Descriptions and Prescriptions: A Biblical Perspective on Psychiatric Diagnoses and Medications

Helping the Helpers

by Michael R. Emlet

OCD, ADHD, PTSD, Bipolar Disorder . . . these are not just diagnoses from the DSM; they are part of our everyday vocabulary and understanding of people. As Christians, how should we think about psychiatric diagnoses and their associated treatments? We can t afford to isolate ourselves and simply dismiss these categories as unbiblical. Nor can we afford to accept the entire secular psychiatric diagnostic and treatment enterprise at face value as though Scripture is irrelevant for these complex struggles. Instead, we need a balanced, biblically (and scientifically!) informed approach that is neither too warmly embracing nor too coldly dismissive of psychiatric labels and the psychiatric medications that are often prescribed. Biblical counselor and retired physician, Michael R. Emlet, gives readers a helpful way forward on these important issues as he guides lay and professional helpers in the church through the thicket of mental health diagnoses and treatments in a clear, thoughtful primer in which the Bible informs our understanding of psychiatric diagnoses and the medications that are often recommended based on those labels. This first book in the Helping the Helper series will give readers biblical, gospel-formed categories that will help them understand and minister to those who are struggling with mental health issues.

Genres: Counselling, Christian, Psychology, Nonfiction, Science, Theology, Mental Health

112 pages, Paperback

First published September 1, 2017

About the author

Michael R. Emlet, M.Div., M.D., practiced as a family physician for twelve years before becoming a counselor and faculty member at the Christian Counseling & Educational Foundation (CCEF).

Reviews

[Shannon · Rating 4 out of 5]

I was initially hesitant to read and review this book. I am both a Christian and someone who has multiple mental illnesses. I wasn't sure which way this was going to go, as some Christian's opinions about mental illness are not particularly helpful for those who suffer from those illnesses. This book is broken down into two sections; Understanding Psychiatric Diagnoses and Understanding Psychoactive Medications. Then the sections are further broken down into smaller chapters. The first sections discusses how mental illnesses are diagnosed, a brief history of things like the DSM and how these diagnoses impact ministry. There were two quotes from the author in this section that I really liked; "If a Christian has no problem using Tylenol for a headache, why wouldn't she use an anti-depressant when she is depressed?" and "Even with clear cut medical problems we don't say, "I am diabetes" or "I am cancer". Why would we say, " I am bipolar" or "I am ADHD", as though this is the sum total of our person-hood?" I agree very much with both of these statements and I am happy that the author included them.

The second section of this book discusses psychoactive medications and begins by explaining the different categories of medications and what they are used to treat. The author then goes on to explain how these medications works and the chemicals they effect. So this book would be very useful for someone who has little to no knowledge about some of these conditions and the medications that are used to treat them. Throughout the book the author offers both Biblical references and scientific references, facts and information, which I found to be very helpful. One of the quotes from this section that I really enjoyed was, "I believe it is right to view the development of psychoactive medications as a good gift from God, an extension of the ruling and stewarding function he gave to humanity at creation (Genesis 1:26-28). At it's best, scientific discovery explores God's world in all its astounding complexity and seeks to alleviate some of the misery we experience as fallen creatures in fallen world." The author does take the time to discuss how pastoral and other counseling can be very useful for those who have mental illnesses. And although psychoactive medications are a gift from God, we also need to make sure that our relationship with God is also on the right path. He gives a lot of good advice about finding psychiatrists and therapist who at least understand, if not share, your religious beliefs.

Overall, I thought this was a very good book that discusses some very difficult issues. Many in the Christian community, especially in the past, have thought that mental illnesses were simply individuals who weren't "being good enough Christians". Which we of course know if not true; mental illnesses are just as real and serious as physical illnesses. The author did a great job in this book of explaining everything from a Biblical viewpoint, as well as a scientific one and I would definitely recommend this book.

Thank you to the publisher, New Growth Press, for sending me a review copy of this book.

[Shantelle · Rating 4 out of 5]

4.5 stars

Descriptions and Prescriptions: A Biblical Perspective on Psychiatric Diagnoses and Medications by Michael R. Emlet wasn't exactly what I was expecting - especially not in the first quarter or so of the book. But it had good information to impart, and I feel like I've learned a lot. I received some things to ponder, and now have an overall more balanced view of medications and how to help those dealing with mental struggles.

