Someone recently told me that he had finally and reluctantly decided to go to the doctor about his painful and debilitating depression and ask about going on meds. I knew this person had tried every other spiritual and commonsense remedy but was simply not getting better.

With his permission, here’s the advice I gave him plus another few points I’ve thought of since. Perhaps it will help others in a similar situation:

So sorry to hear you are still suffering in this way. But I’m very happy to hear that you are going to the doctor’s today. I know you are nervous but I wouldn’t worry about the visit – you will probably be just one of a dozen depressed people the doctor will see that week. He’s used to it.

I’m glad you are willing to consider the meds. The side-effects are usually minimal for most people and are often greatly exaggerated by opponents of medications.

Somebody recently told me that since they started on meds they didn’t have the real lows they used to experience. However, they didn’t have the sweet highs of spiritual communion with God so much either. The reality is that that’s meds at work; to some extent, they do flatten out our emotions – the highs and the lows. But as I explained to this person, taking meds can be an act of self-denial. You may have to deny yourself these fleeting moments of wonderful spiritual feelings in order to function better for all around you who are dependent upon you. Taking meds can be an act of service to others.

I would simply encourage you to tell the doctor everything – don’t hold back, don’t minimize, don’t play it down – just tell exactly how you are feeling. You may get quite emotional opening up for the first time like this, but the doctor is very used to this and you shouldn’t feel embarrassed.

In the coming weeks, don’t read too much or watch too much TV. It’s time to relax your mind, seek peace and quiet, exercise daily, eat well, sleep well. Avoid screen technology in the late evening.

Try to maintain a routine each day but don’t overpack each day and try to accomplish too much.

Be patient with the medication, give it a few weeks to build in your system. Be very regular in taking them, do not skip them. Ask God to bless His provision of these drugs, and that He would direct them to the right places in your body.

Given what you’ve told me about your state of mind, you should ask your doctor about ongoing counseling, preferably from someone with expertise in CBT (Cognitive Behavior Therapy). That will help you re-train your mind/thinking patterns for long-term recovery. If it was a Christian counselor, that would be even better, but make sure they are trained in CBT.

I’d encourage you to keep your pastor informed, and maintain Christian fellowship in a local church. Ask your pastor or a trusted mature Christian if he would meet with you every week for the next month or so to encourage you and pray with you.

I’m afraid I have to caution you against telling lots of people about taking anti-depressants. With almost every other medication, you’d get lots of sympathy and prayer support. However, in the church there’s a lot of ignorance, prejudice, and misunderstanding around anti-depressants, and you may not get much sympathy or prayer support. I’m sorry I have to say that, but that’s the reality. You can probably tell which people will be sympathetic and supportive – usually people who have been through a lot in their lives – so you may want to carefully explore confiding in one or two of them.

Although you may not feel like it and your concentration is lacking, have a set time each day to pray and read the Bible. Not 2 hours (!), but start small, say a few mins of reading and a couple of minutes of prayer, and once you’ve got that going regularly at the same time each day, start slowly increasing it as you feel able.

Keep your hopes up. I know it feels like a dark hole at the moment, with no light in view, but the vast majority of people come through this with the Lord’s help if they use the means He has provided.

The Lord will bring good out of this. I’ve lost count of the number of times I’ve seen God use experiences like this in His people’s lives to sanctify them and prepare them for future service to other suffering Christians.

  • http://veritaemedicinae.blogspot.com/ Chris

    Good counsel.

    Half the battle getting the umph to do something about it. My commendations to this gentleman.

    The medications won’t cure the depression but they will help to stabilize his mood and allow him to use the means of grace. Ahhh! That’s the medicine for all of us, depressed or not!

    “Why art thou cast down, O my soul? and why art thou disquieted in me? hope thou in God: for I shall yet praise him for the help of his countenance” (Psa 42:5, KJV).

  • Anita

    Great post. Incredibly encouraging and helpful for those at that point. I wish I had read it 3 months ago.

    Isaiah 61:1-3

    To a certain degree, it is true that medication helps, but we still live within these flawed bodies and minds, and true deliverance will not become reality until we enter glory. Therein lies our hope, and we glorify our Saviour for securing that hope for us!

  • http://www.docsdining.blogspot.com Jason Kanz

    David,
    This is excellent. Thank you for sharing it. I appreciate your consistent commitment to wise and humble soul care.

