There is almost always something interesting in the world of research and this weekend is no exception. One article caught my eye because it details a secular research project about prayer and self control.[i]  It describes a research project in Germany with 79 participants who were made up of 41 who identified themselves as Christian, 14 atheists, 10 agnostics and 14 who came from other religions. 
 
The test subjects were asked to either pray or think about anything intently and then were asked to watch some comedy video clips. One half of the group was asked to repress their emotional response to the clip and the other was encouraged to laugh. Then both were tested for the ability to carry out a task that required some self control. They were asked to look at words such as blue that were written in red ink and then identify the color of the ink not the word. 

The goal was to not answer too quickly as a result of reading the word instead of identifying the color of the ink. The
study found 2 things that are interesting. The people who tried to suppress the laughter/emotions seemed to struggle later doing the name that color test. They also found that the people who prayed instead of intently thinking about
whatever they wished did better with regard to self control. Those who prayed could resist the temptation to jump to the wrong conclusion about the color of the ink. 

The idea of praying that we might resist temptation is not particularly original. Our Lord and Savior, Jesus Christ said
just that to the remaining eleven disciples in the garden of Gethsemane. “And when he was at the place, he said unto them, Pray that ye enter not into temptation.” (Luke 22:40 KJV) 

Two things just jump out at me. One is that Jesus did not tell his disciples to get their acts together so that they could
resist the temptation that was coming. He told them to “pray that they would not enter it.” Unfortunately instead of praying intently about the coming test, they fell asleep. Jesus told them to ask for help because they would certainly need it. 

Second, our Lord did not then and does not now intend for us to face temptation alone in our own strength. And, so Paul tell us  “No temptation has overtaken you but such as is common to man; and God is faithful, who will not allow you to be tempted beyond what you are able, but with the temptation will provide the way of escape also, so that you will be able to endure it.” (1Cor 10:13 NASB)

The results are interesting because they match what we would expect if we read what Jesus said and then did it. I always encourage readers to keep in mind that this is not a case of research proving the Bible to be correct. It is correct, inerrant, inspired, infallible and sufficient! Instead the research outcome merely illustrates what you expect to
happen when someone follows what the Bible says. 
 
So, prayer is important. In prayer we can ask God for help in temptation in the name of Jesus. We can expect that God will enable us to pass through it and endure. We should all start our own research projects today!   
  
[i] http://www.dailymail.co.uk/sciencetech/article-2515637/Does-prayer-help-resist-temptation-Talking-God-boosts-self-control-emotional-stability-claims-study.html Does prayer help us resist temptation? Talking to God
boosts self-control and emotional stability, claims study. Mail Online,  By Robin Yapp PUBLISHED: 10:56 EST, 29 November 2013 | UPDATED: 10:58 EST, 29 November 2013 
 

Tomorrow is the big day. Thanksgiving is wonderful time when we get to remember the blessing of freedom that God has given us here in the United States. In the process most of us will nearly eat ourselves into a coma with turkey, dressing, mashed potatoes, gravy, deviled eggs, green bean casseroles and then, pie of all kinds. I always tell my patients who must diet that they get two days off a year and Thanksgiving Day is one of them. With all the food
we are going to eat it might comforting to know that there is a way to reduce the adverse effect of all those excess calories. 
 
In today's New York Times Gretchen Reynolds tells us that even if we hardly move an inch all day and eat 10000 calories or more,1 we can keep all of it from going to notorious fat deposits in special places on our bodies.
The antidote is binge exercising! In a study done at the University of Bath in England, test subjects were told to walk no more the 4000 steps a day and to eat 50% more food each day. 
 
The subjects were divided into two groups. One group consisted of strict couch potatoes and the other would run for 45 minutes each day. The runners were also instructed to eat an extra 25% more food than the couch riders. The study found that the bad effects of eating way too much food and doing next to nothing all day were present within 7 days and included changes in their fat cells and their insulin production and effectiveness. 
  
The runners on the other hand did not suffer these changes to the same degree. Indeed, it appeared that a seven day binge of eating could be offset by a similar seven day binge of exercise. Blood sugar control and changes in fat cells were greatly reduced in those who binged on exercise along with the pie. 
 