For a long time, I've wanted to know more about the struggles of the mind. Helping people work through emotional/mental issues - counseling, on a small scale - has been something on my heart. On the other hand, I'm a deep thinker and I understand, to some extent, some of these mental struggles, having dealt with anxiety for many years.

So yes. This book was very interesting to me. At first, it was a little over my head, what with some of the history of psychiatric stuff and all these technical terms, in-depth diagnoses, and medications and what they do. But as I kept reading, Descriptions and Prescriptions really became engrossing to me. I started understanding things a little more. And then, toward the middle of the book, the author started talking more about the spiritual and emotional side ... and asked the question: How do we approach mental illnesses and struggles? Is medication always the answer? Where does faith factor into all this?

There were some real-life stories and situations that were very helpful in understanding people and seeing this author's points.

Overall, I felt Michael R. Emlet approached this subject with solid history and facts, wisdom, good information, grace, and some great thoughts. One thing I liked that he said, more than once, is: we are both body and spirit. To neglect one or the other when helping someone, or reaching out for help yourself, is a mistake.
I'm glad I read this book. I plan to keep it on my bookshelf for future reference, and recommend to those wanting to understand more about this subject.

I received a copy of Descriptions and Prescriptions from Litfuse Publicity Blogger Program in exchange for my honest review.

[Mary Town · Rating 4 out of 5]

As a Christian medical student who struggled a lot with the way that diagnosis and medications are used in psychiatric care, I found this book very helpful for reframing our approach to people struggling with mental health.

[Jake Stone · Rating 4 out of 5]

Balanced and helpful on a controversial subject for many in the church.

[David Puerto · Rating 5 out of 5]

Un libro sencillo y claro para todos aquellos que poco o nada sabemos sobre la salud mental, asuntos psiquiátricos, medicamentos y diagnósticos. Muy balanceado. Recomendado.

[Carrie Schmidt · Rating 4 out of 5]

Before I go further with the review, I need to make clear that this is a book written primarily for people involved in ministry – breaking down info and applying wisdom to the situations they would find themselves in. It’s not meant as a patient reference or really even for someone whose loved ones suffer from mental illness of some sort.

There are several things I really liked about Emlet’s approach. While he remains mostly neutral, he achieves a great balance between advocating for the appropriate use of counseling/meds, as well as “viewing medication as simply one component of a full-orbed God-centered body-soul treatment approach”.

“…be glad for symptom relief but simultaneously look for the variegated fruit of the Spirit; perseverance in the midst of suffering, deeper trust in the Father’s love, more settled hope, love for fellow strugglers, gratitude, and more.”

Two other points that he made really stood out to me:

--“Using medication in select situations may be analogous to calming the surface waters to allow for deep-sea exploration.” In other words, sometimes you need to calm the brain’s misfires before you are able to work on the spiritual. Such was the case in my own life. I knew what I needed to do to have peace – lean into Jesus and His Word – but it wasn’t working. Once the medication I was prescribed started working, I was able to climb out of that pit using the spiritual tools I already knew were mine in Christ.

--A good standard question for ministers to ask themselves is, “What seems wisest for this particular person with these particular struggles at this particular time?”

Bottom Line: Descriptions and Prescriptions by Michael R. Emlet is a very balanced (and quick!) read about some hot-button topics within the Church as a whole. Neither wholly discounting nor wholly embracing the use of counseling and medications, Emlet instead attempts to lay the groundwork for a Biblical approach to treating psychiatric diagnoses. I can see how this would be a very helpful resource to clergy and lay ministers who are on either end of the cold-hot spectrum and even for those struggling to explain why a balanced perspective is best.

(I voluntarily reviewed a complimentary copy of this book.)

first seen at Reading Is My SuperPower

[Rob Schloemer · Rating 5 out of 5]

This book is helpful in informing readers about the spectrum of psychiatric diagnoses and medications. Emlet does an excellent job reminding readers that, no matter where one falls, medication is only part of the journey—the greater work of the gospel remains paramount. Taking medication for a diagnosed illness does not diminish the transformative work God continues to do in shaping a person to reflect the image of Christ. The book offers much encouragement and practical reminders. Ultimately, wisdom is the key in determining the use of medication, and having a support system—including counsel from pastors/elders—is vital. An easy and helpful read!