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  • http://www.scripturezealot.com ScriptureZealot

    Very nice post. I’ve gone all through this. They help me a little, but I’m drug resistant, and resistant to every other type of therapy. But I was also resistant to see a psychiatrist at first, and I was glad I did. This has all brought me so much closer to the Lord, as much as I don’t like the discomfort.
    Jeff

  • http://ainesahm.blogspot.com Anne

    This is an excellent article…I shared it on Facebook. I have dealt with depression myself and this article is what I needed to hear when I took the plunge, ended denial, and went to my Dr. for medication. My Dr. went one step further: she gave me an Rx for meds and a referral for CBT, and made an appointment to see me some weeks after (I can’t remember the time frame). Best. Decision. Ever. Although, looking back, I regret not seeking out my Dr. earlier and dealing with depression when I “should” have.

  • Gene

    Thanks for sharing the wise and encouraging counsel. I’ve been a Christian for my entire adult life (I’m 57)and I discovered that I am bi-polar about 5 1/2 years ago. A that time I had been severely depressed for about 6 weeks and the meds prescribed by my family doctor were not helping. Unless a person has experienced the seemingly inescapable darkness of this condition it is difficult to grasp how horrible it can be. At the end of my rope, I ended up going to a psychiatrist who tried a different anti-depressant. My reaction to this medication resulted in my bi-polar diagnosis. My body adapted fairly quickly to the medication and I came out of my depression and leveled out. This medication has enabled me to live a normal productive life and I truly thank God for leading me to this doctor and this treatment. I know that God could have healed me without any medication at any time along the way but he didn’t choose to do it that way. After I came out the other side of this suffering, I found that my faith has been greatly strengthened and I now appreciate the grace of God in a much deeper and vibrant way. I am a adult lay Bible teacher at my church and I believe God has used this situation for His glory to make me more Gospel and grace centered. I also believe that the forces of darkness meant this for evil but our great Savior meant it for good! I know that everyone’s experience is unique, but I do not hesitate to recommend seeking psychiatric help when there is a ongoing battle with depression and anxiety. It is unfortunate that there is still great misunderstanding of these maladies within the evangelical ranks as you have noted. Thanks again for your posting.

  • Hope

    I really appreciate this article, except for one point. You say, “Somebody recently told me that since they started on meds … they didn’t have the sweet highs of spiritual communion with God so much either.” Okay, that’s fine. An anecdotal report of one person’s experience can be helpful. But to go from that (or however many other such stories you’ve heard) to saying that this is always or typically the case is inappropriate. You say, “The reality is that that’s meds at work; to some extent, they do flatten out our emotions – the highs and the lows.” While that may be true of some drugs for some people (and perhaps some drugs more than others), it is certainly not the experience of every person taking an antidepressant, not is it a necessary conclusion from the mechanisms by which the drugs are understood to have their effects. “The reality is” that this *may* happen, but to write as though this is something to be expected in all cases is to perpetuate a myth about one potential side effect – while at the same time acknowledging that the risk of other side effects is exaggerated by opponents of psychiatric medications. This may unnecessarily discourage some sufferers from trying antidepressants.

    • David Murray

      Good point, Hope. I should have been less dogmatic on that point. You’re right to say it is a possible side-effect but not a certain side-effect. It is the one that is most mentioned to me, but most are glad of the overall benefit and can accept this as a downside.

  • Trudy

    People who suffer depression need to find a competent doctor who will do a complete workup.

    Depression can be the result of other illnesses (such as hypothyroidism, Vitamin B12 deficiency, infections, etc).

    • Emily

      I agree Trudy. A wise doctor is key. I feel it is extremely, extremely important to rule out other root causes of depression and or anxiety. Such as vitamin deficiencies or hormonal imbalances as well as the other issues you mentioned. This is very complex and every individual has been created differently.

  • Mia

    Thank you for this article. I’ve been taking antidepressants for a week now and it’s been hard so far, so it’s good to know there’s hope.

  • http://vineandfig.blogspot.com Jim Swindle

    I was on a prescription for depression for a while, and it helped me–but eventually I had side effects, tongue twitches making it seem like my teeth were dirty. I tapered off the medication, and am doing well. The medicine seemed to stabilize me enough that I could deal with the things that were depressing me. Other things that really helped me: Daily, write the date and a couple of thanks lines to God, such as, “Thank, you, God, for books. Thank you, God, for keeping me from doing anything really stupid this morning.” Also get enough exercise and try eating much less sugar for a couple of days.

