DEPRESSION: Many of us feel depressed around Christmas. Did you know scientists and biblical counselors recognize at least three myths about depression?
In part 3 of this three-part series, learn the truth about medication for depression. Part 1 looked at . . . Part 2 covered diagnosis and the Bible. This post first appeared here on CareLeader.org, June 29, 2016, and is used with permisison.
Would you like caring biblical counseling for depression? I offer counseling by Skype and in person. Contact me. Let’s set up a short complimentary consultation. Don’t go it alone.
Myth #3: Medication Doesn’t Help Treat Depression
Some people are under the impression that depression is purely a spiritual issue and that medication isn’t effective or needed in treating depression.
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Some who cite the ineffectiveness of antidepressants claim that they are slightly more effective than a placebo.
A fact sheet produced by MIT explains the origin of that idea:
Clinicians began hearing this question from patients after news articles reported on a 2002 analysis of published and unpublished studies submitted to the U.S. Food and Drug Administration (FDA) as part of the approval process for several new types of antidepressant medication. This analysis concluded that the newer types of antidepressants are only marginally more effective than placebo.
However, these analyses do not reflect how antidepressants are used in actual practice. Drug trials measure only how a person responds to a single medication taken at a specific dose for a limited time. In clinical practice, however, the patient and clinician work together to find the dose and the medication or combination of medications most effective for you. Most clinicians believe that this process results in much better results than these analyses imply.
Medication: A Wisdom Issue
Dr. Michael Emlet, in an interview for our DivorceCare and Single & Parenting projects, pointed out that the Bible doesn’t prohibit taking medications for psychiatric disorders. He said,
When Jesus came, He not only forgave sin but He also healed disease. He also relieved suffering.
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Medications may be one way that suffering is relieved…. I would say medication is a wisdom issue. It’s going to vary from individual to individual whether or not medications may be wise.
I think some people want to rush too quickly to medications. Other people refuse to even consider the possibility of medications. Both of those positions could be problematic because they reflect motives of the heart that may be off base.
Dr. Emlet reminds us of the importance of remembering the limitations of medicine:
Medication can help treat depression and shouldn’t be written off as one of the ways that God can bring healing and relief to a person’s life. For example, with stabilized emotions and higher energy, people can be enabled to make needed changes in their lives.
But people need more than drugs. Drugs, as helpful as they can be, do have limitations. They don’t treat any of the underlying spiritual or environmental issues that contribute to a depression.
Some people may not require medication to treat their depression at all. Less severe cases can be treated with nonmedicinal approaches and basic behavior changes. For example, one study reported by Reuters found that simply getting active three times a week reduces the risk of depression in adults by 16 percent, and additional exercise reduces the risk even more. You can also suggest that a person try a change in diet, since a lack of essential vitamins and minerals can result in depressive symptoms.
A strategy for effective care begins with an accurate understanding of the person’s problem. For more on how to understand depression from a biblical perspective, see Jeff Forrey’s article How pastors can help the depressed. It will help you understand the unique role pastors play in helping people deal with depression.
Also check out Kathy Leonard’s article 3 reasons depression is complicated, which features interviews with counselor Leslie Vernick and Dr. Robert Kellemen. It’s a great post to share with your church leaders to help them understand why we shouldn’t use simplistic reasons to explain depression.
Be sure to subscribe to my blog for resources that help you. Below is the sign up. When you sign up, you get a free resource from me, dropped in your email..
Struggling? Make an appointment (in person or by Skype). The Lord has effective and caring solutions to depression.–LAM
DEPRESSION: Many of us feel depressed around Christmas. Did you know scientists and biblical counselors recognize at least three myths about depression?
In part 1 of this three-part series, find out the truth about causes of depression. Part 2 covers the a depression diagnosis. Part 3 looks at medication–when it’s useful, when it’s not. This post first appeared here on CareLeader.org, June 29, 2016, and is used with permisison.
Would you or someone you love like caring biblical counseling for depression? I offer counseling by Skype and in person. Contact me. Let’s set up a short complimentary consultation. Don’t go it alone.
“Pastor, I’m depressed…doctor says it’s some sort of major depressive disorder.”
