Apr

20

2012

Justin Taylor|3:40 pm CT

Should We Be Positive about Psychiatric Medication?

A balanced answer here from CCEF’s Ed Welch:

If I am thinking about my father, who was overmedicated, I would say one thing.

If I am thinking about another family member, who was helped by psychiatric medications, I would emphasize medication’s usefulness.

He mentions in particular two groups that he would want to be positive with:

Group 1: Psychotic people and their families. “Psychotic” is a general term that can include delusions, hallucinations and other severe mental experiences that make it difficult or impossible to work or have relationships.  Schizophrenia, bipolar and even depression can move into psychosis.

Psychiatric medication has quieted the voices of schizophrenia, abated the storms of bipolar, and relieved the vice-grip of depression. Medication is not always successful with these symptoms, but so what. I would argue that families and friends would be wise to encourage (plead with?) the person who is prone to psychosis to both see a psychiatrist and take the medications that a psychiatrist recommends.

Group 2: Those who feel unsure, guilty or ashamed because either they are taking medication or their children are taking medication. I would like to think that we have not compounded your pain, but I suspect that this group has overheard some comments from biblical counseling that have made them feel worse.

If medication is helping, even a little, here is what we would say.

“That’s great.”

If you feel like a spiritual failure because you are taking medication, we would say, “No way. Why do you even think that?” (Most of my colleagues would say something less abrupt.) Then we would try to reason how Scripture itself is not giving you a reason to feel like a failure.

If you feel like a failure because your child is taking psychiatric medication, our guess is that you have worked harder at your parenting than ten other parents combined. We hope you are not judging your parenting success against the parent whose child sits quietly, gets all A’s, does homework without supervision, rarely gets frustrated, and is compliant and obedient. Parenting probably had little to do with any of that!

Some kids are just hard. The strategies that worked for some parents will not necessarily work for you. To make matters worse, you will receive an endless stream of advice, which will leave you angry, because you feel like you should do everything you can for your child and the advice is often contradictory. We hope you will not add guilt over medication to that list. Rather, success is marked by “help me and my child, Lord Jesus.” It isn’t measured by having a medication-free zone in your home.

He goes on to explains that wise decisions can take different forms in different situations:

A divine directive would be nice: “do this or take this and everything will be fine.” But our Father has a better way. We confess our neediness, consider relevant biblical teaching, seek the counsel of others, make the hard decisions, learn from what helps, avoid those things that hurt, and know God-with-us. For some of us, a positive decision for medication will be a wise consequence of this process.

In a previous post Welch explained three reasons why they sometimes seem negative about such medications.

23 Comments

  1. It does not seem that Ed knows the addictive nature of psychiatric medication. No atention to the potential side effects are mentioned either. The ease by which this type of medication is prescibed is concerning. As part of the article he should have included this to give a more balanced opinion i suggest. He is playing with fire!

    • Of course, there are a lot of things that are “addictive.” For example, caffeine.

      Also, there are side effects to caffeine.

      And caffeine is widely available.

      Are people who drink tea, coffee, or soft drinks “playing with fire”?

  2. Am I the only one having an incredibly hard time swallowing the pragmatic approach this guy is taking? If it works even just a little bit, it must be good? Really?? The underlying argument in the above writing for the support of psychiatric drugs is altogether unbiblical and worldly. Do whatever works for you, stay away from anything that hurts, plead with relatives to see a psychiatrist (usually trained by/with wordly philosophy)and do/take whatever they prescribe….oh my word, none of this can be supported by a Biblical framework, and much of this advice seems to fly in the face of scripture. The only mention made of Biblical counseling (which would hopefully seek to discern spiritual correlations and causes for some of the conditions mentioned in group 2) is a derogatory one, insinuating that anyone who is feeling guilty (maybe the Holy Spirit at work in some people???) is doing so because the Biblical counseling they have received has been bad and is to blame. According to this guy, any and all having their consciences pricked should immediately let themselves off the hook! Stop feeling so bad by going to scripture to see where it tells you not to feel so bad! This does not sound like any other teaching I have ever heard, especially from the pulpit.

    • There’s nothing inherently wrong with a pragmatic approach in medicine. Don’t we want medications that work? When we go to the doctor with an ailment, don’t we want him to fix the problem?

    • Hm, I don’t see an actual argument about how “none of this can be supported by a Biblical framework, and much of this advice seems to fly in the face of scripture”?

      If it isn’t unbiblical, however, then it’s probably a good thing to help alleviate people’s consciences with regard to medication.

