On counseling and medication

An interesting discussion on counseling and medication over at another blog raised a good point that I’ve often found is a stumbling block to Christians. David Powlison, quoting the Director of the National Institute on Mental Health, said:

Psychiatric medications can sometimes take the edge off symptoms, but they can't give people what they really need. People need meaning and relationships. Psychiatry can't give that. Medication can't give that.

This is something that is apparently difficult to understand for those who have not had immediate contact with the effects of this kind of medication (known as “psychotropic” medication).

I once had a student whose comment revealed that even those who HAVE had contact sometimes misunderstand. She said in an off-hand manner, “I’ve taken anti-depressants. They make you happy!”

The truth is, they don’t. They might help you to be normal (in a chemical sense), but they don’t make you “happy.” My concern deepened as I counseled this student about this, because she had faced mild-to-moderate depression for so long that she had come to assume that her depressed state was “normal”-- thus, having that edge of depression taken off was “happy” feeling to her.

Here’s my best analogy of what psychotropic drugs offer: Suppose you love running, and have your heart dead-set on running a marathon in a year. In preparation for a training regimen, you visit your doctor, who informs you that the slight pain in your knee is actually a problem that needs to be addressed surgically; in short, if you don’t have your knee scoped, you won’t be able to train for the marathon, let alone complete it.

Here’s the analogy: if you have your knee scoped, is that going to make you ready for the marathon? No. You’ll still have a lot of work to do to condition your body (and your mind) for running the marathon. But if you don’t have your knee scoped, you are guaranteed that you won’t be able to run the marathon.

So it is with psychotropic medication: they won’t overcome your depression for you, but they might address the physical/physiological obstacles that would keep you from being able to do the work of overcoming depression. (Likewise with anxiety and other clinical mental health issues.)