Film 1: Jeni’s Story

A young mother and pastor’s wife, Jeni had always believed that depression was a figment of people’s imagination. Certainly a Christian would never get depressed. Jeni and her husband, Greg, tell how depression unexpectedly shattered their world but also how God used the experience for their benefit and to make them a blessing to many others.

Film 2: Onica’s Story

Though only 15 years old, Onica has already suffered many losses in her life, including numerous painful bereavements and her parents’ broken marriage. Her relationship with family counselor Dr. Emilie DeYoung, who also appears in this episode, has helped her on the road to recovery and equipped her to face the future with hope. Onica also relates how God has used Alpacas in her healing.

Film 3: Timika’s Story

Timika has probably been depressed for many years. Only recently, however, did she recognize it and begin to seek spiritual, psychological, and physical help. A nurse educator, she now recognizes the opportunity she has to prevent her students suffering in the same way.

This film also looks at the unique challenges faced by the African American Community in dealing with mental health issues. Thabiti Anyabwile brings a unique pastoral expertise and Helen Brent speaks with the wisdom of decades spent working as a mental health nurse in the inner city. Sadly (for us), this lovely Christian lady passed away just a few months ago, but we rejoice with hope that she has gone to enjoy eternal light, life, and love.

Film 4: Paul’s Story

Paul has struggled with anxiety, discouragement, and depressive tendencies for the past 3-5 years. As a pastor, and a father of ten children, some of whom have special needs, he brings a deep biblical, spiritual, and practical insight into depression and also how the church can help those who suffer with it.

Film 5: Sue’s Story

After ten years of suppressing grief and anger about the death of her mother, Sue suddenly fell into a deep depression. Hospitalized and mentally fragile, Sue began a long road to recovery. Her story shows the power of the Gospel and how God used this experience to deepen Sue’s spirituality and make her a brighter witness for Christ.

Hard to imagine any good resulting from such painful and tragic circumstances isn’t it?

Well, today I want to encourage you by demonstrating how much good God can bring good out of such evil, how much light He can create out of such darkness, and how much comfort He can produce out of such deep sorrow.

Over the last couple of years, I got to know a Christian family who had seen family members suffer with mental illness, including schizophrenia. A close relative died from schizophrenia-related issues and left a substantial sum of money in his estate. After much prayer and consultation, the family decided to donate the money for research into mental illness and how it affects Christians, pastors, and churches.

Research Opportunity
The next step was to invite proposals from researchers. Thus, about 18 months ago, I announced a Major Counseling Research Opportunity on my blog and invited proposals from researchers. We received a number of excellent proposals, but the standout was one from Lifeway Research. It rose to the top not only because of the research expertise that Lifeway brought to the work but because of Lifeway’s ability and passion to get the research into the church so that pastors and Christians could use it in their ministries. What’s the point in doing the best research in the world if no one ever reads it and if the church never benefits from it?

As I discussed the proposal with Lifeway’s Ed Stetzer, he continued to expand the vision and to seek further partners that would both contribute to the research and help to make it widely available. I was, therefore, delighted when Focus on the Family also came on board and brought their own unique experience and expertise to the project.

All things for good
Do you see what I mean about God working all things together for good? Out of the tragic death of one unknown schizophrenic, two major national Christian organizations are involved in producing and publicizing research and resources that I believe will help thousands of people suffering with mental illness and their caregivers.

So, here we are, 18 months on and launch day for the research. The full study will go live here on Lifeway’s website this afternoon. Focus on the Family have also set up a landing page at Thriving Pastor that contains a summary of the research, articles on mental illness, and other helpful resources in a free eBook Serving Those With Mental Illness.

At that website you’ll also find a video interview about mental illness in the church with Ed Stetzer and Focus’s Jared Pingleton, together with numerous other recommendations for books etc. Ed’s being generating interest among various national media organizations and journalists and later on this afternoon will host a media call with Kay Warren (wife of Rick Warren).

