All right, so tonight we are returning to issue of mental illness and medications from biblical perspective. We're focusing tonight specifically on depression and bipolar because those are two of the most diagnosed issues. This will probably be our last one. unless people have a request for more, we'll probably return to biblical counseling in some form, kind of like as a general principle, as we go forward on these topical studies. But I think the next few that we're gonna do for the next, I don't know, maybe five months or so, are probably gonna be a little bit historical, early church stuff and historical stuff about the time around Jesus. So we have covered in the past Michael Imlett, Descriptions and Prescriptions, A Biblical Perspective on Psychiatric Diagnoses and Medications. So we looked at diagnoses in general from a biblical perspective. Tonight we're mostly going to be deriving stuff from a book called Good Mood, Bad Mood, Help and Hope for Depression and Bipolar Disorder by Charles Hodges. Both these guys are doctors. So I heartily recommend this. This one is especially good for those that are actually suffering from some form of depression. Not just informing about depression, but people that actually have it. I think there's helpful stuff in here. I want to also recommend Blame It on the Brain by Ed Welch. It's distinguishing chemical imbalances, brain disorders, and disobedience, because that's always an ongoing issue in this realm. And then I got a couple pamphlets about depression, bipolar, anxiety. panic attacks, things like that. And then what do you do when you become depressed? So these are just some general handout type stuff that would be helpful, very quick read type things. So just know that we have these as resources on an ongoing basis. This stuff is available. You can talk to me or maybe we can get, I mean, if we want to, we can get a set and keep it out there. So these are some of the things I've looked at and some of the things that you guys can look at if you want. And tonight it's the good mood, bad mood stuff, and it's mostly on bipolar and depression. So there's a lot in that book, far too much material where we could get into all of it. So we have to brush over a lot of material. I also have MP3s, sometimes it's just lectures of these guys talking about what they wrote in the book, so if you don't have time to read a book, but you have time to listen, you can hear these guys lecture on the material that's in there. So just know, that's there. This subject tends to be a minefield, though. The depression, bipolar stuff, especially depression stuff, it tends to be a minefield. They are the two most common diagnoses made in medicine today. That's mostly due to the changes in the way that depression is categorized and the way that it is diagnosed. And the two are linked because depression is part of the bipolar symptom set, you could say. We'll talk about that more in a little bit. So we're finding what we're seeing is a rapid increase in the rate of depression. And it's not due to an increase in illness. It's based on changes in the criteria on which they're making the diagnoses. So for instance, if you look at the rates of depression of people before 1950, it's like below, born before 1950, it's like below 5%. After 1950, it has just gone up and up and up and up to the point where something like 25% of the American population has been diagnosed or there's up to 25% at any one time. Changes in the way that they're diagnosing it and identifying it is the issue. So they're applying the label depressed to both those that genuinely have this illness or this mental struggle and to those that are simply having emotional struggles, what we would call maybe normal sadness. So for instance, from the years 1987 to 1997, just 10 years, the diagnosis for depression shot up 300%. That's not because the human brains are changing. It's because of the way they're thinking about it. Now what's happening with bipolar is that it has split into two, bipolar I and bipolar II, and they are not the same thing. Bipolar I is what you think of as like the classic manic-depressive. They're replacing that with the category of bipolar I. Manic-depressive and, they say it's because they want to distinguish manic-depressive from schizophrenia. So they're recategorizing manic depressive as bipolar 1. And that's identified with those manic episodes where they're kind of crazy, like literally kind of crazy, and then super depressed episodes. And it's these up and downs. These manic episodes, they are accompanied by psychosis sometimes. They're very severe, and they can be dangerous. People can do things where they ruin their lives. They spend tons of money that they don't have. Their sexual practices get suddenly very, very licentious. Things like that. They do very, very drastic things. And then medicine is essentially part of the element of what is needed for them to lead a normal life. This is bipolar I now. They usually need medicine. A lot of times it's lithium. And the benefits of the medicine for these folks tend to outweigh the negative side effects that come with these medicines because whatever they have is so severe. Now bipolar II, a new category and a lot of people that have been diagnosed with bipolar are never explained the difference if they have one or two and The the severity of one verse the other they just hear bipolar and a lot of times doctors don't really explain Well, you have this one and not this one. So bipolar 2 is a new category didn't even exist in the DSM the the Diagnostic manual that is always used that we've talked about didn't even exist until 1980. It's less severe. It's less distinct It's diagnosis is more vague. It's more nebulous You don't have to be hospitalized. You don't have to have these severe manic episodes So what they're seeing happening is that Those with depression that are not seeing benefit from the drugs that are being prescribed to them are then being recategorized as bipolar 2 That's kind of why this new category is being filled up with people. A lot of them are coming through this process of, well, I'm depressed and these drugs aren't helping. They're like, well, since you're not depressed and the antidepressants aren't helping, you must be bipolar too. Here's the kicker though, the medicine used to treat depression can cause the kinds of behavior and symptoms that are considered primary indicators of Bipolar II. So it may be that the treatment of depression with current antidepressants is the cause of many of the symptoms that lead to the diagnostic or the diagnosis of Bipolar II. You see how that's working? Depressed people, they take medicines, it makes these additional symptoms happen, and those additional symptoms are what they say is bipolar II. And so they get shifted into that category. It's not so much a new disease, it's potentially, really what's likely happening is they're just treating the side effects of the medicine that they're giving to the old disease of depression. There's budding research on the potential biological causes of bipolar disorder. They're potentially going to find the actual pathology. That's