Christian Counseling - The Use of Medication in Treatment of Depression

Some recovering from depression or who are in remission swear by antidepressant medication, while others are fearful of trying the treatment, and still others can't take them due to serious side effects.
Several short-term studies showed that 45% to 55% of chronically depressed participants had at least a 50% reduction in symptoms by taking tricyclic (older class) or selective serotonin reuptake inhibitors (SSRIs - newer class). Only 25% to 35% of those with chronic depression achieved remission with the first drug. (Harvard Mental Health Letter, December 2009, pg. 2.)
The belief is that those with chronic depression need an extended period of medication use. It is also believed that long-term medication management reduces relapses. Typically, clinicians think of long-term to be about six to 12 months. Clearly, there are others who need an indefinite period of maintenance therapy, and still others who may need it for the remainder of their lives. One study showed that outcome for chronic depression was improved when participants' wishes for a particular treatment was given to them. Twice as many achieved remission when participants desired and received drug therapy, and six times as many for those desiring and receiving talk therapy. Clients need to tell their therapists what they desire and don't. However, there are exceptions to "The client knows best," which I will get to in a moment.
Some, with some good reason, distrust putting any unnatural substance in their bodies. Side-effects can be substantial, and the long-term consequences may not be understood for years or perhaps even decades after the FDA grants approval. It can also be an issue of faith, just as it is for some who consider whether or not to enter counseling. They may believe God is sufficient to heal them and, if He meant it to be some other way, they would not be depressed. They reason they should endure the malady because it's God's will. But for how long?
One of the significant issues confronting those who are depressed is that their sense of judgment is often skewed by the disorder. Further, I don't believe depression is ever the result of God's will or desire. It is the result of evil in the world and in us, the beliefs we hold, the traumatic experiences of the past or present, and genetic vulnerabilities.
One important point in decision making regarding medication usage is comparing risk with benefit. If the risk for suicide, inability to work, or other health concerns exist (coronary disease), then it is highly important clients consider the use of medication. If necessary, a therapist can help a client understand and overcome his or her concerns, resistances and fears.
"The client knows best" is often true, but not always. There are times a client must rely on his or her doctor's judgment, such as when a client suffers from severe depression, or when he or she is unable to sufficiently participate in treatment.
The client always has the final decision about whether or not to take medication. But before doing so, the client should always be active in researching, thinking and discussing treatment alternatives with knowledgeable family, friends and doctors. The out-dated notions that either the client or the doctor always knows best is being supplanted by a greater and more relevant understanding--together, the doctor and client know best, and that, under the leading of the Spirit. A collaborative, working and trusting alliance is necessary to a good outcome, regardless of whether or not medication management is part of the treatment.