In this fourth lesson, Pastor Dave Capoccia considers what the truths from the previous lessons about the Bible’s sufficiency and the mind-body connection mean for the issue of psychotropic drugs. Pastor Dave overviews the topic of psychotropic drugs from a biblical perspective and then considers a few frequently asked questions.
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all right well good morning welcome to sunday school let’s begin with a word of prayer heavenly father thank you for this time as we address this serious topic today i pray that this would be an edifying time give me words to explain well and help us to take seriously what is spoken and to compare it to your word and live accordingly in jesus name amen now in our fourth lesson of the biblical counseling 101 sunday school class why do i do what i do and how can i change i want to actually go right into our time today by reviewing the homework remember you do have homework for this class i hope you’re doing that that’s how you actually get the most out of this course i’m only a guide here i’m introducing many topics to you in the class but you really learn it you really get it reinforced in the homework so hopefully you’re continuing that extremely important habit of reading the bible and praying every day i’m not going to go over the extra credit assignment i hope you found that edifying especially the more thorough explanation of the placebo effect and also the importance of double blind studies versus just anecdotal subjective experiences but let’s talk about the other article the regular homework that i asked you to read a biblical view of illness i asked you to write down five observations or questions so what are some things that stuck out to you or that you had questions about from reading that article actually let me start with one clarification if you found a little bit confusing at the very beginning when he said some illness is due to sin and other illness is due to personal sin that may be a little bit confusing but when he says it’s due to sin he means just the fall the effect of the cursed world he’s not saying you actually did something and that’s the reason why you’re sick that’s more when he’s talking about personal sin okay but other things that you noticed or had questions about yeah mark that’s right so mark mentioning the author’s mention of job and how illness actually reveals our character and even moves us towards sanctification interesting too where he makes the point about paul with his affliction it may have been an illness but it was actually to prevent him from sin to keep him from exalting himself he said the thorn in the flesh we’ll mention that verse again in just a moment what else yeah glendon that’s right that’s a really important point to make i hope that’s one of the main takes takeaways you got from this article is that illness actually can be spiritually strengthening and it can be a special avenue for glorifying god if you’ve been part of our zoom prayer meetings that’s one of the things that i’ve also tried to remind our church about when we pray for those who are sick in our church don’t just pray that they get healed that is something we want to pray but more important than that is that a person will be able to be strong in the lord and glorify him through that illness in fact for some people their greatest testimony for the lord happens when they are very sick maybe even terminally ill that is when they have unlocked for them a special time of ministry we need to embrace that and we need to help one another embrace that with compassion with sympathy with grieving along with the other person but directing them this is not an accident from god this is now a special time of your ministry other questions or comments yeah april um right yeah april that’s a good point just pointing out how the author purposefully uses a different term than psychosomatic he calls it physiological spiritual or spiritual physiological i forget exactly the order because that helps us remember that there is a component of how we react to our circumstances we are responsible for it which is sobering but also encouraging now it’s kind of amazing i presented this to you last time but it’s kind of amazing and also maybe a little bit troubling that a lot of the affliction even physical affliction that we and others experience is actually caused by our own minds that’s not to say that every time that somebody feels physical symptoms of illness and they can’t figure out the cause that you say oh you have a spiritual problem you must have some sin in your life we might be making the same mistake as job’s friends it could be something that they just haven’t discovered yet but if they have physical symptoms or if we have physical symptoms and there’s there’s a clear spiritual problem in a person’s life you can say oh i i think there might be a connection you’re so anxious or you’re so angry or you’re so depressed and they can’t find a medical cause for what you’re going through there could be a connection here there’s likely a connection here well i hope you were benefited from that article and that you’ll also benefit from the new articles let’s talk about this next week’s homework i actually want to keep you in the christian counselor’s medical desk reference with two articles very connected to what we’re going to talk about today so the first this is your regular assignment besides bible reading and prayer and remember that’s important it doesn’t matter to me so much how much you do but just do it be consistent and focus bible reading and prayer with god i also want you to read chapter five from the christian counselor’s medical desk reference are psychotropic drugs needed in counseling and biblical counseling make fives observations and questions on that and then for extra credit this will be sent to you in the email if you’re signed up as part of the class i do have a few paper copies but another article attention deficit hyperactivity disorder so the author takes time to view that from a biblical counselor’s perspective any questions about the homework okay now before we get into the main part of our lesson i want to get to something that we didn’t get to at the end of the last lesson kind of a review and application of some of the things we were talking about in lesson three the mind-body connection and i want to do this with with a set of theoretical scenarios suppose a christian brother or christian sister if that would be more appropriate and you’re female comes to you and tells you that he is depressed he says he feels very little joy in life very little motivation to go on