What is depression? Biblical counselors Ed Welch and David Powlison shed some light on the epidemic of our age--depression. Hear them explain what depression is and what might be some underlying causes and cures.
What is depression? Biblical counselors Ed Welch and David Powlison shed some light on the epidemic of our age--depression. Hear them explain what depression is and what might be some underlying causes and cures.
Bob: People who today might manifest a variety of psychological symptoms are often diagnosed these days as having a chemical imbalance in the brain. Can we be sure that's really what's going on?
Ed: There is no test that can demonstrate a chemical imbalance.
Bob: Dr. Ed Welch is skeptical.
Ed: There is no blood test that you can do with anybody with a psychiatric problem. So that's one thing to keep in mind.
The other thing to keep in mind is that medication does not help as often as people think, and there is more and more research suggesting that -- that, indeed, some people do seem to be helped in the sense that some of the symptoms do seem to be alleviated, but there are a lot of people who don’t seem to be helped by the medication.
Bob: This is FamilyLife Today for Tuesday, June 28th. Our host is the President of FamilyLife, Dennis Rainey, and I'm Bob Lepine. Today we going ask some hard questions about what the Bible has to say about what may be going on in your brain.
And welcome to FamilyLife Today. Thanks for joining us on the Tuesday edition.
Dennis: Bob, I never made it to prayer here at FamilyLife this morning because on my way to work I received a phone call from a friend. She was calling to get my advice about her husband.
It seems that her husband is depressed, and so depressed he doesn't want a relationship with her, doesn't want to talk about his problems, doesn't want to discuss why they don't have much of a relationship. All he's interesting in doing is sitting in front of the computer screen and playing computer games, doing searches on the Internet, and giving his life to his work and to his hobbies.
You know, as I talked about a possible solution, I couldn't help but think about the whole subject of depression and just wonder if the Christian community has really developed a healthy view of depression or do we have more of a medical view that's purely based upon the scientific community. Where is the balance for the Christian?
Beginning yesterday we talked about a book called Blame It on the Brain, which is talking about chemical imbalances, brain disorders and disobedience, all from a Christian perspective. We have with us the author of that book, Ed Welch, along with his associate from the Christian Counseling and Educational Foundation in Philadelphia, David Powlison. David, Ed, welcome back to FamilyLife Today.
Ed: Thank you, Dennis.
Dennis: David is the proud father of three children. He and his wife Nancy have been in the Philadelphia area for the past how many years?
David: Twenty-five years -- we're coming up on that anniversary.
Dennis: You became a believer, actually, as an adult, is that right?
David: Yes, I did. I was almost 26 years old.
Dennis: He has written a number of books; also a counselor at the CCEF. Ed Welch is also on the faculty, a counselor …
Ed: Excuse me, Dennis, I am the proud father of two daughters, okay? You had said he was the proud father of three, and I'm the proud father of two.
Dennis: I was about to get to that. I was about to get to Lindsay and Lisa, is that right?
Ed: Okay, thank you.
Dennis: Along with your wife Sharon. Yeah, we cut to the chase here and talk about what we're proud about.
Bob: He wanted his most important credentials stated first.
Dennis: Absolutely. Undoubtedly, when you wrote this book, Ed, you must have had in mind the subject of depression. This is a huge issue.
Ed: I suspect you've done a number of shows on it. People call it the common cold of mental problems. It is everywhere, there's no question. Just the sheer number of prescriptions for depression would indicate that.
Dennis: Do we have a Christian worldview of depression, or is, for the most part, our view of depression that that has been developed by the medical community?
Ed: That's a good question. It's interesting -- when you say the word "depression" you are usually using a psychiatric term. I think the problem with that particular term is it actually limits our understanding of the problem rather than expands our understanding. What it says is you have a chemical imbalance and need treatment. The best treatment is some sort of medication.
However, when we take a look at it from a biblical perspective, we tend to see a good bit more. Maybe there are some physical problems at the brain level, but what happens -- with the case that you were talking about, how does a Christian approach somebody like that?
Well, you simply want to know this man, to study this man. What is it like for you? Where are you struggling? You simply want to come alongside of him. You have some sense already that he wants to avoid people; that there are difficulties in his life, and he's unwilling to turn to Christ or to other people for help. So you have some idea of what is going on already.
Dennis: I have another friend and, in his case, his wife has had a chronic problem with depression for more than 15 years, to the degree that some days she can't get out of bed.
Ed: Rather than looking under the word "depression" in Scripture, perhaps a better way to begin the discussion would be to open the Scripture up more broadly and just say, "Scripture, where do you speak to people who say 'I hurt. I hurt really, really, bad.'" I mean, depression is saying more than that many times but at least, it's saying, "I hurt." And to the comment "I hurt," Scripture says all kinds of different things.