pretty new, but we're going to see in coming years greater clarity. It actually points to it being taken out of the category of mental illness and put into a different medical category, which would be great if it is that sort of thing because that would be more likely that they'll find better treatment. Something similar to that happened in the early 20th century once they realized they had asylums full of people and a lot of them were considered insane and they had psychosis, severe mental illness symptoms. and kept in these asylums and they were, what they found out after they realized or discovered how to test the brain tissue and stuff like that with these dyes is that these people were actually having tissue damage, brain tissue damage from infectious disease. A lot of times it was actually syphilis. They were going crazy because of the brain damage done by syphilis. People thought they were just insane. and put them in the asylums with insane people. So this kind of thing has happened before, where they found out later what was going on, the actual pathology of it, and then were able to treat it better. And there is potential that that is happening with bipolar. I know that I heard it or read it, and I couldn't go back and find the source because it's been months ago at this point. So, I don't want to go into too much detail on it because I could be wrong, but I remember hearing them talking about it and I was like, oh, that's actually really interesting, but it's got a few years where this has got to play out. So, what we do know, though, based on the numbers, drugs like Prozac, drugs like them, are not curing this situation of this high diagnosis of depression and bipolar. The Prozac and these other drugs are not curing it, like they initially said was going to happen. In fact, research shows they're actually losing effectivity. The drugs, the antidepressants, are losing effectivity on the patients while placebo effects are actually increasing. So that's what the research is showing. Recent research also shows, and by the way, I'm gonna cite research and articles and sometimes I'll give you the name, but if you want the names and you wanna look at these articles more closely, they're cited in like the footnotes of these books. And so I know it's kind of nebulous to stand up and just say, well, research shows this and that. And you can kind of add anything to a sentence like that. And who can argue with, well, research shows. Well, I just want you to know it's out here and they're not like a bunch of Bible thumpers. Most of these they're not biblical counselors writing these articles. These are from the field and biblical Counselors are citing them and using their conclusions to make points, but they're not doing this research. So it's not like this is just cherry-picked Stuff it's it's in here. And uh if you want more on that, so Recent research shows that there are current that the current medical treatment for those identified as depressed does not seem to work for the vast majority. Okay, so the JAMA article is the Journal of American Medical Association, that's the big Association, Anti-Depressant Drug Effects and Depression Severity. And we've talked about this a little bit. It's a little bit of overlap from what we have talked about. So that's the name of the article. They said that true drug effects were, and I quote, non-existent to negligible for individuals with mild, moderate, and even severe depression. That's 70% to 87% of those diagnosed with depression fall into that category where it's not very, very severe. most of them saw nonexistent to negligible side effects. Only in what they called very severe depression was the effect of the drug seen when compared to a placebo. So it's not that they never saw any effect, it's that it wasn't above a placebo effect. And even the placebo effect could account for 80% of the effect of the drug. Again, research shows that 70 to 87% of depression cases, a placebo is just as effective as a psychotropic drug. And in the midst, and in the most severe cases, the placebo effect still plays most of the role in the effect that they are seeing. Approximately 25% of the population are diagnosed with depression, which is a huge number. That's millions and millions of Americans. They're diagnosed with either depression, anxiety, or bipolar, and less than a quarter of them will experience remission from depression as a result of the medicine that they take. So there's this huge number of people diagnosed with it, and a very tiny portion of them find any remission from the medicine. So what's happening is that we're not finding a cure or a cause for depression. They thought they had a cause identified, and then they threw medicine at this cause, and it's not curing it the way that they thought initially the hope was. But we are diagnosing more and more people with it still. And then giving them psychotropic drugs that provide benefit to just a select few. And this is all done in spite of significant side effects, which we've talked about. There's significant negative side effects, which then lead to additional drugs to deal with them. So that's what you see happening. They'll try a drug. Well, this isn't doing much, and I'm having these effects, and we'll take this drug. and they layer them, and they try these different combinations, and it's sort of a guess and check type deal. And it changes the way that they feel. Okay, so these drugs are doing something to them, but it's not fixing the initial problem. So after many years, they'll usually come back and say, I'm no better off. I feel different, but it's not better. So, what do you like more? The way that you were before the drugs or this change state that you had with the drugs? A lot of people complain that they don't feel low, but they don't feel high. They just kind of feel meh. You know, the meh. That's how they feel all the time. It just kind of mutes their personality, their desires, stuff like that. So, that's what's happening. And this is not my own analysis. This is what the doctors are saying. This is what the research over the past few decades seems to be pointing us to fairly clearly, is what's being pointed. It's not all that uncommon for patients to go years switching or adding drugs. And then simply seeing variation in negative symptoms, but no overall improvement. And then sometimes, in the end, they just come to the conclusion like, I'm worse. This is worse off. I'm spending this money. I'm taking these drugs. and it's affecting me and it's not better. Let me add the caveat here to anybody listening here or online. These tend to get downloaded. Don't just stop your medicine without consulting your doctor. No one here is qualified to tell you what you should and shouldn't be taking. No one's claiming that. And that sort of thing. And no one's claiming that you should go find a drug or anything like that. We're just citing what the doctors are telling us. And if you hear things and you're like, well, maybe I should try getting off, then talk to your doctor. Don't just drop it cold turkey. That can be dangerous as well. So those statistics about meds helping