each day how would you respond to this person what’s the first thing you might say to him or do with him yeah herb okay ask him how you can help that’s a that’s a good question to ask yeah catherine okay well catherine said how long he’s been feeling that way or she’s been feeling that way both of these responses are good because the very first thing we should do is ask more questions get more data don’t just be like well let me tell you what the bible says about depression and hopelessness you need to find out more information because that’s going to allow you to give a more skillful and helpful answer i’ve mentioned this verse before i think in this class but certainly in other venues proverbs 18 13 proverbs 18 13 says he who gives an answer before he hears it is folly and shame to him you want to go to the bible right away that’s a good impulse but you need to ask more questions you need to find out more information you need to gather data this is critical in counseling so someone tells you that he’s depressed find out more about what’s going on in his life and even what’s going on with his health i told you that depression that kind of more modern term biblically we could describe that same experience as sad hopelessness or sad dissatisfaction that is ultimately an inner man issue and you want to probe that and address that in that person’s life but you are aware especially from last lesson that there are outer man issues issues of the physical body that can contribute to the feeling or experience of depression or hopelessness so knowing this what kind of questions could you ask about a person’s physical well-being yeah mark is a good question to ask tell me about your sleep how much sleep do you usually get when you go to sleep what else yeah okay tell me about your diet um and um maybe some things related to how and whether you eat yeah okay family relationship that’s not so much physical but it certainly will impact a person’s life and can contribute and reveal the cause of hopelessness but more health related questions april very good extremely important question are you taking any medications have you recently started a medication or changed medications that can actually be very very impactful we could just ask generally how is your health we mentioned how is your sleep how often do you exercise have you really recently started or changed medications when’s the last time you visited a doctor and what was the report now depending on how well you know the person person may not be ready to give you all that information but if they’re really looking for help from you those are some good things to find out now i wanted to say this last time i didn’t get a chance but let me remind you i don’t think there are any exceptions in here well maybe a little bit we are not doctors so even though we know certain things about the mind-body connection we should definitely refrain from diagnosing physical illnesses your doctor said this i think this is what’s going on i think you have this disease um we’re not doctors but we can work with doctors to spot and treat physical conditions that contribute to spiritual problems so if you suspect that physical factors could be affecting your counseling spirit one of the best things you could do is recommend they go to a doctor and get a thorough physical exam that can just rule out some physical contributors to whatever spiritual issue they might be going through changes in physical areas will not eliminate a spiritual problem but they can help a person just to give you a quick story about this pastor bill shannon who is someone that i who was the pastor of the fellowship group that we were part of in california when we were at grace community church he was also the one who oversees their counseling department he told a story about one time about a woman in his congregation who was just a faithful god loving woman following after christ and all of a sudden one day she’s like i am just so depressed and i can’t figure out why i just i am just so sad all the time and her husband couldn’t figure it out and nobody could understand why but pastor bill started asked some questions related to her physical health and one of the questions he asked is did you recently change medications and she said yes and when he dug into it a little bit more he found that one of the common side effects of this medication was depression and so he mentioned that to her she spoke to her doctor about it the doctor changed the medication and what do you know that feeling of hopelessness and dissatisfaction went away so it’s important that we ask about physical contributors to some spiritual issues now this guy this theoretical man or woman who comes to you talking about depression let’s say you you go through some of these questions you go through this process the guy visited his doctor the doctor gives him a blood test and he’s diagnosed as a result with hypothyroidism hypothyroidism that is a known physical disorder in which the thyroid gland does not produce enough of a hormone associated with the body’s metabolism now this lack of hormone certainly has an effect on a person physically but one of the inner man characteristics of people with hypothyroidism is depression they have an increased they often have an increased feeling of sadness or hopelessness a doctor if someone is showing behavioral or physical symptoms of hypothyroidism he might order a blood test to see whether there are certain levels in the blood that would confirm a hypothyroidism diagnosis so let’s say this fellow is diagnosed with hypothyroidism the doctor prescribes medication there is no once and for all cure for hypothyroidism but it can be treated if you take ongoing medication it makes up for the lack of hormones and allows you to recover from the difficult symptoms even the feelings of sadness and hopelessness knowing all this the man asks you should i follow my doctor’s treatment plan what would you say that’s a good idea there’s no reason not to this is a known physical disorder the cause is physical the medicine treats the physical problem why not god gave us medicine it benefits us if we if we use it when it treats a physical problem now let’s throw then this monkey wrench let’s say that due to covet and global supply chain problems the man cannot obtain the medicine to treat his physical condition there’s a a backup it’s not available he’s simply stuck with this hypothyroidism he knows he has it but he can’t do anything about it what counsel would you give the man in this condition yeah glenda okay okay so just practically how can i help you am i able to obtain the medication