Is Mental Illness Actually Biblical?

5322424442_ed7eb300eb_b

I recently read two articles by a well known Christian author who is also closely connected to a Christian counseling foundation. The articles essentially argued that mental illness was a social construct created by secular doctors and psychiatrists, and therefore, is not biblical. So, when a person is depressed, he is really just experiencing sadness, and to try to treat it medically is to short circuit the power of God. When a person is anxious, she is really just experiencing worry, and to treat it medically is a secular answer to a spiritual problem. You get the idea.

The desire behind the article was good: the author was trying to demonstrate that Jesus is sufficient for every facet of life. However, I believe that treating mental illness as only (or even primarily) a spiritual problem is both profoundly unbiblical and incredibly hurtful to those who struggle with mental illness.

TOTAL DEPRAVITY REALLY MEANS?TOTAL DEPRAVITY

The Bible teaches that every human being is totally depraved. This doesn’t mean that every person is as absolutely wicked and evil as they could possibly be. That would be utter depravity. Total depravity simply means that sin has affected every facet of my being, including both my soul and my body. Total depravity means that nothing works as God originally intended. My spiritual desires are affected and distorted by sin. My intellect is distorted by and affected by sin. And, most importantly (for this discussion), my body has been affected and distorted by sin.

Why do I get colds and headaches and backaches and indigestion and infections? Why do you have migraines and heart problems and kidney stones and glaucoma? We experience these things because we inhabit bodies which have been marked and marred by sin. Paul spoke directly to this when he said:

So we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day. (2 Corinthians 4:16)

Our outer self is wasting away. Our bodies don’t work correctly. They fall apart and fail us at the worst times. While we live in this fallen world, we live in bodies that are wasting away.

In Romans 8:22-23, Paul wrote:

For we know that the whole creation has been groaning together in the pains of childbirth until now. And not only the creation, but we ourselves, who have the firstfruits of the Spirit, groan inwardly as we wait eagerly for adoption as sons, the redemption of our bodies.

Along with the rest of creation, we eagerly await for the day when Christ will return and we will receive our new, redeemed, resurrection bodies.

Until the day Jesus returns, I will live in a body which does not function as God originally intended. My brain, which is a key, central, integral part of my body, will not function correctly. Chemicals will become imbalanced. Serotonin will not be properly absorbed. Norepinephrine will be unevenly distributed. Synapses won’t fire correctly. My brain, just like every other part of my body, is prone to illness.

I would argue that if we truly believe in total depravity, then we?must?accept mental illness as a biblical category. If I believe that sin has affected every part of my body, including my brain, then it shouldn’t surprise me when my brain doesn’t work correctly. I’m not surprised when I get a cold; why should I be surprised if I experience mental illness? To say that depression, anxiety, ADHD, bipolar, and every other disorder, are purely spiritual disorders is to ignore the fact that we are both body and soul.

Mental illness is not something invented by secular psychiatrists. Rather, it is part and parcel with living in fallen, sinful world.

MENTAL ILLNESS IN THE CHURCH

Treating mental illness as purely a spiritual disorder is very hurtful to those who struggle with mental illness because it points them to the wrong solution. Let me explain. For many years I’ve dealt with chronic physical anxiety. I regularly experience a clutching sensation in my chest, shortness of breath, adrenaline surges, and a sick feeling in the pit of my stomach. On rare occasions, the anxiety is tied to something I’m worried about, but 90% of the time the physical symptoms I experience aren’t at all connected to worry. I’ll be working away on my computer, not thinking about anything, when a feeling of anxiety suddenly descends upon me.

In those moments, I don’t need to be told not to worry. I don’t need to be told to exercise more faith in the promises of God. I don’t need to be told to snap out of it. What I need is encouragement to persevere. I need to be reminded that, even in the midst of suffering, Jesus is near. I need to be reminded that my light and momentary afflictions are producing an eternal weight of glory. I need to be encouraged to press into Jesus.

