Can Christians Be Depressed?
Matthew Stanford, author of the book, "Grace for the Afflicted," talks about the silent epidemic of depression that is sweeping across the U.S., affecting 45 million people, many of whom get no treatment. Medication is often over prescribed, and mental health issues have been turned over to the world, when clergy could be a real help to the hurting if they were trained. Stanford shares his concerns about children being treated for ADHD, and encourages those struggling with depression to seek out a faith-based, ethical psychologist.
About the Guest
Hope and Healing Center & Institute in Houston, Texas, and he teaches in the Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine and the Department of Psychology at the University of Houston. He is the author of Grace for the Afflicted: A Clinical and Biblical Perspective on Mental Illness and The Biology of Sin: Hope and Healing for Those Who...more
Matthew Stanford, author of the book, “Grace for the Afflicted,” talks about the silent epidemic of depression that is sweeping across the U.S., affecting 45 million people, many of whom get no treatment.
Can Christians Be Depressed?
Bob: When a family member or a loved one is dealing with some kind of physical ailment or disease—that can put a stress or strain on family relationships. Matthew Stanford says, when the issue is a mental disorder or disease, the stress and strain can be excruciating for families.
Matthew: You know, so I have a client, right now, who has schizoaffective disorder, which is probably the worst of all mental illnesses. It’s like having schizophrenia and bipolar disorder at the same time. Her moods swing between high, euphoric states and really low depression. She doesn’t believe she’s ill—even though, in the same week she told me there was nothing wrong with her, she told me had wood nymphs living inside of her. Her parents struggle; because here they are—they want to care for their daughter—their daughter says she’s not ill; we can’t make her get any treatment. She lives in a delusional nightmare, and her parents suffer.
Bob: This is FamilyLife Today for Tuesday, June 26th.
Our host is Dennis Rainey, and I'm Bob Lepine. It may be that someone in your family is wrestling with a mental illness or mental disorder. How can people help and support you?—and what can you do, as a parent, or as a spouse? We’re going to talk more about that today. Stay with us.
And welcome to FamilyLife Today. Thanks for joining us. We’ve touched on a tough issue this week and one that brings out a lot of concern and passion.
Dennis: We have. It’s the whole subject of mental health, which involves issues of depression, anxiety, suicide—
Bob: —schizophrenia; there’s bipolar disorder—
Bob: —addictions; right.
Dennis: I mean, on and on it goes. I was just making a statement, before we came on the air, to our guest, Dr. Matthew Stanford. By the way, Matthew, welcome back.
Matthew: Thanks for having me.
Dennis: I was just kind of preaching at him—I was just going: “You know, the Christian community ought to be the leaders in this!
“We ought to be pointing people to a Savior, who compassionately wants to welcome people, who are struggling in the emotional realm.”
Bob: And here’s part of the issue that we struggle with, as Christians—and by the way, we should say that Matthew has written a book called Grace for the Afflicted: A Clinical and Biblical Perspective on Mental Illness.
Dennis: And he is the CEO of The Hope and Healing Center and Institute in Houston, Texas. He’s been married to Julie since 1990—and have four children.
Bob: And we should say—the challenge for us, as Christians, is—we look at behavior issues. Christianity identifies sin patterns in people’s lives—helps people with redemption for sin/forgiveness but, also, sanctification, which is where your sin is dealt with. We look at some of these behavior disorders; and we go, “These are just extreme sin patterns in people’s lives.”
Dennis: Well, we categorize it as that, Bob.
Bob: How can we tell if somebody is dealing with a mental health issue versus somebody who is just a stubborn, unrepentant sinner?
Matthew: You know, I look at Luke 2:52—it says, “Jesus grew in wisdom and stature and in favor with God and man.” I see that, kind of, as the four parts of our being: the mind, body, spirit, and relationships. When a person is struggling with a mental health problem, it affects them on all those levels. People with mental health problems—they have the same spiritual needs as everyone else; those spiritual needs, wants, and desires may just be bent by their illness.
The question being: “When can we tell if somebody has kind of a spiritual problem versus a mental health problem?” What I would say is this: “A person, who has a spiritual problem—when you begin to dissect that problem, there is some sin that is associated with it. The person has unrepentant sin, and that’s why they have excessive guilt; and that’s why they’re sad or feel depressed; or why they’re guilty and they have anxiety.
