Chapala Theological Seminary Counseling Situations

Depression

"Why are you cast down, O my soul, and why are you in turmoil within me? Hope in God" (Psalm 42:5). Even the psalmist spoke to his own darkness — and still turned toward hope.

The Situation

A faithful member who once served everywhere has stopped coming. When the pastor visits, he finds someone exhausted by sleep that does not refresh, uninterested in what they used to love, convinced they are a burden, perhaps unable to say why they weep. This is depression, and the pastor must begin by understanding what it is and is not. It is not simply sadness, which lifts; depression is a heavy, prolonged darkness that drains color from everything and often will not lift on its own. And — this is vital — it is not, in itself, a sign of weak faith or secret sin. Some of the most faithful servants in Scripture were brought low: Elijah begged to die, Jeremiah cursed the day of his birth, Job sat in ashes, and David cried out again and again from the pit. To tell a depressed believer that they simply need more faith or more prayer is to lay a second crushing weight on someone already crushed. Depression can have spiritual roots, but it can also be physical and chemical — tied to the body, to illness, to grief, to exhaustion — and the wise pastor neither reduces it to sin nor pretends it is only medical. He comes as a shepherd, not a judge.

The Ten Steps, Applied to Depression

Step One · Stage 1

Determine the Time and the Place

Depression isolates, so the counselor often has to go to the person, since the depressed rarely have the energy to come to him. He chooses a setting that is unhurried and unthreatening, and he is patient with a person for whom getting dressed may have been the hardest thing they did all day. He does not pack the visit with demands. Simply that he came, and is in no rush to leave, already speaks against the lie depression tells — that no one cares and they are not worth the trouble.

Step Two · Stage 1

Listen

The counselor listens without arguing the person out of their feelings. A depressed person will say things that are not true — "I am worthless," "nothing will ever be good again," "everyone would be better off without me" — and the instinct is to correct each one on the spot. Resist it at first. Before truth can be heard, the person must feel that their darkness has been truly listened to, not brushed aside. Listening also gathers the information the counselor needs: how long this has gone on, whether they are sleeping and eating, whether there has been a loss or a change, and whether there is any thought of self-harm, which he asks about plainly and calmly. Real listening here is itself a kind of medicine.

Step Three · Stage 1

Clarify the Situation

Together they try to understand the shape and possible roots of this depression. Is it tied to a clear loss or stress — grief, job loss, illness, a move? Has it come without any obvious cause, which often points toward a physical or chemical source? How deep does it run, and how long? Is the person still able to function, or has daily life ground to a halt? Clarifying does not mean the pastor diagnoses — that is for a physician — but it helps him see whether he is looking at a discouragement he can walk through with them, or a clinical depression that needs medical care alongside his own. Naming what is happening, gently and without labels that frighten, can itself bring a strange relief: this has a name, others have known it, and it is not the end.

Step Four · Stage 1

Investigate Previous Counseling

The counselor asks what has already been tried and what has helped. Has the person seen a doctor, and have they been evaluated for the physical causes of depression? Are they on medication, and if so, are they taking it as prescribed — for the depressed sometimes stop, believing they should not need it? Have they walked through this before, and what brought them up last time? This is also where the pastor honestly weighs his own limits. Persistent, deep depression — and any depression with thoughts of death — is beyond what a pastor should carry alone. The faithful move is not to keep such a case to himself but to insist, lovingly, on medical and professional help, and then to remain present as the spiritual shepherd alongside it. Referral is not abandonment; it is love that refuses to let pride or fear keep a person from the help they need.

Step Five · Stage 2

Responsibility — Handled With Great Care

This step demands more caution in depression than almost anywhere else, because a depressed person is already drowning in false self-blame. The counselor must never imply that the depression is the person's fault, or a punishment, or a thing they could fix by trying harder. That would only confirm the cruelest lie the illness tells. So "responsibility" here is reframed entirely: it is not about guilt for being depressed, but about the small steps that are within reach. Will they take the medication the doctor prescribed? Will they get out of bed at a set hour, eat something, take a short walk in the sun, keep one human appointment? These are not cures, and the counselor presents them not as commands but as handholds. The depressed person is not responsible for the darkness; they are gently invited to take the next small step toward the light, with the counselor's hand under their arm.

Step Six · Stage 2

Model the Role

By his steady, unhurried, non-anxious presence, the counselor models hope without denying reality. He does not put on false cheer, which the depressed see through instantly and which makes them feel even more alone. Nor does he sink into the darkness with them. He models a third way: someone who can look the darkness full in the face, name it honestly, and still stand in quiet hope — because his hope does not rest on how he feels but on the God who kept Elijah, heard David, and did not let go of any of them. He embodies the patience the person cannot yet feel, holding the hope on their behalf until they can hold it again themselves.

