One of my close friends -- and fellow St. Louis Cardinals fans -- is a wonderful Lutheran pastor who suffers from clinical depression. Earlier this year, he published a book titled "I Trust When Dark My Road." The book (which you can download for free here) allows the reader to look deep into the heart, mind and soul of someone suffering mental illness. Many Americans, myself included, have depression or other related problems. And even for me it's somewhat difficult to think that it afflicts pastors -- as if wearing a stole somehow protects you from the problem. So I was very grateful to see USA Today run a Religion News Service story about pastors and depression. It begins with the sad mention of a 42-year-old pastor in North Carolina who committed suicide in September:

Those who counsel pastors say Christian culture, especially Southern evangelicalism, creates the perfect environment for depression. Pastors suffer in silence, unwilling or unable to seek help or even talk about it. Sometimes they leave the ministry. Occasionally the result is the unthinkable.

Experts say clergy suicide is a rare outcome to a common problem.

But Baptists in the Carolinas are soul searching after a spate of suicides and suicide attempts by pastors. In addition to the September suicide of David Treadway, two others in North Carolina attempted suicide, and three in South Carolina succeeded, all in the last four years.

Being a pastor -- a high-profile, high-stress job with nearly impossible expectations for success -- can send one down the road to depression, according to pastoral counselors.

That's one of the things I picked up from Peperkorn's book as well as my personal knowledge of similar situations. Depression can be caused or exacerbated by a dizzying array of factors, but stress and being overextended and over-obligated can be big triggers. This story gets at that, looking at how some of the personality profiles that are common in clergy (being people-pleasers, for instance) can lead pastors to have major frustration with themselves. The story pretty much focuses on evangelicals and the south, but it gets a wide array of perspective in there anyway.

The president of a pastoral counseling center in North Carolina says that a pastor is like a "24-hour ER" who is supposed to be on call to everyone all the time. As a pastor's kid, I can vouch for the unbelievable frequency of the 2 AM phone call or 4 AM doorbell. The same guy talks about the isolation and loneliness and lack of social support as well. Again, all of these things ring true for many pastors.

The article notes the frequency of depression in the general population (one in four women and 12 percent of men experience it at least once during their lifetime, according to the AMA) and says psychologists agree that it's at least as prevalent among clergy. Then we learn about how few sufferers actually get treatment and how even fewer clergy do.

What makes the article so great, in my view, is that it looks at how theology might compound the problem for some pastors. One man is quoted as saying that clergy don't talk about their depression because it violates their understanding of their faith:

[David] Treadway, pastor of Sandy Ridge Baptist Church in Hickory, was the exception. He told his congregation he was in treatment several months before his suicide. Still the shock was hard to absorb, co-workers said.

Rodney Powe, worship pastor at the church, said he only now understands depression is a mental illness. Christians who don't experience depression trivialize it, he said. "We just say, "Come on, get over it. We have the hope of Christ and the Holy Spirit."' ...

Society still places a stigma on mental illness, but Christians make it worse, [Matthew Stanford, a professor of psychology and neuroscience at Baylor University in Waco, Texas] said, by "over-spiritualizing" depression and other disorders -- dismissing them as a lack of faith or a sign of weakness.

I don't know why I do this, but I read some of the comments to this article and grew disheartened. (Still, USA Today comments are not as bad as Washington Post commenters. Not sure why the Post has such bad trolls on their stories but I recommend you don protective gear before diving into that commenting pool.) People suggested that maybe pastors were killing themselves because "they come to realize that they've been wrong all these years," needed to preach less morality or came to realize they couldn't "impress people" anymore. Someone quoted Scripture to accuse people suffering from depression of being bad Christians and others also tried to argue that depression has no medical component and only a spiritual base.

The article talks about the "career" costs to seeking treatment but also how it's becoming a bit more acceptable to get treatment. I would hope that more stories such as this that engage that hyper-spiritualization of the disease might help improve the situation for other sufferers.

The one thing I was left wondering about was how denominational support structures come into play. In other words, if you have a bishop or district leader to go to or a health plan that covers treatment for depression, does that help more than if you're at a completely independent church?