We don’t take for granted the amount of trust displayed when someone discloses the diagnosis of a psychiatric disorder. And that’s why we respond gently and compassionately. But we also need to respond accurately.
Here is the first of three common myths about depression to keep you from misleading those you care so deeply for.
Myth #1: Scientists Know Exactly What Causes Depression
Even though pharmaceutical ads say that major depression may be caused by chemical imbalances, many people assume that it is caused by chemical imbalances. But it’s not that simple. As Dr. Joseph Coyle of Harvard Medical School was quoted by National Public Radio,
Chemical imbalance is sort of last-century thinking. It’s much more complicated than that.
And Dr. Coyle isn’t alone in his sentiment. PLOS Medicine collected an eye-opening list of quotes from medical researchers who don’t share the confidence that the general public, some doctors, and even pharmaceutical companies have about the cause of depression.
To get a better idea of what causes depression, scientists are exploring whether the depression is due to problems with brain structure, diminished activity levels in certain parts of the brain, and psychosocial factors like stress. But to date, scientists have not been able to make a clear link between physiological factors and depression. A Scientific American article puts it this way:
[N]o studies have established a cause-and-effect relation between any brain or psychosocial dysfunction and the disorder. In addition, depression almost certainly does not result from just one change in the brain or environmental factor. A focus on one piece of the depression puzzle—be it brain chemistry, neural networks or stress—is shortsighted.
The Brain Is Complicated
Even though we hear a lot of promising news about the latest in brain and genetic code research, it’s important to realize that scientists aren’t even close to being able to explain what causes depression or any other mental disorder. Dr. Allen Frances, former chair of the DSM-IV Task Force and of the department of psychiatry at Duke University School of Medicine, writes:
Although we have learned a great deal about brain functioning, we have not yet figured out ways of translating basic science into clinical psychiatry. The powerful new tools of molecular biology, genetics, and imaging have not yet led to laboratory tests for dementia or depression or schizophrenia or bipolar or obsessive-compulsive disorder or for any other mental disorders. The expectation that there would be a simple gene or neurotransmitter or circuitry explanation for any mental disorder has turned out to be naive and illusory.
Frances goes on to quote Roger Sperry, who won the Nobel Prize in medicine:
The more we learn, the more we recognize the unique complexity of any one individual intellect, the stronger the conclusion becomes that the individuality inherent in our brain networks makes that of fingerprints or facial features gross and simple by comparison.
Teasing out the heterogeneous underlying mechanisms of mental disorder will be the work of lifetimes.
Spritual Aspects of Depression Matter Too
Even if scientists are able to identify which parts of the body produce a state of depression, that would be incomplete as an explanation of the cause of depression. Why? It would not take into account man’s makeup as a spiritual and physical creature created in the image of God.
Dr. Sam Williams, a former psychologist who is now a counseling professor at Southeastern Baptist Theological Seminary, explains:
That which makes us distinctively human, our spiritual and moral facets, is neglected by secular definitions of mental order, disorder, and reordering. Thus, the secular concept of mental disorder is not a thorough description of nor does it provide an explanation for people’s problems.
A more thorough biblical psychology must factor God (and subsequently the moral and spiritual valence of each symptom) back into the equation if we are interested in a diagnosis that is consistent with our worldview.
This is important for the people you care for to understand, because many of them become less receptive to nonmedicinal treatments when they accept a biomedical explanation for their depression. Dr. Todd B. Kashdan, psychologist and professor of psychology at George Mason University, explains in a post on myths about what causes depression:
They become pessimistic that recovery is possible. They become less confident that they can manage and regulate negative moods that arise (and they always do)…. Essentially, they become less flexible in their options for treating depression and less confident that they will escape its clutches.
Just because depression scientists don’t know exactly what causes it does not mean that biological factors don’t play a significant role in why people experience depression. But, again, as Dr. Williams observes,
Superficial, deterministic explanations dehumanize people, rendering them as automatons rather than persons with the dignity and honor ascribed to us in Psalm 8.
Be sure to subscribe to my blog and get resources that help you. Below is the signup. When you sign up, you get a free downloadable eBook dropped in your email.
