The Depression Industry?

The article entitled ‘Depression Industry?’, written by Nancy Lambrechts, was published in the July 2008 issue of Evangelicals Now

Depression industry?

The medicalisation of sadness

In his controversial book, Limits to Medicine – Medical Nemesis, Ivan Illich argues that the ‘medical establishment has become a major threat to health’.[1] Written back in 1975 Illich warned against the over medicalisation of life. More recently Dr Hamish Meldrum, head of the British Medical Association picks up this theme, ‘the obesity epidemic is being mistakenly targeted with medical treatments and doctors appointments… we are in danger of over medicalising’.[2] In a recent feature in the British Medical Journal Gordon Parker, a Professor of Psychiatry follows this line of thinking; he argues, it is normal to feel depressed and that the medical community is in danger of medicalising sadness, and treating normal human emotional states as illness.[3] There is a growing trend to medicalise modern problems, people medicate themselves to cope with everyday living, thereby blaming factors outside their control for the way they are. Since the 1990’s the depression epidemic has exploded with antidepressants becoming the top selling prescription drug in 2001.[4] This increase in antidepressants sales has been reached by extending the boundaries of the term depression to encompass everyday situations that cause anxiety, disappointment or sadness. Using the actual word ‘depression’ can therefore be misleading and unhelpful, because what is a normal human response to a difficult life experience is increasingly being diagnosed as mental illness. Therefore I will avoid using the term depression where possible, to avoid unhelpful labelling.

The myth of the chemical imbalance

A common perception amongst evangelical Christians is that ‘depression’ is caused by a chemical imbalance in the brain that is best treated by antidepressants and/or Cognitive Behavioural Therapy (CBT). However the ‘chemical imbalance’ theory is not based on solid evidence and is therefore not entirely true. Dr Joanna Moncrieff, senior lecturer in Psychiatry at University College London, argues, ‘it is high time that it was stated clearly that the serotonin imbalance theory of depression is not supported by the scientific evidence or by expert opinion. Through misleading publicity the pharmaceutical industry has helped to ensure that most of the general public is unaware of this.’[5] Drug companies have passed off the chemical imbalance theory as fact because it suites their purposes, sells their drugs and lines their pockets. The antidepressant industry is driven by multi billion dollar sales each year; a huge incentive to keep the public believing in a chemical imbalance. Yet despite the drug companies claims there is no way of establishing this imbalance, for ‘the brain is simply too complex and is sustained by too many chemicals for us to be able to pinpoint chemical imbalances with our current level of knowledge.’[6] Recent trials for antidepressants showed that there is little difference between the drug and placebo, bringing into serious question the benefit of drug treatment for ‘depression’. A Guardian headline made the point: ‘Prozac, used by 40 million people, does not work say scientists’.[7] A myth has grown up around a deceptive theory, leading people to believe that their normal ‘problems originate in abnormal biological processes that can be rectified by drugs, people have started to interpret their experiences in terms of their brain chemicals,’[8] believing they are mentally ill, medicating themselves, masking the emotional pain and in many cases not dealing with the real underlying issues.

Problems with Cognitive Behavioural Therapy

Recently cognitive behavioural therapy (CBT) has been receiving more recognition for treating people with life problems. CBT was developed by Aaron Beck in the 1960’s. The Beck Institute website explains that CBT ‘addresses your thinking, emotions, and physiological symptoms’, and ‘is based on the premise that your underlying beliefs about yourself, others and the world influence the way you perceive situations and prompt you to have certain thoughts, emotions, behavioural responses and physical symptoms’.[9] The therapist helps the client to overcome his difficulties by changing his thinking, behaviour and emotional responses. Surely this approach should present some sort of dilemma for the Christian, for surely it is the word of God that should renew his mind and correct his thinking; and govern the way the Christian interprets the world, himself and others. CBT sets the therapist up as the authority on what the client should think, and inevitably the client will be conditioned by the core beliefs of the therapist. Even if the therapist is a Christian, their professional training would have been based on a secular model of counseling that does not consider the teaching of the Bible. The Beck Institute website goes on to explain that through the process of CBT the client begins to chip away at their deep seated core beliefs that are often formed in childhood. What if these deep seated core beliefs are Christian? A young man seeks help, he has been brought up in a Christian home and his parents have taught him that sex before marriage does not please God. He has been involved in a sexual relationship with his girlfriend, the situation is causing him great distress and he is struggling to cope with the feelings of guilt. It is unlikely that the therapist will support the parent’s beliefs, but instead will challenge the beliefs and conditioning that have caused this young man distress, and encourage him to view the situation in a more realistic and positive light. Why does the church send God’s people to professionals to pay money to talk about their suffering, their pain or their guilt? The Cognitive therapist is not equipped to help, encourage, rebuke or correct the people of God, or to truly comfort them in their suffering. Why have we let the medical professionals replace the role of the church community? Because we have medicalised human suffering and sin and think the answer is primarily medical and not spiritual.

The standard evangelical line

How do evangelical leaders help those suffering and struggling to cope with the trials of life? Through attending Christian seminars on ‘depression’ and reading books on the subject written by prominent evangelical leaders, I can only conclude that the standard evangelical line is to accept the disease model of depression, likening people’s emotional suffering to a broken leg or diabetes.[10] But this is an invalid comparison. There is no conclusive medical examination that can diagnose depression, no urine, or blood test, no specimen examination or X-ray. Therefore a conclusive and certain diagnosis of depression, as an illness, is virtually impossible. Diagnosing a broken leg however is simply done by an X-ray which gives a definite and conclusive result.Because many evangelical leaders interpret sadness or anxiety induced by the trials and suffering of life as ‘illness’, it follows that they deal with these problems by advising medical treatment, in the form of antidepressants or talking therapies. Those suffering are sent to the professional, as the pastor lacks the skill needed to deal with a medical condition. Many Christians accept this way of dealing with those suffering from emotional despondency and ask no questions.

Have we been deceived?

Have we been deceived and led astray by a myth[11] created by the depression industry for their own commercial gain and credibility?[12] Have we simply accepted the deception, not discerning what is best and true?[13] Dr Moncrieff makes the point, that the message that our problems are of a medical nature that drugs can cure, ‘has profound consequences. It encourages people to view themselves as powerless victims of their biology’, and ‘stores up untold misery for the future when people come to realize that their problems have not gone away but have failed to develop more constructive ways of dealing with them. It sets a precedent for the use of chemical solutions,’[14] and many people believe the only way to cope is to have an antidepressant prescription for life. The spiritual consequences for accepting the medical model of ‘depression’ are equally profound. It excuses sinful behaviour, as the person is sick and unable to help the way they think, feel or act, and it robs people of hope to ever change without medical treatment. Are we really helping the people in our congregations by setting them on this path? We know that as Christians we are not powerless victims of our biology and therefore can help the way we feel, think or live. The Bible teaches that we are responsible and accountable for the way we live, and that we are not powerless for the Spirit of God lives in us, helping us battle the trials we face and comforting us in our suffering. We should expect trials and suffering as the normal Christian experience and not be surprised when they come. But our suffering is not unbearable or without hope,[15] because this life is not all we have; the Lord Jesus has promised to come back and make all things new. He will banish all pain, tears and suffering.[16] We can place our trust and hope in him and not in medical treatment to deal with the sadness, grief and suffering of this world. By sending God’s people with problems to the professionals we are doing them a great disservice and misleading them to think that the nature of their problems is biological. We are robbing them of hope to change without treatment and weakening the power of the gospel to transform us by the renewing of our minds.[17] Isn’t it time we re-thought this issue?

WARNING: If you are currently taking antidepressants and after prayerful consideration would like to stop it is advisable that you do so responsibly and consult the doctor who prescribed them.

 [1] Ivan Illich, Limits to Medicine, Medical Nemesis: The Exporation of Health, Marion Boyars Publishers Ltd, London, Reprinted 2002, p.3.[2] Amy Iggulden, Evening Standard, London, Thursday 02.08.07, p.1.[3][4] Joanna Moncrieff, The Myth of the Chemical Cure, Palgrave Macmillan, Hampshire, 2008, p.3.[5][6] Edward T. Welch, Blame It on the Brain?, P&R Publishing, New Jersey, 1998, pp. 109-110.[7] Sarah Boseley, The Guardian, London, Tuesday 26.02.08, p.1.[8] Ibid Moncrieff p.224.[9] [10] In Kirsten Birkett’s The Essence of Psychology depression is likened to a broken leg on p.78. and diabetes on p.90.[11] Colossians 2:8[12] ‘The evidence presented in this book demonstrates the eagerness of the psychiatric profession to embrace the myth of disease-specific treatments. This is understandable, given the profession’s long-standing battle to align itself squarely as a branch of the medical profession.’ Moncrieff p.222.[13] Philippians 1:9-11[14] Ibid Moncrieff p.221.[15]Romans 5:3-5, 1 Thessalonians 4:13, Matthew 11:28-30  [16] Revelation 21:1-5

The above article proved to be highly controversial and was not well received by many prominent Evangelical churches and leaders in the UK. The article, ‘Depression: how the churches and GPs can work together’, in Evangelicals Now (October 2008), was a typical response from those committed to the ‘Christian’ counselling scene.

Yet Nancy Lambrechts wrote the article out of a concern that people were not being properly cared for by the Church. Her aim was to show Christian believers that there is power in the gospel to really transform lives, and that in most cases people do not need medication or therapy to change their thoughts, behaviour or emotions. We believe that the evangelical church needs to carefully rethink its approach to depression. Should the church simply embrace the psycho-secular approach to people’s emotional problems? We believe that the church should seriously examine the Scriptures in relation to the suffering caused by depression and not indulge in censorship. It is for this reason that we have decided to put the article written by Nancy Lambrechts back on the web, along side other material dedicated to this issue.

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