Blogs

Suicides have spiked so much that Ron Wyden wants a 3-digit hotline
“In 2016, almost 45,000 suicides took place in the United States, up from about 30,000 in 1999, according to CDC data. Rates rose by more than 30% in half of all U.S. states since then, according to the CDC. Having a single, easy-to-remember phone number for mental health issues could make it easier to remember in a crisis, similar to how people know to call 911 in an emergency”

Christian, you are not the center of the universe
“Next time you feel anxious after watching a cable news broadcast or reading a tweet, remember we worship the same God Daniel did.”

SELF-Control as a Fruit of the SPIRIT and Implications
“I was recently struck by the tension represented in the reality that self-control was a fruit of the Spirit (Gal. 5:22-23). Something we can only do by the empowerment of the Holy Spirit is attributed to the self as its means of expression. The Bible gives us a positively-connoted, Spirit-empowered, self-hyphenated word. How does this work? ”

The Number 1 Reason for the Decline in Church Attendance
“The number one reason for the decline in church attendance is that members attend with less frequency than they did just a few years ago.”

Why Your Online “Church” Isn’t Enough
“We don’t see things correctly. The idle often think their weak. The faint-hearted rebuke themselves for idleness. We need another set of loving eyes to come alongside us and properly apply the gospel. And for that you need a local church. And for that to actually “work” and matter and do what it’s supposed to do—you need to pursue being known and to know others.”

The Mentally Afflicted Christian
“If as Christians we are primarily concerned with correcting the woes of others, while conveniently avoiding helping the suffering sinner or giving a reason for hope, who will show this person the love of Christ, if not the Christian?”

New Book

Hitting the Marks: Restoring the Essential Identity of the Church by Barry J. York.

Kindle Books

Seeing and Savoring Jesus Christ by John Piper $1.99.

The Story of Reality: How the World Began, How It Ends, and Everything Important that Happens in Between by Gregory Koukl $3.99.

Clear Winter Nights: A Journey into Truth, Doubt, and What Comes After by Trevin Wax $1.99.

The God Who Is There: Finding Your Place in God’s Story by D. A. Carson $1.59.

That’s the question a New York Times opinion piece asked last week.

• The suicide rate has been rising in the United States since the beginning of the century, and is now the 10th leading cause of death, according to the Centers for Disease Control and Prevention.
• The trend most likely has social causes — lack of access to mental health care, economic stress, loneliness and despair, the opioid epidemic, and the unique difficulties facing small-town America.
• While long-term solutions are needed to address these serious problems, the field of psychiatry desperately needs new treatment options for patients.
• And yet no new classes of drugs have been developed to treat depression (and by extension suicidality) in about 30 years, since the advent of selective serotonin reuptake inhibitors like Prozac.
• These can often take weeks to work, as does talking therapy.

The good news is that scientists think that they may have found one — an old anesthetic called ketamine that, at low doses, can halt suicidal thoughts within hours (see my recent article about Dr Carlos Zarate who is pioneering Ketamine research). It works on a different bodily system to the usual SSRI’s.

The article goes on to highlight some ketamine success stories and clinical opportunities as well as some of the problematic side-effects. However, it seems to have some unique ability to reverse acute suicidal ideation and may therefore be used to save lives in these critical hours and minutes, which is cause for much thanksgiving to God. With the Lord’s blessing, perhaps this might be an opening to far more effective anti-depressants. Let’s keep praying for the Lord’s blessing and guidance on Dr Zarate and other medical researchers laboring away for the good of suffering humanity

The Coddling of the American Mind: How Good Intentions and Bad Ideas Are Setting Up a Generation for Failure by Greg Lukianoff  and Jonathan Haidt.

Yesterday we looked at the first Great Untruth that our culture has embraced in recent years:

• The Untruth of Fragility: What doesn’t kill you makes you weaker.