Struggling? Make an appointment (in person or by Skype) with me. –LAM
Sharing Hope with Your Heart,
God has no foster children! Rather, each Christian is fully adopted and irrevocably His. Counselor Marie Notcheva, whose profile you can read on Heart2Heart Directory, reassures us that God has no foster children — only forever children. Marie’s article appeared first here on her website and is used with permission.
Several years ago, I read a book called Three Little Words, a memoir of a girl’s horrific childhood in the foster care system. Eventually she was adopted, as a teen, by a loving family. It was a painfully raw and all-too-accurate glimpse of what some foster children experience.
Being shuffled through countless homes of indifferent or abusive foster parents obviously scars foster children. They come to see themselves as unloved, and presumably unlovable. Even the fortunate ones who are adopted face problems; they cannot trust adults, believe that they are loved, or understand what a permanent place in a family means.
Many adoptions are actually disrupted when youngsters lash out and display belligerent behavior. Growing up in foster care means existing in constant limbo. Biological parents who don’t come through and foster parents who aren’t “for keeps” breed a deep-seated insecurity.
Foster children often expect to be rejected – even after adoption.
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A Permanent Place in God’s Family
Ashley Rhodes-Courter, the author of this particular memoir, describes an incident of teenage rebellion some time after her adoption had been finalized. When confronted by her parents, her first thought was that the adoption was over. She had long since steeled her heart against loving or being loved by anyone, and spent the first several years of her family life waiting for the proverbial shoe to drop.
She anticipated another rejection and ultimate return to the group home. Against her expectations and previous life experience, her parents assured her that she was irrevocably their daughter, and that it was high time to drop the “poor orphan” act. (They then punished her for her infraction).
That was the turning point for Ashley. Finally, she was able to begin building trust in her mother and father, knowing that no matter how “bad” she was, there was nothing she could do to make them reject her.
An awful lot of Christians are walking around with a “foster child” mentality, it seems to me.
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This is a mindset I’ve encountered in counseling, and it’s something I have fallen prey to myself at times. What we need to internalize is this: we are adopted sons and daughters of God, co-heirs with Christ, and have a permanent place in the family (Galatians 4:5; Ephesians 1:5; and John 8:35, respectively). Why is this so hard to believe? My answer, and it’s a fairly simplistic one, is because it takes humility to see this.
We did nothing to earn our status as His children. It was all of His grace…completely, freely, and lavishly bestowed on the unlovely delinquents we were when He found us. Pride wants us to earn our keep; to do something that will merit God’s approval. This is the carnal nature that prompted the Prodigal Son’s request to be made a hired servant.
You Are Completely Loved!
Humility, on the other hand, rejoices in the fact that we are fully known, completely loved, and sealed with the spirit of adoption (Romans 8:15). We can cry “Abba, Father” no matter how distant we may feel from God, because He has set His love on us for Christ’s sake (Romans 1:5) and called us His own (Isaiah 43:1; 1 John 3:2). In fact, He loves us even as He loves His only begotten Son, Jesus (John 16:27).
By human standards, this is a difficult concept to grasp. Repeated rejection by human authority figures (and especially by parents) can pervert one’s view of a benevolent God. Nevertheless, the One Who has redeemed our unworthy selves loves us unconditionally, and has made our identity secure. Legal adoption is a binding covenant. John 1:12-13 illustrates this clearly:
But as many as received Him, to them He gave the right to become children of God, even to those who believe in His name, who were born, not of blood nor of the will of the flesh nor of the will of man, but of God.
We have assurance that God really is as good as He says He is. He will never reject any who come to Him (John 6:37).
For you have not received a spirit of slavery leading to fear again, but you have received a spirit of adoption as sons by which we cry out, ‘Abba! Father!’ (Romans 8:15).
Foster children are literally slaves to fear. They live in constant anticipation of the next infraction – or whim of the legal system – to be the end of whatever tenuous family situation they are in.
How does this sad mindset play itself out in a child of God?