  3. with held to protect loved ones from clueless

    Neither of the previous posters seem to have been touched by the situations that can call for psychiatric drugs. Those of us that have watched love ones struggle to make sense of a world/brain that is lying to them about what reality EVEN IS much less be able to understand and comprehend the love that is in scripture!
    This is why so many people can NOT come to a church for help because there are simple minded people that think that they can just slap a bible verse on it. Guess what??? Biblical counseling DOES NOT work if the person can not hear you over the voices in their head. It is very difficult to make it work if their thoughts are so scattered that they cannot pay attention long enough to learn from it.

    Most psychiatric drugs ARE NOT addictive. ADHD drugs are not addictive. A lie put out by the Tom Cruise religion and people are gullible enough to not research it. Anti-psychotics are not addictive. Anti-depressants are not addictive.

    Drugs do not work on their own. People still need God. People still need biblical counseling to get past the bad choices, the sin that has overcome their lives while trying to deal with their disease. And they need love without judgment from people that CLAIM to have the Holy Spirit in them. Most especially people that haven’t been given the thorn in their side need to quit talking and start listening to people that are going through it.

    • I totally agree that treatment for anyone using psychiatric medication should still include therapy, counseling and ministry and should never be the end-all-be-all conclusion to their treatment. I also believe a lot of people are over-medicated or medicated unnecessarily. However, you cannot say that none of these drugs are addicting. I happen to know that some are.

  4. It’s possible that some of the people posting might need a sedative :)

    Seriously, though…if God made creation, and creation is good, then we don’t want to be gnostic about such things. God likes matter — he made it (C.S. Lewis): this includes things like pharmaceutics. If He gives people the genius to figure out ways of treating illnesses, we should be in favor, if they help and don’t harm.

    Anyone who’s posted above will have taken antibiotics, or analgesics, or cough syrup, without problem. But if the issue is psychiatric in nature, suddenly everything changes — inexplicably.

    As someone who’s a pastor, and who’s worked in 3 psychiatric facilities, I can say A) I’ve seen God take away people’s depressions very quickly, through prayer, seeking Him, and standard biblical means. B) If i knew someone who was seriously depressed/psychotic, and these means didn’t immediately provide relief, I honestly feel it would be evil, and in some cases criminal, to NOT suggest psychiatric care — with the medication that involves.

  5. with held to protect loved ones from clueless

    Thank you Mark and what should be considered when exposed to those cases. They all drive. They drive when they are severely depressed and suicidal. They drive when they are psychotic, hearing things, seeing things and they are on the roads with the people that have a problem with medication. Something I don’t think ever occurs to any of the people that want to get philosophic about it.

  6. “success is marked by “help me and my child, Lord Jesus.””

    This is a profound general observation. We often look for the clear-cut panacea. The problem with clear-cut panaceas is that we trust the panacea rather than God. It would seem reasonable that God would remove panaceas so that we trust Him instead. God blesses even poor decisions made with a mind, the heart of which truly trusts Him, whether the immediate outcome is the most desirable or not. We are sent up the mountain of decision with knife in hand, fire and wood, and the proverbial son who asks where the lamb is; and we are expected to observe that “the boy and I will return” even before the climb is made. God will keep His promises.