And…I need to be connected to someone who can help me deal with the physical aspects of anxiety.

Here’s the unfortunate reality: even if my thinking is biblical, faith-filled, and God-honoring, my physical symptoms of anxiety probably won’t go away. Why? Because most of the time the problem is primarily physical. Something isn’t working correctly in my brain, which in turn causes me to experience the physical symptoms of anxiety.

When interacting with Christians who experience anxiety, depression, PTSD, or any other form of mental illness, we need to treat them as whole people. We need to treat people as both body and soul. Do they need to exercise faith in the wonderful promises of God? Sure. But they also need to deal with the physical aspects of mental illness as well. Doctors are a wonderful gift from God who can offer help to those who struggle with mental illness.

We need to place mental illness in the same category as every other form of illness. When a person experiences chronic migraines, they most certainly will be tempted to doubt the goodness of God. We can serve them by encouraging them that God is good, and that he cares for them. But we also can serve them by taking them to the best migraine specialists in the country.

If we’re going to effectively care for fellow Christians who struggle with mental illness, we need to recognize that mental illness is a real thing. We aren’t only souls. Rather, we are a complex composition of soul and body. Let’s make sure we address both the soul and the body.

Let’s Talk About Mental Illness

Mental illness is tricky business. As Christians it is something we desperately need to talk about yet almost never have the courage to talk about. We need to talk about it because it affects so many people. My guess is you either know someone who struggles with mental illness or you struggle with it yourself. Mental illness is not limited to the crazies on the street who talk to invisible phantoms. Moms, dads, pastors, executives, accountants, and karate instructors struggle with mental illness. When we don’t talk about mental illness openly and honestly the result is tragedy and hurt and pain and confusion.

We don’t have the courage to talk about mental illness because, frankly, we’re not sure what to say. For those of us who struggle with anxiety or depression, trying to explain it someone who has not experienced it is extraordinarily difficult. For those of you who don’t deal with mental illness but know someone who does, my guess is that you’re not quite sure how to help them. You desperately want to help but don’t know what to say or what to do.

If the body of Christ is going to effectively serve those who struggle with mental illness we need to have some open, honest conversations about it (and just to be clear, this post is in no way directed at anyone in my church!). As one who has struggled with chronic physical anxiety for many years let me add my voice to the discussion. I hope that my fragile thoughts can serve both the strugglers and those of you who care for the struggling.

THEOLOGY BEFORE TREATMENT

When talking about mental illness the temptaion is to immediately jump to solutions. You need more faith. You need more prayer. You need to fast. You need to pray against Satan. You need an SSRI drug. You need electroshock therapy. You need to have your blood levels tested.

While these things certainly have their place, if we are going to truly understand mental illness and help those who are struggling we need to get our theology straight, and the theological starting point for talking about mental illness is the doctrine of total depravity.

Total depravity is a fancy theological way of saying sin has affected every facet of our being. Sin has wreaked havoc upon our souls. Apart from God’s intervention we are fundamentally bent toward sin. We cheat, lie, gossip, slander, prey on the weak, and are fundamentally opposed to God in every way. We are spiritually depraved. The glory of the gospel is that when God saves us he begins to reverse this fundamental depravity, transforming us more and more into his image.

Total depravity also means that sin has also wreaked havoc upon our bodies. We get colds and cancer, backaches and fibromyalgia. Our bodies betray us. They simply don’t work like they’re supposed to. The glory of the gospel is that someday we will be given new, immortal, resurrection bodies. But we’re not there yet. All of creation, including our bodies, groan for the day of our final redemption.

A SOUL AND BRAIN PROBLEM

When someone says they are feeling anxious or depressed we are too quick to go to spiritual solutions. We assume they aren’t trusting God or they aren’t believing God’s promises. We assume that if they would start thinking correctly all the bad feelings would go away. If they would simply believe God’s promises everything would be straightened out. But that’s not necessarily true.

