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(OPINION) The first time Sarah J. Robinson tried to kill herself was eight months after she became a born-again Christian.

She had struggled with suicidal thoughts since elementary school. She would imagine jumping into highway traffic or fill her hand with pills and consider swallowing them. But her depression only deepened after she was baptized as a teen and poured herself into Bible studies and upbeat youth-group projects.

She felt like a failure. Finally, she pressed a knife harder and harder into her skin – but she couldn't force herself to end it all on the kitchen floor. Looking back, she wrote: "I didn't want my family to find me there, so I got up and put the knife away. I climbed into bed, put on a worship CD, cursed God and went to sleep."

Robinson kept stacks of journals and they provided crucial material for "I Love Jesus, But I Want to Die," a book written during three years of struggle and research. Her battles with depression have continued, even during her years working as a youth minister.

Images of handwritten pages appear in the book, including this 2007 plea: "Lord, I'm struggling. I need your help. This week has been really rough – I've been sad & lonely & angry & numb. I cut myself and berated myself, wished for the end, tried so hard to hide it. I'm not just empty – I've become a vacuum, taking on more and more of the absence of your presence. … God, please don't let me be lost."

It was hard to be that vulnerable, said Robinson, reached by telephone in Nashville. But including actual journal pages "seemed like a no-brainer" if the goal was to "let other people who are hurting know they are not alone. I wanted them to know that I've been there – in that kind of midnight."

Among secular researchers, it's common to find two views of mental health issues, said Robinson, citing the work of Stanford University researcher Carol Dweck. The first is a "fixed mindset" that assumes these conditions are predetermined and unchangeable. Thus, "setbacks and failures reveal who we really are and will always be," said Robinson." The second is a "growth mindset" that says individuals can adapt and change.

In pews and pulpits, many believers simply assume all mental-health struggles represent a lack of faith. Strugglers will be healed if they dedicate themselves to Bible study and prayer while turning away from their sins. Church-based "pastoral counseling" is an option.

"The idea is that if I put the right things into the spiritual vending machine, then I'll get the right things out," said Robinson. "If I'm doing everything I've been told to do, but I'm not getting the benefits that I should, then something is wrong. … I have failed, as many people say, to 'choose joy.' "

The result, as she writes in the book, is this devastating equation: "God is good – just not to us. God is present, but not with us. God is gracious, but not to us. These thoughts lead to a cancerous self-hate, reinforcing the lie that our sickness is beyond God's reach."

The problem is that some people come from families that have struggled for generations. Others have been abused. Some have been diagnosed with bipolar disorder, chronic anxiety, eating disorders or blinding migraines. All of this leads to intense shame.

There are clergy, she added, who acknowledge that "some of these problems are outside our wheelhouse" – so they maintain lists of professional resources and form partnerships with licensed counselors. It's also important to notice if pastors ever preach on subjects linked to anxiety and depression, mentioning that their congregations want to help.

"We need our pastors to make this a normal topic in the life of the church, not something that is seen as abnormal or strange to talk about," said Robinson. "People need to know there are all kinds of issues here, not just something wrong with your 'thought life.' You can't deal with a chemical imbalance by fixing your 'thought life.' …

"We need a team. We need spiritual support. We need small groups. But in some cases, we need doctors. We need professionals. Churches have to know that they can't have a one size fits all solution of these kinds of problems."

Terry Mattingly writes this weekly "On Religion" column for the Universal syndicate. Republished with permission of the author.