depression would probably improve if every person struggling with a depressed mood or sorrow were not so casually diagnosed as having depression. Remember, there is no lab test, there's no biological scan that can determine depression. A doctor can look at the subjective things and he can say, I think it's depression, but he can't do blood work or put you in a scan and say, yep, my diagnosis was correct. They just can't do that. Sadness is now driving people to their doctor instead of to their pastor or to their church or to their savior. It's driving people to the doctor. Sadness has become an abnormal emotion that people now think of as like, this shouldn't be. And this book, particularly, and I agree with him, argues that's just not the case. That shouldn't be the case. Sadness should not be looked at as, I mean, yes, we all agree it's unpleasant, but it's not looked at as some abnormal thing that needs to be medically fixed, necessarily. Doctors are then supposed to determine depression subjectively by a list of nine symptoms. This is how they do it. They have nine symptoms in the DSM. That's the Diagnostic Statistical Manual of Mental Disorders. And the way that they have this list of nine things, and they're supposed to see five or more of those present for two weeks, and it must represent a change in the person's behavior. So the nine things that they look for are a depressed mood daily for most of the day, nearly every day, as indicated by subjective report or the observation of others, Number two, a loss of interest or pleasure in all activities for most of the day, nearly every day. Number three, weight loss or gain of more than 5% of body weight due to an increase or decrease in appetite. Number four, inability to sleep normally or excessive time spent sleeping daily. Number five, visible restlessness and agitation or sluggishness and slowing down as seen by others. Number six, fatigue or loss of energy daily. Number seven, feelings of worthlessness or guilt without a reason. Number eight, decreased ability to think, concentrate, and make decisions. And number nine, recurring thoughts of death or suicide without a plan, suicide attempts, or plans for suicide. So those are the nine things they're supposed to be looking at. And they're saying, well, these shouldn't come from a medical condition. It shouldn't come from substance abuse or delusions or hallucinations. And it shouldn't come from a result of someone's death unless It lasts longer than two months. So they give you two months to get over someone's death. And then after that, they're like, you shouldn't have these anymore, or at least not as significantly. So that is, luckily, I think that is supposed to change in the next issue, in the next edition of the DSM, because that seems crazy. Two months is not very long to get over somebody's death. And these problems are supposed to cause problems with family, friends, work, that sort of thing. I have a friend back home that her husband died. And every time I talk to her, it's just the sadness. Her face changes. Her voice changes. And she is mourning the death of her husband and has been for years now. Not years, years, but a few years now. And I don't expect her to get over it anytime soon. Her husband was just a great guy. I think it's nuts that somebody's mental condition should get over that sort of thing in two months. So what reliable doctors are saying is that this method is leading to overdiagnosis. They're saying there's too many people. There's a major depressive disorder. It's getting diagnosed too easily, too quickly. this criteria is showing or saying that more people have a major depressive disorder than actually have it. In other words, the criteria don't work well. And they're saying this. According to them, it's not me looking at that and like, well, this doesn't work. They're saying this doesn't work well. It's too subjective. It's too vague. The bar's set too low. Nearly anybody can meet these criteria when they are normally sad at some time in their life. When really bad things happen to us, a lot of us will experience those things. Studies show a large percentage of people, that's 79 to 95%, qualify for this diagnosis multiple times a year. So the bar is just set too low, which means too many people are being qualified as depressed. The problem is this list includes feelings and experiences almost everybody has in the normal course of life. It's sort of like having a diagnostic model for pneumonia that included everybody who coughs. Well, everybody that coughs doesn't have pneumonia, but coughing is part of pneumonia, so it's like that, the bar's set too low, you know what I mean? Many people that experience significant loss will experience a lot of these symptoms for weeks or months, sometimes years. They're gonna have several of these symptoms. Yet, it's not because they have a mental disorder or disease that needs medical treatment. They don't need medical intervention. On top of that, a surprising amount of psychiatrists, like 25%, do not actually even use that criteria when they're diagnosing depression. And remember, we said this before, most people don't even get that far. Diagnoses and prescriptions are usually done by non-specialists or general practitioners or family doctors, your primary care physician. Most of them are the people that do the prescribing. Most people don't get to a psychiatrist level. And once they do, a lot of them don't necessarily use that criteria. So it's like two-thirds of those non-specialists don't use that criteria at all. So a majority of them. And studies have also shown such doctors are only correct in their diagnoses 60% of the time. So that's just a little bit better than a coin flip. If you go to a primary care physician or some non-specialist and you have this guy treat you or Expect him to diagnose depression. He's only right about 60% of the time. So that's not much better than 50-50. That same flawed model for diagnosing depression is then woven into a similar model for diagnosing bipolar II and I, but bipolar I's a little bit more obvious. So bipolar II is really the culprit here. So if there's flaws in that, then there's gonna be, if there's flaws in the depression diagnoses, there're gonna be flaws in the bipolar II diagnoses. Problem we are seeing is diagnoses that are inaccurate, and then because the diagnosis is inaccurate, the treatment that they come up with doesn't actually help. And again, that's what they're seeing. None of this means that those wrongly diagnosed with depression are not experiencing significant sadness and emotional turmoil. They surely are. but an inaccurate diagnosis leading to an unhelpful treatment will actually prolong their suffering. It's gonna give them hope in something that's not actually gonna help. So when we say this, when we're saying that there's too many people diagnosed with it, doesn't mean that you're not really suffering. It just means there's not something wrong with your brain that's making you suffer. You're suffering, but it's not because you need medical intervention. So just let me point that out. We need to learn to distinguish between those