No More Shame
Guilt over failure and indwelling sin drives the insecure Christian away from the Cross, rather than towards it. He or she cannot face a God who is still perceived as a righteous Judge rather than a loving Father. God is both, of course; but what the fearful believer fails to grasp practically is that His righteous judgment has already been poured out on Christ, and there is no longer condemnation (Romans 8:1). She fails to realize that her sin was already foreseen by God, has been forgiven, and is no longer held against her.
As Jerry Bridges writes,
…He is, as it were, coming alongside me saying, “We are going to work on that sin, but meanwhile I want you to know that I no longer count it against you.”
God is no longer my Judge; He is now my Heavenly Father, who loves me with a self-generated, infinite love, even in the face of my sin.
While on the surface shame and pride may seem at odds with each other, actually they work in tandem. When a Christian sees herself as a foster child of God, she will seek to avoid Him when plagued with guilt – at least until she can “get her act together” enough to approach Him. However, it is actually the height of arrogance to believe that there is ever a time when we are more acceptable to God than another. Putting merit in our own works-righteousness or penance actually demeans the centrality of the Cross. C. J. Mahaney writes,
Paul called himself ‘the worst of sinners’ (1 Timothy 1:16). He wasn’t paralyzed by condemnation. He was exalting God’s grace by recognizing his own unworthiness and sin as he marveled at the mercy of God.
So Long People-Pleasing
A child of God who does not realize her true identity is constantly anxious about where she stands with God. Desperately trying to earn the favor of her Father, which she doesn’t recognize she already has, she tries to impress others or appear more spiritual. For example, I had one bulimic counselee tell me she wanted to “redeem [herself] in God’s eyes by becoming a nutritionist, and hopefully help others.”
I confess that I have fallen prey to this mindset myself, when I make idols out of goals or “splendid vices” (George Whitefield’s term for spiritual activity done with wrong motives). Getting my book Redeemed from the Pit published was very important to me, and when it became a reality I was preoccupied with obtaining endorsements from well-known authors in the biblical counseling field.
When they like my work, I somehow feel God approves of my endeavor. When they decline or suggest revisions, I despair – their opinion of my writing overshadows pleasing God. It becomes too easy to forget that my work is ultimately all for His glory, anyway. Although I would never say so out loud, being thought well of by “celebrity Christians” can eclipse the truth – that God neither thinks more nor less of me based on man’s opinions; and I have nothing whatsoever to commend myself to Him in the first place. He loves me with an everlasting love (Jeremiah 31:3) simply because I am His daughter.
This tendency to think God sees us as others do takes many different forms, but the root is the same – doubting the reality and immutability of God’s personal and tender love.
Let’s think about this logically: An omniscient God knew from eternity past exactly what you would be like, He saw every sin and dark thought that would enter your mind, yet He set His love on you anyway by electing you as His child. He called you out of darkness, then transferred you to the Kingdom of His beloved Son (Colossians 1:13).
Jesus Himself is not ashamed to call you His brother or sister (Hebrews 2:11), so on what grounds would He decide to kick you out of His family? What, exactly, would you have to do to “disrupt” your heavenly adoption and get sent back from whence you came?
It’s time, as the Courter parents so bluntly put it, to “drop the poor orphan act” and realize we’re God’s for good. And that’s Good News.
Intimacy cannot grow apart from relationship, and the entire New Covenant proclaims that our relationship as children is irrevocable. We didn’t do anything to earn it in the first place – we were all broken and flawed when God called us – so what makes us think we can lose His parental bond?
Craven fear and cringing supplication have no place in the life of a child of God. Repentance is a gift freely offered to all who will accept it and return to God on His terms…no running, hiding, and fear of the boom lowering anymore. The writer of Hebrews poetically banished any possibility of seeing ourselves as foster children when he wrote:
Therefore let us draw near with confidence to the throne of grace, so that we may receive mercy and find grace to help in time of need (Hebrews 4:16).
Sharing Hope with Your Heart,
If you have a dark secret, you probably are more like a turtle than a fancy show dog. Fancy show dogs lap up attention. Turtles hide. They are afraid. They like to blend in. Their hard shells protect them, or do they?
Through my childhood and into my 20s, I was all turtle. I tried to hide my dark secrets. The problem is, I acted out — quietly, for turtles are quiet — in ways that hinted at the pain I covered up, retracting my feet and head into my shell, my hiding place. Where is you favorite hiding place when you hurt? A book? TV? Wine? In the arms of a lover? Church?
