Helping Your Teen

Bob: Do people, who have been diagnosed with bipolar disorder, need medication, or counseling, or both?  Here is physician, Dr. Charles Hodges.

Charles: I think that Bipolar Disorder I is a disease. Someday, when we get smart enough and technically capable enough, we’ll define the pathology that goes along with Bipolar Disorder I. But I can tell you that for Bipolar Disorder I—yes; individuals who have had episodes of mania and bought 12 dozen gross of eggs—they are going to need counseling because, somehow or another, they are going to need some tools that enable them to work their way back into the home. They’ll benefit greatly from what the counsel of Scripture would give them—helping them get back into a normal run of life after they are no longer manic.

Bob: This is FamilyLife Today for Wednesday, May 24^th. Our host is the President of FamilyLife^®, Dennis Rainey, and I’m Bob Lepine. We’ll talk today with Dr. Charles Hodges about how we ought to respond to people who are showing symptoms of manic depression.

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Stay with us.

And welcome to FamilyLife Today. Thanks for joining us on the Wednesday edition. You and I have both spent time with a lot of families who have had children or spouses whose behavior has become so confusing / so erratic that the parents are at a loss—they don’t know what to do. They feel like a failure, and they don’t know where to turn.

Dennis: And they are looking for some kind of diagnosis, or something to blame, or to explain what is taking place.

Bob: And something to fix it pretty quick too.

Dennis: Oh, no doubt about that. And we have a physician with us who is kind of bringing more of a balanced approach and helping us think through issues like this. Dr. Charles Hodges joins us again on FamilyLife Today. Charlie, welcome back.

Charles: It’s good to be here.

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Dennis: As I mentioned earlier, Charlie is a family physician—how many years? 

Charles: Thirty-eight.

Dennis: Yes; a lot of experience. And frankly, I have to just say, on behalf of your profession, I think some of the wisest people in our medical community really have come out of the family physician sector. After they’ve gotten three decades—when they step out of medicine—we are losing so much wisdom, and history, and knowledge that you are not going to be able to even look up online.

Charles: Well, then, probably there are going to be a lot of them retire here shortly—that’s for sure.

Dennis: No doubt about it. He’s been married since 1971 to his wife Helen. He has written a book called Good Mood, Bad Mood. We’ve been talking about depression and bipolar disorder. You’ve been throwing around a phrase that is called DSM. What does that stand for? 

Charles: That’s the Diagnostic Statistic Manual of Mental Disorders.

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It first appeared in 1950. It’s been revised, now, five times. In it is the list of disorders, or diseases, or syndromes that are recognized by the psychiatric community and the medical community as illnesses that need to be treated. I think the key to understanding the DSM is to realize that they are labels which are voted on by a committee—that’s the first thing they need to know. And then, the other is that, for almost all of them, none of them have underlying pathologic definition.

Now, when I say that, we do not understand what the problem is, at the cell level, when someone says they are depressed—we can’t describe that. Now, there are people who say it’s a chemical imbalance; but unfortunately, in the 50 years that the chemical imbalance theory has been around, no one has ever been able to demonstrate exactly what it is or why it happens. As a result, much of the same thing could be said about the rest of the diagnoses in the DSM.

Dennis: And that’s what I wanted to ask you—

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—Bob was talking about teenagers and spouses who perhaps have the other spouse suffering from some kind of mental disorder. It seems to me, we’ve developed so many categories for all kinds of issues that there is a new syndrome coming on the scene—it seems like—about every month. Is that true? 

Charles: Truth of the matter is that the number of things that are supposed to be diagnosed are set by this committee, and it’ll probably remain the same for years. The difference is when those ailments become popular—I guess would be one way to put it—you know, somebody decides to make more diagnoses of it. That could be said for depression. It could certainly be said for ADHD, and it can be said for bipolar disorder.