[Chuck · Rating 2 out of 5]

It's not sinful or an indication of a lack of faith if someone uses psychiatric medications. I agree with Michael Emlet that their use is a wisdom issue, with a mixture of pros and cons. However, I think he is trying too hard to be "neutral" about their use. There are serious adverse effects with antipsychotics, antidepressants, ADHD stimulants, and others.

For example, the ineffectiveness of antidepressants when compared to placebo is well established, especially in the research of Irving Kirsch. Emlet does mention his work, but only in a footnote on p. 65, with a reference to Peter Kramer's opposite view. Kirsch's work on the placebo effect with antidepressants essentially classifies them as placebos. See the following (free) video lecture as an introduction to his research; "The Emperor's New Drugs": http://education.madinamerica.com/cou....

Emlet's spot-on sense of humans as body and soul is not the sense of human nature behind the biological model that dominates the diagnosis and treatment of "mental illness" in modern psychiatry.

I also think he watered down the concerns with psychiatric diagnosis. When the current edition, the DSM-5 was being developed BOTH of the previous chairs for earlier editions (Robert Spitzer for the DSM-III and Allen Frances for the DSM-IV) publicly expressed concerns with the process and with some of the decisions in changing certain diagnoses. There were legitimate concerns with the 3rd and 4th editions as well. Read "The Myth of the Reliability of the DSM" by Stuart Kirk and Herb Kutchins: https://www.academyanalyticarts.org/k...

[Stephanie Ridiculous · Rating 3 out of 5]

Hovering between a 3 and 4 star rating.

There's a lot of good stuff in here; a helpful and balanced evaluation of the diagnostic and prescription process, the DSM, the pros and cons of diagnoses and medications, and an urging toward holistic care. All great.

Being a few years old now it's not surprising that the term "Asperger's" was used, but still disappointing. I'm also not a super big fan of the incredibly brief summary of Person First vs Identity First that came out with a blanket statement against Identity First instead of encouraging folks toward a more nuanced and situational application of that idea. Particularly relevant because while not necessarily the focus of the book, Autism is mentioned quite a few times & that's a great example of where you should be taking the persons lead instead of telling them how to feel about it all.

All in all, a helpful quick read if you're new to secular psychology & psychotropic medication & what, if any, implications does that have for soul care?

[Anthony Locke · Rating 4 out of 5]

This is a short and helpful book on a topic that, in my experience, is not discussed enough by church members or their leadership. Emlet suggests a "just right" approach rather than the "hot" (rush to use medication/psychiatry as first option) or "cold" (avoid medication/psychiatry at all costs) approach. He reminds readers that the body and the soul are often intertwined and that a counselor/pastor's approach to an individual varies at a case by case level. Emlet doesn't emphasize one at the expense of the other, rather he says, "It depends." The most helpful book for me was at the end where he describes what it looks like to be too hot or too cold and encourages readers to walk the "tightrope" in the middle with wisdom and love. I'm glad the elders at Hinson are reading this and allow folks like me to listen in on their conversation as they think about the books implications and applications for the church.

[Josh · Rating 4 out of 5]

Balanced, compassionate, and wise. And all that in less than 100 pages, succinctly compiling so much of CCEF's way of doing ministry. Highly recommended. (2017 review.)

Reread in 2025, and still agree with my initial assessment, though I would give it 4-stars now (5-stars has to check all the boxes, and this one doesn't quite). There are a few places where I wish Emlet had pushed back harder against the cultural tendency to reduce humans to biological machines, or helped resist the trend towards professionalization of care (which, in an indirect way, even good parachurch organizations like CCEF can do). But still a useful guide that addresses a complex topic.

[Becky Bollinger · Rating 5 out of 5]

I appreciate the balanced, careful way that Emlet tackles this topic, using both Scripture and science to inform his conclusions. He gives a compelling picture of a "full-orbed God-centered body-soul approach" to helping people facing psychiatric disorders.

Emlet tackles tough questions and concepts with clarity and in a conversational tone. Church leaders, lay-counselors, and anyone who cares for people: this book is for you.

[JEM · Rating 5 out of 5]

If you’ve ever wondered how biblical counseling and psychiatric diagnoses and medications mesh - how, or even IF it is possible, then this is the perfect book. Michael Emlet gives a clear, balanced biblical perspective on this topic. Highly recommend.

