Antidepressants for Believers?

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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Jamison and Steel: Interviews on Suicide

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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.

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Dr. Kay Jamison

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.

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DANIELLE STEEL

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.

 

For more information or assistance, please contact NAMI at: http://www.nami.org/

 

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Bedlam: Prisons and the Mentally Ill

Taking a Stand for Our Brothers and Sisters

 By Mark Earley, Christian Post Guest Columnist, Wed, Aug. 08, 2007
The least of these is my brother
The least of these is my brother

In the 16th century, London’s mentally ill were often kept at Bethlem Royal Hospital. The conditions inside the hospital were notoriously poor. Patients were often chained to the floor and the noise was so great that Bethlem was more likely to drive a man crazy than to cure him. The conditions were so infamous that the nickname locals gave the hospital—Bedlam—has come to mean any scene of great confusion.

Unfortunately five hundred years later, we’re still treating the mentally ill more like prisoners than patients. Fifty years ago, more than 550 thousand people were institutionalized in public mental hospitals. Today, only between 60 and 70 thousand are, despite a two-thirds increase in the country’s population.

Since there’s no evidence that the incidence of mental illness has dropped precipitously, the mentally ill who previously had been institutionalized had to have gone somewhere. While some are being treated successfully in their communities, at homes and groups homes, but for many that “somewhere” is behind bars. This last part shouldn’t come as a surprise.

Five years ago, the Washington Post told the story of “Leon,” a one-time honor student, who had 17 years in and out of jail on various drug-related charges. It was only after several suicide attempts, including drinking a “bleach-and-Ajax cocktail,” that Leon was diagnosed with bipolar disorder. Leon’s story was a microcosm of a larger problem: “Prisons and jails are increasingly substituting as mental hospitals.”

As one advocate for the mentally ill told the Post, “a lot of people with mental illness are charged with minor crimes as a way to get them off the streets.” In effect, they are behind bars for “being sick.” Fast forward five years and little, if anything, has changed. A few weeks ago, another piece in the Post discussed the same problem.

Psychiatrist Marcia Kraft Goin told readers something that should shock and outrage them: “The Los Angeles County Jail houses the largest psychiatric population in the country.” As with the earlier Post piece, the conclusion was inescapable: “People with [untreated] mental illnesses often end up with symptoms and behaviors that result in jail time.” You don’t have to be a “bleeding heart” to understand that this is an injustice—any kind of heart will do.

Not only are the mentally ill not getting the help they need, they are as lambs to the slaughter in our crowded and violent prisons. They are being victimized twice over. They’re not the only ones being victimized.

At a time when most state prisons are unlawfully overcrowded, there are better uses for prison beds than as makeshift mental hospitals. As Goin wrote, “treating” mental illness as a criminal justice problem costs “more than treating patients appropriately in their community.”

As part of its ministry to prisoners and their families, Prison Fellowship supports community-based alternatives to incarceration. Not only because it makes “financial sense” but because it’s what Christ would have done. In Matthew 25 he called the ill and the prisoner his “brothers” and he expects us to offer them something more than bedlam.

“There but for the Grace of God go I…” –Bryan

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From BreakPoint®, August 6, 2007, Copyright 2007, Prison Fellowship Ministries. Reprinted with the permission of Prison Fellowship Ministries. All rights reserved.  “BreakPoint®” and “Prison Fellowship Ministries®” are registered trademarks of Prison Fellowship.

Good Links:

http://en.wikipedia.org/wiki/Bethlem_Royal_Hospital

http://www.bethlemheritage.org.uk/

http://www.pbs.org/wgbh/pages/frontline/shows/asylums/etc/faqs.html

http://www.afscme.org/publications/6042.cfm

Tourette Syndrome [Awareness]

To understand and name something is often half the battle.  An understanding of Tourette Syndrome can help us to serve people who painfully struggle with this particular challenge.

What is Tourette syndrome?

Tourette syndrome (TS) is a neurological disorder characterized by repetitive, stereotyped, involuntary movements and vocalizations called tics. The disorder is named for Dr. Georges Gilles de la Tourette, the pioneering French neurologist who in 1885 first described the condition in an 86-year-old French noblewoman.

