January 27, 2012

Depression and serotonin

by Jesse Johnson

If you have been a pastor for longer than one week, you have probably counseled someone who was taking medication for depression. This presents a consummate pastoral dilemma because pastors want to bring the Bible to bear on all of life, and at the same time, we didn’t go to medical school.

There is the reality that the help God gives us in the world comes in the form of special revelation (his Word has given us all things pertaining to life and godliness) and general revelation (medicine can really help you when you’re sick). Depression seems to have one foot in both worlds, and so it can offend secular psychologists when pastors take people to the gospel to bring joy, and it can rankle pastors when a person says that they are taking medication to find a way to cope with life.

And let me admit right away that the only medical knowledge I have comes from Wikipedia, I cheated in high school biology (I was caught and repented at conversion), and know nothing about the inner workings of the brain.

So I defer to the professionals when it comes to medical issues, and if a doctor says someone has a chemical imbalance that medicine can correct, I am certainly in no position to quibble.

This is why a report I heard this week on NPR (hardly a bastion for biblical counselors) astounded me so much I had to pull over to focus on it. Correspondent Alix Spiegel went on a quest to find the medical evidence that depression can be caused by a chemical imbalance. I’d encourage you to listen to the piece in all nine minutes of its radio glory, but here is a summary.

Spiegel begins by relating what happened to her when she was 17; she was so depressed she felt like she had a black hole in her chest. He parents took her to Johns Hopkins Hospital, and she was told:

“The problem with you,” she explained, “is that you have a chemical imbalance. It’s biological, just like diabetes, but it’s in your brain. This chemical in your brain called serotonin is too, too low. There’s not enough of it, and that’s what’s causing the chemical imbalance. We need to give you medication to correct that.”

Then she handed my mother a prescription for Prozac.

 

As a pastor, I have heard similar stories countless times. To be clear, I never have (and never would) counsel someone to stop taking medicine that a doctor gives. As I said earlier, I defer to the professionals. But the million dollar question Spiegel is asking is this: “is depression caused by a chemical imbalance?” After all, if pastors are expected to defer to the medical world on this issue, then obviously the medical world has evidence that links depression to biological issues, right? Dr. Joseph Coyle (a professor neuroscience at Harvard and the editor of Archives of General Psychiatry) tells Spiegel: “Chemical imbalance is sort of last-century thinking. It’s much more complicated than that. It’s really an outmoded way of thinking.”

Spiegel then takes the listener on a tour through the history of Prozac. She explains why it is used to fight depression. Ostensibly, depression can be caused by low levels of a chemical called serotonin in the brain, and Prozac helps correct that. But Spiegel explains that this narrative—she calls it the “low serotonin story”—is propagated more for its simplicity than for its medical veracity.

Alan Frazer, chair of the pharmacology department at the University of Texas Health Science Center at San Antonio, candidly explains: “I don’t think there’s any convincing body of data that anybody has ever found that depression is associated to a significant extent with a loss of serotonin.”

Another researcher, Pedro Delgado (chair of the psychiatry department the University of Texas) adds that there have even been studies done that disprove the notion that depression is caused by low serotonin.

Spiegel’s piece concludes with some startling admissions. One after another, the experts grant that there is no real evidence linking depression to low serotonin. Amazingly, they justify the propagation of the “low serotonin story” simply because it is easy to understand. In other words, it doesn’t have to be true to be helpful. I’ll reprint a transcript of her conclusions:

So why are so many people still talking about low serotonin causing depression?

Frazer says it’s probably because it has had, and continues to have, important cultural uses. For one, he says, by initially framing the problem as a deficiency — something that needed to be returned to normal — patients felt more comfortable taking a drug.

“If there was this biological reason for them being depressed, some deficiency that the drug was correcting,” Frazer says, then taking a drug was OK. “They had a chemical imbalance and the drug was correcting that imbalance.” In fact, he says, the story enables many people to come out of the closet about being depressed, which he views as a good thing.

Still, there’s no question that the story also has downsides. Describing the problem exclusively in biological terms has convinced many people to take antidepressants when other therapies — like talk therapy — can work just as well.

One critic I talked to said the serotonin story distracted researchers from looking for other causes of depression. But Delgado agrees with Frazer and says the story has some benefits. He points out that years of research have demonstrated that uncertainty itself can be harmful to people — which is why, he says, clear, simple explanations are so very important.
“When you feel that you understand it, a lot of the stress levels dramatically are reduced,” he says. “So stress, hormones and a lot of biological factors change.”

