The Puritans not only accepted the existence of medical causes for depression and other mental disorders, but they also proposed various medical remedies. Admittedly, some of their “treatments” were extremely primitive, but they clearly understood that there was some physical or medical elelement to some depressions.

After listing various spiritual and social remedies (we’ll consider some of these tomorrow), Richard Baxter says “If other means will not do, neglect not medicine.”  Just as in our own day, there was sometimes significant resistance to medication. Baxter’s solution? Force it down their throats!!

Though they will be averse to it, as believing that the disease is only in the mind, they must be persuaded or forced to it. I have known the lady deep in melancholy, who a long time would neither speak, nor take physic, nor endure her husband to go out of the room, and with the restraint and grief he died, and she was cured by physic put down her throat with a pipe by force.

While we would probably end up in prison if we tried such methods, Baxter’s basic insights on the role of medication and doctors are sound and have abiding value:

1. Choose a physician who is specially skilled in this disease, and has cured many others. He advises against consulting young men and busy men who don’t have time to sit down and carefully listen to the depressed person’s story. Interestingly, Baxter didn’t have any hang-ups about calling this a disease and grouping it with other physical illnesses: “The thinking faculty is diseased and become like an inflamed eye, or a foot that is sprained or out of joint, disabled for its proper work.”

2. Medicinal remedies and theological are not usually to be given together by the same hand. He does allow for exceptions to this, but as a general rule he says that if you have access to “an ancient, skillful, experienced, honest, careful, circumspect physician, neglect not to use him.”

3. The root of depression is in the blood and is often accompanied by other physical problems. Baxter believed that the blood carried the human spirit, and that if the blood was diseased, so was the human spirit, and other organs that the blood served. Although we might laugh at Baxter’s archaic understanding of the human body, his instincts were right, in seeing physical causes and consequences of this “mental” disease [and maybe he’s not so far off the truth after all: A blood test for mental illness]

4. Sometimes depression is caused by sudden shock. Baxter had seen otherwise sound-minds “suddenly cast into melancholy by a fright, or by the death of a friend, or by some great loss or cross, or some sad tidings, even in an hour.” Baxter said that this proved that the cause was not always found in the body, but his understanding of the mind/soul/body connections helped him to see that even the shocking impact of such news or events on the mind impacted the body too.

But the very act of the mind doth suddenly disorder the passions, and perturb the spirits; and the disturbed spirits, in time, vitiate the blood which containeth them; and the vitiated blood doth, in time, vitiate the viscera and parts which it passeth through; and so the disease beginning in the senses and soul, doth draw first the spirits, and then the humours [bodily fluids], and then the parts, into the fellowship, and soul and body are sick together.

5. The physician and pastor need great skill to know where the depression started. He must find out if it began “in the mind or in the body; and if in the body, whether in the blood, or in the viscera, for the cure must be fitted accordingly.”

6. Even if the depression have a psychological cause, medication can still have a role in curing it.

Though the disease begin in the mind and spirits, and the body be yet sound, yet physic [medication], even purging, often cureth it, though the patient say that drugs cannot cure souls, for the soul and body are wonderfully co-partners in their diseases and cure; and if we know not how it doth it, yet when experience telleth us that it doth it, we have reason to use such means.

7. Even if the depression was caused by demonic influence, medication may help to drive the devil out.

It is possible physic might cast him [the devil] out, for if you cure the melancholy, his bed is taken away, and the advantage gone by which he worketh. Cure the choler, and the choleric operations of the devil cease. It is by means and humours in us that he works.

Editorial N.B.
One modern editor of Baxter’s writing says of this section: “Of course Baxter was as unaware of modern biochemisty and physiology as he is of modern pharmacology. Nevertheless his insights are still valuable today…It may be appropriate to summarize this section of Baxter’s work as follows: those with depression of a spiritual nature, require spiritual counsel. Those whose depression is a result of somatic illness need medical care to correct that cause. People who suffer from endogenous depression may require both spiritual and medical treatment, depending on their case. Baxter’s advice about physicians is pertinent at this point.”