for you but let’s say there’s there’s none in the united states there’s no way to obtain the medication what can we say yeah jane okay so jay’s suggesting maybe look into other solutions maybe a homeopathic maybe there are other ways that can help treat the condition magnet what are you going to say yeah okay so mag to mention that encourage this person not to be focused on himself but to actually think about how can i glorify god in the midst of this and even minister to others now from the homework reading i think one of the points that dr smith made that was really good is that we have to beware of becoming obsessed with a cure if you are able to find a cure that is good stewardship of your body before god but that’s not the reason why you’re alive you’re here to glorify god and if you get totally distracted with finding a cure it will drain your finances drain your energy and totally remove your ability to glorify god if you’re able to get better do it but if not don’t worry too much about it you say oh but i have this hypothyroidism it makes me feel increased depression well what did people do before there was a even a discovery of hypothyroidism or a cure for hypothyroidism with the christians who had that just left in the lurch no the lord was sufficient for them it was harder physically it was harder for them to rejoice in the lord to be content to be focused on ministry but the lord was still sufficient and this is something that we need to remind our counselors who may have an issue that cannot be treated even something that affects or or has an influence on the inner man you know what’s interesting to me i started listening to a little bit of jeremiah burroughs the rare jewel of christian contentment he’s a puritan 1600s and at one point of the book he mentions when it comes to contentment that some people just have a more melancholy disposition which is kind of an interesting statement it’s almost like without knowing about hypothyroidism he was mentioning that there could be something physical like that that some christians just have it is more difficult for them in a certain sense and yet the lord is still sufficient you can still be content you can still walk with the lord faithfully even if you have a condition like that so we want to sympathize show compassion to somebody who has a condition that cannot be treated but we also want to direct him to his supreme compassionate sympathetic sufficient lord and the lord’s word kind of along the same lines let’s say alternate scenario the depressed man comes to you and as you talk with him he reveals that he was recently diagnosed with a painful and rare form of cancer and there is no cure what counsel should you give the man in that physical situation it’s a similar situation right grieve with him you know people accuse biblical counsel is just throwing the bible at people we don’t want to do that grieve with him and say i am so sorry this is the world that we live in god didn’t make it like this and one day it won’t be like this but it is the way it is now and i’m so sorry i’m so sorry to hear that this is the case with you even be willing to cry with that person show compassion scripture says grieve with those who grieve but then give him hope give him hope in the kingdom that is to come assure him that he can rely on and glorify the lord even in a terminal in illness and like we said the beginning it’s actually a special opportunity for ministry remember this is paul’s attitude philippians 4 13 i can do all things through christ who strengthens me that is i can endure all things brother sister you can we can together and as paul also says about his thorn in the flesh i want to actually read that passage to you sec second corinthians 12 verses 7 to 10 again we don’t know what the thorn of the flesh was it could have been physical could have been something circumstantial but paul says about it in second corinthians 12 7 to 10 because of the surpassing greatness of the revelations for this reason to keep me from exalting myself there was giving me a thorn in the flesh a messenger of satan to torment me to keep me from exalting myself concerning this i implored the lord three times that it might leave me and he has said to me my grace is sufficient for you my power is perfected in weakness what was paul’s response to that man god is unkind man god doesn’t care about me no he said most gladly therefore i will rather boast about my weaknesses so that the power of christ may dwell in me therefore i am well content with weaknesses with insults with distresses with persecutions and difficulties for christ’s sake for when i am weak and then i am strong our moment of severe affliction is a time of great weakness but if we look at the example of fall that’s actually a time where we can be spiritually strong and a great witness for the lord we can have joy in the lord even in our times of greatest trial now one more scenario with this man you’re asking questions as you talk with this man you find out he is indeed suffering physically he reports extreme muscle tightness painful bowels headaches but he goes to a doctor and the doctor cannot find anything medically wrong with him also as you get to know the man though you can see that he is racked with anxiety he’s extremely worried about his life and the doctor notices this too and the doctor suggests you see a psychologist and then a psychiatrist to deal with the anxiety the man asks you whether he should what would you tell him that’s one of the main questions of our course right is the bible sufficient is the lord sufficient is this an inner man problem if it is then the lord should be sufficient shouldn’t he dr smith in his article he kind of poses the same question right the same situation and the conclusion that he comes to at the end is why would you send him to someone who can only offer an inferior solution you have something much more effective you have something superior tell this man that christ in the bible are sufficient that the world has inferior answers and that you would like to help him see that let me walk with you disciple you train you in the word of god so that you can respond to the temptation of anxiety rightly and there foresee the blessing even the physical blessing of trusting the lord in your life now i’m going to say more about that now i mentioned a psychologist and psychiatrist what is the difference anyone tell me mark you were going to say yeah one is medic medical doctor which one the psychiatrist that’s right they have more medical training there they’re actually uh md’s and functionally what is different about what they do yeah jay