The early symptoms of TS are almost always noticed first in childhood, with the average onset between the ages of 7 and 10 years. TS occurs in people from all ethnic groups; males are affected about three to four times more often than females.

It is estimated that 200,000 Americans have the most severe form of TS, and as many as one in 100 exhibit milder and less complex symptoms such as chronic motor or vocal tics or transient tics of childhood. Although TS can be a chronic condition with symptoms lasting a lifetime, most people with the condition experience their worst symptoms in their early teens, with improvement occurring in the late teens and continuing into adulthood.

What are the symptoms?

Tics are classified as either simple or complex. Simple motor tics are sudden, brief, repetitive movements that involve a limited number of muscle groups. Some of the more common simple tics include eye blinking and other vision irregularities, facial grimacing, shoulder shrugging, and head or shoulder jerking.  Simple vocalizations might include repetitive throat-clearing, sniffing, or grunting sounds.

Complex tics are distinct, coordinated patterns of movements involving several muscle groups. Complex motor tics might include facial grimacing combined with a head twist and a shoulder shrug. Other complex motor tics may actually appear purposeful, including sniffing or touching objects, hopping, jumping, bending, or twisting. Simple vocal tics may include throat-clearing, sniffing/snorting, grunting, or barking. More complex vocal tics include words or phrases.

Perhaps the most dramatic and disabling tics include motor movements that result in self-harm such as punching oneself in the face or vocal tics including coprolalia (uttering swear words) or echolalia (repeating the words or phrases of others). Some tics are preceded by an urge or sensation in the affected muscle group, commonly called a premonitory urge. Some with TS will describe a need to complete a tic in a certain way or a certain number of times in order to relieve the urge or decrease the sensation.

Tics are often worse with excitement or anxiety and better during calm, focused activities. Certain physical experiences can trigger or worsen tics, for example tight collars may trigger neck tics, or hearing another person sniff or throat-clear may trigger similar sounds. Tics do not go away during sleep but are often significantly diminished.

What is the course of TS?

Tics come and go over time, varying in type, frequency, location, and severity.  The first symptoms usually occur in the head and neck area and may progress to include muscles of the trunk and extremities. Motor tics generally precede the development of vocal tics and simple tics often precede complex tics.  Most patients experience peak tic severity before the mid-teen years with improvement for the majority of patients in the late teen years and early adulthood. Approximately 10 percent of those affected have a progressive or disabling course that lasts into adulthood.

Can people with TS control their tics?

Although the symptoms of TS are involuntary, some people can sometimes suppress, camouflage, or otherwise manage their tics in an effort to minimize their impact on functioning. However, people with TS often report a substantial buildup in tension when suppressing their tics to the point where they feel that the tic must be expressed. Tics in response to an environmental trigger can appear to be voluntary or purposeful but are not.

What causes TS?

Although the cause of TS is unknown, current research points to abnormalities in certain brain regions (including the basal ganglia, frontal lobes, and cortex), the circuits that interconnect these regions, and the neurotransmitters (dopamine, serotonin, and norepinephrine) responsible for communication among nerve cells. Given the often complex presentation of TS, the cause of the disorder is likely to be equally complex.

What disorders are associated with TS?

Many with TS experience additional neurobehavioral problems including inattention; hyperactivity and impulsivity (attention deficit hyperactivity disorder—ADHD) and related problems with reading, writing, and arithmetic; and obsessive-compulsive symptoms such as intrusive thoughts/worries and repetitive behaviors. For example, worries about dirt and germs may be associated with repetitive hand-washing, and concerns about bad things happening may be associated with ritualistic behaviors such as counting, repeating, or ordering and arranging.

People with TS have also reported problems with depression or anxiety disorders, as well as other difficulties with living, that may or may not be directly related to TS.  Given the range of potential complications, people with TS are best served by receiving medical care that provides a comprehensive treatment plan.

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Source for this post: http://www.ninds.nih.gov/disorders/tourette/detail_tourette.htm#147223231

Great site at: http://tsa-usa.org/