[Todd Miles · Rating 5 out of 5]

A seriously helpful book. I highly recommend to all who are in pastoral ministry. Strong balance rooted in Scripture.

[Rachel Winkler · Rating 5 out of 5]

This was such a balanced and gospel-centered, biblical perspective on psychiatric diagnoses and medications. Emlet truly strikes a rare balance that recognizes the human as a complex unity of both soul and body, and I think correctly asserts that both of those aspects have to be considered in ministry. Mental illness is such a complex thing, and while there is a lot we don’t know, we should neither dismiss or elevate either the spiritual/heart factors or the physical/biological factors that all play a role.

Emlet argues that the use or non-use of medication for mental illness is a wisdom issue and will vary from person to person based on the severity and nature of each individual’s situation. For some, using medication may remove barriers to their sanctification, and for others it may hinder spiritual growth. For some, refusing to take medication may be unwise and reflect pride and self-sufficiency, whereas others who are insistent on taking it may be demonstrating a lack of desire to address other underlying heart issues.

Like anything else, medication can be used as a gift of God’s grace to aid His children in living for His glory in a fallen world, or it can be viewed and used idolatrously. Ultimately, each person (with the help of the church’s wise counsel and medical professionals’ expertise) must evaluate for themselves prayerfully their heart posture before the Lord and do what will best facilitate growth in the grace of the gospel, learning and experiencing deeper and richer love for, dependence on, and communion with Christ.

[Tima · Rating 2 out of 5]

As Christians we often view mental illness incorrectly and either dismiss medicine completely, or forget the faith that plays such an integral part in our lives. Some people feel that taking medications for a mental illness is of the devil, while others take or advise taking the medicine blindly without any regard as to the side effects, reasons for needing the drugs, etc. The author has taken a Biblical approach to show both the benefits and downsides of both approaches. His desire in writing the book was to give Christians a look at both perspectives with a hope that the reader can see the middle line and choose something that will fit them and their Christian lifestyle.

As a person suffering from a mental illness myself, I was intrigued with how the author would conclude his perspective. I've had Christians on both sides of this "counsel" me and I was looking forward to seeing his conclusions.

The book is very thin (98 pages), so will make for a quick read. I was surprised at how technical the writing was. If you aren't very medical, it will be very easy to get bogged down in the first few chapters. The author uses several stories to help tell what he is talking about so this does lighten up the depth a little. He concluded with the idea that there isn't a right or wrong, but rather a mixture of the two with regards to every single patient being different and therefore needing different things. The concept is great, but I finished with the feeling that I wasn't really helped in any way. And that the author's real feelings on the matter were that the ultimate goal was to not have to take any medication if at all possible. So while the theory was probably correct, this book didn't really help me at all. I think this book would be better suited for a person who works with mental illness and not a patient in search of the correct balance.

I received a copy of this book from Litfuse Publicity. All thoughts expressed are my own.

[Jonathan Wallace · Rating 4 out of 5]

“Descriptions and Prescriptions” offers a concise overview of psychiatric diagnoses and medications from a Christ-centered and Biblical perspective. From a scientific standpoint, the information about diagnoses and medication is very brief but helpful for someone who knows little or nothing about these topics. Christians have wide-ranging opinions concerning the use of these types of medications and I think Emlet does an excellent job of considering many different perspectives in his writing. This book is written for both those who are perhaps too “warm” or too “cold” towards medication with the hope that readers will from a more balanced perspective. Considering the complexity of psychiatric disorders, the use of psychoactive medication really is a wisdom issue rather than something that is plainly right/wrong.

[Abbie · Rating 5 out of 5]

Very helpful for me as I’m growing to have a more balanced view on both diagnoses and medications. This short book offers a gentle and biblical look at the pros and cons of each. Diagnoses offer helpful descriptions but don’t offer explanations of why someone has a disorder. And in the end, there’s so one-size-fits-all answer for meds, but it’s a wisdom call for each individual.

[Brenden Wentworth · Rating 5 out of 5]

A concise yet very informative and practical take on how to approach psychiatric diagnoses and the use of medications in the Christian life for counseling and even personal use!