yeah who does the medication psychiatrist gives medication a psychologist gives counsel in therapy now what kind of medicine do psychiatrists usually give psychotropic drugs what are psychotopic drugs well i’ll give you a definition here as i describe it psychotropic drugs are literally soul-turning psycho from tsuke the greek word for soul tropos means turn or change so these are soul turning or maybe easier way to describe it in modern terms mind altering medications also known as psychiatric or psychoactive drugs so when i use the term psychotropic drugs today i am referring to legal medications that are prescribed to treat what are called mental illnesses or mental disorders so these medications would include antidepressants antipsychotics anxiolytics hypnotics mood stabilizers and stimulants and they’re described for disorders are prescribed for disorders such as clinical depression anxiety disorders bipolar disorder and attention deficit hyperactivity disorder psychotopic drugs are the main topic of our class today the question we want to know the answer to is what role if any should psychotropic drugs play in the christian life and in biblical counseling now hopefully you’ve been through our previous lessons so that some of the things i say aren’t as startling to you as they might otherwise be we’ve talked about the bible sufficiency we’ve talked about what biblical counseling is we’ve talked about the mind-body connection you need to remember all that but i recognize that this is probably going to be the most controversial class that we do in this course so i want to start with a few qualifications number one i recognize that this topic hits close to home for many of you you or someone close to you may have taken or is currently taking psychotopic drugs your experience with these drugs may be good bad or more or less neutral know that i’m not discounting your experience whatever it was or is by what i say today but i ask you to remember that no experience is self-validating or self-interpreting every experience the significance of every experience must be determined and analyzed by an objective truth source the only safe truth source for evaluating all of life and our experiences is the word of god so as we consider this topic today i ask you to remember again the council of james 1 19-21 be quick to hear slow to speak slow to become angry and receive with humility the implanted word be a berean compare what we say today to what the bible says that’s number one number two i recognize that there are genuine brothers and sisters in the lord who take slightly different or majorly different stances towards psychotropic drugs than what i’m going to present to you our disagreement in this topic is probably not so great that i could not fellowship with that person anymore they’re still dear brothers and sisters in the lord if you after today’s course are not convinced i think pastor dave’s totally wrong about this well i still want to fellowship with you i don’t think this is something that breaks fellowship but i do need to talk i do need to talk to you about it because i do think that a wrong approach to psychotropic drugs will really hurt the church and will hurt many people individually so we need to address it and then number three i am not a doctor i am not a psychiatrist but i can tell you this if you are on psychotropic drugs and you decide you want to stop taking them do not i repeat do not go off of them suddenly and without the guidance of a doctor it is well known that psychotropic drugs create powerful withdrawal symptoms that can move someone to act in bizarre and even dangerous ways so do not be reckless do not be foolish be wise if you’re persuaded that you don’t need psychotropic drugs gradually wean yourself off with a doctor’s help all right with those qualifications here’s our agenda for today we’re going to overview the topic of psychotropic drugs from a biblical perspective deal with a few frequently asked questions and then hopefully if we have time in the end take some questions because i know this might generate some questions but let’s dive in i’ve already given you a definition of psychotopic drugs they are mind-altering chemical medic medications commonly used to treat mental illnesses what are called mental illnesses what exactly is a mental illness what is a mental disorder those are synonyms here’s a recent definition from the apa the american psychological association mental disorder is or mental illnesses any condition characterized by cognitive that is thinking and emotional disturbances abnormal behaviors impaired functioning or any combination of these such disorders cannot be accounted for solely by environmental circumstances that is by the things happening in your life and may involve physiological genetic chemical social and other factors now there’s some technical language there the definition might be a little hard to understand but we can paraphrase it this way if you characteristically think feel or act abnormally or have impaired ability to act and function in your life you have a condition constituting mental illness and from where does mental illness come note that the apa’s definition gives a variety of factors environment physiology genetics chemicals social situation and more that is not described but if you look at what is mentioned how many of those are physical of the five three of them right physiological genetic chemical but you know one key term in this definition in the second part the word may what does may indicate they’re not sure they don’t know for certain now i told you before that the bible doesn’t use the term mental illness but it does describe the same phenomenon using different language so how might we define mental illness using the bible let me give you my working definition i say working because i reserve the right to refine this but i do think even though this may sound radical especially based on what we just heard i think it is fair and i think it is biblically accurate here’s my attempt to define mental illness biblically a mental illness is a condition in which wrong that is false foolish or sinful thoughts beliefs and desires in the heart have become so habitual that a person’s life has become dominated by self-destructive behavior and effects i’ll read that again a mental illness is a condition in which wrong that is false foolish or sinful thoughts beliefs and desires in the heart have become so habitual that a person’s life has become dominated by self-destructive behavior and effects so in this view biblical synonyms to mental illness if we were to use an alternate term it would be