Bob: When we talk about depression, sometimes we think of it in clinical terms. Sometimes we just think of it as that sense of feeling blue, you know, "I'm not doing well today, I'm depressed. For some reason I'm down. Circumstances aren't going well, and so it has affected my mood."
But when you hear about a person who can't get out of bed on certain days and who has struggled with depression for a 15-year period and who isn't choosing that feeling for himself or for herself, you do begin to wonder is there something going on internally, biochemically, something that a person can't get past the fog on? What are we to do with that kind of clinical sense of depression, David?
David: You know, we’re asking this million dollar question and we’re trying to put twenty-five cent answers. What we say will be little snatches and stabs, hopefully, in the right direction on that. Let me say a couple of things that strike me. One, her mood and the paralysis that she feels in light of it, is the dominant thing that jumps out from her life, but people have lots of other facets of their lives as well.
So, for example, I need to be equally interested in how is she doing as a mom? How does she define what makes life meaningful? Where does she find identity? I can think of many people with whom I've worked where similar types of patterns; they do grab your attention. Some, I'd say, are even more serious than what we've said. I mean, someone's suicidal, and so forth.
But invariably I've found with people, you know, things such as a person who has harbored bitterness. Now does solving bitterness mean all their depression will go away? No, but solving bitterness is extremely important, and it may well have ripple effects.
I've known many depressed people who had no living sense that God is gracious and that their sins were a bigger problem than their sufferings, and that He really loved them, and He was merciful to them. Often, people who are very legalistic and moralistic and feel like there is some ladder they have to climb in order to please God or make life right, and they're climbing up this ladder, and whether it's how your family turns out or what you look like, and they're failing, and they're depressed.
You can see how there are just some major rebuilding of the foundations of your identity. Is that going to necessarily solve all the feelings of feeling down? Not necessarily, but you can sure imagine it could have some huge ripple effects. And you could go on and on. I've just hit a couple.
People for whom fear of man paralyzes them; perhaps that man in front of the computer screen -- I would hazard a guess there must be some problem in his life. Maybe there's difficulty at work; maybe he and his wife had a big fight; maybe he had an affair, I don't know. But there is something he's running from, something he's finding a refuge in that video game. It's his tiny, controllable, feel-good world in a big world that's gone amuck and is very frightening.
There are all kinds of things that we, as Christians, can say and do into that world. There are all kinds of Scripture that speaks to a man to invite him to come out into the light. Let's try to take this apart; let's try to put it back together.
Dennis: David, Ed, you two gentlemen both are counselors, right? Ed, you've done a great deal of research into neurological studies, right?
Dennis: You've seen a number of people who have been depressed who have come into your clinic there in Philadelphia.
Dennis: What percent of those folks do you help move from being controlled by depression to becoming healthy spiritually? I'm not saying they are totally healed from …
Ed: No vulnerability to a blue mood , things like that …
Dennis: Right, but what percent of them are you able to truly help move to -- and I hate to call it the victorious Christian life -- that seems so trite, but to growth and to becoming a follower of Christ so they are able to get out of the bed?
Ed: If people are submissive to the Word of God, we see everybody grow, absolutely everybody. But, Dennis, I think you're raising an interesting question, what does change actually look like?
There are some people -- change, I believe, for them looks like they still feel depressed. They still feel this sense of blueness, or worse, in the midst of their life. But they are able to turn to Christ in the midst of it; they're able to consider others as more important than themselves …
Dennis: … they're able to function …
Ed: … they're able to love.
David: Raise their kids, go to dinner, go to work, love people.
Ed: But they would still say that they feel depressed quite a bit.
Bob: So you're saying there may be some people who somehow, in the way that God wired them or the circumstances that have been a part of their life or the combination of those things -- they may live life in a less happy mood than other people will -- that's just kind of their lot, and they need to learn how to function in faith with that as their life experience.
Ed: I think we would probably say that the norm for the victorious Christian life is a life that turns to Christ in the midst of ongoing hardships. That's the norm -- where faith does not feel real good. It does not feel like this jolt of caffeine. It's just plain hard.
Bob: Part of my context for even the discussion on this -- I mentioned yesterday my dad being diagnosed when I was in high school with manic depression. I guess it's the same thing as what's called bipolar disorder today. Are those the same kinds of things?
Ed: Mm-hm, yes.
Bob: He was in the hospital for three weeks, and I remember the doctor explaining, “Here's what the problem is. Your dad has a low level of lithium in his blood chemistry, and we need to adjust the level of lithium, and when we do, we'll get it to a point where it will even out his moods.”