with a brain disorder from those that are simply sad, even very sad, for identifiable reasons, like reasons that you should expect to be sad. We recognize there are many serious diseases that come with a disturbed mood. So there's hypo or hyperthyroidism, there's Cushing's disease, hunting disease, even pancreatic cancer. These diseases can have effects on mood. There's biological things that have effect on mood. But there's also very serious life problems. that affect our mood, but that have nothing to do with medicine or disease, nothing to do with biology. We need to distinguish between medical and non-medical causes of our bad moods and their associated aches and pains, because physical aches and pains can come along with that. But some of these are just for identifiable reasons. People are being sad because bad things happen. The dominant pathological theory today This is, you're probably gonna know, this is chemical imbalance theory. That is an imbalance, too much or too little, between neuroepinephrine, dopamine, serotonin causes. They're saying some imbalance there causes depression. I think a lot of them, correct me if I'm wrong, Kristen, a lot of them say, well, serotonin's too low, you need more serotonin. Yeah. Right, okay, excellent. So that's why a lot of these medicines focus on the reuptake of serotonin. And if they increase the reuptake, it decreases the serotonin. If they decrease the reuptake, it increases the serotonin. Yeah, glad I got that right. She can just nod and be like, yes, you're. No, just making this up. So this idea was originally proposed in 1965. Most said the serotonin was too low. However, they can't prove that. It remains unproven to this day. There's never been an article proving a serotonin deficiency causes any mental disorders, and we don't know what the correct balance between the neuroepinephrine, dopamine, and serotonin should be in the human brain. It's not like we have numbers, then we can compare our numbers to what it's supposed to be. It's not like blood glucose levels or something like that, where you can find out somebody's diabetic because they have the symptoms, and then you run a blood check, and yep, they do, they have it. Also, depression could not consistently be induced by reducing serotonin levels or relieved by large increases of serotonin. So when they ran those tests, they couldn't create depression by reducing serotonin and they couldn't make it go away just by increasing serotonin. What can happen though is that these serotonin medicines may create an abnormal state in the brain that patients prefer to the symptoms of depression. Does that make sense? Because it does do something to your brain and you will feel differently. And it might not cure the depression, but it makes you feel differently and you might prefer the way it makes you feel to the way depression made you feel. In France, so this is a little bit crazy. So in the US, they primarily use serotonin reuptake inhibitors. In France, they reverse that. They do serotonin reuptake enhancers, which lowers your serotonin. So they are lowering serotonin levels, and that has the same rate of depression alleviation as the Prozac-style drugs that increase serotonin, which tells you Something's not right there. The theory isn't fitting the data. How can both lowering and raising serotonin cause the same rate of relief if low serotonin is the cause? This is sort of like the history of the peptic ulcer. There's still kind of this idea that peptic ulcers are caused by stress. You get stress, you get ulcers. And that came, that was the dominant theory for 50 years. It was believed that stress released a hormone that caused stomach ulcers and it had an impact on your gastric acid and that created these ulcers. It was proposed by a scientist based on what he saw in lab rats, didn't see it in humans, saw it in lab rats, extrapolated to humans. Though no pathological tie was made for the humans. So medicine was given that could occasionally relieve symptoms of the ulcers. So you could maybe it wouldn't hurt as bad or be as inflamed, but it wouldn't cure it. So they could occasionally relieve these symptoms, but they never cured anyone. Those that suffered had stress, of course, because constant stomach pain is gonna put you in a bit of stress that is very unpleasant. You're gonna be more stressed. So the stress is caused by the ulcers, not the ulcers caused by the stress, but they're correlated, right? But one wasn't causing the other the way they thought it was. Eventually, a couple doctors discovered it was actually caused by an infectious disease, not stress or gastric acid. And all it took was a couple weeks of amoxicillin. It's a simple antibiotic, super cheap. It's basically just, it's like penicillin, but a couple weeks of amoxicillin and Pepto-Bismol and the ulcers would be permanently cured. People suffering for years and all they needed was a simple antibiotic and Pepto-Bismol for two weeks and they're better. So these doctors went and they presented it, and nobody believed them. And they were ridiculed, everybody was skeptical towards them. There was tons of money in the field that depended on that stress gastric acid caused theory. And eventually, to prove it, one of the doctors took a flask of the offending bacteria that they said he drank it, gave himself ulcers, Because that's what he was saying, this bacteria causes these ulcers. He drank it, gave himself the ulcers, took the amoxicillin and the Pepto-Bismol and cured himself in two weeks, and he won a Nobel Prize. He convinced everybody, like finally they have the pathology, they have the proof. But there was 50 years of people saying this causes this, this is how you treat it, and it was wrong. Even though that treatment could occasionally correlate with physical benefits. So that's basically what is happening. It's a similar story playing out with the chemical imbalance theory. It has a similar origin, and it has about the same lifespan as the peptic ulcer theory. It's been around about 50, 55 years now. There's no scientific evidence chemical imbalance is the root cause. Occasionally, medicines based on that theory can help a few people, but the disorder is definitely not being cured. So we know that for a fact. Depression and bipolar are not going away based on the medicines that treat this root cause. In fact, it's increasing drastically. Again, we said it's because of the diagnosis, but that's, they're still not making it go away. So today researchers are actually abandoning this theory. Again, that doesn't mean that chemical imbalances play no role or that they don't correspond to what's going on, but remember how stress correlated with those ulcers and the gastric acid could inflame the problem that the stress was correlated to. But neither was the cause. Correlation doesn't mean causation. Brain chemicals correlating to your depression doesn't mean that the brain chemicals cause the depression. Correlation isn't even proven when it comes to depression and chemical imbalance either because we can't necessarily correlate people's brain chemicals when they are depressed. The available evidence does