What do you think of Christians taking antidepressants?
By Pastor John Piper, given on March 30, 2010
The following is an edited transcript of the audio.
What do you think of Christians taking antidepressants? I have been on them and have been accused of not relying on God.
That relates to an earlier question about how any physical or personal means that you use can signify that you’re not relying on God. So eating might be a failure to rely on God, because he might just fill your stomach by miracle, and you don’t have to eat. Or not sleeping would be a way of relying more on God, since you don’t have to have your psyche made stable by sleep at night. And so on.
God has ordained physical means. Aside from the ones that seem more natural, like food, there’s medicine: aspirin, Nyquil, etc. This water is helping my throat right now. [Sips it.] Was that sip a failure to rely on God?
Could be. “Just throw this away and rely on God! He will keep your throat moist. You don’t need to be drinking. You’re an idolater, Piper. You’re idolizing this because you’re depending on it.”
Well, the reason that’s not the case is because God has ordained for me to thank him for that. He created it and he made this body to need a lot of fluid. And it’s not a dishonor to him if I honor him through his gift.
Now the question is, “What medicines are like that or not like that?” Taking an aspirin?
My ophthalmologist told me about 4 years ago, “Take one baby aspirin a day and you will postpone cataracts or glaucoma or something.” He said, “I can see just the slightest little discoloration, and the way it works is that circulation helps.” So he told me to pop one of these little pills in my little vitamin thing. And I take it every day. And I just said, “Lord, whether I have eyes or not is totally dependent on you. But if you would like me to use this means, I would.”
My answer is that when you start working with peoples’ minds, you are in a very very tricky and difficult situation. But I think I want to say that, while nobody should hasten towards medication to alter their mental states—even as I say it I think of caffeine, right?—nevertheless, I know from reading history, like on William Cooper, and by dealing with many people over the years, that there are profoundly physical dimensions to our mental conditions.
Since that’s the case, physical means can be appropriate. For me it’s jogging. I produce stuff in my brain by jogging. But that might not work for somebody else, and they might be constantly unable to get on top of it emotionally. I just don’t want to rule out the possibility that there is a physical medication that just might, hopefully temporarily, enable them to get their equilibrium, process the truth, live out of the strength of the truth, honor God, and go off it.
When I preached on this one Easter Sunday a woman wrote me, thanking me that I took this approach. She said, “You just need to know that I live on these things, and I know what it was like 20 years ago and the horrors and the blackness of my life. And now I love Christ, I trust Christ, I love my husband, our marriage is preserved, and I’ll probably be on these till I’m dead.”
So I’m not in principle opposed. I just want to be very cautious in the way we use antidepressants.
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“You say, ‘I am rich. I have everything I want. I don’t need a thing!’
And you don’t realize that you are wretched and miserable and poor and blind and naked.”
Rev. 3:17, NLT
If you would come to me and speak this boldly, I’d run you off. “You have no right speaking to me in this way!” Our personal relationships are essentially based on “boundaries.” My continuing friendship with you is based to a large degree on your respecting these social rules and restrictions. We look to social protocol to guide us.
God is the only one we would allow to speak to us so boldly and directly (and even then it’s still unwelcome).
Self-sufficiency has become the specific goal of the speaker, it is how he measures a respectable Christian life. Respectability however, is a disturbing development for simple believers. “I don’t need a thing.” Within our hearts there is a hunger to be independent. Self-sufficiency and pride are disturbing thought processes for simple disciples.
There is a delusion that is quite prevalent– we may feel that we have arrived. We finally are capable of something important. We have done all the necessary things, we have jumped through all the hoops, and have “made it.” It somehow feels like we have accelerated the sanctification process. Much of this comes from a feeling of being ‘spiritually exceptional.’
Jesus is confrontive. He will not diminish the truth, to spare our feelings. I think that that is quite remarkable. We esteem and value honesty, but when it is focused on us it seems difficult.
“You don’t realize that you are wretched and miserable and poor and blind and naked” (Rev. 3:17).
None of these five words would we use to describe ourselves.Let’s consider them anyway:
wretched– terrible, very bad
miserable– unhappy, depressed
poor–lacking sufficient resources
blind– sightless, without vision
naked– bare, without covering
These five words that describe the “real” position of the believer in pride. These five words dismantle us, stripping us of our lies. We have evaluated ourselves and discovered that we must be exceptional believers. (Perhaps my innate specialness is true after all!)
