Monday, July 1, 2013

The Christian and Depression, Part VI

Okay, we've made a start in addressing the disease of Major Clinical Depression in the life of a born again Christian.  We've discussed some of the main physical and chemical causes of the disease, and some of the symptoms, and some of the myths surrounding it - - - myths propagated by Christians, and by unbelievers.  But what about treatment?  If a man or woman is diagnosed as having this disease (and a professional diagnosis is necessary: this is no place for guesswork), how can it be treated?

I've approached this particular post with fear and trembling, because I'm not a mental health professional, and I don't want to mislead anyone.  (If you haven't read the previous posts in this series, please do so: if you, or someone you love, might be suffering from Depression, you need all the reliable information you can get.  The other posts are linked at the bottom of this one.) As we've repeatedly said, most people reading this blog probably don't suffer from this disease, statistically speaking; and occasional feelings of sadness or gloom shouldn't be confused with the clinical illness: they're just part of life.  But, if you're a born again Christian who might be afflicted by this particular "thorn in the flesh," you need to know that you're not crazy, you're not "imagining things," you haven't "failed God," and that plenty of other believers are in the same position (1 Peter 5:9).  That can't be emphasized enough. Without offering my own case as "anecdotal evidence," I'll simply repeat that I've been treated for this disease for over twenty years, by various professionals in various places, thousands of miles apart.  That's why I know, first-hand, the suspicion and ostracism that often befalls Christians in this position.  Our brethren have been (and some remain) slow to understand how any genuinely saved person, who has received Christ according to John 1:12,  can be mentally ill.  But those of us who suffer from this condition understand each other, which is why I'm writing this series of posts.

Although every individual case is different, and involves different therapies, it's also true that different types of depression require different approaches.  Mild to moderate depression, for example,  does not usually respond to most antidepressant medications.  Bipolar disorder may (or may not) require more intense therapy, from lithium to electroconvulsive therapy (rarely).  But we're talking here about Major Clinical Depression, and there are basically two areas of therapy: medication, and/or psychoanalytic therapy (talk therapy, etc.).  Let's start with medication.

Medication. Most people with Major Depression are treated with medication at some point: some for a relatively brief period of time, others (like me) for years. Sometimes, your primary care doctor can do a perfectly adequate job of helping you with such medication, without even referring you to a psychiatrist.  (We'll say it again: Depression is usually caused by a problem with brain chemicals.  It's not a form of insanity, although it's a mental illness.  A shrink is not always necessary.) If your primary care physician refers you to a psychiatrist, he or she may or may not prescribe the stuff; they probably will, at some point.  (Not a psychologist: although they are professionals, psychologists are not usually Medical Doctors, and can't prescribe medications.) There may be a period, sometimes a lengthy period, of trying various medications, to see which one works best for you; or perhaps the doctor will get it right the first time.  It's just like antibiotics: some will work in your case, and some won't.  The important thing - - - although it seems obvious - - - is that you take the medication, exactly as prescribed.  One of the symptoms of Major Depression is a hopelessness or exhaustion that can cause a person to skip their meds, just as they might skip a meal,  because "it all seems so pointless." On the other hand, don't "self-medicate," and decide to skip a few doses because you're "feeling better."  Few people enjoy taking medicine of any kind: that doesn't matter. It's more "enjoyable" than being helplessly, constantly depressed.  If you need it, take it, and ask God to bless it, exactly as you'd ask Him to bless your food.  He's still your ultimate and primary Physician!  Also be aware that most antidepressants take a period of weeks, even five or six weeks, before they "kick in" and start to work.  Don't expect instant results; we're not talking about "happy pills" here.  Nobody's selling these on the street-corner for a cheap thrill, because they don't provide any thrills: antidepressants don't even offer the sort of euphoria that sometimes accompanies painkillers.

The Mayo Clinic has stated that over 25% of people suffering from Major Clinical Depression can be successfully treated with medication alone.  In other cases, a limited period of psychological treatment (talk therapy) may be required, and then discontinued.  In any case, one thing is important to remember: for a Christian, taking such medication is not a "sin," or a sign of spiritual failure; and it's certainly not like taking barbiturates or tranquilizers or other mood-altering substances.  God has provided these things for some of His children, just as He's provided antibiotics, anesthetics, and insulin.  They're not right for everybody, but they're right for some, and no Christian should feel guilty about taking them.

(For the record, I'm not one of those people who believes that everything can be solved with a pill or a drug.  I completely agree with those who say that in the West, particularly Europe and North America, the population is terribly over-medicated.  I'm particularly indignant about the routine way in which so many people medicate their children.  But that's not what we're talking about here.  We're talking about a specific treatment for a very real disorder.)

Antidepressants are often (if not usually) prescribed along with anti-anxiety medications.  These drugs work together, and neither group can be called "happy pills."  They're treating a physical condition - - - and, if you need to take them, you won't be taking them forever.  The goal is to get to the point where they can be discontinued: but only your doctor can make that determination.  

Your brain, if you're Depressive, has a chemical imbalance.  You don't need to be scared of taking medication to treat it.  Just remember: your help doesn't come from the pills; it comes from the God Who created your body, and enabled men to develop the medications.  Take the medicine if you need it, but trust in God; and if "the brethren" don't understand, pray for them!

There are various classes of antidepressant medications, that work in different ways.  There are "selective serotonin reuptake inhibitors" (SSRIs), "tricyclics," "monoamine oxidase inhibitors" (MAOIs), and "atypical" antidepressants.  But you don't need to know all that; if you're a Depressive, your doctor and pharmacist already know it.  You need to know that, like any drug, these drugs can have side-effects, both trivial and deadly serious: but finding the medication that's right for you is your doctor's job.  Your job is to pray to your Primary Physician, Who created you, that the doctor gets it right!  Then let the medicine do its work, and stay in your Bible, and maintain your fellowship with God's people.  That's very, very important!

Because Major Clinical Depression is a serious matter, I'm attempting to give you as much information as I can, speaking as one Bible-believing Christian to another.  I'm hoping that you'll trust these posts; they're not coming from someone who believes that "all you need is drugs" or who worships at the altar of science.  But I've seen too much of life to say, as some Christians do, "Mental problems are all imaginary," or "you're just suffering for your sins."  If you're a Bible-believing Christian, striving to serve your Saviour in this fallen world, you don't need condemnation, and you don't need a pat on the head: you need straight talk from somebody who's been there.

In the next post, we'll discuss the other type of treatment for Depression: psychotherapy, "talk therapy," Cognitive Behavioral Therapy, and some other things.  Some of this stuff can be very helpful; some can be very harmful.  I am not ignorant of the evils that have been done in the name of "mental health," as you'll see. Psychologists and psychiatrists are sinners just like you and me, and they've done a lot of harm.  But what Christians need to acknowledge is that they can do a lot of good, too - - - maybe in your case. 

God bless you!  If you don't have Major
 Depression, you're greatly blessed; but you probably know someone who does, and who you can comfort and embrace in Christ.  Just remember, as we said at the end of our first post:  And we know that all things work together for good to them that love God, to them who are the called according to his purpose (Romans 8:28).

Be encouraged!  God still has work for you to do down here on the ground, or He'd have already taken you Home!