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Archive for the ‘Psych Medications’ Category

Psychiatric Meds: Should I or Not?

SOURCE:  Brad Hambrick/CareLeader

“Pastor, should I take psychiatric meds?”

Let’s begin this discussion by placing the question in the correct category—whether an individual chooses to use psychotropic medication in his struggle with mental illness is a wisdom decision, not a moral decision. If someone is thinking, “Would it be bad for me to consider medication? Is it a sign of weak faith? Am I taking a shortcut in my walk with God?” then he is asking important questions (the potential use of medication) but placing them in the wrong category (morality instead of wisdom).

 Better questions would be:
  • How do I determine if medication would be a good fit for me and my struggle?
  • What types of relief should I expect medication to provide, and what responsibilities would I still bear?
  • How would I determine if the relief I’m receiving warrants the side effects I may experience?
  • How do I determine the initial length of time I should be on medication?

In order to answer these kinds of questions, I would recommend a six-step process. This process will, in most cases, take six months or more to complete. But it often takes many months for doctors and patients to arrive at the most effective medication option, so this process does not elongate the normal duration of finding satisfactory medical treatment.

Having an intentional process is much more effective than making reactionary choices when the emotional pain (getting on medication) or unpleasant side effects (getting off medication) push a person to “just want to do something different.” With a process in place, it is much more likely that what is done will provide the necessary information to make important decisions about the continuation or cessation of medication.

Preface: This six-step process assumes that the individual considering medication is not a threat to self or others, and is capable of fulfilling basic life responsibilities related to personal care, family, school, and work. If this is not the case, then a more prompt medical intervention or residential care would be warranted.

If you are unsure how well your church member is functioning, then encourage him to begin with a medical consultation or counseling relationship. If he would like more time with his doctor than a diagnostic and prescription visit, suggest that he ask the receptionist if he can schedule an extended time with the physician for consultation on his symptoms and options.

Step 1: Assess life and struggle

Most struggles known as mental illness do not have a body-fluid test (i.e., blood, saliva, or urine) to verify their presence. We do not know a “normal range” for neurotransmitters like we do for cholesterol. The activity of the brain is too dynamic to make this kind of simple number test easy to obtain. Gaining neurological fluid samples would be highly intrusive and more traumatic than the information would be beneficial. Brain scans are not currently cost-effective for this kind of medical screening and cannot yet give us the neurotransmitter differentiation we would need.

For these reasons, the diagnosis for whether a mental illness has a biological cause is currently a diagnosis-by-elimination in most cases. However, an important part of your church member’s initial assessment should be a visit to his primary care physician. Encourage your church member to:

  • Clearly describe the struggles/symptoms he is experiencing.
  • Describe when each struggle/symptom began.
  • Describe the current severity of each struggle/symptom and how it developed.

As the person prepares for this medical visit, it would be important for him to also consider:

  • What important life events, transitions, or stressors occurred around the time his struggle began?
  • What is the level of life-interference he is experiencing as a result of his struggle?
  • What lifestyle or relational changes would significantly impact the struggle that he’s facing?

Step 2: Make needed nonmedical changes

Medication will never make us healthier than our current choices allow. Our lifestyle is the “ceiling” for our mental health; we will never be sustainably happier than our beliefs and choices allow. Medication can correct some biological causes and diminish the impact of environmental causes to our struggles. But medication cannot raise one’s mental health potential above what that person’s lifestyle allows.

Too often people want medication to make over their unhealthy life choices in the same way they expect a multivitamin to transform an unhealthy diet. They assume that the first step toward feeling better is receiving a diagnosis and prescription. This may be the case, and there is no shame if it is, but it need not be the guiding assumption.

Encourage your church member to look at the lifestyle, beliefs, and relational changes that his assessment in step 1 would require. If there are choices he could make to reduce the intensity of his struggle, is he willing to make them? Undoubtedly these changes will be hard, or he would have already done so. But let him know that they are essential if he wants to use medication wisely.

