From Scripture & Science: How to Talk About Mental Health

Mental health has become a growing topic of concern in our culture- but how do we talk about it? Dr. Chris and Alisa Grace discuss signs of mental health and look to both scripture and science for advice on how to talk about it, and what resources are available to those in need. 

Mandy: Welcome to another Art of Relationships Podcast. We are grateful for listeners like you. Let's get right into it.

Alisa Grace: Hey, we are so glad to have you back with us for another episode of The Art of Relationships Podcast. I'm joined here with my handsome husband, Chris Grace. Hi, Chris.

Chris Grace: Hey, good to see you.

Alisa Grace: How are you doing today?

Chris Grace: Real good, thanks. It's fun to be back and fun to just be able to start exploring some fun topics related to relationships. It's something we do all the time, and it's really fun. But it's good to be back here, and hopefully COVID is leaving for at least a season.

Alisa Grace: Oh, yeah, please.

Chris Grace: So people can get back to things.

Alisa Grace: Yeah, we actually just went through it, both of us, about a month ago, huh?

Chris Grace: Yeah.

Alisa Grace: Oh, man. That was killer. But yeah, it's good. It's the summer and things are kind of quiet here on campus. We're at Biola University, where we have our Center for Marriage and Relationships. And so it's good to be talking with people, and we have a really special topic that we actually want to address today. Something that's really important, really widespread, and something that we're guessing that either you struggle with or someone you knows struggle with this.

Chris Grace: Yeah. And the topic is, when you become too attached to the Los Angeles Dodgers or the LA Lakers and they disappoint you. And what do you do when-

Alisa Grace: Oh, it's painful.

Chris Grace: ... You're watching TV and all of a sudden, we lose it in the ninth inning? It's just-

Alisa Grace: Oh, it's painful.

Chris Grace: ... It's such a hard life.

Alisa Grace: But we still love our Dodgers.

Chris Grace: We do.

Alisa Grace: We still bleed blue.

Chris Grace: Yeah, there we go. Well, no, it is a hard topic. And so we will introduce at least, and the topic is going to be, I think we should spend some time, is looking at mental health. And mental unhealth, mental disorders, psychological disorders. And I think looking at it in general, one of the things I think we could spend some time and I'd love to get your thoughts, Lis, and then I'll share some of mine. It's what happens when someone that we are close to is struggling with mental health. Whether it's, you know, anxiety is most common, depression. All of those types of struggles, whether it's with emotions or thoughts or certain behaviors, even addictions. But what do you do? And we run into this question all of the time, not only on college campuses, but at conferences across the country.

Alisa Grace: Everywhere.

Chris Grace: Yeah. And I think a lot of people, I think, fear that they are just ill-equipped, they don't know what to do. If it's a child, they call us and say, I don't know what to do with my youngster. This kid's in the third grade and is falling behind or their college kid is coming home after a troubling semester. So I think we need to just spend a couple of sessions and times, I guess, talking about what is mental illness or mental health? How is it identified? Are there been changes going on in the last number of years? And then, what happens when someone very close to me is struggling?

Alisa Grace: Yeah. That is such a great question. And I think of another person out there that might be affected by this would be the young mom who has young children at home and everything ... She just worries and has irrational fears about what might happen to her children. It might be the man at work who is having a panic attack on the way home from work, because there's just so much stress and so much anxiety going on. So this could affect anybody, any place, anytime.

And so, Chris, I want you to tell us a little bit about how would you tell the difference between something that would be common, everyday stress that everybody encounters versus when it becomes a problem and it might be considered a mental disorder?

Chris Grace: You know, what happens anytime we experience, as humans, emotions, you know how we are teasing about baseball, but some people just get so excited and so happy about certain events and they get very sad or fearful. And they happen to be a little bit more emotional. Others maybe don't have as many strong emotions. They don't express them. They probably feel them about the same. So people vary on this range. You are very excitable when good things happen, you get real excited, you jump up and down and you're real fun to be around with good news being shared. And you're also pretty steady and calm during difficult times. And I'm similar, but I kind of have more muted responses. And we've had to learn that, that our emotional expressions are different.