Remember, we are body and spirit. Too often we make everything spiritual and forget about the body part. A guy could be feeling anxious because he has too many bills and too little money. Anxiety is a normal temptation in those circumstances and the guy may need to be exhorted to trust God more.

But, because our bodies do not function correctly, a guy could be feeling anxious for no reason at all. I have experienced this all too often. Adrenaline courses through my body. My heart races. I have shortness of breath. I can’t sit still. My body is in fight or flight mode. And I’m Not. Worried. About. A. Single. Thing. Changing my thinking won’t change my feelings.

In these times I need two things. First, I need to be reminded that God is near, he is my Father, he cares for me, and he will take care of me even though I can’t feel it. I don’t need to be exhorted to trust God more because I’m not doubting God in the first place. Second, I need something to get my body chemistry straightened out. This is where medicine and doctors can be very helpful.

THE STARTING PLACE

The starting place for truly understanding mental illness is recognizing that we are both body and soul. Yes, there are times when our souls are whacked out. But there are just as many times when our bodies are whacked out. This is the biblical reality. We need to be careful about the assumptions we make. When someone is dealing with depression or anxiety we need to ask careful, thoughtful questions. We need to figure out if they are dealing with a soul problem or a body problem (usually they’re intertwined). We need to relate to them as whole people, not just souls.

If your friend had a migraine you wouldn’t start by telling them to increase their faith in God. You would start by treating their migraine. Yet too often we offer unhelpful, overly spiritual solutions to those struggling with mental illness.

Let’s slow down. Listen. Pray. Be there for them.

+original photo by R.i.P

Why Many Christians Don?t Want To Talk About Depression

Many Christians struggle with depression, yet receive little sympathy from their fellow believers.

They are viewed with a certain amount of suspicion – they must be harboring some secret sin or they’re failing to exercise faith. ?Otherwise, they?d be healed. ?When you feel like you are being judged, you won?t be likely to talk about your depression.

In his insightful article on depression, A Depressing Report About Depression, David Murray says that often Christians feel uncomfortable talking about being depressed, or seeking help because there?s so much confusion about depression:

?The vast majority of people know very little about the role of the brain in our thinking and feeling processes. I?m afraid that even many Christian counselors and pastors lack vital understanding of brain science, and especially of the role the brain plays in our spiritual lives…?

?Yes, of course, some depressions can be caused by sinful actions, thoughts, and feelings. But depression can also be caused by the ?machine? that processes our perceptions, thoughts, and feelings breaking down and malfunctioning. Like the factory with a broken conveyor belt, it doesn?t matter how many high-quality raw materials you put into it, the goods are going to come out damaged until the machinery is fixed. You can press the switch as often as you want, but if the cable is broken you will remain in the dark.?

Another reason Christians are hesitant to talk about depression is hyper-spirituality.

?Although Christians with heart disease, diabetes, blood disorders, cancer, etc. do not think that it is unspiritual to seek and use medicines to relieve their symptoms and even cure their illness, many seem to think that there is some special spiritual virtue in suffering depression for months and years without any medical intervention. Their family and friends don?t usually see much super-spirituality in this approach!?

?And the next time someone tells you that taking medication for depression shows a lack of faith, or a lack of trust in God?s Word, ask to see their usually overflowing medicine and vitamin cabinets!?

Sadly, many years ago, when my wife began to struggle with depression, I didn?t understand it. I thought she wasn?t thinking right, wasn?t exercising enough faith. ?She was caving in by taking medication. ?Then I thought that maybe it was somehow my fault, that I was doing something wrong as a husband.? Or maybe it was a demonic attack. ?But eventually, I came to see that our outward man is decaying, and that our brain is part of our outward man. ?If our bodies can develop diabetes, why couldn?t our brain develop problems?

The fury of a depression

When someone is depressed they are really suffering. ?I?ve heard the phrase ?the fury of a depression,? and my wife has confirmed it. ?She?s told me that no one can know what it?s like if they haven?t experienced it.