I know this is true. I have been a runner for 44 years now and I started running for one simple reason. I liked to eat, and hated to diet. I also knew that while I was not going to get any taller, that I could be bigger. So I ran and I still do. And, I weigh about the same as I did when I left high school. 
 
So tomorrow, while you are thanking God for His goodness toward us and eating that second piece of pie, you might want to think about taking a walk after lunch. 
 
God bless you and yours as you serve Him. 

1. The Power of a Daily Bout of Exercise, Gretchen Reynolds, New York Times, November 27, 2
 

I have been practicing medicine for 38 years and that has allowed me to see amazing changes in the way we deliver health care. Some of them have been revolutionary in the way they save lives. Heart, lung, liver, kidney
transplants come to mind along with bone marrow transplants and innovative cures for cancer. Other changes have been more of a double edged sword. Of those my favorite has been the internet.

I would not want the reader to think for a moment that I want to return to some golden age of pre internet existence. There is not a day that goes by that I do not use internet based reference material as I look for the best answers and treatment for the patients I see. When I research to write blogs or books, the place I go first is...the internet. In my college days, all writing began in the library in front of a card catalog looking in rows of drawers with small cards that directed me to books, and articles and their bibliographies. It was a time consuming labor intensive pain in the process and I do not miss it for a minute. When I have to do research, I love the internet.

It does require something of us that is forgotten at our own peril. Not everything that is posted in the internet will be true or accurate. And very little of it is posted without some kind of purpose behind it. This seems so obvious that no one should have to say it. The recent State Farm commercial with the young woman who meets her French Model
date on the internet stands as the comedic warning. As she stands there with a fellow who looks more like the Neanderthal man with anything but a French accent she says, "You know they can't put anything that isn't true on the internet!" Well, "they" can and they do.

In medicine the most recent and discouraging example involves a website that I have referred patients to for
general information about medical problems. WebMD seemed to be a place where reasonably reliable information could be found by the public free from bias. Well, this past week it was revealed that in the campaign to bring the
Obamacare/ Affordable Care Act to life, WebMD received a contract for 4.8 million dollars to “teach doctors about Obamacare.”[i] What appeared to be an unbiased journalistic opinion turned out to be little more than an advertisement for a government program that was paid for with our tax dollars.

It really doesn't matter which side of the Unaffordable Care Act question you find yourself on, it should outrage us when tax dollars are used this way. When I was a youngster I read our local paper from front to back and I remember full page advertisements that looked like news articles back then. But, at the top and bottom there was always a small but very visible statement in parenthesis that said (this is an advertisement). Because of the disclaimer, I knew I was not reading an unbiased account written by a journalist who intended for me to know who, what, where, when, and why something happened. 

WebMD has given away the trust I placed in them to write about medical issues free from commercial bias. In exchange they received several million more dollars than I would have ever given them. But, I won't
send patients there again without the warning.

And it is that warning that I am writing about today. Caveat Imperator or let the buyer beware! The internet is a marvelous place to do research about medicine as long as you carefully look at the source to make sure what you’re reading is not an unidentified paid advertisement. When looking at research the first question I ask is who paid for it? It's the medical equivalent of show me the money! If the website that offers to diagnose your problem also has banner ads for the drug to treat it, you might want to look someplace else.  And, if the website that tells you how great government healthcare will be is being paid millions of dollars to do it, you might want to look someplace else for the facts.

As the Old Testament writer said, "the bribe perverts justice!"



 

 
  
  
[i] “Concierge Medicine: WebMD pockets
millions from Feds to promote Obamacare,” Washington Times, Tuesday November 12,
2013, by Jim McElhatton, retrieved electronically at www.washingtontimes.com. 

A friend asked me to watch an interview with Dr Sanjay Gupta on CNN in which Gupta says that he has been wrong about marijuana. He has opposed legalization of marijuana for years and has changed his mind. Now he thinks it would be good to legalize it for medical use. 
 
