Jan
19
2010
Depression and Medicine
From an article on depression by Ed Welch:
The severe pain of depression makes you welcome anything that can bring relief. For some people, medication brings relief from some symptoms. Most family physicians are qualified to prescribe appropriate medications. If you prefer a specialist, get a recommendation for a psychiatrist, and ask these questions of your doctor and pharmacist:
- How long will it take before it is effective?
- What are some of the common side effects?
- And, if your physician is prescribing two medications, will it be difficult to determine which medication is effective?
From a Christian perspective, the choice to take medication is a wisdom issue. It is rarely a matter of right or wrong. Instead, the question to ask is, “What is best and wise?” Wise people seek counsel (your physicians should be part of the group that counsels you). Wise people approach decisions prayerfully. They don’t put their hope in people or medicine but in the Lord. They recognize that medication is a blessing, when it helps, but recognize its limits.
Medication can change physical symptoms, but not spiritual ones. It might give sleep, offer physical energy, allow you to see in color, and alleviate the physical feeling of depression. But it won’t answer your spiritual doubts, fears, frustrations, or failures. If you choose to take medication, please consider letting a wise and trusted person from your church walk come along side of you. They can remind you that God is good, that you can find power to know God’s love and love others, and, yes, that joy is possible, even during depression.
If you want more on Welch’s perspective, read the whole article, and see his books Depression: A Stubborn Darkness—Light for the Path and Blame It on the Brain? Distinguishing Chemical Imbalances, Brain Disorders, and Disobedience.
14 Comments
I appreciated the helpful review done by Donn Arms from the Institute for Nouthetic Studies on Welch’s book: Depression, A Stubborn Darkness. Here is the link:
http://www.nouthetic.org/blog/?p=293#more-293
Far more helpful than the review mentioned in Comment 1 is the book written decades ago by John White, The Mask of the Melancholy. Depression has a number of causes and effects. For some depression is caused by a lack of sunlight and has no spiritual reason that needs the work of a biblical counsellor. And there are probably many other kinds of depression of a similar nature. Extreme cases of depression render the subject quite beyond the reach of counselling, whatever the initial cause, as the brain has simply shut down. In the darkness of depression it is not enough sometimes to shine a light in, as the depression has robbed the person of eyes with which to see. The tendency of some biblical counsellors not to see this aspect of the problem suggests that they take insufficient cognisance of the created aspect of our humanity, seeing everything in purely spiritual terms, much as the gnostics did in the second centure
My 20-year-old son has suffered depression on and off for nearly 4 years. We have found Welch’s books very helpful.
Timothy (Comment #2 above), have you even read Welch’s books? He is far from the gnostic view of life.
Good thoughts. It’s vital to note that feelings of depression can come from a variety of sources, and can be resolved in a number of ways.
However, feeling “depressed” is not the same as being diagnosed with clinical depression or a major depressive disorder. That formal diagnosis indicates that a critical level of depression has been reached and, regardless of the cause of depression, must be treated with extreme seriousness.
Medication is frequently prescribed at this point as a stabilizer–not as a cure–to prevent the person from doing harm to his/herself and to increase to receptivity to other means of treatment (i.e. counseling).
In reply to Dan, no I have not read Welch’s books but then I was not commenting on them either. It was the review noted in comment 1 which I have read that provided the launch of my remarks. From that review I would guess that you are right about Welch not being guilty of gnosticism but I am less sure that the review which IS very critical of Welch is similarly innocent. So I would urge people to read Welch despite not having read him because I am sure that he is better than his critics.
In reply to Elliott, with whom I am in substantial agreement, I would suggest that those who need medication are often so ill that selfharm is quite beyond them. Sadly, I was going to say ironically but that seemed to unfeeling, it as the very depressed improve that selfharm can become a greater risk
I’m with Timothy regarding the Institute for Nouthetic Studies.
I read the book a while back, it really helped me to make a good decision regarding the treatment of the physical symptoms of depresion.
