In my 16 years as a physician assistant, I have treated hundreds of patients for different forms of mental illness, from simple cases of mild anxiety and depression, to unstable bipolar or schizophrenic patients (including suicidal patients that required involuntarily admission for treatment). Some patients came to me begging for help, while others wore their symptoms with shame, hesitant to admit they were struggling. I have found that some people, Christians in particular, resist treatment for mental illness because they believe taking medication is a sign of weakness (or lack of faith in God). But if this were the case, prayer and spiritual practices would always bring relief. There are many contributing factors to mental illness beyond just the spiritual aspect – we must also consider the biological, psychological, lifestyle, and situational components.
God has allowed Man to progress in medical knowledge over the years, ordaining many medical discoveries to help treat our illnesses and pain. Antidepressants are one such development, and have helped to ease the suffering of many. They help to clarify thinking, make people less emotional, and allow these individuals to make better decisions (which makes them better spouses, parents, and co-workers). However, it seems that when patients go to a medical provider complaining of any relational, emotional, or behavioral issue, medication is universally prescribed. Whether out of convenience, ignorance, or profitability, the medical culture today is pill heavy when it comes to treating mental illness. But if medicine is not the answer for everyone, how do we discern when it is?
We should first assess the severity of the symptoms. Depression is different from discouragement, which is natural for us to all feel from time to time, and a part of the human condition. Discouragement is a transient state, with an obvious cause, and doesn’t seriously affect one’s ability to function in life. Scripture teaches us that there is an appointed time for every season in our lives, so we will all go through different stages of joy and grief (Ecclesiastes 3:1-8). It also teaches us that there can be a purpose to our suffering (2 Corinthians 1:3-6). When suffering propels us into the arms of God, we receive His comfort, and then are able to share that comfort with others who are also suffering. Because of this, I believe we do ourselves a disservice when we seek medication to face temporary seasons of discouragement or suffering.
Unlike discouragement, clinical depression will consist of debilitating symptoms such as: trouble sleeping (or excessive sleep), change in appetite, loss of pleasure in activities, social withdrawal, feelings of guilt or hopelessness, inability to function at work or in relationships, or even suicidal thoughts. A clinically depressed person often becomes apathetic, negative, or even resentful about life. They have trouble seeing beyond their own discomfort, and their very being seems to disappear beneath the illness. In such situations, medication can be life-changing (and even life-saving).
In addition to clinical depression, there are other circumstances when medication can be beneficial, and at times even critical. Sometimes the medication is necessary long-term, and other times just initially for a season, to help stabilize the symptoms so the individual can function in society while they seek additional help in their journey to wholeness. Some examples . . .
- Those with bipolar illness, schizophrenia, or frequent panic attacks.
- Those struggling with addiction, who are self-medicating their anxiety and pain with another substance.
- When a mood disorder influences one’s behavior to the point of causing conflict in important relationships, leading to serious problems like marital discord or job instability (so it isn’t just affecting their own life, but also those around them).
- Unresolved grief after a significant loss or trauma, especially after a year, which is interfering with the individual’s ability to function and enjoy life.
Some argue that mental illness is no different than any other medical condition, and that if we would be willing to take medication for diabetes, then we should be willing to take prescription medication to correct a chemical imbalance in our brain. While I can appreciate this argument, this only focuses on the biological aspect of depression, and it is not that simple. Though there are some cases of diabetes and mental illness that require permanent treatment, there are many cases in which lifestyle changes can assist in the healing process. Depression is a complex medical problem with biological, psychological and spiritual aspects to consider. Because of this, it requires a multi-disciplinary approach to healing, one that that addresses all three levels of our humanity "affected" - body, soul, and spirit. In this first article, I will attempt to touch on the biological and psychological components of mental illness.
THE BODY (BIOLOGICAL PART)
Many biological components to mental illness can be addressed through healthy lifestyle changes. Scientific evidence now demonstrates that inflammation in the body can contribute to symptoms of depression. Inflammation is the immune system’s natural response to disease or infection, but too much inflammation creates oxidative stress that is detrimental to our health (to our brain and our heart). Smoking, excessive alcohol intake, poor sleep, poor diet, vitamin deficiencies, hypothyroidism, obesity, and lack of exercise all contribute to inflammation. In addition to causing inflammation, these things can hinder the brain’s ability to produce the neurotransmitters (serotonin, norepinephrine, dopamine, etc) needed to stabilize mood. (For more information on these components, see links at end of article)
Sometimes making changes in lifestyle alone can help the brain naturally produce the chemicals needed to combat symptoms of anxiety and depression, so this is always a good place to start. However, for many, these changes will not completely solve the problem.
