Category: mental health

Should I Take Medication?

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.

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.

If that physical dimension could be helped by medicine.

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.

How to Die Well

“Even though I walk through the valley of the shadow of death,
   I will fear no evil,
for you are with me;
   your rod and your staff,
 they comfort me.”

Psalm 23:4, ESV

“Precious in the sight of the Lord is the death of his saints.”

Psalm 116:15, ESV

 

“Death is like my car. It takes me where I want to go.” 

Pastor John Piper

Our generation simply doesn’t know how to die well.  There are so many conflicting messages and attitudes which have steered us away from the reality of dying.  Much of it is the natural development of unbelief.  Our pop culture develops this and gives it momentum.  We are trying to convince ourselves that “death is impossible, my life will not end.’  But we’re escaping into a delusion.  We are running from what is real.

There is a Latin phrase,  Ars moriendi  (“The Art of Dying”) which the Church practiced in past generations.  In past time, Christians would be buried as close as possible to the Church building.  Many would be interred within the very walls of the Church.  The understanding was that the dead were part of the congregation.  That there was only a thin veil that stood between the living and the dead.  The dead didn’t just vanish.  They are with us.

My generation is confused.  We have forced death to wear a mask.  We insist on a significant camouflage to hide the reality of sickness and death.  No one really ever talks about it, and so no instructions are given on how to die well. So we don’t, we die poorly–in ICUs and LTCs, completely sedated, separated and unable to process it or help our families process it.  There can be no solid connection between the living and the dying. And to be very honest, this is not working.

For many, the fear of dying is intense and paralyzing.  Death brings us a terror that twists us; we don’t know how to respond to it.  Additionally there seems that there is no one available to direct us.  Death is a spooky taboo that no one really explains.  The implication is that we are simply to avoid death, ‘it may not come for you’.  But that is not what is real.

“Death avoidance” pretends to lift us above the issue, where we can imagine that we will stay separated somehow from its obscenity and ugliness.  Funerals are nothing more then an aberration.  We have become ‘teflonized’, these things just slide on and off.  We just refuse to calculate, or accept what is happening.  We have ‘molded’ our fear into a more desirable shape.  We simply cannot function in the steady gaze of what is real.  We just shut down and refuse to function. We simply pretend.

Its time for the Church to step up and guide us to our next step.  Our pastors and elders have got to prepare us to die well.  It is a part of being a disciple.  It is discipleship, and dying is inclusive.  We need somebody to prepare us for the inevitable and the certainty that is approaching us.  I need someone that will help me face my own death.

You know what?  No one escapes.  And the reality of that drives some of us mad, or addicted, or psychotic.  The idea of filling a casket up for forever is incomprehensible.  We cannot live with this sick idea of dying.  It disturbs us on the deepest level possible.  It is completely evil.

Psalm 23 has been pure comfort and healing for generations.  And it is an excellent starting point for us.  Verse 4 develops the idea of traversing death.  The writer has incredible insight of passing through death.  This verse alone is worth “billions of dollars in gold”.  Psalm 23 has made me a very wealthy man.  His Word has become my rich treasure.

 

Social Anxiety Understood

“In any social situation, I felt fear. I would be anxious before I even left the house, and it would escalate as I got closer to a college class, a party, or whatever. I would feel sick in my stomach-it almost felt like I had the flu. My heart would pound, my palms would get sweaty, and I would get this feeling of being removed from myself and from everybody else.”

“When I would walk into a room full of people, I’d turn red and it would feel like everybody’s eyes were on me. I was embarrassed to standoff in a corner by myself, but I couldn’t think of anything to say to anybody. It was humiliating. I felt so clumsy, I couldn’t wait to get out.”

Social phobia, also called social anxiety disorder, is diagnosed when people become overwhelmingly anxious and excessively self-conscious in everyday social situations. People with social phobia have an intense, persistent, and chronic fear of being watched and judged by others and of doing things that will embarrass them. They can worry for days or weeks before a dreaded situation.

This fear may become so severe that it interferes with work, school, and other ordinary activities, and can make it hard to make and keep friends.

While many people with social phobia realize that their fears about being with people are excessive or unreasonable, they are unable to overcome them. Even if they manage to confront their fears and be around others, they are usually very anxious beforehand, are intensely uncomfortable throughout the encounter, and worry about how they were judged for hours afterward.

