I initially set out to write an article helping pastors and church leaders recognize and respond to signs of mental illness among adolescents, but in the process of doing research, I kept encountering stories like the one below, told by a Christian psychiatrist, who was asked by a fellow church member about the mental health issues of a person named Anna:
“The Scriptures tell us that in Christ we have everything we need for life and godliness, correct? So can you explain to me why Anna’s bipolar disorder and her dependence on medication is not an issue of weak faith or sin?” Only two of us stayed after the church meeting that morning, talking over coffee. I was a deacon in the church at the time, and the man who asked the question was a friend and respected elder.1
Since this kind of reasoning is apparently prevalent among Bible-believing Christians, before looking at practical ways to respond to mental illness, it’s of even greater importance that we examine how we view mental illness in the first place and those who experience it (which may include ourselves). If we have a faulty view of mental health issues, our response will be counterproductive, unhelpful, and potentially harmful to those we want to help.
It’s likely that anyone in ministry will come into contact with, and need to minister to, someone dealing with a mental disorder. More than 50% of Americans will be diagnosed with a mental illness or disorder at some point in their lifetime, and one in five will experience a mental illness in a given year.2
Adolescents, especially, are experiencing greater mental health challenges than ever before. For example, in 2021, more than 42% of high school students felt persistently sad or hopeless and nearly one-third (29%) experienced poor mental health. In the same year, “more than 1 in 5 (22%) students seriously considered attempting suicide and 1 in 10 (10%) attempted suicide.”3
Adolescents, especially, are experiencing greater mental health challenges than ever before
With mental health issues so pervasive, it will help to sort through our own thinking about these issues so that we’ll be better prepared to respond to them. Thus, in what follows, after defining what mental illness is, I’ll endeavor to make two main points—first, that it’s okay to experience and express struggles, difficulties, and challenges, including in relation to mental health, and second, that it’s okay to seek out and use medical assistance to support mental health.
What Is Mental Illness?
The distinguished Christian psychologist Gary R. Collins notes that there is no universally agreed upon definition of mental illness, but explains that it is typically characterized by the following three symptoms. First, there is some kind of distress, which might include “anxiety, depression, anger, or other suffering that is emotional or psychological more than it is physical.” Second, a deviance is present in which “the person thinks or acts in ways that most people in the society would consider to be unusual or socially inappropriate.” Finally, disability and dysfunction are common, so that “the person with a mental disorder may be unable to attain his or her goals, have difficulty handling the day-to-day routines of living, or not be able to hold a job or a clear conversation.” He further observes that the distress, deviance, or disability “may be mild and minimally bothersome, but these also can be more disruptive and sometimes of severe intensity.”4
The Normalcy of Personal Struggles
While all orthodox Christians acknowledge the Fall of Adam and Eve, we tend to focus on its spiritual rather than physical or mental consequences. But as Christian psychiatrist Matthew Stanford writes, because of the Fall, we are
born with an imperfect body, scarred as the result of generations of sin. Genetic defects, biological predispositions, and anatomical abnormalities are all the consequences of being conceived in sin (Psalm 51:5). On the day that Adam and Eve fell, they forfeited their intimate relationship with God, and they became mortal. And we were placed at the mercy of the environment and natural biological processes that wreak havoc on our bodies and minds.5
In light of a holistic understanding of the Fall, we shouldn’t be surprised that humans, Christians included, often suffer from physical and mental dysfunctionality. We should also beware of the often tacit assumption that Christians shouldn’t talk about their struggles or weaknesses, even if they experience them. As the earlier story about the elder suggests, even mature Christians can mistake struggles as signs of a weak faith. This may be more true of mental health issues than physical ones. As counselors Steve Midgley and Helen Thorne point out, “People will rally around a congregation member with cancer far more quickly and easily than someone whose diagnosis relates to the mind. Mental illness is perceived as confusing, weird, something that only specialists should engage with and, potentially, too long-term for any sustainable care.”6
We should also beware of the often tacit assumption that Christians shouldn’t talk about their struggles or weaknesses, even if they experience them
Yet Scripture abounds with examples of God’s people who encounter difficulties and express their feelings to God and to fellow believers. Job confessed to his friends, “sighing has become my daily food; my groans pour out like water. . . . I have no peace, no quietness; I have no rest, but only turmoil” (Job 3:24, 26).
