Medication: An Interview with Andrew Solomon

What domedications 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.

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AndrewsolomonBy 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.

 

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A couple of decent websites:

http://www.pbs.org/wgbh/takeonestep/depression/faces-andrew.html

http://www.noondaydemon.com/biography.html

 

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Ministering to Yourself, [Self-Encouragement]

Why are you cast down?

The Psalms are a classical example of self encouragement. The writer sometimes fell in to some moments of depression and he would write encouraging words to uplift his spirit. Today these have become encouragement verses or scriptures for us to emulate. Read Psalm 42. It is somewhat an unusual portion of scripture, in as the writer addresses his/her own soul.  That alone makes it unique. And if we think it out, we become aware of an awesome truth.

“I suggest that the main trouble in this whole matter of spiritual depression in a sense is this, that we allow our self to talk to us instead of talking to our self . . . Take those thoughts that come to you the moment you wake up in the morning. You have not originated them, but they start talking to you, they bring back the problems of yesterday, etc. Somebody is talking. Who is talking to you? Your self is talking to you. Now this man’s treatment was this; instead of allowing this self to talk to him, he starts talking to himself. ‘Why art thou cast down, O my soul? he asks. His soul had been depressing him, crushing him. So he stands up and says: ‘Self, listen for moment, I will speak to you.’ Do you know what I mean? If you do not, you have had but little experience . . . We must stand up as this man did and say: ‘Why are you cast down? Why are you disquieted within me?’ . . . instead of listening placidly to him and allowing him to drag you down and depress you. For that is what he will always do if you allow him to be in control.”

D. M. Lloyd-Jones, Spiritual Depression: Its Causes and Cure (Grand Rapids: Eerdmans Publishing Co., 1982), pp. 20,21.

When I allow myself to indulge in anger, impatience, worry, pride, or spite, I provide an entrance for Satan to enter my life and run rampant through my mind. He doesn’t have to scheme, plan or deceive me. He can walk right in and begin chasing my self-centered emotions all over the place.

Notice the flow– My impatience breeds irritation; irritation– anger. Anger chases bitterness, and bitterness– unkindness. Satan just keeps bringing more and more situations and circumstances in my life that wreak havoc with fruit of the spirit. In my weakened state, my heart is left vulnerable to more and more assaults.

“He who has no rule over his own spirit is like a city that is broken down and without walls.”

–Proverbs 25:28

The Bible teaches us that we are responsible for our behavior. As believers we simply do not have the option to allow depressive self-talk to go on unedited and unchallenged.  If we think about it, as we are depressives and the mentally ill, we must take a stand! This idea can help us through much anguish of soul. The concept of ‘kindling’ a depressive bout can lead us to ‘flare up,’ and get out-of-control. Remember, depression is both physical, emotional, and spiritual issue.

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When Does Depression Become Sin?

The Bible is plumb full of commentary on depression. King David experienced intermittent times of intense depression.  He was a man who had to work through a great deal of it, and we can see that he succeeded in breaking through into freedom.

Would David today be treated with antidepressants?  Could he have been treated at a mental hospital? (I honestly think the answer is “yes” to these questions.  He was definitely devastated by depression at certain times.)

There is no question he experienced both spiritual and physical depression.  But I believe that David teaches us that depression has a spiritual component in our fallenness.  It has to be treated holistically, covering both the physical and the spiritual.  It’s like having two hands injured but only treating just one of them.

We need to discern the difference between:

  • depression caused by guilt (sin)
  • depression caused by a medical issue (organic)
  • depression as a reaction to a trauma or loss (reaction)

This is key. These all can be working at the same time (and very often do).  But there will only be a partial release if there is only a partial solution. The three can overlap each other. Any of the three can be the predominant kind of depression.

The points below deal primarily with “guilt” or “sin depression.” (I’m not qualified to speak out on the othe1) Confession of sin may free us from certain issues of depression.r two.)

 13″If you don’t confess your sins, you will be a failure.  But God will be merciful if you confess your sins and give them up.” Proverbs 28:13   (CEV)

 2)  The story of Cain and Abel reveals the issue of “angry depression” taking over a person’s actions.

“6The LORD said to Cain:

 What’s wrong with you? Why do you have such an angry look on your face? 7If you had done the right thing, you would be smiling.  But you did the wrong thing, and now sin is waiting to attack you like a lion. Sin wants to destroy you, but don’t let it!”  

Genesis 4:6-7  

3)  David was depressed until he confessed his sin of adultery with Bathsheba.

3“When I refused to confess my sin,
      my body wasted away,
      and I groaned all day long.
 4 Day and night your hand of discipline was heavy on me.
      My strength evaporated like water in the summer heat.” Psalm 32:3-4 (NLT)

4)  The way out of depression caused by guilt is confession and seeking God’s forgiveness. 

 5 “Finally, I confessed all my sins to you
      and stopped trying to hide my guilt.
   I said to myself, “I will confess my rebellion to the Lord.”
      And you forgave me! All my guilt is gone.

  1 Oh, what joy for those
      whose disobedience is forgiven,
      whose sin is put out of sight!
 2 Yes, what joy for those
      whose record the Lord has cleared of guilt,
      whose lives are lived in complete honesty!” 

Psalm 32:5 , 1-2

5) If you are a Christian and are experiencing “moderate-to-heavy” depression, I would encourage you to seek out medical help.  Medication may be helpful to get through this rough time, and talk therapy can be a life-saver.  If your depression is caused from guilt, it will NOT get better, until you deal with it in the presence of God.

RedcrossNow I’m not a physician, nor is this post medical advice. If you are experiencing thoughts of depression and suicide seek out help immediately. Call 911 right now.

Your regular doctor can guide you to a good psychiatrist which may help.

 

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