We both love how Matthew has taken the concept of sin and given a breath of fresh air to the topic. You must read this book because in its pages you will finally gain a biblical perspective on sin and what it takes to free yourself from the bonds that so easily entangle!

Gary and Michael Smalley
Smalley Relationship Center
When mental illness afflicts a loved one, how can we understand what is happening and respond appropriately? This biblically-literate and scientifically-informed book offers helpful insight, encouragement, and practical advice. For pastors and for those who hurt for those who hurt, Matthew Stanford offers sensitive and welcome guidance.

David G. Myers, Ph.D.
Professor of Psychology, Hope College and author of Psychology Through the Eyes of Faith.

Wednesday, March 31, 2010

Women, Depression and the Church (Part 2)

So what should a woman struggling with profound sadness and depressed mood do to determine the best course of treatment and healing? A good place to start is with a physical by your primary care physician (PCP). During that office visit the PCP can order testing and perform a physical exam that will rule out many other potential disorders that may be causing the problem (e.g., hypothyroidism, Addison’s disease, pancreatic cancer). In addition, the PCP can likely make a referral to a psychologist or psychiatrist who will further evaluate the person once a non-brain related disorder is ruled-out.

If a psychological assessment shows that the individual meets criteria for a diagnosis of major depressive disorder the person should then begin treatment. Treatment may include antidepressant medication and some form of talking therapy (psychotherapy). It is imperative that an individual diagnosed with major depressive disorder receive some form of psychotherapy. Medication alone is typically not effective in fully managing the symptoms of major depressive disorder. In combination, psychotherapy and medication have consistently been found to be a more effective treatment than either alone.

What if a physical illness is ruled out and the person does not meet criteria for a diagnosis of major depressive disorder after a psychological assessment? At this point antidepressant medication should no longer be considered an option and some type of counseling is the most appropriate course of action. Personally, I would recommend some type of pastoral counseling either through the church or a local Christian counselor. Spiritual healing and wholeness only come through an understanding of who we are in Christ. In addition, during a time of psychological distress the person’s friends and family have the opportunity not only to remind their hurting sister of the truths of God, but also to love them, walk beside them, and encourage them. Two sets of verses that I have found helpful in doing this are Philippians 4:11-13 and 1 Peter 1:3-9. These verses teach us that while difficulties and trials (like depression) will come into all of our lives, contentment in Christ is learned through a process of daily submission to God and ever increasing dependence on the great hope laid before us, Jesus.

Tuesday, March 23, 2010

Women, Depression and the Church (Part 1)

After the birth of our second child Caleb, my wife Julie became co-coordinator of a women’s outreach ministry at our local church. She was on a steering committee of 10women, all of whom were married and had young children. Julie knew all of the women well but quickly found out something she didn’t know, 7 out of the 10 women (70%) were taking antidepressant medication. This came as a shock to us, not because someone would be on an antidepressant medication but because of the sheer number of women in the group taking them.

All of the women in the group were very open about their antidepressant use and the struggles that had lead them to get the medication. Many said that they felt like they couldn’t handle life, that they were overwhelmed having to meet so many people’s needs. They felt like they were not good mothers and wives. They described feeling a lack of fulfillment in their lives, they were exhausted and it was taking a toll on their marriages. One woman said “I couldn’t stand to be around myself”. So they all sought out something from their family physician that would help them feel better about life and themselves.

We all know someone who is taking an antidepressant medication. And I certainly do not want to deny the potential benefits of these medications in individuals who truly need them. But while it is generally accepted that 5% of Americans suffer from clinical depression (women more than men) a far greater percentage of the population is being treated with antidepressants. This dramatic increase in the prescribing of psychiatric medications over the last two decades has caused some in the Christian community to question the legitimacy of depression as a psychiatric disorder and the use of antidepressant medications by those in the church.

In a recent study I conducted to investigate this problem I found that Texas pastors perceived biological causes as more important than psychosocial and spiritual causes for all mental disorders. There was however, significant variability in how much of a contribution the pastors believed spiritual factors influence various disorders. Spiritual factors were perceived to make a significant contribution in major depressive disorder but thought to have little influence in cases of schizophrenia and bipolar disorder. This may result from the fact that depression has a sub-clinical manifestation, as mentioned above, not seen with schizophrenia and bipolar disorder. A sub-clinical manifestation of depression could rightly be perceived by a pastor as resulting from spiritual factors (e.g., guilt over sinful behavior, poor marital relationship). Exposure to these types of sub-clinical problems might cause an over generalization of spiritual influences to all “depression” regardless of the severity. This same type of type of generalization would not be possible in disorders without sub-clinical manifestations like schizophrenia and bipolar disorder.

It is important to realize that being “depressed” or having the “blues” is different than meeting criteria for major depressive disorder. To limit confusion and facilitate appropriate treatment I recommend that an individual not begin taking antidepressant medication unless they have undergone a full psychological assessment (which takes several hours and is usually done by a clinical psychologist) to determine if they truly meet the criteria necessary for a diagnosis of major depression.