As your church member identifies these changes, he should assess the areas of sleep, diet, and exercise. Sleep is vital to the replenishing of the brain. Diet is the beginning of brain chemistry—our body can create neurotransmitters only from the nutrition we provide it. Exercise, particularly cardiovascular, has many benefits for countering the biological stress response (a primary contributor to poor mental health). The first “prescription” should be eight hours of sleep, a balanced diet high in antioxidants, and cardiovascular exercise for at least thirty minutes three days a week.

A key indicator of whether your church member is using psychotropic medication wisely is whether he is using medication (a) as a tool to assist him in making needed lifestyle and relational changes, or (b) as an alternative to having to make these changes. Option A is wise. Option B results in overmedication or feeling like “medication didn’t work either” as he continually tries to compensate medically for the volitional neglect of his mental health.

Step 3: Determine the nonmedicated baseline for mood and life functioning

This is an important, and often neglected, step. Any medication is going to have side effects. The most frequent reason people stop taking psychotropic medications, other than cost, is because of their side effects.

If your church member is not careful, he will merely want to feel better than he does “now.” Initially “now” will be how he feels without medication. Later “now” will be how he feels with medication’s side effects. In order to avoid this unending cycle, there needs to be a baseline of how he feels when he lives optimally off of medication.

One of the reasons postulated for why placebos often have as beneficial an effect as psychotropic medication is the absence of side effects. Those who take a placebo get all the benefits of hope (doing something they expect to improve their life) without any unpleasant side effects. Getting the baseline measurement of how life goes when one simply practices “good mental hygiene” is an important way to account for this effect.

“As I practice medicine these days, my first question when a patient comes with a new problem is not what new disease he has. Now I wonder what side effects he is having and which drug is causing it,” says Charles D. Hodges, MD, in his book Good Mood Bad Mood.

There is another often overlooked benefit of step 3. Frequently people get serious about living more healthily at the same time life has gotten hard enough to begin taking medication. This introduces two interventions (medication and new life practices), maybe three or four (often people also begin counseling or being more open with friends who offer care and support), at the same time. It becomes very difficult to discern which intervention accounts for their improvements.

Writing out his answers to the following questions will help your church member discern if he needs to move on to step 4 and make the needed assessment in step 5.

  • What were the struggles that initially made me think I might benefit from medication?
  • How intense were these struggles, and how did they manifest themselves?
  • What changes did I make in my lifestyle and relationships to alleviate these struggles?
  • How effective was I at being able to make the needed changes?
  • How much relief did the lifestyle and relational changes provide for my struggles?
  • How do I anticipate medication would assist me in being more effective at these changes?

Step 4: Begin a medication trial

If your church member’s struggles persist to a degree that is impairing his day-to-day functioning, then you should encourage him to seek out a psychiatrist or other physician for advisement about medical options. In this conversation, he should consider asking the physician the following questions:

  • What are the different medication options available for the struggle I’m facing?
  • What does each medication do that impacts this struggle?
  • What are the most common side effects for each medication?
  • How long does it take this medication before it is in full effect?
  • If I choose to come off this medication, what is the process for doing so?
  • What have been the most common affirmations and complaints of other patients on this medication?

These questions should help him work with his doctor to determine which medication would be best for him. Remind your church member that he has a voice in this process and should seek to be an informed consumer with his medical treatment, in the same way he would for any other product or service.

In this consultation your church member will also want to decide upon the initial period of time to remain on the medication (unless he experiences a significant side effect from it). In determining this length of time, he would want to consider:

  • His physician or psychiatrist will make recommendations based upon additional factors (beyond the scope of this article)
  • Staying on the medication a minimum of at least twice the length of time it takes to reach its full effect
  • Significant life stressors that would predictably arise during this trial period (e.g., planning a wedding)
  • How long it would take to make and solidify changes that were difficult to make without medication (see step 3)

Once this set period of time is determined, your church member’s goal is to continue implementing the changes he began in step 3 while monitoring (a) the level of progress in his area of struggle and (b) any side effects from the medication.