not support the idea that chemical imbalances are the direct cause of major depression. There's no simple direct correlation between serotonin or norepinephrine levels in the brain and mood. And that sounds like, oh, you're just a biblical, well, I'm not a biblical counselor or anything, but you're just one of these anti-science Christians or something. That's kind of going to be the reaction. But here's some major secular sources. Thomas Insull, a psychiatrist who directs the National Institute of Mental Health, said this of the chemical imbalance theory. There is no biochemical imbalance that we have ever been able to demonstrate. Irvin Kirsch, Associate Director of the Placebo Studies Group at Harvard Medical School, likewise said, the data does not fit the theory. And again, that's just a few, but these people are, these groups are transitioning their research away from that theory, and they're kind of moving on. In the 50 years that this theory has been pervasive, there's not a single well-documented study that gives the smoking gun for the chemical imbalance theory. Research is moving on. to other causes. And when I met with Lou Parillo, I think I mentioned him before, he said, he basically told me that. Like, that's basically been put in the past and they're moving on from that. And I was like, really? I hadn't heard that. And then I'm reading all these studies and seeing these guys like, yeah, the data doesn't match that. We're kind of moving on. Doesn't mean that they never play a role or that medicines involved with that are never useful, but that's not the cause. or move beyond that. Often the response to this data is something like, well, I was sick and I took the antidepressants and I got better, which can be a true experience, of course, but that's kind of considered reasoning backward. In a 2002 JAMA article, again, the Journal of American Medical Association, Researchers compared, they took three things, and they wanted to compare Zoloft, which is a well-known antidepressant we've talked about, St. John's wort, which I'd never heard of, but is an over-the-counter herbal remedy, and then they took a placebo pill. And they took these patients, and they gave them these drugs, and they looked at the results. And from that, those that took Zoloft, 25% testified to a full remission of depression. The patients that took St. John's wort, that herbal remedy, 24% had a full remission of depression. And of the patients that took the placebo, 32% testified to a full remission of depression. So such results have been repeated by additional studies. Two, it's not just one, it's been repeated. That method and those results have been repeated by additional research. Such as one study, it's simply titled, they cited, again, a secular work, cited called Antidepressants Don't Work. Now when people say that, it doesn't mean that not taking antidepressants never helps, or that taking, they don't mean that taking antidepressants never helps. But what they show is that there's no substantial benefit over a placebo most of the time, for the majority of the time. So it's kind of like saying, I mean, if your car started 10% of the time, would you say your car works? If you got to work, able to drive to work 10% of the time, would you say, well, I have a working car? No, that's kind of the point. Statistical analysis has been done on these study results and the message is that 82 to 87% of those treated with the drugs themselves, the drugs were not the source of relief. It's a huge, huge number. The drugs themselves were not the source of the benefit that they were seeing. That means two things. First, a select few can get a benefit from the drug. There are a select few that do, and we've talked about that in very severe cases of depression. It's like calming the waters so that the person can think and physically interact and things like that. Again, we've talked about that. So there are a select few because some tiny portion does benefit from it. And the benefit that correlates with taking a drug most of the time cannot be said to be caused by the drug. So taking a drug and getting better doesn't mean the person had depression or if they did, did the drug help them get away from it or get cured of it. If a sugar pill cures depression, cures depression at that rate and placebos perform as well as they do, then antidepressants can't claim their effectiveness proves that depression is a disease, if you follow that logic. Remember what we said. We've said this every time, that doesn't mean that drugs dealing with our biological brain chemistry will never be useful in playing a part in treatment of severe depression. That seems to help for the very seriously depressed or about 13 to 10% of the people, somewhere around there. But a faulty theory is going to lead to a faulty treatment and no cure. And that's what we're seeing. We're seeing treatment that isn't curing these people, and it's not actually helping them, and it's not curing this epidemic. It's safe to conclude that nearly 90% of diagnosed people see no true chemical benefit from antidepressants. 90% of those who pursue better moods medically gain nothing but diagnostic labels. So not only are 90% of depression cases not really depression, But 90% of the people that take antidepressants don't benefit from taking antidepressants. It's not a coincidence that those two numbers are so similar. It's because they don't really have depression, therefore antidepressants don't help them get over it. That little benefit, that little select few that have depression, those are the ones that tend to benefit from the meds. And again, the meds are just one factor in the treatment. Doing something is what causes people to hope. This is what they're seeing. Some sort of treatment being enacted makes people become hopeful. Okay, I'm doing something. This might work. And they become hopeful. And hope is scientifically proven to improve outcomes. It's a weird thing, but it's proven. Hope helps your body overcome. They even did this with knee surgery. Like physically people had arthritic knees and there was this surgery that they were doing for it and the doctor, one of the doctors doing it was becoming skeptical that these surgeries were actually helping people. So he wanted to test it with a giving people this knee surgery, and then doing a less invasive knee surgery. And they were like, well, you need to also have a blind study group, a placebo group. Well, how do you do that? Well, what they did is they prepared them for surgery, like they were going to have surgery, and they just did these minor incisions to make it look on the outside. So they actually cut the skin, but they didn't actually do the arthritic knee surgery. So they had this group of people that didn't know whether or not they had knee surgery or not, and they tested it against people that had major knee surgery and minor knee surgery, and they compared these three groups. So essentially, that placebo group, all they had was the hope that the surgery they thought they had worked. And what they found was that those with the non-medical interference, had the best rate of reduction in