Today, we will look at what the book teaches about the second Great Untruth:

• The Untruth of Emotional Reasoning: Always trust your feelings.

This chapter sets out to dismantle this Great Untruth by insisting that while feelings are always compelling, they are not always reliable. “Often they distort reality, deprive us of insight, and needlessly damage our relationships. Happiness, maturity, and even enlightenment require rejecting the Untruth of Emotional Reasoning and learning instead to question our feelings.”

The authors illustrate the struggle between reason and emotion by the image of a small rider on an elephant.

“The rider represents conscious or “controlled” processes—the language-based thinking that fills our conscious minds and that we can control to some degree. The elephant represents everything else that goes on in our minds, the vast majority of which is outside of our conscious awareness. These processes can be called intuitive, unconscious, or “automatic,” referring to the fact that nearly all of what goes on in our minds is outside of our direct control, although the results of automatic processes sometimes make their way into consciousness.

The rider-and-elephant metaphor captures the fact that the rider often believes he is in control, yet the elephant is vastly stronger, and tends to win any conflict that arises between the two…The rider generally functions more like the elephant’s servant than its master, in that the rider is extremely skilled at producing post-hoc justifications for whatever the elephant does or believes.

Emotional reasoning is the cognitive distortion that occurs whenever the rider interprets what is happening in ways that are consistent with the elephant’s reactive emotional state, without investigating what is true. The rider then acts like a lawyer or press secretary whose job is to rationalize and justify the elephant’s pre-ordained conclusions, rather than to inquire into—or even be curious about—what is really true.:

What’s the answer to this? The authors propose CBT (Cognitive Behavioral Therapy).

CBT was developed in the 1960s by Aaron Beck, a psychiatrist at the University of Pennsylvania. Beck saw a close connection between the thoughts a person had and the feelings that came with them. He noticed that his patients tended to get themselves caught in a feedback loop in which irrational negative beliefs caused powerful negative feelings, which in turn seemed to drive patients’ reasoning, motivating them to find evidence to support their negative beliefs. Beck noticed a common pattern of beliefs, which he called the “cognitive triad” of depression: “I’m no good,” “My world is bleak,” and “My future is hopeless.”

Beck’s great discovery was that it is possible to break the disempowering feedback cycle between negative beliefs and negative emotions. If you can get people to examine these beliefs and consider counter-evidence, it gives them at least some moments of relief from negative emotions, and if you release them from negative emotions, they become more open to questioning their negative beliefs. It takes some skill to do this—depressed people are very good at finding evidence for the beliefs in the triad. And it takes time—a disempowering schema can’t be disassembled in a single moment of great insight

The book does not suggest that everyone needs to get a therapist and start CBT. Just learning how to recognize cognitive distortions and challenging them is a good intellectual habit for all of us to cultivate. With a little training, people can be trained to question their automatic thoughts on their own, every day. With repetition, over a period of weeks or months, people can change their schemas and create different, more helpful habitual beliefs.

The authors summarize this chapter as follows:

• CBT is a method anyone can learn for identifying common cognitive distortions and then changing their habitual patterns of thinking. CBT helps the rider (controlled processing) to train the elephant (automatic processing), resulting in better critical thinking and mental health.
• Emotional reasoning is among the most common of all cognitive distortions; most people would be happier and more effective if they did less of it.
• By encouraging students to interpret the actions of others in the least generous way possible, schools that teach students about microaggressions may be encouraging students to engage in emotional reasoning and other distortions while setting themselves up for higher levels of distrust and conflict.
• Students, professors, and administrators should keep in mind Hanna Holborn Gray’s principle: “Education should not be intended to make people comfortable; it is meant to make them think.”

The Coddling of the American Mind: How Good Intentions and Bad Ideas Are Setting Up a Generation for Failure by Greg Lukianoff  and Jonathan Haidt.

Depression, Anxiety, and the Christian Life: Practical Wisdom from Richard Baxter by Michael S. Lundy with an introduction by J. I. Packer.