Monday, March 15, 2010

Support Group / Bible Study Resources

I am often asked if there is material available for individuals interested in starting faith-based support groups or Bible studies for individuals struggling with mental illness and their families. Two resources that I highly recommend are Dr. Steve Waterhouse’s Depression Recovery According to the Bible and Steve and Robyn Bloem’s Christians Afflicted with Mental Illness. Both of these resources come from pastors who have experienced the pain and suffering associated with mental illness first hand.

Monday, March 1, 2010

Trauma and Suffering

There are five key truths that the scriptures teach us about trauma and suffering. First, that God is present and in control of our suffering. In times of great suffering and pain, we often feel the farthest from God. Where is He? Has He forgotten me? How could He let this happen? This was also the case in the lives of great men of faith in the Bible. Look at David (Psalm 13:1), Jeremiah (Lamentations 3:8) and Job (Job 9:16). Even Jesus at the height of his pain cries out “My God, my God, why have you forsaken me?” (Matthew 27:46) From our limited human perspective, pain and suffering seem contrary to our idea of a sovereign God who is good and loving. We think that God blinked and wasn’t able to stop this traumatic event or He isn’t really a loving God. We forget that Adam chose to sin and that we live in a fallen world, full of suffering. Suffering should not cause us to question God’s sovereignty, as Job so clearly understood (Job 2:10). God is sovereign despite our circumstances. He created all things and He controls all things (Deuteronomy 4:39;
1 Chronicles 29:11; Psalms 103:19; Daniel 4:35; Colossians 1:15-17). He allows us to experience the consequences of sin while remaining fully in control of all things including Satan, who can only bring suffering into our lives if God allows it (Job 1:12; Luke 22:31). God is in control of our circumstances, and He wants to transform us into the very image of His Son.

Secondly, we learn from the scriptures that God is good and cares for us. We have all heard this statement, “How could a loving God allow __________?” Fill in the blank with any horribly traumatic event that occurs here on planet Earth. People often use this statement to argue against not only the love of God but also the very existence of God. But God does love us and that is evident in our redemptive history. The creator of the world made a way for disobedient, powerless creatures to come into an eternal relationship with Him. He is patient and gracious. He became one of us (John 3:16) and then sacrificed Himself for us (1 John 3:16). Self sacrifice is the ultimate act of love (John 15:13). God is indeed good and He longs to be in an ever deepening relationship with us.

In James 1:2, we are told to “consider it pure joy” when we go through difficult times. What kind of strange mental gymnastics does God want me to do? I’m supposed to be happy when I’m in pain? No, not at all. Even Jesus was sad when he went through difficult times -- at Lazarus’s grave, in the garden of Gethsemane, and on the cross. The third truth we are called to recognize is that through our trails and suffering we have an opportunity to draw closer to God. During the easy times we often become self-reliant, forgetting our need for God. It is in the hard times, when our faith is tested, that we recognize our need for complete dependency on Him. James tells us that persevering through the difficult times develops a mature and complete faith (James 1:4). We are ever being conformed into the image of Christ and suffering is a necessary part of that transformation (Romans 8:29; Philippians 1:29; 1 Peter 2:21).

Jesus understands what it is to suffer is the fourth truth. We do not worship a distant, unapproachable God. We worship a God that knows what it is to be human (Hebrews 4:15). He knows what it is to suffer (Hebrews 2:17-18). Just think about Jesus’ life for a moment. He didn’t experience just one traumatic event during His time on Earth. His whole life was full of suffering. The prophet Isaiah told of His suffering hundreds of years before His birth (Isaiah 53:3-5). He was born into unimaginable poverty in a country occupied by a cruel army (Luke 2:1-7). He narrowly escaped a mass slaughtering of children that was ordered because of His birth (Matthew 2:16). He was physically assaulted by Satan (Matthew 4:1-11), persecuted because of His teachings (Luke 4:28-29), thought insane by His family (Mark 3:21), betrayed by His own disciple (Mark 14:43-45), deserted by His friends (Mark 14:50), falsely arrested (Mark 14:56-59), publicly humiliated (Mark 15:16-20; Luke 23:8-12), beaten to the point of death (Matthew 27:26), and then slowly and painfully publicly executed by crucifixion as a common criminal (Matthew 27:33-39). We can take great comfort in the fact that God can relate to us on our level, He understands what it is to suffer.

Finally, our identity is not defined by traumatic events or suffering but is grounded in Christ. God does not see you as a victim. He sees you as His child. The scriptures tell us that as children of God, we were chosen before the creation of the world to be holy and blameless adopted sons and daughters, lavished with grace, redeemed, forgiven, given spiritual wisdom and understanding and marked with the Holy Spirit (Ephesians 1:4-14). We are in Christ! We sit at the right hand of the Father! We have His righteousness! We must not allow tragedy or circumstances to define who we are or how we live. We have His very life within us and we must choose to live out of that truth.