something like soul enslavement heart ensnarement spiritual bondage consider biblically speaking all sin and unbelief and false thinking is a form of mental illness remember ecclesiastes says insanity is in their hearts all their days right speaking of the people of the world when you are pursuing sin acting foolishly in a sense you’re acting insane but usually either by god’s grace or by other um intervening factors our insanity is somewhat small and local when we get into the habit of thinking desiring believing foolishly when that becomes unrestrained it begins to have more and more destructive effect of our lives when it becomes really noticeable the world would call that person mentally ill but biblically that’s a person who’s just ensnared enslaved in his inner man now let’s compare these two definitions according to the apa’s definition who’s responsible for mental illness yeah nobody is it’s it’s all these factors which are beyond your control so nobody’s responsible for mental illness according to a biblical definition who’s responsible you are whoever is suffering with it according to the apa’s definition what is the main what is a main if not the main source of mental illness okay our environment is one what we’re gonna say glenda okay so you mentioned medication that would be part of the proposed treatment but in terms of identifying primary causes remember three out of five are considered physical at least in their list so a primary if not the main cause of mental illness according to the apa is your body physical factors according to my proposed definition what is the source of mental illness not the body but the the heart the inner man the soul according to the apa’s definition of what is the implied solution to mental illness glenn already mentioned it medication along with counseling therapy but according to a biblical definition what is the implied solution heart change repentance which is produced by christ’s word and the spirit now i’m going to support my biblical definition a little bit more as we go through the class today but take a moment to notice something just in comparing these two notice the importance of the labels you use to describe people and behavior notice how the term mental illness or mental disorder already suggests that the problem is physical that the mentally ill person is a victim and that the solution is medical but if you use a different term like soul enslavement that suggests that the problem is spiritual that the enslaved person is a self-victimizer and that the solution is spiritual so this is a key point to remember for all of christian living and counseling i wrote it there on your hand now labels suggest solutions labels suggest solutions therefore use biblical labels as much as possible therefore use biblical labels as much as possible be careful about using terms like mental illness emotional health or bipolar disorder even though these are common jargon of the world these terms can obscure the true nature of these realities use biblical language use biblical labels as much as possible when describing these types of things yes steve sorry steve i can’t hear you yeah steve’s making a good point that uh so important that we start with the bible because the bible actually describes what is compared to the world even the apa they use the term abnormal but what is abnormal and this is something that ed welsh brought out in his article to this uh psychiatric yeah i think psychiatry students or psychologists maybe both he says you guys want conversions but you haven’t agreed what you want to convert people to in fact if you look at the history of mental disorders things that were mental disorders at one time no longer are like if you thought that you were a boy when you were a girl that was considered a mental disorder in the past but increasingly that’s not considered a mental disorder it does always change and that’s why you’re so right steve we need to start and stick with the word of god and even use biblical labels now again if you find my biblical definition startling even example of blaming the victim i think you’ll come to understand more why i take this viewpoint when we overview how and why psychotropic drugs are administered so this is point one on your handout psychotropic drugs overview oh yeah there we go as you can see fundamental to the issue of psychotropic drugs is whether the issue is biological or spiritual and today many people talk about issues such as depression or bipolar disorder like they are biological issues one would expect then if a mood or if it is biological that a mood disorder diagnosis would include the presentation of some kind of tangible verifiable biological evidence from the body after all this is normal in medicine this is normal for other health diagnoses for problems in the body you have a broken bone here’s an x-ray that shows it i’m not lying to you you can see it you have high blood pressure here are the numbers that back it up you have hypothyroidism here’s a blood test that shows the elevated chemicals in your body however for those of you who might know how do doctors diagnose someone with a mental disorder yeah mark mental disorders are diagnosed on the basis of observed and reported symptoms observed and reported symptoms some of them physical symptoms some of them behavioral there is no medical test to diagnose a mental disorder a doctor might look at a blood test to rule out physical diseases and physical disorders but there is no test for a disease in the mind instead doctors just look for a common sense of behavioral common set of behavioral symptoms they diagnose you on that basis and then they prescribe you psychotropic drugs and or therapy for example for an adhd diagnosis american psychological association has determined that a doctor simply needs to confirm six of 18 symptoms over the course of six months the possible symptoms include often does not seem to listen when spoken to directly often avoids dislikes or is reluctant to engage in tasks that require sustained mental effort such as school work or homework often has difficulty awaiting turn often blurts out answers before questions have been completed that’s just a sample by the way how would the bible diagnose a child with those behavioral symptoms go ahead and raise your hand yeah jay he’s acting foolishly april that’s some rebellion this is evidence of laziness carelessness sinful self-centeredness and a simple lack of self-control the bible speaks to these symptoms and what does the bible prescribe as a solution all right go ahead tina okay if yeah often in the home it’s the discipline the rod of correction