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. *
“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.
With wheelchair users making up only 5% of disabled people it has become a poor way of acknowledging those of us with a different type of disability.
More than 1 billion people in the world are living with some sort of disability, according to a new international survey. That’s about 15 percent of the world’s population, or nearly one of every 7 people.
The numbers come from a joint effort by the World Health Organization and the World Bank. The last time anyone tried to figure out the prevalence of disabilities was back in the 1970s, when WHO figured it was about 10 percent. The current report suggests the 15 percent estimate will grow as the world’s population ages.
Like the 1970s numbers, today’s figures are at best an approximation. Many countries don’t collect numbers carefully, and definitions of disability differ from place to place. The World Bank/WHO folks sought out tabulations of people who have trouble seeing, hearing, walking, remembering, taking care of themselves or communicating. Worldwide, the most common disability in people under the age of 60 is depression, followed by hearing and visual problems.
The report includes a foreword by theoretical physicist Stephen Hawking, who can’t feed himself or get dressed or speak without assistance because of his amyotrophic lateral sclerosis, a debilitating and usually fatal disease. He says there’s a moral duty to help disabled people.
The head of WHO, Margaret Chan, offers up another reason: “Almost every one of us will be permanently or temporarily disabled at some point in life.” An editorial in the medical journal The Lancet points out that accommodations for people with disabilities, such as curb cuts, help the non-disabled as well (such as people with strollers).
Why even come up with a number? Knowing the prevalence of disabilities helps organizations set priorities and figure out what it will cost them to set up the kind of programs called for by WHO and the World Bank — programs that make it possible for people with disabilities to take care of themselves, to work and get around.
The report didn’t estimate the total cost of establishing such programs. And it offered no solutions for perhaps the biggest challenge: finding the money
“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’.