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 temptation 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.


Stephen Altrogge serves as a pastor at Sovereign Grace Church. Find out more at The Blazing Center.