We may be able to control debilitating anxiety with meds, but what happens when they become unavailable? Where will we turn then? Americans are at the mercy of modern supply chains to an extent that most of us don't appreciate. My limited understanding of psych meds is that one typically cannot be simply cut off. One should be weaned off gradually, else a psychotic break may result. We may think our supply of meds is secure. We assume commercial and government forces are protecting those manufacturing capacities and ingredient supply-chains. But history shows these assurances are illusory.
<Edited to add one paragraph and the conclusion notes>
This is something I have thought about often. Over the course of a year and under doctor's supervision, I weaned off my bipolar and anxiety medication because I did not want to be beholden to them, and to see if years of therapy and deeper commitment to the life of faith would provide the support I needed to do without the drugs.
The year that followed was the worst of my life, and not because of the lack of drugs. My first child was born with a lung infection and spent her first six weeks in NICU. I persevered with the no-drugs approach, but began to spiral into self-destructive behaviours that increasingly damaged my relationship with my wife. Now, God delivered me from that path--which was headed towards abandoning my family or suicide--as He usually does: through relationships with my wife, family, and parish.
But the key stipulation was that I had to go back on the meds. It took about two months, and then after nearly a year of extreme depression that impaired my ability to do my job, I got back to a normal state. Nothing to that point: not church attendance, not counselling, not prayer, nothing helped. I have never felt so entirely cut off from God, not even in my atheist days!
I know someone who becomes suicidal within two days of missing her depression and anxiety medication. So, what happens if we lose the supply chains? You get a lot more suicide. This has been the dark and hidden side of history--and in the past the social safety nets were much tighter than they are today. But for those few widows or wounded forced to become beggars, I wonder how many of them survived very long. If they did not die of starvation or sickness, I wouldn't be surprised if not a few didn't take their lives. And if they didn't kill themselves in an instant, they might well have done it slowly over the period of a year. Anxiety might not make one suicidal. It could simply make it impossible to eat or do the basics, thus destroying the body more slowly and amounting to death anyway. Again, this is nothing like the "where am I getting rent from" or "can I afford to feed my family this week" anxiety. This is a completely and utterly debilitating disorder, not simply a bit of depression because "things ain't going too well, doc."
Now, I am not condoning suicide in any way, but I think the Church (East and West) has historically done a poor job of understanding these people. They get no Christian burial because their act is seen as the ultimate sin. That's fine and well if you think that your mind and emotions are actually under your control, but any monkey with a brain can see that that is just not true most of the time.
Justin's perspective presented in this series of articles has been fairly mainstream in the history of the Faith, whether Orthodox, Catholic, or Protestant (the worst manifestations of which deny the existence of mental illness altogether). I don't see why Christians can praise God for all sorts of modern medical miracles and yet turn around and say we shouldn't be trusting drugs for our mental health. True, they have side effects and don't work for everyone--but so does blood-pressure medication; so does chemotherapy, but I don't see anyone except the religious radicals saying the cancer patient shouldn't turn to the medical field for help, or the person with high blood pressure shouldn't take her medication.
Does my trusting the doctor and the drugs he prescribes preclude my trusting in God? Obviously not, and it is stupid to even suggest such a thing. Christ says God will clothe us as He does the lilies of the field, but those clothes aren't just going to drop out of the sky. We have to do the work.
Humans are embodied beings. Our emotions are as much a process of our physical bodies as blood pressure and cancer are. If were are going to be consistent here, then we should be telling--and rightly so--the Christian not to trust in his blood-pressure prescription but to trust in God to heal him. BUT, maybe that healing from God will happen through the medication provided by those minds He has given to Man to figure out these things.
And to anticipate Justin here (I'm guessing based on prior interaction), I am aware that many (most?) drugs manage symptoms and don't provide cures. We can get all conspiratorial and say that is how the drug companies want it, but I think that the evidence of cancer research suggests that that isn't always the case (even if it is sometimes). Some diseases (dis-ease) have to be managed, some can be cured. Again, why are Christians so comfortable with people taking daily drugs for asthma (with all the myriad of potential side-effects there and all the various drug options, some of which work for some people and not for all--the science of medicine has never had any success in producing a 100% effective drug for all people), but they are not comfortable with Christians taking medications for a mental illness?