It?s a sad thing if someone in their pain can?t talk with anyone about it. ?So the first thing to do is to listen. ?With sympathy and ?compassion. ?Be slow, slow, slow to offer solutions. ?There will come time later to explore possible physical and spiritual causes.

photo by freephotouk

20 Years Of Depression

Last week, Stephen did 2 posts on depression and anxiety. ?My wife Kristi told me I could write about her experiences in the hope that some would be encouraged.

20 years ago, my wife Kristi awoke in the morning with a rapid heartbeat and intense anxiety.

We went to the emergency room, where they did all kinds of tests to try to determine the cause of her abnormal heartbeat, which was between 140-160 beats per minute (60-90 is normal). ?They found nothing and by the time we left a couple hours later she was back to normal, though she remembered that a few days before she had felt strange sensations in her head.

A couple days later, it happened again as she was playing a game with the kids. ?Her intense anxiety continued for weeks. ?This was a horrific time for Kristi. ?She would cry constantly for no reason. ?My sweet wife, who was normally lighthearted and cheerful, sat there with a hopeless expression on her face. ?Her eyes looked dark and empty to me. ?She was unable to be around people. ?She was completely incapacitated. ?She was suffering pain I couldn?t fathom.

I didn?t know what was going on. ?I thought it was a demonic attack. ?I fasted and prayed and rebuked the enemy. ?I thought it must somehow be my fault, that I wasn?t leading and caring for my wife somehow. ?I thought I might have to step down from being a pastor.

Eventually after seeing several doctors, ?Kristi was diagnosed with a depressive disorder that initially manifested with anxiety. ?She started on some medication, and about 6 weeks later she began to feel better and able to care for the kids and house again. ?Finding the right medication was God?s mercy to us at that time, though that would not be Kristi?s last bout with depression and anxiety.

Sadly, many well-meaning Christians were not helpful in the months and years that followed. ?Often they assumed Kristi?s depression was caused by sin and taking medication represented a lack of faith. ?One pastor?s wife told Kristi, ?I know the Lord would never lead me to take medication.? ?We hoped she would never have to experience the onslaught of depression.

Depression and anxiety are complicated.

Physically caused depression and anxiety are different from spiritual depression and fear-based anxiety though sometimes they can overlap, which makes it very difficult to sort out and care for people. ?In 30 years of pastoring I have known folks who regularly give into unbelief and negative thinking who don?t get clinically depressed, and others who trust God and search their hearts who battle depression.

I can say ?God causes all things to work together for good to those who love him? to one woman, and when she is taking her medication she responds in faith, yet when she goes off her medication she hears the same verse and says, ?I guess I don?t love God then.?

Medication can be a wonderful mercy from God. ?In our culture many are too quick to take medicine, but when someone is suffering ?the fury of a depression? who wouldn?t desire relief? ?It is not a sin or unbelief to take medication. ?We?d never tell someone with diabetes it is a sin to take medicine.

Yet, as an experienced Christian doctor told me, medication should never take the place of sanctification. ?Even when one takes medication he must continue to do heart work, seek to trust and think right thoughts about God.

Physically depressed/anxious people don?t want to be that way. ?They are suffering. ?They are in pain. ?If Kristi could have escaped it by simply changing her thoughts she would have. ?In 20 years of battling depression and anxiety, Kristi has consistently examined her heart, sought the Lord, exercised faith, and graciously endured much misunderstanding.

Care for those who suffer with severe depression. ?Be slow to speak, quick to listen. ?Pray for them. ?Be patient with them. ?Be a friend to them. ?One person I know went for a walk every day with her depressed neighbor. ?I hope I can be that kind of friend.

photo by qwz

Understanding the Workings of Depression and Anxiety

Yesterday I wrote a post suggesting that we need to talk more openly about anxiety and depression in our churches. The post seemed to strike a nerve with a lot of people, and many people thanked me for writing about the subject. In light of that, I want to write a little more on the subject in the hope of helping us more effectively serve those who labor under anxiety and depression.

