One psalm in the Bible ends in the dark and never climbs out. For anyone who lives with a mental illness, or who loves someone who does, that psalm may be the most useful prayer they own. This study works on one question: how do you keep talking to God, and keep showing up for the people around you, when the illness has not gone away? It will not promise a cure. It offers Psalm 88, a few hard-won observations from Dr. John Swinton, a professor of practical theology and pastoral care at the University of Aberdeen, and one short practice of lament to try this week.
You can work through it alone in one sitting or over several days. A group can take it in two meetings, stopping after the section on Psalm 88 the first time. Nothing here requires you to tell anyone anything.
If you are thinking about ending your life, or you are worried that someone else is, set this study aside for now. In the US, call or text 988 to reach the Suicide and Crisis Lifeline at any hour. Then tell one person near you what is going on.
Go at the pace of whoever is carrying the most
Swinton spent 16 years as a mental health nurse before he worked as a chaplain and then became a professor. He knows what treatment can do, and he never sets friendship against medicine. This study takes the same stance. It belongs beside whatever care you or your loved one already has. Prayer and therapy can share the same week, the same day, the same hour.
If you are leading a group, say three things out loud before you start. Anyone may pass on any question, and passing needs no explanation. What people share stays in the room unless someone’s safety is at risk. And the group is a place to belong, which means nobody diagnoses anybody. Have the 988 number and the names of one or two local counselors written down before the first meeting, so you are not searching for them in a hard moment.
Read the psalm that does not turn
Psalm 88 is a lament, written as poetry and titled in the KJV as a psalm of Heman the Ezrahite. It records how the world looks from inside suffering. As a prayer, it tells you what the speaker felt, and it does not announce that God has abandoned anyone. Read it aloud, all eighteen verses, without stopping to explain anything. In a group, let one person read while everyone else listens.
It begins, “O LORD God of my salvation, I have cried day and night before thee” (Psalm 88:1). A few verses later the speaker says, “Thou hast laid me in the lowest pit, in darkness, in the deeps” (Psalm 88:6). Then comes the question many people living with depression already know by heart: “LORD, why castest thou off my soul? why hidest thou thy face from me?” (Psalm 88:14).
And it ends here: “Lover and friend hast thou put far from me, and mine acquaintance into darkness” (Psalm 88:18). Swinton sums up the ending as “darkness is my only companion.” That reading matters. Every human companion in the verse has been removed, and the only thing left keeping the speaker company is the dark itself. There is no final verse of praise, no rescue, no lesson.
Read it again, and mark these as you go:
- Every place the speaker addresses God directly. How often does the psalm stop talking to God?
- Verse 13: “But unto thee have I cried, O LORD; and in the morning shall my prayer prevent thee” (Psalm 88:13). In older English, “prevent” means to come before. The speaker is praying before the morning arrives.
- The place where you would expect a turn toward hope. What is there instead?
The rest of this study rests on one observation. The darkest psalm in the Bible is addressed to God from its first line to its last. The speaker has no resolution, and he keeps praying anyway. Scripture kept that prayer, unfinished, and handed it to the church.
Why the unfinished prayer is a gift
Swinton points out that most laments in the Psalms follow a pattern. The situation is terrible, God seems to have broken faith, enemies are closing in. Then, partway through, the psalmist remembers God’s unchanging love. The circumstances stay bad, but worship returns. He describes a woman he interviewed for whom it went something like that: in the middle of her difficulty, she found God. Then he adds, “Other people don’t.”
He treats that as the reason the church needs Psalm 88. A community that only knows the psalms that resolve has nothing to pray with the people whose darkness has not lifted. Swinton’s counsel is to “get into the habit of learning how to lament faithfully,” because “lament’s always prayer.” Lament is faith speaking honestly, and it needs no apology afterward.
He also explains why habit matters. Of the depths of depression, Swinton says “there’s no words for it then.” You cannot always compose a prayer from the bottom. If the Psalms are already familiar, you have borrowed words when your own are gone. They make it possible, in his phrase, to be “talking hopefully about devastation.” Hopeful here means the sentence is still aimed at Someone, even when it sounds like grief.
Some readers will find Psalm 88 more despairing than comforting, and that reaction deserves respect. You may not want a prayer that agrees with the dark. If so, notice what the psalm does with the dark: it says it to God. That alone may be enough for now.
What the woman in the pit wanted
There is a fair objection here. If the Bible blesses a prayer with no way out, could lament become permission to stay stuck? Could a church sit beside someone in the pit and call that faithfulness while the person goes without treatment?
Swinton’s own story answers it. The woman he interviewed described her depression as lying at the bottom of a deep pit with slippery walls she could not climb. Christians often say all we can do is sit with someone, and Swinton calls that a good thing. But this woman did not want company at the bottom. “She wanted to get out.” Medication got her out, reconnecting her with life, with herself, with other people and with God. Swinton says “it was a kind of a spiritual process for her.” She needed people who stayed, and she needed mental health professionals.