I know the friend asked me because from a distance he heard conversation that I had with an individual who wanted to know if I thought it would be reasonable to have patients smoke pot who had a medical problem that it seemed to help. At the end of the conversation my friend came over to talk, and said that he wanted me to watch the CNN interview because he did not know who to believe. A rather smart, articulate neurosurgeon has said that medical marijuana is probably a good thing and perhaps it should be legalized. So, I watched.[i] 

Dr Gupta said many things that were interesting. He said that 95% of the research done looked at the adverse effects
of smoking marijuana including the effect it can have on a developing brain. He said that very little of the research looked at what could be the benefits. In his defense, the doctor said that he was NOT advocating the recreational use of marijuana because he has children. He did not offer any studies that showed the benefits of smoking pot. 

When he was pressed by the interviewer as to why he made the change from being against legalization of pot to being for it, Gupta said that his experience talking with patients was the motivating factor. He told the stories of two patients who used marijuana or one of the substances derived from it. One was a child with seizures whose story is heart
rending.  

The reason I don’t find Dr Gupta convincing and I could not agree with the person who wanted me to give my approval to medical marijuana in certain circumstances is the same. Both wanted me to agree based on the stories of patients that they had heard. It is the difference between anecdotal evidence and research. 
 
Anecdotal evidence is the story of one person about the benefits marijuana or any other kind of treatment. Research on the other hand has looks at disease & treatment in large populations. Medical research is supposed to look at a drug, procedure or a question in medicine and answer it by looking at in large populations, thousands if possible. It is also supposed to be objectively measured in a way that is reproducible. A treatment or drug given today should offer the same benefit in 6 months in a different population. All of these studies should have a control group that shows a statistically significant difference between the outcome of being treated and not being treated. 

Remarkably there is at least one person out in cyberspace who has the same reservations I do about “medical marijuana” and the need to legalize pot smoking. In the Huffington Post, Sue Rusche, the CEO of National Families in Action wrote an excellent article which gives a reasonable answer to Gupta’s call for legalization. The article is titled “What Dr. Sanjay Gupta Doesn’t tell Us About Weed”[ii] and in it Rusche presents several things  that we know about marijuana that make using it less inviting. 
 
While there are 400 ingredients in marijuana, Dr Gupta only talked about 2, THC and CBD. Rusche explained that THC
is the “cannabinoid” that the recreational user desires and CBD is the ingredient that seems to hold any medical benefit. The catch is that most marijuana in the US is grown to reduce CBD and increase THC. THC or  tetrahydrocannabinol is the part of marijuana that is credited with the mind altering effects.  
 
The problem with most pot being sold as medical marijuana is that it is grown for it intoxicating effects. THC
concentrations in marijuana in 1970 averaged 3 percent. Today that average is 13% with some samples as high as 36%. Gupta says that marijuana has a relatively low risk of addiction at 9% when compared to cocaine at 25%. Rosche points out that the rate for adolescent user addiction is 17% and for regular daily users it can be from 25% to 50%. That meets or exceeds the rate of cocaine addiction. 
 
Marijuana is not a minimal risk medication like aspirin or Tylenol that we can take with a reasonable expectation of safety and benefit. In an excellent review in this week in the Psychiatric Times, the risk of psychotic episodes is 40% greater for uses than for non users, and the risk for schizophrenia is higher among teens who smoke it than those who do not.[iii] 

So why would we want to legalize a drug that has rather limited medical use without real research? Rosche proposed what I think is the most reasonable response. Instead of a wholesale legalization for medical use that will turn into the circus that now is California and Colorado, why not do real research? The following is a quote from Rosche.

“The government should provide research grade CBD to patients like Charlotte under a compassionate use program while science catches up with and improves the folk-medicine approach(that is generating millions of dollars in profits) we have now. Patients and their families should sign a hold-harmless contract so taxpayers won’t have to shoulder lawsuits from unexpected side effects that might result from being medicated with an experimental, untested drug.” 
 
That makes so much more sense than legalizing a dangerous, addictive, psychosis causing drug because a notable
articulate neurosurgeon has decided that it ought to be on the basis of incomplete science and anecdotal patient stories. Let’s do real research and let the facts decide the best course.   
  