it’s training it’s accountability it’s discipline that’s what drives out and deals with that foolishness and self-centeredness but according to the apa these symptoms are indicators of the mental condition adhd and what is the solution for the and what is the proposed solution for adhd medication ritalin or something like that a similar situation exists for other mood disorders diagnosis and treatment are given on the basis of reported symptoms and behaviors not tangible medical evidence now you’re probably wondering well how can medical professionals justify such an approach well the main theory that is undergirded the use of psychotropic drugs is called the biogenic theory of mood disorders also known as the chemical imbalance theory it has been postulated that the reason that you are depressed say or the reason that you have great mood swings or the reason your child is hyper or distracted is because a certain chemical is being suppressed within the brain it’s low perhaps it’s serotonin or perhaps epinephrine the drugs seek to alter their brain chemistry to restore the normal amount of the chemical this is a nice theory but the theory has never been proven despite many attempts to do so actually it is unprovable our medical technology is not sophisticated enough to peer that closely into the brain and to the synaptic connections to observe whether things are being suppressed or not in truth no hard evidence has ever been given to demonstrate a causal connection between chemical levels in the brain and so-called mood disorders there may be some correlation but no demonstrated causal connection and today many doctors and scientists will admit that they do not know what causes mental disorders depression add bipolar disorder they will even admit that they do not know how the drugs are helpful as treatments isn’t that kind of unnerving for example here’s what the mayo clinic says about the cause of depression this is from their website it’s not known exactly what causes depression as with many mental disorders a variety of factors may be involved such as biological differences brain chemistry hormones and inherited traits maybe or here’s what britain’s national health service website says about antidepressants quote it’s not known exactly how antidepressants work it’s thought they work by increasing levels of chemicals in the brain called neurotransmitters certain neurotransmitters such as serotonin and nor adrenaline are linked to mood and emotion neurotransmitters may also affect pain signals sent by nerves which may explain why some antidepressants can help relieve long-term pain while antidepressants can treat the symptoms of depression they do not always address its causes this is why they’re usually used in combination with therapy to treat more severe depression or other mental health conditions actually increasingly doctors and psychiatrists today have criticized the chemical imbalance theory as misleading and insufficient you can find various articles and statements about this online for the sake of time i won’t read all the ones i have here i’ll just give you one from the psychiatric times 2019 article entitled debunking the two chemical imbalance myths again says quote ironically anti-psychiatry groups are quite right in heaping scorn on the chemical imbalance theory of mental illness but not for the reasons they usually give basically saying that some people think it’s all conspiracy by psychiatrist he says that’s not the reason but they are right about certain things scientifically speaking there never was a network of validated hypotheses capable of sustaining a full-blown global chemical imbalance theory of mental illness furthermore the ssris that is selective serotonin reuptake inhibitors that’s the main type of antidepressant they were accorded to rockstar status as effective antidepressants that they did not deserve most troubling from the standpoint of misleading the general public pharmaceutical companies heavily promoted the chemical imbalance trope and the direct to consumer advertising there was no concerned attempt by our profession psychiatrists to promote a causal or etiological theory of mental illness in general based solely on chemical imbalances increasingly what the medical professionals will say is physiology is a factor but it’s complicated there’s much more to it it’s not simply a chemical imbalance so you’re probably wondering based on that if such is the case if doctors are not sure about the causes of so-called mental illnesses and they’re not even sure how psychotropic drugs treat those causes then why do doctors still prescribe the drugs well they do know that brain chemicals are involved but again correlation is not causation just because they’re connected doesn’t mean that one causes the other but what is the main answer if they don’t really know what’s going on why do they still prescribe the drugs yeah glenda money is certainly involved though i think we should refrain from saying oh they’re all just in it for the money some of them do have good motives yeah judy certainly it’s just general practice have it yeah this is just what you do if somebody comes in their kids acting up put them on adhd all right put them on the ritalin yeah herb okay it could be come down to ego many times i think you’re you’re getting some periphery factors here but what’s really at the center of this why they prescribe these drugs is because they work they work for antidepressants many people do report that the drugs make them feel better and for ritalin people do report that their child is less hyper once they’re on the drug the basis for psychotropic drugs then is totally pragmatic there’s no tangible medical proof but psychotropic drugs seem to make people feel better and restrain unwanted behaviors so these results are treated as evidence that the problem really is biological and not spiritual but let’s probe this conclusion a little bit can you think of any other situation in which people use drugs to make themselves feel better yeah coffee okay yeah jay alcohol narcotics pain relievers this is not a new thing is improved mood then proof of a restored chemical imbalance in the brain no chemical balance i meant or think of another situation or can you think of another situation where drugs successfully prevent unwanted or dangerous behavior in people or animals use a drug to restrain behavior can you think of any other examples of that exactly you tranquilize wild animals with drugs you can restrain behavior through sedatives you can restrain behavior through general anesthesia this is what they do when somebody gets intubated right they