Church members who want to help their pastors avoid depression should accept their human limitations, not expect them to be present for every event, and insist they take care of themselves, counselors say.

Ministers who become depressed almost always talk about the high stress and expectations of the job — even if they impose those depression-triggers on themselves.

“Being a pastor is like being a single parent — there’s never enough love to go around,” said Steve Scoggin, president of CareNet, a network of 21 pastoral-counseling centers in North Carolina. “In a congregation in the Baptist tradition, everyone is your boss. Expectations are as numerous as your congregants.”

“Clergy don’t do a real good job in setting boundaries for their availability,” said Scoggin, who described a typical pastor as a “24-hour ER.”

“That constant availability is one of the worst stressors,” he said.

Economic recession and its strain on church budgets are adding to the normally high stress and unrealistic expectations of ministry, say pastoral counselors and psychologists.

Meanwhile, Baptists in the Carolinas are reeling from news of several suicides and attempted suicides among their pastors in recent years. Could they have been avoided?

Scoggin said cultivating a climate that accepts pastors as human and encourages self-love and self-care offers some prevention. “These suicides are born out of a lack of the social supports that can intervene in times of personal crisis,” said Scoggin.

“Suicide looks impulsive, but there is almost always depression that leads up to that,” he said. “It’s when depression gets to a point where there appears to be no way out.”

Only a tiny fraction of depression results in suicide, whether or not it is treated. But suicide almost always starts with depression.

CareNet, a subsidiary of North Carolina Baptist Hospital, has an agreement with the Baptist State Convention of North Carolina to treat Baptist pastors whose insurance doesn’t pay for counseling.

The Minister Care Plan provided 102 counseling sessions to Baptist ministers last year, which also includes marital counseling, said Scoggin, of Winston-Salem.

BR photo illustration by Dianna L. Cagle Sometimes pastors feel overwhelmed by members' demands and because of their role as shepherd, don't feel they can share their challenges with others.

Of 35,000 counseling sessions conducted by CareNet last year, conservatively 10 percent were clergy of various denominations, he said. CareNet is the largest hospital-based counseling program in the country, and its Minister Care Plan is unique among the Baptist state conventions, he added.

The convention-provided counseling for underinsured ministers is underutilized, Scoggin said. “We could do a better job of making clergy aware of these resources.”

Congregations likewise are not encouraging pastors to live healthy lifestyles.

“There is not a lot of encouragement for self-care practices,” he explained.

Not all depression can be prevented or avoided. Clinical depression is an imbalance of the normal chemical functions of the brain. Environmental factors, such as stress, can trigger depression, but avoiding those factors can’t always prevent it.

But some depression could be avoided if ministers and their congregations spent some time on prevention.

“We assume clergy lead a life of commendable spiritual discipline and healthy personal habits,” said Scoggin, but that assumption is incorrect.

H.B. London, director of pastoral ministries for Focus on the Family, agrees.

“Ministry eats up your time,” said London of Colorado Springs, Colo. “One thing that leads to depression is the inability to get rest. … A guy burning the candle at both ends is going to burn out at some point.”

Scoggin said the high demands of the Christian faith are sometimes misapplied.

“Our focus on faithfulness is also our greatest weakness,” he said. “It doesn’t allow us to focus on the very things that trouble us.”

“Most pastors have high expectations of themselves,” he explained. “They really understand that as the gospel. They forget the greatest commandment is to love others as you love yourself. We confuse self-love with selfishness. It is a healthy, mature love of self that enables you to love the world — living from the inside out, rather than from the outside in.”

Counselors agree a first step for congregations to help their pastors is to let them be human.

“We want our pastors to be pretty much perfect,” London said. “We don’t want them to have problems, because then those become our problems. But the most effective pastors are the ones that are vulnerable.”

When church members put a pastor on a pedestal “right there next to Jesus,” they “deny his humanness,” said Fred Smoot of Duluth, Ga, executive director of Emory Clergy Care.

The next step often is to blame the pastor when things go wrong, he added. “The difference being having a hero and having a scapegoat is sometimes very little.”

With expectations so high, it becomes very hard for a minister to admit he or she needs help, counselors say.

“Although (ministers) have been called to what they’re doing, they still come out of their own humanity,” said Scoggin. “And depression is part of the human condition.”

Several counselors noted there are prominent examples of depressed people in the Bible who were nonetheless used by God — Job, David, Elijah, Jeremiah. “Some of the best diagnostic descriptions of despair are in the psalms,” Scoggin said. “And if you don’t think Jesus got a little depressed and anxious in the garden (of Gethsemane), you haven’t really read the story.”

Despite those examples, there remains a huge stigma among Christians against depression and treatment for medical illness, counselors say.

In this regard, sometimes ministers are their own worst enemies.

Research by neuroscientist Matthew Stanford of Baylor University shows that pastors, particularly conservatives, often dismiss mental illness as spiritual weakness or sin.

In a 2008 study, 30 percent of Christians who approached a pastor about their own or a family member’s diagnosed mental illness were told it was not mental illness at all.

Those pastors in the study most often recommended prayer or repentance of sin, not psychological counseling, for the treatment of depression, anxiety or other mental disorders. Afterward, 57 percent of the Christians who were told they weren’t ill quit taking their antidepressants or other medication.

Also troubling, Stanford said, is that people who suffer from depression or other mental disorders most often go to pastors first for help. Pastors “are the gatekeepers” to counseling services, Stanford said. “Why do we think that people with no training would know where to refer someone?”

“There is a tremendous distrust of psychology,” said Stanford, an evangelical Christian. As a result, depressed pastors are even less likely to seek counseling than their congregants, he added.

Untreated depression often will show up looking like something else, said CareNet’s Scoggin. “People have all kinds of ways to hide their depressiveness.”

Some pastors “eat their way to depression,” he said. “Obesity is epidemic among clergy. That’s documented. And obesity can be symptomatic of an underlying personal distress.”

Other depressed people will become mildly agitated or impatient, develop insomnia or hypersomnia, overeat or not eat, or become sad, tearful, lonely or hopeless, he said. As a step toward creating a healthy climate for pastors, Scoggin said, congregations should teach a more holistic approach to faith — one that includes exercise, good eating habits, and adequate time off.

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