December 13, 2017

Antidepressant Medication: A Christian Psychologist’s View by Mike Benoit

psychology4a.jpgFor one last post on the issue of Christians and Antidepressants, I’ve asked former BHT fellow Mike Benoit to share his perspective from within the discipline of psychology.

Mike Benoit is finishing a Ph.D. dissertation in Counseling Psychology and looking for an academic position somewhere. His new venture is a podcast called Giving Psychology Away found at http://givingpsychologyaway.podomatic.com/ or at iTunes. He and his wife have two children (one unborn) and live in Ohio.

All the advantages of Christianity and alcohol; none of their defects.” – Aldous Huxley, Brave New World on the effects of soma.

I want to publicly applaud Michael and Denise for their honesty and willingness to disclose their personal struggles to the benefit of the Body of Christ. The stigma of depression has been steadily declining in our culture, yet in the Church there remains a strong reticence to discuss any mental health issue. We need to avoid the extremes of theological discussion devoid of compassion and entirely anecdotal accounts that claim to be the last word on the issue. What follows is a reaction to my experience with many Christians struggling with depression, not just to what Michael and Denise have written.

Soma in Aldous Huxley’s Brave New World was a drug that set people on mental holiday and gave them an escape from the real world, whenever they so desired. The notion of antidepressants as soma realized is aided by the ubiquitous drug commercials we see on television: a sad ball becomes a happy, bouncing ball; a bed-ridden depressed man becomes a vibrant, productive colleague; a lonely young woman becomes a young woman hemorrhaging friends, all within the course of a 30 second commercial. The promise of a quick fix appeals to our American sensibilities, but it gives some of us pause. We do not want to chemically alter our brains; we don’t want to do artificially what we feel we ought to be able to do by our own power.

Christianity Today had an article not long ago entitled The Gospel According to Prozac: Can a pill do what the Holy Spirit could not? Early in the article (I’ve been unable to find the full text) a person is quoted as saying that antidepressants have brought him closer to God. This person is making the same mistake that Aldous Huxley did in reducing our faith to feelings. Often people attribute their pain during depression to abandonment by God. There is also a resistance to drugs for fear of isolating ourselves from God by improving our moods so that we never feel pangs of guilt for our sin. I think these fears exaggerate the effects of antidepressants, which tend to regulate not eliminate our negative emotions.

If our emotions were the key to our faith, we should be very worried indeed. If I’ve learned one thing in my training, it’s a profound distrust of my own emotional life. Very minor things can influence my emotions, and even my thoughts and behavior. I have nothing like the same control over my brain that I had when I entered graduate school. Our emotions are mediated by our brains, which are extremely fragile, vulnerable to disease and accident as well as being changed by our circumstances. If our faith boils down to how we feel about God, then I have no security. We, as Christians, don’t know how to live with our brains – something so human mediating our experience of the Divine. There appear to be distinct brain processes involved in mystical experiences. It may be possible to poke (or otherwise stimulate) a part of our brains and induce a “spiritual” experience. A burning in the heart does not mean that the accompanying thoughts are revelatory, nor does that absence of that feeling mean that we are far from God. Emotions are a profound motivator and a wonderful gift, but they are not to be trusted infallibly.

We know that God cares about our brains and that He will raise them up in the last day. We trust that those who loose their mental abilities to brain damage or the insidious effects of dementia or Alzheimer’s have not been stolen out of the hand of our loving Savior. Jesus is objectively our Savior, by his real death and physical Resurrection. He gives Himself to us objectively in the sacraments and through his word. When we fall prey to depression, we ought not to despair of our Savior.

A recent survey of a sample of Pentecostal Christians (Trice & Bjorck, 2006) revealed that they attributed the causes of depression to ‘natural’ things (circumstances, etc.) more than to spiritual failure, which was surprising to the authors. However, they found that they considered spiritual interventions (Bible reading, scripture memorization, fasting, prayer, deliverance) to be much more effective than counseling or medication to treat depression. The authors point out that for this particular sample, it appears that it isn’t your fault if you get depressed, but it may be your fault if you stay depressed, because you didn’t exercise your faith sufficiently. While this study was among Pentecostals, I think that similar results would be found among evangelicals.