[i][i] You can find Dr Gupta’s comments on CNN under video.  Search Sanjay Gupta and Weed!   
[ii]“What Dr. Sanjay Gupta Doesn’t tell Us  About Weed” Sue Rusche. Huffington Post 08/19/2013.   
[iii] The Cannabis-Psychosis Link June 27, 2012 | Schizophrenia, Alcohol Abuse, Psychotic
Affective Disorders By Marie-josee Lynch, MD, Rachel A. Rabin, MSc, and Tony P.
George, MD, FRCPC - See more at:  http://www.psychiatrictimes.com/schizophrenia/cannabis-psychosis-link-0#sthash.pARp70VE.dpuf

Running from Depression!
I Run! I don’t jog. I run 6 miles a day most days and I do those miles in 8 to 8.5 minutes a mile. Sometimes I press
myself and work down into the 7 minute mile range. If it sounds like I am bragging a bit, I could be accused and would probably be guilty. I started running 44 years ago for one reason. I was lot better at running than I would ever be at dieting. It was a good strategy. 
 
Along the way I would encourage my children to run and would run with them when they were getting ready for soccer or basketball. I think one daughter started running with me in elementary school just because it was the one time in the day that she could have her busy physician father to herself.  
 
This past weekend, I ran with my oldest son and it was sort of like a “what goes around comes around” nightmare for me.  Charlie and I have been training for a half marathon in Disneyworld in November. He is now in far better shape than I am. I have been working myself back into shape after a year of injuries and this weekend was to be my first 10 miler in 6 months. 
 
Charlie can run in the six minute range and I can, if I work hard, run in the 7:45 range. It was 5 miles out and 5 miles
back and we were doing it in 8:20s. Charlie ran out ahead and I started thinking that somewhere along 8 miles I would just stop and walk the rest of the way. But, Charlie came back and when we got to 8miles, he started doing the same
things to me that I did to him to keep him running when he was 13. “Real men puke at the finish line.” That is what I told him and that is what he told me as he reminded me of saying it. And, I finished all 10 miles. It reminds me that we
should be very careful of the things we say to our children as they grow up. It can come back to haunt.  

But what does this have to do with Biblical Counseling and depression. Well, Medscape published a news item in September that said that running can help people with depression. In fact the article  quoted from the Chocrane Collaboration published by Wiley, in which researchers looked at people who struggled with depression and were helped either with medication, psychological counseling, or running. ( See below for citation)
 
All three seemed to help. Running helped just as much as medicine or psychological counseling but no more. Of course there are significant advantages to running over medication in the realm of cost and side effects. As I look back over my running career, I am certain there were times in my life that going out and running 10 miles helped me deal with real struggles that I faced. 

I ran mostly at lunch time when I could and once the group I worked for came to me and suggested that running at lunch time was just too disruptive and I should do it some other time. I gently but firmly informed the messenger that my lunch hour was mine to do with as I wished and that I would continue to run. But, more importantly, I suggested he go talk with my nurse Sandy. She would tell him that she wanted me to go run at noon! It made the second half of the day much better for her if I burned off some of my nervous energy! 
 
As a young physician I remember reading an article that listed the suggestions that an older physician made to his
depressed patients. After returning to work, reading a chapter in the gospel of Luke, attending church, the old doctor told the strugglers to go walk 2 miles a day. It reminds me of Paul in Philippians 4:9 when he tells us, “the things you
have learned, and received, and heard and seen in me, practice these things, and the God of peace will be with you.” Paul was telling people who were struggling with worry to get back to doing the normal things of the Christian life.  

And so, I think I can say that in some of the 44 years that I was running, I was running away from worry and sadness. I
know a couple of years ago on one of the darkest days of my life, I ran. And, I only ran because I knew that if I was going to make it through the struggle, it would be because God enabled me to keep on breathing, and keep on running. 
 
So Science tells that running helps depression. I suggest vigorous physical exercise to any depressed counselee who
is physically able to do it. It helps. When combined with counsel that comes from the Word, it can be life-saving. 

Exercise for depression (Review)  Cooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J, Waugh FR,
McMurdo M, Mead GE,  This is a reprint of a Cochrane review, prepared and maintained
by The Cochrane Collaboration and published in The Cochrane Library  2013, Issue 9  http://www.thecochranelibrary.com


 
 




 

There are two medical articles to comment about today. The first is my favorite and it says that smoking marijuana may lead to a psychotic episode that could end in schizophrenia. An article posted in Medscape Family Medicine news this week (10/1/13) presented research that indicated that those who smoke pot had a little less than a 1% risk of developing a psychotic episode. But, of those nearly half would go on to develop Schizophrenia Spectrum Disorder. Amphetamine users were also in the study and were found to have psychotic episodes. Of those in the study 4.5% had drug induced psychotic episodes with 30% going on to develop schizophrenia. 