Happy Day
It’s been a real joy and privilege to see God bringing so many strands together – painful providences, a generous family, Christian research expertise, media connections, and the bundle of buoyant life that is Ed Stetzer – to produce so much good for so many who live in daily agony of body, mind, heart, and soul.

I’ll be sharing and commenting upon the research in more detail in the days ahead, but in the meantime, why not get over to Focus on the Family, download that free eBook, and equip yourselves to serve God’s suffering children.

Counseling can often be discouraging work. In this video, Dr. Peter Newhouse reminds us of why we should love this work.

You can see other short FAQ videos from the Christians Get Depressed Too video series here or view five feature length documentaries here.

In this video, we look at five areas where symptoms of depression are usually found.

You can see other short FAQ videos from the Christians Get Depressed Too video series here or view five feature length documentaries here.

Dr. Eric Johnson, Professor of Pastoral Care at Southern Baptist Seminary, discusses the kind of person that gets depression.

This is an extract from Jeni’s Story, which you can view in full here.

Email/RSS readers click through here to view video.

Although we may fail to communicate this at times, we are actually friends, and when friends disagree, it’s always worthwhile remembering the things we agree on, what we share in common.

First of all, we share the same core of Christian doctrine. I’m pretty sure we can all subscribe to the BCC doctrinal statement.

Second, we all regard one another as Christian brothers. More than that, I hold these men (and many more men and women they represent) in the highest possible regard. I use Bob and Heath’s resources, alongside multiple CCEF books, etc., in my counseling classes.

Third, we all share the same motivation – the desire to honor the Lord by helping suffering people with all the legitimate resources that God has placed at our disposal.

Fourth, although we differ in some important areas, we probably agree on at least 95% of counseling presuppositions and practice. If you were to compare the advice we would give to most counselees, while Bob, Heath, and Charles would no doubt be much more skillful and insightful than I, the general contours of our advice would overlap about 95% of the time. I’m pretty sure we use the Bible equally in our counseling.

So what explains our differences? I hope these answers might shed some light not only on our recent discussion but also help other Christians think differently about other debates they are involved in and those they are debating with.

(Slightly) Different Worldviews
First, we probably have slightly different worldviews. We are all trying to look at the same world through the same spectacles of the Word of God. However, we do seem to differ slightly in how we view certain areas of the world.

One of the challenges of the Christian life is to know how to balance the terrible impact of sin upon the world versus the wonderful impact of common grace. That balance or emphasis will determine how optimistic or pessimistic we are about learning from the world.

I think it would be fair to say that Bob, Heath, and Charles probably view some parts of the world (like psychology, pharmacology) through a more negative lens than I do. They approach these worlds with more caution and skepticism than I do. They may be right to do so, and I have to say I used to be much more skeptical myself (my Seminary dissertation defended Jay Adams to the hilt). However, for good or ill, I see more common grace in these areas than I used to. There’s danger at both extremes, and none of us are at either extreme, but we are at slightly different points in the reject all/embrace all spectrum, with hopefully all of us moving closer to the perfect balancing point.

Different Experiences
As I interact with my biblical counseling friends I’m often struck by how much personal experience plays into our approach to counseling.

For example, if I’ve seen people run to pills way too quick, if I’ve witnessed friends and family suffering from the side-effects of some meds, if I’ve seen people messed up by weird psychology and worldly therapy, if I’ve seen nouthetic counseling save a life/family/congregation, etc., then I’m going to approach counseling with a certain bias.

On the other hand, if I’ve seen people helped by meds, if I’ve seen Christians’ lives transformed by CBT, if I’ve worked in tandem with gifted and godly Christian psychologists, if I’m in a context where pride or ignorance are preventing many suffering Christians from even considering meds (to their own and their family’s detriment), etc., then that too will lend a bias to my counseling.