Unfortunately, the real story is complicated and, in a way, not all that reassuring. Researchers don’t really know what causes depression. They’re making progress, but they don’t know. That’s the real story.

Jesse Johnson

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Jesse is the Teaching Pastor at Immanuel Bible Church in Springfield, VA.
  • Anonymous

    Im too depressed to comment and I don’t know why.
    Just kidding, very interesting post. I know it has long been an issue in “the church” whether or not to accept drugs as a remedy and the NPR program is quite interesting. I am definitely going to look it up.

    • http://thecripplegate.com Jesse Johnson

      If you wanted to read more about it, check out Ed Welsh’s Blame it on the Brain. There is also a secular book from 2002 which makes the same case: Blaming the Brain, The Truth about Drugs and Mental Health, written by Elliot Valenstein. You can get the firts 35 pages of that for free from Google Reader. Valenstein is a Psychology prof at The University of Michigan.

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  • Matt Waymeyer

    Fascinating article, Jesse. Equally astonishing is the fact that these doctors who so freely prescribe Prozac to correct low levels of serotonin don’t even test the serotonin level of their patients when examining them. In other words, they don’t confirm the chemicial imbalance that the medication is designed to correct. In fact, many times they prescribe Prozac with no physical exam whatsoever.

    Incidentally, I would disagree that with the idea that truths such as “medicine can help you” fall into the biblical category of general revelation. I would explain why, but ironically I’m running late for a doctor’s appointment!

    • Allen

      Matt, when you are back from your doctor’s appointment (in which I hope the medicine helps you :)), could you elaborate on your statement about medicine and general revelation? Thanks!

    • http://thecripplegate.com Jesse Johnson

      Matt,

      Feel free to explain your objection here in the comment thread. Or feel free to explain it in 400-1000 words, and we can make it its own post here. Just email it to me :)

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  • Richdpowell

    Drug companies love to see money flowing in. So why not create remedies that people think they need to cope with life. They’re the experts right? Think about it. Their future in making money depends on creativity. Dr. Bob Smith and Dr. John Street have have provided a greater biblical understanding and keen insights on this issue. I wonder how Elijah dealt with his depression since prozac wasn’t available during the difficult days of the divided kingdom. Truly this issue is a reflection of Jeremiah 17:5-6.

    • http://thecripplegate.com Jesse Johnson

      True, although I can equally picture the other side of the argument saying that Jeremiah and Elijah did not deal with their depression very well. Those two people did not go to their graves happy with life (well, I guess technically speaking Elijah didn’t go to his grave at all).

      I think you make a good point though: if the reason you take drugs is that the company selling the drugs says they help, you should probably get a doctor’s opinion. What astonished me about this piece is that the doctors were granting that the evidence is not there…

  • Anonymous

    Good post Jesse, thank you! I am eagerly waiting for Matt’s coming back. =)

    I think the answer of “how” to treat depression lies on the “what”. What is depression? There’s no definite answer for that.

    I’d like to mention, too, that I’ve seen how some people, uncaring Christian people, seem to have all the answers: they say it’s sin the person has and only repentance will heal them. I am reminded of the pentecostals, who see demons under every doily; people with depression find no godly love from them either.

    • http://thecripplegate.com Jesse Johnson

      Good point Elaine. And thanks for the balance. It is easy to say that depression is all biological, but that is probably not true. It is easy to say that there are no biological factors, and that too is probably overly simplistic.

  • Larry

    Dr. Thomas Szasz, author of “The Myth of Mental Illness” makes the same case…

    • http://thecripplegate.com Jesse Johnson

      Thanks for the video.

  • Jeffreyamoore

    Jesse,

    Perhaps, in the future I can send you a perspective not only on this issue, but the on the difficulties to be considered on the material/inmaterial realities of our humanity. I have been researching, reading, and thinking about this for the last 35 + years (the last 19 as a believer) with both past and more current research (some more conclusive and some not).
    I will defer it per the discussion per our time together yesterday, as I have other more immediate priorites. Thanks for your thoughts.

    Blessings,

    Jeffrey

    • http://thecripplegate.com Jesse Johnson

      Thanks Jeff. Email me anytime.

