6 Words of Counsel about Depression, Medication, and Biblical Counseling
David Murray recently posted a response he made to someone who told him he had reluctantly decided to see a doctor about taking medication for depression. You can find my responses to David’s post at Depression, Medication, and Biblical Counseling.
Several people have said, “Bob, I’d love to hear what your response to David’s friend would have been.”
In my initial post I summarized some of my potential responses. However, I’ve hesitated to craft a full blog response because I don’t counsel by monologue.
Instead, I counsel by trialogue—the Divine Counselor through God’s Word, the human counselor, and the human counselee. In a trialogue, I interact with another person as together we seek the wisdom of God’s Word for life in our broken world.
Before I would ever respond directly to someone about depression and medication, I would be asking questions, empathizing, interacting, exploring God’s Word together, etc. with my friend.
However, since I have been asked, I’ll make an exception. Please assume that the following “monologue” is embedded within a relational “trialogue.”
I’ll work from David’s original scenario:
“Someone recently told me that he had finally and reluctantly decided to go to the doctor about his painful and debilitating depression and ask about going on meds. I knew this person had tried every other spiritual and commonsense remedy but was simply not getting better.”
Let’s assume that I know this person at least somewhat well, that he lives in another town, and let’s call him, “John.”
6 Words of Counsel for My Friend, John…
“John, I’m so sorry to hear that you’re suffering like this. You’ve addressed your struggles with depression very courageously in many different ways. I really applaud you for that. There’s so much more I’d like to hear about—what the depression has been like for you, more about the ways you’ve worked to address all of this, what hope would look like for you… And, since it sounds like you’ve been hesitant to visit a doctor and ask about medication, I’d like to hear more about that. But right now it seems like you would really like my perspective, so I’ll share a few preliminary thoughts, and then we can interact some more. How’s that sound?
First, John, I affirm your decision to go to a doctor to talk about your symptoms, your battle with depression, and the possibility of medication. God designed us as complex mind/body beings, and it makes great sense to consider possible physical causes or contributions to your ongoing struggles.
A second thought, John…when you visit your doctor, I’d encourage you to talk openly about your symptoms, discuss possible physical causes, ask about any appropriate medical tests, and interact about whether he thinks anti-depressant medication could be appropriate in your situation. I’d encourage you, perhaps even before you go, to do some research—it doesn’t have to take too long. Here’s a book you can have—Good Mood Bad Mood—by a Christian medical doctor, Charles Hodges. It’s an easy and helpful read and a very hope-giving book that will address many of the questions you said you’ve had about depression and medication.
Third, if your doctor recommends an anti-depressant, I would encourage you to ask about the particular prescription. Discuss the reasons he’s recommending that particular medication, along with any questions or concerns you might have about any potential side-effects. That way you can make an informed decision and you can be prepared if any side-effects do occur. I’d also encourage you to ask your doctor about what expectations you might have about the likely effectiveness of that particular anti-depressant in helping you with your depression. Good information and realistic expectations are vital. For example, if someone were diagnosed with a specific type of cancer, they would undoubtedly do their homework to learn more about the diagnosis, the best treatment options, the possible side-effects, the realistic benefits, etc.[i]
A fourth idea, John, is related to what you’ve shared with me about how you want to continue to approach your struggle with depression in a comprehensive way. In addition to seeing your doctor, I would encourage you to connect with an equipped, compassionate biblical counselor. Seek someone who is committed to comprehensive, Christ-centered, gospel-based, grace-focused, hope-filled biblical soul care. If you want, I could give you contact information for a couple of people in your area that could be very helpful (and they charge no fee). Whoever you see, don’t be afraid to ask them hard questions about their approach. I’d especially encourage you to make sure they take a comprehensive biblical approach where they understand and appreciate the complex mind/body issues you are dealing with. Perhaps your pastor or another person in your church has just such equipping—that would be wonderful. But even if you don’t see your pastor for ongoing, more intensive counseling, I would encourage you to open up to your pastor and bring him into your journey. There are many ways he and your church family can come alongside and help.
That’s a good bridge into a fifth idea, John. As you meet with this Jesus-focused counselor, I’d encourage you also to remain embedded in your local church. You’re hurting right now, and Christ does not want any of His children suffering alone… Of course, you need to be wise. We both know that not every person in every church is always the most compassionate or understanding. Seek out those people you know you can trust to respond well and wisely, supportively and lovingly. Ideally, if you’re in a small group and have established trusting relationships, or if your church has a group specifically focused on struggles with depression—those would be wonderful options. When Martin Luther’s ‘right-hand man,’ Philipp Melanchthon, was struggling with intense depression, Luther urged Melanchthon to resist the urge to isolate himself because isolation is the last thing we need when we are battling depression. I agree with Luther.
Sixth, and finally, I’d encourage you, John, to keep up your physical exercising and your spiritual exercising. I know that sometimes you will not feel like it, and I certainly don’t want to add any ‘guilt-inducing’ requirements. But try to follow through on basic matters like eating right, getting enough hours of sleep, exercising. I know these can all be battles when you’re facing depression, but to the extent that you are able, keep yourself physically active. And keep yourself spiritually active—reading your Bible, praying, and also journaling. Many people have found writing their own Psalms of Lament, modeled after Psalms 13 or 88, can be very helpful. But with all of this—keep it within reason. I’m not talking about hours of physical or spiritual workouts.
Well, John, I’ve said a lot. My prayer for you, my friend, is that you will find Jesus-care—care from Jesus, care from a Jesus-like counselor, and care in a Jesus-like church. Could I pray for you right now, John?”
The Rest of the Story
That’s about 900 words of counsel. It’s not perfect. But I think it captures some of what I’d want to share with someone struggling with depression and struggling with whether or not to consider medication.
Join the Conversation
So…what would your 750-to-1,000-word response sound like?
What would you say differently? What would you add? Subtract?
RPM Ministries: Equipping You to Change Lives with Christ’s Changeless Truth
[i]For those of you reading this post who have taken anti-depressants and experienced few side-effects along with improved moods, I truly thank the Lord. However, we must be careful not to extrapolate too much or too far from our individual experiences. Sadly, the research indicates (and many personal testimonies concur) that for a significant percentage of people the side-effects can be significant and the effectiveness of anti-depressants can be insignificant. I want to give hope—but not false hope. I want to encourage people to make an informed decision. That, to me, is compassionate.