Now, I’ve painted two extremes there, but I think part of the difference between my friends and I has to do with our different experiences. It looks as if Bob, Heath, and Charles’ experience has been more of the former and mine more of the latter. Although we try to be as objective as possible, we can’t deny that past experience influences present practice.

Different Purposes
Bob and Heath have massively important roles in leading the Biblical Counseling Movement. They are not just writing as individuals but as leaders seeking to unite, guide, and equip thousands of men and women across the world. They are extremely gifted motivators and organizers with a huge responsibility to build understanding, cooperation, development, etc. That stewardship should and does influence their stances and words. I totally respect and admire that.

I’m more of a loose canon (or a pesky mozzie?)! I’m not that into labels or movements. I don’t have an official role or leadership position in any national organization, and I don’t seek that either – it’s not my gifting or calling. But I hope there’s a role for me too. I hope I can be a Biblical Counselor without being part of the Biblical Counseling Movement. I hope I can provoke reflection and reformation – maybe highlight areas from time to time that need more thought and action.

I do see myself as an advocate for Christians suffering with serious depression and other mental disorders, especially those who have suffered from a lack of sympathy and holistic care from other Christians.

I’m not saying that my friends are not; I’m pretty sure they see themselves also as advocates for depressed Christians, especially for those who have suffered at the hands of some over-prescribing doctors and some damaging psychology. But I believe one of my purposes in life is defending and caring for depressed Christians who have suffered from careless or ignorant words and actions from within the church.

Different Sins
It’s very difficult for us to engage in any controversy or debate without sinning. Sometimes pride, territorialism, ego, and competitiveness (we’re all Type A males I think!), produce exaggeration, misrepresentation, anger, defensiveness, excuses, false accusation, and so on. I’m as susceptible to that as the next guy. The result is that sometimes we magnify differences that are really quite small and we are sometimes reluctant to concede, “OK, I was wrong there.”

So why not just do this in private? Well, we have private discussions also. But public communication is good too, even if it’s sometimes tainted with sin, because hopefully it helps others too as they observe, read, weigh, and come to their own decisions about these matters.

We have to be careful it doesn’t get out of hand of course, but the church often benefits from disagreements. When conducted in the right spirit it can lead us all further into the truth, especially in this complicated area of the relationship between the body, the mind, and the soul, and what are the appropriate roles for biblical counseling, medicine, and psychology in each case.

Probably Bob, Heath, Charles, and Chris have other explanations for why we differ. But that’s my analysis, offered in a conciliatory and constructive spirit.

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.

Here’s another video of the same talk, this time with sign language.

RSS/Email subscribers may need to click through here to view.

Researchers at Emory University have discovered a brain scan that can predict whether medication or Cognitive Behavior Therapy (CBT) is the best for each person’s depression. At present the treatment plan is often based on the doctor’s or patient’s preference, but only 35-40% of people see any improvement with their first choice of treatment. It’s basically been trial and error.

But Dr. Helen Mayberg and her team of researchers used PET scans to measure brain glucose metabolism in the interior insula region of the brain, and found that scan patterns prior to treatment can provide important clues as to which treatment will be best. Patients with low activity in the anterior insula showed remission with CBT, but poor response to medication, while patients with high activity in the insula did well with medication and poorly with CBT.

Until now brain-imaging has been primarily a research tool, but the National Institute of Mental Health director Dr. Thomas Insel believes that “these results demonstrate how it may be on the cusp of aiding in clinical decision-making.”

Speaking personally, I’ve never seen a medication-only approach work in the long-term. I have seen medication work well in treating moderate to severe depression, but only when combined with counseling and lifestyle changes (e.g. diet, sleep, exercise, relaxation, Christian fellowship, etc.). However, this research might help explain why antidepressants just don’t seem to work at all for a large number of people.

If the success or otherwise of anti-depressants can be predicted, then that should build confidence in some cases and avoid weeks of frustrating and futile experimentation in others.

Full Story: Biomarker Could Point the Way Past Trial-and-error Inefficiencies

Thought it?

