What’s Your Take on Christians Using Antidepressants?
by Pastor John Piper
I’m going to say that there are times when I think it is appropriate, but I want to go there cautiously and slowly, with warnings.
Depression is a very complex thing. It’s got many layers. I think we all would agree that there are conditions in which nobody would deny that certain people are depressed in a pathological way because they’re immobile. They’re not even able to function.
And then there’s a continuum of discouragements and wrestlings with having an ‘Eeyore-type’ personality, which may or may not be depressed.
So that means that I want to be so careful not to have a knee-jerk reaction. When you come into my office and describe to me your discouragements, I don’t want my first response to be, “See a doctor and get a prescription.”
I fear that is way too quick today. The number of people on antidepressants as a first course rather than the last course is large.
And the assumption is that you can’t make any progress in counseling unless you get yourself stabilized or something.
So I just want to be very cautious.
As a Christian who believes that Christ is given by the Holy Spirit to deliver us from discouragements and from unbelief and sorrow and to help us live a life of usefulness, what makes me able to allow for antidepressants is the fact that medicine corresponds to physical realities.
And the physical realities are that we get headaches that make us almost unable to think. Migraine headaches can put a man out. And we are pretty much OK if the doctor can help us find some medicine that would not let us get these immobilizing headaches.
And the headaches clearly have a spiritual impact, because they’re making me unable to read my Bible and function in relation to people that I want to love and serve. And so medicine becomes spiritually effective in that way.
So we apply this principle that we all use to depression, and then the fact that the body is included in depression. Whether we should use the terms “chemical imbalances”—I’ve read both sides on that. Some people say that there is no scientific evidence for such a thing and others say that it is a given. Whatever. Everybody knows that there are physical dimensions to depression.
If that physical dimension could be helped by medicine—in the short run especially, sometimes long term—then I think, in God’s grace and mercy, we should take it as a gift from his hand.
John Piper is the Pastor for Preaching at Bethlehem Baptist Church in Minneapolis, Minnesota. He grew up in Greenville, South Carolina, and studied at Wheaton College, where he first sensed God’s call to enter the ministry. He went on to earn degrees from Fuller Theological Seminary (B.D.) and the University of Munich (D.theol.). For six years he taught Biblical Studies at Bethel College in St. Paul, Minnesota, and in 1980 accepted the call to serve as pastor at Bethlehem. John is the author of more than 30 books and more than 25 years of his preaching and teaching is available free at desiringGod.org. John and his wife, Noel, have four sons, one daughter, and an increasing number of grandchildren.
“A Christian is not a person who believes in his head the teachings of the Bible. Satan believes in his head the teachings of the Bible!”
“A Christian is a person who has died with Christ, whose stiff neck has been broken, whose brazen forehead has been shattered, whose stony heart has been crushed, whose pride has been slain, and whose life is now mastered by Jesus Christ.”
“No longer do I call you servants, for a servant does not know what his master is doing; but I have called you friends,for all things that I heard from My Father I have made known to you.”
It seems that the purpose of life is not to find our freedom. It’s really meant to find our Master.
Yes, the idea of being a slave to anyone is repugnant. We chafe at this, and yet man was never meant to be seperated from the Lordship of Jesus. We’re instructed repeatedly with the New Testament idea that “our life is not our own” Over and over God proclaims Himself as the King.
That troubles us somewhat.
Not so much when life is fairly good, granted, but in those hard moments when a decision must be made between enjoying the titillating “lusts of the flesh,” or accepting the fruits of the Spirit. This is one of those “lordship moments.” They come, and go, and they show us exactly who we are.
If you’re really going to be authentic–a legitimate and real disciple, then you must determine who is going to be “boss.” This isn’t one of those casual decisions. You must securely fix it in your heart.
Your decision must become a settled issue.
The thief on the cross knew salvation, he was promised an eternity with God simply by faith. But I submit to you that he had put himself under the Lordship of Jesus, simply by recognizing the sign, “the King of the Jews.” I believe he saw and understood its imlications. Jesus was King!
This is a very hard word for some, but many of our personal issues hinge on this.
I know this first-hand. It can be a monumental struggle. You must admit to not only having Jesus as your Savior, but you also must put your life under His total Lordship. You need to pick up your cross daily in order to follow. You need to learn how to kneel.
I’ve chosen a crown to open up this post–it’s done on purpose. I simply want you to to understand the supreme call He has on your life. Here’s Bob Dylan, and he nails this idea down:
But you’re gonna have to serve somebody, yes indeed You’re gonna have to serve somebody Well, it may be the devil or it may be the Lord But you’re gonna have to serve somebody
“I hope everybody can find a little flame Me, I say my prayers, then just light myself on fire and walk out on the wire once again.”
Counting Crows, “Goodnight Elizabeth”
Hope is a powerful thing— nothing compares. It truly is the ‘anchor of the soul.’ Without it, life would be hopeless, and that is intolerable to a human being. We will implode without hope. The psalmist was well aware of this tendency; he speaks to himself about this. He ‘talks to himself’ which can seem a little weird to some.
