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.

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

Bipolar Basics. “Just the Facts Ma’am”

Bipolar disorder symptoms are characterized by an alternating pattern of emotional highs (mania) and lows (depression). The intensity of signs and symptoms can vary from mild to severe. There may even be periods when your life doesn’t seem affected at all. Take care when this happens.

The manic phase of bipolar disorder–
Signs and symptoms of the manic phase of bipolar disorder may include:

  • Euphoria
  • Extreme optimism
  • Inflated self-esteem
  • Poor judgment
  • Rapid speech
  • Racing thoughts
  • Aggressive behavior
  • Agitation
  • Increased physical activity
  • Risky behavior
  • Spending sprees, credit card irresponsibility
  • Increased drive to perform or achieve goals
  • Increased sexual drive
  • Decreased need for sleep
  • Tendency to be easily distracted
  • Inability to concentrate
  • Drug abuse

The depressive phase of bipolar disorder–
Signs and symptoms of the depressive phase of bipolar disorder may include:

  • Sadness
  • Hopelessness
  • Suicidal thoughts or behavior
  • Anxiety
  • Guilt
  • Sleep problems
  • Appetite problems
  • Fatigue
  • Loss of interest in daily activities
  • Problems concentrating
  • Irritability
  • Chronic pain without a known cause

Types of bipolar disorder
Bipolar disorder is divided into three main subtypes:

  • Bipolar I disorder. You’ve had at least one manic episode, with or without previous episodes of depression.
  • Bipolar II disorder. You’ve had at least one episode of depression and at least one hypomanic episode. A hypomanic episode is similar to a manic episode but much briefer, lasting only a few days, and not as severe. With hypomania, you may have an elevated mood, irritability, and some changes in your functioning, but generally, you can carry on with your normal daily routine and functioning, and you don’t require hospitalization. In bipolar II disorder, the periods of depression are typically much longer than the periods of hypomania.
  • Cyclothymia. Cyclothymia is a mild form of bipolar disorder. Cyclothymia includes mood swings but the highs and lows are not as severe as those of full-blown bipolar disorder.

Other bipolar disorder symptoms:

In addition, some people with bipolar disorder may have rapid-cycling bipolar disorder. This is the occurrence of four or more mood swings within 12 months. These moods shifts can occur rapidly, sometimes within just hours. In mixed state bipolar disorder, symptoms of both mania and depression occur at the same time.

Severe episodes of either mania or depression may result in psychosis or a detachment from reality. Symptoms of psychosis may include hearing or seeing things that aren’t there (hallucinations) and false but strongly held beliefs (delusions).

Taken from the Mayo Clinic/Bipolar Disorder Symptoms.

Paranoia for Beginners

A person who is paranoid has fears, such as being watched, harmed or poisoned. He or she does not trust others and is suspicious that others are “out to get” him or her. These seem very real.

It’s normal to wonder if people are talking about you when you hear them whispering as you walk into a room. These thoughts are usually passed off and not dwelled upon for most people. We give them little credence. Not a problem.

A person who is paranoid, however, does dwells upon suspicious thoughts. He or she goes out of their way to prove their suspicions even though no evidence exists to confirm their thoughts. It’s very hard to reason or speak what is real.

Paranoia is usually found in small degrees in almost every mental illness.

Symptoms

  • Use and/or withdrawal of certain drugs, such as marijuana, crack cocaine and angel dust (PCP)
  • Alcohol withdrawal
  • Deafness or problems with hearing
  • Illnesses that affect the central nervous system, such as Alzheimer’s disease or other dementias, a stroke, a brain tumor
  • Mental illnesses, such as bipolar disorder or schizophrenia
  • Paranoid personality disorder, (PPD)

How to Recognize Paranoia

A person with paranoia may also:

  • Appear cold and aloof
  • Be withdrawn and anxious in social situations
  • Act stubborn and combative
  • Appear “on guard” at all times, out of fear of being controlled or harmed

A paranoid person also:

  • Complains about his or her health and often feels vulnerable and inferior to others
  • Holds grudges easily
  • Displays bitterness and resentment toward others
  • May be easily drawn into religious cults or other groups with strict beliefs
  • Is quite susceptible to conspiracy theories, religious or political
  • Can have delusions of being persecuted

Treatment

Treatment for paranoia depends on its cause. If it is a symptom of another condition, treatment for the condition will often take care of or lessen the paranoia. Paranoid personality disorder is treated with counseling, support therapy and often with medication. Treatment for this disorder is not easy, though, due to the nature of paranoia. Persons who are paranoid often do not trust others including doctors, therapists or family members trying to help them get treatment. It is likely that you will need to intervene, patiently and gently. 

Ministering to the paranoid treatment requires a huge commitment. Typically you’ll see lots of anger as they confront others of mistreating them.

What You Can Do for a Friend or Relative

The most important thing you can do is to encourage your friend or relative to get professional help. Be aware that you may need to make the initial appointment with a professional. You may also need to take them to the appointment and stay with them. Be supportive. Paranoia requires patience, understanding, love and encouragement of the person’s loved ones and friends.

Those close relationships are typically what frees a person who struggles.

Be aware of the types of medication your friend or relative takes and when they should take it. You should also alert their physician or psychiatrist to any side effects that you notice when they do or do not take their medication.  If I may, I would suggest a movie for you, “A Beautiful Mind.”  This may give you a little insight.

Cleveland Clinic PPD Introduction Site http://my.clevelandclinic.org/disorders/personality_disorders/hic_paranoid_personality_disorder.aspx

Suite 101 PPD Site http://personalitydisorders.suite101.com/article.cfm/paranoid_personality_disorder

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