Mental Illness & Medication vs. Spiritual Struggles & Biblical Counseling

By



Silence

Christians have to break the stigma
and the shame of mental illness.
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These past few weeks have been very trying. From deaths of people who inspired us to yet another reminder that we are not completely immune from the horrible acts of others, grief seems to be everywhere we turn.

Earlier this month, we spent a lot of time talking about mental illness here at the blog, in light of the sad news from Rick Warren and Saddleback. I spoke about the church’s response to this problem that is bigger than we want to admit, and looked at what others have to say as well. I did want to discuss more fully one issue that we can have a tendency to tiptoe around as if we are on eggshells–mental illness and medication.

Michelle Boorstein from the Washington Post called me that week, and she asked some penetrating questions about why Christians might struggle with this issue more than, perhaps, mainstream society. In that article she quoted me as saying:

Part of our belief system is that God ­changes everything, and that because Christ lives in us, everything in our hearts and minds should be fixed. But that doesn’t mean we don’t sometimes need medical help and community help to do those things.

That’s the heart of my issue, but let me address it more fully here.

Mental illness is a tough thing to consider because it can open a debate that many would rather not have. But given the overwhelming response these past few weeks on my blog and in other spheres of social media, it bears discussing more fully before we close the conversation for now.

Among evangelicals, you will find some who are very open to dealing with mental illness as a physiological reality, but you will also find others who think that there is no other value to be gained from listening to the world.

One might wonder why we can’t just read enough Scripture or pray enough. Why can’t that cure us? Because the reality is that in some cases, there are physical, chemical, or physiological issues. Yes, prayer can help, and yes, God does still heal in miraculous ways. But more often than not, more prayer and more faith are not the only remedy for mental illness. Medicine is still needed.

Most people would agree that in many ways we are an overmedicated society. I don’t deny that. But that is a separate discussion for another day. Just because we need to be careful in how we prescribe and administer medication does not mean we should be afraid of medical intervention entirely.

And yes, mental health is a spiritual issue in some instances, but it can also be a medical issue. We have to recognize– and admit– that the faith community sometimes is unsure of how to deal with this tension. All truth is God’s truth, and there are both spiritual truths and medical truths that are part of dealing with this issue.

Earlier in life, I became aware of some mental health issues in my own family. When I became a Christian, the initial reaction I heard regarding these issues was that if people would trust the Lord enough, then they would be healed. But let’s use that same line of reasoning with a physical medical issue that we all can acknowledge. You don’t trust the Lord through a broken leg alone. One of the ways you trust the Lord is that you go to a doctor and you get a cast.

When I became a pastor, I was a bit naive. In my recent CNN article, I gave the story of Jim. I began to realize that Jim and I were praying together, and we were reading the Scriptures together. And yet, when he was on his medication, he really was healthy and whole. This was a turning point for me to understand that perhaps the key word in real mental illness is illness. I had to see that he was sick– not just struggling spiritually, but actually physically sick, which was a major distinction.

David Murray explains another helpful distinction:

If there’s one thing we can all do, it’s to avoid making our own experience the rule for others. That’s the most common mistake I’ve seen people falling into here (and I’ve done it myself as well). Just because medication worked for you, does not mean it will work for everyone else. Just because biblical counseling alone worked for you, doesn’t mean it’s the answer for everyone else. Just because you’ve never been depressed, doesn’t mean depression does not exist. Cases are so different, and causes are so complex, that we need to exercise charity, sympathy, and patience in all our dealings with one another.

David’s article (and others I recently linked to) are probably MORE helpful than mine because I’ve only see mental illness and the benefits of medication through others in my family and church. The writers I linked have lived it themselves. The reason I listed prominent Christian leaders in that particular post was to help break the stigma.

At the end of the day, part of the reason it’s difficult to acknowledge these real issues is that there can be a perception that Christians are not supposed to have these issues. Part of our belief system is that God changes everything. Sometimes we find ourselves asking “why hasn’t God fixed this?”

But that stigma can be a hindrance instead of a help.

Some will respond to our questioning by saying it is all because of sin. Or a lack of faith. Or a lack of repentance. Yes, there are consequences for sin. But just because someone is struggling with anxiety or depression or another form of mental illness does not mean it is a result of something they’ve done or not done.