THE SOUL (PSYCHOLOGICAL PART)
There are often changes, whether in thinking or behavior, that are necessary for one’s symptoms of depression or anxiety to improve. It may be as simple as shifting our expectations, or walking away from the source of the stress (i.e. finding a new job or ending a toxic relationship). For me, much of my progress came after I realized others were not to blame for my feelings or reactions; that was all me. I learned that I needed to repent of my sinful response to the sin that was committed against me - and only in this would I find true victory. As Danny Silk writes in his book "Keep Your Love On", "The moment you pick up the dueling sword, you are equally guilty for whatever blood is shed." I had allowed the reasons for my pain to become the very excuses that prevented me from healing, and in the process, had given others power over my peace.
Counseling or psychotherapy can help uncover such problems, and address the issues related to our soul. Our soul encompasses our mind, will, and emotions, so anything related to our thoughts, choices, or feelings falls into this category. Our souls are not innately bad, but they were never meant to rule our lives. Only when we submit our souls to our spirits can we hear God’s voice clearly. As Watchman Nee wrote, “If we are living in the soul, we are working and serving in our natural strength, rather than drawing from God.” Part of the problem today is we let our souls dominate, and when this happens, we cannot trust our thoughts and feelings. When we think or feel something, we often react quickly, before we have weighed things with the Lord, and without regard for the potential consequences. Here is where Godly counseling may be of some benefit. But earthly knowledge is not the same thing as Godly wisdom . . . so even in counseling we need to be careful which tree we are eating from.
I have gone to a few counselors in my life, and each person offered something helpful for the situation I was facing. I learned to use more "me" statements that "you," and to talk more about how something made me feel than what I thought or assumed about a situation. One counselor advised me to excuse myself to the bathroom any time I felt like I was about to “lose it.” She said no one could tell me whether my bladder was full, and this would give me an opportunity to calm down before I said something I regretted. She equipped me with practical tools to help me navigate conflict as I worked on growing into a “better me.” These tools helped me better endure conflict, but primarily through suppressing my anger (I still felt like a mess inside). In reality, I did not want to merely survive my relationships; I wanted to thrive in them. I needed more than just coping mechanisms; I needed a heart transplant, and counseling could not help me with that. (Ezekiel 36:26)
Then there was a different counselor who pointed out it was okay for Bob and me to have a different walk with God, that our beliefs did not have to be exactly the same. As I prayed about this, I realized I had been trying to impress my viewpoints on Bob, and he needed the freedom to walk out his own spiritual journey with God. When I gave up my attempts to influence or control him, it drastically changed our relationship for the better. However, it was not the counselor’s insight that changed our relationship; it was taking these things to God, allowing Him to speak to my heart about them, and then surrendering to His lead as I applied them in my life.
I have learned that no amount of knowledge or advice has the power to change us. Scripture says the truth will set us free, but it is not the knowledge of truth that does this, it is the application of it. Though improvements can come through psychology, genuine healing and lasting change only comes when we connect truth with the power and presence of Jesus Christ. Otherwise it is just self-help, techniques rooted in knowledge and will power alone . . . and that which is dependant on our own strength will only fail in time. As Graham Cooke says,
Truth by itself will only change people. Truth causes transformation when it is powered by grace. When those two spirits work together, they have an incredible effect upon humanity. It doesn’t matter if the individual is Christian or pre-Christian, truth and grace affects them. There is a difference between change and transformation. Change can seem a temporary alteration of behavior during a particular season. It could be that people drive their carnal behavior underground when confronted and then return to it when the heat is off. Transformation occurs by the actions of God’s grace on truth when we allow the Father to touch our innermost place and we surrender life at that point.
In summary, to successfully tackle the many layers of mental illness, it comes down to addressing every related part: body, soul, and spirit. In part two of this article, I discuss the spiritual aspects of mental illness and how to differentiate suffering that is meant for a divine purpose, from that which needs medical intervention. Now that we have covered when it may be beneficial TO use medication, the question still remains, when is it best NOT to use medication for symptoms of depression and anxiety? I attempt to answer that question in part two.
In the meantime, my hope is that the stigma associated with mental illness does not prevent people from seeking the help they need, and that they realize they are not a failure at their faith simply because they are struggling. God's strength is made perfect in our weakness, so being at the end of ourselves is not necessarily a bad thing. We are all a work in progress, each on our own lifelong journey of healing and transformation. So . . . let’s take advantage of the resources God has given us and press into the fullness of our true identity, embracing every bit of life, liberty, and love He imparts to us along the way.
Read Part Two of this article HERE.
FURTHER READING & RESOURCES on the biological aspects of depression:
I highly recommend Dr. Sam Fillingane's videos (we follow his treatment model in our family practice) - You can watch them HERE (#15 on depression, #10 on vitamin D, #12 on omega 3, #6 and #43 on MTHFR, and #5 on sleep apnea)
Poor Sleep - Read more HERE and HERE
Poor Diet – Read more HERE
Vitamin Deficiencies – Read more HERE and HERE
Lack of Exercise - Read more HERE and HERE
Alcohol – Read more HERE
Excessive Caffeine – Read more HERE