Step Seven · Stage 2

Review the Alternatives

The counselor lays out, gently, the real avenues of help — because depression lies by insisting nothing will help and there is nothing to be done. There is the medical avenue: seeing a doctor, being evaluated, and not being ashamed of medication, which for many is as proper as insulin for the diabetic. There is the bodily avenue: sleep, food, movement, sunlight, and the slow rebuilding of rhythm, which God used for Elijah before any word was spoken. There is the relational avenue: refusing the isolation depression craves, staying connected to a few safe people, the body of Christ around them. And there is the spiritual avenue: not as a club to demand more faith, but the quiet practices of the Psalms, honest prayer that tells God the truth of the darkness, and worship that does not depend on feeling. The point of reviewing these is to break depression's lie of helplessness by showing that there are, in fact, many doors, and they can be opened one at a time.

Step Eight · Stage 2

Explore the Outcomes

Carefully, the counselor holds out a realistic hope. He does not promise a quick or total cure, for false promises shatter and deepen despair. But he can say with full honesty that depression, walked through with help, very often lifts; that countless people who were certain they would never feel light again have come out into the morning; and that the very feeling of "this will never end" is one of depression's symptoms, not a true forecast. He helps the person see that the path of isolation and giving up leads deeper down, while the path of small steps, accepted help, and patient endurance — though slow — leads toward healing. Above all he holds the hope steady when the person cannot, the way one holds a candle for someone whose hands are shaking.

Step Nine · Stage 2

Supply Information — the Word and the Psalms of Lament

When the time is right, the counselor brings the comfort of Scripture — but the right Scripture, in the right way. Not the brisk command to "rejoice always" flung at someone who cannot, but the Psalms of lament, where the people of God cry from the depths and God does not turn away. "Why are you cast down, O my soul?" — the psalmist speaks to his own darkness, and still says, "Hope in God." "Out of the depths I cry to you, O LORD" (Psalm 130). These show the depressed believer that their cry is not faithlessness; it is prayer, and it is in the Bible. He brings the truth that God's love does not rise and fall with our feelings, that Christ Himself was "a man of sorrows, acquainted with grief," that He sweat in Gethsemane and cried "My God, my God, why have you forsaken me?" — so there is no pit so deep that He has not been lower. This is offered not to argue the person out of the dark but to assure them they are not alone in it, and that the darkness is not the final word.

Step Ten · Stage 2

Provide Closure

Closure with the depressed is never a single triumphant session but a long, faithful walking-alongside. The counselor leaves with a concrete and gentle plan — the doctor's appointment kept, the small daily steps, the next time he will come — and he makes the next contact soon, because the depressed easily believe they have worn out their welcome. He stays in touch through the long climb, celebrates the small gains without overstating them, and remains watchful for any deepening, especially any return of thoughts of death, ready to escalate to emergency help at once. And where professional care is carrying the medical weight, the pastor's closure is simply to keep being the shepherd — present, unhurried, refusing to disappear — so that the person knows that whatever the darkness says, they have not been, and will not be, left alone.

Theory Lens — the Cognitive Approach

The Cognitive approach (associated with Aaron Beck and Albert Ellis) observes that our feelings are shaped in large part by our thoughts, and that depression runs in well-worn grooves of distorted thinking: all-or-nothing ("I always fail"), overgeneralizing from one setback to "everything is ruined," filtering out every good thing and keeping only the bad, and catastrophizing the future. The cognitive counselor helps a person notice these automatic thoughts, test them against reality, and replace the distortions with truer, more accurate ones. There is real wisdom here that a pastor can use, for much depressive thinking genuinely is false, and learning to recognize a lie as a lie is a mercy. It also rhymes with something Scripture says: that we are transformed "by the renewing of your mind" (Romans 12:2), and that we are to take "every thought captive to obey Christ" (2 Corinthians 10:5).

The biblical caution. But the pastor must not reduce depression to wrong thinking, nor make the cognitive method his whole gospel. Two errors must be avoided. First, not all depression is caused by distorted thoughts — much of it is rooted in the body, in chemistry, in grief and exhaustion, and to tell such a sufferer to "just think correctly" is as cruel and useless as telling a man with a broken leg to think his way to walking. The cognitive tool addresses one cause among several; it is not the master key. Second, even where thinking must be renewed, the gospel goes deeper than technique: the mind is renewed not merely by better self-talk but by the truth of who God is and who we are in Christ, and by the Spirit's work, not by willpower alone. So the pastor may gladly help a person catch and test the lies depression tells — that is good and biblical — but he sets the technique within the larger care of the body, the presence of the community, the means of grace, and above all the steady love of God that holds us when our own minds cannot. The tool serves the shepherd; it never replaces him.

The short-answer questions are for your own reflection: write your answer, then press Reveal model answer to compare. Unit completion is based on the multiple-choice questions.