Both marijuana and amphetamine derivative drugs have become widely used today in one form or another. Currently Marijuana is at the center of public attention with states such as Colorado and California legalizing use in different circumstances. As a result, I hear a rising tide of opinion among Christians that if the government makes Marijuana legal, then using it should be a matter of Christian liberty. Just like the Romans in chapter 14 could eat meat offered to idols without being judged or criticized by their vegetable eating brethren, we ought to be able to smoke pot. 
 
There many reasons why this kind of thinking borders on the ridiculous. First, we are spending millions of dollars
in health care and government programs to convince people to quit smoking. Smoking tobacco is a known risk to health. How smoking marijuana could be safe is hard to tell. Marijuana alters personality and over time lowers intelligence. And, we know that there is a risk for psychosis and schizophrenia. 
 
It is hard imagine how any believer can justify the recreational use of marijuana. Christians are the temple of the Holy
Spirit. It is our first duty to take care of these bodies so that we can serve God best. 

In the same Medscape Family Medicine issue another article was reviewed that concerned post partum depression in teenage first time mothers. The importance of the study is that 5 sessions of counseling conducted during the pregnancy resulted in cutting the incidence of depression after delivery in half from 25% to 12.5%. The article said nothing about the content of the counseling delivered.


Paul presented the idea when he wrote a letter to Titus. “Older women likewise are to be reverent in their behavior,
…teaching what is good,  so that they may encourage the young women to love their husbands, to love their
children, to be sensible, pure, workers at home, kind, being subject to their own husbands, so that the word of God will not be dishonored.  (Tit 2:3-5 NASB) Paul wanted older women to teach younger women what to expect from
married life and how to prosper in it. 
 
Right now my wife spends 2 Wednesdays a month working with younger mothers in a MOPS (Mothers of Pre-Schoolers) program. It is aimed at helping young mothers deal with the stresses of raising young children. Perhaps a similar program that reaches out to young women waiting for their first child could be just as effective in lower the rate of depression in women after the birth of their children.

 See Medscape Family Medicine at medscape.com titled, “The Risk of Substance Induced Psychosis leading to
Schizophrenia varies with substance used and  Age.”

 “Can Post-Partum Depression Be Prevented?”  Also at Medscape Family Medicine. 

As a doctor who teaches Biblical counselors, I get to answer this question. I do it reluctantly because while the
question seems simple, it really can be complicated. I am writing about it today because once again the question has made the news. 
 
It comes this week because of the unspeakable tragedy that came to the Warren family in the death of their son.
Warren and his wife had the opportunity to share their experience on CNN. My continued response has been to pray for them. And, I am not writing about them or their interview. 

Ed Stetzer wrote about the interview and the state of thought among Christians in his part of the Church and said the
following. 

     “So, what can we do as people of faith to address issues of mental illness? Churches need to stop hiding mental illness. The congregation should be a safe place for those who struggle. We should not be afraid of medicine. We need to end the shame.”
     “The fact is, mental illness is real. And it's a real illness.”
     “It is also important that we recognize that prayer changes things. In fact, the gospel impacts every area of our lives
and God can—and does at times—supernaturally heal every kind of illness. Yet, God often chooses to do so through an approach that includes prayer, study, Christian community, and medical intervention.”
     “Medicine is not the answer to everything, and we live in an overmedicated world, but we need to treat character problems like character problems—and illnesses like illness.”[i]

I appreciate the effort that Lifeway and Stetzer have gone to in order to help people who struggle with their emotions.
But, in the article, churches and their members appear to be criticized for contributing to the problems of those who struggle by refusing to recognize the reality of their illnesses.  I said illnesses on purpose because I believe that at the heart of this article is a simple problem. Mental Illness is not a simple term. It includes hundreds of diagnoses with multiple variations. Many of them are controversial. Some of them are not. But, what happens when you lump them altogether and then ask survey questions? Here is an example from the article. 