In this blog post I’ll share:
- Some of my own dark secrets.
- How God healed my shame.
- Do this. Don’t do that.
My Shameful Secret
When you meet a turtle, you can bet they’ve been hurt. . .by parents or kids at school or a tragedy of some sort. Show dogs often have hurts too. They hide in other ways. One way is pointing you to their accomplishments. Another way is making jokes. Are you more like a turtle or a show dog?
Here are several of my secrets that turtle-ized me.
- Depression from childhood to my early 30s.
- A child of divorce. . .three times. My parents divorced twice, once when I was age 8, they remarried a year later, and divorced again in my mid 20s. My dad remarried and divorced.
- Sexual abuse survivor. I repressed the memories for nearly 20 years.
- Drug abuse. I drove drunk. I drove high. This happened in high school. I’m not proud of it. I was stupid.
- Self-harm. I went through a stage in high school where dug my fingernails into my wrists and drew blood.
- Binge eating followed by starving in college, yelled at myself — “pig, pig” — and ate more then punished myself by eating nothing for one or two days.
- Perfectionism. I thought I was lovable only when I did everything right. But I couldn’t, so I hated myself.
Yes, there’s more. I’ve learned to share only secrets where I now have healing and am open to talk about freely. What about you? Do you have secrets? Are you careful to share it with trustworthy people? Have you shared a secret with someone who betrayed your confidence? Didn’t their betrayal hurt worse than having a house drop on your head?
How God Healed My Shame
The turning point for this turtle was God-ordained. I wouldn’t have chosen it. In his wisdom, God picked the time and day. He knew I’d find safety in him and my husband.
A Saturday morning in the summer, I woke up, bawling. My poor husband thought I was in physical pain. I wasn’t. Memories from my childhood and teen years flooded me unexpectedly and I cried a Mississippi River. I had pushed down some of these memories for decades. I knew they were true. I had chosen to pretend.
Three important decisions I made that day:
- Share my deepest secret with a counselor.
- Start journaling my thoughts and feelings.
- Sing to Christian music every day.
Sharing my secret freed me from holding it in holding it in holding it in. To get it out, I first shared it in third person, but my counselor and I both knew I was talking about my secret–sexual molestation by a family member. After I shared with the counselor, I told my secret to my husband. He asked me why I had never told him. I said — and I meant it — that it had never crossed my mind. What a turtle I was!
Journaling provided a safe place to write where it hurt. Singing to solid Christian music filled with biblical truth helped renew my mind according to the Bible. I am thankful to God that he gave me the time to journal and sing, and people to confide in.
In you, Lord, I have taken refuge; let me never be put to shame (Psalm 71:1, NIV).
Do This, Don’t Do That
Keeping a dark secret hurts you and others. Sharing them with a safe Christian friend or gospel-centered counselor heals. Here are a few do’s and don’ts for healing if you or a friend has a dark secret.
DO pray and ask God for healing.
DON’T pretend the dark secret is no biggie.
DO read the Psalms. David and other psalmists pour out their heart as they wrestle with hurts and hard emotions.
DON’T distract yourself day after day with food, TV, computer games, porn, or alcohol.
DO journal your thoughts and feelings.
DON’T “vomit” your secret on anyone and everyone or all over the Internet.
DO get the help God wants you to have.
Friend, God loves you just as you are. You don’t have to have it all figured out. It’s okay to be messy. We’re all sinners, right? And in Christ, you and I are saints! Hold dear to your identity in Christ.
In Christ, you are set free from condemnation and shame.
Therefore, there is now no condemnation for those who are in Christ Jesus. (Romans 8:1)
In Christ, you are able to live victoriously.
But thanks be to God, who gives us the victory through our Lord Jesus Christ. (1 Corinthians 15:57)
OFFER: I encourage you to sign up for a complimentary 15-minute consult to find out if biblical counseling is for you. To sign up, send me a contact message. We can pick a time that works for you. Thank you.
Sharing hope with your heart,
Failure is bad, shame is worse.