Twenty years ago my wife and I took an evaluation for placement in a language school. I assumed I was quite exceptional, but two hours later I was told that I failed the test and would be assigned to the lowest level for the rest of the semester. I was shocked! And my dear wife, was put into the highest. What a blow to my pride!
“We will speak the truth in love, growing in every way more and more like Christ.”
He reaches out to us because He loves us profoundly. It is a love that is not based on any kind moral performance. However, it is quite necessary for us to step into the piercing light, and an intense desire to enter reality. It is difficult for us to slough off the lies, and to understand what is true. Trust me, Jesus speaks nothing but the truth, and He loves us while He does it.
Today I realized that I was sick and very tired of myself. It’s really not disgust, or even loathing. It’s more like a weariness, an exhaustion. I’ve never felt this way. In a strange way it intrigues me. Could this definite disenchantment mean something spiritual? Does it have value, or am I just feeling self-absorbed or conceited?
There is a real rigidity to evil. As I have seen it– sin hardens all who touch it, plain and simple. My growing immobility disturbs me, as I know I’m developing a “hardness of heart.” Atherosclerosis is a condition of a sick heart where arteries become blocked. It’s also known as “hardening of the heart, or arteries.” It is a patient killer, slowly and surely making hard deposits that block the flow of blood.
The Bible speaks about having a hard heart. It also uses the metaphor of fallow ground that must be plowed up. Jesus used the same image in His “Parable of the Sower” in Matthew 13.
“A sower went out to sow. 4 And as he sowed, some seeds fell along the path, and the birds came and devoured them. 5 Other seeds fell on rocky ground, where they did not have much soil, and immediately they sprang up, since they had no depth of soil, 6 but when the sun rose they were scorched. And since they had no root, they withered away. 7 Other seeds fell among thorns, and the thorns grew up and choked them. 8 Other seeds fell on good soil and produced grain.”
There are only four real options.
The first is seed that never arrives.
The second lands on hard stones.
The third possibility is landing on thorns and thistles.
Only the fourth flourishes.
The question I have is this, can the hard soil become soft, and can the good soil become overgrown with thistles? Is this a static, set experience? Or could it be far more fluid? I seem to move from one soil condition to another.
I have found that my own heart drifts. Manic Depression is a mental illness where emotions fluctuate constantly. They gallivant around, floating here and than there. I maybe depressed and suicidal in the morning, and then I can be euphoric in the evening. It’s having the identity of a “wandering star.”
I want my heart to soften. I want to sit with Jesus and hear His words. I need Him to share what He is thinking about. Any sin I entertain has a hardening effect in my spiritual heart. This really scares me. *
#3 The Devil will try very hard to condemn you for your past.
There are some days that are harder then others. You see, I have lived profligately, harmed many, and influenced others to do evil. I have wounded and hurt people very deeply. There are days when I have this mental image of myself– I’m a ‘Fountain of Feces’ spewing and polluting my filth to anyone passing by.
But I am also the Prodigal. I’ve squandered everything. It’s gone. I’ve been to the pig pen. Filthy and starving. Coming to my senses, I decide to return home, and sell myself to the employ of Him I once called “Father.”
But the most outrageous thing has happened. It is so wildly fantastic that it defies any reason. (I hardly dare to think it real). The man who I once called “Father” refuses to listen to my list of sins. He has embraced me, dressed me, established me as a son. I have new shoes, and a signet ring.
I am a wonder to behold. A feast of unparalleled joy is waiting. I pinch myself– is this really happening to me? Those days in the pig pen, what a stupid waste. I want to weep and shout for joy– all at the same time! It doesn’t seem real.
The subject of my grossness and sin has been forgotten. I have not been interrogated or punished. (Since then, I’ve learned that Someone else took this on.) But my perversity and my iniquity has never, ever been discussed. Their is no list of my sin, no cataloging has taken place. The promises tell me that my past sin has been put on a big barge, and shipped to the deepest part of the ocean– and dumped!
“You will again have compassion on us; you will tread our sins underfoot and hurl all our iniquities into the depths of the sea.”
As critical-thinking believers, with just a modicum of divine truth, what we do with our personal sin is huge. It determines much about our walk. We function out of our past. The plant is rooted in something. But our Father has turned our prodigal past into our personal future of total redemption.