    • Lisa

      Thank you for this. I’m 41, and had never had an anxious or depressed day in my life. At this time last year, I had a sudden onset of ill health that caused choking episodes at any time of day. Within a week, I was unable to sleep at all, and went about a week and a half with no measurable sleep. I was exhausted, but every time I started to drift off, I’d get jolted awake, feeling like I’d stopped breathing. It was unspeakably scary. My husband and Dr. insisted I take some medication to force sleep, and I ended up an an anti-anxiety medication. It took several months to get me sleeping at a tolerable level. My health continued to be a struggle, and I spiraled into severe, scary depths of depression that I could have never imagined. I’m now on 2 different mood stabilizers, an antidepressant, and the original anti anxiety medication that my doctor gave me. This has been the darkest valley I’ve ever been in, but I truly thank God for bringing me this trial. I had never known what it was like to truly cling to Jesus until this year. My experience with friends in the church has been the exact opposite of what you’ve shared, however. I have connected with several women who have been through similar ordeals and medications, and all have been very sympathetic and faithful to pray for me. My husband has been the best of all, never judging me in any way. He doesn’t like the idea that I’m on the medications any more than I do, but agrees that it’s the best for now. I was extremely resistant to taking anything, and spent months having anxiety over the fact that I was even on such medications and that I was having side effects. I learned to stop saying how much I hated “these drugs”, and realized that while they’re not ideal, they saved me from being hospitalized. I’m thankful they are available. My health issues have improved over the last year, though it’s still quite a tangled web. I’ve gone the natural route for healing of my physical issues, and this takes more time than the pharmaceutical route. I’m hopeful that I’ll be able to get off all of these drugs in time. But I no longer wake up every day stressed out over the fact that I’m taking them. It’s where God has me right now, and once I got the right balance of medications, I finally became functional again, able to take care of my family and not cry in despair when I awoke every morning. For any of you responding to this article who are or have been struggling with depression and anxiety, my favorite book other than the Bible has been Beside Still Waters by Spurgeon. Our pastor gave this to my husband a while back, and I pulled it off the shelf early last year. Spurgeon uses scripture truth to speak to my heart. He truly is the prince of preachers. This book is such a blessing. Consider buying it. I’ve given many away this year, and everyone I’ve give it to has absolutely loved it. One more thing…I’m glad to hear you say that CBT is helpful. I have been counseled that these types of therapy are are secular. I was directed to a nouthetic counselor, and she was wonderfully biblical. But my husband and close friends were counseling me just as well as (and better than)this professional counselor, so I stopped after a few sessions. I’m so thankful to have a godly husband and friends that keep directing me to Scriptures. “Lord, to whom should we go? You have the words of eternal life!” But as far as CBT, I’ve been talking to my husband considering it if/when I try to wean off medications and meet with any difficulty. I’ve read that CBT is more effective that antidepressants. Even if CBT didn’t have Christian origins, I think this might be a “plundering the Egyptians” situation where it’s possible for secular wisdom (that God can and does give in His common grace)can cross paths with Christian living.

  • http://dreamfireintl.net Derek Iannelli-Smith

    …? I thought this was the author of Jesus on Every Page, that I reviewed here: http://dreamfireintl.net/2013/09/04/jesus-on-every-pagebook-review/

    • David Murray

      Yes, Derek, same guy. Thanks so much for your review!

  • Tammy

    My husband was just diagnosed with a prolactinoma, a pituitary tumor characterized by wild hormone levels, severe headache, hot flashes, mood swings (personality changes), and more. He is 50. He was diagnosed with depression at age 31 (and symptoms were present going back to childhood, but we didn’t know that then). If only we had known to get a hormone panel done, he wouldn’t have been stuck in psychiatry taking useless meds for almost 20 years (and little to no relief of symptoms). Now that his symptoms are severe, they landed him in the ER where an MRI revealed the true culprit. Please, don’t assume depression is always a mental illness. It may very well have a physical cause. Pituitary tumors are present in 1 of every 5 people, though often they cause no symptoms, or the symptoms are diagnosed as somethiing else, like depression. But the hormone panel blood test will tell you if something is physically wrong.

    But if you are going through an emotional crisis, of which depression can be a symptom, first ask yourself if you have a child who is now the same age that you were when you went through a tough time in your childhood. Being reminded can open up old wounds that need to be processed. That’s when you need cognitive therapy, like EMDR. Anti-depressive meds can help, but they’re addictive and you can get withdrawal symptoms to get off them. Take them if you need them, but consider them a temporary crutch, not a permanent solution.

