Depression. I wonder what comes to your mind when you hear that word. For some, it will be a friend or loved one who has depression so you've perhaps observed something of what it is secondhand. Maybe there have been times where you've longed to help and support them through their depression but struggled to know how best to do that. For some of us it is firsthand experience that we have. We know the pain and despair of depression all too well; either from past experience or perhaps being in the midst of it right now. There will be others who have questions that come to mind: What is depression, what makes it different from feeling sad or miserable, what causes it, what can be done about it?

So I'm very aware that we will all be approaching this topic from different angles and experiences, and I'm sure as a church family there is much that we can share and learn from one another because of that. Yet, depression is not often spoken about. Sadly, there is still a lot of stigma surrounding depression, and it can be a really difficult topic to open up about and to discuss. I'm hoping to briefly address two questions: What is depression? Why should we take it seriously?

What is depression?

So what is depression? Depression isn't actually one thing; it has many forms, and the general term depression covers a wide range of types and severity. So it's varied and it's complex too. The reason why one person becomes depressed is different from why another does. There is no simple cause or explanation. What happens to us in our lives can be a trigger, like an unwelcome or traumatic event—becoming physically unwell, being made redundant, the end of a relationship, a major life change, moving somewhere new or retiring. But it's not only about what happens to us, because people react to the same thing differently and we know that some people are more prone to depression than others.

So it's likely that depression is caused by complex interaction between external factors and internal factors. You might have heard theories that try to explain depression in terms of one thing: The chemicals in our brain or the state of our childhood or perhaps the insufficiency of our faith. I think we need to be wary of these explanations. As Christians, who believe the Bible, it seems most helpful to have a holistic approach, to consider all its aspects: Physical, psychological, relational, and spiritual.

Now I've got a question for you. When was the last time you heard someone say the words depressed or depressing? I know I certainly hear lots of people during June say, "Oh, this weather is so depressing." And you might hear someone say, "I'm really depressed about my job at the moment." These words are often used in our everyday conversation when we really mean fed up, sad, or miserable. So it's not surprising that we can begin to think that they are one and the same thing. But depression is not feeling sad or miserable. It's much more than just emotion. And actually a lot of people who are depressed say it's more like an emptiness or an absence of emotion, and it interferes with many areas of life.

There is a cluster of symptoms associated with depression, the two main ones are depressed mood and losing all interest and pleasure in things. Others include feelings of worthlessness or guilt, thinking negatively about things, and also losing all hope for the future. That would fit into the psychological part of our holistic model. But there are physical symptoms too, so there might be changes in appetite, disrupted sleep pattern, low energy levels, and poor concentration. For someone to be given a diagnosis of depression, they would need to experience at least five of the full list of symptoms nearly every day for at least two weeks. But it's not obviously as straightforward as that, and lots of other factors are taken into consideration, and diagnosing depression should only be done by someone qualified to do so.

Depression is lonely. The sense of isolation and feeling cut off from other people in the world is one of its most crippling aspects. Depression affects our relationships, our ability to cope with social occasions, and it can make it hard to contribute in conversation. This isn't just a relational aspect, it can be a spiritual one too because God's presence can feel very distant and unreal, and we can feel completely alienated from him.

Fourthly, depression is a bewildering experience. It's often really difficult to describe in just words, so metaphors and images have been used by many as a powerful way of conveying what it is. Winston Churchill famously called his depression the "Black Dog." Others have likened it to being stuck alone in a deep, dark pit, being caught in a tunnel, or being lost in thick fog.

So depression is varied and complex, it's far more than—and in fact it's not the same as—feeling sad. It's a lonely experience. Metaphors and images as well as a holistic model can help us to better understand it.

Why should we take it seriously?

So our next question: Why should we take it seriously? Firstly, it's common. Figures vary slightly but it's widely accepted that one in every six adults will experience an episode of depression during their lifetime. The prevalence seems to be increasing, and the World Health Organization predicts that within 20 years more people will be affected by depression than any other health problem, which seems staggering. Depression currently affects about 121 million people worldwide, and that's set to rise. But rather than us just focus on national and global levels, let's think about how it affects us closer to home.

What do these statistics mean, for instance, for the church? Well, at All Souls, I think we have about two to two and a half thousand people. So it means that at least 400 of our members will have depression at some point in their lives. Four hundred. And it's definitely not that those 400 people will have less faith or be less spiritually mature than others, because as we highlighted earlier, depression is caused by a complex mix of many different reasons. So it's common. It's common in society and it's common in the church.

The second reason we need to take it seriously is that depression is debilitating. It can completely sap our physical, mental, and emotional strength, making normal day-to-day activities a huge challenge. Sometimes, anything other than staying in bed, under the duvet, can seem impossible.

Depression is also potentially dangerous to the people with severe depression. When life is painful and unbearable, and depression makes someone feel that there is no hope of things ever getting better, then sometimes death can seem to offer the only hope of relief. So it's not uncommon for people with depression to have thoughts about harming themselves or ending their life. This is obviously a very serious, very sensitive, and very difficult area. If we're ever aware of any risk of self-harm or suicide in ourselves or in other people, then we really need to take it seriously and seek help.

The last and probably most important point is that there is much that can be of help to people with depression and to those supporting people with depression. Psychological therapies, counseling—talking therapies as they're sometimes called—can be of great benefit and anti-depressant medication too.

But I think as Christians, I think we can sometimes be less likely to recognize or admit that we may have depression. Because surely we should be full of the joy of Christ, and we can feel a real sense of shame in being so low, which can perhaps make us more reluctant to seek help. This is where other people come in. As we share life and we live in community, rather than conforming to an increasingly individualistic society, we'll hopefully have people who we can be open about our struggles and who can help to support us both practically and prayerfully.

So depression is a fact, and one that we all need to seriously. Even if we never have depression ourselves personally, then some of our Christian brothers and sisters, some of our friends, family members, and colleagues surely will. With God's strength we can share and carry one another's burdens and we can be channels of his love, hope, and presence.

Dr. Henny Saunders is a clinical psychologist working in the U.K. for the National Health Service and a member of All Souls Church, Langham Place, London.