The tragic suicide of Hickory pastor David Treadway Sept. 27 highlights a problem some say is growing worse by the year.

No one knows for sure how many ministers suffer from depression — or how many attempt suicide. Even those who counsel depressed clergy don’t know those numbers.

“It’s like nailing Jell-O to the wall,” said H.B. London, vice president for pastoral ministry at Focus on the Family. But he offered an estimate, based on research and a decade of ministering to ministers, that 18 percent to 25 percent of all ministers are depressed at any one time.

Most counselors interviewed for this series agreed depression among clergy is at least as likely as in the general population. “I would venture to say it is as common among clergy as non-clergy,” said Matthew Stanford, a professor of psychology and neuroscience at Baylor University in Waco, Texas.

And those numbers are staggering.

“The likelihood is that one out of every four pastors is depressed,” said Stanford, an evangelical Christian who studies the handling of mental illness in the Christian community.

About one in four adults will experience a mental-health disorder in a given year, according to the National Institute of Mental Health. Not all are as serious as major depression, or clinical depression as it was previously labeled. But major depressive disorder does affect 6 percent to 8 percent of all adults per year.

During their lifetime, as many as 12 percent of men and 26 percent of women will experience major depression, according to the American Medical Association (AMA).

Some counselors who treat clergy say depression is on the rise.

Anxiety in the pulpit “is markedly higher” in the last five years, “and the accompanying depression, as a reaction to it, is therefore higher,” said Fred Smoot, executive director of Emory Clergy Care in Duluth, Ga., which offers pastoral care to 1,200 United Methodist ministers in North Georgia.

“The current economic crisis has caused many of our pastors to go into depression,” said Smoot, a former Methodist pastor with a PhD in pastoral counseling.

Most counselors agree the majority of clergy depression goes unreported and untreated because of career fears, social stigma and spiritual taboo.

“Clergy do not talk about it because it violates their understanding of their faith,” said Steve Scoggin, president of CareNet, which provides pastoral counseling in 21 North Carolina centers. “They believe they are not supposed to have those kinds of thoughts.”

Nearly two out of three people suffering with depression do not actively seek or receive treatment, according to a study by the Depression and Bipolar Support Alliance, even though the rate of successful treatment is about 60 percent. When treatment fails, it’s usually because the patient quits taking prescribed anti-depressants, researchers say.

Depression causes two-thirds of the 30,000 suicides reported each year, AMA says.

Even some depressed people who are taking anti-depressants commit suicide, which prompts skeptics to ask if the cure is worse than the disease. But the research indicates otherwise.

For instance, a recent study of 227,000 depressed U.S. veterans found that the patients treated with anti-depressants — including the popular SSRIs and SNRIs — were significantly less likely to commit suicide than those not taking the drugs, and the risk of suicide decreased when patients started the treatment. Anti-depressants, the study concluded, have “a protective effect” against suicide.

However, the Food and Drug Administration warns that teenagers, and perhaps adults 18-25, are under greater risk of suicide while taking anti-depressants. That warning has sparked much of the concern about the drugs.

A study published in August in the British Medical Journal showed that anti-depressants do increase the risk of suicide among people under 25 but have no effect on adults 25-64 and actually reduce the risk of suicide among senior adults — the most under-diagnosed population for depression.

Skepticism about anti-depressants is based on a “Catch 22,” said Stanford. “Depressed patients are most likely to commit suicide — even treated patients,” he said. But it’s the depression, not the treatment, that is the cause.

“There is no empirical evidence that (anti-depressant treatment) causes suicidal thoughts in adults,” the Baylor neuroscientist said. “And it’s definitely true that untreated depression is more likely to result in suicide.”
There are apparently no statistics that suggest ministers are more likely to commit suicide than other professionals.

Studies purporting to measure the suicide risk of various occupations have produced wildly different results, and none of them point to pastors. According to the American Psychiatric Association, other factors are much more important than occupation, particularly a mental disorder, substance abuse, loss of social support and access to a firearm.

The danger, researchers say, is not your job but perhaps the lack of one.

A 2003 journal study found that the unemployed are two or three times more likely to die of suicide than those with a job. Likewise, a 1998 study in the British Medical Journal found “the link between suicide and unemployment is more powerful that other socio-economic measures.”

In a time of recession and rising unemployment, researchers warn, depression, suicide and violence are likely to spike.

Even before the U.S. economy went south, pastors were facing other tough issues, according to those who counsel them. The economy is only amplifying the pressure, they said.

Stagnant church growth, slumping budgets, cultural transition, specialization and “boutique” churches are some of the pressures haunting those in ministry, the counselors said.

“Many pastors are wondering if they are past their prime” in light of that pressure to change with the times, Smoot said. “One of the responses to it is to get depressed.”

Pastors feeling the pressure to bring about change in the church will face tremendous pressure from the other direction — to resist change at all cost, some leaders say.

“Most of our churches are family chapels,” said Monty Hale of Columbia, S.C., referring to the typically small congregations, common in the south, that revolve around a few core families. “The pastor’s job is making sure that nothing changes. These guys that are coming in and trying to move them along to impact (spiritual) lostness are going to get the response, ‘You’re not from around these parts.’”

The power structure in the average 200-member church is programmed to resist change, said London. “No pastor is going to go there and tear the world up; you can’t buck the power structure,” said London, who leads Focus on the Family’s clergy-care ministry, which has ministered to 100,000 pastors of many denominations.

“The issue that so many pastors face is that they are type-A personalities, they want to succeed, and they don’t see a lot of progress,” said London, himself a pastor for three decades. As a result, 80 percent of pastors become discouraged, according to Focus research. Disillusionment and depression often follow.

“If you serve a church that is resistant to change, you’re dead in the water,” he said bluntly. “Even Billy Graham couldn’t succeed there.”

Related stories
Culture, isolation push some to depression 
Members should help pastors set boundaries