“Depression is the leading cause of disability worldwide,” according to support service Beyond Blue. With almost half of Australia’s population anticipated to experience some form of mental illness, about one million adults each year struggle with depression in Australia.

Guan Un is a freelance writer who lives in Sydney’s inner west. He wrote a thesis on personal Christian ministry to those with depression, and he also co-wrote and produced Kinds of Blue, an anthology of short comics about depression.

For most of his life, Guan has wrestled with depression. Ahead of National Mental Health Week, Guan shares an intimate and frank list of what we all need to know about someone experiencing depression – and whether healing and hope can exist.

1. This is hard for me to write

Despite wrestling with depression for the majority of my life. Despite expecting to wrestle with it until the the day I die. Despite seeing depression attack friends and family. Despite reading and writing and speaking about depression for some time now… this is still difficult for me to write.

Part of the difficulty is facing that spectre again. Like any spectre that lurks in our history, you can’t help but flinch when you catch sight of it again.

Depression is the worst thing I’ve ever felt, an internal pain that makes you wither inside and feel alien and adrift inside your own mental space.

Part of it is also a difficulty in being able to communicate about this with other people, because your understanding and experience of depression almost certainly varies from my own. Thankfully, awareness of mental health issues is better than it ever has been, so it’s doubtful that you think depression is just a deep sadness or that you can snap out of it.

I imagine there are people who are reading this, who are wrestling with the black dog, and all I can say is that I physically ache for you, and I pray for you, and I wish I could put myself in your place, so that you no longer have to dwell within that deep darkness.

Depression is the worst thing I’ve ever felt, an internal pain that makes you wither inside and feel alien and adrift inside your own mental space. Poet Jane Kenyon called it ‘the anti-urge, the mutilator of souls’.

And yet, despite all that, depression is not the end of the story.

2. As a Christian, depression is easier to understand

I’m a Christian and I find depression easier to understand because there’s answer for its very existence: depression is a byproduct of sin (which opened the floodgates of internal and external corruption to the world, alongside disease, labour and death).

However, this is not the same as saying that depression is a result of a person’s sinfulness. Firstly, that is rarely true and secondly, to say depression is a sin, is to load guilt upon a psyche that is, in many cases, already strained to breaking point. In many case, I’ve found that those who believe depression needs to be fixed by repentance – you know, when you are sorry for the wrong you have done and want to turn away from doing it again – is more a reflection of their own discomfort with suffering, than anything about the sufferer.

3. As a Christian, depression can feel impossible to bear

At times it feels like an impossible task, to stay Christian while wrestling with depression. American novelist William Styron once described his depression as a state where ‘faith in deliverance, in ultimate restoration, is absent’. How then can someone who follows Jesus and also suffers with depression, bring themselves to live out the call to faith that is found in Hebrews 11:1 (‘the assurance of things hoped for, the conviction of things not seen’)?

The things that are supposed to help can feel like a marathon on shoes made of broken glass.

How are they to ‘rejoice with joy that is inexpressible and filled with joy’, when they can barely shape their lips to smile? (1 Peter 1:8)

On top of that, the things that are supposed to help can feel like a marathon on shoes made of broken glass.

Even normal conversations can feel like a catch-22. Either you ask me ‘How are you?’ and I answer ‘Not great’, and I have to explain; or you ask ‘How are you?’ and I try to pretend things are fine, so you won’t be uncomfortable.

4. I know the answer to depression, I’m just not there yet

Often, I feel like the traveler who trusts the map that says the city is ahead, even if I am not yet over the hill, in a place where I can see if for myself. In the same way, I can know hope is there even if I cannot feel it for myself.

And it’s at times when I’m in the darkness that ten words become enough: “Blessed are you who weep now, for you shall laugh.” (Luke 6:21)

I can know hope is there even if I cannot feel it for myself.

And it’s at those times I’m reminded of the Psalmist who can sing in the same song — “Why are you cast down, O my soul, and why are you in turmoil within me?” and “Hope in God; for I shall again praise him,my salvation and my God.”

I don’t know if the Psalmist felt depression exactly, as defined by our current medical terms, but it certainly was a deep sadness, and a sadness that he could also reconcile with a hope he knew — even when his feelings put him at arm’s length from that hope.

But he trusted the map — the promises of God, recorded in the pages of the Bible — and kept moving toward the city.

5. Treat depression as a disease of the body

This call to “treat depression as a disease of the body” might sound confusing at first, because it is a mental health issue. But I think this helps because it breaks down the distance between mental health issues and physical issues.

Fueled by erroneous catchphrases like ‘if there’s a will, there’s a way’ or ‘mind over matter’, we can be fooled into trying to think our way out of depression. But current research points to depression as linked to chemical imbalance in the brain, and chemicals respond about as well to ‘snap out of it’ as a flu virus responds to ‘just get better already’.

In many cases, what depression does respond to is exercise. In an astonishing amount of cases, depression responds to CBT (cognitive-behavioural therapy), counselling, and medication. If you are wrestling with depression, please see your doctor, and get the best help that you are able to get.

6. Depression is not exempt from the good news

My friend Sarah once ran a project where she interviewed Christians suffering from depression, of various levels, about their experience of church and sermons. She asked them to compare a time when they were depressed, to a time when they were okay.

What she found surprised many people: across the board, those suffering from depression reported that while they enjoyed church and sermons more when they were not distracted by the black dog, they still heard and responded to sermons when they were depressed. Their responses were more muted but they did respond. Even in depression, they needed to hear the call of the good news of Jesus.

‘How do I care for someone suffering from depression?’ And the answer is simple: love.

Again, this is not the same as saying that being a follower of Jesus somehow cures them of depression. While it is not beyond God’s reach to be able to do that, there is nothing support me or you promising someone else that that will be the case.

But perhaps it should not be a surprise that the light of the good news of Jesus was still a light to those living in inner darkness. At those intense times of inner darkness, such light can be all the more necessary. Those struggling with lack of self-worth, and unsure of their own identity, need to hear of the God who sees them, regards them as worthy of love, and sent his Son to die for them. The same God who regards them now as whole and pure, as his sons and daughters, who he sees with the same love as he sees his own Son.

7. Depression is not exempt from love

I am often asked: ‘How do I care for someone suffering from depression?’ And the answer is simple: love.

This is not the answer someone wants to hear, if they are really looking for the magic phrase that will lift the cloth of depression like a magician revealing a trick.

But love is the answer. Love that gets down in the dirt. Love that is patient when you get little affirmation and less thanks. Love that doesn’t turn into victimhood or martyrdom.

Sometimes carers do need permission to care for themselves too (and if you need that permission, please take it now). For someone who is caring at close-quarters, the battle can be long and unrewarding, and greatly helped by those who are willing to step in and love by your side for a term. Long-term care is like a spider-web; it’s at its best when it has many strands of support, which is where a church community can be invaluable.

There are no guarantees about where the story for those struggling with depression will end. There aren’t necessarily silver linings to the black clouds.

For me, I’ve been off meds for years, and I know I need to be vigilant: to go running even when I don’t feel like it; to watch for self-abusive patterns of thinking; to be honest and patient with my struggles, with my friends and with my Lord. But even then, I hesitate to offer that as a promise.

And yet there is that promise of ten words, there is an amazing city that we cannot yet see, and there is a hope even if you can’t feel it now. Those I can guarantee. Because God guarantees it to those who believe and trust in the good news of Jesus.