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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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.
“You shall love the Lord your God with all your heart and with all your soul and with all your mind.38 This is the great and first commandment.39 And a second is like it: You shall love your neighbor as yourself.”
Love is the ultimate response God is looking for from us. It is the currency of Heaven. The Kingdom’s economy is ‘the gold standard’ of love. It’s the way business gets done in eternity. Love! Without love ruling our lives now, we will arrive there as paupers and beggars. We will disobey Jesus.
God is our primary target to love. And the quality of it can be appreciated from its ‘source point’. Heart. Soul. Mind. These are the starting places for our affection. The caliber of our worship is summed up by the word, “all.” That word has a totality, and a significance to it. It further intensifies love to the only acceptable place. Love indeed is the perfect “make-up.” We’re never more beautiful then when we love God or another person.
As disciples who are indeed flawed and broken, we can still find a place where we can minister from. I can’t do a lot anymore, but I can love. Loving God is something I can do, even with my issues. I can always love. I can always give my all, my heart to someone else. I can always love!
And actually, this disability strips my discipleship to a simpler and basic level. At the “lowest common denominator” my faith is still valid and vital. I love Jesus, even when I can’t be a senior pastor or teach at my Bible School anymore. I accept this. I can even rejoice in this new “inadequacy.”
Loving Him and following Him can be done, even with a limp.
Several years ago I sat waiting for my bus at King’s Cross in London, England. I was all alone, and felt it. There was a strong sense of brokenness and I was aware of my disability. I was coming a bit unglued by the enormity of my mental illness. I sat staring at the floor just in front of me. I could do nothing else.
But in my field of vision, just in front of me, hopped a bird with a crippled foot. Something had damaged him. The thing that profoundly spoke to me was that bird was not at all devastated, not at all. And the Lord spoke to me about that bird, and His comfort pumped through my veins. I felt I was right where I was supposed to be. I had become the ‘broken’ sparrow, and I could still follow. Maybe, even better now, because of my ‘limp’.
“He who masters his passions is a king even if he is in chains. He who is ruled by his passions is a slave even while sitting on a throne.”
Sometimes, I absolutely need a spiritual ‘wake-up call.’ The last few days for me have been taking on the general theme of freedom. It’s very easy for me to accept being a slave. The bait that’s used is very desirable and attractive. It’s hard to let such wonderful morsel go by without a taste. I will sin– and repent later. But hidden deep inside me there is something very small, but very potent. It is a desire to be free from sin. God has placed that within.
Freedom, or that characteristic of walking unencumbered, doesn’t seem incredibly important, at times. But it is a question of identity.
As a Christian believer, am I really a child of the King, a prince in a spiritual world?
Royal blood was spilled to set me free. Is choosing to sin really in my calling?
There are many things that ‘trigger’ my Bipolar depression. Triggers are those things which set off symptoms, ‘kindling’ a sequence of events that leads to total catastrophe. All it takes is one–a lie perhaps, or a delusion that gets ‘airplay.’ I just slide right into the ‘paranoid’ trap set just for me. I essentially experience a total collapse of mood and emotion. Life will crash in all around me. I am left sitting in ashes, in a heap. I have become a ‘king in chains.’
My hospitalizations all have come as a result of giving myself over to ‘twisted thinking.’ My suicidal tendencies are intensified, in part due to becoming enslaved. I become chained and held captive to these dark forces. Meds and ‘talk therapy’ can really help. They are limited though to what they can do to push back the inky darkness. But when I use these things, and add to them:
prayer, as intimate as I can make it
reading the Word, searching for insights
and fellowship, anything more than a handshake
I have a ‘recipe’ for freedom. But, I must initiate a believer ‘s response. I would like to suggest that “freedom” and “intimacy” are synonyms. You can’t have one without the other. Is Jesus real to you? Is His presence ‘more-than-life’ itself?
Whoever you are–it’s time to get free. Really free. Fall in love with Jesus again and the chains will fall off. Unless you do they will remain.
“For freedom Christ has set us free; stand firm therefore, and do not submit again to a yoke of slavery.”
Some of us struggle with mental or physical illness. Some people don’t understand us and they walk away. This really hurts, and so we isolate ourselves even more. We might feel not only forsaken, but cursed. We may see ourselves as consummate losers. But these things shouldn’t separate us from our Father’s love. I think He loves “his special needs” children even more, lol.
But we must believe that we our transformation is happening, more and more, into the image of Christ. We are becoming like him (hence the word, Christlikeness). This is a long process, but it is happening! God has given his word. Don’t give up. Don’t give up on his plan for you.
I’m seeing lately that spiritual growth and getting older often work hand-in-hand (and why shouldn’t they?) As we get older, we will start having many different issues. When your 50 years old, you don’t have the same situations that you had when you were 14 or 30. Physically we grow and understand things differently, and this works into us spiritually. This blends or melds together, especially when the Word and Spirit are present.