Step 5: Assess level of progress against medication side effects

Near the end of the trial period, your church member should return to the life assessment questions he answered at the end of step 3. He should compare his ability to enjoy and engage life at this point with his answers then. The questions to ask are:

  • What benefits have I seen while on medication?
  • What side effects have I experienced?
  • Is there reason to believe my continued improvement is contingent upon my continued use of medication?
  • Are the side effects of medication worth the benefit it provides?

The more specific he was in his answers at the end of step 3, the easier it will be for him to evaluate his experience at the end of step 5. At this point, encourage him to try to be neither pro-medication nor anti-medication. His goal is to live as full and enjoyable a life as possible. It is neither better nor worse if medication is part of that optimal life.

Step 6: Determine whether to remain on medication

At this point in the process there are several options available to the individual; this is more than a yes/no decision. But any option should be decided in consultation with the prescribing physician or psychiatrist. Your church member can decide to:

  • Remain on medication because the effects are beneficial and the side effects are minimal or worth it.
  • Opt to stage off the medication because the benefits were minimal or the side effects were worse than the benefits.
  • Stage off the medication to see if the progress he made can be maintained without medication, knowing that if not, he is free to resume the medication without any sense of failure.
  • Opt to try a different medication for another set period of time based on what he learned from the initial experience.

Regardless of what he chooses, by following this process he can have the assurance that he is making an informed decision about what is the best choice for him.

Prescription Drug Abuse Among Older Adults May Be Difficult To Detect

SOURCE:  Adapted from an article by Joy Mali/Lifehack

Prescription drug abuse may not be as noticeable as other forms of substance abuse, but it still has very dangerous consequences. Even though a doctor may have prescribed a drug, it is still a chemical substance that can cause mental, physical, and emotional issues if incorrect or more frequent doses are taken.

Addiction does happen among seniors, and it is often undetected because caregivers and loved ones do not know the signs of prescription drug abuse among this age group.

What are the most commonly abused drugs?

Senior drug abuse typically falls into a few categories of medication that are frequently prescribed to seniors for various health conditions. Opioids are the most commonly abused type of prescription drug, and oxycodone, Vicodin, morphine, Percocet, and fentanyl are all addictive. Opioids are prescribed for seniors who are dealing with pain from surgery, arthritis, or other conditions.

Another common type of abused drug are stimulants, such as Ritalin or Adderall. Older adults are prescribed stimulants for narcolepsy and other disorders. Other frequently abused prescription drugs are benzodiazepines, such as Valium, Xanax, and Klonopin. Benzodiazepines are regularly prescribed for conditions such as anxiety and insomnia, yet they can be extremely habit forming.

What are the dangers of prescription drug abuse?

Drug abuse is particularly harmful to seniors because of their fragile health. Often, a medicine that is supposed to cure a minor health issue can eventually be abused, causing a potentially fatal health problem. The number of opioid-related deaths among seniors has increased sharply in the last ten years because it is easy to accidentally overdose on this type of medication. If a senior becomes dependent on benzodiazepines, they may have seizures once they stop taking the medication. Other forms of drug abuse can cause heart problems, organ failure and strokes.

How is senior drug dependency detected?

One of the main issues with the prescription drug abuse epidemic among seniors is that older adults do not show typical signs of drug dependency. If any behavior changes are observed, do not assume that they are merely caused by older age. It is important to seek medical help if an elderly loved one exhibits the following signs:

  • Trouble walking or poor balance
  • Repeatedly losing or misplacing medication
  • Demanding narcotic prescriptions for minor health problems
  • Sudden lack of hygiene and poor personal appearance
  • Seeming sleepy and disoriented
  • Poor vision with inability to read prescription instructions
  • Sudden weight loss and lack of appetite
  • Drastic personality alterations or extreme mood swings
  • No longer interested in socialization

Should seniors attend a treatment center?

Older people can become addicted to prescription medication just like anyone else and should receive treatment just like anyone else. Modern medical care makes it possible for seniors to live happy and healthy lives. It is therefore imperative for an older person to get the help they need to recover. At a prescription drug treatment center, they can receive assistance detoxing from the drug and learn how to cope with addiction. If medication is still required for a medical condition, a person can talk to their doctor about other, less addictive options.

