British pastor-theologian Mark Meynell’s When Darkness Seems My Closest Friend: Reflections on Life and Ministry with Depression (SPCK, 2018) is the most helpful thing I have read in understanding serious depression.

It also contains counsel on how friends can help their brothers and sisters with this affliction. In the book, he lays out three categories in particular: (1) be present, (2) persist, and (3) reassure.

Here is an edited excerpt from a section in the book.

1. Be Present

This is where Job’s friends got it right initially. They simply met with this overwhelmed, broken soul in companionable silence, on the very ash-heap where he sat scraping the dirt out of his aching sores. It was a pitiful scene. They wept with him and sat with him for a whole week (Job 2:8, 11–13). In contrast to so many, they moved towards another’s pain instead of recoiling from it. That takes guts by itself. It is a remarkable act, for which Eliphaz, Bildad and Zophar deserve great credit, at least. It would have been emotionally exhausting and costly. What’s more, they resisted the urge to speak.

Silence is scarce in today’s world, but it is so precious. Its absence is one possible reason why it feels so threatening. Wherever we go, it seems that we must be accompanied by music, advertising, tannoy announcements, general chatter and hubbub. We can’t even escape being serenaded in public toilets. This makes it even harder for modern people to resist plugging every conversation gap with something else. It takes practice to hold back.

My problem is that I am all too aware of another’s awkwardness with silence. I can pick up on any anxieties about saying the wrong thing or feeling helpless. That can then be counterproductive, ironically making matters harder. So, even though being a good friend is not exactly a matter of skills to study, it is possible to invest in learning how this can be done better. We can do a lot worse than developing an ease and a contentedness with silence. Practice using the time to reflect on life, to pray and praise, to read, and ultimately just to ‘be’. That must be a beneficial exercise in our 24/7 culture anyway. I, for one, enjoy the companionship of being in a room with others while we all just read our books!

For I have found that I most want others ‘to be’ for me, rather than ‘to do’ for me. I long for them to have the confidence to know that their friendship in and of itself brings healing, that I don’t need their answers or action plans. If I did, I would ask for them—and sometimes I do. I wish they knew that feeling helpless is actually OK—at least it demonstrates an awareness of the affliction’s nature! And it is fair to say that sharing silence with a friend will never by itself do harm, and may well do great good. That seems counter-intuitive because of its apparent passivity. But I do believe that it is a profound act of love, simply because someone else’s time is such a precious gift. Especially these days. American novelist Margaret Runbeck captured the paradox well: ‘Silences make the real conversations between friends. Not the saying but the never needing to say is what counts.’

However, it is also true that physical presence may not literally be what is needed (which will come as a relief to those who have little time to spare). For someone in the cave, it is as good to know that a friend is constantly there. Solitude (which should not be confused with loneliness) can be helpful at times, especially for those who are more introverted. But, at those points, it is vital to be reminded that, even when I am out of sight, I am not out of mind. So a friend’s presence might simply amount to a regular text message to ‘check in’, to ask how the day is, for example. That’s not so difficult, surely. Some might worry that’s just a token gesture. But I would far rather have gestures than absence. Without gestures, my mind spins ever darker explanations from my own failures.

At its heart, this is a question of relationship quality and trust. This is why the next aspect is crucial. It is also the toughest.

2. Persist

It is vital to avoid the Job’s comforter syndrome, whereby one probes to get at the roots of the suffering so as to satisfy one’s own theological framework. Furthermore, asking questions is not an opportunity to road-test any psychotherapeutic ambitions or have a stab at amateur diagnosis on the back of a couple of interesting blogposts. It may be that the best help a friend can offer is to point the way to a professional therapist, if this is needed—and in my experience, it usually is. But a friend’s most important asset is the most obvious: simple, accepting friendship. Come what may.

The purpose of gentle enquiry is simple—to show interest in the cave-dweller, to seek understanding, to help him or her to feel heard. In fact, others’ attempted understanding (however imperfect) is what I have craved more than anything. Especially when I didn’t really understand what was happening myself. Throughout the cave experience, others’ attempts to understand has been the surest way of feeling valued.

So ask open-ended questions. Gently probe the person’s experience to find anything that connects. Even if you can’t find them, offer analogies as they occur to you, but move on quickly if they don’t resonate. Here are a few simple suggestions to give the general gist:

  • Can you say what makes it so hard right now?
  • Can you say more about what you said the other day?
  • What do you wish others understood?
  • Is it like trying to hear yourself think next to a traffic junction, or something else?
  • Are there times of day that are worse than others?
  • Have you met others with similar pain? Did that help a bit?
  • Have you tried to write some of this down?

Notice the focus here: it’s far more a matter of description than diagnosis. Attempting this surely lifts much of the pressure, because most of us don’t have anything like the skills be a good friend. If willing. I cannot tell you how wonderful it is to encounter this. Writer and actor Stephen Fry was absolutely right:

If you know someone who’s depressed, please resolve never to ask them why. Depression isn’t a straightforward response to a bad situation; depression just is, like the weather.

Try to understand the blackness, lethargy, hopelessness, and loneliness they’re going through. Be there for them when they come through the other side. It’s hard to be a friend to someone who’s depressed, but it is one of the kindest, noblest, and best things you will ever do.