And so we have to take that into account. So, if you and I show exact same levels of anger in a certain situation, it might not be weird for me because that's normal. But it might be weird for you and more extreme because you're not commonly, predisposed to that. And so once we take that into account, I think the primary difference between what is normal fear, what is normal anxiety, and when does it become something, what we would call disordered? Or when does it lead to maybe even a diagnosis of anxiety?

So the interesting thing about that is, it's not a quick, easy answer. But if this begins to interfere with your daily functioning, if you no longer are able to participate in certain thing, if all of a sudden, you've been on this sports team or in this club or working in this environment and you can't go to it because you fear what's going to happen, and all of a sudden you begin to change your life and it starts to interfere with things, now you're starting to look at, okay, this is starting to have real world effects. Or let's say it's sadness. Is it normal to be sad? Yeah.

Alisa Grace: Oh yeah.

Chris Grace: Yeah. Somebody is hurt in our life, somebody that we love is dealing with something that is hard or somebody has hurt us.

Alisa Grace: Or you have a disappointment.

Chris Grace: You have a disappointment. So, you're sad. Well, how long is it okay to be sad? How long is it okay for your child, your high school student, or you as a college student, how long is it okay to be sad about a breakup? Is it okay to be sad for a weekend? The answer is, yeah, probably. If you've been dating a person a long time, now you go through a breakup, it's not only feelings of maybe disappointment, sadness, regret. How long before you know that it's disordered and it's beyond what you can do to fix it, and you need professional help? Well, the answer simply says, if it begins to interfere with your daily functioning, and if you are no longer able to feel like you can snap out of it or get out of it. And if it lasts a period of two weeks or longer. And that two weeks, you're not able to do daily function. You're not able to get out of bed, you're blowing off classes, you're not going to work.

Alisa Grace: You're sleeping a lot.

Chris Grace: Yeah. You're sleeping a lot or not sleeping, either way. So the point is that two weeks we would begin to say, all right, a normal emotional reaction or response to this is somebody that could get out of this after a couple of days, maybe a week. But it's interfering with daily functioning, you feel like you're not in control and you also experience these things for longer than two weeks. For both anxiety and depression, that's the trigger, at least, to say, all right, I need to get to somebody else. So that's the quick answer to the question, Lis.

Alisa Grace: I love that. That's really, really helpful. I think when I think about some of the signs that you would look for, that was really helpful that you talked about some of the physical symptoms, you said. Like you're sleeping too much or you're too little. Or maybe you're overeating, or you even have a loss of appetite, just not eating at all. Headaches, unexplained aches and pains. What about worrisome behaviors? What behaviors would you see somebody exhibiting that would be a warning flag to you?

Chris Grace: Yeah. So if a person is dealing with, let just start with anxiety as one, remember, anxiety is something that we're all going to experience at some point. There's nothing wrong with these feelings, worry and maybe fear. When it becomes intense or excessive and your behavior starts to show things like not attending certain events, so you avoid that. You can normally find a place to go and relax, but now all of a sudden, you can't find that safe space. So physical symptoms, you have racing hearts, trembling, sweating, crying. But your behaviors are almost feeling like, I don't control them. I can't get away from them. What I used to do to calm down doesn't work. And, so, you know... Oh, go ahead.

Alisa Grace: What about a loss of your desire to keep up your appearance? Something like, you're just not showering, you don't feel like getting out of bed, taking care of yourself, you just have an overall lack of motivation?

Chris Grace: Yeah. And I think that's more related to depression or a sign. Now, remember, there's a lot of what we call comorbidity, which is, most of these disorders that we're going to talk about happen in conjunction with one another. There's a strong, what we call high comorbidity, the coexistence of both anxiety and depression in the same person. And so they overlap a lot. Which, first of all, leads to diagnosis problems. You know, people don't know ... Well, what do you have? Oh, I've got depression. Oh, I've got anxiety.