Wrapping Up:

With more research illustrating the prevalence of substance abuse among senior citizens and the effectiveness of targeted treatment options, there is hope for families of aging loved ones concerned for their elderly loved one’s health and safety. Caregivers should be aware of the risk factors and potential warning signs to address suspected substance abuse as soon as it’s recognized so that treatment interventions can be discussed with clinicians as soon as possible.

Chemical Imbalances & Depression: A Theory Falls victim to New Research

SOURCE: Charles D. Hodges, Jr., M.D.

There is interesting news in the field of medical research for depression. [i]I am always grateful when medical researchers take another look at a significant problem in life when the current answers don’t seem to work well. This is so true of depression. People do struggle with real sadness today and the answers that medicine offers are just not working as well as hoped.

Research in the past decade has told us that the most popular medicines we have for depression do not work very well for up to 80% of the people who take them.[ii] There is a growing sense that the diagnosis of depression is made too often. It is also a concern that normal sadness over loss is being confused with the disease depression.[iii]

Today, most all of us know or have heard about chemical imbalances and how they are supposed to cause depression. Most of us have heard about serotonin and how a low level of it in our brains can cause us to be depressed. We have seen the commercials on television for medications that are supposed to correct the deficit. But, new research would indicate that the chemical serotonin may have little or nothing to do with depression at all.

Researchers at the Wayne State University School of Medicine noticed that 60 to 70 percent of patients who take the serotonin reuptake inhibitor antidepressants will still feel depressed. And so they devised a research project that would look again at the role serotonin and chemical imbalances play in depression. What they found indicated that serotonin may not be a major factor in depression.[iv]

Keep mind that the study was done on mice. They were found to have a gene that resulted in them making very little serotonin in their brains.  And no you do not need to remind me that we are men and not mice. J But, these mice with little brain serotonin did not display a depression-like behavior pattern under normal circumstances. When they were subjected to the same kinds of situations that caused behavior that looked like depression in animals, these mice responded just like normal mice that had normal levels of serotonin. Most of the genetically serotonin deficient mice did not respond to the SSRI antidepressants in the same way normal mice did with changes in their “depression-like” behavior.  

The conclusions from the study were that it is likely that serotonin may not be a large factor in depression. In essence the chemical imbalance/ serotonin deficiency theory of depression is most likely wrong. While this is not great news for those who are invested heavily in the production and sale of the current crop of antidepressants, it is good news for patients.  

The reason it is great news is the last line in the article. “These results could dramatically alter how the search for new antidepressants moves forward in the future, the researchers conclude.” In other words, science is moving on to look for a better way to explain why some struggle with sadness. The outcome could be a better understanding of the cause at the brain cell level of the disordered sadness part of depression today.

This could result in laboratory testing and brain scanning that would allow us to make a better diagnosis. And, that could lead to more effective treatment. This study opens the door for researchers to resume looking for a real explanation for the disordered sadness of depression.

When we understand the change in the human brain or body that causes depression two things could happen. The diagnosis of depression will become far more accurate reducing the numbers of people over-diagnosed.  And, a better treatment could be found for those who suffer with severe, disordered sadness.  

For the 90% of patients today with normal sadness over loss, accurate testing could help them avoid from being treated with medicine intended for the treatment of disease. Having a test that says the patient does not have depression would help doctors encourage patients to seek care that fit their problem such as counseling. And that is where Biblical counseling can offer great hope.

 

[i] American Chemical Society. “Serotonin deficiency? Study throws into question long-held belief about depression.” ScienceDaily. ScienceDaily, 27 August 2014. .

[ii]Charles Hodges M.D., Good Mood Bad Mood.  Shepherd Press, Wapwallopen, PA. p48-49.

 [iii]Ibid, p68-69.  

