I was 24, recently converted, and full of faith. One day I met Richard, a godly middle-aged Adventist. When he told me he was recovering from a nervous breakdown, I couldn't believe it. I said, "A Christian shouldn't have a breakdown, Richard." His glance reflected hurt and indignation. He quickly asked, "Why not?" Wanting to help him, I replied, "Our faith in God lifts us above stress." Richard didn't pursue the conversation. I didn't realize it at the time, but he must have felt sorry for my youthful ignorance. There was no way I could have known that years later, as an experienced minister, I too would suffer a major stress-related breakdown.
A few years after I met Richard, a conference president told my theology class that he expected us to "work hard and harder still to finish the work." As a young minister I followed that advice to the point that I felt guilty if I stayed home because someone canceled a Bible study appointment.
Early symptoms
Most of the time ministry brought me much joy. My theological training, however, had not prepared me for the pain caused by the artillery and missiles some of the saints fired at me. As I worked in small churches I found it difficult to deal with conflicts, and was drained emotionally. In my mid-40s I started to become strangely tired. Instead of me "finishing the work," the work was finishing me! I found it difficult to relax. I couldn't enjoy my meals. I couldn't appreciate the beauty of a flower or the colors of a butterfly. The sound of my kids playing happily jarred my nerves. My mind was caught up with church problems. I wasn't enjoying the ministry as I had. Despite planning ahead, there were times I couldn't remember what to do next. Sometimes I resented living in the parsonage next to the church. "Won't the members ever leave me in peace?" I would say to myself.
A change was taking place in me so slowly that I was hardly aware of it. I didn't recognize then that I was experi encing the early-warning symptoms of a breakdown. I thought of going to a doctor but put it off, hoping that the next holiday season would recharge my batteries. It didn't. I continued to have highs and lows, but the lows gradually sank a little deeper. At times an uncharacteristic depression would pass over me temporarily. Although I realized that I might be suffering from stress, I never comprehended where the seriousness of the condition could lead.
With most illnesses, physical pain jars one to action. With psychological-emotional exhaustion, the warning symptoms are more subtle and harder to detect. 1
Recently I spoke to a number of people who were recovering from burn out. While most of them on hindsight can now recognize the early-warning symptoms, they could not recognize them at the time of their occurrence. Personally I was only vaguely aware of the indicators, and it took a crisis to awaken me. By then it was too late to prevent an irreversible slide into severe breakdown. This is why it is so important for clergy to be able to identify the early symptoms.
Needless to say, when one is experiencing warning symptoms of burnout it is unwise to accept a new appointment with added responsibilities, yet this is exactly what I did. It was an unwise decision, and it produced the extra wave that sank my ship.
The crisis
One night about two years ago I had an extended visit with a couple who were pulled toward legalistic fanaticism. After that emotionally draining visit I drove off into the country for a Bible study. I slammed on the brakes too late. At 60 miles per hour the car plunged over the embankment, flew 50 feet through the air, and crashed in swampy ground. The car was badly damaged, but I wasn't seriously hurt. In stunned amazement I prayed: "Thank You, Lord, for protecting me. I didn't even see the comer coming; there must be something wrong with me." My advanced state of crisis required that accident to convince me fully that I was ill. From then on my health deteriorated rapidly. I was diagnosed as suffering from stress-related breakdown/ depression. To my surprise, blood tests revealed the presence of a virus that caused chronic fatigue.2
Doctors told me that prolonged stress had affected my immune system, allowing the fatigue-causing virus to assert itself, thus further lowering my ability to handle stress.
Emotional-psychological burnout
Severe "burnout" (sometimes called a nervous breakdown) causes suffering of greater intensity than most physical pain. With physical illness one's mind can still think well enough to cope with suffering. However, when the mind that controls the coping mechanism breaks down, the result is devastating. Without any exaggeration, my struggle was equal in intensity to the trauma of awakening from a nightmare to discover that it is real. Fitful sleep was invaded with panic attacks involving adrenaline rushes, heart spasms, and phobic thoughts (phobias and emotional liability are common with this condition).3 I could understand why many suicides are motivated, not by some new and isolated tragedy, but by a desperate desire to escape the torturous symptoms of clinical depression.4
I had no option except to accept medical advice and take extended sick leave. Two years later I am still not well enough to cope with the emotional demands of ministry. It took time for accumulated stress to cause the break down. It takes time to get better. To have my life turned upside down was not easy, even though the Lord has closely blessed my every new step. For some one who has been an active minister for many years, it's very difficult to have to do something else, for my heart is still in the ministry. This type of frustration is inevitable in a deeply burned-out minister and causes much emotional pain.
The family suffers too, as it now has to live with a sick person whose depleted emotional reserves cannot cope well with the demands of growing children (particularly teenagers). Full blown chronic fatigue, which is a classic symptom of burnout, has to be experienced to be properly understood. Most drivers know what it's like to feel so tired while driving that it seems impossible to stay awake any longer. But when one experiences similar mental fatigue by 10:00 a.m. despite having had a good night's sleep, then one knows the frustration of chronic fatigue syndrome.5
Clinical depression
Clinical depression, often caused by burnout, is more common than many ministers realize. Dr. Fran Singer writes: "It has been estimated that one in 20 men and one in 10 women will become clinically depressed at some time in their lives."6 Christians are not exempt, but for fear of embarrassment they try to conceal their illness. To admit depression is seen as lack of faith, especially in a climate that measures faith by joyful emotional experiences.
