This week has been a blizzard of interesting research and much of it has been important to those of us who are involved in biblical counseling. As a physician and biblical counselor I often find myself answering questions that fall in the no man’s land between medical illness and spiritual struggles. The questioners general want me to tell them whether or not their problems have a physical cause or a spiritual source. This week several articles found their way to my email that have something to say about the question.
An article published in the June, 1st edition of the American Journal of Psychiatry described research in depression that caught my eye. The authors stated that “Older patients with a long illness duration and moderate to severe depression appear to benefit from antidepressants as compared with placebo. Antidepressants do not appear to be effective for older patients with short illness duration.”[i] That would coincide with conclusions I reached in writing “Good Mood Bad Mood,”[ii] which stated that 90% of people who are labeled as depressed are simply suffering from sadness due to some significant loss in life.
That 90% number lined up with research that has shown that up to 90% of people who take antidepressants do not benefit much more than if they took a placebo pill that looked like but did not contain the active drug. The connection that I see with the AJP article is that it looks at two very different groups of patients who were elderly. One had chronic problems for years with a depressed mood. The second had developed a depressed mood for a short period of time.
I suspect that the second group would likely be among those who struggled with sorrow due to a loss in life. Loses in life seem to be common as we age and are identifiable in up to 90% of those who are labeled with major depressive
disorder. It would then be reasonable that medication meant to treat a disease would offer little benefit to those who are struggling with a recent identifiable loss in life.
A second article published in JAMA:Psychiatry on June 12th, examined the connection between infectious disease, autoimmune disorders and mood disorders. The researchers found that “A prior hospital contact because of autoimmune disease increased the risk of a subsequent mood disorder diagnosis by 45% … Any history of hospitalization for infection increased the risk of later mood disorders by 62%+…)[iii] A third article reported a study that relapses of schizophrenia appear to be connected to loss of brain mass as measured by MRI imaging studies. The longer the relapse the greater the loss.[iv]
The last article published in April in the journal “Social Cognitive and Affective Neuroscience” reported that individuals that meditated gained relief from anxiety and that relief correlated with changes that could be seen in MRI scanning.[v] It evidently makes a difference what we choose to think about or worry about.
The point of all this is threefold. First, it appears that as we look at depression we are dealing with two very different kinds of people. There are those whose problem is of long duration not connected to anything in particular who make up the 10%. And, then there are those who struggle with sadness over an identified loss for a much shorter time.
Second, not all emotional struggles are caused by spiritual problems. There are medical ailments that can have significant adverse effect on our emotions. In biblical counseling we need to be aware of this. When we counsel those with sad moods, anxiety and other emotion struggles we need to be certain they have seen their doctor to rule out treatable correctable medical disease. None of us want to find out that we have been counseling someone for anxiety when they had hyperthyroidism.
Finally, “For as he thinks in his heart, so is he. (Pro 23:7 NKJ). What we think about has a profound effect on our emotions. It should not surprise us that when we choose worry instead of trusting in the Lord, that it might show up in a functional brain scan. The study that showed the changes in our brain scans and reduced anxiety as a result of meditation should be an encouragement to biblical counselors. When it comes to worry, and many other spiritually driven emotional struggles, Paul tells us “not (to) be conformed to this world, but be transformed by the renewing of your mind, that you may prove what is that good and acceptable and perfect will of God. (Rom 12:2 NKJ) What we
choose to think about matters! What we mediate on can change our minds literally.
[ii] Good Mood Bad Mood, Shepherd Press, 2013