In my not-so-narrow experience, this is because there is a nonsense bias that undergirds the way all modern Americans think: a kind of gnostic dualism. The mind and emotions, because they seem non-physical and spiritual, are treated differently from the body. And yet it is clear throughout Scripture that the maintenance of the physical body is itself a spiritual act. And we know pretty conclusively from modern science that the mind and the emotions are utterly and inextricably tied to the body. They do not reside in some ephemeral other place. People with brain tumours sometimes demonstrate profound personality and temperament alterations. Brain damage can likewise completely alter someone's personality and sense of identity irreparably.
Justin said, in this article, that there is nothing more non-biblical than saying that trusting in God seems impossible. He'll get no argument there. It is the most non-biblical thing in the world. But saying so doesn't change someone's experience of reality, and our individual experience of reality is the only experience we have access to. This is why "Just trust in Jesus" is the most patronising thing you can say to anyone--whether it be depression and anxiety, or cancer, or heart disease, and so on.
We all KNOW we need to trust in Jesus. Don't tell me that. Show me how to get there. Be my guide. Bring my whole body along. And if the drugs run out or supply chains fail, be there for the person who has been relying on the drugs. Because if we have this attitude of "don't trust in the supply chain, trust in God," then we need to be prepared to be the instrument by which God rewards that trust in Him. Very, very few are the blessed ones to whom God sends an angel to minister or touches directly without other human intervention. We can't all be Tobits or Lazarus. WE are the instruments of God. If we are going to tell people that they shouldn't rely on drugs, then we'd also better be able to tell them--with all sincerity and intent to follow through, and none of this pharisaical hypocrisy--that they CAN rely on us, because if we are willing to say seriously that someone should not rely on drugs, then we are speaking on God's behalf, and that should shut us all up quicker than a whip crack!
Be thankful if you don't suffer from this, just as you can be thankful you don't have cancer or heart disease or asthma. It is real.
*Sorry for the dissertation*
*And mea maxima culpa for any offence given by my tone. I've heard this all before, and mental health is always treated as somehow different from other illnesses. This needs to stop.*
Thank you for your "dissertation" and for sharing your personal experience. You bring many good and thought provoking points. I have a dear friend in my parish who had a psychotic break about 10 years ago and tried to kill herself. She had been on meds ever since. She feels extremely dead inside and completely without any connection to God. No matter what she does by way of following the commandments: prayer, spiritual reading, almsgiving, good works, attending church services, participating in the sacraments... this feeling of alienation from God never changes. I strongly suspect the medications she is on are responsible for making her feel this way, but without the medications, she would likely kill herself. So even if the medications have this terrible negative side effect, this side effect is the lesser of evils if the meds prevent suicide. It is all so very complicated. And I agree with you that suicide is not always a choice made by a sane individual, and it is unfortunate that the church doesn't recognize this. We had a parishioner whose baptized son suffered from Schizophrenia and he killed himself by self-immolation while he was obviously delusional, and yet we could not have an Orthodox funeral for the boy. Sorry, but that just seems wrong. Anyways, I appreciate your thoughts on this topic.
You’re bringing up a few very important points. Thank you.
Throughout my anxiety series so far, I have followed the way Jesus contrasts trust in God the Father versus Mammon—a true binary choice of trust. What you’re describing in the manufacturing and supply chain of psych meds is a very complex version of Mammon, the modern way in which we trust in material, political, and financial supports.
I think you’re right. What happens when the meds dry up? This could just mean insurance stopped paying and you can’t get a refill. Or could mean one country invaded another and there goes our supply chain. If we’ve never learned to trust God on or especially off meds, we’re up a creek.
Psychiatric medication is a complex topic. I plan some kind of article or podcast addressing this question at least once, but probably in some kind of miniseries. I will take the approach of a journalist because I’m not a doctor nor an expert (and I don’t even play one on TV). But many journalists before me have done the same exact thing. Robert Whitaker’s Mad in America and Anatomy of an Epidemic are admirable starting points of study.
One of the things that people report about being on meds is that the medication blunts their negative emotions, like anxiety, but it also blunts positive emotions. I worked at a clinic once where the director told me she took medication to handle her anxiety, but it also resulted in her not caring if she saw her kids. She didn’t feel anything positive when she was with them. And she told me this with as much nonchalance as the ingredients in her latte. It was an extremely dystopian moment. Psych meds can have very strange effects.
You’re right that abruptly ending medication could be result in harm. Psychiatric medications are powerful drugs and have often unpredictable effects. If someone wants to be off their medication, they should be weaned off (titrated) under the supervision of a qualified physician.