And the way it was with my dad, we didn’t see the depression as often as we saw the manic side of things, where he was just doing grandiose behavior, just stuff that was really strange, you know? Well, Dad came home from the hospital after about a three-week period, and he had his prescription for lithium. I've got to tell you, I remember, for the first couple of months, Dad was pretty flat.
Ed: Did you think that was good or not so good?
Bob: Well, you know, there was part of me, as a teenager, going, "At least he's not doing the grandiose manic behavior." Would I rather have him kind of flatlined and sitting in a chair reading and doing crossword puzzles, or would I rather have him embarrassing me? “ The crossword puzzles were a better solution, but it wasn’t like I had Dad there, you know?
Over time, he adjusted, but he took lithium for the rest of his life until he died. It did seem to affect his behavior. Now, I'm not saying that it ever got to some of the real heart issues that may have been present in my dad's life. Undoubtedly there were issues there that never got explored, but that treatment did seem to balance out his personality.
As a Christian, should we say we need to examine both what may be there medically and what's there spiritually? Do we put emphasis on one or the other? How would you counsel somebody who comes to you and says, "Here are the symptoms, I want this thing as fixed as I can get it."
Would you tell them, "Go get a prescription and let's keep talking about the spiritual issues?" What would you do?
Ed: Well, as a counselor, believe it or not, I've been counseling for over 20 years, and I've had very, very few people who ever asked the question, "Should I take medication?" They're already taking medication.
If they have a hint of these kinds of problems, they know, from the advertisements, from their next-door neighbor, that these medications are available. So we typically, as Christian counselors, will see people already taking medication.
There are two principles that I might want to underline. One is that there is no test that can demonstrate a chemical imbalance. That's a theory. There is no blood test that you can do with anybody with a psychiatric problem that actually demonstrates it.
Bob: So when they said my dad's lithium level was low, it wasn't because they looked under a microscope with his blood and said, "Look, there, the lithium is low."
Ed: It was a hypothesis that came out of their worldview. Correct. So that's one thing to keep in mind. The other thing to keep in mind is that medication does not help as often as people think, and there's more and more research suggesting that.
But, indeed, some people do seem to be helped, in the sense, not that all of a sudden, they're brilliant spiritual people but some of the symptoms do seem to be alleviated. That’s true, that some people are helped, but there are a lot of people who don’t seem to be helped by the medication.
David: Let me give a different story that I think brings out a different side. A man came to see me. He’d had three episodes – just real high, then hit the skids, profound depression, mental hospital, slow climb out. In the process of getting to know him, the natural question is “Well, what was going on at the times when you flipped out?”
He said, “Well, it’s very interesting. The first time was a week after I got married, and the second time was a week after the birth of my first child, and the third time was a week after the birth of my second child.” Now you look at that and you think, “That isn’t quite like a disease. Malaria or cancer don’t work that way. There’s something in this about how this man processes life.”
I can be agnostic. Why does he go nutty that way where I would go nutty a different way? You know, I don’t think I’ll ever be manic. But if I cracked up, I’d crack up a different way. But why then? Why one week after those events? He didn’t have the kids, after all. His wife did.
And again, what Ed has said about broadening out what you do, normalizing the abnormal. As I got to know him, it became clear that two of the dominant themes that ran through his entire life were that he was a man that was extremely lazy and just loved comfort, and he was a man that was extremely controlling and everything had to play by his rules. Well, let me tell you. If you live for comfort and for being controlling, don’t get married . . .
Bob: And don’t have kids.
David: . . . and don’t have kids. I would not want to be pushed to say there’s a one-to-one correlation where those idolatrous desires completely decide why he got nutty, but I sure find that provocative. If he is able to grow before Christ in the areas of being controlling and lazy, could it be that the next time a life stressor comes in he will not react the same way that he did.
In fact, I lost touch with him eventually, but it seemed like as he grew it actually undercut the very dynamic that sort of pushed him to lose it.
Bob: You know, as I think back on what we’ve talked about today and think about my experience with my dad, the thing that I have regretted often was that after he got his lithium prescription, we looked and that and said, “Well, good. He’s better now. He’s fixed. He’s cured.”
Nobody ever did the heart work that we’ve talked about here today, the heart work that you’ve talked about, that says, “Let’s dig underneath the surface and see – are there spiritual issues? Are there emotional issues that may be triggering some of these episodes?
I think ultimately that’s the message of what we’ve talked about today and the message that’s in Ed’s book. That is, don’t be satisfied with something that covers over the issue, and don’t think that just because the behavior is moderated that the issue is dealt with. It’s incumbent on us to look below the surface and to say, “Are there sin issues that need to be dealt with in a person’s life?”
Now I say that, and I want to be very careful. I don’t want the folks who are dealing with depression or with bipolar to go, “Oh, you’re saying it’s all sin.” I’m saying there’s a lot of sin in my life that needs to be dealt with and there probably is in yours as well, and the correlation between depression or bipolar and your sin is something that ought to be examined for your own sake.