Emlet, who has both the experience of a physician and biblical counselor is a wise guide for a touchy subject.
This will be my go-to when it comes to approaching questions such at this that require razor sharp distinctions and wise counsel

[Andrew Dionne · Rating 5 out of 5]

A nicely written booklet on psychiatric diagnosis and medicine, and how the biblical counselor or pastor ought to understand it. I will definitely reference this book in the future. Great addition to my library.

[Denise Weaver · Rating 5 out of 5]

I love the balanced approach the author takes on psychiatric diagnosis and medication. He helps readers to identify if they are too warm or cold to medication and helps them find a more balanced perspective.

[Adam T. Calvert · Rating 5 out of 5]

By far the best book I've read regarding a Biblical view of psychiatry and its practice.

This book is aimed toward pastors and other Christians involved in abundant counseling ministry; but really any Christian could benefit from it. He seems uniquely qualified to write it (having both an M.D. and an M.Div); and the church can benefit greatly from that.

While he rightly doesn't support the use of drugs for something that is a legitimate sin issue, he certainly shows that there truly are issues that should indeed be dealt with from the use of drugs (under the care of a psychiatrist or other medical professional qualified in those drugs).

Knowing which ones fall into which category is also dealt with. And the answer is that it really depends on the person, the abnormal behavior (whether it's depression, anxiety, hyper-activity, obsessive compulsiveness, mania, etc.). And the goal of course is to get to the root issue that is causing the abnormal behavior. Is it sin? Is it a chemical imbalance? Is it both?

How the person is treated depends on the answers to those questions.

Nonetheless, the main objective for the counselor at the time of crisis with the counselee is to show the love of Christ and bring God's Word into the situation. This does not mean to counsel them to immediately stop taking any kind of psychotropic drug (he especially warns against that, as abruptly stopping some of those medications could have life-threatening consequences). Nor does it mean to immediately recommend they start taking psychotropic drugs.

Emlet does a terrific job of continually bringing it back to the uniqueness of each individual coupled with the effects of total depravity; and how each person and situation calls for a unique approach.

Far from making a blanket statement that all psychotropic drugs are perfectly acceptable and taking them should not be causes for concern for a person's spiritual life, Emlet persuasively argues that it's just as much true that pastors and other Christian counselors should be very cautious in taking the approach that the one being counseled just needs more faith in Christ or the Scriptures. There are legitimate abnormalities to the mind and how it functions (certainly as a consequence of the fall); but there are also Biblically acceptable medications in restoring that person's mental health.

Obviously, in and of itself medication is not the answer to someone's spiritual heath. Bible reading, prayer, fellowship with other believers, and an active role in serving the body of Christ and advancing His Kingdom will always grow spiritual health. But sometimes medication is truly needed to get a person to the point where he or she is able to do those things (or do them more effectively).

I'm so thankful for this balanced and Biblical perspective on looking at psychiatry, its place in a broken world, and its use (in part) in redeeming that broken world. God bless Michael Emlet and his ministry!

I highly recommend this book to pastors and those who counsel regularly from God's Word. While you can read it in one sitting, be assured you'll want to keep it as a reference for a long time to come.

[Erin · Rating 5 out of 5]

Michael R. Emlet draws on his years of experience both as a family physician and counselor to present a tool for people in ministry everywhere. Whether you are a pastor, church leader, or lay person interested in learning more about psychiatric diagnoses and the uses of medication, you will enjoy Emlet's balanced and Biblical perspective on this difficult topic.

In the first half of the book, Emlet discusses the what the DSM is, how it has changed over the years, and what a diagnosis may or may not mean for an individual. In the second half he dives into the issue of medication, and trying to find the wise balance of when to consider using medication to go alongside other areas of treatment. I thought this was a great point in Chapter 14: "It is important to remember that we exist as body-spirit creatures. We are simultaneously body and soul. There's never a time we're not spiritually engaged. And there's never a time we are not bodily engaged. This means that attention to both physical and spiritual aspects of our personhood is mandatory in ministry."

I liked how Emlet made a point that if a person has a psychiatric diagnosis, that's not so different from a person who may have a physical diagnosis. Someone may be battling cancer, but they themselves are not cancer. It's similar with mental issues, in the fact that someone may suffer from bipolar disorder, but that does not define who they are. They are still a human being in need of a Savior and compassionate interaction with fellow men. "A diagnosis, if present, is one of many starting points for ministry, and certainly not an end point," Emlet encourages in Chapter 8.