After introductory essays by J. I. Packer and Michael Lundy, this book the presents modernized text of Richard Baxter’s writings on depression. The first is “Directions to the Melancholy about Their Thoughts,” the second is “The Cure of Melancholy and Overmuch Sorrow, by Faith,” and the third is on “The Duty of Physicians.”

In the first, Baxter lists no less than 35 symptoms of depression, all of which are related to the spiritual aspect of depression. It’s an astonishingly detailed and accurate insight into the spiritual dimension of depression. I’ve never come across a more insightful x-ray of the depressed mind and soul of the depressed Christian.

Some of the most striking are:

19. Their perplexed thoughts are like unraveled yarn or silk, or like a man in a maze or wilderness, or one who has lost his way in the night. He is looking and groping about, and can make little of anything. He is bewildered, confused, and entangled even more, filled with doubts and difficulties, out of which he cannot find the   way.

22. [Depressed] individuals have lost the power of controlling their thoughts by reason. If you convince them that they should reject their self-perplexing, unprofitable thoughts and turn their thoughts to other subjects or simply be at rest, they cannot obey you. They are under a compulsion or constraint. They cannot push out their troublesome thoughts; they cannot redirect their minds; they cannot think about love and mercy. They can think of nothing but that on which they do think, as a man with a toothache can think only of his pain.

34. Few of them respond positively to any reason, persuasion, or counsel. If it does seem to satisfy, quiet, and cheer them for the moment, the next day they are just as bad as before. It is the nature of their illness to think the way they do. Their thoughts are not cured, because the underlying disease itself remains uncured.

35. Yet in all this distress, few of them will believe that they are depressed, and they hate being told that they are. They insist it is merely a rational sense of unhappiness from being forsaken and under the heavy wrath of God. Therefore, they can hardly be persuaded to take any medication or use other means for the cure of their bodies. They maintain that they are well, being confident that it is only their souls that are distressed.

What’s so helpful about Baxter’s list is that depressed Christians can so readily identify with it. It rings true in their experience. They read it and say, “He gets it. He understands me,” thus making them willing to consider his prescriptions and directions. He obviously had sat with many depressed people and listened so long and so carefully that he could eventually articulate their experience even better than they could. What a door-opener to the reception of his counsel!

How should we respond to Christians with depression? Baxter urges pity and sympathy.

This is the miserable case of these unfortunate people, greatly to be pitied and not to be despised by anyone. I have spoken here only what I myself have frequently observed and known. Let no one look down on these individuals; persons of all sorts fall into this misery: educated and illiterate, high and low, good and bad, as well as some who previously lived in decadent self-seeking and sensuality until God made them aware of their foolishness.

Depression, Anxiety, and the Christian Life: Practical Wisdom from Richard Baxter by Michael S. Lundy with an introduction by J. I. Packer.

Depression, Anxiety, and the Christian Life: Practical Wisdom from Richard Baxter by Michael S. Lundy with an introduction by J. I. Packer.

The Causes of Depression

In his introductory essay to this book, J. I. Packer discusses how the Puritans understood the body-soul connection in depression and how problems in one can lead to problems in the other. Referring to Richard Baxter in particular, he viewed depression as “a psychophysical reality, a ‘diseased craziness . . . of the imagination’ that might be caused by the body being out of sorts (“sorrows that come from your spleen”), or by overload or overstrain on the mind, or perhaps both together.”

The Condition of Depression

In addition to spiritual symptoms such as terrors of hell and temptations to blaspheme and commit suicide, “Melancholics characteristically could not control their thoughts; they were unable to stop despairing about everything, or to begin a discipline of thanksgiving and rejoicing in Christ, or to concentrate on anything but their own hopelessness and felt certainty of damnation. They would cultivate solitariness and idleness; they would spend hours doing nothing. They would insist that others did not understand them, and that they were not sick but only realistic about themselves, and they would prove perversely obstinate in the matter of taking medication.”

