Burnout is a term first used in the 1950s. It encompasses tiredness, exhaustion, emotional drain and often depression in those who have given everything for others. The concept has a special application for those in the health professions and in the pastoral ministry who spend their time concentrating on giving out to those who are needy whether in body, mind or spirit. Yet there is a sense in which the term produces inherent conflict for Christians. If we don't burn out, do we risk simply rusting out? Should we not aim to burn out in the Lord's work?

When we turn to the Bible we are encouraged to take care of ourselves, our families and our fellowship.

Caring for ourselves

Many of us, especially in the caring professions, need to be needed, especially by the most needy. It gives us a purpose in life and may sometimes be a substitute for other relationships and way to control our own insecurity. We need to understand ourselves in this respect. We need to remember that depression is no respecter of persons. We all have our breaking points. When three 'life events' come together, danger and depression threaten. That is especially true of experiences involving loss. These may be bereavements in the family or amongst close friends or other losses in our lives such as our job or our health or our home.

Paul instructs the Ephesian elders, 'Keep watch over yourselves' (Acts 20:28) We need an understanding of who we are. We all have our own personal foibles, but God is able to use us despite our weaknesses. When I was at school my historyteacher gave me a book entitled Eminent Victorians by Lytton Stracey. The book is a critique of some nineteenth century Christians and was written to discredit them. But it had the opposite effect on me. I realised God could use people in a remarkable way in spite of their flaws, and it helped me to look at people as they really are, warts and all, and liberated me from just seeing them all as heroes.

Rosemary and I live in Bristol where George Muller, a German Christian, devoted his life to caring for orphaned children. John Nelson Darby was a fiery Irishman who was the founder of the Exclusive Brethren movement. Both did great things for God but like Paul and Barnabas they fell out with each other. One day Darby came to Muller and held out his hand to make up, but Muller said there were a few things to discuss first before he would shake Darby's hand. This annoyed Darby who walked off. Yet despite their weaknesses and personal animosity God used them both.

We also need to be realistic in our own expectations. Do we have a true vision for the work to which we are called or is it merely a fantasy? Is it a vision given by God that we are able to share and discuss with others - or is it an unrealistic fantasy of our own making, kept locked in our brain and not tested with others?

Elisabeth Elliot wrote Shadow of the Almighty which tells the story of her husband Jim, who dedicated himself to missionary work and was killed by the Auca Indians in Ecuador in 1956. It is a triumphal story fulfilling his words as a 22 year old 'He is no fool who gives what he cannot keep to gain what he cannot lose'. Yet later she wrote No Graven Image, a novel where she describes the death of a patient from anaphylaxis after treatment by the missionary with penicillin. There is seemingly no benefit to anyone and no answers as to why this happened: 'Why O Lord?'

Yet times of difficulty or ill health can make us pause and take stock and ask 'Where am I going?'

Caring for our families

Paul writing to Timothy, and Peter in his first letter, speak of the care we need to take of our families. Communication is important. 'Consider each other' is biblical advice. We need to learn to listen to what the other is saying rather than just hear what they are. All relationships include extra baggage. Often when teaching I would do a stick drawing of a man and wife hand in hand, but each with the other hand behind their back carrying a suitcase of stuff from the past, still to be unpacked and shared together. Each of us brings extra bits and pieces to a relationship and these need to be disclosed. There are added difficulties in being married to a carer, one who is 'called of God'. Children of Christian leaders or missionaries often feel they are living in a goldfish bowl.

The need for a Sabbath was ordained by God in creation; a day of rest restores both the individual and the family. Sunday is not a day of rest for many Christian leaders and often not for doctors. The pattern of rest and working is seen throughout God's creation. The heart beats and rests and beats again. We breathe in and we breathe out. We sleep, we dream, and we wake refreshed. Thus throughout nature there is the pattern of work and rest that we neglect at our peril.

We need to learn to protect ourselves and our families. That may mean saying 'No' to requests or invitations.

Care for our fellowship

Romans 12 and Hebrews 10 remind us of the importance of being part of the body of Christ and playing our role in our local church. We need friends and confidants and should look for support structures. When Paul Berg was vicar of Christ Church Clifton, he had three elderly women as prayer warriors. John Stott had his Advisory Group of Elders who he called his 'AGE' group with whom he could discuss which invitations to accept from around the world. Jesus had women as financial supporters as well as his close friends at Bethany. We need close friends with whom we can share even if we risk being let down as Jesus was.

Even the greatest Christian leaders will have times of grief and trauma and sometimes may become depressed. In CS Lewis's A Grief Observed he describes in very personal terms his grief over the death of his wife. By then he had written many books of inestimable help to those who are going through a time of suffering, none of which were of any help to him.

There are some questions we will never know the answers to in this life. Some of them may aggravate depression and burnout. God is sovereign and he works in mysterious ways. He gave William Tyndale the ability to translate the Bible into English. Tyndale needed money to complete the task. The Bishop of London who objected to his work told people to buy every copy and burn it. Money from the ensuing sales enabled Tyndale to complete the work. Later the King James Version of the Bible drew extensively on Tyndale's translation and within a few years a copy was placed in every parish church in England.

As the years pass our abilities change - and not always positively. Teachers may no longer be able to teach; travellers may no longer be able to travel; carers may be no longer able to care. Our health and other life events will overtake us. We are indeed jars of clay. All of us are subject to psychological and physical afflictions.

The Bible encourages us to consider - reflect - give thought - remember. As we get older, as Christians we will still want to be useful for the Lord, but that may be in ways that we have not thought of when we were fitter and more active.

This article, based on a talk given at the Oxford Centre for Mission Studies in March 2015, is published to honour Monty Barker who died on 1 July 2015. He was an eminent psychiatrist who had an enormous influence on the medical students he mentored, particularly psychiatry trainees. His impact stretched beyond the UK to France and India. An obituary is published in the current issue of CMF News.