Faith and mental illness

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By Michael Horton

According to a 2013 survey by LifeWay Research, one-third of Americans agree that “prayer and Bible study alone can overcome serious mental illness.” Nearly half (48 percent) of evangelicals agree. (1)

Why on earth would Modern Reformation imagine that it had something important to say, from a distinctly Reformation perspective, on mental illness? That was a big question we discussed in our editorial meeting. By the end, though, after sharing our own experiences, the answer became clear. To the extent that evangelical attitudes reflect theological imbalances—and even errors—we think we have something indeed to contribute.

Like their neighbors, Christians acknowledge that people suffering from cancer, AIDS, migraines, or cerebral palsy are still responsible for their actions. Their suffering does not entitle them to hatred, self-loathing, or the mistreatment of others. And yet, we allow room. With even a modicum of sympathy, we recognize they are miserable in ways that are not just limited to their physical distress. First, we want to relieve their immediate pain and, as much as possible, the effects of their disease; we seek every possible medical treatment for them. If a brother or sister has cancer, diabetes, or a stroke, we pray that God will give the doctors and nurses wisdom and skill to relieve their suffering. We realize there is an important place for caring for their bodies and souls, for their medical needs—which are beyond the church’s competence—and for their relationship with God.

And yet, when it comes to mental illness, we still don’t really believe that it is a medical problem. Many of us were raised in an era when “it’s all in your head” meant that mental illnesses weren’t real—at least not as real as a broken arm. This tendency reflects not only a lack of appreciation for the rapid growth in medical diagnosis and treatment of such disorders, but a cluster of theological misunderstandings. So here are a few introductory theses to consider.

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Is it ethical for a Christian to treat depression with anti-depressants?

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Christians suffer in this life, not only because they live in a fallen world, but also because of their cross-bearing identity with Jesus Christ. Depression is one way that disciples of Christ suffer. With the advancement of medical technology, there is an ever-increasing range of psychotropic drugs available for treating the symptoms of depression. Arguably the most advanced are the selective serotonin reuptake inhibitors (SSRIs), of which Prozac is the most well known (and will be used as representative of this class of drug for the purposes of this essay). Since its release in 1986, Prozac has become the “most widely prescribed antidepressant in medical history.”  It has been known to elevate mood and even make some feel more than well. The medical community has been divided over biochemical changes in the brain relative to depression and Prozac. These facts have led many to raise concerns over whether laws, knowledge, and ethical practices are lagging behind in this new medical technology.

Is it ethical for a Christian to take Prozac for depression? In this essay I argue that, in specific circumstances, it is appropriate to incorporate Prozac into a holistic approach to treating depression, provided that sacred means inform the secular. In navigating the ethical path that advocates a cautious use of antidepressants in treating depression, this essay is divided into four parts. In the first place, depression is contextualized in light of the Fall. Secondly, the Christian is called to and benefits from a life of suffering. Thirdly, the Christian must guard against the therapeutic narcissism of our age. Finally, it is argued that godly wisdom for restoration can draw upon both sacred and secular means.

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