If we are not dependent on our feelings for our salvation, then why wouldn’t we want to do all in our power to help us to function better and be able to serve our neighbors more effectively? Jesus could have told us about microbial transmission of disease and extended life immensely, but He did not. Jesus’ ministry was to point us to Himself. Simply because medication does not appear in scripture does not mean that we are forbidden from using it. Scripture speaks of Christ.

Medication is not a panacea, and it should be used responsibly and intelligently. We need not trust our physicians totally, but should take responsibility for our own mental health. In broad brushstrokes, the current thinking about the treatment of depression is as follows: counseling works, medication works, counseling combined with medication works better than either alone. Of course exercise and proper nutrition cannot be overlooked either, nor can the research being done on light therapy for those whose mood disorder follows a seasonal pattern (Seasonal Affective Disorder). If you begin to feel that your emotional life is being deadened by a drug, take this concern to your doctor and discuss it. Since depression is not a unitary phenomenon, there are many roads to remission. For most people, being on an antidepressant will, and should, be temporary. A faithful counselor who can hold up a mirror to you and help you to see your behavior and relationships more clearly is an invaluable resource (but a topic for another time).

There are many good reasons to be wary about beginning antidepressants, beyond the side-effects, which are fewer and more manageable in the second generation drugs, there is some evidence that permanent changes may occur in the structure of the brain over long term use. For instance, if one changes how much of a neurotransmitter is available in the brain, then the brain areas that produce that neurotransmitter may slow down production. Additionally, using medication to lift mood when the factors that have caused depression are not addressed, just postpones the problem. Pain is motivational. A moderate level of psychological pain can drive a person to change things about his or her life. If the pain is relieved by medication, there may be less motivation to act. Too much psychological pain, of course, is debilitating and benefits no one.

Trice, P. D. & Bjorck, J. P. (2006). Pentecostal perspectives on causes and cures of depression. Professional Psychology: Research and Practice, 37, 283-294.

Comments

  1. Thanks for this. Very helpful.

  2. Michael Benoit says:

    By the way, when Michael calls me a “psychologist,” he means guy-with-lots-of-training-in-psychology, since the term “psychologist” is owned by the States and reserved for license holders. At present I’m not licensed to wash your dishes, much less practice psychology professionally.

  3. I appreciate what you have written and just want to make a couple of points. You said, “Our emotions are mediated by our brains, which
    are extremely fragile.” Yes and no. Our brains can be easily influenced emotionally but actually our brains are pretty hearty. Have a look at how the brain adapts to Parkinsons disease, for example, and you will see how good of a job our brain does at adapting to trauma and change.

    You are dead on in saying even with medication the underlying issues still need to be addressed.

    What the Pentecostals said has psychological research backing it. Cognitive behavior therapy is the leading therapy for depression and one of the things that is encouraged is for people to get out and do something meaningful. For people of faith, it is exactly what the pentecostals described.

    Lastly, I was in a presentation once by a leading researcher on the elderly. They looked at what factors improved the quality of life for the elderly. The number one thing they found that helped was church. This was in a secular/state school environment and the researcher went on talking about social support, etc. However, they also had people in the study with the same level of social support and connectedness (non-church) and they didn’t do as well as those who went to church! What happened next blew my mind. They said they still see no reason to tell people to go to church! This reasearcher didn’t believe in God = why encourage people to go to church. Even if you were an atheist, if you as a health professional saw that something worked that well (the number one factor in their study), why wouldn’t you encourage it? I was floored. Anyway, good post. Keep up the good work and good luck with your studies, internship, post-doc, etc.