Tim Keller has written a helpful article on the four models of counseling in pastoral ministry. In it, he writes:

We must beware of giving people the impression that through individual repentance for sin they should be able to undo their personal problems. Obviously, we should not go to the other unbiblical extreme of refusing to acknowledge personal responsibility for sinful behavior as well…While we can’t fall into the reductionism of believing all problems are chemically based and require medication, we also cannot fall into the reductionism of believing all problems are simply a matter of lacking spiritual disciplines. Schizophrenia, bipolar depression, and a host of other psychological problems are rooted in physiological problems that call for medical treatment, not simple talk therapy.

Keller is spot-on. Both ends of the spectrum are dangerous places to counsel from. It’s not always a result of sin. Yet the answer is not always medication.

We sometimes think that because Christ lives in us, that everything in us– in our hearts and our minds– should be fixed and made perfect in this lifetime. As a Christian, I know that Christ does change all of those things. But to use the illustration from before, if a leg is broken, we still need a cast. The whole pulling-yourself-up-by-your-bootstraps-because-you-broke-your-leg thing just doesn’t work. You’re still going to fall down, and your leg will not heal correctly. And if a chemical imbalance is present, external help may still be needed. We need to extend that belief that physical illness and mental illness really can and should be seen as the same when it’s genuine mental illness.

There are spiritual struggles. People do go through spiritual darkness, and all people of faith recognize that. It’s not perfectly delineated, but there is a difference between a spiritual struggle and a physical mental sickness. They do relate– yet they are also not the same.

When it comes to spiritual struggles or personal struggles (what some would call “a down time”), faith-based counseling (what we call biblical counseling) is a wonderful tool. But, at the same time, faith-based personal and spiritual struggles are not the same thing as mental illness. And it’s exceedingly important for us to identify the difference between them.

If I’m struggling with grief, with sin, or with any host of issues, having people who can encourage me or even counselors in the Christian tradition are wonderful. But there is a difference between that and mental illness, which is a physiological reality.

We wouldn’t shame someone for getting a virus. Why do we shame someone for having a chemical imbalance that leads him or her to a lifelong struggle with depression? Often there is an expectation– because we really do believe, as the Apostle Paul writes to the Philippians that “I can do all things through Christ who strengthens me.” But that doesn’t mean that we don’t need the support of the community to do those things. It doesn’t mean we don’t need medical help to do those things.

I may sound like a broken record, but it bears saying again and again. People are crying out for help, and we cannot afford to be ignorant or afraid. Christians have to break the stigma and the shame of mental illness.


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Ed Stetzer About Ed Stetzer

Ed Stetzer is President of LifeWay Research, one of the best and most-quoted Christian research organizations in the world. He has planted churches in multiple states; trained pastors across the US and on six continents; and taught at 14 seminaries. Author or co-author of 12 books, Stetzer is a leading voice among evangelicals. He is a contributing editor or columnist for several publications, including Christianity Today, Outreach Magazine, The Christian Post, and Facts and Trends.


  • Janet Kraft

    This article is based on the bogus chemical imbalance theory created by psychiatrists to legitimize their profession and promoted by pharmaceutical companies to legally push their drugs on people that are hurting and need help. It bothers me a great deal that Christian pastors are hopping on board this train that has led to the destruction of so many lives. To discount all the people whose lives have been totally trashed from the side effects these bogus drugs produce is not only wrong, it’s out right criminal. I find it hard to believe that God wants us to numb down all our bad feelings. Where in the world does it ever say to do that in the Bible? In addition, people really need to look at what they are eating, listening to and how much (or little) they are exercising. Signed – a pharmaceutical victim who took her drugs AS PRESCRIBED and is now one of the unfortunate ones whose life was ruined but thankfully renewed thanks to Jesus Christ my SAVIOR!

    • Char Fox

      My only concern with this is that I have a son who, while fed breastmilk the first 2 1/2 years, while fed lean meats and vegetables and milk and fruit juices with no sodas and junk for foods, he showed signs of Aspergers at the age of 3. Without medication, he was thrown out of three daycares which affected my employment. Even in a daycare that accepts special needs, he still needed medication in order to remain there. His issues involved hurting others (adults and children), mostly out of carelessness and not focusing his attention while being extremely hyper around others. So it wasn’t the food. I also ate healthy, exercised daily, and did not drink or smoke while pregnant.