Bob: So, if somebody has a teenage son or a teenage daughter and the behavior has become very erratic—the son or the daughter is being violent to pets in the neighborhood—

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—you’re scared that the child is going to be violent to a brother or a sister. They won’t come out of their room one day; and the next day, they are just bouncing all over the place. As a parent, where do you go?  How do you get help?  How do you figure out what’s going on inside of your son or your daughter’s life? 

Charles: Well, I would say the first place to go is to the family doctor or the family pediatrician. People, who are acting abnormally, need a good physical exam—they need laboratory work. After that, a lot of good historical information needs to be gathered by the doctor.

A lot of issues play into that kind of scenario that you’ve just described—children watching television four to seven hours a day / children playing violent, computer games for equal amounts of time / unfortunately, children being medicated for educational problems. The truth is that a considerable number of the adverse events that we’ve seen in the last ten years, with regard to violence in classrooms, have been associated with children who have been medicated for educational problems.

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Generally speaking, they are taking multiple medications. Those medications do alter behavior and also the way that they think.

Bob: Now, that’s interesting because somebody would hear that and they’d say, “Well, yes; it’s no wonder that those kids are the ones who acted violent because we had already identified that there was a problem; and we had them on medication.”  You’re saying maybe the medication is contributing to the violence? 

Charles: That would be my opinion. I don’t know that that’s going to be widely held by everybody; but I look at the kinds of behaviors and the side effects that are listed for SSRI, the [Selective] Serotonin Reuptake Inhibitor-type antidepressants that we’re using currently—when I see them used in children, along with amphetamines, which is what the drug is that we use for ADHD—

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—whenever we start seeing abnormal behavior in that group of children, my concern are the side effects of both the antidepressant and the amphetamine. Amphetamines are widely-known to cause erratic behavior.

Bob: So, back to the visit to the family doctor—with the teenage son, who has been acting violently or aggressively—the doctor runs the lab work, and takes the history, and says, “I don’t see anything in the lab work that indicates there is anything going on here.”  And then, the doctor is likely to say—isn’t he?—“I think, maybe, a prescription of an anti-anxiety medication or antidepressant would help your son even out a little bit.” 

Charles: Really depends on the age. If it’s a teenager, most family physicians are probably going to defer that to a psychiatrist—and rightly so—because the medicines that are available to use for things like this in teenagers carry with it significant side effects. I don’t think most doctors would do that.

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Myself, I would look at the situation and say, “Well, you know, it’s time to talk to somebody in counseling—who can look over the child’s life, look over the arrangement of how the home is working, look where the child is spending his time—and try to take an inventory of that / see if it’s contributing to the problem.” 

Dennis: You rattled off a number of activities that teenagers might engage in that might cause ultimate—some kind of distortion of behavior. What about adults?  Have you seen a correlation between physical issues taking place in them, or perhaps, something similar to what’s taking place in teenagers? 

Charles: Things that are not good for children are generally not good for adults. So, spending multiple hours sitting down, watching television / multiple hours playing computer games is no better for adults than it is for children. And the side effects for the antidepressants and for amphetamines that are used to treat people, who are now labeled with adult ADHD, carry with it the same kind of side effect problems as they do in kids.

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Dennis: —such as? 

Charles: Side effects for amphetamines that are a problem are: anxiety, psychosis is observed, abusive behavior.

I can remember counseling with a family. The occasion for them bringing the child in was that he popped his mother a good one—slugged her. And he was taking three medications for attention problems—he was on an amphetamine; he was on antidepressant; then, he was on Risperdal^®.

What I did was—counsel with the family—the family rearranged in a way that was beneficial to the child / got the school involved and tried to rearrange school in a way that was beneficial to the child. Then, as soon as school was out, I sent the parents and the child back to the pediatrician, who prescribed the medication, and said, “Why don’t we see if this kid could do well on a vacation?”  The pediatrician wasn’t really interested in doing that, but did it anyway.

What we found out was—the child quit taking the medicine—he had a personality.