  7. I take medication for anxiety / panic disorder. To be clear the difference between anxiety and anxiety disorder is like the difference between being sad and being depressed. In other words, the difference is not one of gradation; it is a different animal all together. Secondly, I decided to take meds only after a long prayerful drawn out battle. I would like to offer my story/ some observations that may give a little color to what is too often an academic argument.
    First, anxiety and panic attacks run rampant on both sides of my family going up to my grandparents on both sides. I started having panic attacks out of nowhere when I was 20. I did therapy for a few years, and that was extremely helpful. At 28 I started waking up every day feeling extremely nauseous (which is how anxiety usually affects me). I lost 25 pounds in about a month and a half because I could not eat. Soon I started to get depressed because I could not figure out where this despair was coming from. I couldn’t wrap my mind around what was happening. I spent about 3 months fighting severe anxiety until finally my homegroup (fellowship group) my wife and my mother told me that I should try medication. This was after a lot of prayer on their part and mine. I now take an SSRI and the results have been really positive (about a year in). It took a couple tries to get the meds right, but I feel completely normal (not sluggish, no weight gain on my current medication). The worst side effect is that sometimes my legs sweat at night.
    My observations:
    1. The time spent battling anxiety was the hardest time of my life. However, I have never been so God dependent. Through that battle the lord brought me to the end of myself.
    2. Meds did not take away anxiety, but rather brought my anxiety to a controllable level where I am able to do the spiritual work necessary to fight this thing. I am now able to see where I did not trust God in previous bouts of anxiety. I am able to see my idolatry of comfort and health. God has mercifully granted me opportunities to practice holding onto Truth, to hold onto His promises, when the lies hit.
    3. I do not believe this would have been possible without the meds. The anxiety was so severe, I could not think straight. I was fighting so hard for survival that I could not do the work necessary to renew my mind. The pain was too intense.
    4. Medicine is not the cure. For me personally, I am not sure it is a permanent help either.
    5. Healing can occur in the absence of a cure. Faith heals. I believe that anxiety will be with me my whole life. It is a part of who I am, and to be honest I am not sure I would want to be without it. Like an old friend anxiety rears its head and I quickly run to God for strength. In some sense I see it as my “thorn,” a thorn that keeps me from being my own God. Throughout this process God has granted me so much healing, but I have never been “cured” of anxiety.
    6. My time taking my pill is a bit like communion for me. Every time I take the pill I remind myself that it is not the cure, but rather that God provided a way, and that I will go wherever he wants to take me. Therefore, I am very serious, deliberate, and prayerful when I take my medication. I suppose it is a bit like devotional time.
    7. Ultimately, I do not believe my anxiety is about me. I see it as another way to hopefully disciple others who are suffering.
    Conclusion, I believe if pursued correctly medicine can be a common grace that can help you battle this fallen world wisely. It is important to be under authority and in a good community that can help check against over medication or other abuses that can occur. James 1:2 really guides my heart in my battle with anxiety so if you are suffering remember God is sanctifying you. He is giving you an opportunity to cling to him. “Count it all joy, my brothers, when you meet trials of various kinds, for you know that the testing of your faith produces steadfastness. And let steadfastness have its full effect, that you may be perfect and complete, lacking in nothing.”

  8. Even secular psychologists (Thomas Szasz) have noted that “mental illness” is a myth. The mind is not a physical entity like the brain. As such, the mind cannot be ill.

    As a young man and before knowing Christ, I was diagnosed with all sorts of mental illnesses. I was put on all sorts of psychiatric medication. It was all a hoax. My real problem was idolatry of the heart and sin against my creator.

    What does the biblical testimony tell us about schizophrenics, cutters, and those who cannot control their bodies? Maybe some demonic activity going on, don’t you think?

    I’ve read a lot of literature on this issue from both sides. It’s saddens me when believers turn to medication when all the power for life and godliness is found in Christ.

    • The mind may not be a physical entity, but there is no doubt that the brain can be broken and have some affect on the mind. Stroke or brain damage by some other means is a pretty obvious example. But the brain is complex enough that chemical changes can influence it. Some people even want to do this intentionally using alcohol or other drugs. Sometimes it happens through more organic means like clinical depression.

      I’ve suffered depression and I can tell you that it’s like being squeezed out of your own head by a storm of thoughts that you have no control over. It’s not demonic, it’s a physical disorder. I have no doubt that people can be possessed. I’ve seen that. This isn’t the same thing.

      If the brain can be fixed or supported so the mind can function properly with the body, then that’s a reasonable course of action to take.

    • Keller has a really good sermon, I wish I could remember which one, that talks about the Bible’s response to our sufferings. If I could some it up:

      I can’t remember if he uses the term suffering, but that is the term I will use. Please overlook how loaded the term is. I dont think this sermon was about providing a theology of suffering. Anyway:

      We are complex creatures, and our suffering is also complex. Any theory of suffering and the response thereto that does not fully embrace the complexity of human nature is untenable and ultimately unhelpful.

      The Biblical worldview of suffering is the only one that fully captures this complexity. Its response is therefore the most helpful and complete.

      Sometimes our “suffering”/illness (dont remember the term) is physical, mental/psychological, or spiritual.

      The Bible acknowledges all three and gives some different prescriptions on all three including- rest, prayer, counsel.

      Again I wish I could point you to the sermon, but I found it very helpful and it also informed my decision to turn to medicine for a short time to help me battle.

    • While there’s a lot of value to what Szasz argues about mental health, not all of it is equally valuable, and not all of it is valuable.

      Hm, I could be wrong but I don’t think Szasz would preclude the use of medication in a person if there is a legitimate and identifiable mental illness for which medication would be beneficial if not required.

      In any case, I’d be interested in knowing which arguments of his you specifically had in mind with regard to the topic.

    • Also, I don’t necessarily agree with everything he says, but Gaius Davies is a (Reformed) Christian psychiatrist who has made useful contributions here and there.