Depression vs. Unbelief vs. Anxiety vs. Worry

In order to serve the anxious and depressed, I think it’s helpful to distinguish the difference between anxiety, worry, depression, and unbelief. Worry is a sin involving the thought life. I worry about my finances and the health of my children and that mysterious pain in my foot. My thoughts are always involved in worry.

Sometimes when I worry, I also feel anxious, which is a physical manifestation of the worry taking place within me. Under normal circumstances, I will repent of my worry, change my patterns of thinking to reflect my trust in God, and the symptoms of anxiety will go away.

This isn’t always the case however. Those who are familiar with anxiety know that it can take many different shapes and shades. There are times when changing my patterns of thinking does not relieve the anxiety that I am experiencing. I can be trusting God with my mind and yet still experiencing the symptoms of anxiety, such as a rapid heart beat and high levels of adrenaline.

This is really important to understand. The feeling of anxiety doesn’t necessarily mean that I am sinning.

Or, there are times when I experience anxiety without any associated thoughts of worry or fear. I will simply wake up feeling anxious, like there is a large animal sitting on my chest and squeezing the breath out of me. On these days, it’s obvious that my body is just out of whack for the day.

I don’t experience clinical depression, but from what I have been told by those close to me, depression can work in a similar manner. There are times when depression is obviously the result of some form of sadness, discouragement, or unbelief. But this isn’t the case for everyone. Many times a person can be thinking God-honoring thoughts and yet still feel very down. Other times people simply wake up feeling awful. Our bodies and minds have been affected by sin and don’t work as they should.

Different Strokes for Different Folks

What this means is that we need to be careful in the way that we counsel the anxious and the depressed. We need to listen carefully to them and seek to understand the exact nature of their struggle. We need to, if possible, avoid giving “quick fixes” like, “Can’t you just stop thinking about this?” Or, “Don’t you know that God works all things for good?” The experience of anxiety or depression doesn’t necessarily mean that a person is in sin.

The first step in helping the anxious or depressed is to listen carefully to them. Then, after listening carefully, we need to communicate our love and the love of Jesus. Jesus is our High Priest who sympathizes with us in our darkness, and he deeply loves us, even when we can’t feel it. We can serve by communicating these simple truths and then by praying for the person. This isn’t all we can do, but it’s a great start.

I realize that this post is far too simplistic to address all the different scenarios, but it’s a start. I’ll shoot to write more on this in the next week or so. Until then, let’s listen carefully, communicate the love of God, and pray for our friends.

+photo by kudumomo

Talking Freely About Depression and Anxiety

I think we need to talk more openly about depression and anxiety in our churches.

Several weeks ago I mentioned in a sermon that I have struggled with anxiety throughout my life. Immediately after my sermon a woman came up to me and asked me to pray for her because she was struggling with anxiety. She said, “I’m glad you mentioned it, because it made me feel like I could come up and ask for prayer.”

Think about it for a second. Millions of people around the world struggle with anxiety, depression, and other mental illnesses, and millions of people within our churches struggle as well. Many women go through a period of strong depression following the birth of a child. Many great Christians of the past have struggled with depression, such as Charles Spurgeon, William Cowper, and David Brainerd.

And yet for some reason, we don’t like to talk about it. It feels weird and uncomfortable. Why is it such a taboo subject? I think that there are a couple reasons.

We Don’t Understand It

Most of us have not and will not experience true depression and anxiety. Yes we get sad and yes we get worried, but this is just isn’t the same. Depression and anxiety can be debilitating and crushing in ways that normal sadness and worry are not. Because we haven’t experienced it, we have difficulty understanding those who are sinking in the darkness, and we tend to compound the matter by saying, “I do understand.” And when people feel misunderstood, they are hesitant to talk about their struggles.