  • Matt Waymeyer

    I’m back from the doctor and yet still short on time, so here’s the short answer: I would define general revelation as the universal self-disclosure of God by which He makes Himself known to all people everywhere (Ps 19:1-6; Rom 1:18-23; 2:14-15; Acts 14:17). The problem with categorizing a truth such as “this medicine will make you better” as general revelation is that it is none of these things: it is not information that is made known universally to all people everywhere; it is not divine revelation, at least not properly defined (revelation is that which God reveals or makes known and which therefore carries divine authority, not that which man discovers by his own investigation and which therefore often possesses a degree tentativeness and uncertainty); and it is not the self-disclosure of God (it consists of information about the human body and physical health rather than information about God).

    Scripture presents general revelation as the act of God revealing truth about Himself. To summarize the content of this revelation, it consists of the existence of God (Rom 1:19-25), the glory of God (Ps 19:1a; Rom 1:19-23), the power of God (Ps 19:1b; Rom 1:20), the goodness of God (Acts 14:17), and the law of God (Rom 2:14-15). For this reason, when people refer to a particular math theorem or a biological discovery as general revelation, they have departed from a biblical understanding of this category both in terms of its content and in terms of it being divine revelation.

    As Robert Thomas writes: “Information and discoveries originating in secular fields do not belong in the category of God’s revealed truth. They therefore have no basis for a ranking alongside God’s special revelation. They may appear to be beneficial to one or another generation and thereby earn at least temporarily the designation of truth, but they must always be tentative because they lack the certitude and authority of God’s revealed truth” (Robert L. Thomas, “General Revelation and Biblical Hermeneutics.” The Master’s Seminary Journal 9/1 (1998): 14-15).

    For the longer answer, I would recommend the following resources, three of which have links provided:

    Bookman, Douglas. “The Scriptures and Biblical Counseling.” In Introduction to Biblical Counseling: A Basic Guide to the Principles and Practice of Counseling, eds. John F. MacArthur and Wayne A. Mack, 63-97. Dallas: Word Publishing, 1994.

    Thomas, Robert L. “General Revelation and Biblical Hermeneutics.” The Master’s Seminary Journal 9/1 (1998): 5-23; see: http://www.tms.edu/tmsj/tmsj9a.pdf.

    Matt Waymeyer, “Confident to Counsel.” 2001 Shepherds’ Conference Seminar Notes, Grace Community Church, Sun Valley, CA; see pages 6-9 of: http://audio.gracechurch.org/sc/2001notes/Confident%20to%20Counsel.PDF.

    Matt Waymeyer, “An Overview of General Revelation.” Expository Thoughts blog, February 7, 2009; see: http://expositorythoughts.wordpress.com/2009/02/07/an-overview-of-general-revelation/

    • http://thecripplegate.com Jesse Johnson

      So should I expect a CGate post on this?

      • Matt Waymeyer

        You just read it! :-) But seriously, if you look at the comparison chart in my Shepherds’ Conference notes (see link above), it pretty well summarizes my thinking on the issue. Bookman and Thomas are excellent resources as well.

    • http://mriccardi.blogspot.com Mike Riccardi

      Thanks Matt. That was extremely helpful.

      So would you say better categories than “special vs. general revelation” might be “special vs. common grace”?

      • Matt Waymeyer

        It’s hard to say. Part of the difficulty is that we’re dealing with extra-biblical terminology (at the least when it comes to the words “general” and “common”), so there needs to be some degree of flexibility in our dialogue. But at the same time, because the concepts of revelation and grace are clearly biblical, I’d be looking for a clear passage of Scripture which describes these kinds of helpful human discoveries as an expression of divine grace. (Notice how the verses I cited earlier as descriptions of general revelation do indeed use the language of divine revelation.) No passage immediately comes to mind, but I’d be open to considering some possibilities.

        • Scott Bashoor

          Perhaps we need to distinguish between 3 categories: special revelation, general revelation, and common grace. They overlap in some places, but are still distinct. Medical discoveries would be common grace.

          • http://thecripplegate.com Jesse Johnson

            I confess to not having thought of the distinction Matt makes. I like your proposal Scott. In my mind, I’ve always put common grace in the category of general revelation, as it shows us God’s nature. I deduce that from Matthew 5, reasoning from common grace of rain to God is love. I agree that science fits the category broadly of common grace, but I’m not sold on locking it out of general revelation yet either. My jury is still out.