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Really didn’t have much of a personality when he showed up, initially, in counseling; but once he was off all the medication, he did much better. Then, you start balancing off the benefits against the side effects, particularly for this child. Aggressive/assaultive behavior is a bad side effect, and it’s been known for people who use any kind of stimulant amphetamine drug.

Dennis: So, it seems to me, Charlie, that there are so many voices today that move to the drugs to solve the problem. Parents are set up—it’s back to what Bob said at the beginning—they want something to address the issue to fix it. They’re set up to kind of go with what the authority says is the problem. How can parents really know what’s going on so they don’t develop some kind of potion of drugs that is going to set their child up to fail? 

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Charles: You know, I think they need to have a physician that they trust and a physician that is not intent on treating every child who comes to the office with medication for learning problems or behavior problems. I think that’s an important thing. That requires you to develop some trust and time with the physician that you see. That’s, I think, the place to start.

Bob: You know, one issue we have not touched on yet—and I want to give a little disclaimer before I even ask you the question or bring this up. We’ve not touched on the root cause of all human behavior, and that is sin. Here is the disclaimer: “We’re not trying to say that your problem is you’re making volitional choices that are causing you to act this way. We’re not saying it’s all in your head. We’re not saying you’re a bad person if you’re depressed. We’re not saying you’re a bad person if you’ve got a bipolar issue.”

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I just remember, with my dad—and I shared a little bit about my dad earlier this week—I remember thinking: “I’m glad he’s on meds. I wish somebody was helping him with the spiritual issues in his life.”  And this is where I think both the medical and the spiritual community need to find a way to work side by side.

Charles: I agree with that, absolutely. I think the important thing about bipolar disorder, particularly with your father—and one thing I want to say so that somebody will hear it is that—people who have Bipolar Disorder I / what I would have called the old manic depression and who have had more than one episode of mania—they really do need to take their medicine. And they shouldn’t take anything I’ve said today to indicate to them that they should stop it. They really do need to take it.

I think that Bipolar Disorder I is a disease. I think there will someday, when we get smart enough—that’s the problem—when we get smart enough and technically capable enough—we’ll define the pathology that goes along with Bipolar Disorder I.

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I can tell you that individuals who have episodes of mania and bought 12 dozen gross of eggs—they are going to need counseling because, somehow or another, they are going to need some tools that enable them to work their way back into the home. They’ll benefit greatly from what the counsel of Scripture would give them as far as helping them get back into a normal run of life after they are no longer manic.

Bob: Yes; I’ve said to a lot of people, “Take your meds; but don’t think that, because you’re taking the med, you’ve solved the problem.” 

Charles: No; and I talk about a young lady in my book—her name was Eve. She is probably a really good example for depression and what you would do with a young person who is depressed. She had suffered a major medical event that could have killed her but didn’t. She recovered quite well—was in the hospital for about a week. Then, at the time of discharge, the doctor told her that: “Yes, you are all well.

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“You can go back to doing what you are doing. But you should understand this—what happened to you could happen again. If it does, it could kill you.” She suffered more from that than she did from all of the problems that were associated with the original illness. In fact, she became very sad.

Bob: You’re saying the anxiety that she was under, thinking, “I might die the next episode,” was worse than what she’d been going through? 

Charles: Absolutely; it caused her more trouble. She had more problems in life as a result of what she thought about what had happened to her as opposed to actually what happened to her. She was in school at a major university. She quit going to classes, quit taking care of personal hygiene matters, wouldn’t clean her room, [and] didn’t eat. She was a Christian, and she stopped going to church.

That’s always interesting to me—that the first three things that people do, when they get in trouble in life—a lot of times is they quit going to church, quit reading their Bible, and they quit praying. It’s like watching the man on fire running away from the lake—

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—she was in that kind of situation. She was drinking regularly—and had never been much of a drinker in her life and was spending a lot of her time being drunk. And I think for her—you know, she thought that: “If this was all that God was going to do for me, then, I might as well get drunk.”  I think that was part of her process of thinking.

