Should Christians Take Medication for Anxiety and Depression?
Martin Luther, the spearhead of the Protestant Reformation, had a lifelong struggle with anxiety and depression. He would talk to himself, curse the devil out loud (as well as “break wind” in the devil’s direction!), and continually battled the crushing weight of feeling condemned. On one occasion, he was feeling so down and depressed that his wife dressed up in black funeral garb and told him that, because he was acting like God was dead, she figured she would join him for the funeral.
But Luther is not the only one. The great Reformed, Baptist preacher, Charles Spurgeon, wrote honestly about his deep struggle with lifelong depression. This depression was so debilitating, that Spurgeon found his ministry greatly hindered during these seasons of difficulty. He described his depression succinctly: “My spirits were sunken so low that I could weep by the hour like a child, and yet I knew not what I wept for.”
Jonathan Edwards, the greatest theologian to ever come out of North America, struggled his entire life with what he called “melancholy,” which would probably be diagnosed today as a constant, low-grade depression.
Lest you believe that depression is a modern epidemic, it is helpful to see that many people, including great Christian leaders, battled this issue throughout church history.
Were these men ungodly just because they struggled with depression or melancholy? Were they forgetting the gospel and focusing too heavily on a thorn in their flesh?
But…we don’t only see depression and anxiety in church history; we see them in the Bible as well. King David says in Psalm 31:9-10, “Be gracious to me, O LORD, for I am in distress; my eye is wasted from grief; my soul and my body also. For my life is spent with sorrow, and my years with sighing; my strength fails because of my iniquity, and my bones waste away.” The Apostle Paul says he feels constant “…anxiety for all the churches.” (2 Cor 11:28) - whether this is sinful anxiety or not, the emphasis is still on the overwhelming weight he constantly experiences. Even Jesus, who is perfect, feels a strong level of non-sinful angst in the Garden of Gethsemane–an angst and panic so strong that his sweat was as drops of blood.
All of these men endured, at least some degree, of crushing angst. Now, we realize that anxiety and depression are two different things. Some struggle with one but not the other. But, since they are often related (and medicine can be prescribed for both), we’re lumping them together for the purposes of this article.
Here’s the question we’d like to answer in this blog: Had medicine been around during the ministries of these men, would or should they have taken it? Below we try to evaluate what the Bible would have us think about this important issue. We’ve also had a professional psychiatrist look over this blog to get their opinion on the medical side.
Between two extremes
This question is at the center of a big debate going on in Evangelicalism; much ink has been spilled over whether or not Christians could/should use medication to help battle anxiety and depression.
On one end of the spectrum are those who say “absolutely not.” They will say that since anxiety is a spiritual issue, it should be battled spiritually – through prayer, Bible study, repentance, etc. Any attempt to use physical means to battle a spiritual issue is trusting in the flesh instead of Christ.
On the other end of the spectrum are those that think that medication can replace the Savior. They think that people don’t need to do the hard work of dealing with the deeper spiritual realities of putting sin to death – because if they can take a pill to help them feel better, then the problem is solved.
But, being someone who has struggled with constant anxiety my entire adult life, I would say that neither of these extremes are correct.
Rather, Jesus is the solution, but sometimes medication can help you see Jesus more clearly.
What is the purpose of using medication for anxiety and depression?
The best example we can give is this:
Imagine that you are on a ship in the ocean and you fall overboard and into the water. Your head keeps going under the water because you can’t swim, and you start freaking out. You feel like you are going to drown. Because you are in a panic, you can’t figure out how to get back on the boat. So, someone throws you a lifesaver. Once you grab the lifesaver, you are not back on the boat. To get back on the boat you will need the gospel. You will need Bible study, repentance, community, prayer, and counseling.But, at least while you’re hanging on to the lifesaver your head isn’t going underwater, so you can at least see the boat and see how to get back on board more clearly.
The purpose of medication is the same as that lifesaver. The lifesaver doesn’t get you back on the boat – it just keeps your head from going under so you can actually see the boat. The lifesaver is not the solution – it helps you see the actual Solution (Christ) more clearly.
The problem with the first view we mentioned above is that it assumes it is wrong to throw someone a lifesaver. It assumes that someone using the lifesaver must be bad, weak, or unspiritual. On the other hand, the second view acts like the lifesaver has replaced the boat. And neither of these extremes are right.
The first view thinks that medication can only be an idol and the second solution thinks that medication should be an idol.
Medicine is not the ultimate solution; just like a lifesaver is not the boat. But using a lifesaver does keep you from drowning, so you can eventually get back into the boat.
The primary objections to using medication for anxiety and depression
One of the biggest objections to using medicine is that some believe it is putting one’s hope in something other than the gospel. Again, they would essentially say that you shouldn’t use physical means to treat spiritual problems.
