Burnout and Depression on Clergy: A research paper

Abstract
Burnout and depression among clergy is a common occurrence across denominations. This paper presents clergy as candidates for burnout, causes, stressors, emotional exhaustion, and treatment of burnout and depression in clergy. The clergy member’s reticence to reveal personal depression including suggestions for future research is also discussed.

The Effects of Burnout and Depression on Clergy
In 2005, Kessler, Chiu, Demler, and Walters reported the annual incidence of mood disorder diagnosis (major depressive disorder, dysthymic disorder, or bipolar disorder) as approximately 20.9 million American adults, or 9.5% of the population (as cited in NIMH, 2007). Clergy, as helping professionals, are not exempt. Burnout and depression are common occurrences in this profession. For example, one needs only to look at the Roman Catholic Church and its clergy members. In a study by Kenedy and Sons, (as cited in Virginia, 1998), over an 11-year period (1986-1997), the total number of priests dropped by 9,086. If this trend were to continue, in slightly over 50 years, there would be no more priests. This fact led to a study on burnout and depression in clergy. However, this malady is not restricted to one denomination. Koenig (as cited in Trice & Bjorck, 2006) stated, “Pentecostal Baby Boomers can report significantly higher 6-month and lifetime rates of depressive and anxiety disorders than other Protestants in the same age group” (p. 284). Likely, burnout and depression is no respecter of denominations or of the clergy that serve and lead them.
In the numerous studies on burnout and depression, some basic definitions have surfaced. The term burnout is commonly a word used to describe an emotional condition as connected to occupation. Freudenberger (1974; 1975), one of the earliest to mention burnout from his own personal experience, defined it simply: “to fail, wear out or become exhausted by making excessive demands on energy, strength, or resources” (as qtd. in Francis, Louden, & Rutledge, 2004, p.5). Maslach, creator of the Maslach Burnout Inventory (MBI) that measures burnout in helping professions, defines burnout in three dimensions: feelings of exhaustion, depersonalization, and poor achievement (Hills, Francis, & Rutledge, 2004). Depression, on the other hand, is a mood disorder with distinctive traits of sadness and gloom, lack of drive and concern for life, and negative thoughts. Physical indications such as sleep interruption, loss of hunger, and weariness also indicate depression (Trice& Bjorck, 2006). Burnout is not the same as depression, but they are often related, and burnout is a common precursor to depression. On the other hand, a person could be depressed and then experience burnout in the occupation.
Clearly, the topic of burnout and depression in clergy needs more research. In this paper, clergy as candidates for burnout and depression will be discussed briefly, followed by discussion of internal and external factors, stressors and emotional exhaustion, and treatments. Finally, reasons for clergy members’ reticence to disclose their depression will be given, as well as some suggestions for future research on this subject.
Clergy as Candidates for Burnout and Depression
In the public eye, ministers often receive admiration; few people know that clergy are prime candidates for burnout and depression. Clergy who are younger and less experienced in the ministry are more prone to burnout than are older, more experienced clergy (Rodgerson & Piedmont, 1998). According to Jones and Francis (2004), male ministers scored higher on an anxiety index than males in general.
Stress is a factor for clergy. A recent study by Krause, Ellison, and Wulff, (as cited in Lee 1999), demonstrated that vital and demanding functions in the church damage ministers more than they do congregants. Furthermore, some of these stressful episodes are difficult enough to surface as accounts of frustration, anguish, depression, and doubts about one’s competence (Lee, 1999). Clergy have a limited supply of emotional resources and often find them depleted by stressful occupational demands. Depersonalization (decrease in qualities that make a person feel important) may occur as the minister develops cynical opinions, as well as negative feelings, about the congregant. The minister might even feel the congregant deserves the trouble (Francis, Kaldor, Shevlin, & Lewis, 2004). In a study on anxiety and depression in Roman Catholic priests, Knox, Virginia, and Lombardo (2002) found further evidence that clergy are candidates for burnout and depression. Two factors contributed to the psychological well-being of the priests. First, priests who had support from both peers and superiors reported less psychological stress. Second, job contentment was an important variable concerning depression and anxiety.
Internal and External Factors
Historically, many experts believed burnout was a myth, but further study has revealed both internal and external factors in burnout. One body of research suggests the problem is external and often systemic through the entire church structure. The external factors include too much work, too little support, rigid work schedules, difficult parishioners, being on call twenty-four hours a day, and excessive bureaucracy, as well as unhelpful and often irrelevant denominational organizations (Grosch & Olsen, 2000). Blanton and Lane (1999) found the following external predictors of emotional wellbeing in clergy: congregational expectations, ability to sustain family life, contentment within the parsonage context, social support, and financial factors. The second body of research suggests, “those most likely to burnout would be those who were idealists, perfectionists, and compulsives” (Grosch & Olsen, 2000, p.620). This research implies that these persons suffer narcissistic tendencies, low self-worth, development difficulties from childhood, and perfectionism of Type-A variety (Grosch & Olsen, 2000). Both of these emphases likely have relevance and should be integrated. That is, both internal and external influences contribute to burnout and depression.