A clinically depressed person is not someone who is merely going through a very sad experience. "Feelings of sadness, frustration, and unhappiness are natural reactions to real-life problems, a painful loss... a conflict. Psychiatrists refer to such reactions as 'adjustment disorders.' If the symptoms gradually clear up as the problem subsides, you've probably just had an ordinary adjustment disorder. If not, you may be suffering clinical depression."7
It was only after I experienced burnout that I could fully appreciate what the psalmist meant when he described his inner turmoil: "My eyes grow weak with sorrow, my soul and my body with grief. My life is consumed by anguish and my years by groaning; my strength fails because of my affliction, and my bones grow weak" (Ps. 31:9, 10, NIV).
Even the strength of David's mind was reduced to severe depression that lasted for years. Evidently, strong spiritual leaders are not exempt from severe depression! It is significant that the psalmist mingles expressions of suffering with expressions of great faith: "But I trust in you, O Lord.... My times are in your hands" (verses 14,15, NTV). Apparently David's sufferings were caused, not by any lack of faith, but by the prolonged conflict situations he encountered.
So it's usually not appropriate simply to tell depressed Christians to "have more faith" or to "lay your burdens at the foot of the cross." They may already be plagued with the misconception that their condition is a result of lack of faith when in reality it may have a medical basis. It is far better to reassure them sympathetically that God is with them and that the suffering will pass.
Some practical pointers
While it is not within my ability to give medical advice, I will briefly mention some practical pointers that have helped me personally.
Early in my illness the Lord led me to a wonderfully comforting book, Self- Help for Your Nerves8 It persuaded me that the traumatic symptoms I experienced were unpleasant but not harmful in the long term. It showed me I should not be unduly frightened by the involuntary bodily reactions and moods of my breakdown/depression, and indicated that these always pass and will diminish in time.9
I also benefited from physical exercise and a simple diet free from highly refined food and rich desserts. The doctor prescribed an antidepressant drug, and it helped me. It was not a mood-elevating drug, but it helped by raising the level of neurotransmitters in the brain. 10
I have found spa bathing calming to my nerves. Hobbies create needed therapeutic pleasure without harmful stress, and they distract the mind from morbid preoccupations.
In my case, I wish that the church had made available some trained counselors who could visit incapacitated pastors on a regular basis. In the New South Wales Police Force a special counselor visits weekly with stressed-out police officers and provides valuable encouragement and direction. This kind of ministry in a church setting would be invaluable to pastors.
Preventive measures
If you suspect you may be on the burnout track, find a doctor who under stands the complex nature of ministry. He or she may advise you to slow down, or may surprise you by recommending a long period off work. This may seem to be overly cautious, but is preferable to having to experience other potential effects of depression. It may take courage to inform your administrators that you feel stressed out, that they should give you freedom to lighten your load. Let your congregation know of your limitations and your need to slow down. If you don't, they will keep sending work your way. Some ministers try to give the impression that they are unbreakable, but church members respect ministers who reveal their humanity.
Learn to say no more often. Don't worry if this occasionally offends some well-meaning church members who think that you should operate up to their expectations. No minister can entirely escape criticism.
Sometimes even a healthy minister may have to try to adopt a five-day week as a survival measure. We vary enormously in our workload abilities. "Each individual must find his or her level of stress tolerance, because below it you'll feel bored and frustrated, and above it you'll suffer exhaustion."11
1. See M.W.P. Carney, "The Diagnosis of Depressive Symptoms and the Prediction of ECT Response," British Journal of Psychiatry 3 (1965): 659-674.
2. See A. S. David, "Postviral Fatigue Syndrome: Time for a New Approach," British Medical Journal 296 (1988): 696-699.
3. See lan Hickie, "The Psychiatric Status of Patients With the Chronic Fatigue Syndrome," British Journal of Psychiatry 28 (1990): 536.
4. See P. O. Behan, "The Postviral Fatigue Syndrome Analysis of the Findings in 50 Cases." Journal of Infection 10 (1985): 211-222.
5. See William Vayda. Chronic Fatigue: The Silent Epidemic (Sydney, Australia: Simon and Schuster, 1991), p. 174.
6. Fran Singer, "Let's Talk," New Idea, Sept. 5. 1992, p. 86.
7. Diagnosis and Statistical Manual of Mental Disorders, 3rd rev. ed. (Washington, D.C.: American Psychiatric Association, 1987).
8. Claire Weeks, Self-Help for Your Nerves (Sydney, Australia: Angus and Robertson, 1989), p. 28.
9. See also Vayda, pp. 51, 65.
10. See Philip Elmer-Dewitt, "Depression: The Growing Role of Drug Therapies," Time, July 6, 1992, p. 58.
11. Vayda, p. 51.
