Thank God for Paxil

There is an undercurrent in some corners of Evangelicalism that says anyone who takes antidepressants, whether for depression proper or anxiety (both of which could be called a form of melancholia), is simply masking over a sin problem in his life.   If he would simply repent, then these “crutches” would not be necessary.  In the last couple of years, I’ve heard at least two preachers say that while there are some people who have medical conditions that warrant the use of antidepressants, most mental health problems are related to unresolved issues of guilt in people’s lives.  Whether this is true, I am not qualified to say.  But I strongly suspect that neither of these preachers was qualified to make this judgment either.  More likely than not, they were parroting what they had heard some nouthetic counselor say - with one unintended consequence being that anyone known to be taking these meds automatically is brought under suspicion of being unrepentant.

No doubt, there is a kind of anxiety that is always sin, such as worrying about the necessities of life (Matthew 6:25).  But there is also anxiety that comes with the acknowledgment of sin (Psalm 38:3).  Likewise, there is depression which flows from a discontentment with the way God disposes of us, and then there is depression that is a discontentment with being alienated from God (or feeling this to be the case).  And although a person needs to turn to Christ in each of these cases, this doesn’t immediately alleviate the symptoms of depression or anxiety.  Why?  Because even a believer often struggles to believe.  Roland Bainton in his famous biography of Martin Luther rightly said:

“. . . faith in Christ is far from simple and easy because he is an astounding king, who, instead of defending his people, deserts them.  Whom he would save he must first make a despairing sinner.  Whom he would make wise he must first turn into a fool.  Whom he would make alive he must first kill.  Whom he would bring to honor he must first bring to dishonor.  He is a strange king who is nearest when he is far and farthest when he is near.”

Add to this that in many cases melancholia has an organic component.  Such people have a mental illness or defect.  Granted, the illness may have some connection to sin, either personal or the sin of Adam, yet that in no way precludes medicine to help the person function again.  To argue that would be the equivalent of prohibiting chemotherapy to someone who once smoked cigarettes or prohibiting heart surgery to someone who had been a couch potato.  Neither logic nor compassion can go there.

Consider the counsel of Richard Baxter in his Christian Directory to those prone to melancholia.  He said:

“. . . commit yourself to the care of your physician, and obey him; and do not as most melancholy persons do, that will not believe that physic [medicine] will do them good, but that it is only their soul that is afflicted; for it is the spirits, imagination, and passions, that are diseased, and so the soul is like an eye that looketh through a coloured glass, and thinks all things are of the same colour as the glass is.  I have seen abundance cured by physic; and till the body be cured, the mind will hardly ever be cured . . .”

Now, I’m sure there are people that abuse antidepressants and doctors who over-prescribe them.  But what is there in this world that’s not abused by sinners?  Even justified, sanctified sinners?  We sometimes eat too much, drive too fast, or say things we shouldn’t say.  But does that mean because these things can be abused that anyone who eats or drives or talks should have a cloud of suspicion hanging over their heads?  Of course not.  But why the distinction between these activities and the taking of legal, often helpful medications?  Because people who are prone to deep debilitating depression or anxiety are strange, sad people.  And although their deformity isn’t physically manifest, it might as well be because it makes “normal people” feel uncomfortable.  The deeply melancholy are a small minority, and the majority simply cannot comprehend why these people don’t just pick themselves up, dust themselves off, and get on with living.  Or to make it sound more “spiritual,” they wonder why these sad ones can't just repent and trust God.

Note: For further reading on this topic, see D. Martyn Lloyd-Jones’ book, Healing and the Scriptures, particularly the chapter entitled “Body, Mind, and Spirit.”