Stressors and Emotional Exhaustion
Stressors and emotional exhaustion also contribute to burnout and depression in clergy. Many different types of stressors can lead to burnout and depression. In assessing emotional exhaustion among Australian clergy, Francis, Kaldor et al.(2004) found clergy who scored high on the index of emotional exhaustion also were more likely to (a) have differences with their congregation, (b) find difficulty filling roles in the church, (c) find it hard to deal with negative congregants, (d) have difficulty making and keeping close relationships, (e) experience high anxiety, and (f) think often of leaving the ministry. In a study on burnout in the Roman Catholic Church, Virginia (1998) found secular clergy (ministers who work with people one-on-one) experienced a much higher degree of depression (72%) than did both religious clergy (those who belong to a religious order) and monastic clergy (those who live in a private community) (40.8% and 39.5% respectively). Those who work closely with people appear to have a greater degree of depression.
Treatments
One potentially therapeutic treatment is to investigate the dynamics of the client’s family of origin. According to Grosch (2000), this can be helpful in three ways. First, a minister may be ashamed at the realization of burnout, and think that he/she knows the solution simply needs a little more problem solving. The resolution often appears easier than it is. Second, clergy often find to their dismay they are repeating roles they played in their own families of origin. Third, seeing that they are playing out old family conflicts with a new family, their church, can be enlightening, as well as maddening, because stopping this action on one’s own is difficult. This is when a good counselor may have an opportunity to assist the clergy/client with appropriate psychotherapy for this internal dynamic of depression.
A second treatment, usually coinciding with proper psychotherapy is correct pharmacology. Many clergy have a strong aversion to medicine because of their culture and belief system. (This topic will be discussed more fully in the next section.) Nevertheless, persistence and education about what antidepressants combined with proper psychotherapy can accomplish, including pertinent information about potential side effects, can be extremely beneficial to the patient. In a study on long-term treatment with antidepressant drugs (ADs), Furukawa, Cipriani, and Barbui (2007) found little evidence for increasing the dosage of the initial AD or for switching between chemical classes of ADs after the initial crisis. However, they did find evidence for the effectiveness of long-term drug-therapy to prevent a relapse in a patient who showed improvement after the original crisis.
A third treatment involves religion and, specifically, how it can be therapeutic for those who are religious. In a recent study, Koenig (2007) found that depression in deeply religious patients abated 70% faster than in those who were not as religious. Koenig shared numerous studies that suggested religion could help to prevent or promote recovery from depression. Sloan (as cited by Koenig, 2007) discussed the ethical mandate not to make the patient feel guilty over a lack of religious activity; furthermore, therapists should never recommend religion to nonreligious patients. Other religious therapies for depression include spiritual interventions such as prayer, fasting, Bible reading (bibliotherapy) and retreat therapy. More studies are needed concerning the efficacy of spiritual interventions for depression in clergy.