    • Emily

      Tammy~From personal experience, I could not agree more with your wise words. I am not a doctor and would never want a person who is in crisis to not consider medication. I would be very cautious. I spent 12 years on anxiety/depression meds. that, looking back, I really believe were not necessary. Had I known more about ruling out the possible root causes of the depression/anxiety, I would NEVER have taken them. I never knew how EXTREMELY difficult tapering off SSRIs can be. It was horrid for me. Being off for three months I am experiencing the natural highs and lows in life like I haven’t in over a decade. I felt very “flat” on the meds. That being said, I also have a close family member with clinical depression that can not be off meds. So PLEASE just use caution.

  • http://www.gratefulforgrace.com Mindy at Grateful for Grace

    Thank you for sharing this and especially for the warning (and as a side benefit since it’s on the blog, a rebuke) about the reaction from many Christians. The problem is even greater though: Many pastors and elders believe this. I have seen it and have had to deal with it first hand on my blog when I shared about Christians and Severe Depression. Based on a friend’s response, Piper, NANC, and others, believe that depression is at least a spiritual problem, possibly a spiritual AND physical problem. The issue I have with that is that women can experience depression due to thyroid problems, hormonal problems, and simple neuro-transmitter problems. Not only myself, but many other women have told me that as soon as they got on thyroid medication (or in my case, Kavinace a natural supplement), the depression stopped. Abruptly. That tells me that it was a physical problem alone that needed to be addressed. It started manifesting in the spiritual walk when the women struggled for so long, trying “every other spiritual and commonsense remedy but was simply not getting better.” They didn’t approach their elders or pastor because of the stance that it was spiritual and the extreme hesitancy towards suggesting medication could solve something. It breaks my heart. I hear it so often now, in response to my blog post.

    To say to tell your pastor is something many won’t do because their pastor is one of the ones who won’t understand.

  • Lou G.

    Thank you for writing this. I really appreciated your approach to the topic. I have struggled quite a bit with depression at certain times and have always avoided going to the doctor for a prescription for medication primarily because I have a physical and chemical reaction to certain drugs (like alcohol and others) that other people do not. So out of fear of dependency I have fought hard to not have to use them. That said, I think that if someone with depression is like me and has had reaction issues to other drugs in the past, they need to be 100% honest with their doctor about that. Unless it has been previously documented in their medical history, there is no way for the doctor to know that the patient’s response my not be typical.
    Drug misuse can cause death and many serious consequences, so even though I don’t think we should be afraid to see the doctor for help through medication, we have to be forthright about our own weaknesses (whether physical or spiritual) in this regard.
    Thanks again for this very helpful post.

  • Jason

    As far as the concern about not experiencing “sweet highs of spiritual communion with God” — the psychiatrists would call that emotional flattening, although the interactions between neuropsychiatric issues and spiritual experience may not be so straightforward. That being said, choice of antidepressant can influence the risk of such an experience — the literature I’ve looked at suggests it’s more an issue with the SSRI (Prozac, Zoloft, Paxil, Celexa, Luvox, and Lexapro). I experienced flattening on Zoloft, and my psychiatrist said that the standard procedure would be to add Wellbutrin to the mix (although I see other sources advocating a switch rather than augmentation).

    If someone is really concerned about this possible side effect, they should talk to their doctor, who can prescribe something else. Or, if the doctor and patient decide an SSRI is best (and there are reasons why they are the most prescribed agents), one can always augment or switch if flattening becomes an issue. (I’m not aware of any good data on how often flattening happens, but I would disagree with David that it’s an inherent part of anti-depressant action. Some drugs are mood stabilizers, but unless there are signs of a bipolar disorder, mood stabilizers are not going to be the first or even second-line drug).

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  • harr ycourt

    Great article.

    What if the person is a pastor? They have poured their life into the church. People come and go. The pastor sees the numbers and finance dropping and takes everything personally? Pastor is getting older, young people don’t come etc etc.

  • Nathan

    There is nothing in any of this advice that can claim to be biblical or distinctively Christian. It may be a relief to someone to hear a Christian tell them that it’s ok to go to a doctor and get medication, but that’s a wisdom issue. It may be equally wise to advise against medication depending on the person and the circumstances. My biggest concern with this is advice is that it recommends a particular kind of psychotherapy that is divorced from Scriptural truth, setting up a conflict between the authority that comes from God and the authority that comes from mankind. There is also a conflict in recommending a type of therapy that focuses on cognitive functions while advocating for a biological/pharmaceutical solution to the problem. Finally, if it is commendable to sacrifice experiencing spiritual ecstasy in order to better serve God/man, it should be at least as commendable to endure the emotional hardship of depression while serving God/man. I’m sure David and I disagree on some foundational issues here; I only comment to show that there are legitimate concerns against this counsel that are not grounded in ignorance, prejudice, and misunderstanding, but in biblical wisdom and brotherly love.

