The priest looked unsure. Usually he could speak to a listless congregation about spiritual tolerance or encourage them with psalms, but now he was silent. He is compassionate but has no hopeful relationship with the redemptive work of Christ or the help of a present Savior. Why? This pastor was concerned that the spiritual support he was providing might be wrong or unhelpful because his congregation had recently been diagnosed with depression.
Most people believe that depression is caused by a chemical imbalance, but this assumption has been challenged by a new medical study titled “The Serotonin Theory of Depression.” The project, led by Dr. Joanna Moncrieff of the University College of London, as an umbrella review, surveys major psychiatric research on the relationship between depression and serotonin, a neurotransmitter psychiatrists have long called the most likely chemical cause of depression. . After re-examining and gathering a lot of relevant and reliable research, the study concluded that “there is no convincing evidence that depression is caused by serotonin disorders.”
Since that conclusion first appeared in Molecular Psychiatry on July 20, 2022, it made waves and received some criticism. At the very least, the publication of the study provides a new opportunity to assess what we know (and don’t know) about the experience of depression. Below are the four questions that the study asks and how to answer them as a biblical counselor.
1. Does this new research mean that depression is only a spiritual problem?
Discrediting the serotonin hypothesis does not mean that the body and brain are now marginalized players in depression. Years ago, Charles Spurgeon described his depression as a physical occurrence that he could not control. He wrote, “A moist heart will produce many terrible things, which we are ready to regard as spiritual emotions.” Our brains and bodily fall are complicated. Current research studies only show that doctors are inaccurately saying that the drug is treating an underlying serotonin deficit, not that there is no physical cause of depression.
2. Will studying serotonin affect the amount and type of medication prescribed for depression?
As groundbreaking as the new metastudy is, the conclusion is not surprising. Voices in traditional psychiatry have always urged interpretive caution regarding medication and chemical imbalance theories. Real-time direct measurement of neurotransmitter levels in the human brain has been nearly impossible. No one finds a neurotransmitter deficit and then fixes it. However, the earliest class of antidepressants, like many psychoactive drugs, was discovered by accident: drugs created for other purposes have an ameliorative effect on people suffering from depression. And while SSRIs (selective serotonin reuptake inhibitors) such as fluoxetine (Prozac) were proactively developed to address hypothesized serotonin deficits, their exact effects on the human brain remain unclear.
Discrediting the serotonin hypothesis does not mean that the body and brain are now marginalized players in depression.
SSRIs will remain the most common treatment for depression for one simple reason: they can be used regularly. At this time, general practitioners and psychiatrists did not prescribe because of the strength of neurobiological research but because of their clinical experience.
If a depressed person is helped by drugs approved by the Food and Drug Administration through clinical trials (and the help does not outweigh the side effects), that is enough. The chemical mechanisms for such help do not need to be fully understood, and certainly are not. The current study does not mean that patients taking antidepressants for depression should stop the treatment. But warn that the factors that make existing antidepressants effective, are not yet known.
3. If not serotonin, what causes depression?
The brain is a complex network of interdependent networks. We would be naive to think that depression can be reduced to the action of one neurotransmitter system when there are dozens. Research on serotonin hopes to identify one link in a complex chain of events by focusing on one important neurotransmitter. But while low and low serotonin may be an important link, other neurotransmitters may be more promising.
But whatever neurotransmitters may be involved, their involvement does not necessarily indicate causation. However, we can only say that neurotransmitter changes accompany depression. A common analogy is that fires and fire trucks happen together, but fire trucks don’t necessarily cause fires. To demonstrate that problems with neurotransmitters are the cause of depression is not yet within the limits of what brain research can do.
If there is a trend in the current literature on depression, it is the link between traumatic events and subsequent depression. Note, for example, how the recent COVID-19 lockdown, and the upheaval surrounding it, has shown its mental health effects on many people. It’s as if we gather all our energy to overcome the crisis, then, when the crisis subsides, the body collapses and the emotional changes that are important in the physical damage. We can think of the neurotransmitter network as part of the process, although our understanding is quite limited. But what we do know is that global levels of anxiety and depression are rising during the pandemic, and this should mobilize pastors to love those who suffer.
4. What should be done?
The review study does not mean that, with less evidence for chemical imbalance, we can assume that depression is the result of a sinful or stupid choice! Sadness, tiredness or fatigue, altered sleeping and eating patterns, loss of happiness, lack of concentration, and feelings of weakness or lack of energy and momentum are not sins in themselves. To assume that someone who suffers from a deep and persistent sense of darkness must be sinful is to follow the lead of Job’s discredited counselors. Many psalms record the pious experience of being very low. The clear words of Psalm 88 seem so beautiful. There, the psalmist states, “Darkness is your closest friend” (v. 18, NIV).
Although there are cases where depression is caused by sin (for example, found in adultery and anger at the loss of secret idolatry), depression is not definitely a sin.
Depression, however, is always affliction.
When you listen to someone who is depressed, you will hear that they are hurting. Sometimes we know the cause of our suffering – the death of a loved one or a chronic illness – and sometimes we don’t. The genius of the Bible is that we can help those who suffer without knowing all the exact causes of their suffering, because God does. While we are still interested in the cause, we do not have to find to bring comfort to bear. We can rely on the hope of God’s presence in suffering (Ps. 23:4), whether it is the result of a very sick world, a wrong body, a wrong choice, or a combination of all. We can help those who suffer to know that God cares about their suffering and speak words of hope that can be trusted, despite the terrible storm.
The genius of the Bible is that we can help those who suffer without knowing all the exact causes of their suffering, because God does.
Jesus met the people in the dark with a faithful and sufficient provision. And sometimes with significant freedom from darkness as well. As experienced counselors, we can say that more people are taking antidepressants in our churches than we imagine. You may not know everything that is going on in your body or mind, but you do can encourage the suffering that is not trite in holding faith as a quick fix but also refuse to stand on the side as if the only medicine is needed.
Our goal when ministering to someone with depression is to seek to understand the person’s experience, study God’s counsel in the Bible to find words that are appropriate for the occasion, and skillfully give grace to those who listen (Eph. 4:29 ). . Perhaps this news about serotonin will be an invitation for us to redouble our efforts in biblical treatment. So we join forces with other potential helpers (friends, pastors, doctors, counselors). When we do this, we are sure that we have everything we need to live and be righteous in the knowledge of Christ (2 Pet. 1:3).
Source : www.thegospelcoalition.org