What I typically find is that that level of sadness or depression—that level of anxiety or stress—does not usually rise to the level of a disorder that causes them to be dysfunctional in their ability to go to work / to go to school; it may start to affect their relationships. But, when you have clinical depression, you can’t work normally; you can’t hold normal relationships—it affects every aspect of your being—relationships, mind, body, spirit.
What you find with some of the spiritual issues is that that spiritual issue tends to be kind of focused in one area, and then it’s just beginning to manifest at some level. The other thing I find is—if someone has a clearly spiritual issue, that’s just spiritual in nature—when they begin to open up to receive spiritual guidance and care, you begin to see that begin to relieve itself; you then see recovery and restoration.
Whereas a person who has, say for instance, bipolar disorder, who is being ministered to spiritually—has been given pastoral care and may be even growing in their faith—you don’t necessarily see the symptoms of the bipolar disorder itself changing. You might see how the person perceives them changing or how they perceive themselves or God changing. They may feel better, but the symptoms themselves don’t change; because the symptoms have more of a physical basis.
Bob: And these can overlap; I mean, somebody can have a physical issue and have sin issues.
Bob: So we shouldn’t just say, “Well, it’s all this,” or “It’s all that. Take some meds and that’ll fix everything”; right?
Matthew: I think that’s one of our biggest problems right now. We have a tendency to go to the extremes in every aspect. You know, we have people in the secular world saying: “Oh, well, you just have this disorder. Take these pills, and you’ll be fine.” And we have people in some parts of Christendom / some parts of the church, saying: “Well, this is solely spiritual. Just read through the Proverbs, and everything will be great.”
Both of those are equally wrong; because they’re not receiving, accepting, or understanding how God made us as a multi-part unity.
We need to be, in essence, treated or intervened at all levels of our being. I think that’s why the church has an incredible opportunity here, because the church really should be leading here. The church is the one who presents a holistic approach to the human / to the world. We’re the ones that have the Book that tells us that, indeed, we are a multi-part being and that all aspects of our being are important to God. I mean, I can tell you—as a mental health care provider, I have never had a client who just took medicine and everything was fine after that. You need more than that to have full recovery and healing.
You know, I would say the same thing about—you know, a spiritual intervention is very important—but unless it’s a solely spiritual issue, you’re not going to get full relief just from a spiritual intervention. That’s not to deny that God doesn’t intervene and miraculously heal at times. I think He absolutely does; and we should pray for healing for anyone who’s ill in any way, but I think that we need to intervene completely in the person’s life, much like we do with other things.
We would do this with cancer; I mean, if a person has cancer, we know we want them to have a positive attitude; we know we want to be supporting them, spiritually; we know we want to support their family. Let’s just do the same thing for mental health issues.
In the church, I think what we have to do, first and foremost, is understand that these are real illnesses that have, at least, some biological basis—depending on the illness that you’re looking at—and that there’s going to need to be some biological aspect to the treatment, probably. I think, secondly, we have to understand that there’s a difference between a mental illness and a counseling issue. Someone, who has a parenting problem or a marital issue—where they can go to a counselor and have someone give them advice and guide them through that—that is different than somebody who has bipolar disorder. That person may need some pastoral care also, but pastoral care alone is not going to be enough to alleviate the symptoms of that bipolar disorder.
Bob: Matthew, the number one most-prescribed medication in America today—I don’t know if this is worldwide, but in America—is depression medication.
Matthew: Right; absolutely.
Bob: That wasn’t the case 40 years ago. Of course, part of that’s because we didn’t have depression medication 40 years ago. Do we have an epidemic of depression that wasn’t around a generation ago, or are we just observing things we didn’t observe before? Why is depression what it is today in our world?
Matthew: That’s a great question! It requires kind of a nuanced answer, because the reality is—we absolutely do have a silent epidemic of mental health problems in the world. Four hundred fifty million people in the world suffer from mental health care problems—that would be the third-largest country in the world, if you put it together as a country. In the United States, in a given year—45 million individuals, which is an enormous number—and that’s just adults; it doesn’t include children. A majority of those individuals receive no treatment. Even in the United States, they receive no treatment.