Reasons for Clergy Reticence
The problem of burnout and depression in clergy cannot be fully understood without a discussion on the reticence of most clergy to disclose the problem in the first place. Trice and Bjorck (2006) cited the following authors’ comments concerning this resistance on the part of Pentecostals, which would include their clergy. For example, according to Dobbins, “Some salient aspects of Pentecostal’s belief system may negatively impact their willingness to seek professional psychological help when they are depressed” (p. 284). According to Vining et al., “Pentecostal traditions teach that an individual suffering with emotional illness should confess sin and have more faith” (p. 284). Dobbins said belief in the miraculous might also lead Pentecostals to believe they are not employing their faith if they use professional help. In fact, the very act of seeking help from a professional counselor rather than depending on God may be construed as a poor witness to that counselor. Dobbins, and Vining et al. maintain that Pentecostals often have been suspicious of higher learning (p. 284). Education, in the early days of the movement was considered a hindrance to the anointing of the Holy Spirit on one’s life. Macnutt stated, “Moreover, Pentecostal traditions view suffering as a part of the maturing process in faith development” (p. 284). Clearly, for Pentecostal clergy, and likely many other fundamental groups, these elements would hinder them from being forthcoming about their depression.
A second hindrance that keeps clergy from admitting depression is the feeling of being “faithlessly abandoned” by an individual or a group within the church. This can leave the minister with an acute sense of isolation, no longer knowing whom to trust. Those who let the minister down or withhold support at a crucial moment of need are often fellow leaders and/or friends. Cumbee (1980) called this experience the Uriah Syndrome (modeled after Uriah who was abandoned, isolated, and indirectly murdered by David) and gave an example of what he called Ecclesiogenic Neurosis. Once trust is lost, clergy are not likely to be forthcoming with such personal information as their own depression. This also happens at the denominational level with pastors and friends who oversee the minister. The results in the minister’s life are often catastrophic and irredeemable. Perhaps the most serious consequence is that a minister rarely, if ever, will seek help for depression because he feels he cannot. Carl G. Jung, a minister’s son, perhaps put it most succinctly when speaking acidly saying about his father:
Once I heard him praying. He struggled desperately to keep his faith. I was shaken and outraged at once, because I saw how hopelessly he was entrapped by the Church and its theological thinking. They had blocked all avenues by which he might have reached God directly, and then faithlessly they abandoned him (Jaffe, as qtd. in Cumbee, 1984, p.284).
A person in this position feels abandoned, as well as isolated. Few options are available. Hence, depression in these cases often continues unchecked, wreaking havoc in the life of clergy.
Conclusion
“Physician heal thyself” (Luke 4:23, KJV). Most people do not think of members of the clergy as needing a healer, but the literature makes it clear that clergy are as susceptible to burnout and depression as are their congregants. With this awareness, certain conclusions can and should be drawn. First, it would be beneficial to have a method of early detection for burnout and depression in clergy. Since younger and less experienced ministers are more susceptible to depression, it would be wise for church leaders to use a measure (such as the Maslach scale for burnout) early in clergy careers. A required test, along with a psychological profile and some preventive therapy, could keep many a young minister from burnout and depression. Denominational leaders need to be educated and insist their clergy be educated as well.
Second, understanding the religious views and cultural belief systems of each clergy/client is helpful and necessary for the clinician. Previously, the therapist did not concern him or herself with such matters. However, current studies show that the spiritual aspect of the client is another important dimension of the patient’s soul. It should not be ignored. Most clergy have strong belief systems and often find themselves trapped in a personality type that causes them to struggle with the minutiae of principles about those beliefs. Combined with the external factors that affect all clergy in some ways, many are in danger of succumbing to burnout and depression. They are in need of spiritual help. Jesus said, “They that be whole need not a physician, but they that are sick” (Matthew 9:12, KJV). Who will heal the shepherds?
Third, further research is needed on the treatment for burnout and depression. New information on therapeutic, pharmacological, and spiritual interventions would help not only clergy, but also many others who suffer from depression. Many treatments for depression in clergy can also help people in other occupations.
Finally, clergy need education to realize that depression is not necessarily evil or due to a lack of faith. The reasons for depression are numerous, and treatment varies; however, healing may begin with the knowledge that sometimes depression is simply a part of human development.

