Thursday, June 14, 2012

Stick to Preaching, Preacher! - When Pastors Try to Be Doctors

Not all doctors are created equal and not all doctors are qualified for the same tasks. Just as you would not go to a heart specialist for back surgery, neither should you go to a "Doctor of Divinity" or "Doctor of Ministry" for advice about depression. Nevertheless, there are some pastors who think that they are entitled to speak with authority about the causes and cures for psychiatric illnesses. I strongly beg to differ.

Today we're going to examine an article entitled "Don't let depression paralyze your heart" by a local pastor Dr. Rex Yancey. I don't know Dr. Yancey personally but I've been told he is a good person. This post is not intended to attack him personally but to dismantle some of his comments about depression and show that professionals should not try to practice outside their field no matter how many good books they've read or how confident they think a few counselling courses makes them.

First I want to warn against falling prey to the argument from authority. It is tempting to accept all Dr. Yancey's statements at face value because he has earned a D.Min. (Doctor of Ministry) degree. After all that schooling, he must know what he's talking about, right? Well, that depends on the subject at hand. Yes, he probably is an expert on his religion, church administration, and maybe some type of general counselling. However, he isn't the kind of doctor you'd go to if your kidneys were failing and he's not the kind of doctor you should trust if your brain isn't working properly. If we're going to ignore evidence and simply go with whoever sounds the most authoritative, remember that I have a Doctor of Divinity degree so I can legitimately call myself Dr. Tweenky Dee if I want to (but the truth is that I don't think my D.D. and his D.Min. are worth the paper they are printed on - it's like having a degree in Harry Potterology). So let's not fall for the authoritative slant. Let's examine the positions of his column and go where the evidence leads.

Depression is an unpleasant emotion.

No, depression is not just an "unpleasant emotion." It is a brain disease, a medical illness in which you experience many unpleasant emotions. It's not just getting the "blues" or the "blahs" as Dr. Yancey suggests, but it is living with a persistent recurrence of symptoms that can vary from being troubling to down-right crippling and disabling.

It has been my experience that the deepest depression comes after the greatest achievements

Perhaps that is Dr. Yancey's experience but that is not everyone's experience and it certainly doesn't mean that there is some game of cosmic tit-for-tat going on. Stress from any event, even a very positive one, may put a person at risk for depression but there is no guarantee.

What causes spiritual depression?

I don't know what "spiritual depression" even means since no spirit has ever been demonstrated to exist so I will assume that he is using the word to give religious flavor to a material concept. Let's take his list of causes one by one:

1. Temperament - our personality traits can put us at risk for depression but it is not a cause for depression. Dr. Yancey makes no real effort to back this up as a cause - he just waxes eloquently for a couple paragraphs about how we're all different. Yes, we are different and some of us are introverted and shy but that does not cause us to be depressed. Overcoming depression is not a simple matter of "making more friends" or "just cheering up."

2. Physical condition - Dr. Yancey related how Yahweh gave Elijah a piece of cake which seems to suggest that hungry folks are depressed. That may well be but starvation is not on the accepted list of causes for depression. In fact, I'd say that's a bit of an abuse or conflation of the word "depression." Sadness due to hunger that lifts after eating is not depression - it's low blood sugar.  So while it's true one's physical condition (in the sense of disease, hormonal imbalance, neurotransmitter imbalance, or other some such) may cause depression, his example falls far from the mark. You cannot cure your depression by getting up and having a nice meal - even if an invisible, magic sky fairy feeds you cake.

3. Satan - no, just no! There is no evidence, not one single study, that has found "Satan" to be the cause of depression. STOP TELLING PEOPLE THAT PSYCHIATRIC PROBLEMS ARE DUE TO SATAN! This lie has been responsible for so much misery and death during human existence and yet we still have professionals who are willing to abuse their position and put sick people at risk. This is the exact lie that kept me from getting the proper psychiatric help I needed for almost 20 years. 

If you want to argue this point, please explain to me how it is that Satan and his demons are conquered by anti-psychotic medication. Is Satan allergic to Seroquel? Does lithium drive out Legion? Did Jesus use Geodon?

4. Loneliness - again, this can put us at risk for depression but it is not a cause. When we are lonely, we may feel a little down but we always have the option of giving someone a call and blues go away. Depression cripples your ability to make that call or visit with people. It is not a transient, situational feeling but a persistent mental disorder.

5. Alcohol and drugs - risk factors, yes; direct causes - not exactly. While it's true that alcohol and some drugs are depressants, they do not precisely cause depression. Some people drink alcohol and never have a day of depression in their lives. People who abuse alcohol are more likely to get depressed and that makes sense but it's not true that one glass of red wine a day is going to make you depressed. The anti-alcohol message is Baptist dogma, not psychiatric science.

Now that Dr. Yancey has given us his list of (flawed) causes, he's going to give us the cure. Science hasn't found a one-size-fits-all cure for depression so let's see what we can find:

1. Understand the cause - this has some truth to it so I want to give credit where credit is due. There is always a cause (or perhaps many causes) for depression. It might be a major life event such as a death in the family, an ongoing traumatic situation, or just something you inherited from your family. Understanding the cause is the first step in dealing with your situation. Once you understand, you can shed the guilt and start making needed changes in your life if you want to.  For example, once I understood that I just drew the short genetic straw, I was able to stop feeling guilty and unworthy and become more proactive in taking my medication. Understanding why this happened to you will not cure your depression but it will help you cope.

2. Share your feelings - absolutely talk about things with someone you trust (hopefully a professional therapist) or write about them. Keeping your feelings bottled in tends to amplify those feelings in my experience. Again, sharing will not cure your depression but will help you cope.

3. Confess your sin to God - sin didn't cause your depression and repentance won't cure it. This is another damnable lie. If you've wronged someone and you feel guilt, go to them and make it right. If that cures your blues, fine, but that is not depression. The guilt that goes with depression is not always rational and often revolves around feelings of unworthiness. Fixating on how you stand in comparison with the invisible magic sky fairy will only reinforce those feelings and may drive you deeper into depression.

4. Help someone else - if you are able to do this, do it! It's empowering and doesn't have to cost you much. But remember that if you are depressed, you must take care of yourself before you can help anyone else. That's my golden rule of depression.

I'm sure Dr. Yancey had good motives for writing this but I fear he gives us the wrong impression about the nature of depression and his explanations and solutions regarding sin and Satan are not only incorrect but deeply destructive.  As difficult as it is to believe, people in 21st century America are still being told that their mental illnesses are the product of sin and demons. Thousands of children are physically and emotionally harmed by deliverance or exorcism services. Thousands more are bilked out of their money by charlatans like Bob Larson. At some point, we need to hold these "doctors" responsible for the harm they do by spreading this sort of misinformation. They are not psychiatrists and should never give medical advice as if they are. The same goes for me. The information I gave you is from the Mayo Clinic but if you are experiencing any kind of mental problems, please consult your doctor or psychiatrist and take their advice.