have to put them on um if they’re moving around they would mess up their procedures so they have to be sedated you can use drugs to do that so is restrained behavior proof of restored chemical balance it’s not so there really is no proof that psychotropic drugs are restoring chemical balance or that the issue is truly or mainly biological so what are these drugs doing as i said no one really knows for sure they keep getting prescribed if i may offer an opinion this is not the authoritative word of god this is just based on my admittedly limited observation and experience but in my opinion the drugs appear to work fundamentally to inhibit or suppress the mind they suppress the mind and i say this because if you observe people who are on many psychotropic drugs it’s like they’re not really there not fully there sometimes they look catatonic also some people i’ve spoken to on psychotropic drugs they will confess they they just can’t think they feel like they’re in a fog how might suppress thinking improve mood can’t think about your problems right can’t focus on it that might make you feel better or how am i suppressed thinking restrain unwanted behavior you don’t have the mental energy and cognition to act you’ve been sedated psychotropic drugs then appear to function more like chemical handcuffs mental pain relievers or mental tranquilizers rather than restorative treatments that’s why they have their effect at least that’s what makes sense to me you know there’s an interesting parallel and another kind of more extreme psychiatric treatment designed to treat mental disorders and that’s electro convulsive or shock therapy in shock therapy a patient is put under general anesthesia and receives controlled electric shocks through his brain and endures mild seizures these shocks and seizures alter the chemical composition of the brain and people often report improved mood but you know what one of the side effects of shock therapy is amnesia often people report temporary memory loss of the time of treatment and even of the weeks and months leading up to it you can imagine if you can’t remember your problems you’ll probably feel better now people in the world might consider a suppressed mind an acceptable trade-off for the results of psychotropic drugs hey i feel better now i can get on with life hey my kids are acting better now i don’t need to concern myself with them anymore but why should such a solution be considered unacceptable for christians let me offer an answer christians fundamentally love people therefore we’re not interested in merely making people feel better or even causing them to act better we’re not merely interested in that we care about people’s souls we want to get to the heart of their problems and not merely treat symptoms and according to the bible what’s at the heart of these problems whether a person’s manifesting anger hopelessness anxiety careless hyperactivity or reckless self-confidence it’s a soul caught up in wrong thinking beliefs and desires a soul that is destroying itself in this life and apart from reconciliation with christ by repentance it will be eternally destroyed and punished by god in the world to come it’s like we said before actually maybe i didn’t say this before but i’ll say it now the world through psychology and psychiatry does offer help to people and their problems but it’s limited the help is only surface help and it cannot by its very nature minister to people’s deepest and most important needs the needs of the inner man the needs of the spirit now there are other problems with psychotropic drugs this approach like how in some cases the drugs are ineffective and actually make the problems worse not better or the drugs have many side effects many of them are not fully understood and also the drugs must be taken long term even for the rest of your life one of the sad things about add adhd it’s likely you’ll never graduate many adults who started on the drug they must continue with it or take something similar but the greatest problem with psychotropic drugs is that they bury the true spiritual cause of problems of course then as christians we should not settle for psychotropic drugs as a true solution wow our time is going fast so i’m going to have to kind of speed through this next part next couple parts and some to repeat what we concluded at the end of the last lesson about the mind body connection christians do want to acknowledge allow and seek biological solutions when the issue can be demonstrated to be biological christians should acknowledge that biological factors can impact though not determine the disposition of the inner man but since there is no proof that so-called medical disorders are biological in origin rather that the bible describes their symptoms like anger and depression being sins and spiritual issues christians aren’t therefore to reject the chemical imbalance theory the accompanying system of necessary drug treatments and instead minister the deeper sanctifying and so liberating word of god to people especially in the church now i don’t think i’ll have any time for questions today but i will mention at least a few of the frequently asked questions sorry if you didn’t get all the notes maybe we can come back to that afterwards in the past people treated certain physical problems as spiritual problems because no one was fully aware of the physical situation might christians be doing the same today by avoiding the use of psychotropic drugs well we as christians ought to be totally fine with physical treatment when a physical cause can be demonstrated but we should take great pause when someone asserts a possible physical cause for something the bible identifies as something spiritually caused and this is the situation with psychotropic drugs besides if we went by this reasoning and said well possibly in the future they might discover some physical cause based on that reasoning we can never counsel with the bible again you say oh you never know and christ in the bible are sufficient in the meantime it’s like with hypothyroidism somebody can’t get a treatment for that the lord is still sufficient even though it will be a little bit more difficult reaching for an unproven solution to an unproven cause that is just foolish that’s poor stewardship especially when these so-called solutions bring their own problems another question some behavior just seems so extreme can the bible really explain these issues as being of the spirit i admit that’s what some people do and say can be pretty bizarre and alarming and again if you demonstrate a physical problem in the brain i’m all for treating it but we need to