     “Thirty-five percent agree with the statement,  "With just Bible study and prayer, ALONE, people with serious mental illness like depression, bipolar disorder, and schizophrenia could overcome mental illness."[ii]

 The problem with the question and the conclusion is that depression and bipolar disorder are not homogeneous problems. Some researchers believe that up to 90 % of those who are diagnosed with depression may be suffering with normal sadness over loss.[iii] More researchers are very concerned about the validity of the current criteria being used to make the diagnosis.[iv] A growing number believe that many of those diagnosed with depression would be better cared for by simply talking to a skilled helper instead of being cared for medically.[v]

 So I would suggest that we should not ask the Church to change its attitude towards “mental illness” on the basis of  surveys that ask general questions about a complicated matter. Instead, I think what we really need to have is a conversation about what mental illness is and what it isn’t. If we are going to change the attitudes of the church body toward those who struggle with their emotions, it will require us to stop using the generic term “mental illness” expecting everyone to respond to it in a defined way. We will need to look at the objective scientific evidence for each specific diagnosis and behavior in the light of scripture. And, no Christian in medicine or counseling should be afraid of that. Then maybe we can separate the character problems from the illnesses. And respond to them the way James told us in his letter. 
    "So speak and so act as those who are to be judged by the law of liberty. For judgment will be merciless to one who has shown no mercy; mercy triumphs over judgment.  (Jam 2:12-13 NASB)  
  
[i] Mental Illness and the Church: New Research on Mental Health from LifeWay Research.  Ed Stetzer Blog at Christianity Today 9 17 2013. 
http://www.christianitytoday.com/edstetzer/2013/september/mental-illness-and-church-new-research-on-mental-health-fro.html  
[ii]  Half of evangelicals believe prayer can heal mental illness. Blog at Lifeway.com Bob Smietana. 9/ 7/13.
http://blog.lifeway.com/newsroom/2013/09/17/half-of-evangelicals-believe-prayer-can-heal-mental-illness/  
[iii] Good Mood Bad Mood, Shepherd Press, 2012, 61-68  
[iv] Good Mood Bad Mood, 23-31



 
[v] Good Mood Bad Mood, 69. 
  

Early in my career as a medical student I learned a very important lesson and it was the concept of suspending judgment. My instructor in history taking told me that I needed to become “unshockable”. I was going to see things and hear stories that would leave most people with their mouths hanging open and their eyes as big as silver dollars. But, I the physician needed to be able to see and listen without showing my approval/disapproval, amazement or disgust. 
 
It required me not to make a judgment about the person before I knew as much about their problem as I could. 
 
I have been reading Job this week on my annual tour through the Bible, and there have been several things that have
caught my attention. The first thing comes right in the first verse of chapter one. The writer under the inspiration of the Holy Spirit says that Job “…was blameless, upright, fearing God and turning away from evil.” Those are very
absolute adjectives. This story is about the suffering of a man that most would say was good by our standards. We would say that because that is what text says. 

I am not going to discuss a theology of suffering in this post. Others are far more qualified than I am to do that. But,
one important thing comes to mind about Job and his three “friends.” I have said that those three stand as a warning to anyone who is interested in trying to help a suffering struggler. They refused to suspend judgment. 
 
The story is familiar to most. Job loses his children, his possessions and his health and then while he is sitting on an
ash heap scraping his boils with a broken piece of pottery, his wife tells him to curse God and die. Job responds by telling her that she was speaking like the foolish women speak. The writer goes on to tell us that “in all this Job did not
sin with his lips.” 

And, just when things looked like they couldn’t get worse for poor Job, those three friends show up. Those men did
fairly good job of comforting for the first seven days. They sat with Job and said nothing. They don’t get into trouble until they start talking. And, then they go after Job with their minds made up. Nothing this bad could happen to Job
unless he had sinned. And, for most of the book they hound him from their position of ignorance. 

Proverbs 18:13 tells us “He who gives an answer before he hears, It is folly and shame to him.” When we try to help
people who are struggling perhaps the most important thing we can do is the one thing Job’s “friends” missed. Suspend judgment, listen long and avoid deciding the cause of the strugglers suffering until you’ve heard the whole story! And, sometimes as in Job’s case, there won’t be a conclusion to make because part of the story is unknown. 