  • Crazy Church

    I do understand the necessity of short-term medication use for Christians in extreme cases – primarily because (I believe) Western Christians have a general lack of understanding of spiritual warfare. They have bought whole-cloth the “chemical imbalance” explanation of mental illness that springs from a naturalism-materialism / Darwinian worldview. My experience though tells me that the Cons of psych meds outweigh the Pros: http://thecrazychurch.com/medication/

    • Char Fox

      Not all can be attributed to a lack of understanding however. Alzheimers, autism, mental retardation from birth…these prove the existence of mental illness. The woman with the issue of blood was “healed”. Demons weren’t cast out of her. So all sickness isn’t attributable to demons. Just as I stated below in Matthew 4:24, it states those with diseases and “torments” and those possessed with devils and those “lunatick”. So even the Bible testifies to those who are tormented or lunatic but isn’t attributable to demons or spiritual warfare.

  • Char Fox

    I believe so many in the church do more harm by demonizing everything. And then, so many in society do more harm by labeling everything. Like with most things, the old pendulum swings left or right, but can’t seem to manage that center spot.

    I have heard claim after claim that the Bible doesn’t address mental illness. In researching this issue, it certainly does! Matthew 4:24 states “And
    his fame went throughout all Syria: and they brought unto him all sick
    people that were taken with divers diseases and torments, and those
    which were possessed with devils, and those which were lunatick, and
    those that had the palsy; and he healed them.” If you read the Greek translation, the words are σεληνιάζομαι (selēniazomai) which means “to be a lunatic”, and δαιμονίζομαι
    (daimonizomai) which means “in NT to be possessed, afflicted, vexed, by a demon or evil spirit”. As both of these are in the same verse, it stands to reason that not all “lunatics” are possessed by a demon or evil spirit.

    Further delving into speaking cursings or blessings, the sins of the fathers (generational curses), one can see that these verses are discussing how parents pass on their bad traits to their kids. And while the children are not punished for their parents’ sins, continuing those traits become their own sins which they are punished for. Accepting Christ means being forgiven for those sins and working with Him to heal us of those issues. Sometimes it may take medication. We don’t tell diabetics not to medicate. We might tell them they eat too much to cause it. But that does nothing to explain juvenile diabetes, for which medication is a necessity for life.

    Yes there are side effects to medications, but not everyone experiences them. No, there is no definitive test. I’ve spent years in counseling (Christian and secular), and years of medicine trials until just recently we’ve finally hit upon the right combinations for me. It is a difference of night and day. Staying in the Word has also been a huge help in this and I feel that at some future point, the medication may be able to be stopped. But for now, I’m listening to the still small voice that tells me I need to remain on it. People see the difference, I can see the difference. And if you’ve ever dealt with bi-polar or severe depression, you might find small side effects are well worth it to be free of the severe ups and downs that feel like they’re driving you insane.

    Years ago, we didn’t know much about cancer. For now, we don’t know much about mental illness. Perhaps years down the line, we will find a proven method of testing for that chemical imbalance. Sometimes it can be passed on from parents who filtered your bloodstream with booze and illegal drugs. It may be the chemicals we lace our foods with in modern day society, or the pollutants we’ve put into our air. But if we believe in an unseen God, what is so hard about believing in an unseen chemical imbalance?

  • maria deniels

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  • @BFichterWrites

    Thank you for this wonderful article. I blog about life with neurological disorders, as I’ve got Tourettes, OCD tendencies, and Generalized Anxiety Disorder. When I was young, I wanted to ignored my disorders as much as possible, but when I got into college, however, I realized that God didn’t make a mistake when He carefully made me in my mother’s womb. I was made the way I am for a purpose, to accomplish something in God’s plan I couldn’t accomplish any other way. Honestly, given the choice, I wouldn’t change who I am. Life can still be really rough, particularly with anxiety attacks, but I’m content with God’s decision. I’m told from time to time that if I were really trusting in God, if I really trusted Him to heal me, I would be healed from Satan’s curse. I don’t see it that way, however. I love the Lord with all my heart. I believe He could cure me if He wanted to. I asked God often (with the faith of a child) to heal me when I was young, but as God told Paul, “My grace is sufficient for you, for My power is made perfect in weakness,” and so I believe He has made known to me. And I’m okay with that. It means God has a mission for me; it means He made me special, and that’s an incredible gift.

