Why does taking medication for mental health issues seem to ruffle Christian feathers more than any other kind of pharmaceutical intervention? Are there moral or ethical implications for Christians who choose to use psychotropic (mental health meds) medications? Today I’ll be giving a Christian therapist’s view on medication, including when and why we should or should not use it.
A Tiny History of Psych Meds
Psychotropic medications, or psych meds, as I’ll refer to them, have gone through several distinct phases of development. Modern versions appeared around the middle of the 20th century. Around this time that doctors and researchers started noticing that there were many more distinct diagnoses besides schizophrenia and depression. More specific medications helped with each of the emerging disorders. In the 1980s, additional research allowed drug makers to target specific receptors in the brain, tailoring the use of medications even more.
Ages ago, when doctors had little explanation of mental disorders and few treatment options, suppression of symptoms often came with dire consequences. Complete suppression of the personality and emotions were one of the consequences. Other individuals were simply sent away and locked up when their symptoms and functioning were unmanageable to their families. As we’ve come to understand common mental health issues more and more, we’ve also come a long way with treatments, including various modalities of therapy and medication.
What is the Purpose of Medication?
Today, medication serves to alleviate or lessen symptoms that prevent proper functioning for individuals with specific diagnoses. These symptoms are both biological and behavioral. Unlike purely physical disorders, whose symptoms affect primarily the body, mental disorders cause a change in the behavior of the individual. Although the cause is still biological, it can not be seen so much in physical changes. The individual presents with quasi-physical symptoms such as crying spells, fatigue, or unexplained aches and pains. The rest we see in the behavior, such as changes in eating and sleeping patterns, lack of motivation, difficulty concentrating, or social withdrawal. For our purposes here, I am primarily talking about the most common disorders, such as depression, anxiety, and bipolar.
I am a masters’ level therapist, which means I am well-trained for traditional therapy. I have no medical training. Therapists with my credentials do not write prescriptions, but we are expected to have foundational knowledge about frequently used medications and how they function in the brain and body. I have to refer to primary care doctors or psychiatrists if I want my clients to consider medication.
It has been well-understood that the best response in treatment of depression and anxiety comes when there is a combination of talk therapy and medication. Some people start with a counselor, while others go first to their primary doctors to seek medication.
Medication as a Support to Therapy
In my practice, I often see people who want to try therapy in hopes that they will avoid the need for medication. Many times, this works just fine. Occasionally, I see cases in which a person is struggling too much with the biological symptoms of depression or anxiety to make good use of therapy. For example, a depressed client may be trying to learn the basics of Cognitive Behavior Therapy (CBT). She is too overcome with the feelings of hopelessness and worthlessness to make headway. An anxious client may understand the need for mindfulness and breathing exercises. Her biology is overriding her ability to practice these techniques with a racing pulse, shortness of breath, and feelings of dread.
When the physical and behavioral symptoms of a client become too overwhelming to the extent that they seem unable to benefit from therapy, I usually broach the question of medication. Since I cannot prescribe, I see my role as exploring the cognitive and emotional aspects of taking psych meds. I also do a lot of psychoeducation about neurotransmitters and how the medication works, since physicians do not always take the time to do this.
Here’s the bottom line for most clients. If you’ve tried therapy for a while (2-3 months of regular sessions) and you’re feeling the same or worse, talk to a doctor. And of course, some people know they need medication right away to manage symptoms that are preventing them from living their lives. In that case, medication would be starting simultaneously, or even before, starting therapy.
When is Medication a Bad Idea?
There are a few occasions for which I would not recommend medication. First, if the symptoms haven’t been happening for very long or if therapy is getting a really good response. Sometimes medication helps people get through difficult seasons, say a death of a loved one, a divorce, or tough medical battle. In general, these types of situational depression, bereavement, or anxiety would be better served with the support of therapy (but not always).
A second reason I would not recommend therapy is that some people want to take a pill as a way to numb pain instead of working through it. If you are planning to take medicine until the pain goes away and never seek counseling, it’s probably not a good idea. Again, the best response is seen from people who couple medication with talk therapy.
Some people have other biological reasons that they should not take medication. It may be another medical condition or pregnancy (although there are several medications that experts consider safe during pregnancy). Others have tried several medications and either don’t get the desired response, or else they suffer adverse side effects. Occasionally these last people may be good candidates for other techniques such as electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS). One uses electricity and the other uses magnets, and both are safe, effective, and non-invasive for people who are treatment resistant to medication. (And it’s not like the horror movies you’ve seen about shock therapy!)
Jesus’ Heart for Healing
My concern for Christians is that there is a stigma in our churches about the use of medication for psychiatric conditions. Unlike diseases such as diabetes or cancer, mental health issues hit us the hardest in our minds and emotions. Christians tend to think of these as the domains of the Spirit, whereas the physical body is separate. This is a falsehood. Jesus cares just as much about our physical bodies as he does about our minds and hearts. He proves this with His miracles in the Gospels. We have conceded that modern medicine is useful for our bodies. Why are we resistant to the idea that it might be good for our minds as well?
When Jesus heals a body and makes it strong for its purpose on earth, we praise Him. Our minds and hearts are equally essential to our purpose, and He is interested in healing them. But He may not always choose supernatural means. By all means, you should probably pray more. I know I should. But I will also take my meds when I need them. One mission of Soul Grit Resources is reducing stigma that prevents Christians from having access to good mental health care. I want Christians to consider that God may use medication and therapy to heal His children.
How Can Christians Make Decisions about Medication?
If you are considering whether medication may be for you (or talking about it with clients for my therapist friends), there are a few steps I think you can take. First, learn about how the medications work and how your brain could respond. There are lots of helpful YouTube videos about this. Don’t let side effect warnings put you off–the cold medicine and vaccines you take also have these. Be aware of side effects, but don’t let them make the decision for you.
Second, seek wise counsel. That’s the Christianese way of saying ask people you trust. These people should include God first, your physician, and your therapist. Your therapist should respect your decision about meds, but can offer some very helpful scientific as well as anecdotal information. You can also rely on God to give you clear direction about this.
Third, you don’t have to feel bound to a particular medication if it doesn’t work for you. I would recommend giving it at least two months (unless you have immediate side effects). Then your doctor can help you decide if your dosage is right or if the medication needs to be changed. As I expressed above, medication reduces the symptoms of depression or anxiety enough to help you make good use of therapy. Once you have learned some of the skills in therapy that you need for managing your symptoms and functioning, you may not need the medication after a while, anyway. Therefore, don’t take the new prescription as a life sentence.
Where to Start
I realize that some people reading may not know the first place to start with talking about medication. For most people that have garden-variety depression or anxiety, a general practitioner or primary care doctor can help with prescriptions. If you have diagnosis like bipolar or schizophrenia, your PCP will refer you to a psychiatrist. Additionally, you may have to see a specialist if you have other health concerns or if you are pregnant. You can ask your therapist all these questions, and she will point you towards your doctor after providing some psychoeducation. Your therapist can also help you understand your diagnosis. She will give you some talking points and questions to discuss with your doctor. Sometimes I administer a brief questionnaire that talks about symptoms. Then I have the client take that paper to the doctor to discuss the best medication options. You can also find help for selecting a therapist here.
Only God can show you if medication is the right choice for you. However, when you ask Him, it’s wise to be open to the idea that “nothing is unclean,” including medicine. You can help hurting people get the help they need by using your own experiences with mental health and medication. Talk about them openly. In fact, I might just do that next week!