And it can change depending upon the things you're experiencing. So people might have social anxiety, but it's coupled, maybe, with depression. Or they might even have social anxiety that could be coupled with something like a deeper form of a panic disorder. Now those are both within the category or anxiety, but panic disorders, all of a sudden you're ... So in an anxiety type of behavior, it could be things like excessive crying, but it could be, you're just driving down the street and all of a sudden you have this dread feeling and it almost feels like a heart attack, and you don't know where to go. You don't know what to do.

We've had friends say they've driven to an emergency room only to be found out that it was just a panic attack. So stress could lead to this, high levels where you're just anxious all of the time. You're not eating well. Those are behaviors to look for. Same with sleeping in or not sleeping, same with the over amount of fatigue with depression. So those are some of the signs to look for and some of the behaviors. And then-

Alisa Grace: Can I ask you this, Chris? I mean, this is so interesting because your background is, you have your PhD in psychology, your specialty area is social psychology, but you also have training in mental health first aid. Here at the university, you were vice president of student development, dealt a whole lot with students that were in mental health crises. So you have a wide background in this. Can you talk a little bit about whether these things, are they situational, caused by temporary circumstances that might happen? Are they more biological in nature? Like biochemical?

Chris Grace: Sure.

Alisa Grace: Will you talk a little bit about that? Anxiety, depression, does it suddenly occur in somebody and pop up or is it something they've lived with all their lives? And they're just now determining that that's an issue?

Chris Grace: Yeah. Well, all the answers are right. You struggle with stress and a person maybe handles it well at one point in one time of life, but stress clearly can overwhelm us. So that's what we call situational, things that are kind of in our control. You might have a bad job, you might be in a bad relationship, you might not have any money, you might be dealing with family issues and that's all causing stress, but stress does have the ability to be navigated and managed. But one of the symptoms, well better yet, causes of something like a mental health struggle is every day stressors and major stressors.

Alisa Grace: Trauma.

Chris Grace: Just trying to deal with the pressures of life, let's say.

Alisa Grace: Oh.

Chris Grace: The other one though, besides pressures of life, that we oftentimes look at is that there's clearly genetics involved. Now how much you can attribute to Grandma Ruth back in the day, or crazy Uncle Herald who always was struggling with addictions, whatever? I mean, genetics is a piece, much more in some than in others. So schizophrenia, probably a stronger genetic link. Manic depression is a pretty good genetic link, that is, if you have both parents, your odds increase to a certain level. Twin studies have shown us that, that oftentimes when you have an identical twin who struggles with schizophrenia, you have a 50% likelihood yourself. So what does that mean? Well, it means that certain strong disorders, probably more linkable to genetics. Something like anxiety and depression could be fairly high, that is, you have a greater likelihood, 15 to 20% likelihood, if one of your parents is struggling with this. But even if both parents have depression or anxiety, it doesn't mean you will. So that means it's not fully genetic. In fact, they're still trying to figure this out.

So I think Lis, that's the two issues that are best ... But also interestingly enough, there's a third and actually a fourth. Some people look at where you live, like higher latitudes. In the northern hemisphere, deal with more depression than people in the southern latitudes where they get more sun and that's been found. But it just-

Alisa Grace: What do they call that? Affective disorder?

Chris Grace: Yeah. It's seasonal affective, SAD. But seasonal affective is different than where you live. You know what I mean, the northern hemisphere. But it does say that when weather gets cloudy and cold, it can have an effect that's right.

The other though is, the way you think. Okay, the same thing can happen to you that happens to me, and you don't respond as strongly with anxiety, let's say, in a certain situation. Well, it's the same event, same situation. Let's say you're identical twin, but one of you is thinking differently, has a different mental worldview about this and says, oh, you know, I will process it this way. People that struggle with certain disorders, they focus too much on things like their own, it's kind of self-defeating, thoughts. They focus on their mistakes a lot. They maybe compare themselves to other people very unfavorably. And then they reject compliments. And then they don't correctly evaluate how good they're. So, you could have the same things happening, but one person thinks slightly differently and that doesn't cause as much of a problem. So those are some of the, what we would say, ways in which we can explain this.