References
Blanton, P. W., & Lane, M. L. (1999). Work-related predictors of physical symptomatology and emotional well-being among clergy and spouses. Review of Religious Research , 40, 331-348.
Cumbee, D. W. (1980). Depression as an ecclesiogenic neurosis. The Journal of Pastoral Care, 34, 254-267.
Francis, L. J., Kaldor, P., Shevlin, M., & Lewis, C. A. (2004). Assessing emotional exhaustion among the Austrailian clergy: Internal reliability and construct validity of the scale of emotional exhaustion in ministry (SEEM) . Review of Religious Research , 45, 269-277.
Francis, L. J., Louden, S. H., & Rutledge, C. J. (2004). Burnout among Roman Catholic parochial clergy in England and Whales: Myth or reality? Review of Religious Research , 46, 5-19.
Furukawa, M. T., Cipriani, M. A., & Barbui, M. C. (2007). Long-term treatment of depression with antidepressants: A systematic narrative review. The Canadian Journal of Psychiatry, 52, 545-552.
Grosch, W. N., & Olsen, D. C. (2000). Clergy burnout: An integrative approach. JCLP in Session:Psychotherapy in Practice , 56, 619-632.
Hills, P., Francis, L. J., & Rutledge, C. J. (2004). The factor structure of a measure of burnout specific to clergy, and its trial application with respect to some individual personal differences. Review of Religious Research , 46, 27-42.
Jones, S. H., & Francis, L. J. (2004). The relationship between religion and anxiety: A study among Anglican clergymen and clergywomen. Journal of Psychology and Theology , 32, 137-142.
Knox, S., Virginia, S. G., & Lombardo, J. P. (2002). Depression and anxiety in Roman Catholic clergy. Pastoral Psychology, 50, 345-358.
Koenig, M. H. (2007). Spirituality and depression: A look at the evidence. Southern Medical Journal, 100, 737-739
Lee, C. (1999). Specifying intrusive demands and their outcomes in congregational ministry: A Report on the ministry demands inventory. Journal for the Scientific Study of Religion, 38, 477-489.
NIMH. (2007, October 31). The numbers count: Mental disorders in America. Retrieved October 31, 2007, from http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america.shtml
Rodgerson, T., & Piedmont, R. (1998). Assessing the incremental validity of the religious problem-solving scale in the prediction of clergy burnout. Journal for the Scientific Study of Religion, 37, 517-527.
Trice, P. D., & Bjorck, J. P. (2006). Pentecostal perspectives on causes and cures of depression. Professional Psychology:Research and Practice, 37, 283-294.
Virginia, S. V. (1998). Burnout and depression among Roman Catholic secular, religious, and monastic clergy. Pastoral Psychology , 47, 49-67.

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  • James Lowery

    I was very excited to stumble across this paper. I am a grad student working on my counseling degree from a local seminary and I just turned in a literature review paper on pastors and depression. Little did I know, that paper would kindle something within me to continue to do research on the topic. I am considering making the topic a doctoral thesis when that time comes for me. I am excited to hear of others who recognize the gap and need in helping the clergy to be what God has intended them to be. Thank you for writing the paper.

  • Vukani phoseka

    I am also glad to find this researched paper,i am a catholic priest doing Masters in counseling psychology at Catholic Eastern Africa in Kenya,I am from South Africa and i am currently researching on the relationship between work engagement and burnout among young priests in South Africa and related psycho-social coping skills.

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