As each individual person is different, so will be treatment for any needs in the life of that individual. There is no perfect or universal treatment for any of these things, and one must seek God's guidance. I liked how multi-faceted health and wholeness was presented as the goal. This line in Chapter 13 seemed to sum it up beautifully: "...As believers we hope not only for symptom reduction but also tangible growth in love for God and love for people." As far as the book itself, it is informative and easy to read, with extensive footnotes for people who might like to further investigate this subject. The chapters are short so that a reader will not feel overwhelmed by the information. I would recommend book to anyone interested in better understanding these things and equipping themselves to help those in our paths who have these needs.

I received my copy of the book from LitFuse Publicity. All opinions in this review are my own.

This review originated at http://reviewsbyerin.livejournal.com

[Blake · Rating 4 out of 5]

A very insightful book that I think can and should be a resource for believers, so as to understand the psychiatric world and the perpetual labeling of problems that people have with living life in a broken, sin-cursed world. Although the author is a little more favorable of the medical model than I am, I think he gives a fair treatment of what is the problems with the medical model for counseling issues. He also provides helpful insight into an answer for peoples' problems, showing how God and His Word truly do provide solutions to those problems and he challenges the common assumptions within the culture that lead people down the medicinal path but don't truly deal with the root issues, nor do those assumptions/beliefs/practices truly provide people with real hope. I do hope that the publisher can lower the price of this book soon as I believe the cost will keep some from reading the book, given that the book is not a real lengthy book so some might be inclined to not purchase it because of its cost. Overall, I think this is a helpful resource and one I think should be read by all.

[Matt Tyler · Rating 4 out of 5]

I found this book to be careful and balanced. Michael Emlet does a wonderful job making readers aware of "both the limitations and benefits of using psychiatric labels and medications for those with mental suffering." After reading, I think I am a bit more equipped in my own counseling ministry. He also points to other sources that I hope to read as I continue to grow in this area.

Definitely recommended for both pastors and church members.

[Danielle Williamson · Rating 5 out of 5]

Absolutely brilliant. I want to return to it again and again. Since Emlet is a physician, he has a lot of knowledge, coupled with Biblical doctrine and experience, that is helpful in this perspective on diagnosis and medication. I love the fact that he treats diagnosis and medication as different entities and analyzes them in their own categories. Not only that, but he goes straight to the source of current research on the brain and psychiatric medication and that is refreshing. He highlights the importance of counseling ministry that medication- though at times supplemented by- should never be substituted for. His deep compassion for suffering people is a balm for the soul. Emlet emphasizes the importance of saying "yes, and" or "both and" in counseling- yes, the person is a sinner, and yes the person is suffering- which is a helpful perspective to have. Every Christian, counselor, pastor, and physician should read this.

[FeyLetras · Rating 5 out of 5]

Es un libro muy interesante, el autor nos trata de explicar en un lenguaje sencillo y común para que todos los lectores podamos entebder las implicaciones de los medicamentos y diagnosticos medicos con respecto a la salud mental.
Me parece muy bueno para quienes quieren tener una mejor vision al respecto de estos temas. No todo es negro o blanco, tenemos que tener una vision equilibrada del uso de medicamentos, y de la ayuda psicologica o psiquiátrica en cristianos.

[Brett Barnes · Rating 5 out of 5]

I am not an expert in this area, but this seems to be a really helpful, concise overview on how to navigate the complexities of emotional health, treatments, medication, counseling, etc. for the people you are ministering to...or for yourself. I strongly recommend this book to anyone who is in a position to lead, counsel, or minister to others.

[DeAron Washington · Rating 4 out of 5]

This book had me squirming most of the time because I have my preference it was made very clear. I think he gives a fair critique to both sides of the issue. This book could be so much longer, but I believe he used the 99 pages wisely. No matter what your preferences you should read this to join me in my amens and ouches.

[Shane Williamson · Rating 5 out of 5]

Carefully balanced and hopeful. A brief but vital resource for pastors and those ministering to others. Thankful for the wisdom of Michael Emlet for charting a nuanced course in which persons and their sufferings are considered holistically. A must read.