“Every time I think of you, I give thanks to my God. 4 Whenever I pray, I make my requests for all of you with joy, 5 for you have been my partners in spreading the Good News about Christ from the time you first heard it until now. 6 And I am certain that God, who began the good work within you, will continue his work until it is finally finished on the day when Christ Jesus returns.”
Philippians 1:3-6, NLT
It is my wish for you that you could walk in your own shoes, and not somebody elses. Also that you would know the grace of God intimately. Being disabled means special efforts will often be necessary, but Jesus’ love for your soul will be molded to fit that disability. There will be no wheelchairs or canes, or even ‘seeing-eye dogs’ allowed in heaven. I imagine there will be a considerable pile outside the gates. Glory awaits.
“I consider that our present sufferings are not worth comparing with the glory that will be revealed in us.”
“I am reckoned among those who go down to the pit; I have become like a man without strength,“
In May 2011, this is what I wrote–
“I feel like I am going through a meat grinder. Pushed against my will (and desire) I’m finding myself in a place I’d rather not be. My therapist confirmed today that I’m in a “mixed state” where bipolar mania and depression come together. I compare it to two massive ocean currents smashing into each other. (please Google, “mixed state”).
I’ve been into this state for just two weeks and the urge to commit suicide is starting to become surprisingly strong. For my own safety, I’m almost thinking that it maybe time to go to the hospital again. I must tell you that these are places that you really don’t want to go if you don’t have to. (FYI, my particular choice is Alaska Psychiatric Institute in Anchorage. It’s actually a somewhat “nicer” degree of miserable, and they have cooler art.)
I also get paranoid that people are attacking me and are plotting to ruin me. I am quite suspicious of Facebook and my depression chat. I believe that the people that I encounter there are trying to get at me behind my back. Social networking with these type of services can be a nightmare.
But, then there is also the grandiosity. I believe that I think clearer, better, and faster than other people. It’s like I have superpowers. I will think of myself as extremely gifted, superior to others. I paint and write poetry and do “noble” things.
But I also have tremendous anxiety, with racing thoughts, and even heart palpitations esp. when I am sitting trying to relax. I don’t sleep well at all, in spite of the sleeping pill, the Klonopin and the melatonin, and the Benadryl, (to make sure I do sleep).
I continue to take my psych meds like a good boy. But they don’t seem to work like they used to. I think they can’t handle this particular concoction of depression/mania. Sometimes, I feel like I’m getting better, but I never seem to get well.
The endless cycle of feeling really good and then feeling really bad is a challenging thing. It is difficult to have a stable walk of discipleship under these circumstances. I think being starkly honest and broken over my own fallenness is the key for me. (Now if I can only remember this.)
I know that I’m being very blunt here. Tact has never been an easy thing. As I read I remember the struggle, and how I couldn’t see a way out. I’m thankful for the Holy Spirit who led me when no one else could. I wrote this post some time ag0. I’ve been reasonably stable, but I’m certain that putting it up now maybe timely for some. I’m in a better frame of mind the last several months.
“For when we were still without strength, in due time Christ died for the ungodly.”
I wrote this poem a couple of months ago. I wrote it while trying to process the struggle of dealing with one sister who suffers with mental illness (bipolar disorder and bulimia) and other family members who don’t understand.
I have experienced seven years of major clinical depression myself, and over the last few years have come to the realization that ending up there again is not outside the realm of possibility if I’m not ever vigilant. But that doesn’t make the family relationships any easier, and I often feel like I’m the only glue or buffer holding things together, and I’m not doing a very good job at it.
I share this here to maybe give someone else the strength to keep being that glue or to appreciate the one in the family who is the glue or . . . well, frankly I’m not sure why. It just seems like something I need to share.
A note on the final stanza: I do not, in any way, wish that the person this poem is about was dead. Far from it. I’ve lost too many other family members, including another sister who died of cancer two years ago. But on the day I wrote this, that felt like it would have been easier to take than the present situation.
Why does it feel like I’ve lost you
when you aren’t even dead?
Why am I the only one
who wants to make amends?
Why does it have to be so hard
after all these years?
Maybe it’s the tears
mine and yours, and theirs,
that makes breathing and living
loving and forgiving so impossible
I guess sometimes families and madness
can’t survive one another
Because that’s what you are, you know,
mad, or crazy, or mentally ill
whatever you want to call it
It’s torn us apart
because you don’t understand
why they can’t begin to comprehend
what’s going on inside your head
It’s torn us—you and me—apart
because you’ve convinced yourself
that I don’t at all understand
what’s going on inside your head
You forget I’ve been there
that those crazy, mad thoughts
have been inside my head, too
But then you’ve forgotten a lot of things
all the times I was there for you
just to listen
and the times you were there for me
Forgetting the good
is a tragic side effect
of medications meant to help
Somehow they don’t erase
memories of the less-than-perfect moments
My greatest desire is to forgive
and to be forgiven
to live and laugh and love again
to mend what has been torn asunder
to heal the thoughts inside your head
But right now, in this moment
it feels like you might as well be dead
at least that would be easier to live with