Now, with that being said, anti-depressant medications are heavily over-prescribed in ridiculous amounts. I mean, it’s unbelievable.
The majority of people that receive psychiatric medications in the U.S. receive them from their general practitioner. If they really have clinical depression, then a round of an anti-depressant is an appropriate treatment. If they’re sad—because they have a bad marriage, or financial problems, or whatever, or something else—anti-depressant is not an appropriate treatment to begin with.
On top of that, they should also be receiving therapy; because therapy allows you to get the tools and skills necessary for you to be able to walk beyond the medication, hopefully.
Right now, the problem is—we have a lot of overprescribing. Now, this isn’t the first time this has ever happened. Back in the ‘80s, pediatricians were prescribing antibiotics like they were going out of style, and what that’s left us with is a whole bunch of antibiotic-resistant bacteria. There have been some incredible studies done on those pediatricians—that asked them, “Why would you prescribe an antibiotic for an ear infection you knew was viral?”
It’s always the same answer: “…to appease the parent.”
Dennis: Yes; yes.
Matthew: So why would you not think that, when a person goes in to their general practitioner and says: “I’m sad,” “I’m down,” or “I have anxiety and I’m down,”—and anti-depressants are used to treat anxiety also—why do you not think the same thing would happen?—because people want to walk away with something. I think what we need to do is—we need to be better consumers.
That’s also another place where I think the church has a tremendous role to play. If your clergy and staff at your church—if the leaders of your lay ministry at your church—would simply take a short course, like a “Mental Health First Aid” or a training to understand and recognize mental health care problems, we know people are more likely to go to clergy and ministry staff before they go to physicians and mental health care providers. That’s something the National Institutes of Health found—people in the general population, whether they’re believers or not / whether they’re affiliated with a faith community or not—are more likely to go there first than to those other people we mentioned.
If the church recognized those problems, they could get people to the proper care. They recognize, when someone had a problem, and they could move them into that type of care and pastor them along; or they could say, “No; this is something that we can handle for you right here.”
Unfortunately, we’re just not doing that. We kind of minimize it to say, “You know, it says, ‘Be anxious for nothing,’ so that means anxiety is bad. You shouldn’t be anxious.” Well, I mean, that’s just a bad understanding of the Scriptures. You know, I had a pastor once tell me that depression was a sin; because it says, “Rejoice always.” Sadly, I asked him, “Have you read the rest of the Scriptures?” because, I mean, unfortunately—when people are fearful of something and they don’t understand it—they’ll have a tendency to kind of wrap it up in some Scripture and try to, you know, put a little bow around it.
These are chronic conditions—they can be managed; they’re not quick fixes. This is the epitome of what it means to be burden-bearers and to walk along with somebody and care for them.
We have to be much more grace-filled, I think, as a community.
Dennis: Matthew, I want to go back to something that you ran past very quickly. I think there must be listeners, who are—maybe they are taking drugs themselves—or they’re married or have a child, who is taking anti-depressants. You said it is good for a “round” of anti-depressants, perhaps, in certain cases. What’s a “round”? What is a healthy period of time to take drugs for something like depression? I know you can’t generalize an answer to everybody, but try. [Laughter]
Bob: Help us out here a little bit!
Matthew: “I know you can’t, but do it!”
Matthew: First of all, the cop-out answer is, “It varies from person to person and depends on the severity of their illness.” But I would say this to those people—so you’ve got people out there—say, for instance, they are taking anti-depressants. Let’s also put in people whose children are taking psycho-stimulants for ADHD, because they kind of fall under the same type of category; because a lot of those come from pediatricians.
If you are receiving anti-depressant medication for depression or anxiety, or your child is receiving a psycho-stimulant like Adderall® or something, and you’re receiving that from a general physician—a pediatrician or a general practitioner—you need to keep taking that medication; but as soon as you can, get an appointment with a psychiatrist—an adult psychiatrist or a child psychiatrist; because they need to evaluate whether you really, actually, have the illness that you’re being treated for.
That’s the number one problem—is that people are taking medication for illnesses they don’t actually have. Number two—if you’re psychiatrist says, “Okay; you do have depression, and we’re going to put you on this medication,” and you go—the number one question you need to ask them is: “How are you going to assess whether I’m getting better?” because your subjective report of how you feel is really not good enough; because there is a placebo effect; you want to get better.