realize just how powerfully the inner man can exert an influence on one speak on one’s body and life and remember that so-called extreme behavior is just an unrestrained version of what we all experience first corinthians 10 13 right says that there’s nothing that we encounter that is not common to man you say but look at these look at these mass murderers look at these people who commit suicide there’s something wrong with them they have a mental disorder it’s just another version of what we all have just taken to an extreme remember jesus says what’s the same as murder anger in the heart angry words if allowed to fester and become more unrestrained it is it will manifest it can manifest in the insanity of murder same thing with sadness we all experience sadness discouragement but when not dealt with biblically when allowed to become more and more unrestrained it can lead to debilitating depression and even suicide where you think about people who are delusional so like they’re just they’re believing in an alternate reality there must be something wrong with them physically well again that’s a version of what we all experience we can believe things that are not true because we want to or because we fear something you ever seen somebody who had a crush on someone else who clearly didn’t like that person back it’s like oh you know i can’t wait you know we’re gonna date we’re gonna get married it’s a delusion but maybe not as serious as some that are termed mental disorders but it’s just a more extreme version of that same common to man problem not dealt with biblically allowed to become more and more unrestrained person begins to listen to his own wishful thinking or fearful thinking rather than what the word of god says and what good counsel says by the way if you are interested in a very encouraging resource of how the bible is able to minister even to these so-called extreme cases there’s a book called counseling the hard cases it’s a collection of writings i think we might have a copy maybe not it deals with some really really crazy situations what we would think of as crazy situations then you see how the bible was sufficient to address it not so much a manual of how to deal with these extreme cases as a testimony of how the bible is sufficient for soul problems i’m going to squeak by here and do these last two even if not necessary is the use of psychotropic drugs ever beneficial or permissible well some do take the approach that the drugs can help temporarily to calm the seas so that biblical counseling can actually take place we need to restrain this person a little bit so i can actually talk to him i understand that approach but i don’t agree with it it’s not so easy to go on and off drugs side effects it can be pretty severe and they do have some unknowns and besides if drugs really function to suppress the mind which is the way they appear to function that’s the exact opposite of what you need to counsel someone you need to talk to their mind it’s harder for them to listen to you when they’re on the drugs now what if you say okay i’m gonna counsel this person they’re not on the drugs but they’re still acting in bizarre and dangerous ways what do you do well my biblical counseling teacher dr street and robert smith as you’ll read in the homework they both say the same thing which is be real with your counseling say look i don’t think the drugs are necessary for you i do believe that based on everything you share to me the problem really is spiritual but if you’re not willing to listen if you’re going to continue to act in these alarming ways and what you’re telling me is i prefer the secular treatment i prefer the drugs and if that’s on what you insist then that’s what we’ll do that’s what you can do i don’t think you need that i don’t think it’s ultimately going to help you but if you’re not willing to listen then what you’re saying is i prefer the secular treatment it’s sad but sometimes it’s just what you have to let people do now let me say this also it is still possible to counsel someone on psychotropic drugs it may take a little longer but don’t feel like oh no there’s no way i can talk to him now no you can’t you still can you still can ideally someone that you are counseling who is taking the drugs or realize after a while that they don’t need them when they see that christ is supreme sufficient and satisfying instead and then finally as a biblical counselor should you ever pressure a counselling to go on or off psychotropic meds no that is not your role you can inform about the true nature of the drugs and what you believe is the council’s true spiritual problem and you can definitely advise for someone not to do something suddenly because they’ll have the withdrawal symptoms be ready to help a person if he makes the decision to stop using psychotropic drugs but it is much better if they make a decision about the drugs on their owns you avoid dangerous situations both physically and legally if you let them come to the conclusion and that tends to make the person more committed to his choice it is not helpful when somebody keeps going back and forth between taking the drugs and not taking the drugs and taking the drugs and not taking the drugs but sometimes they’ll do that when someone else is pressuring them to do it they’re not convinced but they’ll go along with it for a little while until they have a bad experience if they decide this on their own they’re more likely to stick to their conviction so it’s better to let them do it of course always if they’re if they’re considering if they want to go off of psychotropic drugs they need to do it with the help of a doctor it is not something to do all of a sudden or just on your own okay i know that may have generated a bunch of questions i’m available to talk afterwards there’s much more we could say on this weighty topic that’s why i’ve given you the homework so please read those articles we’ve dealt with one of the common approaches of dealing with soul problems when it comes to psychotropic drugs next time we’ll talk about another common approach the other side of it psychological counseling let’s pray lord thank you for your word i pray lord that your people will compare what they’ve heard today to what your word says lord bless your people as they trust in your sufficient word and help those lord that we know who are really struggling in their souls they have become more and more unrestrained in their thinking and it’s really hurt their lives lord i pray that you be merciful to them and help us lord to minister well your word and your spirit to such people in jesus name amen thank you everyone