Prozac vs. Prayer:
Depression: A Silent Killer Stalks the African American Faith Community
By Derek H. Suite, M.D., M.S.

Having treated hundreds of individuals and families struggling with depression in my faith-based psychiatric practice, I have come to the realization that there is no such thing as Prozac versus prayer when one is on the verge of a nervous breakdown, or suicide. Just as there is no such thing as sublingual nitroglycerin tablets versus prayer when one is faced with an impending cardiac arrest--heart attack. A better question is life versus death—choose. Most of us will choose life and do what we can to have sound minds and bodies. For Christians-- and many non Christians --facing the frightening chest pain of cardiac arrest, prayer medication, and in some instances, electric shock therapy are considered totally acceptable life-saving treatments. But for those facing the pain of major depression and other serious mental health issues, medication or shock therapy, the God-given life savers in the treatment of heart disease, suddenly become demonic substitutes for prayer, which is seen as the only acceptable form of treatment. In my practice, I spend as much time on mental health education as on actual treatment, especially with Christian men who seem to feel such shame in seeking professional help. Much of the success Full Circle Health has enjoyed has come about as a result of the liberation Christians feel once they deepen their understanding and see the value of a wholistic approach to the treatment of depression,- which is a medical and mental spiritual problem. What most do not immediately realize is just how powerful and deadly clinical depression can be. As silent as hypertension and diabetes and equally as devastating as cancer and AIDS, clinical depression is a bona fide killer. A killer that devastates lives and destroys families at will because it usually goes unrecognized; or its power is grossly underestimated. Untreated or under- treated depression is now the leading cause of disability ahead of all other diseases; and will be the second largest killer after heart disease by 2020, according to the World Health Organization. A recent study showed that 54 per cent of people polled perceived depression as a personal weakness and not as a medical condition.

This perception is unfortunate because it stops people from seeking help-- especially in the Christian community where depression moves beyond boundaries of personal weakness into the realm of sin. In addition to carrying the biological, psychological and spiritual burden of this condition depressed Christian men carry a heavy social burden--the additional stigma, guilt and shame associated with the perception that they are either not “strong enough” or “blessed enough” to be delivered. As a result, many men and women suffer tremendous anxiety and internal conflict around seeking and receiving professional help. Rather than risk the pain and shame associated with letting their church know they are receiving mental health treatment, they choose to suffer silently instead.

And silence in the African American community is a well known killer. Like Hypertension and Diabetes, Depression also works quietly, invisibly eroding its victim’s physical, psychological, emotional, social and spiritual aspects of the self. And depression rarely works alone; the medical community is well aware that untreated depression has been linked to the development of major medical known conditions including heart disease, infectious diseases, alcohol and substance abuse.

Suicide is of course the worst possible outcome of depression and remains a taboo subject within many African American circles. Few African Americans are aware that suicide rate for all African-Americans doubled between 1980 and 1996, according to the Center for Disease Control. Males typically have a higher rate of suicide than females. Between 1980 and 1995, the suicide rate of black males doubled to about eight deaths per 100,000 people. Among people of all backgrounds, approximately 5 males kill themselves to every female who commits suicide. But more females, of all backgrounds, try to kill themselves; there are three female suicide attempts for every male attempt. Men are generally more successful because they use lethal means of killing themselves such as guns and hanging. Suicide, is the third leading cause of death in young people ages 15 to 24, with recent studies showing significant increases in the suicide rates of African American teenagers.

In light of these sobering statistics, it has become critical that African American men see the invisible but real link between the physical mental, emotional and spiritual. An invisible link pattern might look like this: several bad days on the job, or at home lead to depressed moods, stress and anxiety, which may lead to increased blood pressure, difficulty sleeping, fatigue, irritability, loss of concentration, lack of motivation, nagging body aches and increased colds and flu like symptoms because of decreased functioning of the immune system.. To take the edge off or escape from a myriad of problems, some men take to smoking, drinking, drugs, poor eating habits or reckless behaviors, which may temporarily relieve symptoms but ultimately create further illness, stress and anxiety; and so the cycle continues until he becomes noticeably ill with a “more acceptable” physical illness such as a heart attack or stroke ( for some this is more tangible than depression). Rarely is the premorbid mental health functioning of a person who suffers from a heart attack or stroke ever considered a strongly as say lowering cholesterol or getting more exercise. Yet it has been shown that post- heart attack victims tend to have additional heart attacks and die earlier without treatment for depression.

On some level we are all aware of the importance of mental health and how it affects our ability to heal. Why else would we give flowers, gifts, and cards to someone who has been hospitalized for the treatment of a biological condition? Why do we set up ministries to visit and pray for those who are “sick” and “shut in?” Because we are perhaps unconsciously aware of the interconnectedness of the mind, body and spirit and appreciate the power of the invisible (prayer, love, faith) to affect the visible (heart, lungs, brain,) and non visible (mood, pain).

Most Christians, and many religious/spiritual belief systems, agree that we wrestle not against flesh and blood, that which we can see, touch, and feel, but against invisible powers and principalities that can affect us. If this is true then it can be easily argued that invisible things can certainly affect the biological, emotional, and social functioning of visible things. Such a perspective helps many of the Christians I treat understand that Depression, like Diabetes, is invisible and able to transmit visible consequences to its victims. Both conditions can be effectively treated with a combination of invisible (prayer/intercession) and/or visible (medication/therapy) weapons, lest we allow African American families to continue to perish because of a lack of understanding.

The trend of depressed younger people, particularly in communities-of- color, committing suicide or engaging in life threatening behaviors is alarming. Faith- based counselors, teachers, parents and others on the front lines working with the youth community would do well to know some of the basic risk factors for suicide in the youth (and the adult) community. Some of these risk factors include:

• History of depression or mental illness
• History of alcohol or substance abuse
• Family history of suicide, domestic violence or child abuse
• Physical illness
• Easy access to firearms
• Afraid to seek treatment because of cultural and religious beliefs
• Impulsive/Aggressive tendencies
• Isolative behaviors
• Complete loss of faith or hope in God.

In spite of the recent advances in the treatment of depression, current research findings and vital information rarely reach those communities that may benefit most. Some churches have helped put a stop to this trend by forming partnerships with trusted, faith-based medical and mental health agencies. Full Circe Health has been blessed to have formed relationships with over 500 local churches to train and supervise ministers and counselors; and, when needed, provide professional Christ-centered counseling services for those requiring professional, faith-based assistance in the fight against depression and suicide. These collaborative efforts have dramatically lowered the rates of depression and mental health disorders in many communities.

Christ-centered mental health professionals who can provide training and counseling and medical treatment can be of immense help to churches.

Pastors are often grateful to find professional help for their flocks that in no way invalidates or diminishes the healing power of God—who has put the power to choose life and death before each individual.

Choosing life is often followed by a number of action steps taken with faith: from wearing glasses, to changing a diet, to exercising more frequently, to undergoing a surgical procedure, to taking medications such as prilosec, prevacid, or prozac-- in addition to the undeniable power of daily prayer.

So if you are reading this today and know in your heart that you or a loved one could use some professional help, choose life now. If you are thinking about suicide: STOP now and get into contact with us or someone you trust or know will try to help you. God answers prayers in many ways. Give up the fear; make the call and see for yourself that the life you love is just ahead.

Psychiatrist, Derek H. Suite, M.D is the founder and president of Full Circle Health and the Full Circle Life Enrichment Center turer, This article is an excerpt from an upcoming book: Black Men’s Health: Why We Die So Young