Continued from Psychiatrists and Clinical Depression – Part 3
Suicide
Fears abound regarding the terrible thought of depressed people ending their own lives to stop the ongoing agony. What steps can be taken to prevent such tragedies? Research comparing treatment and nontreatment may be a first step, even though some information may be limited.
Conducting a scientific evaluation of suicide is limited by State laws. In California, under the End-of-Life Option Act, the death certificate lists the underlying terminal illness and not that it was a doctor-assisted suicide in cases where an underlying physical illness existed. No actions taken under the End-of-Life Option Act are listed as suicide, doctor-assisted suicide, homicide, or elder abuse. The level of obscurity and thus information available for research is further raised by California and most other states in the fact that an individual’s religion is rarely included in official death certificates or suicide records.
In spite of these limitations, there is one area of concern for which a scientific evaluation can be done comparing those who are depressed and commit suicide and those who are depressed and do not commit suicide. A scientific evaluation can be conducted comparing deaths by suicide among depressed individuals who were treated and those who were not treated with psychotropic medication.
The American Association of Suicidology (AAC) reports “Some Facts About Suicide and Depression” as follows:
“If left untreated, depression can lead to comorbid (occurring at the same time) mental disorders such as alcohol and substance abuse, higher rates of recurrent episodes, and higher rates of suicide … Major depression is the psychiatric diagnosis most commonly associated with suicide. Lifetime risk of suicide among patients with untreated depressive disorder is nearly 20% [1 in 5] (Gotlib & Hammen, 2002) … There is no evidence to date that the prescription of antidepressants for the treatment of depression increases suicidality in children, adolescents, or adults.”[1] (Bold added.)
According to a study by Isacsson et al:
“The calculated risk for suicide among depressed patients who were treated with antidepressants was 141 per 100,000 person years and, among the untreated, 259 per 100,000 person years[2] (i.e., 1.8 times higher among the untreated). This supports the hypothesis that antidepressant medication decreases the risk for suicide in depressed patients.”[3] (Bold added.)
Researchers determine if an individual was taking antidepressants during the time preceding the act of suicide through the examination of bodily fluids and hair samples; through medical and prescription records from subpoenaed medical records; through police reports of the scene of death; through interviews with family, friends, and treating physicians; and through an individual’s personal writing (emails, journals, etc.).
In his book Rethinking Depression, Dr. Daniel Berger II mentions suicide 42 times. We read all his entries and noted that he never once mentions suicide in relation to comparing treatment to non-treatment of depression! Neither does he mention the fact that the suicide rate is higher among those who are untreated.
The research we have presented from the American Association of Suicidology would lead one to conclude that a person with clinical depression should seriously consider treatment. However, because many seemingly unrelated-to-depression diseases start with depression and because depressive symptoms may be due to a bodily disease or malfunction, further medical help may be needed to possibly rule out other factors, including age, body mass index (BMI), comorbid diseases (occurring at the same time), and other bodily and mental disorders, before considering psychotropic medication. In other words, because depression is a systemic illness, the treatment needed may be a medication other than a psychotropic medication.
Conclusion
When depression strikes, the Christian needs to parse out potential systemic involvement, knowing in advance that no medical doctor will have the patient do every test available. Erno Daniel, MD, PhD, an internal medicine doctor who practiced for 30 years at a large medical clinic and regularly saw patients, has written a book titled Stealth Germs in Your Body. In his chapter “What Else Could It Be?” he has a section titled “We Found Nothing” versus “There Is Nothing.” Daniel says:
Clearly there is a difference between “we found nothing (abnormal)” and “there is nothing (abnormal).” In general “we found nothing, so far” means that the screening examinations and tests that were ordered to look for particular conditions yielded negative results at the time they were done. In other words, nothing truly abnormal was found on the examination or on the tests that were chosen to be performed thus far. Clearly, that doesn’t prove conclusively that you are not harboring stealth germs in your body, as there is no foolproof test that can find everything. The absence of a large number of possible conditions does not exclude the presence of some other previously undetected or evolving condition.[4] (Bold added.)
Daniel later explains why exhaustive testing is not done in a section titled “Cost-benefit Considerations in Testing.” He says:
Most likely, you were only tested for conditions that were suspected to be causing your symptoms, and conditions for which there is specific effective treatment available. One of the main reasons why tests for many “nontreatable” conditions are not routinely ordered is because ethical doctors try not to incur unnecessary expenses. Although information obtained from some tests might be interesting, the tests usually won’t be ordered if the results are not expected to yield direct benefit in correcting or managing your condition as demonstrated by evidence-based medical practices.[5]
Also, a decision needs to be made by a believer, after recognizing that there is likely a bodily involvement, whether to solely use depression as a spiritual trial to go through, as many advise, or to reach out for a doctor to evaluate, diagnose, and possibly medicate. This is an individual decision. However, whatever is done, remember that every trial, mental, physical, or spiritual, is an opportunity for spiritual growth.
