A depressing report about depression

Most Americans do not feel comfortable speaking to their doctor about symptoms of depression.

Why?

That’s the question a team of psychologists at the University of California recently tried to answer via a phone survey of 1054 adults. Time reports the results:

  1. 23% were afraid that their doctor would try to prescribe them antidepressant drugs.
  2. 13% said they were worried they would be referred to a psychiatrist
  3. 12% said they didn’t want to be considered a psychiatric patient.
  4. 16% didn’t think psychological issues fell under the purview of a primary care doctor
  5. 15% were concerned about medical record confidentiality.

The first three certainly coincide with my own experience of counseling people with depression; and there is usually even greater resistance to seeking medical help among Christians. The majority of emails, letters, phone calls, cries for help, that I regularly receive contain extremely painful personal stories describing the impact of depression on people’s lives, and the lives of their loved ones. But they almost always conclude with some variation of, “But, I know that anti-depressants are not for me,” or “But, I want to beat this on my own.”

Why should this be?

depression

1. Over-prescription
Most of us have seen far too many people put on to anti-depressants far too soon and often with limited investigation as to causes. We’ve all known people who run for a pill as soon as they feel a bit down; there’s no willingness to bear any emotional pain; there’s no seeking of God’s help, grace and counsel; “Just give me something to make me feel better!”

Others want pills (and are usually given them) to deaden the guilt of living sinful lives. They will do anything to avoid taking responsibility and facing up to the spiritual causes of their pain; and if that means some emotion-killing meds, then pour them in. (Here’s a previous post on the pointlessness of medication-only approaches).

The abundant evidence of over-prescription in our society, even among Christians, is a huge impediment to the really needy going for appropriate help.

2. Confusion
The vast majority of people know very little about the role of the brain in our thinking and feeling processes. I’m afraid that even many Christian counselors and pastors lack vital understanding of brain science, and especially of the role the brain plays in our spiritual lives. It’s so embarrassing to see 20 and 30-year-old medical research, theories, and cliches still being quoted in modern Christian counseling books.

Yes, of course, some depressions can be caused by sinful actions, thoughts, and feelings. But depression can also be caused by the “machine” that processes our perceptions, thoughts, and feelings breaking down and malfunctioning. Like the factory with a broken conveyor belt, it doesn’t matter how many high-quality raw materials you put into it, the goods are going to come out damaged until the machinery is fixed. You can press the switch as often as you want, but if the cable is broken you will remain in the dark.

It’s actually amazing how much the church has gone backwards in its understanding of how the physical and the spiritual interact. I often hear the Puritans being promoted as models of men who used only Scripture to deal with depression. However, Puritans like William Perkins, Richard Baxter, Timothy Rogers, and Jonathan Edwards all understood and taught that there was often a physical or bodily element to many depressions, that needed to be treated with medicine, crude though their own solutions were at that time. For example, Richard Baxter wrote The Cure of Melancholy and Overmuch Sorrow by Faith and Physic (Medicine).

(UPDATE: I was just sent this fascinating Wall Street journal report on the impact of oxytocin on schizophrenics.)

3. Pride
We do not want to think of ourselves as weak (and we certainly don’t want others to think of us like that). Strange isn’t it that no one would view taking medication for any other malfunctioning bodily organ as a sign of weakness; rather, that’s wisdom!  Yet, taking meds for problems with the most complex organ in the body is somehow only for “losers!”

Pride can also be manifested among Christian pastors and counselors who think that they can “do it all.” Instead of viewing themselves as a vital and central part of a team of helpers from various disciplines working together to help a depressed person get better, some actively discourage the sufferer from working with anyone but themselves. This too deprives a person from benefitting from the gifts and talents God has distributed among different specialties.

4. Hyper-spirituality
Although Christians with heart disease, diabetes, blood disorders, cancer, etc. do not think that it is unspiritual to seek and use medicines to relieve their symptoms and even cure their illness, many seem to think that there is some special spiritual virtue in suffering depression for months and years without any medical intervention. Their family and friends don’t usually see much super-spirituality in this approach!

And the next time someone tells you that taking medication for depression shows a lack of faith, or a lack of trust in God’s Word, ask to see their usually overflowing medicine and vitamin cabinets!

5. Side-effects and mixed results
The side-effects of anti-depressants are often over-played by those who oppose any medical contribution to the treatment of depression. And it’s often used as an excuse by those who are resistant to taking them. However, we must accept that, as with all meds, there will usually be some side-effects to taking anti-depressants. Again, it’s strange to see the way that we will put up with some quite serious side-effects when it comes to the treatment of strokes, angina, cancer, etc; yet, with anti-depressants, we seem to demand perfect results with nil side-effects.

The question really is, “How desperate are we?” If we are truly desperate, then we will be prepared to put up with some lesser side-effects in order to start feeling and thinking normally again.

