[36:13] And we know because we know the book of Job that the reason why that's happening is because of something that God is doing behind the scenes but Job never gets to find out.

[36:25] Eliphaz has the answer. He says to Job in Job chapter 4. If someone ventures a word with you, will you be impatient? But who can keep from speaking? Think how you've instructed many, how you've strengthened feeble hands.

[36:37] Your words have supported those who stumbled. You've strengthened faltering knees but now trouble comes to you and you're discouraged. It strikes you and you're dismayed. Should not your piety be your confidence and your blameless ways your hope?

[36:48] Here's the killer. Consider now, who being innocent has ever perished? Where were the upright ever destroyed? As I've observed, those who plow evil and those who sow trouble, reap it.

[37:01] So in other words, Eliphaz is convinced the reason why Job's life is falling apart is because he's done something wrong and he can't help but say it and he thinks he's helping Job to say it. We know the exact opposite is true.

[37:12] So he's a friend of Job who's trying to help Job who's operating off completely false data and doing great further damage in Job's life and God has very stern words for Eliphaz and his other friends because they get so wrong what God is in fact living in Job's life.

[37:30] So whenever we think we know more than the generalities about Christ who knows our struggles and speaks to and uses our struggles, whenever we begin to feel we have a growing sense of how that looks in individual person's life, beware Job's friends because they thought they knew and they were very badly wrong.

[37:46] Be very wary of giving specific diagnoses and understandings which you're going to use now to do surgery on God's behalf in someone.

[37:59] These are things that the church must know. Christ knows, he speaks to, he uses our struggles but we're going to be very careful about how we engage. The big thing for church is this is not working.

[38:17] Can you advance the slide from the back? Thank you. I'll try it again in a moment. How can a person with depression be helped by the church? Secondly, well the church must care for the week. Now this may seem an obvious thing to say but in churches which are committed to church planting, in churches which are committed to personal growth, in churches which are committed to radical discipleship, in churches which are committed to a great experience from the front of church, in churches which are committed to growing in our knowledge and love of God, in churches which are committed to Bible studies and so on, there is a separate commitment which doesn't necessarily fulfil by any of those.

[38:55] That is a commitment to care for the week. Those who don't automatically, naturally, easily engage with any of those things because they just feel too weak to do so.

[39:06] In Munkeringness chapter 12, we discover that God gives all kinds of different people to His church family, people who can do lots of different kinds of things in the church family and we also discover in Munkeringness chapter 12 that God gives people who are weak, who can't do very much to a church family.

[39:23] God does not say that what you do with those people is you put them on the edge of the church family somewhere while you get them with the real business of church which is about planting churches and getting them with your radical discipleship agenda and you leave those people there because they can't be involved.

[39:36] What He says is that people who are especially weak need special honour in the church family. People who are weak and with special needs of one kind or another don't prevent the church from being the church that God wants it to be.

[39:50] They make the church what God wants it to be because He wants it to be a church as it's planting itself and multiplying and serious about following Jesus that is planting a caring community and follows Jesus in His care of weak people.

[40:05] Church must be committed to caring for the weak of every kind and those who are struggling with depression are among those. They talk about themselves in the words of Psalm 88 as being in a pit, as feeling utterly lonely that they have no friends, they have no resources, they're crying out and no help is coming.

[40:26] Well, the church must be willing to be there for them. Whatever else is on the agenda of our church family, God asks us to care for these people. A friend of mine was a pastor of a church and his wife had a very serious depression following the death of her father so that was a problem in the world that led to problems in her soul that she experienced also in her body.

[40:53] She was able to say that it was as if he had gone down into the pit with her. That's a wonderful way to think about what it means to be a caring, loving person in a church.

[41:06] Get down into the pit with the person who's suffering. But a thing to add to that, sorry, a thing to add to that would be this idea of being with them but just slightly ahead of them.

[41:19] In other words, you don't want to give the impression that your experience of life is exactly the same as theirs. You're so committed to being with them that it's okay for them to know that you have a little bit more hope than they do.

[41:32] In fact, in those times when they can't pray because they're no longer sure if God is there or God is real, for them to hear you pray in a God you clearly still believe in, a God you clearly know still loves you, a God you clearly have confidence in to be able to understand and care for this person that you're with.

[41:52] That may be a great ministry to them. They may not even be able to summon the energy to say amen with you, but you're there with them and it's as if they can borrow your faith. So you don't want to be so far ahead that you give the impression that you're just about to win the race and they're still sitting in a wheelchair, but you're walking slowly with them, maybe pushing the wheelchair or you're walking alongside them while they wheel themselves in the wheelchair until their strength grows a little bit more.

[42:19] So we're not miles ahead, maybe a step ahead, maybe a little ahead, that's part of what will help them. Part of what will help them see that a different way to live is possible and it's not that far ahead of where they are.

[42:30] I find that a helpful picture. In the general business of helping people, I think this quote's helpful, I should warn you says a man who found himself curled up on the floor of a room in a psychiatric hospital of depression, he says, I should warn you that it's likely there will be times when your office of help will not be wanted or appreciated.