But this isn’t necessarily biblical. The Bible describes and prescribes the use of physical means to fight sin all the time. King David uses music to soothe Saul’s spiritual torment. When we are tempted with lust we are not told to just “be more spiritual” and not lust; we are told to cut off our hand and gouge out our eye to deal with it (Matt 5:29-30). In fact, it seems like Jesus is saying do whatever you have to, no matter how “physical” it is, to deal with sin! The point is not that you should literally mutilate your body, but you should literally do whatever you can to avoid transgression. In 1 Corinthians church members are going to temple prostitutes and Paul’s advice for them is not to “just try to stop sinning” but rather to get married so they have an appropriate outlet for their sexuality (1 Cor 7:1-5). Will cutting off your hand or getting married actually stop the sin? No. But will cutting off your hand or getting married make it easier to resist sin? Yes.
Now…listen closely…medication is not the solution, it is merely a tool that stacks the deck in your favor. It can make it easier to obey the gospel, or see the gospel more clearly. Why would you not want that? If God hates sin, why wouldn’t you make it as easy as possible to not sin? It’s not more “spiritual” to make obeying God more burdensome than it needs to be. In fact, it is borderline Pelagian to believe that God is wanting you to strive and try harder, instead of benefitting from the common graces he has given you.
God gives us graces outside of the gospel to help us believe the gospel. For example, we should just believe we have new life in Christ, but the physical act of baptism helps us to believe it. We should just know that our sins our forgiven, but eating bread and drinking wine in communion helps us to believe it. We should just be able to not burn with passion, but having a spouse helps us battle lust.
In other words, to trust in the “flesh” is not to use graces God has given you to use to fight sin; trusting in the “flesh” is to refuse to fight sin at all.
A second objection to using medication to battle anxiety or depression regards a false assumption that our problems are merely spiritual. That is borderline gnostic. We are not just souls; we are bodies. Sin hasn’t just affected our souls; sin has affected our bodies. If soldiers, who are constantly stressed in battle, can have their brain chemistry get all out of whack (P.T.S.D.), then the same thing is true for civilians.
If someone was feeling anxiety and they went for a run to relieve the stress, nobody would think they are sinning by using physical means to fight stress. Or if someone had the flu, nobody would fault them for going to the doctor. Nobody would tell a sick person just to sit in their pain because God will use their suffering to sanctify them. God does use suffering to sanctify, but that doesn’t mean you shouldn’t get out of the suffering if you can. That’s why we go to the doctor when we are sick.
The Bible allows us physical means to treat the effects of the fall all the time. We can use the ancient equivalent of medicine (herbs, oil, wine, etc.), David eats food as comfort after losing his child, Timothy is told to drink wine to help his sick stomach, and Psalm 104:15 says that God created wine to make our hearts happy. Notice that wine is a mood-altering substance that is seen as a gift!
You see, there is a bit of a “chicken or the egg” thing going on with anxiety and/or depression. Sometimes spiritual issues cause physical changes (high blood pressure, changes in brain chemistry, etc.), but sometimes physical issues exacerbate sinful tendencies. The physical and the spiritual go together.
The Humility of Medication
I began struggling with depression and anxiety four months into my first pastorate. I knew the problem was spiritual (I don’t have any history of psychological problems or chemical imbalances). So, because it was spiritual, I thought it would be stupid for me to try to combat a spiritual problem with medication. I eventually had to resign from that pastorate due to debilitating depression and thoughts of suicide. I stayed off medicine for four years before I finally went to the doctor. After just six months of taking medication I was able to get off of the medicine and I could see everything much clearer. I couldn’t believe the hell that I had put my wife through for years when I could have taken some medicine for just six months. My pride and my bad theology cost me and my loved ones dearly.
But I’m not the only one. One of my modern pastoral heroes, Tommy Nelson (pastor at Denton Bible Church in Denton, TX), used to be adamantly against using medicine for depression. He counseled people who were depressed to just pray and read their Bible more. Over the last few years he has been hospitalized twice due to depression. I believe that in this God has humbled him, and he has changed his view.
Conclusion
Our Savior has a name and it is not Xanax, Lexapro, or Zoloft–his name is Jesus. He must stay central even while you seek out methods to help you see him more clearly. Should you take medication for depression or anxiety? Maybe or maybe not. In order to answer that question, here are a few things to ask yourself, your doctors, counselors, and pastors:
1. Do I really believe that Jesus is the ultimate solution to my problems?
2. Do I look down on others or myself for using medication?
3. Do I run to medication as my ultimate solution or just something to help me fight sin?
4. Where am I being “holier than the Bible” and forbidding what it allows?
5. Where am I not doing the hard work of repentance, confessing sin to others, prayer, and Bible study? Or, should I use medicine so that I can better pursue these things?
6. Where am I allowing my pride or a false sense of guilt to keep me from taking medication I may need?
7. Is my doctor a believer who understands both the spiritual and physical aspects of my depression and anxiety?
8. Am I regularly walking in community, regularly practicing spiritual disciplines, regularly attending church and taking communion, and regularly serving other people? (Note: Doing these things out of guilt is not the same as doing them with a heart of worship that is seeking to be faithful).
9. Am I doing other things to physically take care of my body (working out, eating healthy, etc.)?
10. Do I need to talk to some other godly people to see what they think I should do?
11. Am I intending to use this medication for a season (until I am able to get off of it), or am I intending to use it permanently? What does my doctor think about the how long I will need to use the medicine? (Note: While some people may have to be on medication permanently – which is totally OK – the vast majority of people will only need it for a season, and should then transition off of it.)