Should depressed people be given drugs?

Big issue being raised is, well, should depressed people be given drugs? The most prescribed medications right now in the US are anti-depressants. The number of anti-depressants prescribed has tripled in the last 20 years. This has now become not something that’s given to you by a psychiatrist, but someone comes in to his primary care physician and his General Practice doctor will give him the drugs as an attempt to try to overcome the depression. This is a movement away, 20, 30 years ago, if someone claimed to be depressed, they might have given them talk therapy. Now, they see issues as being primarily physical. Another factor may also be that with concern about containing costs, it’s a lot cheaper, probably, for your physician, your general practice doctor, to talk to you for five or ten minutes, hear you’re depressed and give you drugs, then to set up 10 appointments at 50 minutes each for a 100 dollars each to try to talk you through it.

So, the drugs that are given, psychotropic drugs for depression, they’re supposed to act in a way that they would say is trying to bring brain chemistry back into balance. They’ll say, your serotonin levels are too low. Now, something about these medications that are different from a lot of other medications is that they don’t actually– when they say your serotonin levels are low, they don’t actually test your serotonin. I’ve had so many counselees, when I’ve asked, “Well, how did they decide to give you anti-depressants?” And they said, “Well, I came in and I said “I was feeling badly, I had no energy. “I described some of those things. “And they would say, ‘Well, here, you need these drugs.'” But, they’re relying upon how you feel, and not upon the tests. Now, I don’t deny that the counselee may have felt badly, or the patient may have felt badly, the question that doesn’t get addressed in the secular realm is that, “Does he feel badly, or she feel badly, “was it caused by the brain chemistry “getting out of balance or is the cause “what’s going on in the heart, “which has then led to the lack of balance?” For example, you think of David. If you would’ve had a way of measuring David’s serotonin before he wrote Psalm 32, before he repented, maybe his serotonin levels were way off, he felt depressed. But the cause was what was happening in his heart spiritually, and so, even if these anti-depressants, if you could show that they work, what they’re treating is not the cause, but the symptoms probably. And, what they’re trying to do is just make the bad feelings go away.

And if you go onto the websites of these drug companies, they will admit it, they’ll actually say, “We don’t know why this works,” and they’ll say, “We don’t cure depression.” The most they’re hoping to do is to deal with the symptoms. Now, these psychotropic drugs, there have been various studies done, and there have been some done around 2010 actually suggesting that most of the claimed effect, and these aren’t biblical counselors doing these studies, these are research psychologists who aren’t necessarily on our side, but even they’ve said that the placebo effect may account for most of what people claim is happening good from the psychotropic drugs, especially for depression. I had a counselee personally, who, two days after going on the drug, said, “Whoa, I’m taking this now, I feel so much better.” Well, the people that manufacture the drug would tell you, whatever it does to you chemically, doesn’t take effect that fast. It takes several days, or even more than a week, so the reason they’re feeling better is because they hope the drug would make them feel better. A sugar pill would have done the same, at least at that point. So, there’s a question as to whether these drugs are even effective for the symptoms.

But, also, psychotropic drugs have adverse side-effects. You’re monkeying with brain chemistry, and the side-effects, if you read the list, are liver issues, heart issues, seizures, mania, weight gain, weight loss, tendency to suicide, loss of desire for sex. I’ve had counselees complain about that one. Another aspect is the effectiveness of whatever you had tends to wear off, and then they put you on a stronger or a different drug, or sometimes you’re on one drug for whatever this problem is, another drug offsets the side-effects of that drug.

Now, having said all that, as biblical counselors, we do not tell people to take drugs, we do not tell people not to take drugs. Our job is focusing on spiritual issues. If someone comes in with depression, I will talk to them, I will try to identify what the spiritual issues may be, and I will try to address those issues. If they ask me my opinion, I might say, “Why don’t we see if we can address the spiritual issues? “These may be the cause.” And if so, if we address the cause, we’ve seen cases where, when those spiritual issues are addressed, the feelings of depression go away, and drugs are no longer an issue. Some counselees are very defensive about taking drugs. I’ll say, “Look, I’ll counsel you if you’re on the drugs. “I’m never gonna force you to get off the drugs. “That’s gonna be, if you ever made that decision, “this will be a decision you would make.”

Other counselees desperately want to get off the drugs. They don’t like how the drugs make them feel. Even in that case, never tell a counselee, “Just flush the drugs.” These drugs have side-effects, there can be withdrawal issues. If a counselee decides to get off the drugs, first of all, hopefully, the spiritual issues are being addressed, so he is gonna be in a position to fight the depression spiritually, but also it should be done under a doctor’s supervision so that it is done safely.

While my opinion is drugs are overprescribed, my opinion is that most depression is spiritual in the root cause, because I am not all-knowing, I also have to be cautious in terms of passing judgment on a particular individual. Is it possible there may be something in their brain, physically, that’s causing this, and not merely a spiritual problem? Yeah, I don’t know enough to say it’s not. Is it possible a drug may help to relieve that? It’s possible. I think, generally speaking, rare, but we do not wanna pass judgment in those situations, and we can address their spiritual issues regardless of whether they’re on the drugs or not.