  9. Many years ago my Pastor preached 2 Sundays on the theme of Depression. His solution was: “Jesus is the Cure!”
    A month or so later I realised I was clinically depressed, so I arrange a meeting with him. I mentioned his sermons and asked if he would lead me out of my depression using the methods he espoused in the sermons. I suggested it would be OK to re-read the source material so he could formulate a plan using Jesus as the cure.
    Then he told me, he himself was clinically depressed and had been on small dose anti-depressants for years. In the end, all he could offer me was the name of the drug he used, which he did.
    It saddened me that he could not walk-the-walk, only talk-the-talk. Yet he was prepared to devote 2 sermons to that which he did not believe in.
    I’ve seen Jesus heal, but He requires belief. If the patient or the Pastor is not a true believer, He will not heal.
    Given that most Churches are led by those who do not themselves relate to the Healing Ministry in any way, drugs are their only way out of their situation.
    God wants our obedience, but when our leaders live in untruth, our obedience avails little.

  10. It may just help to know, as well, that Welch told us in class just last night that he hasn’t suggested medication to someone he counsels in over 15 years.

  11. These drugs are widely over-prescribed making it difficult to draw any generalities about their efficacy. Unfortunately the drug classes used do little to remedy the root cause of blood chemistry imbalance, and only seek to pacify the symptoms, real or imagined. Our crude understanding of pyschoactive pharmacy reflects where disease management was in the 1500s.

    • “These drugs are widely over-prescribed making it difficult to draw any generalities about their efficacy.”

      How does over-prescription relate to a drug’s efficacy? I could agree with you a lot of medication is over-prescribed. But the fact that a certain drug is over-prescribed doesn’t in and of itself necessarily tell us anything about the efficacy of the drug.

      “Unfortunately the drug classes used do little to remedy the root cause of blood chemistry imbalance, and only seek to pacify the symptoms, real or imagined.”

      Among other things, this assumes the root cause is “blood chemistry imbalance.”

      “Our crude understanding of pyschoactive pharmacy reflects where disease management was in the 1500s.”

      Hm, really? General anesthetics are a class of psychoactive drugs. So I guess you think our understanding of general anesthetics such as in pain management reflects 16th century “disease management”?

      To take another example, here’s an intro to a psychoactive agent from a standard pharmacology textbook, which I guess also reflects 16th century “disease management” in your view:

      “The primary psychoactive ingredient in cannabis, 9-tetrahydrocannabinol (9-THC), affects the brain mainly by activating a specific cannabinoid receptor, CB1. CB1 receptors are expressed at high levels in many brain regions, and they are primarily located on presynaptic terminals. Several endogenous brain lipids, including anandamide and 2-arachidonylglycerol (2-AG), have been identified as CB1 ligands. These ligands are not stored, as are classic neurotransmitters, but instead are rapidly synthesized by neurons in response to depolarization and consequent calcium influx. Activation of metabotropic receptors (eg, by acetylcholine and glutamate) can also activate the formation of 2-AG. In further contradistinction to classic neurotransmitters, endogenous cannabinoids can function as retrograde synaptic messengers: They are released from postsynaptic neurons and travel backward across synapses, activating CB1 receptors on presynaptic neurons and suppressing transmitter release. This suppression can be transient or long-lasting, depending on the pattern of activity. Cannabinoids may affect memory, cognition, and pain perception by this mechanism.”

    • “Our crude understanding of pyschoactive pharmacy reflects where disease management was in the 1500s.”

      Psychoactive drugs include alcohol and tobacco. As well as drugs like cannabis, ecstasy, mushrooms, LSD, and hard drugs like cocaine and heroin.

      Apparently our understanding of these drugs is “crude” and “reflects where disease management was in the 1500s.”

      So I guess whenever modern physicians attempt to treat people for alcohol withdrawal or cocaine overdose, or when they warn about the risks of lung cancer associated with smoking tons of tobacco for years and years, they might as well be talking about bloodletting with leeches or turning base metals into gold for all the good that’ll come of it.

    • I agree “rockingwith hawking”: I’m not sure where you’re coming from, Stan Engeles.

      Psychoactive and psychotropic drugs are life saving and life sustaining. I would challenge your understanding of these classes of drugs, as well as the research that leads you to state that “blood chemistry imbalance” is the root of all psychological disorders, and labels them “real or imagined”.

      Are you a medical professional? Do you have experience dealing with someone close to you who suffers in this way? If not, let’s not play Tom Cruise in our assessment of this very complex, serious issue. There’s enough ignorance out there.

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