“Why are you discouraged, my soul? Why are you so restless? Put your hope in God, because I will still praise him. He is my savior and my God.”
Day-to-day life can be arduous. Sometimes faith falters and hopelessness becomes a deadly option. For those of us with debilitating illnesses this can be significant hazard. Depression can severely hinder us.
The writer of Psalm 42 understood this. Discouragement was a real issue, especially when he wondered what was swirling around him. (And I daresay he is not alone in this.)
He insists a certitude. He refuses to give in to the idea that failure is final. He will not allow himself to accept the finality of hopelessness. He will not surrender himself to this idea that ‘all is lost.’ The way he battles back is seen in an inner conversation with his soul. He speaks to himself directly concerning the great faithfulness of God to his situation.
It is real, it’s definitely not fluff. He operates in reality. Hecan’t pretend that the feeling of despondency is imaginary, it is far too cruel and real for it not to be.
However having a hope will cement me in the goodness and mercy of God. It is the sterling silver (.925) belief that He cares for me. The verse in 42:11 ties in with praise and worship. This is no minor thing. When we praise, we break the bonds of hopelessness, in a way that our souls can know, and appreciate. It decisively disarms the depression, and fills the embattled soul with hope. Pain can be a powerful indicator of depression unchecked. But hope changes the manner of which we live.
“Every Christian who struggles with depression struggles to keep their hope clear. There is nothing wrong with the object of their hope – Jesus Christ is not defective in any way whatsoever. But the view from the struggling Christian’s heart of their objective hope could be obscured by disease and pain, the pressures of life, and by Satanic fiery darts shot against them.
All discouragement and depression is related to the obscuring of our hope, and we need to get those clouds out of the way and fight like crazy to see clearly how precious Christ is.”
I wish you the best even as the battle intensifies. Jesus is enough. Look around, see Him and run right to Him. Your faith will hold you.
Before I entered college I hardly gave a thought to cancer and terminal illness. But ever since those college days death by disease has walked beside me all the way. Two of my college acquaintances died of leukemia and cancer of the lymph glands before they were 22. At seminary I watched Jim Morgan, my teacher of systematic theology, shrivel up and die in less than a year of intestinal cancer. He was 36. In my graduate program in Germany my own “doctor-father,” Professor Goppelt, died suddenly just before I was finished. He was 62—a massive coronary. Then I came to Bethel, the house of God! And I taught for six years and watched students, teachers, and administrators die of cancer: Sue Port, Paul Greely, Bob Bergerud, Ruth Ludeman, Graydon Held, Chet Lindsay, Mary Ellen Carlson—all Christians, all dead before their three score and ten were up. And now I’ve come to Bethlehem and Harvey Ring is gone. And you could multiply the list ten-fold.
What shall we say to these things? Something must be said because sickness and death are threats to faith in the love and power of God. And I regard it as my primary responsibility as a pastor to nourish and strengthen faith in the love and power of God. There is no weapon like the Word of God for warding off threats to faith. And so I want us to listen carefully today to the teaching of Scripture regarding Christ and cancer, the power and love of God over against the sickness of our bodies.
I regard this message today as a crucial pastoral message, because you need to know where your pastor stands on the issues of sickness, healing, and death. If you thought it was my conception that every sickness is a divine judgment on some particular sin, or that the failure to be healed after a few days of prayer was a clear sign of inauthentic faith, or that Satan is really the ruler in this world and God can only stand helplessly by while his enemy wreaks havoc with his children—if you thought any of those were my notions, you would relate to me very differently in sickness than you would if you knew what I really think. Therefore, I want to tell you what I really think and try to show you from Scripture that these thoughts are not just mine but also, I trust, God’s thoughts.
Six Affirmations Toward a Theology of Suffering
So I would like everyone who has a Bible to turn with me to Romans 8:18–28. There are six affirmations which sum up my theology of sickness, and at least the seed for each of these affirmations is here. Let’s read the text:
I consider that the sufferings of this present time are not worth comparing with the glory that is to be revealed to us. For the creation waits with eager longing for the revealing of the sons of God; for the creation was subjected to futility, not of its own will but by the will of him who subjected it in hope; because the creation itself will be set free from its bondage to decay and obtain the glorious liberty of the children of God. We know that the whole creation has been groaning in travail together until now; and not only the creation, but we ourselves, who have the first fruits of the Spirit, groan inwardly as we wait for adoption as sons, the redemption of our bodies. For in this hope we were saved. Now hope that is seen is not hope. For who hopes for what he sees? But if we hope for what we do not see, we wait for it with patience.
Likewise the Spirit helps us in our weakness; for we do not know how to pray as we ought, but the Spirit himself intercedes for us with sighs too deep for words. And he who searches the hearts of men knows what is the mind of the Spirit, because the Spirit intercedes for the saints according to the will of God.