  4. Philologus says:

    Almost a year ago I was diagnosed with acute severe depression. I could hardly function. Not that I didn’t want to or wish I could but I could not. My wife had to even take me to my doctor visits because I was not capable of driving myself. Laboratory tests revealed that my neurotransmitters were not functioning properly and were depressed. My doctor is an MD but also believes in functional medicine approach. However, because of the severity of my depression she prescribed anti-depressant drugs to help give me some relief as soon as possible. In my case though the drugs were not effective because of side effect issues with every drug I tried. It was a frustrating experience as I wanted relief. They would put me on one drug, I would be weaned on to it over a week to full dose, then two weeks later they would have to wean me off before they could try another drug. Because I was experiencing some back pain I started seeing a Chiropractor who, when I told him about my depression, said that he maybe could help. He was working with a form of electrical stimulation that uses a very small current at specific frequencies to treat various ailments and he said that it was quite effective in treating depression. At first I was skeptical it would even work but after about 5 treatments I actually did feel better. The therapy is called frequency specific micro-current (FSM) and many MDs are now using this therapy to treat patients with depression.

    Now having said all that I did some research on FSM and found that I could obtain a personal device to treat myself for depression. It’s called Alpha-Stim 100 and it has been shown to be 90% effective in treating depression with at least 60% relief. It’s a small portable handheld device that hooks up to your earlobes. I would treat myself every day for anywhere from 1 to 2 hours. I could actually “feel” the depression lift after about one and a half hours. This improved my functionality immensely! I do not know where I would be today without this device as nothing the doctors did worked for me. The Alpha-Stim can only be obtained by prescription and I did have a little difficulty convincing my doctor to at least let me try it but now even she is convinced of it’s effectiveness and is prescribing it for other patients with depression. This device is non-addictive and it’s effects are cumulative, which means I had to use it less and less as time went on. Now I only use it when I feel the depression starting to raise it’s ugly head again and with just a couple of treatments I can now keep it under control.

    If you are interested in wanting to know more about it or my experience feel free to contact me at ktrek@yahoo.com and I’ll be glad to talk with you. Also, they have an official website where you can read bout it but I used an online vendor that actually “rents” the units until the unit is paid for. Since they cost around $900.00 I thought it was the best way to go because I could always return it if it didn’t work for me. I intend on paying it out though and keeping the device though. It also has other uses, such as pain management, which I have found is VERY effective. You really have to try this device to believe it’s effectiveness. Here is the site where I rent mine from:

    http://www.alleviahealth.com/

    They have a page dedicated to research documents and after my doctor read these she was willing to prescribe. Here is the research link:

    http://www.alleviahealth.com/research.htm

    Hint: many if not most patients with depression also experience body pain and if the doctor will prescribe the device for “pain management” then most insurance companies will cover some of the costs. However, most will not cover it for depression. I found out the hard way.

    My prayer is that this will help others who read this article and are experiencing depression. I personally know how debilitating it can be and Alpha-Stim has been a godsend for me.

    Kevin

  5. Well, Michael… As always, you’ve done simply an admirable job serving the Christian community through your blog in addressing this issue. And again, my thanks to Denise for removing the veil from her own struggle that so close parallels my own.

    This latest post is invaluable. I’ve been on Paxil for quite some time, longer than I had hoped to be, really. It does seem to be working better than anything I’ve ever tried before, so I’m a little reuctant to go off it until I’m confident I’m absolutely ready. The difficulty in this is that I belong to a charismaniac church and too frequently our community has a tendency to speak out against medicinal and psychiatric assistance. This is unfortunate since so many people in our community truly struggle with depression. I think many people are reluctant to come forward with such a struggle though, because of the stigma sttached to it, particularly in charismaniac circles.

    Too frequently the Pentecostal fervor of the charismaniac movement dictates that “In Je-e-e-e-esus you’ve got the victory… and you’d better not have anything else.” So I find the results of the survey dangerously similar to what I heard 35 years ago coming out of the gay lifestyle: On those few occasions I shared my struggle to other Christians, I received “encouragement” to read my Bible more, or to pray harder. I had a few well-intended individuals offer to lay hands on me and cast out that “demon” of homosexuality. I apparently needed more quiet time with the Lord, according to some, while according to others, if I were really a Christian, I wouldn’t have this problem. Of course, virtually every pastor wanted to know if I was tithing, as if simply giving money to the church might undo everything of the past 22 years. I even had a few pastors tell me, “You know, there’s another church just down the street. I think you’d be a lot happier worshipping there.” The non-articulated truth lurking behind those smiling suggestions was that the pastors would be a lot happier if I were worshipping down the street.

