Christians have flocked to psychiatrists and psychologists to seek help for their sadness without giving the first thought to what the Word says about living faithfully and with hope in the midst of a fallen world. Too often this has resulted in medicating when the best approach would have been to address the heart with the Word. To exclude the Word in treating depression, either by itself or in concert with medical attention, is terribly foolish because the Bible has a lot to say to those who are downcast, regardless of the origin. It offers real hope to those who despair of even their lives. It offers Jesus who is our greatest good.

This is a question I am asked often and one to which I’ve given a lot of thought. After several years of learning about depression and counseling women with depression, I have come to what I consider to be the best answer: it depends.  I know this may sound like a cop-out answer but it depends is often the wisest answer to questions dealing with faithful Christian living. Sometimes “right and wrong” is not a matter of doing this or not doing that but a matter of motive or purpose, a matter of the why rather than the what. Additionally, in this case, the topic itself is very complex and there is rarely an easy answer. All the more reason to approach this question with great care and humility.

I believe antidepressants are not evil.  These legal medicines, though not a panacea, have been shown to help some people struggling with chronic depression. I felt I needed to state this right from the get go because, regrettably, there has been in conservative Christian circles a narrow-mindedness regarding the use of antidepressants. The implication has been “if you have Jesus and the Bible you have everything you need to treat your depression.”  This thinking assumes depression is always entirely a spiritual condition, that there is no physiological component which can be addressed by a medicine. However, I think it is safe to say that when Adam and Eve fell all aspects of humanity fell, including physiological brain functions that influence our emotions. The fact that empirical diagnosis of depression is difficult should not preclude the possibility of a physiological pathology. I think it is best to acknowledge that some matters are simply beyond our ability to understand completely, and depression seems to fall into this category often times. In my opinion, to look into the eyes of a chronically depressed person and assume their suffering is entirely spiritual, without considering the possibility of some physiological component, is to fail to love them well. The truth is that so many physical issues can contribute to depression-like symptoms that it is usually prudent to recommend a thorough physical to a person dealing with chronic depression.

With the above in mind, why not just answer the question with, “Of course, it’s right for Christians to use antidepressants.”  Just like it is unwise to assume there is no physiological issue contributing to a person’s depression, it is unwise to assume there is no spiritual issue. The reality is there is always a spiritual component. In the CCEF counseling classes I have been taking for the last couple of years, I have heard a lot about human beings being “embodied souls.” This means we cannot separate the body (the outer man ) from the soul (the inner man). Everything that happens to us impacts the whole of us. To dichotomize body and soul is a sure recipe for hollow ministry, ministry that so misses the mark that it falls way short of being helpful. An immediate “sure, it’s okay” without probing deeper is also failing to love a person well.

Any adversity (or blessing) that comes into our lives requires that we respond to it with our inner being, our souls. We are always interpreting life, trying to make sense of it, and this is always a spiritual activity, whether or not we acknowledge this to be the case. What we believe about God will impact how we respond to the difficulties and blessings of life. For example, imagine you are a mom with small children and you are badly injured in an accident requiring a long term recovery. Clearly the injury is an “outer man” or body issue. But it is also very much an “inner man” or spiritual issue. How will you respond to this adversity? Will you be consumed with worry and anxiety? Will you become angry, frustrated, cynical or embittered? Will you doubt God’s love for you? Or, will you recognize God’s sovereign rule and care in your life and battle against these emotions? Will you find comfort in God’s promises to you and your family? Will you seek to bring glory to Him in spite of the circumstances?

Similarly, a depressed person cannot help but deal with spiritual, soul engaging issues, and often times does so to a greater degree because of how easily depression turns a person inward. These spiritual issues may arise from the depression itself or may be the most significant contributor to it.

So, it depends comes to the rescue. In some situations, barring any particularly obvious or alarming symptoms, it would be most prudent to address a person’s inner man with the Scriptures right from the get go to see if, with the Lord’s blessing, the depression is improved or resolved without the use of antidepressants. In some cases, the physical symptoms are so acute that it would be best to address the outer man (body) issues first, always intending to address the soul when the acute symptoms are less of an impediment. Yet, in others cases, addressing issues concurrently is best. Needless to say, answering the subject question involves significant knowledge of the person and situation and no blanket “yes or no” will do.

Also, I think it is important to discern why a person is seeking to know about the “morality” of antidepressants, and this may not be as obvious as one may think. A person may acknowledge, for instance, that bitterness over a broken relationship is eating her up and is likely at the root of her depression but, rather than dealing with this head on, she wants permission to take the “easy route” to alleviate symptoms (which ultimately will not work.) Or, sometimes, a person may not see the connection between his spiritual life and his depression- he does not realize the Bible can speak into this aspect of his life. Or, sometimes, a person is asking this question because as a “good Christian” she’s ashamed to be considering taking an antidepressant, despite years of enduring bouts of deep depression. Each person comes with a different history, symptoms, circumstances, and motives. Needless to say, what may be right for one may be completely wrong for the other.

I think one of the reasons antidepressants have gotten such bad rap in the church is because they have been abused. We live in a society which promotes personal happiness as the greatest good and this drives people to seek any and all solutions for even minimal sadness. Just like unbelievers, Christians have flocked to psychiatrists and psychologists to seek help for their sadness without giving the first thought to what the Word says about living faithfully and with hope in the midst of a fallen world. Too often this has resulted in medicating when the best approach would have been to address the heart with the Word. To exclude the Word in treating depression, either by itself or in concert with medical attention, is terribly foolish because the Bible has a lot to say to those who are downcast, regardless of the origin. It offers real hope to those who despair of even their lives. It offers Jesus who is our greatest good. To those who are in Christ, it offers the promise of an eternity with no more tears.

So, though I do not in any way support a categorical “it is wrong for a believer to use antidepressants”, I do not support the opposite either. It depends remains my final answer.

CB Campano is a member of Covenant Presbyterian Church in Lakeland, Fla., where she serves in its counseling ministry. This article first appeared on her blog and is used with permission.