We know that in everything God works for good with those who love him, who are called according to his purpose. (RSV)
1. All Creation Has Been Subjected to Futility
My first affirmation is this: the age in which we live, which extends from the fall of man into sin until the second coming of Christ, is an age in which the creation, including our bodies, has been “subjected to futility” and “enslaved to corruption.” Verse 20: “The creation was subjected to futility.” Verse 21: “The creation will be freed from slavery to corruption.” And the reason we know this includes our bodies is given in verse 23: not only the wider creation but “we ourselves (i.e., Christians) groan in ourselves awaiting sonship, the redemption of our bodies.” Our bodies are part of creation and participate in all the futility and corruption to which creation has been subjected.
Who is this in verse 20 that subjected creation to futility and enslaved it to corruption? It is God. The only other possible candidates to consider would be Satan or man himself. Perhaps Paul meant that Satan, in bringing man into sin, or man, in choosing to disobey God—perhaps one of them is referred to as the one who subjected creation to futility. But neither Satan nor man can be meant because of the words “in hope” at the end of verse 20. This little phrase, subjected “in hope,” gives the design or purpose of the one who subjected creation to futility. But it was neither man’s nor Satan’s intention to bring corruption upon the world in order that the hope of redemption might be kindled in men’s hearts and that someday the “freedom of the glory of the children of God” might shine more brightly. Only one person could subject the creation to futility with that design and purpose, namely, the just and loving creator.
Therefore, I conclude that this world stands under the judicial sentence of God upon a rebellious and sinful mankind—a sentence of universal futility and corruption. And no one is excluded, not even the precious children of God.
Probably the futility and corruption Paul speaks of refers to both spiritual and physical ruination. On the one hand man in his fallen state is enslaved to flawed perception, misconceived goals, foolish blunders, and spiritual numbness. On the other hand, there are floods, famines, volcanoes, earthquakes, tidal waves, plagues, snake bites, car accidents, plane crashes, asthma, allergies, and the common cold, and cancer, all rending and wracking the human body with pain and bringing men—all men—to the dust.
As long as we are in the body we are slaves to corruption. Paul said this same thing in another place. In 2 Corinthians 4:16 he said, “We do not lose heart, but though our outer man (i.e., the body) is decaying (i.e., being corrupted) yet our inner man is being renewed day by day.” The word Paul uses for decay or corrupt here is the same one used in Luke 12:33 where Jesus said, Make sure your treasure is in heaven “where thief does not come near and moth does not corrupt.” Just like a coat in a warm, dark closet will get moth eaten and ruined, so our bodies in this fallen world are going to be ruined one way or the other. For all creation has been subjected to futility and enslaved to corruption while this age lasts. That is my first affirmation.
2. An Age of Deliverance and Redemption Is Coming
My second affirmation is this: there is an age coming when all the children of God, who have endured to the end in faith, will be delivered from all futility and corruption, spiritually and physically. According to verse 21, the hope in which God subjected creation was that some day “The creation itself also will be set free from its slavery to corruption into the freedom of the glory of the children of God.” And verse 23 says that “We ourselves groan within ourselves waiting eagerly for our adoption as sons, the redemption of our bodies.” It has not happened yet. We wait. But it will happen. “Our citizenship is in heaven from which we await a Savior, the Lord, Jesus Christ, who will transform the body of our lowliness to be like the body of his glory” (Philippians 3:20, 21). “In a moment, in the twinkling of an eye, at the last trumpet, for the trumpet will sound and the dead will be raised incorruptible and we shall be changed” (1 Corinthians 15:52). “He will wipe away every tear from our eyes, and there shall be no longer any death; and there shall be no longer any mourning or crying or pain; the first things have passed away” (Revelation 21:4).
There is coming a day when every crutch will be carved up, and every wheelchair melted down into medallions of redemption. And Merlin and Reuben and Jim and Hazel and Ruth and all the others among us will do cartwheels through the Kingdom of Heaven. But not yet. Not yet. We groan, waiting for the redemption of our bodies. But the day is coming and that is my second affirmation.
3. Christ Purchased, Demonstrated, and Gave a Foretaste of It
Third, Jesus Christ came and died to purchase our redemption, to demonstrate the character of that redemption as both spiritual and physical, and to give us a foretaste of it. He purchased our redemption, demonstrated its character, and gave us a foretaste of it. Please listen carefully, for this is a truth badly distorted by many healers of our day.
The prophet Isaiah foretold the work of Christ like this in 53:5–6 (a text which Peter applied to Christians in 1 Peter 2:24):
But he was wounded for our transgressions, he was bruised for our iniquities; upon him was the chastisement that made us whole, and with his stripes we are healed. All we like sheep have gone astray; we have turned every one to his own way; and the Lord has laid on him the iniquity of us all. (RSV)
The blessing of forgiveness and the blessing of physical healing were purchased by Christ when he died for us on the cross. And all those who give their lives to him shall have both of these benefits. But when? That is the question of today. When will we be healed? When will our bodies no longer be enslaved to corruption?