pain, which is really strange, which led them to believe that this invasive knee surgery was actually causing more pain than it was helping. And it led to a change in the way that these things were done. I mean, that's not surprising, right? Surgery itself creates its own problems. You're cutting into tissue, it's gonna cause pain and you have to heal. The non-medical interference, combined with the hope that they're gonna get better, reduced the pain the most in that group. Kind of strange, but. proves that hoping helps your body. Again, the very first lecture that we talked about, in part one, we talked about this interaction between mind and body, the way that God has designed us, and we don't necessarily understand it all, and we're not necessarily going to understand it all. So again, I raise the question that I raised many years ago, or years, months ago now, what are we hoping in? Does our theology tell us that there is a God? Yes. Does it tell us that he's sovereign, that he's in control of the things and the suffering? Yes. Does it tell us he cares for us? Yes. Does it tell us that he has purpose in these things and that ultimately it'll eventually all go away? Yes. Do those beliefs reduce stress and anxiety and sadness? Yeah. They do. What we believe about God helps us to handle the world in a way that is less stressful, less sad, and more hopeful. Definitively so, objectively so, and unsurprisingly, research has backed this up. Believing God cares about you makes medical treatments 75% more likely to work. among the clinically depressed. Not just believe there is a God, but believe specifically, and they tied it specifically to the fact that he cares for you. Makes it 75% more likely that you'll get better, or that the treatment that you're getting will work in the clinically depressed. Jesus gives us theology to help combat anxiety, depression, sorrow, things like that. And I know we could cite many, many verses. Let me just give you a few. Matthew 6. And who of you, by being worried, can add a single hour to his life? And why are you worried about clothing? Observe how the lilies of the field grow. They do not toil, nor do they spin. Yet I say to you that not even Solomon in all his glory clothed himself like one of these. But if God, So clothes the grass of the field, which is alive today and tomorrow is thrown into the furnace. Will he not much more clothe you? You of little faith, do not worry then, saying, what will we eat, or what will we drink, or what will we wear for clothing? For the Gentiles eagerly seek all these things. For your heavenly Father knows that you need all these things. But seek ye first his kingdom and his righteousness, and all these things will be added to you. It's a verse right there dealing with worry. If you're gonna make a major life decision, like leaving engineering and going into the pastoral, or moving to a state where you've been like once ever, these are the kind of things that you think of to reduce stress. These are kind of like, God will take care of me. He surrounded me, not only just like, I don't know the future providence of what will happen, but he surrounded me with family and friends that will take care of me even if I can't take care of myself and my own family. They're going to be provided for. I know it for a fact. And that allows you to act more boldly, to act without stress and without worry as much. Now we can't stop at all, but that theology clearly changes the way your brain thinks. And the way your brain thinks changes the chemicals in your body and the impact on your physical organs and all that sort of thing. It's all tied together. And our brains, remember this from back again before, are surprisingly plastic. How you think, what you think about, changes your brain physically. So they can see a physical change in the brain in violin players, for instance. Like when you do this with your fingers playing a violin, Part of your brain literally gets bigger over time as you practice and get better. And eventually, they don't even have to play the violin, they can just do this with their fingers and that part lights up. And then eventually they can think about doing that with their fingers and that part of the brain lights up. It physically changes your brain. So when God says to think about the good, the honorable, the true, the beautiful, all that sort of thing, that will literally change your brain. The things that you think about, the good things, will get bigger in your brain, it'll trigger certain parts of your brains, it'll get bigger, light up, it'll physically change in your head if you are dwelling on these things. And vice versa, if you do it with things like lust, if in all your spare time, whenever your mind is free, you're dwelling on lustful thoughts or evil thoughts or hateful thoughts or whatever it may be, you're training your brain to repeat that and get good at it, because that's essentially what's happening. You're training your brain to get good at it. You're getting better at sinning by thinking about sin, and you're getting better at holiness by thinking about the good, the true, the honorable, the pure, and all of that. Do you know that verse? Do you have that verse memorized? I had you memorize it at one point, remember? I wish I had it memorized. Isn't it like verse 12 for you? Whatever is Good, whatever is pure. Yeah, what is it? Right there. I can't remember all those, but that's a list of the things that we should think about. And as you do that, it will train your brain to get better at doing that. It's crazy to think about, but God doesn't have to sit and give us a science textbook on how to help your brain get better. But if you obey him, that's an ancillary benefit that he doesn't need to explain to us, it just happens. Another verse, Matthew 5.4. That's in Philippians, is it not? What's the citation? Philippians 4.5, 4.8? Okay, we went over it because we went through Philippians. I think you spent a series on that. So we have a series of sermons by Ken Shaw, who is good at these things, that tells us how to train our brains to think on these things. Blessed are we. Matthew 5 4 blessed are those who mourn for they shall be comforted a promise to the sad You will be comforted. That is a reason for sad people to be hopeful and I'm going a little bit long But I do want to get through this whole thing. It's not Too much longer. So a correct understanding of scripture provides not only an eternal perspective of future hope and glory and relief from all sin and suffering, but also a constant ability to progress and improvement in maturity and in thinking and in Christ-likeness, and it will train your brain to physically get better at that. So we have a reason for hope and all these things. Hopelessness can ensure prolonged suffering. Hopelessness is like the worst thing when you're trying to help somebody get better. It is, it's, people start to die when they lose hope. And anybody that works around people that die, that's when they start dying. They will testify to this. When they lose hope or when they want to die, their body will correspond to that. Their mind and their body are