    I agree totally with Michael Benoit: We need to take responsibility for our own mental health, just as we do our own spiritual health. I have that copy of CT for which he cites the article, “The Gospel According to Prozac.” I think I can appreciate that CT was trying to do, but failed in the process. Benoit says in so many words that we cannot trust our feelings. This makes perfect sense; after all, if we live in a fallen world, wouldn’t it follow that our feelings are fallen, along with our biology, physiology, psychology, sociology and everything else?

  6. JohnnyComeLately says:

    Kevin,

    Could you tell us if you have had any side-effects with this FSM device? I thought maybe it could result in short-term memory loss.

    Thanks,
    John

  7. Michael Spencer,

    Thank you so much for posting articles on your blog about depression. I myself have been battling depression for 35 years, approximately 23 of those years as a Christian. While I’m currently in a very good, clear state of mind at this particular point in time, I can honestly say it is only by the grace and mercy of God that I’m doing so well. Through his grace and mercy, I’ve been able to develop my own sort of spiritual cognitive therapy that has been very beneficial. Sadly, my experience with getting treatment for my condition through the church and through medical professionals has been very, very poor.

    While I did, during one particular dark time in my life, take anti-depressants for a short time, I found that my own depression was caused entirely by relational issues with other people and even institutions. I’ve been able to mitigate the effects of my depression by being very careful with the type of people and institutions I interact with, and minimizing, and sometimes eliminating relationships that had a net draining effect on me. While this solution sounds rather simple, it is not simple at all in practice, since a change in jobs, locations, or various other factors beyond my immediate control can put me into contact with negative people or institutions which I cannot easily break free from. (Co-workers, neighbors and family members for instance.) Those institutions that I’ve had to minimize or eliminate in my life include most mass media, especially television, which I have not had in my house for over ten years. There have also been many times where I’ve had to stop my involvement with various Christian groups or churches because of the ultimately negative messages and involvements I had with those groups (I’m speaking in terms of conservative, evangelical/charismatic churches.)

    The most help I’ve had for overcoming my depression has been from a very unlikely source: the teachings and core concepts of Alcoholics Anonymous. The amazing part about this is that I don’t drink, smoke or do drugs nor have I any chemical addictions, and I have never been to an AA meeting! In particular, the concept which has helped me the most is step 2 of their famous 12 steps: “Came to believe that a Power greater than ourselves could restore us to sanity.” The greatest progress I’ve made in my battle over depression is when I’ve made a point of crying out to God for his help, and he has not let me down. I have a lot more to say about this than I can write about at this time, but let me just add that the idea of turning to the teachings of AA for help with my depression occurred during a five day retreat at the Abbey of Gethsemani in Trappist, Kentucky (www.monks.org) — the home of the real Thomas Merton.

    Concerning the remarks from Mike Benoit: there is a major point he makes that I must take issue with.

    Mike states that “If our emotions were the key to our faith, we should be very worried indeed. If I’ve learned one thing in my training, it’s a profound distrust of my own emotional life. Very minor things can influence my emotions, and even my thoughts and behavior…Our emotions are mediated by our brains, which are extremely fragile, vulnerable to disease and accident as well as being changed by our circumstances. If our faith boils down to how we feel about God, then I have no security.” He also later states “Emotions are a profound motivator and a wonderful gift, but they are not to be trusted infallibly.”

    Let me state for the record that I do, in fact, trust my emotions infallibly. I do know, for a fact, that my emotions are essential in my ability to walk out my faith. And I do, absolutely, trust my own emotional life. I also know, for a fact, that very major things are capable of changing and manipulating my emotions, including thoughts, food, media, environment, God, and even Satan. And I must add that I know that my salvation is secure because I can quite literally feel the security of my salvation (through the love of God), and not just think it.

