It comes as a surprise to many to find out that some of their heroes of the faith, overseas missionaries, go through difficulties in their emotional and mental health. But when you think about the added stress of raising your family in a new country, along with the challenge of sharing the gospel among the unreached, should we really be surprised?

Below are just a few reasons that missionaries are especially prone to depression, and, in the conclusion, I’ll share some of the ways that you can help missionaries that you know.

1. Missionaries want to change the world.

One of the ironies of depression is that high expectations can only make depression worse, and missionaries often have sky-high expectations. As a teenager, I remember reading the stories of Bruce Olson, Adoniram Judson, and Don Richardson, and thinking, “What greater privilege could there be, than to take the gospel and the Bible to a people who never in human history have heard it before?”

Wanting to change the world is only half of the equation. Missionaries have to put the rubber to the road by putting practical steps into place that start with bridging culture, learning language, and sharing life relentlessly. This is no small task for a set of visionaries, idealists and discoverers that often arrive to the mission field bright-eyed and bushy-tailed—not to mention twenty-something. Often a missionary’s first term overseas is simply a time of adjusting expectations, of reining in what they can’t do and learning what they can.

2. Missionaries have unique health challenges.

Anyone that emigrates will have health and diet challenges that come from the new environment. And missionaries are often sent to the places of greatest need, which can mean health care is scarce or poor in quality. Even if there is good health care, they have to learn a new medical system. For some missionaries I know, they are the health care—there is no hospital for miles around, and the only medicine is what they bring in.

What we gain in the excitement of travel we lose in health and hygiene obstacles. I have been served goat intestines to celebrate Christmas. I have eaten meat with my bare hands from the back of a roasted goat along with half a dozen of my neighbors. I have been quarantined on an airplane because they thought I was at risk for MERS. I have been to a gym that had a “communal water cup” that everyone used. Since becoming missionaries, my wife and I have had diarrhea on five different continents. I have been to the ER with a poison ivy rash that was not only unknown to the pharmacist, it was impossible to even get in that country because that plant doesn’t grow there.

Depression tends to correlate with a host of other health problems; diabetes and depression, for example, can cause each other. That means that if you have diabetes, you are more likely to fall into depression, and if you are depressed, you are more likely to get diabetes. So it’s no wonder that, along with all the other health challenges of living overseas, come challenges to a believer’s mental, social, and emotional health.

3. Missionaries share a prophetic calling.

Have you ever noticed that the prophets of the Bible were not a particularly cheery lot? The Bible is realistic in its portraits of human character. Moses interceded intensely for the entire nation, placing his own life on the line (Ex. 32:1-14). Jeremiah was nicknamed the weeping prophet. Joel commanded the priests to “weep between the porch and the altar” (Joel 2:17).

In biblical narratives, prophetic success is almost as bad as failure. After the great victory at Mount Carmel, Elijah prayed that he might die because of the threats and isolation that success had brought on him (1 Kings 19:4). Jonah was dragged by God to Nineveh, and when his message had succeeded, he became suicidal (Jonah 4:3).

Other examples of emotional hardship in the Bible are directly connected to calling. As part of his missionary consecration, Ezekiel was commanded not to grieve the loss of his wife (Ezek. 24:16). Hosea was commanded to marry an unfaithful woman as a demonstration of God’s overwhelming faithfulness. Abraham left behind his pagan family in Ur, and his family was nearly torn apart when God came down to destroy Sodom and Gomorrah.

All of the above are examples of the cost of the prophetic calling. Jesus himself was called “a man of sorrows,” and this emotional cost was not limited to his atoning work on the cross. His life of holiness led him to grief at his hearers’ hardness of heart (Mark 3:5), anger at religious hypocrisy (Matt. 23:33), and to weep and feel troubled at the grave of Lazarus (John 11:33, 35, 38). Jesus’ emotional suffering culminates, of course, in Gethsemane, where his “soul is overwhelmed to the point of death” (Matt. 26:38, Mark 14:34).

Success, failure, family pressure, and spiritual pressure—all of these are scriptural situations that can lead a missionary to feel depressed.