It is worth saying that good friends need to decide in advance never to be shocked or thrown. This is not to suggest appearing unaffected or unmoved, nor to deny the possibility of shocking and difficult things being said. Indeed, these may well require some sort of action to be taken. But it is vital not to panic or show alarm during the conversation. For the only way to coax someone out of the cave is to offer space that is safe and secure.

Finally, despite everything so far, it may well be that there are actually things to do. Everyone is different, and nothing should be imposed, only offered. Talk about it!

This is a far from exhaustive list:

  • Pray! And perhaps send a text to say what you particularly prayed for. The cave’s deepest recesses
    somehow make prayer impossible. That’s one of its cruelest hallmarks. Sometimes it was even unbearable
    to hear someone praying for me—perverse and absurd though that sounds. Please don’t condemn that – but pray on regardless. Perhaps use the psalmist’s prayers for himself as a steer.
  • Share: it’s not everyone’s cup of tea, so it is always a matter of knowing friends well. But sharing a song, a poem, a line, a verse—anything really—that you find helpful yourself can be wonderful. Don’t be didactic, though. Avoid things that ‘they jolly well ought to have realized by now’. And don’t be offended if what you share doesn’t connect.
  • Accompany: even though I have found therapy to be lifesaving at times, I still find myself descending as an appointment draws near. I have rarely needed someone to help me do this, but I know it can be so helpful. So offer to go along to an appointment, saying you’re happy just to sit in the waiting room. That speaks volumes. Or perhaps it is simply a matter of keeping an eye out in a crowd in case some protection is helpful, such as at coffee time after church or in the canteen at work.
  • Hospitality: to have friends share their home, while making clear it comes without expectations of being sparkling company, can be liberating. Just offering a ‘normal’ environment, while family chaos continues all around, is such a gift. Please don’t invite others along without agreeing on it, though, even with the best of motives.

Above all, whatever you do offer, don’t give up on doing it.

3. Reassure

One hallmark of friendship highlighted by the book of Proverbs is time spent in conversation. It may be a matter of sharing advice and experience:

Perfume and incense bring joy to the heart,
and the pleasantness of a friend
springs from their heartfelt advice.
(Proverbs 27:9)

Yet even more significant perhaps is the willingness to say difficult or unpalatable things. In fact, such willingness should be regarded as definitive:

Wounds from a friend can be trusted,
but an enemy multiplies kisses.
(Proverbs 27:6)

It is precisely because friends are motivated by love that they should be trusted. A bogus sycophant is as worthless as a fairweather friend. But when it comes to supporting cave-dwellers, caution is crucial. A wounding, accusatory or challenging word, however well-intentioned or apparently necessary, merely twists the knife still further. It is not even a question of thinking twice before saying such things—I would strongly urge avoiding doing so altogether, unless circumstances really make it necessary. Otherwise, you will only compound the guilt and shame explored in earlier chapters. I have been on the receiving end of such words, and they have probably driven me closer to the edge than anything else.

Then, there are some lines that should be removed from your pastoral phrase book at all costs:

  • Why can’t you just snap out of it?
  • Just think positive—none of this negativity helps anyone.
  • Confess your sins, and this will all go away.
  • Take your pills, and it’ll be fine/you must stop your pills because they’re dragging you down.
  • He/she/I has/have been through far worse – what are you complaining about?
  • God won’t give you more than you can handle.
  • It’s sinful to be joyless/anxious/frightened/lose perspective.

Instead, a good friend takes note of the emotional temperature. I have always loved this proverb because it perfectly captures those who fail to do this (and it is surely worth bearing in mind if you plan church worship services):

Like one who takes away a garment on a cold day,
or like vinegar poured on a wound,
is one who sings songs to a heavy heart.
(Proverbs 25:20)

Think. Listen. Pray. Ask yourself, ‘What does this heavy heart most need from me right now?’ This is where words of reassurance come in. If the fog has descended, and reality has been distorted or entirely obscured, then a friend’s greatest gift is to be a counterbalance. To be a Katniss to a Peeta. To offer perspective where it is evaporating, to offer alternative interpretations where only the darkest appear to make sense.

Therapists helpfully refer to the problem of catastrophizing. This is a tendency to accept only the worst explanations for something, or to believe that the most terrible outcomes are possible, and even inevitable. It is especially common in those who have experienced trauma or tragedy. It makes sense because they have known catastrophe, and so, not unreasonably, fear its repetition. But it makes everything get out of proportion.

So one way to reassure is to open up the possibility of other interpretations, to talk us down from believing the worst. To be the person who can say ‘real’ or ‘not real’. It might be a matter of gently offering alternative explanations for not hearing from someone in a while, or simple reminders of the wonders of unshakeable gospel grace, or just a silent arm around the shoulder. Anything really.

You can buy the book here.

You should also know that in July of 2020, Crossway will be publishing two companion books by David Murray:

  • Why Am I Feeling Like This? A Teen’s Guide to Freedom from Anxiety and Depression
  • Why Is My Teenager Feeling Like This? A Guide for Helping Teens through Anxiety and Depression