You’ve almost certainly heard it.

However, depression has been around for much longer than you might think, and it has been accepted as genuine and treated seriously by some of the greatest Christian experts in soul care that God has ever given to His church – the Puritans. Yes, way back then, in days of spiritual revival and reformation, these spiritual giants and geniuses had deep insights into depression’s causes and cures that we would do well to learn from.

Richard Baxter, for example, wrote The Cure for Melancholy and Overmuch Sorrow, By Faith.

“Ah-ha! See. By faith. They saw it as a spiritual problem with a spiritual cure! So much for the Puritans backing up your modern theories.”

Read on, my friend. For sure, most of Baxter’s book is taken up with describing and curing spiritual depression. However, he does this only after carefully distinguishing spiritual depression (which is cured by faith) from physical depression (which is cured “by physic,” or as we would say, “by medicine”). In fact he has a whole section on “Medical care for those with depression” which we’ll get to tomorrow.

Causes and cures
Baxter asks, “What are the causes and cure of melancholy?” and answers:

“With many people most of the cause is in distemper, weakness, and disease of the body, and by it the soul is greatly disabled to any comfortable sense. But the more it comes from such natural necessity, it is the less sinful, and less dangerous to the soul, but still just as troublesome.”

He then goes on to identify “three diseases that cause too much sorrow.”

• Those that consist in such violent pain as natural strength is unable to bear.
• A natural passion, and weakness of that reason that should quiet passion (often seen in the elderly or debilitated).
• When the brain and imagination are impaired, and reason partly overthrown by the disease called melancholy, or depression.

Baxter then goes on to list the signs and symptoms of this third category of disease.

Symptoms of clinical/medical depression
1. The trouble and disquiet of the mind becomes a settled habit. They can see nothing but matter of fear and trouble. All that they hear or do feeds it…In a word, fears, and troubles, and almost despair, are the constant temper of their minds.

2. If you convince them that they have some evidences of Christian sincerity, and that their fears are causeless, they may not disagree, and yet it does not take the trouble away, for the cause remains in their bodily disease.

3. Their misery is so much that they cannot but think of it. You may almost as well persuade a man not to shake in an fever, or not to feel when he is pained, as persuade them to cast away their self-troubling thoughts, or not to think all the enormous, confounding thoughts as they do, they cannot get them out of their heads night or day.

4. And when they are grown to this, they often seem to feel a voice within saying this or that to them, and they will not believe how much of it is a diseased imagination.

5. In this case they often think they have had revelations from God, often confusing Scripture or falsely applying it, and sometimes taking up errors in religion.

6. But the sadder, better sort, feeling this talk and stir within them, are sometimes apt to be confident that they are possessed by the devil

7. Most of them are violently haunted with blasphemous suggestions of ideas about God or Scripture, at which they tremble, and yet cannot keep them out of their mind.

8. When it is far gone, they are tempted to lay some law upon themselves never to speak more, or not to eat, and some of them starved themselves to death.

9. And when it is far gone, they often think that they have apparitions or some spirit touched or hurt them.

10. They avoid company, and can do nothing but sit alone and muse.

11. They cast off all business, and will not be brought to any diligent labour in their callings.

12. And when it comes to extremity, they are weary of their lives, sometimes become strongly tempted to take their own lives, which, alas, too many have done.

13. And if they escape this, when it is ripe, they become quite distracted.

Medical cures?
Tomorrow we will look at the cures Baxter suggests for this kind of melancholy, but note that at least part of it is medical. He says: “Choose a physician who is specially skilled in this disease, and has cured many others.” He advises against consulting “young, unexperienced men” and “hasty, busy, over-worked men, who cannot have time to study the patient’s temper and disease, but choose experienced, cautious men.”

UPDATE: Here’s The Puritans on Medication for Mental Illness

This post is is a contribution to A conversation about faith and mental illness. If you click through, you’ll find links to a number of great posts by Adrian Warnock on this subject.

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