 [iv] Mariana Angoa-Pérez, Michael J. Kane, Denise I. Briggs, Nieves Herrera-Mundo, Catherine E. Sykes, Dina M. Francescutti, Donald M. Kuhn. Mice Genetically Depleted of Brain Serotonin Do Not Display a Depression-like Behavioral Phenotype. ACS Chemical Neuroscience, 2014; 140812102725008 DOI: 10.1021/cn500096g

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Dr. Hodges is a family physician who practices medicine in Indianapolis, Indiana. He is a graduate of the Indiana University School of Medicine, board certified in Family Medicine and Geriatrics, and is a licensed marital family therapist.

Mental Illness and the Church’s Mission

SOURCE:  Rick Warren/American Association of Christian Counselors (AACC)

“Your illness is not your identity,” Pastor Rick Warren shared this week. “Your chemistry is not your character. It’s not a sin to be sick.”

Returning to the pulpit for the first time since his son Matthew’s tragic suicide in April, Warren broke away from his notes to talk frankly about his grief and the challenge of living with his son’s mental illness.

According to USA Today, “Matthew Warren, after a lifetime of struggle with depression, shot and killed himself in what Warren at the time called ‘a momentary wave of despair.’ ”

“I was in shock for at least a month after Matthew took his life,” Warren said. In a world where many Christians often feel the pressure to “put on a happy face,” Pastor Warren’s honesty is refreshing.

“For 27 years I prayed every day of my life for God to heal my son’s mental illness,” Warren said. “It was the number one prayer of my life…And it didn’t make sense.”

As Christian counselors, we must remember the daily challenges facing family members of an individual who struggles with depression, addiction, an eating disorder, or other mental health concerns.

“How proud I was of Amy and Josh, who for 27 years loved their younger brother,” Warren said. “They talked him off the ledge time after time. They are really my heroes.”

As churches and communities we need to rally around and provide support, care and a listening ear to those who live with the daily reality of mental illness, reminding them, as Warren said, that their illness is not their identity.

“It’s not a sin to take meds. It’s not a sin to get help. You don’t need to be ashamed.” This message needs to reverberate through churches all across our nation, where misunderstandings about mental illness and false theology that “faith is enough” often results in unnecessary suffering.

In Troubled Minds: Mental Illness and the Church’s MissionAmy Simpson points out, “Mental illness is the sort of thing we don’t like to talk about. Too often, we reduce people with mental illness to caricatures and ghosts, and simply pretend they don’t exist.”

“They do exist, however. Statistics suggest that one in every four people suffers from some kind of mental illness—from depression to schizophrenia and beyond.

Many of these people, and the family and friends who love them, are sitting in churches week after week, suffering in stigmatized silence.”

Simpson reminds us that people with mental illness are our neighbors—our brothers and sisters in Christ. We are called to love them and care for them.

What can churches do to help advocate on behalf of mental illness? Simpson offers several starting points:

  • Get help if you’re struggling. Break the silence by telling your story.
  • Get educated about the issues—read, learn and seek to truly understand.
  • Talk about mental illness and address common stigmas—in the pulpit, small groups, etc.
  • Build genuine relationships—don’t just help as a “project.”
  • Ask families living with mental illness how you can help with practical needs.
  • Accept people unconditionally—look past their diagnosis and see the real person God created and loves.
  • Start support groups for families living with mental illness.
  • Collaborate with local mental health professionals.

“There are people with mental illnesses in every church, whether this is known or not,” one church leader writes. “Jesus came to love and serve everyone. He feared no one. All churches can learn to serve the Lord better in caring for His people.”

In the midst of unspeakable grief, Pastor Warren shared, “God wants to take your greatest sorrow and turn it into your life’s greatest message.”

How does God want to use you to help those struggling with mental illness and their families?

Christian counseling is far more than a career…it’s a calling to minister and offer hope to those who need it most.

Discerning Depression (and Medication)

SOURCE:  Based on an article by  SUSAN PALWICK

Anyone who works with psychiatric patients will tell you how difficult it can be to get them to take their medication. No one with a chronic illness, whether bipolar disorder or high blood pressure, likes taking pills every day; everyone with chronic illness, whether diabetes or depression, sometimes slides into imperfect self-care. We’re people, not machines. We don’t like doing the same thing all the time, and we don’t always function at the highest level.

