Four Lenses of Diagnosing Problems.
General medicine does not make Christians too nervous. If you have a troubling symptom you go the Internist or Specialist and hope for an accurate diagnosis and plan of treatment that will bring you back to health. Many times this may involve a prescription. If we are told we have a thyroid disorder and need Synthroid, we go fill our prescription and take our dose. If we have high blood pressure we may need medication.
Let’s dive into a controversial subject. When it comes to a Psychiatrist and diagnosis of some psychological disorder and a suggestion for medication we often balk as Christians. Milan and I have had to beg, plead and cajole many clients into seeking this kind of help. Sometimes there is a flat refusal. Why is this? Somehow this kind of help is labeled unspiritual. If we had faith, a close walk with God (whatever exactly that means) and read our bible and prayed we should not be depressed, anxious, have mood swings, compulsions etc.
While all these spiritual disciplines and practices certainly help, sometimes they are not enough. Milan and I like to look at all problems; medical, psychological and spiritual through four lenses.
Most problems we encounter are a mixture of all of these areas. The difficult question is what’s what? For example, years ago I saw a client who was 53 years old. We will call her Sue. The last of Sue’s three children had just moved out to attend college. She was an empty nester after being a stay at home mom for 25 years. She was not sleeping well. She was tired and unmotivated. She was a devout believer for many years and described her relationship with God as “close and life giving” until recently. Now her prayers seem to be “hitting the ceiling” Upon further questioning I learned her best friend had died of breast cancer the previous year. She described this loss as devastating and felt no one but God understood the degree of sorrow she experienced. Her husband was a high level executive and worked long hours. She loved him and the life style he provided, but longed for more emotional and spiritual intimacy in her marriage.
Let’s take these presenting issues and look briefly through our four lenses:
Physical: She is at a menopausal age. Her hormones are changing. Does she exercise?
How is her eating? Does she pay attention to nutrition?
Emotional: Sue has experienced a great deal of loss. She is in a major life transition
which is equivalent to a man retiring or losing his job. Who can she go to for
comfort? Is her husband willing to come in and learn to grow in his ability to
see and meet her needs for comfort and connection? How are her other
friendships? How has she dealt with this grief? Alone? Can she bring
her vulnerable need for comfort into relationship? What did she learn about
connection growing up? Is she a avoider, pleaser, vacillator, controller or
victim? How is her love style impacting her? Is she anxious? What is her
level of self awareness? Is she a giver or receiver…can she be in both roles?
Spiritual: Is this a spiritual crisis/transition? Has she ever experienced this downturn in
her prayer life before? What is her church involvement? What is her level of
spiritual maturity? How much has she suffered? How does she integrate
suffering with God’s love? What is her level of vulnerable, real, connection
within her church setting? Where and how is spiritual opposition operating?
Are there demonic strongholds? What lies does she believe?
Are her sleep problems due to hormonal changes? Is her thyroid low?
When was her last physical? Is she depressed? Are her sleep problems due to
depression? Is there a family history of depression? Anxiety? Panic attacks?
What medications is she on? Are her symptoms a side effect of any
This is just a quick overview… the point is all areas are important to investigate. Leaving out one section means I may miss important information. In Sue’s case, what we discovered over time is that she was indeed depressed, but was uneducated about the symptoms of depression. In fact, as I explored Sue’s history, she had suffered post partum depression after the birth of her last child but had never been diagnosed or treated. Her Father had serious alcohol addictions, which may have been his attempt to medicate depression or anxiety.
After three months of treatment and no alleviation of her symptoms I suggested Sue schedule an appointment with my favorite psychiatrist and be evaluated for anti-depressant medication. (I prefer psychiatrist for this kind of evaluation because this is their area of specialty. Out of 20 or more possible choices of medication, a psychiatrist is trained to differienate between all these options and selects the best possible choice of medicine.)
I explained to Sue that depression can be situational and resolve on its own, or it can be clinical…that is caused by imbalances in brain chemistry. Most any condition for which we take pills or vitamins is an attempt to alter some chemical system in out body for the better. Initially, Sue resisted feeling she should be able to trust God more and that would help her feel better but after another month of sleeplessness, indecision, lethargy, frequent crying and anxiety she agreed to make an appointment.
Sue was astounded at the results. She said what I have heard so many clients say when treatment is successful… “The difference in how I feel amazes me. Overall, I feel I have my feet back on the ground and can manage stress so much better. I’m sleeping again and I can make decisions without agonizing. My head feels clearer and every little thing does not make me cry. I was afraid I would not feel like myself on medicine but it’s just the opposite. I feel like myself again.”
I have heard a similar speeches countless times. Sometimes psychology (symptoms of depression) and medicine can make all the difference in helping someone regain their emotional health. To ignore this avenue of help can make suffering unnecessarily prolonged.