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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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. *
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.
From an article in Christianity Today, February 9, 1998
“The only army that shoots its wounded is the Christian army,” said the speaker, a psychologist who had just returned from an overseas ministry trip among missionaries. He summed up the philosophy of the group he worked with as:
1. We don’t have emotional problems. If any emotional difficulties appear to arise, simply deny having them.
2. If we fail to achieve this first ideal and can’t ignore a problem, strive to keep it from family members and never breathe a word of it outside the family.
3. If both of the first two steps fail, we still don’t seek professional help.
I have been a Christian for 50 years, a physician for 29, and a psychiatrist for 15. Over this time I have observed these same attitudes throughout the church—among lay leaders, pastors, priests, charismatics, fundamentalists, and evangelicals alike. I have also found that many not only deny their problems but are intolerant of those with emotional difficulties.
Many judge that others’ emotional problems are the direct result of personal sin. This is a harmful view. At any one time, up to 15 percent of our population is experiencing significant emotional problems. For them our churches need to be sanctuaries of healing, not places where they must hide their wounds.
THE EMOTIONAL-HEALTH GOSPEL
Several years ago my daughter was battling leukemia. While lying in bed in the hospital, she received a letter, which read in part:
Dear Susan, You do not know me personally, but I have seen you in church many times….I have interceded on your behalf and I know the Lord is going to heal you if you just let Him. Do not let Satan steal your life—do not let religious tradition rob you of what Jesus did on the cross—by His stripes we were healed.
The theology behind this letter reminded me of a bumper sticker I once saw: “Health and Prosperity: Your Divine Right.” The letter writer had bought into a “healing in the atonement” theology that most mainstream evangelicals reject.
According to this traditional faith-healing perspective, Christ’s atonement provides healing for the body and mind just as it offers forgiveness of sins for the soul. The writer meant well, but the letter created tremendous turmoil for my daughter. While evangelicals have largely rejected “health and wealth” preaching—that faithful Christians will always prosper physically and financially—many hold to an insidious variation of that prosperity gospel. I call it the “emotional-health gospel.”
The emotional-health gospel assumes that if you have repented of your sins, prayed correctly, and spent adequate time in God’s Word, you will have a sound mind and be free of emotional problems.
Usually the theology behind the emotional-health gospel does not go so far as to locate emotional healing in the Atonement (though some do) but rather to redefine mental illnesses as “spiritual” or as character problems, which the church or the process of sanctification can handle on its own. The problem is, this is a false gospel, one that needlessly adds to the suffering of those already in turmoil.
This prejudice against those with emotional problems can be seen in churches across the nation on any Sunday morning. We pray publicly for the parishioner with cancer or a heart attack or pneumonia. But rarely will we pray publicly for Mary with severe depression, Charles with incapacitating panic attacks, or the minister’s son with schizophrenia. Our silence subtly conveys that these are not acceptable illnesses for Christians to have.
The emotional-health gospel is also communicated by some of our most listened-to leaders. I heard one national speaker make the point that “At the cross you can be made whole. Isaiah said that ‘through his stripes we are healed’ … not of physical suffering, which one day we will experience; we are healed of emotional and spiritual suffering at the cross of Jesus Christ.” In other words, a victorious Christian will be emotionally healthy. This so-called full gospel, which proclaims that healing of the body and mind is provided for all in the Atonement, casts a cruel judgment on the mentally ill.
Two authors widely read in evangelical circles, John MacArthur and Dave Hunt, also propagate views that, while sincerely held, I fear lead us to shoot our wounded. In his book “Beyond Seduction”, Hunt writes, “The average Christian is not even aware that to consult a psychotherapist is much the same as turning oneself over to the priest of any other rival religion,” and, “There is no such thing as a mental illness; it is either a physical problem in the brain (such as a chemical imbalance or nutritional deficiency) or it is a moral or spiritual problem.”
MacArthur, in “Our Sufficiency in Christ”, presents the thesis that “As Christians, we find complete sufficiency in Christ and his provisions for our needs.” While I agree with his abstract principle, I disagree with how he narrows what are the proper “provisions.” A large portion of the book strongly criticizes psychotherapy as one of the “deadly influences that undermine your spiritual life.” He denounces “so-called Christian psychologists and psychiatrists who testified that the Bible alone does not contain sufficient help to meet people’s deepest personal and emotional needs,” and he asserts, “There is no such thing as a ‘psychological problem’ unrelated to spiritual or physical causes.