  • Matt Waymeyer

    Back to the point of Jesse’s article, my wife and I were once counseling a young woman who was taking Prozac, and she told us very plainly: “Prozac doesn’t take away my sin—it just makes it easier to live with.” Interesting admission. In fact, the descriptions of Prozac and its effects often remind me of the wonder-drug “soma” in the classic 1932 novel “Brave New World” by Aldous Huxley. Listen to the description of soma by the character Mustapha Mond toward the end of the novel:

    “And if ever, by some unlucky chance, anything unpleasant should somehow happen, why, there’s always soma to give you a holiday from the facts. And there’s always soma to calm your anger, to reconcile you to your enemies, to make you patient and long-suffering. In the past you could only accomplish these things by making a great effort and after years of hard moral training. Now, you swallow two or three half-gramme tablets, and there you are. Anybody can be virtuous now. You can carry at least half your mortality about in a bottle. Christianity without tears—that’s what soma is.”

    I don’t intend to over-simplify a very complex issue—and for the record, I share Jesse’s view of never counseling someone to stop taking medication that was prescribed by a doctor—but the parallels are uncanny. And concerning.

  • Anonymous

    Thank you for bringing this to our attention Jesse. Many have been helped by reading Dr Martyn Lloyd Jones’ book, “Spiritual Depression: Its Causes and Cure”. As you know Lloyd Jones was a medical Dr, a theologian and a pastor – well qualified to write on the subject of spiritual depression specifically and on the broader subject of depression in general. If your readers contact us we will be able to email them a FREE copy of Lloyd Jones’ book, in pdf format – http://searchandtrace.wordpress.com

    • http://thecripplegate.com Jesse Johnson

      That’s a very gracious offer. Thanks!

  • http://thecripplegate.com Jesse Johnson

    Good balance Matt, and thanks for interacting here.

  • Anonymous

    Very interesting, thanks for the post. My wife and I are going to a Biblical Counseling conference in Indiana in February. She has been going to these sessions that train people in this for around a year or longer, and my sister-in-law is being trained as a biblical counselor as well there through Grace Community in California. It’s all very interesting. Recently I even had someone tell me that Biblical counseling was dangerous and that I was putting people’s lives in danger by being trained in it. At the same time, my wife has had a lot of success with her youth group girls by using the Bible and exposing lies that they are believing from the world they are so entangled in. The fact is that so many have literally NO interaction with Scripture unless it’s being quoted by someone that they are listening to.

    I definitely agree that this is a subject worth looking more into.

    Thanks!

  • Anonymous

    I also find it interesting that according to some of the “world’s deepest thinkers”, the placebo effect is one of the most elegant/beautiful theories over the last 2000 years. If you want to see them all, check them out here: http://www.edge.org/responses/what-is-your-favorite-deep-elegant-or-beautiful-explanation

    It does frustrate me that most theologians who take the book that contains all theology in it are not considered deep enough, but that’ll all be taken care of at a later date!

  • BG2

    As someone who went through the throes of postpartum depression and used medication to help combat it and eventually come out of it, this is an interesting topic to me. If someone has not dealt with depression themselves, my initial reaction is “You could not possibly know how unlike yourself you feel.” and to say that symptoms of depression do not always manifest as an attitude issue. I dealt with panic attacks occasionally even on mentally good days. I’m not saying that some depression is not caused by sin, but some of it is surely physical. Sin had some part, to be sure, such as worry and a lack of trust. But, at least for the type I experienced, the sleep deprivation and lack of emotional support after having a child contributed to it and made for something that repentance alone did not eliminate. Looking back on that time, I do believe that a better support system, more exercise, better nutrition AND more Biblical council could have taken the place of the medication. But when someone is in the depths of depression, it can be difficult to even think straight enough to realize that. The medication helped me get through that and begin to deal with the sins that were contributing to it. I know one person’s personal experience does not make a great debate point, but I have never been exposed to what was lacking in my church as when I went through it. Pastoral help for depression does and should not stop at the counseling chair. Too many treat it as an unrepentant sin issue, or as an issue that could be taken care of if the person simply “tried harder.” It is also a case where the larger church body should engage and try to lift up their brother. I had a Christian counselor and a counselor through my doctor’s office and both were very helpful. But unfortunately, apart from congratulations and flowers, after the birth of my child and subsequent depression everyone else in the congregation was absent and I felt alone. No offers of help, no offers of an ear to listen, no one even noticing when I missed church for several weeks. When one counselor advises you to do something you are already doing (Bible study, prayer, and repentance) and you go home to face the same panic and terror and the other counselor offers a pill that is widely accepted as an “ok” treatment and one that makes you feel more normal seemingly instantly, the choice becomes an easy one. If pastors want to have more of a role in combating the “easy out” choice (and I agree that it is), they need to go beyond the chair and try to create a congregation and a community that can function as a healing and/or preventative environment for Christians who are struggling.