There’s a popular belief that creative people are more prone to mental illness, or that mentally ill people are more prone to creativity, than the general population. This is a dangerous attitude on several levels: it romanticizes mental illness, portrays creativity as dangerous, and denies the creativity present in everyone. But like most myths, this one contains a kernel of truth. Kay Redfield Jamison, a clinical psychologist and expert on bipolar illness who suffers from the disorder herself, observes in her book Touched by Fire that bipolar tendencies and extreme creativity tend to run in families. Distinguished poet Anne Sexton, who according to her close friend Maxine Kumin heard the trees talking to her every June, found herself unable to write on any of the medication she was given to quiet those voices.

I may have bipolar tendencies. As I’ve written here before, I’ve had depression for most of my life. I’m a writer. And my relationship to medication is ambivalent, at best.

I’ve been on antidepressants for two extended periods. I took them for four years starting near the end of graduate school, and then, after a hiatus of eight years, began taking them again about four years ago. Let me emphasize that I’ve never been suicidal, hospitalized, or completely unable to function: at my worst, I’ve merely been riddled with self-loathing, wracked by daily or hourly crying jags, and unable to imagine a tolerable future. The meds largely remove those handicaps. They make me more resilient to stress, more graceful in social situations – including the teaching by which I earn my living – and generally happier and more optimistic.

They also deaden my writing, which loses the spark and verve it has when I’m off meds.

My husband has also noticed this, so I don’t think it’s my imagination. My psychiatrist believes that I have to be on meds for the rest of my life. But writing’s a huge part of my life and my career, and also my deepest and truest joy. Not being able to do it as well as I can when I’m not on antidepressants (and yes, I’ve tried a variety of meds) makes me, well, depressed.

The situation challenges my spirituality. God gave me the gift of writing, as well as the particular brain chemistry that predisposes me to depression. My depression is as much blessing as curse, if only because it’s given me more compassion for others with mental illnesses. I believe that God wants me to write as well as I can. I also believe that God wants me to be as happy as I can. How, then, am I to respond to the fact that the two seem incompatible?

The easiest answer would seem to be that I should learn to be happy without meds, as I’ve done with some success for the all-but-eight years I haven’t been on them. Those hard-won joys, though, have come at the cost of a social isolation I’m not quite willing to endure again, at least not right now. People seem more comfortable with me when I’m on meds.

This isn’t a problem I can solve quickly or easily, and having it makes me very sympathetic to people who won’t take their medication. I do take mine, although I pray daily about whether I should keep doing so. My current plan is to try to go off it again in a year or two. I’ve recently lowered my dosage, with my psychiatrist’s blessing. I’m writing a little better now, but I’m also a little less comfortable in my own skin. I doubt that God wants me to be a creature of halves and compromises. For now, I take each step as it comes, trying to discern God’s will and my own health, trying to see the path ahead.

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A practicing Episcopalian, Susan Palwick volunteers as an ER Chaplain at a hospital in northern Nevada. She currently teaches as an Associate Professor of English at the University of Nevada, Reno, and is also a Clinical Associate Professor of Medical Education at the University of Nevada School of Medicine, where she specializes in Narrative Medicine.

Should Christians Use Medication For Emotional Problems?

SOURCE:  Dr. Robert Kellemen

In the beginning, God designed us as body-soul beings. “The LORD God formed the man from the dust of the ground and breathed into his nostrils the breath of life, and the man became a living being” (Genesis 2:7). Even before the fall, we were more than inner person—we were and are embodied beings.

Our bodies are works of art fashioned by our heavenly Father who fearfully and wonderfully handcrafted us (Psalm 139:13-16). We are works of God’s hand; made, shaped, molded, clothed with skin and flesh, and knit together with bones and sinews (Job 10:3-12). We are not to despise our physicality.

After the fall, the Bible teaches that we inhabit fallen bodies in a fallen world (Romans 8:18-25). Paul calls our fallen bodies “jars of clay” (2 Corinthians 4:7). As one commentator has mused, we are cracked pots! Paul also describes our bodies as a mortal earthly tent—perishable, weak, flesh and blood (1 Corinthians 15:42-47).