God supplies divine resources sufficient to meet all those needs completely.” Physically caused emotional problems, he adds, are rare, and referring to those who seek psychological help, he concludes: “Scripture hasn’t failed them—they’ve failed Scripture.”
A PLACE FOR PROFESSIONALS
When adherents of the emotional-health gospel say that every human problem is spiritual at root, they are undeniably right. Just as Adam’s fall in the garden was spiritual in nature, so in a very true sense the answer to every human problem—whether a broken leg or a burdened heart—is to be found in the redeeming work of Christ on the cross. The disease and corruption process set into motion by the Fall affected not only our physical bodies but our emotions as well, and we are just beginning to comprehend the many ways our bodies and minds have been affected by original sin and our fallen nature. Yet the issue is not whether our emotional problems are spiritual or not—all are, at some level—but how best to treat people experiencing these problems.
Many followers of the emotional-health gospel make the point that the church is, or at least should be, the expert in spiritual counseling, and I agree. Appropriate spiritual counseling will resolve issues such as salvation, forgiveness, personal morality, God’s will, the scriptural perspective on divorce, and more. It can also help some emotional difficulties. But many emotional or mental illnesses require more than a church support network can offer.
I know it sounds unscriptural to say that some individuals need more than the church can offer—but if my car needs the transmission replaced, do I expect the church to do it? Or if I break my leg, do I consult my pastor about it? For some reason, when it comes to emotional needs, we think the church should be able to meet them all. It can’t, and it isn’t supposed to.
This is why the emotional-health gospel can do so much harm. People who need help are prevented from seeking it and often made to feel shame for having the problem. Thankfully, more and more people in the Christian community are beginning to realize that some people need this extra help. If professionals and church leaders can recognize the value of each other’s roles, we will make progress in helping the wounded. Forty percent of all individuals who need emotional help seek it first from the church, and some of these will need to be referred to mental-health professionals.
Church leaders should get to know Christian therapists in their communities so they can knowledgeably refer people with persistent emotional problems.
“It is through much tribulation that we enter the kingdom of Heaven.”
As a broken believer this happens. I breakdown, my faith is questioned, and I feel all alone. Issues like a simple hot shower and eating something seem impossible. I’m embarrassed to say I once went 34 days with a shower. I laid in bed unable to function. That is the insidious truth about chronic depression, I know it well. God seems far, far away from me. Life doesn’t matter anymore.
There is much I can do before it gets to this point. And although life seems insurmountable. Clinical depression kills people. It slowly devours “a sound mind.” It cripples before it takes away your life. There is nothing quite like it; people tell you it will pass, and that you’ll see the sun again. But at the time that seems to be the worst advice ever given.
“For God has not given us a spirit of fear, but of power and of love and of a sound mind.”
2 Timothy 1:7
Meds help a lot. I take Zoloft and that is a godsend. I never miss a dose. I know I’m not bulletproof. I’ve taken it for several years now. (It’s like insulin for a diabetic).
Afflicted souls are special to God. And that truly comforts me. Sometimes it seems like there is an invisible tether that holds from completely dropping off the edge. When I do pray, it is desperate and brief. More like a quiet scream for help. There are no frills and no eloquence, but I know I’m being heard by Him who guards my soul.
People for the most part, are of little help. I admit that my attitude can be less than stellar. “Unless you have been lost in this section of hell yourself, it’s best if you just shut up.” (I don’t really say this, but I’m tempted to.)
But there are a few that can speak. Almost always these are the ones who have been through some affliction themselves. They have been hurt and they ‘walk with a limp.’ I’m convinced that they can speak in direct proportion to the pain they themselves have suffered. I once woke up to another pastor praying prostrate on my bedroom floor. He didn’t have to do or say anything else. He left without saying some ‘pious’ word to me, what he did was wonderfully done.
“I will trust Him. Whatever, wherever I am, I can never be thrown away. If I am in sickness, my sickness may serve Him; in perplexity, my perplexity may serve Him; if I am in sorrow, my sorrow may serve Him. My sickness, or perplexity, or sorrow may be necessary causes of some great end, which is quite beyond us. He does nothing in vain.”
John Henry Newman
Take care of yourself. If this isn’t your first major depression, prepare in advance spiritually for the next. Identify those ‘dear-hearts’ who can help you in advance. Keep taking your meds, even if you think your o.k. And speak often with the Lord, and learn to listen to His voice. That “sound mind” is a promise for those who truly need it.