This is the second part of a two-part series on how to live a shame-free life. The first part is here.
Did you know that shame can even haunt the wealthy business woman and the Oscar-winning actress?
When you think you’ve failed — your marriage ended up in separation or divorce, your closest friend dropped you like a hot potato, your boss gave you a poor performance review, your kid is failing a few classes, and so on — you can separate what is happening out there and who you are.
Shame cuts to the soul. It attacks who your are.
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A shame-filled person believes she is “less than,” defective, a waste of space. . . nothing. She turns inward and blames herself for herself. She feels worthless.
You haven’t measured up to your standards, and you blame yourself. You aren’t good enough — says you!
Says author and biblical counselor Ed Welch:
Human beings evaluate worth; there is no question about that. We make judgments about people, music, art, and hundreds of other evens in a normal day. They are good or bad, valuable or expendable, right or wrong.. So it is no surprise that we also make evaluation or judgement about ourselves. According to some standard, we determine that we have not measured up.
Crucial questions: Is there a better standard to use for measuring than the ones you use? If so what are they? And if you begin using new and improved standards, will you overcome your shame.
The Usual Suspects
What sorts of standards led you or someone you love toward shame-filled living?
A few commons ones include:
- Growing up in a highly critical home where you were never good enough. You bring home a report card with all As and a solitary B, and your parent focuses on the B and expresses disappointment in you.
- Growing up in an indifferent home. You could pretty much do whatever you wanted — good or bad, and your parents just didn’t seem to care. The word for this is neglect. You felt like you were either in the way or didn’t matter.
- You didn’t fit the culture’s expectations. Perhaps you never finished high school, became pregnant in your early teens, had alcoholic parents, or had a disability of some sort.
- You were abused.
What would you add to the list?
Better Measuring Standards
The better measuring standards are God’s standards (or instructions and commandments in the Bible).
Stop judging yourself against your own standards:
- “I must have more friends to have worth.”
- “I need more money to matter.”
- “I must be prettier to have value.”
- “I need my parents’ approval to feel better.”
Instead, look to God’s standards, which no one can measure up to anyway. He demands perfection! The cool thing is he loves loves loves the broken. He embraces the foolish. He lifts up the weak. Listen:
Remember, dear brothers and sisters, that few of you were wise in the world’s eyes or powerful or wealthy when God called you. Instead, God chose things the world considers foolish in order to shame those who think they are wise. And he chose things that are powerless to shame those who are powerful. God chose things despised by the world, things counted as nothing at all, and used them to bring to nothing what the world considers important. As a result, no one can ever boast in the presence of God.
Therefore, as the Scriptures say, ‘If you want to boast, boast only about the Lord.’ 1 Corinthians 1:26-29, 30, NLT, emphasis added
Life isn’t about you and me. It’s all about God and his glory.
As you identify your shame-based lies you tell you self, you can begin to reframe them according to God’s word. You learn how to renew your mind by thinking the way God wants you to think.
How to Overcome Shame
First, love Jesus above all.
But seek first his kingdom and his righteousness, and all these things will be given to you as well. Matthew 6:33, NIV
As you choose to love Jesus and trust him, you’ll know God loves you and that is enough.
Second, confess to God that your shame has influenced you to look to others for their approval. He delights in hearing from you and has forgiven all the wrongdoing of every believer at the cross.
Third, obey God. When you follow the Great Commandment, your thoughts, emotions, and actions will fall in line with God’s standards.
‘Love the Lord your God with all your heart and with all your soul and with all your strength and with all your mind’; and, ‘Love your neighbor as yourself.’ Luke 10:27, NIV
Will making this change is the way you think be easy? I’d lie if I said yes.
To overcome shame or another negative emotion, you’ll need new godly habits. These godly habits are putting off and putting on. Putting off lying and putting on truth-telling, for instance. Or, putting off selfishness and putting on love for others.
You may need help to succeed in overcoming. Most people do. You can turn to a spiritually mature and godly woman you trust. Or you can reach out to a biblical counselor.
May I encourage you to contact me for a free consultation over the phone? You can ask how biblical counseling by Skype works and how it would help you.
Sharing Hope with Your Heart,