Paul is not saying that the flesh is bad or evil. He is saying that our bodies are weak and natural, prone in our fallen state to disorder and dysfunction.

Some modern Christians seem to take a hyper-spiritual approach to the brain/mind issue. They act as if inner spirituality eliminates all the effects of outer bodily maladies. Some seem to imply that giving any credence to the fallen bodies influence on our emotional state is something of a Trojan Horse that sneaks secular, materialistic thought into Christian spirituality.

Not So the Puritans

The Puritans would have been shocked by such a naïve perspective on the mind-body issue. Puritan pastors and theologians like Robert Burton, William Ames, and Jonathan Edwards recognized that problems such as scrupulosity (what we might call OCD) and melancholy (what we might call depression) might, at least in part, be rooted in the fallen body. They warned that such maladies sometimes could not be cured simply by comforting words or biblical persuasion (see A History of Pastoral Care in America, pp. 60-72).

Edwards described his sense of pastoral helplessness in the face of the melancholy of his uncle, Joseph Hawley. He noted that Hawley was “in a great measure past a capacity of receiving advice, or being reasoned with” (see A History of Pastoral Care in America, p. 73). Eventually, Hawley took his own life one Sabbath morning. Shortly thereafter, Edwards advised clergy against the assumption that spiritual issues alone were at work in melancholy.

Emotions: Bridging Our Inner and Outer Worlds

Emotions truly are a bridge between our inner and outer world. Think of the word “feeling.” Feeling is a tactile word suggesting something that is tangible, physical, touchable, and palpable. “I feel the keyboard as I type. I feel the soft comfortable chair beneath me. I feel my sore back and stiff wrists as they cry out, “Give it a rest!”

We also use this physical word—feeling—to express emotions. “I feel sad. I feel happy. I feel joy. I feel anger.” It’s no surprise that we use this one word in these two ways—physical and emotional. We know what the Israelites understood—our body feels physically what our emotions feel metaphysically.

When I’m nervous, my stomach is upset. When I feel deep love, my chest tightens. When I’m anxious, my heart races. When I’m sad, my entire system slows.

We know much more about the brain than the Israelites knew. It is a physical organ of the body and all physical organs in a fallen world in unglorified bodies can malfunction. My heart, liver, and kidneys can all become diseased, sick. So can the physical organ we call the brain.

Embracing our Weakness/Embracing God’s Power

It is important to realize that every emotion involves a complex interaction between body and soul. Therefore, it is dangerous to assume that all emotional struggles can be changed by strictly “spiritual means.”

For some, spirituality includes embracing physical weakness. In fact, this is the exact message Paul communicates when he calls us “jars of clay.” Why does God allow us to experience physical weakness? “To show that this all-surpassing power is from God and not from us” (2 Corinthians 4:7). It’s the same message Paul personally experienced in his own situational suffering (2 Corinthians 1:8-9) and in his own bodily suffering (2 Corinthians 12:7-10).

We can act as if we are more spiritual than the Apostle Paul. However, in actuality, pretending that our external suffering and our physical bodies do not impact us emotionally involves an arrogant refusal to depend upon and cling to Christ alone.

Certain emotions, especially anxiety and depression, involve physiological components that sometimes may need to be treated with medication. When we ignore the importance of the body, we misunderstand what it means to trust God. It is wrong to place extra burdens on those who suffer emotionally by suggesting that all they need to do is surrender to God to make their struggles go away.

On the other hand, it would be equally wrong to suggest that medication is all someone needs. That would be like a pastor entering the cancer ward to talk with a parishioner who was just told that she has cancer. “Well, take your medicine. Do chemo. You’ll be fine. See ya’ later.” No! That pastor would support, comfort, talk with, and pray for his parishioner.

Sickness and suffering are always a battleground between Satan and Christ. So, while medicine may sometimes be indicated for certain people with certain emotional battles, spiritual friendship is always indicated. Physicians of the body (and the brain is an organ of the physical body) prescribe medication. Physicians of the soul (and the mind is an inner capacity and reality of the soul) prescribe grace.

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