Depression, Drugs and the Desires of the Heart

On a regular basis in our church, pastors, counselors and congregants receive questions about the use of prescription drugs for conditions of the soul and body such as depression and anxiety. How should we think biblically about the topic of medication?

Topics: Suffering


How should we think biblically about the topic of medication?

Those asking this question are generally not referring to the use of insulin for managing diabetes or antibiotics for treating an infection. Medication for allergies, asthma and heart disease, almost all Christians agree, can be appropriately and wisely received as gifts of common grace. The agreement tends to fade, however, and confusion tends to grow, when talking about the use of psychoactive or psychotropic medicine—that class of drugs designed to alter mood, consciousness and/or behavior.

On a regular basis in our church, pastors, counselors and congregants receive questions about the use of prescription drugs for conditions of the soul and body such as depression and anxiety. Often the questions come preloaded with strong convictions. “Surely taking a pill to achieve what only Jesus can give you is totally evil, right?” Or, “You don’t honestly believe God would allow something to be created to relieve suffering people and then refuse for them to take it, do you?” The phrasing and tone of a question often betrays the intentions and convictions of the person asking.

Our emotions, opinions and assumptions can be intense when encountering these questions. The stakes seem high—and personal—perhaps even for those reading this now. These are important questions. How we answer affects the lives of real people. We want to think and talk about them carefully. We want to think and talk about them biblically.

A Profoundly Personal Theological Topic

Perhaps you or someone you love experienced serious hurt through psychotropic medication or the psychiatric establishment. You may have spent years taking these drugs because someone told you about a chemical imbalance in your brain that needed balancing, only to hear that the scientific support of such imbalances is shaky. Then you may have weaned off these drugs, perhaps painfully, only to conclude you had just spent the previous years of your life numbed, sedated or otherwise stiffened to the world in and around your body. Or after years on an antipsychotic medication, you or a loved one might be suffering from serious and possibly irreversible side effects. Your experiences have left you embittered and outraged.

Or you may sincerely believe these same drugs saved your life or a loved one’s by the grace of God through the natural workings of chemistry. Antidepressants, in your personal experience, may have acted as keys, unlocking the emotional prison in which you dwelt. They may have removed the fog from your mind or lifted the clouds or provided a means to deal more honestly and rationally with the world in and around you. Conversations about medication, therefore, are deeply personal for you or those you love.

Maybe psychoactive drugs are not part of your personal experience but simply fit somewhere inside your theological framework. You see a theology of medication in Scripture, based on passages like, “they gave Him wine to drink mixed with gall; and after tasting it, He was unwilling to drink” (Matt 27:34). The way Jesus dealt with a first-century narcotic designed to numb his mental and physical suffering, you believe, should inform our approach to 21st-century narcotics.

The issue of medication could, from your point of view, land outside the theology of the Bible: It belongs solely to the jurisdiction of science and medical practice. Questions of psychopharmacology fit beside, “Where do blue whales travel in the winter months?” or “How do we solve the problem of global warming, if there is one?” You hear the question and think, “Those aren’t questions the Bible tries to answer.”

Maybe you view the decision to take psychoactive drugs as a moral concern and place it inside a category with fornication, abortion and drunkenness. Taking medication in an attempt to lessen worries, sorrows and mental agitation represents a failure to trust the full provision of Christ in the gospel. Thus, treating depression with medication is paramount to “dining in an idol’s temple” (1 Cor. 8:10) or drinking “the cup of demons” (1 Cor. 10:21). If you were to go to a psychiatrist, you would feel like Saul seeking counsel from the witch of Endor (1 Sam. 28:7).

It could be that you view psychiatric drugs as a rather amoral concern. “Which shoe do I put on first, left or right?” “Do I have toast or cereal for breakfast?” “Do I take Zoloft or Paxil or nothing at all?” It falls under the general banner of ethical irrelevance. Who cares? To each his own; “To thine own self be true!” to quote William Shakespeare’s Hamlet. You wonder what all the fuss is about.

With such assorted presuppositions, experiences and convictions, any conversation about this subject is a challenge. How then should Christians think biblically about the question of using psychoactive medication in general and, even more importantly, in the particular lives of the people we know and love?

We do not propose to have the answer to the medication question. What we want to discuss instead is a way to wrestle with the topic that follows the pattern Scripture provides for wrestling with topics like this one. If we approach the question of psychotropic medication as if medication is the real issue, we will likely miss the point.