We may be able to control debilitating anxiety with meds, but what happens when they become unavailable? Where will we turn then? Americans are at the mercy of modern supply chains to an extent that most of us don't appreciate. My limited understanding of psych meds is that one typically cannot be simply cut off. One should be weaned off gradually, else a psychotic break may result. We may think our supply of meds is secure. We assume commercial and government forces are protecting those manufacturing capacities and ingredient supply-chains. But history shows these assurances are illusory.
<Edited to add one paragraph and the conclusion notes>
This is something I have thought about often. Over the course of a year and under doctor's supervision, I weaned off my bipolar and anxiety medication because I did not want to be beholden to them, and to see if years of therapy and deeper commitment to the life of faith would provide the support I needed to do without the drugs.
The year that followed was the worst of my life, and not because of the lack of drugs. My first child was born with a lung infection and spent her first six weeks in NICU. I persevered with the no-drugs approach, but began to spiral into self-destructive behaviours that increasingly damaged my relationship with my wife. Now, God delivered me from that path--which was headed towards abandoning my family or suicide--as He usually does: through relationships with my wife, family, and parish.
But the key stipulation was that I had to go back on the meds. It took about two months, and then after nearly a year of extreme depression that impaired my ability to do my job, I got back to a normal state. Nothing to that point: not church attendance, not counselling, not prayer, nothing helped. I have never felt so entirely cut off from God, not even in my atheist days!
I know someone who becomes suicidal within two days of missing her depression and anxiety medication. So, what happens if we lose the supply chains? You get a lot more suicide. This has been the dark and hidden side of history--and in the past the social safety nets were much tighter than they are today. But for those few widows or wounded forced to become beggars, I wonder how many of them survived very long. If they did not die of starvation or sickness, I wouldn't be surprised if not a few didn't take their lives. And if they didn't kill themselves in an instant, they might well have done it slowly over the period of a year. Anxiety might not make one suicidal. It could simply make it impossible to eat or do the basics, thus destroying the body more slowly and amounting to death anyway. Again, this is nothing like the "where am I getting rent from" or "can I afford to feed my family this week" anxiety. This is a completely and utterly debilitating disorder, not simply a bit of depression because "things ain't going too well, doc."
Now, I am not condoning suicide in any way, but I think the Church (East and West) has historically done a poor job of understanding these people. They get no Christian burial because their act is seen as the ultimate sin. That's fine and well if you think that your mind and emotions are actually under your control, but any monkey with a brain can see that that is just not true most of the time.
Justin's perspective presented in this series of articles has been fairly mainstream in the history of the Faith, whether Orthodox, Catholic, or Protestant (the worst manifestations of which deny the existence of mental illness altogether). I don't see why Christians can praise God for all sorts of modern medical miracles and yet turn around and say we shouldn't be trusting drugs for our mental health. True, they have side effects and don't work for everyone--but so does blood-pressure medication; so does chemotherapy, but I don't see anyone except the religious radicals saying the cancer patient shouldn't turn to the medical field for help, or the person with high blood pressure shouldn't take her medication.
Does my trusting the doctor and the drugs he prescribes preclude my trusting in God? Obviously not, and it is stupid to even suggest such a thing. Christ says God will clothe us as He does the lilies of the field, but those clothes aren't just going to drop out of the sky. We have to do the work.
Humans are embodied beings. Our emotions are as much a process of our physical bodies as blood pressure and cancer are. If were are going to be consistent here, then we should be telling--and rightly so--the Christian not to trust in his blood-pressure prescription but to trust in God to heal him. BUT, maybe that healing from God will happen through the medication provided by those minds He has given to Man to figure out these things.
And to anticipate Justin here (I'm guessing based on prior interaction), I am aware that many (most?) drugs manage symptoms and don't provide cures. We can get all conspiratorial and say that is how the drug companies want it, but I think that the evidence of cancer research suggests that that isn't always the case (even if it is sometimes). Some diseases (dis-ease) have to be managed, some can be cured. Again, why are Christians so comfortable with people taking daily drugs for asthma (with all the myriad of potential side-effects there and all the various drug options, some of which work for some people and not for all--the science of medicine has never had any success in producing a 100% effective drug for all people), but they are not comfortable with Christians taking medications for a mental illness?