What I tell all of my clients, who I refer to psychiatrists that I work with is: “If you go three months and you see no relief—no change in symptoms from medications—you need to ask the psychiatrist: ‘How have you been assessing me?’ and ‘How much longer do you want to try this medication before we say it hasn’t been effective and we might try something else?’”
What I see right now, unfortunately, is—I see people, who’ve been on a medication for a year or two—have only seen their psychiatrist two or three times in all of those years—and will tell me, flat-out, “Oh, I’ve never gotten any better on this.” When I say, “Why are you still taking it?” they say, “Well, that’s what they told me to do.”
Matthew: I tell them all of the time: “If you had an infection on your arm, and you went to your doctor and he gave you an antibiotic, and he said, ‘This is going to clear up that infection,’ and ten days went by and that was still there, you’d be back in that office. So why would you not do the same thing with your depression?”
You need to ask good questions. You also need to receive therapy—
—so for the depressive individual or for the anxious individual—psychotherapy / a talking therapy—not counseling—but a targeted therapy, like cognitive behavior therapy—something that’s been demonstrated to effectively treat depression or anxiety. If you get that therapy, in addition to taking medication, research has shown that you will take less medication; and you will recover more fully and more quickly. The same thing for your children that are on psychostimulants—if you will set up a behavior modification program, with a behavior mod specialist, you will see that, in many instances, they won’t need medication anymore; or they will take less medication.
Without therapy, all you’re doing with medication is minimizing symptoms. You have no opportunity to move beyond that and really take care of what’s underlying the problem. If you’re going to—you know, if you have a first episode depression—you don’t become suicidal / you’re still mildly functional—you know, you probably can take medication for six to eight months, along with some therapy. Within a year, you should either be on a very low dose of medicine or not on it anymore.
Bob: You bring up therapy, and this is where we start to have some red flags go up:
“Who do I put my soul in the hands of?” and “Is behavior modification the goal, or are we now starting to deal with spiritual issues?” Help us understand that.
Matthew: Well, first, let’s say this: psychostimulants are overprescribed. There are a lot kids on Adderall and things like that—Ritalin®—who don’t need to be on them. We forget, as a society, that normal in childhood is a huge tent. We’ve narrowed that down to just this: “Sit still, Johnny, and watch the opera. Why can’t you sit still?”
Bob: I can’t do that! [Laughter]
Matthew: Right; exactly! That’s exactly right! And that’s what we expect. You know, we’ve increased our class sizes. Teachers have way too many kids in classrooms. They’re dealing with a lot of behavior problems. It’s a mess; okay? We don’t allow our children to be children. The example I give a lot of times is this—and I deal with this all of the time—I am 52 years old. When I came out of kindergarten, there was no thought that I would know how to read; only that I would recognize some letters, shapes, and colors. Kindergarten was more fun.
Nowadays, when a child comes out of kindergarten, if they haven’t reached certain reading milestones, they’re actually labeled as “learning disabled.” Now, what changed? Did children change, or did expectations change? Our expectations have changed dramatically; and so, now, as soon as a child shows any kind of a behavior issue, or even one time, they want to put them on medication.
Behavior modification—if a child really does have ADHD—let’s say that they really do have ADHD—the issue right there is that they have not developed impulse control to the point where they can actually control their behavior at the age-appropriate level. What behavior modification does is—it activates those areas of the brain to help their impulse control develop more fully. What you’re not doing—is you are not saying, “I just want to change your behavior; I don’t care about your heart,” because Christian parents should be incorporating into that an understanding of the child’s value and worth, within who they are in Christ, and God created them.
I mean, that’s the thing that’s missing, a lot of times, in a just kind of a secular approach; because, believe me, the child knows that everybody thinks he’s not worth anything; because he’s the one that always gets in trouble. Helping them understand: “You have this issue. It’s a developmental issue; you will catch up. This is a short-term fix to help us right now. God has provided these types of things for us; it’s His provision.” That’s an important thing. I think, as far as the question goes about therapy, I know a lot of Christians are very nervous about that and the idea of, “If I go to somebody, are they going to destroy my faith?”—or whatever.