We Misapply the Doctrine of Sin

The biblical doctrine of sin is one of the most helpful, life-giving doctrines available. The Bible informs me that my heart is sinful and deceitful, and that there is a war taking place within me between the Holy Spirit and indwelling sin. But, the doctrine of sin is one that must be handled with kid gloves, especially when dealing with topics like depression and anxiety. When someone is struggling with serious depression, it doesn’t automatically mean that they are sinning in unbelief or failing to believe the promises of God. There may be some element of that, but it is also likely that there is something physically wrong with them as well.

After all, the Bible tells us that sin has affected every part of man, both soul and body. 2 Corinthians 4:16 says, “So we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day.” Our outer man, including our brain, is wasting away.

Depression is not just a matter of the soul. It really is a matter of the body as well, and we need to understand that. When someone tells me that they have a splitting headache, I don’t immediately ask them how their soul is doing. I may get to that, but not immediately. When someone tells us that they are struggling with depression and I immediately move to spiritual diagnosis, I’m not helping them, I’m discouraging them, and tempting them to close down.

The Solution?

So what exactly am I proposing? Tomorrow I’ll put up some more specific suggestions, but for now let me propose this. Let’s try to create a culture in which our friends who are depressed or anxious feel comfortable talking about it. And that starts with listening to them as they describe their struggle and being quick to offer comfort and slow to offer solutions.

More on this tomorrow.

+photo by Sander van der Wel

Don’t Judge the Depressed

It’s easy to judge people who are depressed.

Have you ever had thoughts like this:

Why can’t they just get out of their funk? Aren’t they trusting God? Isn’t a Christian supposed to be joyful? They must not be trying hard enough. They must not be exercising faith in God. They’re stuck in unbelief.

I’ve had those thoughts go through my mind. To my shame. I thought I was tough and couldn’t understand why depressed people couldn’t be tough too.

But God has slowly been changing me over the past few years as I’ve spent time with people who struggle with depression. I’m slowly learning a few things about depression and how to serve those who are struggling with it. Here are a few things I’ve learned.

(Note: This post was read and edited by a mature Christian who has regularly struggled with depression. Much of what I’ve learned is from them.)

Don’t Judge Them

I’ve never experienced depression, but from what I’ve been told, it’s terrible. It sucks the life out of you, debilitates you, crushes your spirits, and makes it very difficult to think accurately. Because I haven’t experienced this, I need to be very slow in making judgments about those who are in the darkness. I don’t know what it’s like, and until I go through it, I won’t know what it’s like.

I can’t tell a depressed person to snap out of it, any more than I can tell a person with a headache to snap out of it. It simply doesn’t work like that. So I need to withhold judgment and be full of mercy.

Be Compassionate

To my shame, there have been times when I haven’t been compassionate toward those who are depressed. I really, really regret that. Depression is a terrible thing, and those who experience it need to feel my care and compassion. I need to convey God’s fatherly heart of care. They need to know that, even though I don’t understand, I really do care about them and am sad to see them struggling.

What I don’t need to do is correct them. Now don’t get me wrong, there is a time and a place for gently reminding them to trust in God’s character and promises, but my ratio of compassion to correction should be about twenty to one. I need to remind them that God deeply cares for them, loves them, and is with them in the darkness.

Don’t Offer Solutions

There can be a temptation to offer solutions, such as a book or sermon, to a person that is depressed. This usually isn’t a good idea. Depression makes it almost impossible to concentrate and totally destroys any energy or motivation a person might have.

I do need to offer that person hope. Hopelessness is one of the main symptoms of depression, and the afflicted often fear that the darkness will never end. I need to encourage them that God is going to get them through it. That it will come to and end and that God will come through for them. I need to encourage them to hang on to the Lord with what little strength they have, and to remind them that God is hanging on to them.

These are starting places for helping people, not solutions. I hope they help you comfort and care for those who are depressed.

Don’t make my mistake. Don’t judge the depressed, care for them.


+photo by *clairity*