When I start counseling a depressed person, I'm looking for answers to five questions at an early stage in the conversation. I don't ask them in a checklist or condemning manner, but I try to probe sympathetically to get a sense of where they are at.
1. Do you accept you have a problem?
Don't assume that just because a person has come for counseling, that he accepts he has a problem. Family pressure rather than personal choice may have put him there. It is very common for a depressed person to be in denial about the existence, the nature, or the extent of the problem. Sometimes this denial is wilful pride, but sometimes it is because depression can creep over a person so slowly that they do not realize that it has happened. And, of course, part of depression is an inability to see oneself in a true and realistic light.
2. Are you willing to explore all the possible dimensions of this problem?
Once a person has accepted that he has a problem, I want to know how open they are to looking at the problem from a number of angles. Some people will only want to look at the spiritual dimension, and are looking for bible verses; others only want to talk about the physical dimension, and are looking for a pill; still others are only interested in looking back to find all the people and events that have contributed to their problems. But, unless a person is willing to explore all the possible dimensions of depression - physical, spiritual, mental, social, etc., - most counseling effort will be frustratingly handicapped.
3. Do you want to be made whole?
This was the question Jesus asked of the lame man at the pool of Bethesda (John 5:6). At first glance it may seem like a silly question. Surely every sick person wants to be made whole! Surely everyone with problems wants them solved! However, Christ’s challenging question seems to imply that this man had settled into the role of "victim" and no longer wanted to get better. Sometimes a depressed person can also adopt this mindset. Perhaps they are frightened of all the responsibilities of life that might come upon them should they be viewed as well again. Perhaps they would miss the attention and sympathy that being ill often generates. So, we gently ask, "Do you really want to be made whole?" And that leads us to the next question.
4. Are you willing to do what you can to contribute to the healing process
Doctors and pastors are often faced with the frustrating situation of people who need their help, yet are not taking the steps required to benefit from this help: practical suggestions are not followed through, Scripture is not read, necessary medication is not taken, friendships are shunned, etc. Depressed people often need to be encouraged out of passivity and into taking some responsibility.
5. Do you trust me when I tell you that you have good hope of recovery?
As hope is such an important part of recovering from depression, I'd like to ask "Do you have hope of getting better?" However, as depression usually involves a general sense of hopelessness, initially I ask them to trust me that there is hope, rather than have that hope themselves. I encourage them with statistics (the vast majority of depressed people do eventually recover), and with stories of other people I've seen get better. After a few meetings I usually see people beginning to adopt the hope themselves, and that is such an accelerator of healing.
Again, I want to emphasize that this questioning is to be done in a caring and compassionate way. And I'm not saying, "Unless you get the right answers right away, you might as well not even start." However, I've found that these questions usually reveal enough to indicate how fruitful any future counseling will be.
Five Questions to Ask a Depressed Person
By way of Tim Challies's excellent blog, I learned of this helpful post from David Murray's Head/Heart/Hand blog: