Monday, July 9, 2007

Thinking about the idea of chemical imbalance

Pastor Nathan has been teaching a basic introduction to biblical counseling during our evening study on Sunday nights. His teaching has made me think again on the concept of "chemical imbalance" being the cause of various so-called mental illnesses.

I know there is much debate concerning the use of psychotropic or psychoactive drugs among Christians. In my pastoral experience I have counseled several people readily willing to view their problem through spiritual lenses- to seek God's perspective on their trial. They say they are open and willing to consider how sin might be figuring in to their discomfort (their own sin or sin committed against them) or other presenting issues that prompt them to speak with me. All too often, however, I have heard a brother or sister in Christ say something like this- "the bible is good and can certainly help, but if there's a chemical imbalance in the brain, "medicine" is needed to help bring balance".

On the surface, I agree. If there is indeed a chemical imbalance in the brain, perhaps there is a medicinal "cure" or response that can bring back balance? Makes good basic sense. So, my next question is this: how can a chemical imbalance be determined? What test is there so a doctor might know how to help bring balance to the "chemicals" in a person's brain? "chemical imbalance" is used to explain various kinds of mental "illnesses". Certainly there is an objective way to determine what kind of imbalance a person has. Right? Further, given the incredibly powerful nature of psychotropic drugs (they're essentially in the class of narcotic), it makes good sense we would want to know the severity of the chemical imbalance in order to assign proper dosage, etc. Right?

I have high blood pressure. This can be objectively verified by taking my blood pressure. Part of the problem, no doubt, is I'm overweight. Another part of the equation is a family history of high blood pressure. I take a low dosage of a medication to regulate my blood pressure. It works, but I have regular check ups to be sure I am taking the right dosage. They take my blood pressure and determine if a change needs to take place. I am on an ACE inhibitor, a relatively safe drug with few side effects, if any. It has no effect on my brain, even if I wanted to claim it does...ha ha.

Back to the psychotropic and psychoactive drug scenario: these drugs, unlike a blood pressure medication, are very powerful. They at very least effect the level of neurotransmitters in the brain. Obviously, you would think, one would want a reasonably certain idea of the severity of the chemical imbalance occurring before prescribing such a mind-altering (literally) "medication". Right?

This is where I continually become concerned and a bit suspicious.

I have searched and searched. I have asked doctor after doctor. I have read many articles. I have spoken to people far more expert than me on this subject. I have yet to find anyone who knows of an objective medical test that can diagnose a "chemical imbalance" in the brain. The closest thing to a test for "chemical imbalance" I could find is the Positron Emission Tomography (PET Scans) which can test for biological changes in the brain. Of course, the changes can only be observed and not really interpreted. I have also been told by a doctor that changes in levels of neurotransmitter metabolites are detectable in urine and cerebrospinal fluid , however, like the PET scan, interpreting the level changes is difficult at very best. Such tests don't tell "why" or "how" but rather "what".

Here's the truth, as I have come to learn it-and I am open to correction for sure- Psychiatric diagnoses are most commonly made based on criteria outlined in diagnostic manuals, primarily through reference to the "Diagnostic and Statistical Manual of Mental Disorders (DSM)". This manual is basically a compilation of various "disorders" observed by members of the American Psychiatry Association. It lists disorders, based on clinical observation, and what behavioral symptoms identify a given disorder. No medical tests, just the opinions and observations of a select group of psychiatrists.

In reality, "psychiatric diagnoses" rely upon a physician's judgments about a patient's medical history, clinical evaluation of symptoms, and most concerning- from patient response to psychiatric drugs!

In other words- there is no real test to determine if there really is a "chemical imbalance" or "illness"!!!! Yet, statistics say that almost 20% of American adults are taking some kind of psychotropic drug! Further, 67% of those who go to their doctor complaining of depression will be offered an antidepressant or psychotropic drug! Scores of children and teens are given ridilin to treat "ADHD" (attention deficit hyperactive disorder). Ridilin is a psychotropic drug. It's long term effects on a developing adolescent brain are not yet known. No medical test to determine ADHD. No blood draw. Just the doctor's opinion based on what the parents or teachers say. This is incredible to me. A person is basically at the mercy of his/her doctor to play around with doses of a powerful, mind-altering drug, until you "feel" better. No objective medical test. None. Wow.

Earlier I said I was "concerned and a bit suspicious". I am concerned because of the subjective way so-called chemical imbalances are diagnosed (the doctor's clinical judgment alone). I am suspicious because I think someone or some people are getting rich from this exploding business. I think many psychiatrists mean well and really believe in what they are doing. Still, it seems to me, psychiatry is pseudo science at best. It doesn't seem that any one is ever cured of their chemical imbalance (how would we know?), so they are continually reliant upon the "doctor". Convenient. Further, the pharmaceutical companies are getting absolutely fat over this explosion of psychotropic drug sales. Convenient once again.

I don't doubt the reality of depression and other mental afflictions, etc. Furthermore, I am not telling anyone reading this to stop taking what has been prescribed- that could be very dangerous. I do think every believer should seriously analyze the issue and honestly assess what and why they are doing what they are doing. I question the way we look at "mental illness" as Christians and how such a thing is being treated in our day. I'm not saying there is no use for psychotropic drugs. I know of cases where a person, for whatever reason, became a danger to him or herself and in essence had to be tranquilized. The particular anti-depressant they were given acted as a sedative of sorts. Maybe it saved their life? I don't know. By voicing these thoughts I'm only suggesting that we rethink the reality of a so-called "chemical imbalance" and the popular practice of treating it with powerful psychotropic drugs.


Qayaq said...

I heard someone say that this is the result of the "Baby Boomer" generation that was so in love with drugs themselves, with their LSD trips, pot and many others, they sought to have a good time in their own heads and they did this with drugs. Now these people are all grown up and old enough that their generation is running things and doing all the research, so they have legal "designer" drugs to fix any problem they may have.

Your overweight...take a pill
Your depressed...take a pill
You have high blood pressure (no offense) ...take a pill
Heart problems, can't "get it up" take a pill. They even have commercials on TV now that tell you if you are a little depressed, simply take something some powerful mind altering substance that will give you a real good high so you forget your problems.
A pill is a quick fix, it is much easier than changing behavior or fixing the actual problem. I think what you are referring to is the people who don't want to deal with their kids so they give them a "chemical babysitter"
when a little exercise and some attention would do the trick.

In my job I do see people who absolutely need their medication. True Bi-Polar people who cannot function without their medication. People who are normal and sane while on meds and crazy while not on their meds, they hear voices, they cut themselves they do all manner of harm to either themselves or others. However it was discovered, through a blood test or a questionairre I don't know but some how they found out that putting these people on chemicals, even ones that do not naturally occur in the body really helps. Some people need medication just to make life liveable.
In other cases, the drugs are simply a way to keep these people calm and out of everyone elses hair, which is I am sure what is happening with the non- crazy people. In the old days they just chained them to a wall in a dark dungeon, now they just keep them doped up all the time.

TB said...

I am amazed after years of being on/off/on anti-depressants that they did such a wonderful job - I threw them in the trash along with the psychiatrist’s phone number. After all, why did I need to continue to take a medication that did not change the way I felt?

Its amazing how everything changed in a very short time, in comparison to the on again/off again/on again popping of pills, when I looked up at the ceiling of my bedroom and begged, pleaded, argued (not recommended) with God in reestablishing a relationship that had turned acquaintance at best on my part.

Amazingly, I have never had to try to find the physiatrist’s phone number or a new bottle of pills when I am actively trying to have a relationship with my God and my Redeemer.

I have not tasted the cloud of dome or rather the misery of hell (separation from God) since that night in my bedroom. I could once again have the depression, psychiatrist, and anti-depressants back in my life. All I would have to do is turn my back on God - Again.

I am also truly grateful for the spiritual guidance I have received at Redeemer.

Frontier Forest said...

This past Sunday night I wanted to share my thoughts on this very controversial subject with the congregation but we were short on time. Probably best that I didn’t…. But afterwards, I did share with Pastor Nathan.
In 1988, after my divorce and business failure in OKC, I moved to KC. I knew no one and was terrible depressed, even suicidal. The shrink I was seeing put me on some pretty strong stuff. But truth be known, I needed spiritual guidance and repentance, not a bunch of mind-numbing drugs. After all, I had made the choice to move away from God and His Word. Though I never doubted my salvation, I confessed to want nothing to do with the Lord or His people. When I met Cheri, 2 years later, my life changed. She told me it was time for me to move away from my past, throw away my drugs, and stop running from the Lord! Thankfully I did.
It might seem like over simplification on my part, but may I share the one simple, yet profound verse that changed my life almost immediately? We all know about the full armor of God, proposed by Paul in Ephesians 6. But before any of that armor is to be put on, we are mandated to make this most important first step! In verse 10, Paul admonishes us to “Finally, be strong in the Lord and in the strength of His might!” Simply stated for me, this verse told me, “to KNOW GOD, find out who my heavenly Father was and is, what HE wants and expects from me.” How can we be strong if we don’t first know how weak and helpless we truly are? How can we know about HIS might and power if we don’t take the time to get to know what HE can do for us and through us? May I proclaim HIS Words again? “Finally, be strong in the Lord and in the strength of His might!”
I joyfully share my weaknesses of the flesh and failures of the past to strengthen the brethren.

AJF said...

Powerful testimonies...

Qayaq said...

What are your thoughts on pshycotherapy?

William Perry Guilkey said...

Let me begin this post by saying that I can only speak for myself in relation to this topic. However, in my own case, the deep and dark days of crushing depression were, in my opinion, the chastening hand of the Lord on my life. While I have always exhibited a few signs of OCD (i.e. counting highway hash marks and telephone poles by fours; going through a time where if I did something with my right hand, I had to do something equal with my left hand), those were mostly just annoyances (and caused things to take twice as long! Ha!). While I always have been introspective, extremely sensitive to being a sinner and a little melancholy; it wasn't until I was "full bore" into a lifestyle of sin that I reached a place of "bone crushing" depression. I was in a lifestyle that became an "addiction" (What Scripture describes as being a "slave to sin"). I went to rehab in 1994 (for 21 days) and 2003 (for 40 days). I was on Zoloft for depression and Abilify for OCD. I was seeking peace of mind but not freedom from sin (I did not have the ability to seek that). My goal was to be rid of pain (mental) but not give up the pleasure (which Scripture says that sin is--"for a season"). I was the typical proud sinner who wanted to be his own God. I sought God "as I understood Him" (which really meant "as I created Him to be in my sinful imagination"). As a result, I was an idolater. Like the depravity of man described in Romans 1, I recognized God as Creator but did not acknowledge Him as such. As a result, I was given over to my passions and have some stories in my past that are too shameful and painful to mention to nearly anyone (except those who are in my accountability group and are discipling me and even to them, some things are difficult to share). The result of all of this was depression of the deepest kind. I wanted to die but was afraid to do so (just in case I would "really go to Hell"). I look back on those times of "fist shaking blasphemy and bold-faced sin" with sadness, fear and shame. I can relate to John Newton's verse that states . . . "Twas grace that taught my heart to fear and grace my fears relieved . . ." I have absolutely no right to stake a claim on God's mercy. I truly am a recipient of Divine Grace given for God's purposes of election ALONE. Not one thing in me merits anything from God but a place in the hottest corner of Hell, bearing the full brunt of His wrath. HOWEVER . . . God did show me mercy and much like the Apostle Paul, I believe that He did so to "demonstrate His perfect patience." I say all of that to say that the "medicine" that I personally needed was saving faith and repentance. This was the one thing I could not give myself. I spent nearly $15,000 on two stints in rehab, hours of counseling and dozens of pills and found no peace of mind. I spent hundreds of hours in 12 step groups admitting I was controlled by "unhealthy passions" and all I really got from that was a sore butt from the metal folding chairs, bad coffee, some temporary "conscience salve" and a chance to be told I was okay when I wasn't. However, in Christ I have found peace of mind and it was FREE (to me,NOT to Christ). The fruit that flows from that has a cost (my life) but that is not given in a way to "earn it" or to "pay God back," but rather in the knowledge that I have found (or rather "been found") by the treasure, which when found makes one want to give up all he has because of it's all-surpassing worth.
Now, lest people think I am "over-spiritual" and "not in the real world," let me state without equivocation that some days are still hard. Some days I wake up "blue." I am still way too introspective and can talk myself out of assurance (even while reading the Bible). HOWEVER, when God gives me the grace to quit looking at myself and my failures and my problems and my inconsistencies and then points my attention to the cross; the darkness lifts. Instead of living my days in deep, dark valleys, I now live on a pretty even keel of plateaus with a few mountaintops and a few valleys. However, most of it is right on the plateau. It is a narrow way (the world would say a "narrow-minded" way) but a way of peace. Medicine, support groups and therapy never gave me
that. Sometimes they would help me sleep, but they never gave me peace. Thank God for His chastening hand and the fact that His plans are never frustrated for HE NEVER LOSES ONE THAT IS HIS OR ONE THAT HE DETERMINES TO SAVE! Living by faith in future grace!

AJF said...

Wow, powerful post William. Thanks for sharing all of that. Praise God.

Anonymous said...

This subject is so close to home for me. My mother has been so mentally ill for years.
I was around 11 when she was placed in a mental instatution, which was a horrible experience for her and her children(me being the oldest).
At that time these so called "Phychiatrist" did electrical shock treatments, which rendered the patient lifeless and in a state of total confussion. They didn't work except makes matters for the patient worse.
As I matured, I started researching most of the drugs that was given to Mother and found that these drugs are not tested enough before they are given to patients. Truth be know the patients are Guinea Pigs. And look out for those Mental Health and Mental Retardation Clinics, some of the Dr.s and staff have more problems than the patients(just visit one several times).
God and his word is the best theropy. I truley believe that if Mother had had someone in the church that she could talk to at the time, she would not be where she is today. Oh, Mother is not in an instatution, she lives by herself in an apartment, not too far from family. She is 80 and functions fairly normal, she has to take medication for the rest of her life(with out it she is out of control).
Giving children medication for ADD is another subject. Most children don't need the medication. I have a nephew that was placed on several ADD drugs. First, his parents did not discipline him, then when he went to school the teacher or the principal couldn't handle him, so he was diagnosed with ADD. The drugs that he was on caused him to have "ticts" and function in slow motion.
I had kept this wonderful child way before this and had no problems with him(he knew that I had consequences for misbehavor and that I would exert my authority).
Here again, the parents (non-christians would depend on drugs for disciplining a child and did not want to be the "BAD PARENT".
Thank GOD for his wisdom, spiritual guidance, and HIS WORD that keeps me sane and healthy.

Frontier Forest said...

Dear Brother William,
A humble THANK YOU seems a bit inadequate but certainly in order! Your powerfully probing, honest testimony spoke volumes to our very difficult family situation!
My son-in-law is doing relentless battle with self, running from God and wallowing in sins addictive allure. And as we know, sinful addictions always yield shameful and deplorable consequences. Yet he remains belligerently unrepentant, wonders what has happened, and living in a state of total denial! “There’s nothing wrong with me!” But as rushing and raging sin destroys everything in it’s path, a once precious loving family is eroding away, ruined by the deluge of sin. And as always, it’s the innocent ones who suffer the most in the ugly aftermath. And now, our daughter and our 2 precious grandkids are left, trying to clean up and restore whatever can be salvaged.
I will print off your testimony and send it to my daughter. I wished I could send it to him myself, but he needs to hear your story from my daughter.
Thanks again for sharing. I know she will find rest and comfort knowing you have overcome! "But in all these things, we are overwhelming conquerors through Him who loved us."

Qayaq said...

I am glad to see that I am not the only one that has problems. I have noticed that an inordinately high number of Christians seem to suffer from depression. I wonder if that is God's way of building character in His people?
I had a really rough childhood and have spent the past 19 years trying to overcome the first 17 years. I never went to counseling and therefore was never put on drugs. I used to think that maybe it would have been better for me if I had, now I can see that it probably would have been worse. I do a lot prayer and bible study and slowly I am improving.
Drugs work to numb your brain and body to the problem, this is the quick fix for people who do not want to deal with their orginal problem since it is so painful (I was in mental anquish for several years), addictions do basically the same thing, they numb the body and mind to a problem, take your mind off of what is ailing your for a time, the problem is that it causes a whole new set of problems. It is also interesting that doctors put people with addictions on a medication to break that, they just substitute one addiction for another never dealing with the real problem.
These stories are good. Thanks