The Cure of Depression

Baxter’s prescription included

1. “Never letting melancholics lose sight of the redeeming love of God, the free offer of life in Christ, and the greatness of grace at every point in the gospel.”

2. “Not attempting to practice the secret duty of meditation and prayer on one’s own, but praying aloud in company.”

4. Cultivating cheerful Christian community.

5. Avoiding idleness.

6. “Making good use of a skilled physician, a discerning pastor, and other faithful Christian mentors and friends, for support, guidance, and hopefully a cure.”

“Baxter wrote about the care of the soul and the care of the body as if they were indivisible if not indistinguishable components of the same person.”

Depression, Anxiety, and the Christian Life: Practical Wisdom from Richard Baxter by Michael S. Lundy with an introduction by J. I. Packer.

Depression, Anxiety, and the Christian Life: Practical Wisdom from Richard Baxter by Michael S. Lundy with an introduction by J. I. Packer.

Three Authors

J. I. Packer writes a chapter introducing Baxter. Michael Lundy is a clinical psychiatrist who has modernized two texts of Baxter on the subject of depression. Richard Baxter was a Puritan with many pastoral interests, but one of his primary concerns was to relieve depression, as reflected in two of his addresses on the subject published together in this book, together with a shorter essay in the appendix.

The Authors’ Definition

The books provides a dictionary definition of depression:

A recent dictionary defines depression as “a state of extreme dejection or morbidly excessive melancholy; a mood of hopelessness and feelings of inadequacy, often with physical symptoms such as loss of appetite, insomnia, etc.”

But it then supplies J I Packer’s extensive and vivid definition:

Fretful heaviness seizes the mind, sometimes slowing it down to a point of virtual paralysis where thought ceases, sometimes driving it into unfruitful randomness, or a fixed attitude of gloom, or an incessant harping on things felt to be incurably wrong. Depressed persons feel themselves isolated and distant from others— even their nearest and dearest— and from projects in which hitherto their hearts had been fully engaged. Conduct may become eccentric, randomness or inaction may set in, focused creativity may fade away, or sadness may become habitual. Feelings of anxiety, worthlessness, and hopelessness develop, and defensive pessimism takes over. Upset by others’ cheerfulness, the depressed may seem cross-grained and combative. Some depressions are cyclical, low points in bipolar mood swings, where they may be followed by bursts of energetic overconfidence. What medication can do to modify these extremes varies from person to person.

The Authors’ Aims

Why did Packer and Lundy write this book? They wrote it for two reasons.

1. They want Christians “to live as far as possible in the outgoing love, stability, and joy— along with patience, kindness, faithfulness, and self-control—that form the moral profile of Jesus Christ in his disciples. We see such living as true human flourishing, and the promotion of it as central to all forms of pastoral care, church worship and fellowship, personal therapy, and Christian family life. And we see depression in all its forms as a prima facie obstruction to this, in which Satan regularly has a hand.”

2. They believe that mental and emotional thorns in the flesh, such as depression, “may become means of spiritual advance that would not otherwise take place..”

3. “We believe that greater wisdom in this matter than we are used to is found in the pastoral heritage of seventeenth-century Puritanism. Supreme here is the wisdom of Richard Baxter, who in his day was viewed and consulted as a top authority regarding ministry to Christians afflicted by what was then called “melancholy,” but would today be labeled depression. Our hope is that by presenting what Baxter wrote in this field we may contribute to wise pastoral care in Bible-believing, gospel-centered, Christ-honoring churches at this time.

The Authors’ Rejection

Packer and Lundy reject the idea of some Christians that depression in Christians is always a sign of unbelief or some other major sin.

Depression, Anxiety, and the Christian Life: Practical Wisdom from Richard Baxter by Michael S. Lundy with an introduction by J. I. Packer.