    • http://headhearthand.org/blog/ David Murray

      Knowing the circumstances of this case, I believe I am proposing a holistic package of care that addresses the physical, spiritual, cognitive, and social realms appropriately.

      I’m always amazed by the argument that we should suffer in the area of depression without using God-given remedies in order to glorify God, but such advice is never given in any other area of human suffering. No one advocates running to meds. As I said at the beginning of this piece, the suffering person has gone through quite a long process of different measures before coming to this point. This is more about survival than preference.

      If you tune in tomorrow, I think you’ll see that CBT is actually a biblical process rooted in divine methodology.

      • Anita

        Dr. Murray, your responses continue to be a great encouragement.

      • Nathan

        I’m pretty sure I did not advise suffering through depression without using God-given remedies, so I’m not sure what prompted your amazed-ness. Actually, I’m sure I did not recommend suffering purposelessly for Jesus: I did suggest that it is equally logical to ask someone to suffer with depression as it is ask them to sacrifice experiencing spiritual ecstasies, both in the name of service towards God/man. One is not superior to the other, all things being equal; it seems like a preference. I am skeptical of the advice you give because 1)It is not distinctively Christian; it is advice that an unbeliever could give. 2) It could create a conflict between the authority that comes from God through His Word and the authority of man. Even if CBT is rooted in divine methods, it doesn’t follow that in the hands of unbelievers it would be any more effective than Hophni and Phinehas using the ark of the covenant as a weapon. If it is rooted in divine methodology, it should be nowhere more apparent than in the Church of God, which is the pillar and ground of Truth 3) It looks less like a holistic approach than a contradictory approach: Fix it with cognitive therapy, which locates the problem in the realm of thought and behavior, vs. pharmaceuticals, which locates the problem in the realm of malfunctioning biology. Oh, and talk to your pastor, that might help, too.

        I appreciate your compassion and warmth, and your willingness to respond to a total stranger over a blog post, and I will read the new post on CBT.

  • http://headhearthand.org/blog/ David Murray

    Karen, you are the only commenter that I have moderated. And you know why.

  • James Gordon

    Hi Dr. Murray,
    Just over a year ago I crashed (mentally & physically) and it was my doctor who told me I was suffering with severe-depressive anxiety disorder. I begrudgingly started meds. I also read your book “Christians Get Depressed Too.” What an amazing piece of work! It made me cry, throw it away in anger and pick it up again because everything you said, I had been struggling with. That book really helped me in such a way you could never imagine. I have about 10 copies in my home that I give to friends, family and my students when I see the signs of what I was living through before your book. I just want to thank you and I hope one day, I can shake your hand as my brother in Christ and maybe even have a few laughs over a beer. God Bless.

  • http://veritaemedicinae.blogspot.com/2014/01/depressed-about-taking-antidepressants.html Chris

    I commented on your blog on my blog:
    Depressed about Taking Antidepressants
    http://veritaemedicinae.blogspot.com/2014/01/depressed-about-taking-antidepressants.html

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  • steve

    IS IT POSSIBLE TO BE A CHRISTIAN EVOLUTIONIST? BY STEVE FINNELL

    According to a 2013 survey by the Pew Research Center 27% of white evangelical Protestants, 68% of white Catholics and 78% of white mainline Protestants believe that humans have evolved over time.

    Is it possible to be a Christian evolutionist? How is that possible?

    God is either the creator of all things or a human evolutionists. He is not both.

    Genesis 1:26-27 Then God said , “Let Us make man in Our image, according to Our likeness…….27 So God created man in His own image…(NKJV)

    God did not say let man evolve into His own image.

    Matthew 19:4 And He answered and said to them, “Have you not read that He who made them at the beginning ‘made them male and female.” (NKJV)

    Jesus said, male and female were made at the beginning. Male and female did not evolve, they were created.

    Some who claim to be Christians, say that the Genesis account of creation is allegorical or mythical. Is Matthew 19:4 allegorical and mythical as well?

    Others claim to believe in theistic evolution. God is either creator of all things or a humanist evolutionist, God is not both.

    IS IT POSSIBLE TO BE CHRISTIAN AND AN EVOLUTIONISTS? GOOD LUCK WITH THAT!

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