So lament and treatment work together. The prayer tells the truth about the pit. The care is how many people climb out of it. If you live with mental illness, taking medication or going to therapy belongs inside your faith. If you love someone who does, your presence can matter enormously while someone else handles the treatment.
She said something else that changed how Swinton understood the illness. When she was well, she felt like she was walking the rim of the pit, knowing she could fall back in at any moment. In Swinton’s account, she said “the shadow of the pit is always with me.” It struck him “how difficult it must be to live with depression even when you’re not depressed.”
If that describes you, the fear on a good week is part of the illness. It says nothing about the size of your faith. And if you are the friend, the good weeks still need you. The person walking the rim needs company too.
Swinton also recounts that this woman sometimes considered suicide, that her love for Jesus held her back, and that this sometimes left her angry with God. He heard the shape of lament in her words. If anything in her story is close to yours right now, call or text 988 today. Bringing that anger to God is honest prayer, and getting help to stay alive is faithful too.
Joy that does not depend on a mood
Swinton distinguishes happiness from joy. Happiness, he says, is a passing emotion, good while it lasts, and nobody has it all the time. “Joy is the thing in the midst of your darkest hour that gives you the possibility of hope.” He adds, “even if you’re in that deep, dark pit of depression, there’s still the possibility of joy, even if happiness seems to be ridiculous.”
Hold this lightly. It describes a possibility God keeps open, and it sets no standard you have to reach. Swinton reports that people living with severe depression told him that calling it unhappiness gets it wrong, because depression is its own thing. That is why “cheer up” misses the point so badly.
A practice for this week: a four-line lament
Try this once a day for five days, or as often as you can manage. It takes a few minutes. Write it, say it quietly, or just think it. No one needs to see it.
- Name who you are speaking to. Psalm 88 begins with “O LORD God of my salvation” (Psalm 88:1). Yours might be shorter.
- Say the true thing. One sentence about where you actually are today. If it is dark, say dark.
- Ask your question. Psalm 13 asks “How long wilt thou forget me, O LORD? for ever?” (Psalm 13:1). You may ask the same.
- Say what you still want. The honest want, even if it seems small or wrong.
Some days you will only reach line two. Stop there. A prayer that ends in darkness is still a prayer, and Psalm 88 keeps you company.
If you are walking with someone, ask whether they would like you to read Psalm 88 aloud with them. A no is simply their answer for today. If they say yes, read it and leave the silence afterward to them. You can also keep one steady habit this week: the same text at the same time each day, with nothing in it that needs a reply.
If you are the one who stays
Lisa Fields put words to a hurt many caregivers carry quietly: “when people push you away that you care about it, it sometimes causes injury and hurt.” She also named the bind that comes with it. The person you love may have asked you not to tell anyone, and you still need somewhere to put what you are carrying.
Swinton answered honestly: “I don’t have a direct answer to that, but I can give you a way of thinking about it.” He reads Jesus’ summary of the law as one movement of love toward God, neighbor and self. Matthew records the second command as “Thou shalt love thy neighbour as thyself” (Matthew 22:39), and Swinton draws care for oneself from that final word. On his reading, Christians need not place themselves in harm’s way in the name of loving a neighbor, and stepping back can be right. Then he sets the boundary: “abandonment is never acceptable.” If you step back, the wider community makes sure the person is still cared for, perhaps by someone else.
For the hurt of being pushed away, his counsel is “making sure that somebody’s supporting you while you’re supporting somebody else.” He means someone you trust who will tell you hard truths. He does not settle how that fits with a request for secrecy. One reasonable approach is to ask your friend, early and plainly, who you are allowed to lean on. Where someone’s safety is at risk, getting them help comes before keeping the secret.
Questions to sit with, alone or together
- Psalm 88 never stops addressing God, even though it never resolves. What would change if you believed an unresolved prayer still counts?
- When you hear that some people never find the turn toward hope in the middle of their darkness, what is your first reaction? Where does it come from?
- The woman Swinton interviewed needed both people and medication. Where have you, or your church, treated those as rivals, and what did that cost?
- If you live with mental illness, what would you want the people around you to understand about the weeks when you seem fine?
- If you are a caregiver, who is supporting you right now? If no one comes to mind, what is one small step toward changing that?
- If you tried the four-line lament, what did you notice? If you did not, what got in the way?
Leaders, leave these questions untied. If someone’s answer is heavy, thank them and let it rest. Before people leave, make sure no one goes home alone with what they shared, and check in afterward with anyone who seemed to be carrying more than the session could hold.
Go back to verse 13 before you finish. The speaker of Psalm 88 had no answer, no relief and no sense of God’s face, and he still prayed before the morning came. Keep talking to God in whatever words you have, and let a few people keep walking the rim with you.