Days, Diets and Psychiatric Drugs

Let not the one who eats despise the one who abstains, and let not the one who abstains pass judgment on the one who eats, for God has welcomed him. Who are you to pass judgment on the servant of another? It is before his own master that he stands or falls. And he will be upheld, for the Lord is able to make him stand. One person esteems one day as better than another, while another esteems all days alike. Each one should be fully convinced in his own mind. The one who observes the day, observes it in honor of the Lord. The one who eats, eats in honor of the Lord, since he gives thanks to God, while the one who abstains, abstains in honor of the Lord and gives thanks to God. For none of us lives to himself, and none of us dies to himself. For if we live, we live to the Lord, and if we die, we die to the Lord. So then, whether we live or whether we die, we are the Lord’s. For to this end Christ died and lived again, that he might be Lord both of the dead and of the living. Romans 14:3–9

Psychiatric medications seem to fit somewhere inside the same general category as pork, wine, home schooling, Sabbath observance, owning a vacation home, getting a massage, doing yoga and a million other concerns and decisions that occupy the Christian life. The wisdom and rightness of the activity depends primarily upon the motivation and purpose of the person engaging it. Even though Paul obviously doesn’t mention psychoactive drugs in the Romans 14:3-9, his flow of thought should shape our thinking and conversation about medication, just as it should shape our approach to everything else.

Is it right or wrong to drink a glass of wine? Scripture teaches that it depends. Who is drinking it and where and when and how? Perhaps, more importantly, why are you drinking it—to enjoy the gifts of God for the glory of God (1 Cor. 10:31)? Do you drink to enjoy and edify the body of Christ? Or are you trying to escape, check out and numb pain? To whom are you drinking—the Lord or yourself? Are you edifying your brother or sister in Christ or are you draining the glass without any concern for how those around you may be influenced by your exercise of freedom (Rom. 14:13-16)?

It might be perfectly acceptable to drink a glass of wine one day and terribly unwise and even sinful to drink it the next day, depending on the posture of your heart and the particular details of your surroundings.

“Can I buy a vacation home, bigger house or expensive car?” “Should we do public school, private school or home schooling?” “Am I allowed to eat fried food? Should I become a vegetarian or a vegan?” Again, it all depends. What’s motivating your decision and action? Whose glory and kingdom are you seeking? Whose grace and power are you trusting? In whatever choice, is faith working itself through love or is unbelief working itself through self-love?

If we can assign psychotropic medication to a category, then we think it should be this one. Medication itself is simply a substance cultivated by people using the raw materials God created. Can we use them sinfully? Certainly! Just as we can use food, wine, exercise and everything else sinfully! Can we use them ignorantly? Yes! It may be dangerous to put psychoactive drugs in your body over a long period of time. There may be no one telling you that, just as no one tells you how many additives and hormones went into that slab of meat or packaged food you just bought at the supermarket.

Medication influences our bodies and souls. So do cars, homes, processed food and television. Yet surely Paul labors to help us see these created things are not the main issue. We’re not talking about explicit evils, like pornography, but objects, like food or money or bullets, manipulated by a human heart to serve good or evil. The ruling orientation of the heart using them will always be the main issue. Whether you ingest a medication or refuse it, Scripture asks: “Is Jesus Christ the Lord of your life so much that His kingdom and glory motivate and inform whatever you’re doing with medication?”

Whether it’s pain pills, insulin, caffeine or some kind of sedative, the controlling issue is the orientation and posture of the heart. “So, whether you eat or drink, or whatever you do, do all to the glory of God” (1 Cor. 10:31). Are you taking Wellbutrin or Zoloft or Celexa as an expression of faith in Jesus Christ working itself through love for Jesus Christ with deep gratitude toward God in order to help you love Him and others? Or do you simply want to feel better, avoid pain and get a quick fix for the various emotional and physical problems in your life?

On the other side, do you refuse psychotropic medication as an expression of your trust in Jesus Christ in order to help you love Him and other people more deeply? Or is it an expression of your self-righteous soul flexing its moralistic muscles so that you can feel better about yourself and condemn other people? Our answers to these questions matter. They matter to conscience. They matter to God. “The faith that you have, keep between yourself and God. Blessed is the one who has no reason to pass judgment on himself for what he approves. But whoever has doubts is condemned if he eats, because the eating is not from faith. For whatever does not proceed from faith is sin” (Rom. 14:22–23).

Our reasons for refusing medication can be just as sinful as our reasons for embracing it. We can avoid God by running to created things or we can avoid God by solving our own problems. Both consumption and abstinence can mask the same underlying tendency. Medication cannot justify, sanctify or glorify anyone. Avoiding medication cannot either. Jesus Christ can and does. Medication cannot condemn or destroy anyone. Faithlessness can and does. Medication cannot impart or remove genuine love, joy, peace, patience and self-control. The Holy Spirit gives birth to these and much more (Gal. 5:22-23; Eph. 5:18-21).