Alisa Grace: What about from a biochemical perspective?

Chris Grace: Yeah. That's the whole idea of genetics, is underneath that, is this idea of, oh, you're being exposed to a certain amount of chemical in the brain. So for example, increased amounts of, or decreased amounts of dopamine, this circuit, or epinephrine or norepinephrine and anxiety. All of these biochemicals that go through our bodies do seem to get a little bit out of whack. And so now we can go in, you can't really do a great blood test for this, it's a little bit harder. But we do see associations between certain struggles, depression and anxiety, and increased or decreased amounts of certain chemicals. The quickest answer, easiest one is this, if you have anxiety, you don't have enough, probably, at some level in your brain, of something called GABA, gamma-aminobutyric acid. It's just, what we call an inhibitory neurotransmitter. All is that means is-

Alisa Grace: That's fancy talk there.

Chris Grace: Yeah. That's right. Yes. Catch me afterwards. But, GABA, it stops your brain from going off and just going bam, bam, bam. I'm worried. Worried. Scared. Nervous. Scared. Scared. GABA says slow down. It's okay. Don't worry. And we all have GABA. Slow down. Don't worry. It's okay. Well, for someone with anxiety, they don't have enough. So guess what? We give them. If they go into a doctor and you say, you're anxious, the first thing he or she's going to prescribe to you is probably GABA. Some sort of drug or medication that increases the biochemical in you, that's a inhibitory, it slows down thinking. Which slows down your heart, slows down your runaway thoughts. And that makes people with anxiety better able to function.

Alisa Grace: That's so interesting. It's almost like a car that isn't functioning properly because it's low on oil. And so to look at it from that perspective of, it doesn't mean that you're weak or that you're defective in any way. It just might mean that from a biological perspective, your body's just not producing enough of a certain chemical and this medication will do it. I have two questions that I want to ask you, then. I love talking about this. So interesting. First of all, I'd like for you to address the perspective of medication, because I know sometimes a lot of people are really hesitant to get on medication because they're worried about it being addictive. So could you speak to that? And then I have another question that I want to ask you about that, but can you talk about that for a sec?

Chris Grace: Yeah. Biomedical therapies, treatment, gosh, there's all kinds of words for this, psychopharmacology or psychopharmacotherapy, or just plain old drug therapy. Listen, I don't have any problems whatsoever with today's anti-anxieties, antidepressants and antipsychotics being prescribed by the vast majority of all, either general practitioners or psychiatrists. Your general practitioner can pretty much prescribe, and will, on anti-anxiety or antidepressant. And I wouldn't say they're 100% harmless, but they are so well regulated. If you take something, let's say it's something like Xanax for anti-anxiety or something like Prozac or Zoloft, you know, the gold standard, I guess, in antidepressants, they have these things down to where they're not going to cause you to get addicted. They don't cause you to become dependent on them. They don't make you into a zombie. They don't all of a sudden take a depressed person and make them extremely excitable and happy. And you know, everything is great. They don't take somebody who's anxious and all of a sudden make them this zombie.

These drugs, in the amounts given, as regulated, you take them according to prescription, they're going to start in a couple of days, maybe in a week or two, to start alleviating the vast majority of anxiety and depression symptoms. Now, they don't work for everybody. And there's a small segment of people that it doesn't work for. However, I get this question all the time, well, what about Christians who fear, that they just want to rely on God, that maybe they're not praying enough. I would say yeah, pray, gratitude and thanksgiving. But lift up the doctors, thank God for his common grace, which allows these doctors to find the certain medications and dedicate their lives to helping people with depression.

Many of these doctors go in there who are researching this because of personal experiences and they want to help. And so they come up with this cool little, you know, it's just GABA. It's like adding oil, you already have oil. It just adds a little bit more oil. GABA is oil in your car. You're just adding a little bit more oil because you're a quart short. And so to be at quart short is to start feeling like I'm just kind of unable to regulate my fear, and so we give you GABA, it slows it down. You don't become dependent on it. It's like a car. Would a car get drunk on oil? No. Would it get dependent on oil? No, it's already dependent on, you're already dependent on GABA.