Social phobia can be limited to one situation (such as talking to people, eating or drinking, or writing on a blackboard in front of others) or maybe so broad (such as in generalized social phobia) that the person experiences anxiety around almost anyone other than the family.

Physical symptoms that often accompany social phobia include blushing, profuse sweating, trembling, nausea, and difficulty talking.

When these symptoms occur, people with social phobia feel as though all eyes are focused on them. 

Social phobia affects about 15 million American adults. 

Women and men are equally likely to develop the disorder, which usually begins in childhood or early adolescence. There is some evidence that genetic factors are involved. Social phobia is often accompanied by other anxiety disorders or depression, and substance abuse may develop if people try to self-medicate their anxiety.

The use of anti-anxiety drugs may be used and they can help you get through “bad patches” when anxiety becomes too much. It’s possible that these meds can help. Let your doctor guide you.

Understand that social anxiety can be successfully treated with certain kinds of psychotherapy or medications. You probably should find someone who understands what you’re dealing with. They need to be good listeners and have an encouraging voice.

Bringing in a pastor or elder must be considered.

Prayer and counsel are critical. Holding on to God’s promises is necessary and as you deal with this it can be God’s way of strengthening your walk. The Word is packed full of His promises. The Lord knows-He wants you to take up and understand what He wants to give you in this.

“Fear not, for I am with you; be not dismayed, for I am your God; I will strengthen you, I will help you, I will uphold you with my righteous right hand.”

Isaiah 41:10

OCD: Rituals and Obsession

“I couldn’t do anything without rituals. They invaded every aspect of my life. Counting really bogged me down. I would wash my hair three times as opposed to once because three was a good luck number and one wasn’t. It took me longer to read because I’d count the lines in a paragraph. When I set my alarm at night, I had to set it to a number that wouldn’t add up to a ’bad’ number.”

“I knew the rituals didn’t make sense, and I was deeply ashamed of them, but I couldn’t seem to overcome them until I had therapy.”

“Getting dressed in the morning was tough, because I had a routine, and if I didn’t follow the routine, I’d get anxious and would have to get dressed again. I always worried that if I didn’t do something, my parents were going to die. I’d have these terrible thoughts of harming my parents. That was completely irrational, but the thoughts triggered more anxiety and more senseless behavior. Because of the time I spent on rituals, I was unable to do a lot of things that were important to me.”

People with obsessive-compulsive disorder (OCD) have persistent, upsetting thoughts (obsessions) and use rituals (compulsions) to control the anxiety these thoughts produce. Most of the time, the rituals end up controlling them.

For example, if people are obsessed with germs or dirt, they may develop a compulsion to wash their hands over and over again. If they develop an obsession with intruders, they may lock and relock their doors many times before going to bed. Being afraid of social embarrassment may prompt people with OCD to comb their hair compulsively in front of a mirror-sometimes they get “caught” in the mirror and can’t move away from it. Performing such rituals is not pleasurable. At best, it produces temporary relief from the anxiety created by obsessive thoughts.

Other common rituals are a need to repeatedly check things, touch things (especially in a particular sequence), or count things. Some common obsessions include having frequent thoughts of violence and harming loved ones, persistently thinking about performing sexual acts the person dislikes, or having thoughts that are prohibited by religious beliefs. People with OCD may also be preoccupied with order and symmetry, have difficulty throwing things out (so they accumulate), or hoard unneeded items.

Healthy people also have rituals, such as checking to see if the stove is off several times before leaving the house. The difference is that people with OCD perform their rituals even though doing so interferes with daily life and they find the repetition distressing. Although most adults with OCD recognize that what they are doing is senseless, some adults and most children may not realize that their behavior is out of the ordinary.

OCD affects about 2.2 million American adults, and the problem can be accompanied by eating disorders, other anxiety disorders, or depression.  It strikes men and women in roughly equal numbers and usually appears in childhood, adolescence, or early adulthood. One-third of adults with OCD develop symptoms as children, and research indicates that OCD might run in families.

The course of the disease is quite varied. Symptoms may come and go, ease over time, or get worse. If OCD becomes severe, it can keep a person from working or carrying out normal responsibilities at home. People with OCD may try to help themselves by avoiding situations that trigger their obsessions, or they may use alcohol or drugs to calm themselves.

OCD usually responds well to treatment with certain medications and/or exposure-based psychotherapy, in which people face situations that cause fear or anxiety and become less sensitive (desensitized) to them.

Source: http://www.nimh.nih.gov/index.shtml

Bryan Lowe