As we approach people who suffer we need arm ourselves with scripture such as James 2:12-13. “So speak and so act as those who are to be judged by the law of liberty. For judgment will be merciless to one who has shown no mercy; mercy triumphs over judgment.” It will keep us from jumping to conclusions based on our own prejudice. It will also keep us from adding to a suffering struggler’s misery instead offering comfort and help. 

And by the way, it is our ability to suspend judgment that allows us to watch SciFi movies and enjoy them. Everyone knows that engaging the warp drive on the starship Enterprise would crush the crew on the back wall like bugs. We just choose to ignore it long enough to enjoy the movie.

 “The moment a person forms a theory, his imagination sees in every object only the traits which favor that theory” Thomas Jefferson
 
From the first day in medical school at Indiana University that we talked about depression, one thing seemed absolutely clear. Women made up the vast majority of those who presented with the symptoms and the diagnosis. The difference in the rate of diagnosis for men and women wasn’t ten or twenty percent. It was 2 to 1 women over men. We had lots of explanations for the phenomena. Women were and still are more likely to see a physician than men for any kind of health problem. Surveys done over the years will vary some, but generally show women seeing doctors from 50 to 100% as often as men. 
 
As a result, for reasons not entirely clear, physicians, psychiatrists, and psychologists of all varieties have
operated with the bias that depression is primarily a problem that women face. And that would be helpful, if
it was true. In research published this week in the online version of the Journal of the American Medical Association, it appears that the reason why men are not diagnosed with depression as often as women is because we in
medicine are simply not asking the right questions. 
 
The research done at the University of Michigan by Lisa A Martin, PhD and others, found that if you ask men the usual DSM4 (Diagnostic Statistical Manual of Mental Disorders) criteria questions that include a sad mood, men will tell you they are not depressed. “Direct admission of sadness and emotional weakness or vulnerability in men is seen as socially unacceptable.”  It appears that men want nothing to do with being identified as weak, sad, or vulnerable. [i]

 This response appears to be tied to a man’s “adherence or rejection of hegemonic masculinity.”[ii] In English, the more a man agrees with a “John Wayne, Bruce Willis, or Tom Cruise view of manhood the further he will distance himself from anything that looks like sadness or depression. To do great damage to the 1960’s Four Seasons song, “Big Boys* Don’t Cry!”(*Girls in the original) Or, to quote Tom Hanks, “there’s no crying in baseball!”

 So, the researchers did what they often do as they search for the answer they believe is “true.” Instead of asking
themselves if they are over diagnosing women, they changed the questions as Jefferson said they would. The researchers used what is called a “Gender Inclusive Depression Scale.” That scale uses questions that identify anger, aggression, and irritability in men as the signs of depression. And, when they were done men had the same rate of depression that  women did. 

I suppose that we could take this conclusion in several directions. As a physician, I guess I might say that I am not one bit surprised that men and women might suffer sad moods at exactly the same rate. In the book Good Mood Bad Mood, I have reviewed considerable research that tells us that depression as a disease has no easily identified unique pathology (change in our bodies or brains) that would make the diagnosis certain.[iii]  
  
At the same time, research tells us that the DSM4 and now DSM5 criteria are very subjective and are likely to over-diagnose depression as much as 90% of the time. I doubt that changing the criteria to make it more likely that men are diagnosed with depression because they are angry, aggressive or irritable will help them much. Instead of finding
solutions to the anger, aggression, irritability and sadness, we may just be increasing the number of people who will be labeled. 
 
There is something that would help the 90% of men and women who are labeled as depressed because they struggle and suffer due to an identifiable loss in their lives. It would help them to find someone who knows about their loss, who has a plan for that loss, and cares deeply about their struggle and suffering. And, to find out that someone will act on their behalf. I think that would help. 