In my not-so-narrow experience, this is because there is a nonsense bias that undergirds the way all modern Americans think: a kind of gnostic dualism. The mind and emotions, because they seem non-physical and spiritual, are treated differently from the body. And yet it is clear throughout Scripture that the maintenance of the physical body is itself a spiritual act. And we know pretty conclusively from modern science that the mind and the emotions are utterly and inextricably tied to the body. They do not reside in some ephemeral other place. People with brain tumours sometimes demonstrate profound personality and temperament alterations. Brain damage can likewise completely alter someone's personality and sense of identity irreparably.
Justin said, in this article, that there is nothing more non-biblical than saying that trusting in God seems impossible. He'll get no argument there. It is the most non-biblical thing in the world. But saying so doesn't change someone's experience of reality, and our individual experience of reality is the only experience we have access to. This is why "Just trust in Jesus" is the most patronising thing you can say to anyone--whether it be depression and anxiety, or cancer, or heart disease, and so on.
We all KNOW we need to trust in Jesus. Don't tell me that. Show me how to get there. Be my guide. Bring my whole body along. And if the drugs run out or supply chains fail, be there for the person who has been relying on the drugs. Because if we have this attitude of "don't trust in the supply chain, trust in God," then we need to be prepared to be the instrument by which God rewards that trust in Him. Very, very few are the blessed ones to whom God sends an angel to minister or touches directly without other human intervention. We can't all be Tobits or Lazarus. WE are the instruments of God. If we are going to tell people that they shouldn't rely on drugs, then we'd also better be able to tell them--with all sincerity and intent to follow through, and none of this pharisaical hypocrisy--that they CAN rely on us, because if we are willing to say seriously that someone should not rely on drugs, then we are speaking on God's behalf, and that should shut us all up quicker than a whip crack!
Be thankful if you don't suffer from this, just as you can be thankful you don't have cancer or heart disease or asthma. It is real.
*Sorry for the dissertation*
*And mea maxima culpa for any offence given by my tone. I've heard this all before, and mental health is always treated as somehow different from other illnesses. This needs to stop.*
Thank you for your "dissertation" and for sharing your personal experience. You bring many good and thought provoking points. I have a dear friend in my parish who had a psychotic break about 10 years ago and tried to kill herself. She had been on meds ever since. She feels extremely dead inside and completely without any connection to God. No matter what she does by way of following the commandments: prayer, spiritual reading, almsgiving, good works, attending church services, participating in the sacraments... this feeling of alienation from God never changes. I strongly suspect the medications she is on are responsible for making her feel this way, but without the medications, she would likely kill herself. So even if the medications have this terrible negative side effect, this side effect is the lesser of evils if the meds prevent suicide. It is all so very complicated. And I agree with you that suicide is not always a choice made by a sane individual, and it is unfortunate that the church doesn't recognize this. We had a parishioner whose baptized son suffered from Schizophrenia and he killed himself by self-immolation while he was obviously delusional, and yet we could not have an Orthodox funeral for the boy. Sorry, but that just seems wrong. Anyways, I appreciate your thoughts on this topic.
Tom,
You’re bringing up a few very important points. Thank you.
Throughout my anxiety series so far, I have followed the way Jesus contrasts trust in God the Father versus Mammon—a true binary choice of trust. What you’re describing in the manufacturing and supply chain of psych meds is a very complex version of Mammon, the modern way in which we trust in material, political, and financial supports.
I think you’re right. What happens when the meds dry up? This could just mean insurance stopped paying and you can’t get a refill. Or could mean one country invaded another and there goes our supply chain. If we’ve never learned to trust God on or especially off meds, we’re up a creek.
Psychiatric medication is a complex topic. I plan some kind of article or podcast addressing this question at least once, but probably in some kind of miniseries. I will take the approach of a journalist because I’m not a doctor nor an expert (and I don’t even play one on TV). But many journalists before me have done the same exact thing. Robert Whitaker’s Mad in America and Anatomy of an Epidemic are admirable starting points of study.
One of the things that people report about being on meds is that the medication blunts their negative emotions, like anxiety, but it also blunts positive emotions. I worked at a clinic once where the director told me she took medication to handle her anxiety, but it also resulted in her not caring if she saw her kids. She didn’t feel anything positive when she was with them. And she told me this with as much nonchalance as the ingredients in her latte. It was an extremely dystopian moment. Psych meds can have very strange effects.
You’re right that abruptly ending medication could be result in harm. Psychiatric medications are powerful drugs and have often unpredictable effects. If someone wants to be off their medication, they should be weaned off (titrated) under the supervision of a qualified physician.