Are the Puritans Behind the War on Antidepressants?

Fascinating article today over on the Beliefnet Blog by Ronald Pies, M.D., professor of psychiatry, busting the myths surrounding antidepressants, then looking for the cause of these misconceptions and couching the answer within the Puritan mindset.

Do take the time to read it all – it’s only a short piece – but here is the conclusion:

So why is there so much hostility directed at these medications? (The same question could be raised with respect to psychiatry and psychiatrists, but that’s another story). I believe that a good deal of the animus arises from our Puritan heritage, and its attitude toward suffering, sin, and expiation. For the Puritans of New England, disease was essentially a divine punishment for Man’s original disobedience to God. As historian An Vandenberghe has put it, for the Puritans, ‘Even though there were more than two thousand different diseases…the primary cause of all of them was the “Sin of our First Parents.”’ There was also a strong link between disease and personal sin: the person whose tooth ached probably did something nasty with his teeth!

Now, when psychiatrists see patients with severe major depression, these unfortunate souls often express the view that their illness is a “punishment” of some sort. Some believe that God is punishing them for their sins. But this attitude, in a less extreme form, pervades our society’s views about depression—that it is, in some sense, the “fault” of the depressed individual. Some clinicians who argue that depression has an “adaptive” value often begin with the premise that depression represents the person’s “failure to resolve their social dilemmas”—a clinical euphemism for blaming the sufferer. The logical extension of this line of reasoning is that the depressed individual must somehow “repent of his ways”—for example, by ruminating on his problem until it is solved, or by “pulling himself up by his bootstraps.”

In this view of depression, taking a “drug”—the term “medication” is almost never used by those opposed to antidepressants—represents a weak-willed dodge. Antidepressants are seen as merely “covering up the real problem” or as “a crutch.” This attitude is extraordinarily unhelpful for those struggling with a potentially lethal illness. Although I prefer to begin with psychotherapy in most mild-to-moderate cases of depression, the more severe bouts usually require medication. Often, the combination of medication and therapy works better than either one alone. And I use a non-Puritanical metaphor in framing the issue for my patients. I say, “Medication isn’t a crutch, it’s a bridge between feeling awful and feeling better. You still have to move your legs to get across the bridge, and that’s the work of therapy.”

Let me know you thoughts.

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7 Responses to “Are the Puritans Behind the War on Antidepressants?”

  1. Adam Brown Says:

    As some one who has suffered from depression previously, and found the views of the church to be less then helpful, I totally agree with this article. I have found that the typical approach of the church, focuses on your feelings and exploring their roots, in some cases with a judgmental tone, this can be ultimately very harmful, as when you are in a place of depression you really don’t need someone judging you, and insinuating that your current situation is because of a lack of faith. Simply put Depression is a chemical imbalance, not a spiritual battle. Of course prayer and intercession is helpful, but the physical symptoms have to be addressed. Ingoing that is a very bad idea.

  2. Webmaster Says:

    Sadly Adam, your experiences are not uncommon.

  3. T.C. Says:

    I suffer from depression, but would not accept it myself and thought I just needed to get myself together and get on with things. It was the very loving people in my Baptist Church who eventually made me see that I was not ok, was not coping and was dangerously ill.
    I was dead against the need for pills having been brought up in a very judgemental Bretheren Church, but thankfully for me, my current Church got me the medical and psychological help I needed. At no point was I made to feel a failure – by anyone except myself.
    Now I am getting better and as a true follower of Christ I wouldn’t hesitate to recommend anyone who is suffering with depression to see a counsellor or a Dr about having anti-depressants – they saved my life.

  4. Dymphna Says:

    I have long been horrified by those who are blatantly against medication for depression. As the child of an under-medicated depressed mother, and, at one point, as one myself, I can attest to the harm this does in people’s lives.

    The idea that depressed people are at fault for their depression is the very thing Christ spoke out against when he answered the disciples’ question about the blind man and his parents.

    Thanks for linking to this article.

  5. David Says:

    I’m not intending to be the wet blanket here, but:

    I agree with the article that Christian stoicism doesn’t cure clinical depression; unfortunately, psychiatrists frequently don’t either. I know of a frightening number of cases where the cure has been a series of psychiatric experiments consisting of one drug after another followed by electroshock therapy, the final condition of the patient being one of sustained befuddlement.

    I think part of the problem is that psychiatry attempts to treat the psyche while ignoring one of its major components – the spiritual – and this often simply doesn’t work.

    I remember a number of years ago attending a party populated mainly by academic psychologists. Perhaps the experience jaundiced my view of psychology: I have never before or since found myself in such a densely populated area of eccentric misfits who had little to no idea of what makes people tick.

    I should add that my wife took her degree in psychology (in spite of this, she is pretty normal) and largely agrees with my – admittedly inexpert – view of the discipline.

  6. webmaster Says:

    I think part of the problem is that psychiatry attempts to treat the psyche while ignoring one of its major components – the spiritual – and this often simply doesn’t work.

    I couldn’t agree more with that sentiment David, and I often argue the same here.

  7. Adam Brown Says:

    That is very interesting David. During my treatment a few years ago, the therapist I was seeing at the time, ignored my newly found faith, as not important too my condition at the time. At the same time the church that I was attending, sort to treat my depression as a case of ‘lack of faith’, this of course left me in a limbo land. I wonder how common this is.

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