The Psalms are filled with expressions of grief. There are 38 Psalms that are classified as Psalms of lament.7 In Psalm 6, for example, David exclaims, “All night long I flood my bed with weeping and drench my couch with tears. My eyes grow weak with sorrow” (6:6, 7).
Similarly, Paul shared with the Corinthians that “we are hard pressed on every side . . . perplexed . . . persecuted . . . struck down, but not destroyed” (2 Cor. 4:8-9).
The great Victorian preacher and pastor Charles Spurgeon famously struggled with depression his entire life. He described one incident in which “my Spirits were sunken so low that I could weep by the hour like a child, and yet I knew not what I wept for.” Yet, Spurgeon did not regard his affliction as a spiritual weakness or sin. He wrote, “No sin is necessarily connected with sorrow of the heart, for Jesus Christ our Lord once said, ‘My soul is exceedingly sorrowful, even to death.’ There was no sin in Him, and consequently none in His depression.’”8
In light of the Fall and numerous examples from Scripture, we should consider it commonplace for God’s people to experience pain, difficulties, and struggles, including mental disorders. Expressing these challenges to God and fellow believers is psychologically and relationally healthy.
The Appropriateness of Medical Care
Since mental health issues, as we’ve seen, are sometimes construed as stemming from a lack of spiritual commitment, proposed solutions sometimes focus on spiritual disciplines as the remedy. If the afflicted individual would only pray more, read more Scripture, or involve themselves in church activities, a stronger faith would eventually lead to victory over the problems.
But this approach emphasizes special revelation to the neglect of general revelation. Since the early church, Christian thinkers have recognized that there are two sources of knowledge of God and creation—the book of Scripture and the book of nature.9 The vast majority of what we know about human biology has been learned from studying humans themselves (an aspect of the book of nature), and this God-ordained knowledge should be used to help human beings flourish.10 As Christian psychologist Stanton L. Jones observes,
Christians believe that we find revealed in the Bible everything necessary to a full life in Christ, because the Scriptures direct us truthfully to him who is the source of all goodness and mercy. . . . But this does not mean that everything we want to know can be found in the Bible, including everything we want to know about child development, human personality, schizophrenia or depression.11
While potential spiritual issues shouldn’t be neglected when it comes to helping someone struggling with mental health, possible medical causes and solutions should be fully explored. In a statement adopted in 2014, the Association of Certified Biblical Counselors declared that “Examinations by medical professionals are crucial adjuncts to a biblical counseling ministry as they discover and treat, or rule out, physical problems that lead many to seek counseling help.”12 They also direct the counselors affiliated with them to observe the following three principles (among others):
- Biblical counselors must acknowledge that human beings struggle with physical and spiritual problems.
- Biblical counselors shall encourage the use of physical examinations and testing by physicians for diagnosis of medical problems, the treatment of these problems, and the relief of symptoms, which might cause, contribute to, or complicate counseling issues.
- Biblical counselors shall help their counselees respond biblically to physical problems, but deny that spiritual interventions are the only proper response to problems with a medical element. They reject any teaching that excludes the importance of the body and the goodness of God, which leads to the blessing of medical care.13
These principles helpfully summarize the two key points I’ve argued for above—namely, that ministers and church leaders should expect that their members will struggle with both spiritual and physical problems—and that sharing them freely is healthy and biblical—and that mental health issues often involve physical problems that require medical diagnosis and treatment. If we adopt this mindset, we’ll be able to minister more compassionately, wisely, and effectively to those struggling with mental health issues.
Christopher L. Reese (MDiv, ThM) is a writer, editor, and journalist. He is the founder and editor-in-chief of The Worldview Bulletin and cofounder of the Christian Apologetics Alliance. He is a general editor of the Dictionary of Christianity and Science (Zondervan, 2017) and Three Views on Christianity and Science (Zondervan, 2021), and his work has appeared in Christianity Today, Bible Gateway, Beliefnet, and other sites.