Other posts in this series:

7 Questions about suicide and Christians
Mental illness and suicide: the Church awakes
Pastoral thoughts on depression
The problem with “mental illness”
Double Dangers: Maximizing and Minimizing Mental Illness
A Medical Test for Mental Illness
The Puritans and Mental Illness

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  • St. Steve of Northern Lights

    The Puritan Preacher John Colquhoun also touched on a similar topic in his work “A Treatise on Spiritual Comfort.” I found this book to be a great encouragement a few years back!

    Here are his opening thoughts on the topic in chapter 5, The Signs of Melancholy “Of the nature and signs of melancholy with directions to such believers as are afflicted with.”

    “Melancholy, though it so weakens and disorders the mind, as to render a person unable, to enjoy the comforts, and to perform the duties of life, is, nevertheless, seated in the body. But the state of the body which accompanies this disease, is acknowledged by the best Physicians, to be in general beyond the reach of their investigation. By this distemper, the mind is so disordered, that, like an inflamed eye, it becomes disqualified for discerning its objects, clearly and justly. The disease is commonly attended with gloomy thoughts, heaviness, sorrow, and fear, with out any apparent cause of them. Wicked men are as liable to be afflicted with it as are good men.
    In the case of some, melancholy, though a bodily distemper, produces dejection of mind, in that of others, trouble of mind on spiritual accounts, especially if it be great, or of long continuance, produces the disease of melancholy in the body. Melancholy also increases trouble of mind, and trouble of mind again, increases melancholy, where they both exist together, they mutually increase and confirm each other. How great soever, a believer’s grief for sin, and his dread of Divine anger may be, he ought not to be called melancholy, so long as these appear to be rational, and his imagination, to be sound. But on the other hand how small soever, his measure of sadness and of fear may bel yet, if his imagination and mind be so distempered or impaired, that he cannot assign a proper reason for his sadness and fear nor express them in a rational manner, he is to be counted melancholy…”

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  • Paul

    The hopelessness created by a wrong emphasis on “election” and “predestination” is enough to drive anyone crazy. While John Newton was William Cowper’s counselor, Cowper suffered much with mental despair. But after Newton’s death, his mental state improved greatly.

  • Jamie

    The church is moving more and more to the world’s remedies for the soul and even using Puritan medical ignorance for suppport. As am one who suffers from “melancholy”, depression, despond and having tried the “medication” route, I find that most of my trouble is from a well hidden foolish and rebellious spiritual heart which affects my head and then the body. We are complex beings. The noetic effects of sin are very deep.
    Though the drugs of today that alter the mind do offer some help with the symptoms, they never treat the root, hinder the process of restoration and in many cases damage the brain in the process.
    I truly believe depression is a wisdom/mind soul/desire and personality/character issue. When the soul is disordered, Christ, the truth and love is always the answer. Cocaine will make the sould of a depressed person feel better, but not for long. It is the same with psych drugs, you feel better, your brain is muted and the alarm bells signalling spiritual issues is temporarily disconnected. But when the brain fights back and the sould does not change, higer doses or different drugs will be prescribed. Then try to stop taking them. Another story.
    I highly recommend the book “Toxic Psychiatry by Peter Breggin. ps…. he is not a Christian but in my humble opinion speaks better than the Puritans on the causes and cures for depression and anxiety or any other “mental illness” or label that the pharma-phsycho complex would attatch to you. We are body and soul. Medical doctors treat the body, Pastors, with the word and love of Christ are to treat the soul.

    • Jamie

      ps… in 4o years of psychiatric practice, Dr. Breggin has never presribed “meds” for depression, and not one of his patients committed suicide. Also, because he is not a Christian, some of his worldview comes out and is not useful. But we don’t want to throw the baby out with the bath water. Thanks for reading.

  • Les

    Good stuff. I and some others have profited greatly from the Puritans, especially on this subject through Baxter. And contra Paul above, were not the doctrines of predestination and election true, how aweful and truly depressing this life would be.