7 Things I Wish Christian Leaders Understood About Mental Illness

The struggles with mental illness are deep and complex. Here are seven things Christian leaders need to understand about mental illness.

By Ramon Presson

“Too blessed to be depressed” was the message on the church’s sign as I passed by. I wanted to turn my car around, park next to the sign, get out, take all the letters down, and fling them into the grass.

I wish being grateful was the simple medication to prevent depression and counting our blessings was the sure cure for anxiety. For many people of faith, sleepless nights become dreaded days filled with loss, grief, sadness, anxiety, hopelessness, conflict, tension, or anger. The result is that many feel not only defeated but also guilty or shameful for not living the “victorious Christian life.”

Many Christians suffering from a mental illness feel not only defeated but also guilty or shameful for not living the “victorious Christian life.” Share on X

They may believe if only they were more spiritually mature or more disciplined, if only they had more faith or were more obedient, then they would win the battle. The struggles with mental illness are deep and complex. And it’s not only naïve to oversimplify or over-spiritualize the causes, conditions, and cures, but it can also be harmful.

I Love Jesus, but I Want to Die by Sarah Robinson is an honest, hopeful, and helpful book written by a devoted Christian who has battled depression and the dark thoughts of suicide. The book echoes and builds upon Robinson’s 2018 viral blog post and is a great read for church leaders and congregants.

As a licensed therapist and former assistant pastor, here are seven things I wish Christian leaders understood about mental illness.

1. Mental illness is a very broad term to describe a myriad of possible diagnoses and disorders

If you Google “categories of mental illness” you’ll see lists ranging from five to 20 items and descriptions. Categories, depending on the source, include depression, anxiety, bipolar, phobias, PTSD and trauma, eating disorders, addictions, and psychosis. Some sources will include personality disorders, characterological disorders, OCD, ADHD, childhood behavioral disorders, dementia, and the autism spectrum as mental disorders. And under each of these categories of mental illness fall numerous specific illnesses and disorders.

The point is not that church leaders should know the entire list. But you should understand there are many forms of mental illness. More people in our communities and congregations are engaged in a mental health struggle than we realize.

2. The most prevalent mental illnesses in congregations are depression and anxiety

You’d likely be surprised if you knew the number of your congregants taking prescription medication for depression or anxiety. And you would be just as surprised by the “who.” Some of your “best members” are either effectively managing their illness, stubbornly denying it, or successfully hiding their struggle.

“Some of your ‘best members’ are either effectively managing their mental illness, stubbornly denying it, or successfully hiding their struggle.” — Ramon Presson Share on X

And it’s not just adults. Each decade the percentage of children and teens in the U.S. being treated for depression and anxiety increases while the age of children’s initial diagnosis and treatment is getting progressively younger. Children are contemplating and attempting suicide at ages unknown to previous generations.

3. Many, if not most, congregants struggling with any type of mental illness at any level of frequency and severity will feel something ranging from mild embarrassment to deep shame

To many people, their mental illness feels like a personal weakness and failure. Shame says, “There’s something wrong with me,” and not “I have a problem I’m managing and working through.” Fortunately, some have a healthy acceptance of their illness along with a healthy resolve to address it effectively. Let your people know it’s okay to need help and ask for help.

4. Many congregants have a close family member (spouse, teenager, adult child, parent, sibling) whose mental illness not only worries them but directly and significantly affects their daily lives

Many of your congregants feel embarrassment or shame because of a family member’s mental illness, especially if the patient is a spouse or a child. They may be inclined to think the patient’s struggle is somehow a reflection on them as a spouse or parent. Not only are they at risk of wrongly blaming and judging themselves, but they also fear that others do, or would, blame and judge them.

The congregant may also feel overwhelmed by the family member’s condition—its history as well as the current symptoms and behaviors—and be at wit’s end regarding how to help their loved one and cope themselves.

5. Many congregants are struggling with diagnosed and treated OR undiagnosed and untreated childhood, teen, or adult trauma, while some will have past or present struggles with addiction of some type

Trauma may result in addiction as a means of escaping from or coping with the trauma. Combined, the experiences and effects of trauma and addiction (their own or that of a loved one) will rival or exceed the number in your congregation battling depression and anxiety. By the way, there’s often overlap; trauma or addiction may contribute to depression and/or anxiety.

Please note that when Christian leaders oversimplify and label addiction as merely a “sin,” it tends to add to the shame cycle of addiction which perpetuates it and reduces the person’s probability of seeking help.

“When Christian leaders oversimplify and label addiction as merely a ‘sin,’ it tends to add to the shame cycle of addiction which perpetuates it and reduces the person’s probability of seeking help.” — Ramon Presson Share on X

6. God is not calling you to become an expert on mental health and mental illness, and your church doesn’t need you to be an expert

Churches serve their congregants by providing a resource list of area counselors, psychologists, and psychiatrists that leadership can confidently recommend. Church leaders don’t have the time or depth of knowledge, training, and experience to be a one-person counseling center.

I’ve been a therapist for three decades. But every week, I make referrals to other local therapists who specialize in assessing and treating issues I have less experience with. I know my areas of competency, and I know my limits. Sometimes the most caring thing I can do for someone is not to counsel them, but to instead direct them to a therapist who will more effectively help them with their problem.

7. What your congregants primarily need from you is an understanding of the complexity of their struggle and compassion for the difficulty of it

I’ve said to many patients, “I wish I had more answers. I wish I could fix it, heal it, or make it go away. But I can’t. But what I can do is walk with you through this.”

After a discouraging season-ending loss in a season one scene, Ted Lasso tells his players, “Now look, this is a sad moment right here for all of us. There ain’t nothing I can say standing in front of you right now that can take that away. … But I promise you there is something out there worse than being sad, and that is being alone and being sad. And ain’t nobody in this room alone.”

Henri Nouwen wrote of the calling to “help others hold the cup of suffering.” You cannot remove their cup and you cannot hold it for them. But you can hold it with them. Never underestimate the power of with. Remember that Jesus is Immanuel—God with us.

“As a leader, you cannot prevent or remove someone’s sadness. But you can help people feel less alone in their sadness.” — Ramon Presson Share on X

As a leader, you cannot prevent or remove someone’s sadness. But you can help people feel less alone in their sadness. And you don’t accomplish that by being with everyone, because you cannot be everywhere with everyone every time. The body of Christ is to be the extension of Jesus and the extension of His shepherds. True Christian community is the expression of Ecclesiastes 4:9-12. You can and need to model it by example and by teaching your people to do the same.

And Jesus said, “By this everyone will know that you are my disciples, if you love one another” (John 13:35, CSB).