    For this reason, I try to engage others in discussion on mental illnesses. As you said, it’s a difficult topic. I believe, however, that if Christians as a whole moved from trying to “cure” everyone or ignoring the topic, to trying to walk alongside them, offering whatever help they can, offering prayers of love, our country would be changed. People suffering in the black of disorders like Schizophrenia, Depression, Anxiety, Bipolar, and BPD would see the light of Christ in the dark, rather than an endless tunnel. I’m going to share this article. Thank you again for writing it.

  • Guest

    Thank you for this wonderful article. I blog about life with neurological disorders, as I’ve got Tourettes, OCD tendencies, and Generalized Anxiety Disorder. When I was young, I wanted to ignored my disorders as much as possible, but when I got into college, however, I realized that God didn’t make a mistake when He carefully made me in my mother’s womb. I was made the way I am for a purpose, to accomplish something in God’s plan I couldn’t accomplish any other way. Honestly, given the choice, I wouldn’t change who I am. Life can still be really rough, particularly with anxiety attacks, but I’m content with God’s decision. I’m told from time to time that if I were really trusting in God, if I really trusted Him to heal me, I would be healed from Satan’s curse. I don’t see it that way, however. I asked God often to heal me when I was young, but as God told Paul, “My grace is sufficient for you, for My power is made perfect in weakness,” and so I believe He has made known to me. And I’m okay with that. It means God has a mission for me; it means He made me special.
    For this reason, I try to engage others in discussion on mental illnesses. As you said, it’s a difficult topic. I believe, however, that if Christians as a whole moved from trying to “cure” everyone/ignoring the topic, to trying to walk alongside them, offering whatever help they can, offering prayers of love, our country would be changed. I’m going to share this article. Thank you again for writing it.

  • Kikki

    This is a great article. As someone struggling with bipolar disorder, I have had many christians tell me I just need to “have enough faith.” Name it and claim it sort of things. It’s a terrible to feel bad about having to take the medicine which actually makes me able to function as a normal person.

  • Pingback: Mental Illness & Medication vs. Spiritual Struggles & Biblical Counseling – ReBlog | The Peanut Gallery

  • Jonathan Cousar

    When you say, “Christians have to break the stigma and the shame of mental illness” – it sounds like something we hear anytime someone wants Christians to conform to the thought patterns of the world.

    At the risk of sounding terribly unenlightened, I will say that Christians have very good reasons for suspecting the world of psychiatry of not being in line with Biblical teachings.

    This is not to say that you’re not correct in stating that there are genuine mental illnesses that can only be treated with some form of medication. However, just like the number of abortions that are had because the woman was raped make up a tiny fraction of the total number of abortions, people who have genuine medically-induced mental illnesses make up only a tiny fraction of the total number of people who are on psychiatric medications.

    People today go to their psychiatrist as people in the past used to go to their pastor or priest. Psychiatry has really replaced the role of pastoral counseling in today’s secular America. People go to a psychiatrist at the drop of a hat. Probably sixty percent or more of people who go to psychiatrists regularly think they have some form of biologically-based mental illness.

    A large portion of what people today call mental illness – are in fact rooted in sin and in rebellion against God. Many (not all, but many) so-called psychological problems can be traced directly to non-belief in God. When a person believes there is no creator, there is no point to our existence, and in the end we’re all gonna die – that can actually cause real psychiatric problems.

    And the solutions “psychology” provides are also rooted in sin. Psychology is one of the most secular fields today. So it should be no surprise that they go down a dead end path in search for solutions to men’s mental anguishes. Unbiblical paths they follow include teaching self love, increasing your self esteem and venting your anger. Psychology is completely man-centered. A psychologists never tells a patient to look to God. They are only told that the solutions are within themselves.

    As for so-called “Christian” psychology, why would Christians start from a Godless foundation and then try to add God back in? Christian counselors need to start from a Biblical foundation – which would lead them to reject most of what secular psychology teaches.

    Much of what is psychology is today, is simply atheist practitioners trying to ascribe physical and biological causes to problems of the human condition, that are in fact spiritual. Like the way they have tried to show that humanity’s persistent belief in God comes from a “God gene”. The practice of psychology is materialistic in nature. It ascribes the most serious mental problems to physical and biological causes while completely ignoring the spiritual. Christians can’t start from that Godless base and think that they can just tweak it here and there and make it “Christian”.