Look at your greatest pain. The Holy Spirit will very likely take that deep, deep bruise and turn it into your greatest ministry. And He does it without resorting to a list of your ugly, ugly sin. You see, He has already forgotten it.
“The question is who are we going to side with? God says our sins are past, cleansed, and gone. You cannot go on with God until you stand on His Word as cleansed with the heart made pure.”
NAMI’s Interviews With Danielle Steel & Kay Jamison
Last year, Steel published His Bright Light, a memoir of her son, Nick Traina, who committed suicide at age 19 after a life-long battle with bipolar disorder (manic depression). More recently, Jamison has published Night Falls Fast: Understanding Suicide, combining research, clinical expertise and personal experience to explore one of the world’s leading causes of death.On February 8, the Senate Appropriations Subcommittee on Labor, Health, Human Resources, Education & Related Agencies will hold a hearing on suicide prevention that will include testimony from best-selling author Danielle Steel and Professor Kay Redfield Jamison, author of several academic and popular books on mental illness.
Interviews with Steel and Jamison have appeared in “Spotlight,” a special supplement to The Advocate, the quarterly publication of the National Alliance for the Mentally Ill (NAMI). Conducted by NAMI executive director Laurie Flynn, they offer a possible preview of Steel and Jamison’s testimony on Tuesday. Excerpts follow below.
NAMI’s Interview with Kay Jamison
Spotlight (Winter 1999/2000)
NAMI: What do we know about the linkage between suicide and mental illness?
Jamison: The most important thing to know is that 90 to 95 percent of suicides are associated with one of several major psychiatric illnesses: depression, bipolar illness, schizophrenia, drug and alcohol abuse, and personality disorders. These are obviously treatable illnesses. Another thing people don’t think about enough or emphasize enough is that because cancer and heart disease hit older people, they are seen as lethal illnesses. Because the age of onset for mental illnesses is very, very young, people don’t tend to think of mental illnesses as the potentially lethal illnesses they are. It’s important for people to understand that they have an illness to begin with and then that they get good treatment for it.
NAMI: You have spoken specifically of suicide and college students.
Jamison: Yes. Suicide is the second major killer of college aged kids. It’s the second leading killer of young people generally.
NAMI: You also have pointed out that, worldwide, suicide is the second leading killer of women between ages 15 and 45. These statistics are staggering, yet most people don’t seem to be aware of it.
Jamison: Absolutely. Across the world. There are almost two million suicides a year worldwide. I think people just don’t have any sense of the enormity of it. Suicide unfortunately has been so individualized and, because of the early suicide movement in this country, so separated from mental illness. People working in the field of suicide concentrated on existential factors and vague sorts of things, when in fact the underlying science is very clear that they’re associated with a few mental illnesses.
NAMI: Knowing what we do about illness and its treatability allows us to be able to discuss preventing suicide.
Jamison: Right. [U.S. Surgeon General] Dr. David Satcher’s emphasis has been very strong on three fronts. One is public awareness. Secondly, intervention and all that’s involved in making doctors and others more able to ask the kinds of questions needed to uncover mental illness. And then, thirdly, to support the science that’s necessary to study suicide.
NAMI: What else can policy makers and public officials do?
Jamison: I think we have to have public officials talking about it. When you have someone like Jesse Ventura out there saying these outrageous things-I think it’s really beyond the pale-we’ve got to have the president of the United States saying look we’ve got a real epidemic here, and there’s something we can do about it. People are dying from not gaining access to treatment-or from having three days in the hospital, and then going out and dying.
NAMI’s Interview with Danielle Steel
Spotlight (Winter 1999)
NAMI: “His Bright Light” is a very personal story about a very painful subject, the mental illness and death of a child. What did you hope people would learn by sharing your story?
Steel: I hoped first of all that people would come to know my son, and learn what an extraordinary person he was. I wrote the book to honor him, and to share with people what a remarkable person he was, in spite of his illness. I also wrote it to share with people the challenges we faced, so that they feel less alone and less isolated with their pain, in similar situations. I wrote it to give people hope and strength as they follow a similar path to ours.
NAMI: What did you learn from this painful tragedy?
Steel: I’m not sure yet what I learned from the tragedy, except that one can and must survive. But from his life, I learned a great deal about courage and perseverance, and love.