If you decide to seek a doctor’s help, the following may help. Psychiatrist Dr. E. Fuller Torrey advises: “The best way to find a good doctor for schizophrenia or any other disease is to ask others in the medical profession to whom they would send their own family if they had a similar problem.”[6] In addition, we advise that when you call a possible doctor’s office, first say, “I am thinking of using the doctor for my doctor,” and then ask the following question: “How many patients has the doctor monitored to get off a psychotropic medication if a patient requests it?”
Special Appeal
In the realm of the spirit, Christians are to walk by faith, not by sight. They are to be guided by the Holy Spirit, the God of the Bible, His written Word, and the Word that became flesh, Jesus Christ. Moreover, the spiritual realm is vastly more important than the physical realm, for the person indwelt by the Spirit is enabled to walk in a way pleasing to God and to continue living after the physical body dies. Therefore, when depression strikes or creeps into born-again followers of Christ, the first response would be to turn to the Lord for healing and help.
Those who hold the idea that the cause and cure are both spiritual acknowledge that other parts of the body may be affected by depression, but as responses rather than causes. Thus, they would seek to help fellow believers suffering from depression to think biblically in faith, hope, and love. Those who believe that depression is a systemic illness contend that various environmental, physical, mental, and spiritual factors may be involved in cause, symptom relief, and possible cure, depending on each individual person created in the image of God, but fallen. Our position is that depression is a systemic disorder and that the spiritual dimension is the most important aspect for spiritual growth.
Every trial is an opportunity to know God more fully in the amazing relationship Jesus procured for humankind through His own suffering and death. He experienced the most grueling suffering of every kind, the anguish of Gethsemane and both physical and unfathomable spiritual suffering on the cross as He bore the punishment of the accumulated and multiplied sins of mankind. He knows the symptoms of depression because He knows every human being on this planet. And He has promised to never leave us nor forsake us (Hebrews 13:5).
Our Father in Heaven, our Savior Jesus Christ, and the indwelling Holy Spirit are the source of all healing: First, by creation, how He made creatures with inborn abilities to heal; Second, through miracles, especially during the time of Jesus’s healing ministry; Third, through enabling humans to discover new things about God’s creation which may assist the body to heal; Fourth, through transformation from the present body to a glorified body.
The systemic understanding of depression recognizes the complexity of the human condition and that it includes the spiritual dimension. A systemic understanding of depression frees followers of Christ to seek medical psychiatric help without the fear of abandoning Christ in the process, just as those who are suffering from obvious bodily illness are free to seek medical help without fearing that they are compromising the faith in doing so.
However, we continue to discourage using psychotherapy (psychological counseling), because if talk is to be used, it should be the wisdom of God rather than the wisdom of men. Rather than the modern-day format of counseling, the talk should conform to the following:
All scripture is given by inspiration of God, and is profitable for doctrine, for reproof, for correction, for instruction in righteousness: That the man of God may be perfect, throughly furnished unto all good works. (2 Tim. 3:16-17.)
God’s Word in Christ brings forth new life, and God’s written Word describes how the new life that has been given is to live by grace through faith. God also created our bodies and has allowed humankind to discover ways to help and heal the body in many situations. Therefore, we continue to praise and thank God through our Lord Jesus Christ for all He has provided.
This Ends the 4-Part Article “Psychiatrists and Depression.”
[1] “Some Facts About Suicide and Depression,” The American Association of Suicidology, https://www.cga.ct.gov/asaferconnecticut/tmy/0129/Some%20Facts%20About%20Suicide%20and%20Depression%20-%20Article.pdf..
[2] “A person- year is a unit calculated by multiplying the number of people in the study by the time each person spends in the study. For example, if there were 1,000 people in a study that lasted 2 years, the study would have collected 2,000 person-years of data,” https://examine.com/glossary/person-year/.
[3] Gordon Isacsson, Ulf Bergman, Charles L. Rich, “Epidemiological data suggest antidepressants reduce suicide risk among depressives,” Journal of Affective Disorders, Vol. 41, No. 4, https://pubmed.ncbi.nlm.nih.gov/8938199/.
[4] Erno Daniel. Stealth Germs in Your Body. New York: Union Square Press, 2008, p. 195,
[6] E/ Fuller Torrey. Surviving Schizophrenia, Fifth Edition. New York: Harper, 2006, p. 157.