For sure medication does not cure it, but it can provide respite, while you address the true source of the depression.
In Christian cycles, at times, there is a lack of legitimizing depression, and thus, a taboo subject. This book was very frank, and this paragraph in particular helpful when considering medication for the symptoms.
Good Article. For some reason I had it in my mind that Welch was staunchly nothetic and completely against medication. I am glad that I was wrong about him.
I am the only one of four brothers and sisters who is not on medication for depression. It is not because I wouldn’t be prescribed it and I understand very well those who seek out medical relief. I even quite often support them. I am sure that my depression is not as bad as many, but I wouldn’t wish it on anyone. However, my decision not to seek medical help is one I never argue with myself about, even when I am in the pits of despair. I agree with Spurgeon who said something along the lines of depression being his worst enemy and his best friend. I am glad that I have chosen to fight my depression in the way I have. It forces me to Him in ways that I am not sure medicine would allow.
I have been troubled by depreesion, mild to moderate, for many years. Frankly without medication my life would have been crippled. Medication helps and helps a lot. I agree there is no one cure fits all. I agree too that if the root cause is guilt, fear etc then these need to be helped and medication is not the final answer, though it may sufficiently allieve symptoms to enable the sufferer to tackle cognitive elements. Many situations in life sadly cannot be easily changed and what needs to changed is how we react to them. On the other hand often guilt and fear in depression is a symptom rather than a cause. Guilt and fear out of all proportion to reality invades the deeply depressed psyche. medication in cases like this may lift the mood causing the morbid thoughts to disappear or take on more normal proportions.
For me, in terms of helping with thoughts, I found MLJ’s ‘Spiritual Depression’ an exceptional book. I think it should be compulsory reading for every pastor and part of every college course. It deals, of course, not simply with issues that afflict clinical depression but what we may call normal depression that afflicts every believer.
I’m a bit concerned over this position on medication and depression. I’m not suggesting that this a black and white issue. We need to give serious attention to wise answers on this issue. Clearly, many times people are depressed simply because they don’t know how to respond Biblically to their circumstances. In the same way that many people are anxious and worried because they don’t know how to respond God’s way to life’s problems. These people don’t need medication, they need Biblical counsel. Then there appears to be people who are physically depressed and maybe medication is appropriate in these situations.
I think we should also seek the counsel of our doctor, but lets keep in mind that many doctors have a different worldview then a Christian worldview. So we need to understand where they are coming from. Please consider Counsel from the Cross, by Fitzpatrick and Johnson (Chapter 7 – The Gospel and Our Emotions).
I really love Ed Welch and have benefited from much of his writings. But I am concerned with some of the counsel he is giving on depression.
Another book that handles this issue well is “Will Medicine Stop the Pain” by Fitzpatrick & Hendrickson.
I’ve personally found Mike Emlet’s work on this subject very helpful. He’s a biblical counselor and M.D. who works at CCEF with Ed Welch. He’s currently blogging through his course on Counseling and Physiology here:
http://ccef.org/doctor-part-1
Even where depression is derived from a spiritual problem, it can have very physical effects. The spiritual issue must be addressed, but if the depression has been long and established a cycle of perpetual conditioned depression as a response to external stimuli then the physical condition must be treated just as surely as if it were a deep wound that needed dressing for proper healing.
But the converse can also happen where one may be physically prone to a chemical imbalance that results in depression. Over a period of time, this can result in spiritual difficulties even among the very strong in faith.
My case has been the latter. And if you’ve never suffered depression, you have no idea the hurricane of thought that overtakes your mind and robs it of peace. you stand on the outside of it wondering precisely where you stop and it begins and desperately hoping it doesn’t grow so large as to completely encompass you. You also wonder if it isn’t some demon trying to possess you as though God wouldn’t protect you from such. It can negatively affect your relationships with spouse, children and other brothers and sisters in Christ. And it can make you ill-effective in ministry. I praise God that this wasn’t the case with Spurgeon.