NAMI: Lots of people in America might be facing signs of a mental illness in one of their children. What about Nick’s behavior made you realize that it was more severe than just the normal growing pains of a child?
Steel: Nick was different. Always. His moods were more extreme. I sensed from early on, that despite his many wonderful qualities, there was something very wrong. I knew it in my gut, as I think many parents do.
NAMI: How long did it take for Nick to be diagnosed as manic-depressive and receive treatment for that condition?
Steel: Nick was not clearly diagnosed as manic depressive until he was 16, a good 12 years after we began the pursuit of the causes for his ‘differences’. He received no medication until he was 15, and did not receive the most effective medications until he was 16. A long and very painful wait for all concerned!
NAMI: Prior to knowing of Nick’s manic depression, what did mental illness mean to you? Did you associate stigma with mental illness?
Steel: I don’t think I realized, before Nick, that one could still be functional, or seemingly functional, if mentally ill. I thought of it as something totally incapacitating, and of people who were shut away. I don’t think I realized how intelligent and capable mentally ill people can still be. I’m not sure I did associate a stigma with mental illness. It just seemed like a sickness, and not necessarily a shameful one. I just thought of Nick as sick, whatever it was called, and wanted him to be cured.
NAMI: How did Nick deal with the knowledge that he had a mental illness?
Steel: For a long time, Nick himself was in denial about his illness. And eventually, he accepted it. In the last year, he told people he was manic-depressive. Before that, when he felt ‘normal’ on medications, he believed he was cured. He had a hard time accepting at first that he would be manic-depressive all his life.
NAMI: Are schools able to cope with the mental illness of a child?
Steel: In most cases, I don’t believe they are. It is a huge challenge for all to meet, and certainly hard on the other kids to have one child acting out. We were very lucky, in Nick’s high school years we finally found a wonderful school that understood the problem, accepted him as he was, and was willing to work with him in a framework he could cope with. They were remarkably flexible and creative. But for most schools, it’s asking a lot to expect them to adapt to a mentally ill child.
NAMI: If you could tell a family member who is caring for someone who is mentally ill one thing, what would that be?
Steel: Never give up. Get the best help you can. Keep trying, keep loving, keep giving, keep looking for the right answers, and love, love, love, love. Don’t listen to the words, just listen to your heart.
NAMI: What do you think support groups like NAMI can do for families coping with the mental illness of a loved one?
Steel: I think groups like NAMI can provide support, both emotional and practical—the knowledge that you are not alone. And resources, where to go, who to talk to, what works. You need all the information you can get, and it is just about impossible to do it alone.
NAMI: Stereotyping the mentally ill as violent and dangerous is pervasive in America. How do we change this perception?
Danielle: Information. Obviously there must be some mentally ill people who are violent and/or dangerous. But I suspect that most are not. Nick certainly wasn’t either of those, he was gentle, loving, smart, funny, compassionate, extremely perceptive about people, and very wise. I cannot conceive of Nick as ‘dangerous,’ although ultimately he was a danger to himself. But for the most part, I think the turmoils of the mentally ill are directed within and not without.
NAMI: What do you think the average American should know about mental illness?
Steel: I think most people should know how common it is…I also think people should know how serious it is when it goes untreated. And how potentially lethal it can be. It is vitally important to get good treatment, the right medication, and good support. If you let a bad cold turn into bronchitis and then pneumonia, without medication, it can kill you. If you do not treat serious diabetes, it can kill you. If mental illness goes untreated, it can kill you.
NAMI: We know that having “hope” is important to battling any disease. What hope do you see for people with mental illness?
Steel: I see a huge amount of hope. The medications today can give people whole, happy, productive lives. There are lots and lots of people with mental illness holding down good jobs, even with important careers, happy family lives, and doing great things. It is possible to lead a good and happy life if you are mentally ill. If those who are doing just that would speak up, it would give great hope to all those who are still groping their way along in the dark.
NAMI: What is Nick’s legacy?
Steel: Nick’s legacy is the love we had and have for him, the word we have spread of what a terrific person he was. In his lifetime, he touched countless lives, with his warmth, with his mind, with his music, with his words. Through his experiences, others have and will learn. Through the Nick Traina Foundation, hopefully we can bring help to others, in his name.