A self-dependent, non-Spirit-filled life stifles and kills these spiritual fruit. The Father seeks those who worship Him in spirit and in truth (John 4:23-24), not those who figure out how to eat, drink, sleep, dress, save and spend the right way. Medication matters, but not that much. In Christ Jesus, faith working through love in every detail of our lives matters infinitely more.

Wrestling With the Weight of the Heart

To medicate or not to medicate? That really isn’t the question. Medication itself can be a means of serving Christ or self depending on the way that we receive or reject it. How might we wisely consider the reception or rejection of medication? Here are a few questions to process.

In this season of anxiety, depression or confusion, what might the Lord be exposing, challenging and redeeming in your life?

Fear, anger, despair and despondency expose who and what we worship. They can help us see whom and what we truly value, trust and fix our eyes and hope upon. Are you open to what your Lord is trying to help you see and understand about the loyalties and loves of your soul? Are you willing to admit what anxiety, anger and depression reveal about you? Or are you avoiding the hard questions God and people in your life are asking?

How will receiving or rejecting medication help sanctify you and give glory to God?

These complementary goals should motivate all that we say and do, though the reality often falls far short. As those being moved to maturity by the work of the Holy Spirit, our sanctification to God’s glory is our ultimate end (Rom. 8:26-30). Will taking medication help this process or slow it down? Will it shortcut or numb the work God is doing? Will it help you see or blind you further?

Are you honestly, confidently and desperately approaching the Father in prayer?

When we suffer, we seek refuge somewhere. We run to whatever fortresses we have come to rely upon whenever life goes wrong. We talk to ourselves. We listen to ourselves. Sometimes we talk to other people. But do we talk to God? We have a Father who delights to hear and respond to His children. What a tragedy it would be to forsake His friendship as if He is unconcerned with your physical or emotional well-being.

Have you invited wise, loving, Christ-cherishing men or women into your life who listen to your struggles and counsel you wisely?

Godly counsel is often hard to find. Our friends tend to give us the benefit of the doubt rather than asking the difficult and awkward questions that love demands. Sometimes we are more concerned with preserving a friendship than the progress of that friend’s faith. Have you earnestly sought out counselors who will delve into what’s going on in your heart and circumstances, listen carefully and ask hard questions about your motivations and desires?

Is your decision to take or not take medication an expression of faith in Christ and a desire to love Him and others?

Be honest here. Deceiving yourself will only generate confusion and wreckage. Rarely will our motivations be completely pure. The thoughts we entertain and decisions we make tend to flow from a mixture of Spirit and flesh, a collision of His will and ours, and some interaction between biblical wisdom and human folly. The question at any time is: Who and what has the upper hand—Spirit or flesh, His will or ours, wisdom or folly?

Are you taking medication to simply run from and numb the pains and sorrows of this fallen world? Are you taking pills to avoid taking hold of Christ in His Word? Conversely, are you refusing medication in a vain effort to pull yourself up by the bootstraps, relying on your personal grit and avoiding the Lord?

Will your use or non-use of psychoactive drugs edify the body of Christ or tear it down?

This is a hard point to consider. Most of us prefer to see our choices and actions in a vacuum, as if they don’t influence and affect everyone around us. God wants to change this. When we’re thinking about drinking a glass of wine, gathering on the Sabbath or taking medication, He wants us to consider the spiritual welfare and edification of the people nearby.

For example, if you’re considering medication out of genuine love for your spouse who grieves for you every day because you won’t get out of bed and frets over your welfare because of the morbidity of your thoughts, you could be on the right track. If you refuse medication in order to exercise faith in God’s power for the sake of your spouse and children, then praise the Lord: you could be on the right track, too.

Are you seeking first His kingdom and His righteousness in your life as a whole such that taking or not taking medication serves as an extension of that larger mission in your life?

If the regular, instinctive and passionate desires and decisions of your life revolve around you, your kingdom and your personal glory and pleasure, then almost everything you think and do will be wrong. After all, “without faith it is impossible to please Him” (Heb. 11:6). Those actions, whatever they may be, will lead you further from the Lord, not closer (Isa. 64:6; Matt. 6:1-7). Whether you take medication or don’t, whether you eat pork or not, and whether you work as an engineer or schoolteacher, won’t actually matter.

Yet, if the ever-growing delight and longing of your soul is the Lord and His renown, then most of the activities of your life, by His grace, will honor Him. “The one who eats is not to regard with contempt the one who does not eat, and the one who does not eat is not to judge the one who eats, for God has accepted him” (Rom. 14:3). What a comforting thought! God has accepted him. Pursuing some course of action with our childlike faith, because of Jesus Christ, is acceptable to God.