    Let me state further that my road to overcoming depression began when I learned to trust my emotions, especially feelings of depression and anger. A huge, and extremely significant mistake I’ve made in my life, and this even from my youth, is the horrendous mistake of not trusting my own emotions: this has caused more trouble and turmoil in my life than any other factor, except for a few. So where did I learn of this idea of not trusting my emotions? Well, my earliest remembrances of this is from watching Star Trek when I was a little boy, and being fascinated by the character of Mr. Spock. While that was the beginning, there were a lot of other voices and experts who contributed to this idea, especially in the evangelical Christian realm. The whole idea of “not trusting your emotions” in regards to your salvation, or anything else for that matter, is a message I’ve heard literally hundreds of times, and I accepted it as being true. Silly me. Unlearning this lie had done more to help me than any of the other lies in my life I’ve had to overcome.

    Here is the truth in regards to emotions: they are always and absolutely true. However, that which causes an emotional reaction may or may not be true. For instance, I can have a very emotional reaction watching a Hollywood movie–but the movie is entirely fictional. Though my brain “knows” that the story is fictional, subconsciously I treat it as fact, and hence react to it as if it were real. (Perhaps it can be best said that I’m giving myself permission to believe a lie!) While this is one small example, the truth is that I am bombarded with information from all sorts of sources other than movies, even the spiritual world. Those messages that do the best job of convincing me of their factualness have, of course, the greatest emotional impact. Those things which I perceive as lies or misperceptions have no where near the emotional impact on me than those things that I accept as true. Hence, it’s not the emotions I need to look out for, it is those ideas, concepts and experiences that are the causes behind the emotions. I need a better filter to sort out the lies from the truth. Amazingly, I’ve found a surprisingly good and very accurate “filter” are my own emotional reactions! Hence, I’ve learned to trust them implicitly.

    Is it literally that simple? Yes it is, conceptually speaking. But filtering out lies and truth is no where near as easy in practice as it is in theory, and I’m literally unable to do it without God’s help. Even so, the battle is ongoing, and allowing a lie in, even a little one, can have devastating emotional impact…hence one needs to be always on guard. (However, the devastating emotional impact is often an excellent indicator that a lie has been swallowed somewhere along the way!) But the lies that are the most subtle and the most easily swallowed are those that come from authority figures within the church. (ditto most everything in gcw’s comment!) To be very honest, I’ve found that a great majority of authority figures within evangelical/charismatic protestant Christianity (and a lot of the books in the Christian bookstores) don’t really have a clue as to what they are talking about…they are simply regurgitating that which they’ve heard from some other “authority,” if not something worse. It is a rare and unusual day when I hear actual spiritual truth from the lips of a servant of God, but there are a few out there.

    And that’s why I keep coming back to the Internet Monk blog…I’ve heard more Spiritual truth out of the lips of Michael Spencer than from twenty years worth of church pastors…and that’s the truth. (Not to mention a common affinity for Thomas Merton!)

    pseudo Thomas Merton

  8. Great Series of Posts.
    This topic is close to my heart because this past year I developed a major depressive disorder. I chose to start an anti-depressant (Prozac) and it has worked wonderfully. Since I am finalizing my medical education, I have seen quite a few interesting psychiatric patients and have for the most part accepted parts of the “medical model” of mental illness. This is certainly not to say that some people are not responsible for their mental health problems. I only mean that there are real biochemical processes that are underpin for our thoughts, feelings, and emotions. For those people who doubt what I call the medical model, consider the following scenarios:
    If a 2 day old infant was brought to you with a congenital heart defect that required surgical repair, would you hold the infant responsible for the defect? I hope not.
    If a 50 year old obese man presented with a heart attack, would you say the person was responsible for his disease? Maybe, because their obesity is a strong risk factor for heart attacks. Would you deny treatment to this man because he brought the problem on himself? I hope not. If after the heart attack, the man refused to change his lifestyle and had another heart attack, would you refuse to treat him? If you did, you would probably lose your medical license.
    What if I told you that the above mentioned man had an inherited medical condition that led to early heart attacks. Would you still hold him responsible for his heart attack(s)?
    The reason I bring these up is that sometimes moral questions in medicine are reasonably easy to answer. However, they are sometimes more complex such as when people have genetic predispositions combined with poor lifestyle habits.
    Now consider the following question: Is the brain an organ? Yes. Can it dysfunction due to either inherited or behavioral reasons? I would answer yes to both of these. Is it easy to sort these out in clinical practice? Certainly not.
    So here is my take on anti-depressant usage. The brain is an organ that sometimes gets sick. Sometimes this sickness is related to inherited conditions we have little control over. Remember that the fall affects every part of people. Sometimes however, our brains don’t work due to difficult situations, stress, or just plain disobedience. Most people with depression have a combination of these situations. If people want to try counseling great. If they want to try antidepressants great. We should always encourage people to modify destructive environments and behaviors in their lives, but would you advise a friend not to take antidepressants so they “learn their lesson?” If you would advise against anti-depressant usage consider whether you would advise our obese man not to take his blood pressure pills while he tries to lose weight?
    I hope this long piece provides some food for thought.
    Mitch