“In one of the villages, Jesus met a man with an advanced case of leprosy. When the man saw Jesus, he bowed with his face to the ground, begging to be healed. “Lord,” he said, “if you are willing, you can heal me and make me clean.”
Luke 5:12, NLT
Let’s jump right into this passage from Luke 5. A very sick man desires to become well. The Bible text reveals that his condition is agonizingly desperate. His leprosy has advanced; he is covered with it from ‘head-to-toe.’ He is completely infected; he is ‘unclean’ and without hope. There is no treatment for what he has, doctors can do nothing, so he comes to Jesus.
We must emphasize this, the leper has no illusions of wholeness. He knows it; he doesn’t need to be convinced, or persuaded by anyone else. It occurs to him, that Jesus the healer (of lepers, and the like) may provide healing, or at the least a morsel of comfort. This leper approaches the presence of Jesus, with such humility it is almost painful to witness. This man is completely broken; he has no hope, except Jesus.
There is a fellowship of misery–some of us are “card-carrying” members.
Our diseases differ, but they have affected us completely. Our pain, and our darkness vary. Some have physical pain, others have a mental illness. When we meet, there should be a secret handshake or a password. We share a comradeship— we are all part of the same community. We are a broken club of tired and decidedly unclean misfits.
How do we measure our pain and desperate darkness? What do we use to measure it? For the most part, our lives have been destroyed. I think we can understand it by looking up at Jesus. Lying in the dirt, we believe the unbelievable. Our faith doesn’t activate his healing as much it guides it to our greatest need. The presence of Jesus drives away the pain. His love for us echoes into our emptiness. And he wants to do this! He has come for us. He carries us through this.
I struggle with deep depression and despondency. I have been on meds for a long time. But when I come into Jesus’ presence, all this melancholy is driven out. He comes and injects a true hope into my spirit. Am I a stellar example of perfect discipleship? I think not. (My wife could tell you this.) But isn’t about us becoming “angels”, it’s about us becoming intimate with Jesus.
“The power of the Church is not a parade of flawless people, but of a flawless Christ who embraces our flaws. The Church is not made up of whole people, rather of the broken people who find wholeness in a Christ who was broken for us.”
The leper would be healed by the authority (and touch) of Jesus Christ. What is impossible with men, is possible with God.
“Jesus reached out and touched him. “I am willing,” he said. “Be healed!”And instantly the leprosy disappeared.” (v. 13)
What do you say to people who ask if you’ll eventually stop taking medication?
I say to people that they don’t expect a diabetic to stop taking insulin, or someone with a heart condition to stop taking blood thinners. I have a chronic, lifetime disease and the only responsible thing for me to do is stick with my medications.
People wonder about medications’ long-term effects on the brain. I explain that while the medications’ effects appear to be reversible as soon as you stop taking them, the long-term effects of having repeated depressive episodes appear to be absolutely dire. There is lesioning of the hippocampus, and brain cells die. And this is in addition to the havoc that such repeated episodes cause in your daily life.
Imagine you have heart disease. You’re prescribed medication, you do better for a while, so you stop the meds. Then you have another heart attack, so you go back on the medication to get better. Twelve heart attacks later, what kind of shape are you in? It’s obviously crazy. If you have recurrent depression, you are not being “courageous” or “genuine” to go off your medication. You’re being foolish.
Can you explain the importance of balancing therapy and medication?
Different treatments work for different people, and I am open to the endless possibilities out there. But for most people, a combination of medication and therapy is the surest-fire way to handle depression.
The medication alleviates the worst symptoms and lets you function again. It makes life and the world bearable. But once you have emerged from the horror, you need to learn skills for managing the illness. You need to understand where it comes from. You need to make your peace with the idea that you cannot be fully yourself without the use of medications or other support structures.
And you need someone capable who can keep an eye on you. Ideally, you also need to understand the structure of your own personality and who you are; this gives you a feeling of peace and allows you to get through a difficult time with dignity.
By his mid-twenties, Solomon established himself as a multi-disciplinary wunderkind, earning international accolades for his work as a novelist, journalist and historian. After the death of his mother, the then 31 year old Solomon descended into a major depression, rendering him unable to work or even care for himself. He was helped by a combination of medications and talk therapy. This experience formed the bedrock for his National Book Award-winning “Noonday Demon: An Atlas of Depression”, a tour de force examining the disorder in personal, cultural, and scientific terms.