After a while, though, she realized that, if she kept doing what she was doing, that she wouldn’t live very long. And so, she quit drinking; and she showed up for counseling. That was a question she wanted to know: “Do I have another disease?  Do I have depression?”  I listened to her for a while and I decided, “No; you don’t have a disease.” We never did talk about depression again, but what we really did talk about was the way she was viewing the adverse event that had happened in her life.

I always start out with folks, who are struggling—you know, after they’ve been struggling for a while and their life is a wreck—the first thing that I take them to is

2 Corinthians 5:9, where it says, “Therefore, also, we have as our ambition whether at home or absent to be pleasing to Him.” Then, I make them memorize this sentence: “I want to glorify God with my life more than I want to breathe,”—

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—“I want to glorify God with my life more than I want to be…”—for her, “…healthy,” / “I want to glorify God with my life more than I can be safe.” 

Then, I take them to Matthew 22 and point out that: “If you really want to glorify God with your life, you need to be willing to say what Christ said,”—you know—“that you have to love the Lord your God with all your heart, and all your soul, and all your mind; then, love your neighbor as yourself.” Then, from there, we go to John 14, where it says, “He who has My commandments and keeps them, he’s the one who loves Me.” 

Then, we start going through their life, piece by piece: “What are you doing now that you weren’t doing before?  What are you not doing now that you should be?”  And that’s what we did with the young lady.

The other thing that I included was John 13:17—it’s a familiar chapter—it’s the washing dirty feet chapter. I pointed out to her that Christians are happiest when they are acting like their Savior, and their Savior was acting like a servant. You know, when He’s done washing all their feet, what does He do? He stands up and says: “What have I done? 

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“You call Me your Lord and your Master, and you are right; because I am. I washed your feet. You ought to wash one another’s feet.”  Then, He says, “Happy are you now that you know these things, if you do them.”  It’s a thread—just boom!—connects everything.

So, part of the assignment becomes Christian service—two hours a week going into a nursing home and doing something for the little old lady, et cetera, so on and so forth. I always tell them, though: “It can’t be for a relative. They can’t pay you anything / you can’t take anything from them—they have to be worse off than you are.” 

Dennis: The thing I hear you doing is pointing the other person outward—

Bob: Yes.

Charles: Oh, yes! 

Dennis: —to give your life and pour your life out on behalf of others. I also hear one other thing—and you say this in your book—that hope is an active ingredient in medicine.

Charles: Oh, absolutely.

Dennis: It sounds like it’s also an active ingredient in counseling.

Charles: Yes; absolutely. There was a really good study that looked at the difference between people, who were treated medically for depression—

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—who either believed in a God who cared about them versus people who didn’t. What they found was that the people who believed in a God who cared about them—not just believed in God / not just believed in some great force—but they believed in a God who actually cared about them—they were 75 percent more likely to get better than the people who didn’t.

Another study that was published in JAMA Psychiatry looked at people in two groups, all of whom had a family history of depression. What they found was that, among those who took religion seriously, it reduced your likelihood of being depressed as a descendant of someone who was depressed by 90 percent. They could look at your brain with an MRI, and it was different than the folks who didn’t take religion seriously.

Bob: Now, this is from the Journal of the American Medical Association Psychiatry.

Charles: Yes.

Bob: This is not from a pastor who is suggesting this.

Charles: No; no.

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Bob: So, it’s a scientific journal that is reporting on the effect of believing in God and taking your religion seriously.

Charles: Seriously.

Bob: Wow! 

Dennis: I’m fascinated that they would even allow that kind of statistic to get out, truthfully. [Laughter] 

Charles: There are a lot of good people in medicine; and mostly, what they are interested in is the truth. We’ve seen this over and over again. In the early 1980s, Barry Marshall and Robin Warren were looking for the pathology with regard to peptic ulcer disease. The current belief, at the time, was that stress caused ulcers: “It’s not what you’re eating. It’s what’s eating you.” 