    Since the use of psychiatry and psychiatric drugs is endemic to our culture, I would think it would be wiser for Christian writers to remind people of the problems associated with that, rather than trying to encourage people to get more comfortable with it.

    • MonteJ

      Are there spiritual problems that no amount of medication or psychiatric treatment will never be able to cure? Absolutely!

      Are there mental illnesses based on someone’s body simply over or under-producing a chemical in the body?

      Absolutely! (no different than when a diabetic’s body isn’t producing insulin.

      This is not a question of “either/or”. We need discernment – and when we jump to a wrong conclusion it can have disastrous results.

      Christians who discount the value of psychiatric treatment are as misguided as psychiatrists who discount the value of spiritual health.
      I am deeply disappointed by the ignorance and lack of respect that people on both sides of this debate show for one another and it results in such damage to hurting people.

    • @BFichterWrites

      While I do believe there are many unbiblical secular alternatives out there that shouldn’t be helping people, I believe in large it’s because the Church has failed to address the problem. Whether or not people are alwyas correctly diagnosed, they are people crying out for help. As someone with multiple disorders, I can tell you that I’ve talked to numerous Christians who have gotten very uncomfortable the moment I broached the subject. I feel very comfortable talking about my disorders, but many aren’t. It takes great bravery to go to someone for any type of help with a problem such as a mental illness. People who feel lost in their problems like this will go to the “experts” for help, whether they’re experts or not. (And believe me, a basic MD or neurologist can be of great help, that boat for the drowning man who prayed God would help him.) Where the Christian church can begin to bring people light, as you’re talking about, is in that place where they reach out to those who are hurting from these disorders or from sin. Either way, we need to reach out with a strong arm, and we’re not.
      As far as medications go, that’s a tricky place. Yes, they are sometimes overprescribed, but as MonteJ pointed out, we don’t judge diabetics who are lacking insulin. I firmly believe God has given us brilliant scientists to help us discover medicines for our ails. It’s another part of the Common Grace He sheds on our world.

  • Andrew Leong S C

    Dear Bro Ed, As a christian naturopath, I would normally
    attempt to identify the ROOT CAUSES of a person’s health condition first. This
    is the basis of Prov 26:2 and Gal 6:7. Many a sickness could be due to the sowing
    and reaping effect, namely, the way one EATS-THINKS-FEELS-LIVES. Then again in
    Ps 88, Heman is a prime example of a man of God who had lived with depression
    since young. That’s the decree of God. Meanwhile, Paul faced Timothy,
    Epaphroditus, and Trophimus whom he could do very little to help in terms of
    praying. And the great Elisha had become sick with the illness of which he
    would die. Therefore, when confronted with ill health, it’s vital that we “pray
    as if everything depends on God, work as if everything depends on you.” As a
    naturopath, I will search out all available info (360%) for the benefit of my
    patient. And the best remedy is always from a natural (non-chemical) SOURCE.
    For example, in mental illness, to me, the leading natural and least invasive
    therapy is Orthomolecular Medicine: http://orthomolecular.org/

    All psychotropic drugs will give the patient unwanted and
    unbearable side effects in the long term. Hence, if you choose to go on
    conventional medicine (drugs), always do it on a short term. After all,
    conventional med has only a history of 200 years, compared with natural
    medicine which has been sighted throughout the whole OT. And please remember,
    conventional medicine can never cure cardio-vascular diseases, diabetes,
    arthritis and other lifestyle diseases. This is because “chemical
    drugs” can never replace one’s nutritional deficiency in the first place,
    not to forget other contributors like stress and toxic elements exposure.
    Beloved, I wish above all things

  • Jerry Wells

    Here is my concern. It is easy to diagnose a broken leg and know that a cast is needed. How do you diagnose a chemical imbalance and know that a drug is needed? Is the testing that is done accurate? What I am hearing from many of my friends is that they went to a professional counselor. He did a quick assessment and then prescribed medication. I have heard this over and over again. What is the best way to diagnose mental illness and know that you your diagnosis is accurate?

  • http://twitter.com/Kevin_Hester Kevin Hester

    Great article! God’s power will be unleashed, when the church addresses taboo issues such as mental illness, gossip, slander,etc.

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  • Leigh Ann Mayfield

    Thank you for standing by, speaking up, and sharing with us as we come alongside our dear pastor and his family and support them in breaking the stigma and shame. God bless you for writing this piece.

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