    • Anonymous

      Amen to this statement of yours dear sister!

      “If pastors want to have more of a role in combating the “easy out” choice (and I agree that it is), they need to go beyond the chair and try to create a congregation and a community that can function as a healing and/or preventative environment for Christians who are struggling.”

      The church is, can be and should be a powerful force, as a community of God’s people, in helping the lonely and the afflicted. It sounds like you are well now (praise God). May you know His enabling grace as you begin to work with the leaders of your church, helping them to create this type of community, equipping many to be the kind of comforters of others that God wants all of us to be.

      2Co 1:3 Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies and God of all comfort,
      2Co 1:4 who comforts us in all our affliction, so that we may be able to comfort those who are in any affliction, with the comfort with which we ourselves are comforted by God.

      Make use of the offer we made (see my post earlier on in this string) regarding a free copy of “Spiritual Depression: It’s Causes and Cure”

    • http://thecripplegate.com Jesse Johnson

      Thanks for your comment. I tried to be really balanced here. I’m not bashing medication, and I hope my post didn’t imply that I’m pooh-poohing the issue. Like I said, and like your comment brings out, depression is something that often has one foot in both worlds.

      Which is precisely why this radio report astounded me so much. Because the low-serotonin story is so well accepted, I guess I had always simply assumed there was actual science behind it.

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  • avonchch

    There’s some weird comments and advice on here. Wait until depression or mental illness of one sort or anothewr strikes you.

    Depression causes a lot of imbalances and problems, the worst one I believe is the loss of friends who will love you through it no matter what. I know, I have suffered with depression for years and no one from the church visits me anymore. They didn’t much anyway.. I don’t bother going anymore. Thank God I have a wife (she still goes to church) who looks after me or I would be alone. Depression causes a lot of chemical imbalances because one doesn’t eat properly. One looses the ability to look after oneself as they should, could or even want to. I have great and grandiose ideas in the cool of the evenings but getting up in the morning they all come crashing down again. It is such an effort just getting out of bed. Serotonin, I don’t know if there is any left in me, sometimes it feels like it has all gone. Abiding and constant joy sure has gone, though I do have glimpse of that every now and then thank the LORD Jesus Christ and his Word. All the heretical, Scripture twisting, false teachings going on world wide makes me depressed, drives me nearly stark raving mad, insane, mentally sick, maybe that effects the serotonin levels? Is that why I am unhappy most of the time? I am blessed, but I am not happy as far as this world goes. I am/will be blessed as Matthew 5:1-12 teaches. Not in the way Robert Schuller or Rick Warren teach on those verses though*. Their teachings depress me terribly. How come they are allowed to get away with that? Anyways, I’m ok, I take my meds morning and evening and I am still able to read and write and surf the net at night.

    * Why the Human Will Cannot Overcome Sin

    • http://thecripplegate.com Jesse Johnson

      Well, thanks for surfing over here. What is the wierd advice you see here? If you are specific, I can reply to your comment.

      I did notice in your comment that you talk about depression causing chemical imbalances. I have often heard it the other way; that chemical imbalances cause depression. At least that is how the “low serotonin story” goes, according to Spiegel. Anyway, I wouldn’t be surprised if there is a little of both, or if there is no real objective scientific way to see the direction of the causal relationship. What do you think?

      • avonchch

        Jesse, my name is Douglas Johnson, you may be a long lost cousie or something? :~) I think we have a few there in the USA from eons ago? Not sure as my folks are dead so I can’t ask them. Ummm, I will re-read your post and the comments again, a bit slower and more carefully and let you know what I think. I won’t be back for a while as it is 1:20am here in Christchurch and I better get to bed. I need heaps of beauty sleep so as I don’t frighten people when I go out.

        I must say, some of the articles on here I have found very helpful and encouraging. Thanks.

    • Daniel L.

      I appreciate the pain of your case. I am sorry for your pain.