And, there is a great place to look for that something or someone who could help. I would start in John 11. Jesus knew, had a plan, cared deeply and acted to help Martha, Mary and Lazarus. And He will do the same for anyone who comes to Him bringing their anger, aggression, irritability, and sadness over loss. As He said, “Come unto me all you who labor and are heavy laden, and I will give you rest.”(Matthew 11:28-30)  
  
[i] The Experience of
Symptoms of Depression in Men vs Women, Analysis of the National Comorbidity Survey  
Lisa A. Martin,  PhD1; Harold W. Neighbors, PhD2; Derek M. Griffith,  PhD3,4 
JAMA Psychiatry. Published online  August 28, 2013. doi:10.1001/jamapsychiatry.2013.1985 
[ii] ibid  
[iii] Good Mood Bad Mood, Charles Hodges MD,  Shepherd Press, 2012, www.shepherdpress.com, Wapwallopen, PA.


See chapters 3-5.

Recently published research by the National Institute of Health has shed some light on the process of addiction to
alcohol.[i] “Chronic alcohol exposure leads to brain adaptations that shift behavior control away from an area of the brain involved in complex decision making and toward a region associated with habit formation, according to a new study…” Granted the study was done on mice and not men, but it appeared to give us an understanding of why alcohol abusers become enslaved to the habit. As the brain moves away from thinking about choices to fulfilling
habitual behavior, the individual becomes controlled by the use of the drug. 

This is not surprising in the least to anyone of us who understands what the Bible says about alcohol and addiction.
“And do not get drunk with wine, for that is dissipation, but be filled with the Spirit,” (Eph 5:18 NASB). The comparison between drunkenness and being filled by the Holy Spirit does center on the issues of control and behavior.  The
man or woman who chooses to be controlled by alcohol will eventually be enslaved by it. 

 As with the NIH study, the longer the individual gives themselves to serve alcohol, the more they become a slave to
 it as Paul said in Romans 6:16. “Do you not know that to whom you present yourselves slaves to obey, you are that one's slaves whom you obey, whether of sin leading to death, or of obedience leading to righteousness?
 (Rom 6:16 NKJ) Just like the mice, the longer I choose to be drunk, the more it becomes a habit that controls me.

 And, that is the bad news. The good news is that men and women by God’s grace can find freedom from drunkenness and the trouble that comes with it. Paul reminds us that although drunkards are on a
list of sins that are very popular today, being on that list will exclude us from God’s kingdom unless we confess Christ as our Lord and Savior. When we do that, Paul says that we have been washed, sanctified and justified “in the name of Jesus Christ.” (1Corinthians 6:9-11) The best part of the passage is when Paul looks at the group and says, “and such were (my emphasis) some of you. Nothing in the Bible tells us that we should expect to be slaves to our sins as Christians. Instead, we have the hope and promise that since we have been raised with Christ, that “we too might walk in newness of life.”(Romans 6:4)

 Another article a week ago took aim at the idea of sexual addiction.[ii]  A research study showed that the brains of individuals who struggle with pornography simply do not respond as those with other addictions such as substance abuse.  It is always interesting when science finds itself agreeing with the Bible even unknowingly.  Sexuality outside
the confines of marriage is not a disease. It is simply sin. You only need to read Romans 1:18-32 to understand what the real problem is. When we choose to worship creatures/ourselves instead of the Creator, eventually God will give us over to the degrading passions that we want most.
 
That is the bad news. But, the good news is the freedom from the power of sin over our lives that we find in the
gospel. "Therefore if the Son makes you free, you shall be free indeed." (John 8:36 NKJ)
  
  
[i] http://www.nih.gov/news/health/aug2013/niaaa-22.htm?utm_medium=email&utm_source=govdelivery
 NIH study finds chronic alcohol use shifts brain’s control of behavior, 8/22/2013



 
[ii] http://www.socioaffectiveneuroscipsychol.net/index.php/snp/article/view/20770/28995 
Sexual desire, not hypersexuality, is related to neurophysiological responses elicited by sexual images
 Vaughn R. Steele, PhD1,2, Cameron Staley, PhD3, Timothy Fong, MD4 and Nicole Prause, PhD1,4*
 1The Mind Research Network, Albuquerque, NM, USA; 2Department of Psychology, University of New Mexico, Albuquerque, NM,
USA; 3Counseling Center, Idaho State University, Pocatello, ID,
USA; 4Department of Psychiatry, University
of California, Los Angeles, USA