gonna start to match up. But hopelessness can ensure prolonged suffering, especially when it comes to depression and related mental illnesses. Therefore, the Christian faith provides an ever-present weapon against that. We should not let psychiatry define normal sadness and suffering into a brain disease. Sadness is normal and it can be healthy. It can be a healthy response to many of the losses and the suffering that we experience in life. There's a lot of things that happen to us where the correct emotional response should be sadness. And there's a lot of things that we do that should make us sad. And God created us to be that way. Sin should bring sadness. If you do some secret sin, and it doesn't make you sad, I'm worried for your soul. A sanctified person, a true believer, should get sad at their sin, repent for it, and be lifted of that burden, of course, but they shouldn't be happy about it. It shouldn't not bother them, is what I'm saying. Sadness fits many of these situations we will face in life. Ongoing physical ailments can make people sad. An unfaithful spouse, a broken marriage, it can upend your entire life. It can cause years of turmoil and stress and sadness. The intensity and duration of our sadness corresponds to the size and the duration of our loss. That's normal. That's what we should expect. The bigger the loss, the more sad you're going to be. Normal sadness goes away when the problem goes away, or when the person adapts to life with that problem. You eventually adapt to living life when a loved person that died is gone. You eventually adapt. It makes you very sad, but you start to get better, you adapt to it. That's the root of that idea of time heals all wounds, partially because we adapt to horrible situations. We get used to dealing with our problems, and that's part of what's supposed to happen. Disordered sadness, in contrast to normal sadness, disordered sadness, or melancholy, seemingly comes without a cause. The criteria in the DSM cannot distinguish between normal and disordered sadness, and that's a problem. When we look at these criteria for depression, they can't tell if you're being sad for reasons that should make you sad, or if you're being sad for no reason whatsoever. The seemingly severe, very severe depression, those small percentage of cases, They usually, they don't have anything that they can explain it. There's not a point in time when they can remember, well, this happened, and then I became sad, stuff like that. But a lot of times what's happening is, well, my family moved away to be missionaries, and I miss them, and they're sad. Or this person in my life died, and now I'm sad, and I can't get over this sadness, and now I need an antidepressant. And the doctor's like, yeah, now you need it. You should be over it by now. So suddenly your brain has a disease, and you need antidepressants. So this is one of the causes of overdiagnosis. People with normal sadness can meet the criteria for depression, and we need to recognize that people can be depressed without having depression. Being sad doesn't mean you have melancholy. Being depressed and having depression are not the same thing. They shouldn't be considered the same thing. And that changes how we look at the problem, and it changes the things that we look to to help the problem. Normal sadness is designed into the church. It draws in social support. You can't usually hide your sadness and the church is aware of it and flocks to you. We weep with those who weep, Romans 12 and 15. It signals to the church someone needs help and it motivates a sad person to get help. Being sad can protect you. If you're doing a thing that makes you sad, particularly if it's a sin, that sadness will motivate you to stop doing that thing because it's unpleasant. So sadness can be a very healthy, good thing to experience. Normal sadness may come from sin, and it may spur repentance. So look at 2 Corinthians 7, verses 8 through 11. He had written in 1 Corinthians about this guy that was sleeping with his mother. And he's like, you got to stop. You got to kick him out of church. What are you doing? How are you tolerating this? What's wrong with you? And then in 2 Corinthians he said, For though I caused you sorrow by my letter, I do not regret it, though I did regret it, for I see that that letter caused you sorrow, though only for a little while. I now rejoice, not that you were made sorrowful, but that you were made sorrowful to the point of repentance. For you were made sorrowful according to the will of God, so that you might not suffer loss in anything through us. For the sorrow that is according to the will of God produces a repentance without regret, leading to salvation. But the sorrow of the world produces death. For behold, what earnestness is this very thing, this godly sorrow?" Godly sorrow. has produced in you, what vindication of yourselves, what indignation, what fear, what longing, what zeal, what avenging of wrong in everything you demonstrate to yourselves to be innocent in the matter. Godly sorrow that produced vindication, indignation, fear, longing, zeal, and avenging of wrong. What if those Corinthians got that letter reacted in sorrow, and then suddenly somebody gave him a pill to make that sorrow go away. Could that psychiatrist diagnose the difference between, wait, no, no, no, I don't wanna get rid of that sorrow. You're supposed to have that sorrow, because what you're doing is wicked. I'm not taking away that sorrow for you. Can the DSM criteria prevent that sort of thing? No, and it shouldn't. I mean, we shouldn't expect it to. There is a godly sorrow that produces repentance. There are things that we do that ought to make us sad. Normal sadness. can be caused as well from discontentedness. It can be caused from fighting, bickering amongst each other. That can cause sorrow in this church if we did that, if we had broken relationships. James 4, what is the source of quarrels and conflicts among you? It is not the source of your pleasures that wage war in your members. You lust and you do not have, so you commit murder. You are envious and cannot obtain, so you fight and quarrel. If you are envious of somebody's things and you cannot obtain it and it makes you sad, I don't want you to take a pill to make that sadness go away. I want you to get over your envy and your covetousness. This is godly sorrow. Sorrow is used by God to draw us back to Him or turn us from destructive behavior. C.S. Lewis wrote, in The Problem of Pain, he said, God whispers to us in our pleasures, speaks in our conscience, but shouts in our pains. It is his megaphone to rouse a deaf world. So the world has basically thought of sorrow as this horrible thing that needs to be medically dealt with. And though that can be a situation at times, usually it's not. Statistics prove it. Research proves it. Usually that's not what's going on. Usually it's normal sorrow. People need care. Pastoral care. Care from their friends and their family and sometimes counselors to help them deal with it. And a biblical worldview and the truths found in scripture teach us to deal with it. It won't make you happy about the bad