      For the sake of looking carefully at these issues, I do think it is important to point out that sin can cause all of the issues you described. I am not saying it is in your case at all. That’s not the point. My point is that it is impossible to say that all of your circumstance is certainly not sin and its effects.

      Other illnesses are different. Cancer, for example, is not caused by sin, but mutated cells. We know for certain that it is not directly sin. You can’t contract cancer through negative thinking or psychological trauma. All of the symptoms of depression could come from pride, selfishness, or unbelief. I’m basically making the same distinction MacArthur makes in the Charismatic Chaos series where he talks about organic diseases vs. (whatever he named the opposite that I can’t remember). Organic diseases are those such as being crippled or having a tumor. They are categorically different than lower-back pain or other so-called functional disorders.

      I honestly not trying to personalize it to you at all, I’m just saying that all of this complicates it all the more. Sin COULD cause the same effects.

  • http://www.reformedbygracebaptist.org/ Howard Brown

    Jesse, thank-you for such a helpful article and helpful links and resources. This is a frequently occurring and perplexing issue as a pastor over the years. I have seen dearly loved sheep perscribed drugs that have side effects like unreasonable suicidal urges, or, a common side effect of anti-depressants, depression and sleeplessness with attendant weight gain. One dear sister who had been in a car accident with a bad, bad bonk to the head looked at wife and I in tears and asked, “When will this black depression end?” We can point to the blessed hope, the rapture or being gathered to our loving Father, but a pastor’s heart longs that there could be a pill that really did fix a identifyable, measurable chemistry based imbalance.We have been assurred that there was one as we are told the low serotonin story. I, too, was disturbed by the practice of diagnosing deficient serotonin without any laboratory work. I wrestle with questions of what is “chemical?'; “is an of this chemical?” Thank-you for sound resources, guys! See you at conference.

    • http://thecripplegate.com Jesse Johnson

      Thanks for commenting Howard. I too have seen a myrad of cases where a person medicated for depression goes off the deep end. Of course, it is difficult/impossible to blame the medication or the depression. After all, people do weird things, and just as it is not correct to blame the brain, it is probably equally strange to blame the drugs. Also, I’m sure most of us know people who have been helped by medication through these issues as well. Which is exactly why this is such a difficult topic.
      See you in March,

      Jesse

  • Reader

    Thank you for posting this. I look forward to exploring some of the additional resources provided in the comments. I work in the pharmaceutical industry (a struggle in itself many days for a Christian!) and a couple of months ago was assigned to begin work on a trial for depression. As a Christian, I struggle daily with my role in developing yet another drug for this condition, especially when I see how subjective the efficacy analyses seem to be.

    • http://thecripplegate.com Jesse Johnson

      I’d encourage you to talk to your pastor, and ask him for counsel. At the very least, follow John’s advice to another person distressed about his job: be honest, work hard, and be content with your wages.

  • http://holidaylonging.com/ Holiday Longing

    As one who has been on antidepressants off and on – and who’s mother and sister also suffered with depression and used medication to treat – I can say that there’s undeniably a chemical or brain issue for us. The medicines work too well. Whether it’s serotonin or a problem with the amygdala (Prozac works there in the short term), there’s something going on in the body. I don’t disagree that there are many other causes of depression. Those need to be addressed. And I do my best to stay off the pills cause I don’t like the side effects. But it’s not all in my head – it’s in my head!

  • http://holidaylonging.com/ Holiday Longing

    I agree with that young woman’s statement. Prozac does not eradicate sin, it just tops it off! I feel angry rather than acting out in some way like yelling (maybe that’s the effect it has on the amygdala). Most of the time this is controllable, but there are times where it happens so fast that I’d rather be aware of sinful anger and deal with it privately than to hurt others around me. Frankly, I can deal with the depression and/or anger when I am by myself, but I don’t like to hurt others when a pill can help.

    I also had a friend who had never experienced depression, til she went on drugs to fight endometriosis. When she explained how black the world became, I told her, “Welcome to the land of the depressed.” I told her that she just needed to remember that the blackness isn’t reality, it’s a lens through which she sees reality and she needs to do her best to ignore it. But sometimes pills help us ignore it better.