  9. Philologus says:

    [quote]Kevin,

    Could you tell us if you have had any side-effects with this FSM device? I thought maybe it could result in short-term memory loss.

    Thanks,
    John [/quote]

    Actually John no…there are no side effects and to tell you the truth my memory actually improved. I have found my thinking to be very clear and focused. Not the jumbled mess I used to have. I only use the Alpha-Stim now when I need to, which is about once every two weeks.

    Another great use of the Alpha-Stim is that it lowers high blood pressure too. My depression was coupled with anxiety disorder also and I have found that the Alpha-Stim will relax me within minutes. I think there is plenty of evidence to show that the Alpha-Stim is completely harmless without any side effects.

    My experience with it has been positive and I think that anyone who has severe depression should at least try it for a couple months rental. What do you have to lose besides a couple of hundred dollars? You probably have spent more than that already and will certainly spend more on a lifetime dependence on medications. Once on meds I have seen very few people ever get off them and I think it’s by design.

    Kevin

  10. I know this is about 2 years late, but I just read this article and had a few thoughts…

    As I will officially be a doctor in just a few months, topics like this are especially of interest. As the author stated, medicine is definately not a panacea. However, this is how most RX are treated. Someone commented on another linked article that his meds help raise his serotonin levels to the adequate level. So my question is why is his body not making enough serotonin? Is his body deficient in that medication? No, not at all. There is something else that is hindering his body’s ability to produce or regulate the proper levels of serotonin.

    I have seen personally and in my clinical residency setting, that ‘proper’ nutrition, exercise, and believe it or not, good chiropractic care has more affect in these areas than does medicine.

    The reality is that when your nervous system (your brain and spinal cord) are functioning properly (which is attained by a properly functioning spine) the body can then regulate, balance and heal itself optimally.

    2 points:

    First- I think it’s funny that many Evang-Xians have seen Chiropractic as spiritually-sketchy, due to many in the profession who are kind-of new-agey. I believe that Focus on the Family even had Chiropractic on their “cult” list as recent as 4-5 years ago. However, Chiropractic seems much more in line w/ recognizing God’s perfect design in the body than does medicine, which always seems to have the attitude that ‘health’ comes from the outside-in (in the form of a drug most often), whereas Chiropractic sees health coming from the inside-out (that we already have the amazing ability to heal within us).

    Second- This also fits with the research regarding blood pressure and chiropractic. This research even made it on Good Morning America – which is amazing in it’s own right, since the AMA pretty much owns the media 🙂
    It was found that a specific chiropractic adjustment to the Atlas (first cervical vertebra in your neck) was as effective at lowering blood pressure as 2 BP lowering meds. Even I think that is amazing. And it has no side effects.

    So in our attempt to deal with issues of mental illness, I think it is very important to think holistically, regarding our health overall, and that psychological drugs should be the LAST route of treatment, after a significant change/approach w/ regard our nutrition and nervous system health (why not try Chiropractic?).

    God Bless. Thanks Michael for your blog.