Dennis: I think one of the most important points that we've talked about today that is clearly a biblical point, and that is that all of us are called to be obedient to Jesus Christ and to His Word in the midst of suffering. Some of that suffering may be emotional. Some of that suffering may be dealing with discouragement, depression, a blue mood, for an extended period of time.
Some of that suffering may mean dealing with issues like bipolar or being married to someone who is depressed, discouraged, or bipolar. The bottom line is that in the midst of our suffering, we are still called to be obedient to the Scriptures and to be a part of the redemptive process of trusting Christ in our own lives for the circumstances, but also being redemptive with our spouses and with our children.
I’m looking at an email here. We don’t have time to read it, but it’s about a sixteen-and-a-half-year-old who was molested and raped evidently, growing up. And she’s been depressed most of her life. This little girl didn’t ask for those things to happen, but you know, now that they have happened, she’s got to process it. She has to deal with those issues biblically.
David: And those events are depressing by definition. You shouldn’t feel happy and gay by having events like that happen. So the feeling of sorrow and loss and confusion is a natural feeling. Now, exactly as you’ve said, she needs to be able to look at all of that and find a way to process it. One would presume that if she really does grow, there’s going to be ripple effects that affect her mood.
Dennis: That’s right. And again, we’re not minimizing that people are hurting and that they don’t need encouragement and hope. I hope that’s what this program has been all about, coming alongside folks and I wish I could reach through the radio at a point or two and put my arm around someone and say, “Go ahead and take the step you need to take toward the Scriptures and toward Christ.”
Bob: We’re hoping that not only the conversations we’re having this week can be helpful, but that if folks will get a copy of Dr. Welch’s book, Blame It on the Brain, it can help them understand the issues they’re dealing with better, but also help them understand that you need to look not only at the medical side – and it’s important that you do that – but also look at the spiritual side of what may be going on with some of these issues.
In fact, Dr. Welch is going to be back with us in a couple of weeks. We’re going to talk more about the issue of depression coming up here in a few weeks on FamilyLife Today. We’re going to go a little deeper into that subject. But if you’d like to get a copy of the book Blame It on the Brain by Dr. Ed Welch, go to FamilyLifeToday.com.
There’s information about how to order a copy of the book online. Again, our website is FamilyLifeToday.com. There is also a link there that will take you to the CCEF website and you can find out more about the upcoming national conference being hosted in Louisville, Kentucky.
The Christian Counseling and Educational Foundation is going to be hosting its annual conference, and this year this issue of psychiatric disorders is the central theme of the event. So again, if you’d like to find out more about that, go online at FamilyLifeToday.com.
You can also reach us by phone. Our number is 1-800-FLTODAY. Again, if you’re interested in a copy of Dr. Welch’s book Blame It on the Brain, call 1-800-358-6329; that’s 1-800-F-as-in-family, L-as-in-life, and then the word TODAY, and we’ll let you know how you can get a copy of the book sent to you.
Now I know some of you who are listening to our program this week may be new listeners to FamilyLife Today and you’re hearing us talk about a pretty complex issue, and one that can be a source of controversy among Christians. The reason that we’re tackling this subject is because it has a very real impact in marriages and families, so we wanted to spend some time looking at how we can help husbands and wives and moms and dads when these kinds of issues emerge in a relationship.
FamilyLife is committed to providing practical, biblical help for your marriage and for your family. I know, again, sometimes when issues like this surface, one of the questions people find themselves asking is “How can this be happening to me if God really is good, and if he cares about me? If God is really good, why do we hurt?”
Our friend, Randy Alcorn, answered that question in a booklet called If God is Good, Why Do We Hurt?, and this week we want to send a copy of that booklet to you. All you have to do is call or go online and request a copy. Again, new listeners, go to FamilyLifeToday.com, or call 1-800-FLTODAY. Ask for your copy of the booklet, If God is Good, Why Do We Hurt? We’re sending it out this week at no cost. All you have to do is request it.
Again, our website: FamilyLifeToday.com, and our toll-free number is 1-800-FLTODAY. We hope you’ll find this booklet helpful, and we appreciate you tuning in and listening to FamilyLife Today.
Now, we want to encourage you to join us back tomorrow when we want to spend some time talking about Attention Deficit Disorder, hyperactivity, and how we should understand those subjects, and are there spiritual issues going on there that need to be addressed. I hope you can tune in for that.
I want to thank our engineer today, Keith Lynch, and our entire broadcast production team. On behalf of our host, Dennis Rainey, I'm Bob Lepine. We will see you back next time for another edition of FamilyLife Today.
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