4. Missionaries are isolated.

Missionaries are called to build communities of faith where there are none, so it goes without saying that they are often isolated from their peer groups. Historically, some missions agencies wanted their missionaries as dispersed as possible. You can read memoirs, for example, of Sarah Stallybrass in eastern Siberia, or James Gilmour in Mongolia; although their ministries were impactful, isolation took its toll on their overall health, and they were frequently depressed. More agencies are turning towards a team mentality, and away from the mentality that one family—or one man—can do all the work.

Isolation can be especially rough today for women in cultures where women are expected to remain at home or curfews are in effect. Isolation, culture shock, and rejection by your host culture can become a potent cocktail for negative thoughts, and security can be another roadblock to communication.

5. Missionaries are humans.

Depression and anxiety are staggeringly common today. Current estimates are that around 300 million people worldwide suffer from depression. It’s also estimated that 15 percent of American adults will experience depression at some time in their life. It should be no surprise that pastors and missionaries suffer from it too.

But ministerial life, with its spiritual and social pressures, has strangely high rates of depression according to some surveys:

The September/October 2000 edition of Physician magazine reported that 80 percent of pastors and 84 percent of their spouses are discouraged or dealing with depression. [source]

If depressed Christians ask for prayer and aid from their pastor and their church in times of trouble, who does the pastor ask for help? Do pastors and missionaries have anyone they can go to for advice and counsel, other than fellow pastors and missionaries, who often suffer from the same issues?

How can we help?

Unless we break the silence and create new strategies for our changing world, mental health issues will likely to continue to abound both inside and outside the church. But hopefully we as believers can take time to identify the causes, and show that we care for our missionaries and pastors by taking some steps in the right direction.

1. Share failures and successes.

Missionaries that are on a fundraising model can be pressured to put on a brave face and regale their listeners with tales of changing the world. We are either on the way to the field, sharing pictures of potbellied pagan orphans, or we are on the way back, sharing videos of new converts singing joyous hymns. Needless to say, neither is a complete picture of missionary life. In fact, it’s the in-between that is so hard to write and speak about—the humdrum of having only one or two inquirers here and there, of feeling that your role in God’s kingdom has gotten smaller since becoming a missionary. Whether missionaries, pastors, or laymen, we all need to re-imagine a missionary life that is less about us and our successes and more about Jesus, his Church, and his glory.

2. Share the load in times of stress.

Missionaries have tremendous psychological pressure, and often they just need someone to sympathize. When one of their converts is murdered by a family member, or their church has decided to split, what a missionary needs more than anything is a listening ear. One of the predictors of healthy adjustment after trauma is simply how much a person was able to get support (i.e. communication) from their family and friends—so if you know a missionary who’s in a rough time, don’t be hands-off; let them know you are there for them.

3. Share the mundane in times of monotony.

Isolation is one of the biggest contributors to missionary depression, and it is ironic in a time when most missionaries have access to Facetime, Messenger, WhatsApp, and Zoom. If security is an issue and you don’t feel you can discuss their work, you can always just talk about everyday life. And most missionaries would love to hear news from their home country, too. More so than newsletters can ever do, this kind of contact can help us to share together the highs, lows, and even the monotonous “middles” of missionary life.

4. Ask a missionary how they are doing—not how their work is doing.

One of the greatest problems with pastors and missionaries is that they can become so closely identified with their work, to the point that when someone asks “how are you?”, the response always involves how your Bible study group is doing, the recent opportunity you had at the market, or who is becoming curious about the gospel. Just like anyone, often missionaries and pastors need to be asked a second time, “how are you doing?”

5. Pray for a missionary.

It goes without saying that prayer is the best thing you can do for a missionary; but it is not the only thing you can do. Take a moment now and think about the missionaries you know—is there someone that is in need of extra prayer? Is there someone you should reach out to or renew contact with, even now?

---

Cover image: Rembrandt van Rijn, Jeremiah Lamenting the Destruction of Jerusalem, c. 1630.