    If you have never experienced this, it’s easy to say don’t use pills. And I am confident God can use depression to mature us spiritually. But I bet David Brainerd would have used the drugs if they existed in his time…

  • Matt Waymeyer

    The primary reason I object to classifying the findings of science or psychology as general revelation is because they simply do not fit the category of general revelation as set forth in Scripture (see my comments above, as well as the resources listed there). But there is also a practical reason why this issue is so significant.

    Historically, a misunderstanding of general revelation has provided fuel for one of the main arguments for integrating Scripture and psychology in Christian counseling (in contrast to using Scripture alone). The integrationist argument goes something like this: Because God has made Himself known through two channels–special revelation (the propositional truth recorded in Scripture) and general revelation (the non-propositional truth deposited by God in the created order of things)–man has a mandate from his Creator to investigate and discover truths through means such as psychological research, the findings of which should be accepted as having their origin in God. Scripture alone, then, is not sufficient, but rather, as John H. Coe states, “Only when all forms of revelation are taken together can we speak of the sufficiency of revelation” (“Revelation Above and Below the Sun,” Tabletalk, 18/2 [February 1994]: 8). Therefore, all truth is God’s truth and should be embraced as such whether it be found in Scripture (special revelation) or in psychological research (general revelation).

    This basic argument is reflected in the words of the following integrationists:

     Larry Crabb: “All truth is certainly God’s truth. The doctrine of general revelation provides warrant for going beyond the propositional revelation of Scripture into the secular world of scientific study expecting to find true and useable concepts” (Effective Biblical Counseling, 36).

     Bruce Narramore: “The evangelical church has a great opportunity to combine the special revelation of God’s Word with the general revelation studied by the psychological sciences and professions. The end result of this integration can be a broader (and deeper) view of human life” (“Perspectives on Integration,” 17).

     Gary Collins (explaining how he would counsel someone struggling with depression, anxiety, frustration, and loneliness): “My knowledge of special revelation—the Bible—would have been combined with my knowledge of general revelation—what God has taught me about his world through my study of psychology, physiology, counseling, rehabilitation, and other fields” (“An Integration View,” 117).

     Eric L. Johnson: “Non-Christian bias has influenced the content and practice of modern psychology, but it is also the case that God has revealed so much about the brain, learning, human development, motivation, social influences, forms of abnormality, and even helpful counseling practices through the labors of secular psychologists” (“Lord of Psychology,” 24).

     Stanton L. Jones and Richard E. Butman: “Just as the rain falls on the just and the unjust, so too does truth, by the process that theologians call God’s common grace. Romans 1 speaks of God even revealing central truths about his nature to unbelievers (v. 19)….If we understand God’s counsel to be truth, we will be committed to pursuing truth wherever we find it. And we sometimes find it in the careful and insightful writings of unbelievers” (Modern Psychotherapies, 27-28).

    And why is this view such a problem? As Douglas Bookman writes: “To assign human discoveries to the category of general revelation is to lend God’s name to a person’s ideas.” Thus, when the discoveries of man are categorized as revelation from God, they are by definition true and authoritative and therefore must not be questioned, but rather believed and obeyed. The end result is that the findings of psychological research (and other secular fields of study) not only possess a falsely perceived validity but also lack any genuine accountability, for to question them is to question the very revelation of God (paraphrase of Bookman, “The Scriptures and Biblical Counseling,” 74). Incidentally, the same could be said of scientists who see nature as the 67th book of the Bible and therefore embrace a form of theistic evolution as truth that came to us through general revelation.

    Just to be clear, I know that Jesse fully affirms the sufficiency of Scripture for counseling, and nothing he wrote in the original article implies otherwise. It may also be helpful to know that Jesse and I are friends and we are in complete agreement regarding the main point of his original article. I just happened to get us sidetracked by making a side comment that probably should have been sent to him in a personal email. At the same time, I do think it’s important that we wrestle with the question of what exactly constitutes general revelation because of the implications it has in some very critical areas.

  • none

    Depressed people LOVE it when someone tells them they just need to read the Bible more and pray more. That doesn’t help, neither did the Prozac when I tried it in college.

    By the way, what’s with the typewriter in the stock photo? I think they could have found a more modern picture of someone depressed.

    • http://thecripplegate.com Jesse Johnson

      Send me a better pic, and I’ll put it up.

  • Normand Lavoie

    Please check out Dr. Peter Breggin’s website at breggin.com for comprehensive documentation on the dangerous use of anti-depressants. He is a well-known authority on the misuse of psychotropic drugs.