Alisa Grace: That's great point.

Chris Grace: You just simply have not enough. So I always recommend, man, for parents or students, listen, this is so ... And besides, it's very easy to step off if it doesn't work for you. Some of the side effects, maybe sleepiness or, maybe eating too much or maybe your mouth is dry. All of those things can be helped by just simply working with the professional. By the way they prescribe these things, I think properly, in a vast majority of people, in the proper way that protects them.

Alisa Grace: Yeah. Well, and you just, in the process of answering that, you also answered my other question, which was the role that our faith plays in this. I know that there's a branch of Christianity that would say psychology is kind of of the devil. I mean, that would be the extreme, but there would definitely be a branch that would say, if you're turning to a psychologist or a therapist or medication, it's a sign you're not trusting God enough and you just need to pray more about it. And if you're still struggling with depression or anxiety, that just means you're not spiritual enough. You just need to pray, you need to trust God more. What would you say to them?

Chris Grace: Well, yeah. I mean-

Alisa Grace: As a believer and as a psychologist, a believing psychologist, what would you say? Evangelical believer.

Chris Grace: So let's say this, I think in general, any person I would say, yeah, you're probably right. You probably do need to have more trust and more faith and more prayer, but I'd say that to everybody. Everybody in life that walks with Jesus needs to pray more, probably, have more trust in general and to recognize God's special and common grace in our lives. His special grace where he heals dramatically or transforms us, but also his common grace where we get the help we need. Guys go in there and they dedicate their whole lives to helping people who have broken a bone and they set that bone so that you can walk properly. And it's the same thing that happens with people who have a decrease in the amount of a particular neurotransmitter or behaviors that are not doing well.

And do you pray for the doctor? I hope so. Do you have faith that this doctor's going to set your leg? Well, I hope so. If you see a doctor that you don't trust, because they have, I don't know, bad hygienic habits and you just don't like the way their operating room looks and you run away. Yeah, there are people like that, then go someplace else. Does that mean you don't trust God to go in and get your leg set? No, you trust him so much that you're willing to go and say, Lord, give me the help I need. And he says, I've provided that it's right here. But Lord I'm depressed. I'm anxious.

Well, it's like the guy on top of the roof, the house is flooding, so he climbs up on the roof and a guy comes by and he says, God, help me. You know, he's praying to God. So a guy comes by and says, hey, I got a raft. Come on. He goes, no, I'm waiting for God to rescue me. And then a guy comes by in a nice outboard motor. And he says, come on, guy's help, I got you. No, I'm waiting for God to help me. And a guy comes paddling by on a thing. He goes, come on, get on board. I can save you. And he goes, nope, I'm waiting for God. Water rises. And he dies. And he goes to heaven and says, what happened? He goes, man, God, I thought I prayed to you, and that you'd helped me. He goes, I did. I sent you a paddle boarder. I sent you a raft, and sent you an outboard motor guy. And he goes, that's my job. He has sent us antidepressants. And has sent us therapists and he has sent us counselors and anti-anxiety medications.

Alisa Grace: I love that. All truth is God's truth.

Chris Grace: Yeah. I think that's right. So well, this is good stuff.

Alisa Grace: Well, we'll wrap up. Yeah, this is really great. This kind of sets the table of where we're going in the next couple of episodes. We're going to dive a little bit deeper and we're going to look at how these mental disorders can affect our relationships. And two that we're going to specifically unpack is what do you do if you're a parent and you suspect that your child may be struggling with a mental disorder? How do you tell the difference? And then we're also going to talk about how it impacts us relationally in our marriage. When you have a spouse or partner or a close loved one that is struggling with that, what can you do to come alongside?

So we hope that you'll stick with us through these next couple of episodes. We are so glad that you're with us today. And we want to be sure and have you check out our website, as we close, at cmr.biola.edu and check us out there. We are part of Biola University and we're so glad you joined us today. We'll see you next time.

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