First off, I’d say this—if you go to an ethical, competent psychologist or therapist, they will not destroy your faith; that’s not going to be their goal. I’ve worked with hundreds of secular therapists and psychologists in my lifetime, and they’ve been nothing but supportive of people of faith. What you want to find is a faith-affirming environment.
You know, you ask questions of your mechanic. Why would you not ask questions of your therapist? You know, you’ve got to find somebody you trust; somebody you agree with; somebody that believes they know how to treat your illness with empirically-validated treatment.
And you need to ask them about your faith. If your faith is important to you, it should be important to them. Now, that’s different than me saying that you need to go to somebody that is of your same faith—or if you’re Methodist, you have to go to a Methodist, or whatever. Some people—if that’s the only way that you would feel comfortable, great; that’s fine. I don’t have any problem with that, but that does limit the number of people you can find. It’s already hard; there are already very limited mental health care providers.
But you need to talk to them about the fact that it’s important for you to pray; it’s important for you to talk about God in the context of your recovery, your healing, and your illness. If they are not comfortable with that, you don’t go back to them; you go to someone else. In fact, if you’re having trouble finding somebody, call the Hope and Healing Center. That’s one of the things we do. I don’t care where you are around the country—just call us. We help people find care in their area.
You know, you can give us some criteria you want. I have people, all the time, say, “Well, you know, I’d rather go see a male therapist.”
I have more people say that to me than people who would say, “Well, you know, I really want someone who would affirm my faith.” That’s just as important; because, if that’s a core value that you hold—is that God is present, and created you, and cares for you, and loves you—that has to be some aspect of what you’re doing.
Now, I’m not saying that the person is doing some kind of spiritual guidance or counseling on you. That should be anchored in the church. That’s why the church should be involved in what’s going on with you. They should be working, as a team, with this therapist. But that therapist, at least, needs to be affirming that your faith is an important and valued part and that it’s therapeutic for you.
Dennis: And I would say that faith needs to be anchored in the church—
Dennis: —and also in the family. What parents are doing is not behavior modification with their kids; they’re shaping a child’s heart in response to God. Part of that is knowing how to repent of sin and ask forgiveness of another person that they’ve hurt. Those are heart issues that we have to deal with in this.
Dennis: But we still need help in the emotional arena, Bob. That’s where a book like Grace for the Afflicted can be so helpful.
Bob: And we’ve got a link on our website, at FamilyLifeToday.com, to the Hope and Healing Center; so, if folks want to find out more about the work that you’re doing, Matthew, they can go to FamilyLifeToday.com and click through to find your work, there, in Houston.
We also, of course, have copies of your book in our FamilyLife Today Resource Center. The book is called Grace for the Afflicted: A Clinical and Biblical Perspective on Mental Illness. You can order the book from us, online, at FamilyLifeToday.com; or you can call to order: 1-800-FL-TODAY. Again, the website: FamilyLifeToday.com; or call 1-800-358-6329—that’s 1-800-“F” as in family, “L” as in life, and then the word, “TODAY.”
You know, one of the things I’ve often heard from listeners, who’ve been interacting about listening regularly to FamilyLife Today,is how often God meets them right where they are in a situation that is front-and-center for them. They didn’t expect it; but they turn on the radio, and that’s exactly what we’re talking about that day. Of course, we can’t orchestrate that; but God does orchestrate those kinds of things.
Our goal, here, is to provide practical biblical help and hope for marriages and families. In God’s timing—this radio program, or articles that we have online, or resources we make available—God uses those to help strengthen families / to encourage families to give them hope in the middle of difficult seasons, and to provide them with practical help so that they know how to respond to the challenges of life.
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Now, tomorrow, we want to talk about a variety of subjects. One of them we want to talk about is anxiety. When people are experiencing high levels of anxiety, do they just need to believe Philippians 4, where it says, “Be anxious for nothing” or is that too simplistic? We’ll talk more with Matthew Stanford about that tomorrow. I hope you can tune in for that.
I want to thank our engineer today, Keith Lynch, along with our entire broadcast production team. On behalf of our host, Dennis Rainey, I'm Bob Lepine. We will see you back tomorrow for another edition of FamilyLife Today.
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