Brain scientists are increasingly referring to the brain as a “universe,” a universe that we’ve barely begun to explore. With new brain-imaging techniques, the previously slow pace of medical research is beginning to take some leaps forward. Let’s pray for God’s blessing on these researchers, that He would permit them to discover what He already knows about the role of the brain in our thinking and feeling processes, and that the relatively primitive medicines we presently have would be replaced by much more sophisticated and successful treatments.

And let’s pray for pastors, counselors, and Christian doctors that they will be given increasing skill to discern where each person’s depression lies on the spiritual/physical scale. God forbid that we help someone excuse and reason away their sin. But may God also forbid that we heap blame and responsibility on people for something that is not their fault.

Who is sufficient for these things?


Children’s Bible Reading Plan (51)

Here’s this week’s morning and evening reading plan in Word and pdf.

Here’s this week’s single reading plan for morning or evening in Word and pdf.

And for those who want to start at the beginning, here’s six months of the morning and evening in pdf, and here’s six months of the single reading plan in pdf.

Here’s a brief explanation of the plan.


SermonAudio’s founder needs your prayers

Many of you will have been blessed by the ministry of SermonAudio.com. Its founder and President, Steven Lee, has become a dear friend to me and stayed with us for a few days as recently as a month ago. At that time he shared some worries about his wife’s fourth pregnancy. However, it turns out that the problems with the baby are far more serious than originally thought. The baby has a heart defect that’s going to require immediate open heart surgery as soon as he is born. You can read about Steven and Jamie’s traumatic morning in the ultrasound room here.

I don’t usually use my blog to ask for prayer for someone; I know that you all have plenty to pray about already. However, I’m not asking you to pray for a stranger; I’m sure Steven’s SermonAudio ministry has blessed you many times over the years. The Lord has used him and his gifts in a mighty way to spread the Gospel all over the world. Now he and his family need your prayers. I commend them to you.


David Wilkerson’s heartfelt plea for “anguish”

Saw this absolutely phenomenal message over at Timmy Brister’s blog. This is how Timmy describes it:

David Wilkerson shares about what I have learned to be “soul travail.” No one talks about it these days, but I’ve read about it from the Puritans and those whom God used in history to bring revival and renewal to God’s people.

I must say, this brought back many memories of better times in my own spiritual life, and created deep longings for something of this spirit again.


Sermon Prep and the Chemistry of Fear

I have a sermon to prepare.

As usual, I’m excited….and scared.

I’m excited because the creative process is often so enjoyable: discovering profound truth, framing clear and simple sentences, crafting an attractive structure, etc., all by the grace of God of course.

I’m anxious because it may take me many frustrating hours, baskets of waste paper, and deep brain pain. I may have hours of “unproductive” work ahead. And what if, by the end of the day, I still have no sermon worth preaching?

And sometimes that anxiety, even terror, can be paralyzing. Maybe I should catch up on email. Maybe I should organize my study. Maybe I should pray more. Maybe I should write a blog post…

Actually, what I should probably do is go out running (and pray as I go).


In The Creative Brain on Exercise, Jonathan Fields notes:

The physical state of our bodies can either serve or subvert the quest to create genius. We all know this intuitively. But with rare exceptions, because life seems to value output over the humanity of the process and the ability to sustain genius, attention to health, fitness, and exercise almost always take a back seat. That’s tragic. Choosing art over health rather than art fueled by health kills you faster; it also makes the process so much more miserable and leads to poorer, slower, less innovative, and shallower creative output.

In Spark: The Revolutionary New Science of Exercise and the Brain, Dr John Ratey demonstrated that exercise is not so much about six-packs and cellulite, but about brain chemistry and electricity. He cites the following data to prove the connection:

  • A 2004 study led by Joshua Broman-Fulks of the University of Southern Mississippi that showed students who walked at 50 percent of their maximum heart rates or ran on treadmills at 60 to 90 percent of their maximum heart rates reduced their sensitivity to anxiety, and that though rigorous exercise worked better. “Only the high intensity group felt less afraid of the physical symptoms of anxiety, and the distinction started to show up after just the second exercise session.”
  • A 2006 Dutch study of 19,288 twins and their families that demonstrated that those who exercised were “less anxious, less depressed, less neurotic, and also more socially outgoing.”
  • A 1999 Finnish study of 3,403 people that revealed that those who exercised two to three times a week “experience significantly less depression, anger, stress, and ‘cynical distrust.’”

Ratey argues that exercise not only improves the brain’s chemistry, and the way it processes fear and anxiety, but even changes its shape – for the better. Jonathan Fields summarizes the research:

Studies now prove that aerobic exercise both increases the size of the prefrontal cortex and facilitates interaction between it and the amygdala. This is vitally important to creators because the prefrontal cortex is the part of the brain that helps tamp down the amygdala’s fear and anxiety signals.

He concludes:

Anyone involved in a creative endeavor should tap exercise as a potent elixir to help transform the uncomfortable sensation of anxiety from a source of pain and paralysis into something not only manageable but harnessable. Exercise, it turns out, especially at higher levels of intensity, is an incredibly potent tool in the quest to train in the arts of the fear alchemist.

Yes, we need the Holy Spirit. But we may also need a new pair of training shoes.