[42:46] You'll probably do or say the wrong thing. Please rest in God's grace and keep loving that person, whoever they may be. The capacity to share in that kind of way your experiences of weakness and be willing to be rebuffed, to try to love somebody and find that they don't get it.

[43:07] The willingness to try but then try again as we learn more of what to do. We'll all need that as we learn what it means to care for each other and we'll need to be willing to give each other the space to fail.

[43:19] If ours is a church, if ours is a church family where we're used to sharing weakness, where it's no surprise that people are struggling with all kinds of things all the time, then it'll be a much easier place to have depression than a church where it looks like everybody's on top of the world all the time.

[43:36] That's why it's so precious to see testimonies from people like Lindsay and Katrina and to give thought to how we let the church know that those people are in our church too.

[43:49] Then what practically can a church do? We can think about this in the same areas as where does depression come from? The world, the culture around the body and the soul and some just practical things that church can do.

[44:05] We can surround the person with love. We can help change the culture in which they live because there are all kinds of problems coming at them from outside. For them to know that people understand what's going on in their lives, to have seminars like this are a brilliant way to care for people with depression because people know that we understand.

[44:24] Part of what Steph was saying just now was that he was so delighted that there's this kind of thing going on because it makes the world a difference to people who are suffering. To grow understanding of a church culture changes people's world, changes the world in which they live, changes their environment.

[44:40] To stay involved with someone, to know and be known by them, that is to know what's really going on in their life and to let them know as they're able to deal with it what's going on in your life, to build deep relationships, changes their culture, changes their world, changes their reality.

[44:53] It's very easy in depression to find out that the problems are deep and then disappear and find someone easier to put right. What the church is being asked to do here, what helps really change someone's reality is if we seek God's strength to stay involved in the long term.

[45:12] When people are in need, often the immediate response is provided by those who are closest, perhaps a spouse or a child or a parent.

[45:25] One of the hardest things for that person to do, partly because they don't really know what they're doing themselves and partly because they're exhausted, is to find other people to help. What a church can be brilliant at doing is to help recruit help.

[45:37] Church is a team, it's a body, it's got many parts. As we care for the week and understand more and more about what that means, we can be those who are looking around in the church body, always trying to recruit people, not necessarily from a specialist team who do all the caring, but as we grow a church that's more and more able to involve different people in that work, then we'll find that other people are not getting exhausted.

[46:01] What does it mean for a church to do in caring for the body? That's some thoughts about well in caring for the body. Well, very importantly, to encourage thinking about things like the life of matters of lifestyle, like diet and exercise and time management, are helpful.

[46:18] Everybody that, many people that experience depression, find that when they're able to begin to build these things back deliberately in their life, it's another step forward. For a church to know that and be part of it, perhaps help someone develop a bit of routine, perhaps walking a dog with someone, perhaps investing time for coffee with them, not just for the conversation, but because actually if we put the appointment in at 10, that means that we may be able to help them get out of bed a little bit earlier and build those routines in.

[46:43] It's about valuing care for the body, things that we know make a difference. In that category, engaging with the GP is really important. A GP is able to bring all kinds of other helps, including those of antidepressants.

[46:56] We're not experts. I'm certainly not an expert. Most of us in church are not experts at all in how really to care for the body, how to care for brain chemistry. Although I've said that medical profession is a long way off, a very sophisticated understanding of how it all works, they're no great deal more than us and they can do a great deal to help.

[47:13] Medication can transform the experience of people with depression. Church needs to recognize that God's given us our bodies that can malfunction by encouraging care of the body, including done by GPs and the rest of the health service.

[47:27] What does it mean to practice excellent soul care and we could have another week's worth of input here? Match to someone's capacity at this stage of their life, we're essentially committed to listening so we know where they are.

[47:41] We're committed particularly to working out what's really going on in their heart. As we understand and as we love them, as they're part of scripture, we can read, verse and pray.

[47:52] Can we speak to reassure them that we're always going to be there for them? What do they need to hear from us? Of course, we can be praying as a church family constantly. As well as doing those things for the people that we're caring for, who we know are suffering from depression, we need to do the same things for the carers because one of the risk factors for struggling with depression is caring for a close family member who has depression themselves.

[48:20] If we can think about impacting the world and the body and the soul of those who are doing the caring, even just reminding them that they are fulfilling such an important part of God's desire for this church family in giving all their resources to caring for this weaker member of it, we may be doing a huge amount to encourage them and sustain them as real Christians who are not sidelined because the person in their life has depression.

[48:45] Let me just finish with a short prayer now, hand over. Father, these things are massive and we feel at the end of our resources very easily.

[48:57] We don't understand very much about how our bodies work. We don't understand very much about our souls and the world is so complicated and hostile and broken, it's way beyond us.

[49:07] But you've decided that people like us can be of help in your church, that people like us have been given the resources that we need to come alongside other people and be used by you really to love and care for those struggling with depression.

[49:20] And so we want to pray that as we've begun thinking about these things this afternoon, you would help us in question time, help us in the remainder of our conversation time together, but help us as we go into the situations where you have put us alongside people who need us.

[49:34] Would you please help us go from where we are to be more the church, more the people, more the carers that you want us to be for we ask in Jesus' name. Amen.