things that happen. It just makes you understand how sorrow works and to handle it and adapt to it correctly and to never lose hope. We do not yet have a pathological explanation for disordered sadness, for this sadness that cannot be explained. We don't have a pathological explanation for it. We cannot definitively say it's a disease because we don't know the pathology that causes it. But the bottom line is this, nearly 90% of depression today is really just loss-induced suffering or sadness. Loss-induced in terms of anything, not just necessarily a person that died or a child or a spouse, but something that you wanted or something that you had that you lost. causes sadness, and 90% of depression today is caused from those things. And they show that talk therapy, interaction between a counselor and a patient, where they interact and they talk, is just as effective as medication in those 90% of cases. Therefore, biblical counselors and pastors and the church, all of us, are in a unique position to help. Because as the psalmist says, the law of the Lord is perfect, restoring the soul. The testimony of the Lord is sure, making wise the simple. The precepts of the Lord are right, rejoicing the heart. That's something a depressed person needs. The commandment of the Lord is pure, enlightening the eyes. So this subject does not need to be a minefield. I don't know why it is, but all of this information can sometimes create sort of a self-defensive reaction against it, defending the idea, no, no, it's definitely chemical imbalances. It's not like, there's something wrong in the chemicals in my brain that's causing this. Stop, they take it as an attack, as if we're questioning their character or their strength or something along those lines, which, first of all, in the church, you should be used to that. The Bible does that to us all the time. Most of our problems are us causing our own problems, not us being the victim of something. But there tends to be a self-defensive reaction against this kind of information. And then there's this forceful reassertion of one's own depression, like, no, I'm sure that this is what I have, I've been diagnosed. And to that I say I'm not challenging anyone's diagnosis. I'm simply stating what the research and the statistics show. This research should not cause offense. Nobody should get offended at the fact that 90% of depression diagnoses are wrong. And that 90% of people that take antidepressants aren't helped by that. That's just what the numbers show. That's what the doctors are literally saying. I have no access to this information except for what is disseminated through the research and the doctors that do it. I'm not making it up or anything like that. And this should be good news for those that have suffered depression or have been diagnosed with depression. It should be a relief. to find out that many cases of depression are inaccurately diagnosed. It should be a relief to know that you likely, if you have been diagnosed, you likely do not have a biological problem. You don't have a chemical imbalance wreaking havoc on your emotions. Likely, again, not a guarantee. It should be a relief that you may be able to approach your doctor about eventually ceasing and stopping all your ineffective and expensive medications. If you've been doing it for years and it's not helping, then you should be able to approach your doctor like, maybe let's try getting off these and let's go back to a normal state and see how that feels and compare them. It should give you relief that your Christian faith drastically improves your prognosis for improvement. It should be a relief that you may not have a condition that you're a victim of, but rather are simply enduring a period of suffering like everyone else does. You're like the rest of us. We all hurt, we all go through losses at different periods, and none of us deal with it perfectly. It beats us up, beats up our emotions, and then our emotions affect us physically. It should be a relief that you're like the rest of us. Not all significant sadness is clinical or pathological depression. It should be a relief to know that while sadness is quite unpleasant, it can be a useful emotion which drives us to make productive changes. If a sin makes you sad and your sadness motivates you to stop the sin, that is a productive change and the sorrow did you good. We should embrace what responsible doctors and biblical counselors are saying about the secular psychiatric worlds and the pharmaceutical industries perspective on depression. They're using their own data and they're explaining it because we have a biblical worldview to explain it because we understand man and God and the interaction of body and soul better than they do. We should embrace godly sorrow and God's use of our sorrow and God's design for sorrow in our lives. So, there's more data in the books. And these drastically helped me understand these things better. If you want to look at that, please do. If you know somebody that's suffering from stuff, please recommend those books to them. And if you get that negative reaction, then point out those things. You should be happy that you're pretty much just like the rest of us. And maybe you are going through a period of suffering and sadness right now. No one's denying your experience. But there's probably not something wrong with your brain. And you can change your brain by thinking about godly things. And let's get through this together. You can help. Everybody here is equipped to help because everybody here knows the truth of what Jesus Christ did. So with that, let's pray quick. And if you want to look at any of these books, please come up here and take a look at them. And hopefully this has been helpful. Let's pray. Heavenly Father, we pray that when we know these things and we present it and try to help others, we won't do it in an offensive way. We pray that the information would be received well. The sources and the trustworthy doctors and biblical counselors that have put in the work to explain this, their work would be used, Lord, we pray that you would use it to bring people to a right understanding of God and man and the sadness that they experience. I pray that you would make us sorrowful when we sin. I pray that the evil acts that we still participate in would bring great sorrow on us, but it would be godly sorrow. And that godly sorrow would drive us to repentance and a zeal for the truth and a zeal to live godly lives that are honorable to the truth that you have called us to. And we pray, Lord, that you would use our sorrow and any other emotion that is appropriate. Use it in our life to make us more like Christ so that we react to this world and to your holiness and to our sinfulness the correct way, in a biblical way. that makes us more like your son. So thank you for your spirit that does that work in us. Help our brains to develop into more godly brains. Help us to think on the right things, the true, the pure, the honorable, the beautiful. Help us to dwell on you, Lord, to dwell on your salvation. Help us to think about those beautiful, pure things. We pray all this in Christ's name, amen.