But Marshall—he just didn’t buy into it. He was actually doing biopsies of stomach wall. One day, he saw helicobacter in the biopsies. He immediately decided that peptic ulcer disease was probably due to infectious disease and not due to stress. It was amazing the amount of abuse he took from the medical community for a decade before, finally, somebody said: “He’s right. Give him the Nobel Prize.” 

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And he said, “Everybody was against me, but I knew I was right!”  [Laughter] You know, that was—you know the bottom line was he had the pathology.

And I think that’s, at times, that’s where medicine heads. You look at the way we’ve treated depression for the last 50 years, and it’s run its course. Now, we’re looking for better answers. I think that’s a good thing.

Dennis: Well, I want all of our listeners to, as they check out of the doctor’s office today, go by the front desk, here at FamilyLife, pay your bill and make sure you get a copy of Good Mood, Bad Mood. [Laughter] I do feel like we’ve been to a doctor’s office here. We’ve just received some very healthy advice about how to properly love those who may struggle with a true mood disorder.

Charlie—thanks for being on the broadcast. Come back our way again after you’ve done your next bit of research. Will you do that? 

Charles: I’ll be happy to.

Bob: We do have copies, of course, of your book in our FamilyLife Today Resource Center.

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We’re hoping many of our listeners will get a copy, especially if you know somebody who is struggling with this—maybe someone in your family / maybe there’s a co-worker or someone close to you where this is an issue—get a copy of Dr. Charles Hodges’ book, Good Mood, Bad Mood. You can order it, online, at FamilyLifeToday.com; or you can call 1-800-FL-TODAY to order. Again, the website is FamilyLifeToday.com; or you can call 1-800-“F” as in family, “L” as in life, and then the word, “TODAY.” 

I heard recently from some friends of mine who are making summer plans. Included in their plans is a Passport2Identity™ weekend that the father and the son are getting ready to go off on. They have already been through Passport2Purity^®, the resource that we created for moms and dads to go through with their preteens. Now, they’re getting ready for their second adventure.

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Now that the son is 14 years old, they’re going to do a Passport2Identity weekend.

It got me thinking about the resources that we create, here, at FamilyLife. Our goal with these resources is to put tools in the hands of couples / in the hands of moms and dads that can help you strengthen your marriage and your family. It’s all part of our mission, which is to effectively develop godly marriages and families. We believe godly marriages and families can be the difference-maker in this culture. We believe that they can change the world, one home at a time.

We’re grateful for those of you who have been long-time supporters of this ministry. Some of you are Legacy Partners—you give each month in support of this ministry. Some of you will make an occasional gift when you are prompted in some way. And of course, we’re hoping that maybe many of you will be prompted this month.

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We set a goal, back at the beginning of May, to try to raise $1.1 million during this month to provide funding necessary for some projects we’re working on during summer months. We want to have funds in place so that there is no slowdown in these projects.

There is still a way to go. In fact, you can go online to see just how close we are to the $1.1 million goal for the month of May. We’d also ask you to go online and go to FamilyLifeToday.com to make a donation—whatever amount you can afford. If you’ve never given to FamilyLife, this would be a great first donation to make. Again, whatever you can afford, give, online, at FamilyLifeToday.com; or call 1-800-FL-TODAY to give; or you can mail your donation to FamilyLife Today at PO Box 7111, Little Rock, AR; our zip code is 72223.

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Now, tomorrow, we want you to meet a guy who—well his goal is to build homes for wounded war veterans—homes that he can give away to them for free. We’ll hear how he got the vision for this, and we’ll hear about the number of homes he’s built already when you meet him tomorrow. I hope you can be here for that.

I want to thank our engineer today, Keith Lynch, along with our entire broadcast production team. On behalf of our host, Dennis Rainey, I’m Bob Lepine. We will see you back next time for another edition of FamilyLife Today.

FamilyLife Today is a production of FamilyLife of Little Rock, Arkansas; a Cru^® ministry.

Help for today. Hope for tomorrow.

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