In the Biblical Counseling department of BJU, it is debated often whether mental illness is a spiritual problem or a physical problem. Some professors say mental illness is strictly a spiritual problem. Some say that it is both physical and spiritual, or more spiritual with a small physical aspect. If you ask each counseling professor their opinion, each one will give you a slightly different answer. As a student of these professors, I ponder this question frequently. I don’t want to deny that physical problems affect our mental health. But I also know that many of our trials in life come from our sinful hearts. So where should we stand on this issue? As Christians, how should we view mental illness?
What does Scripture say?
As Christians, it is important that we always start with Scripture. God’s Word guides our life, so we need to let it have preeminence, especially in controversial issues. You may think that the Bible doesn’t say anything specifically about mental illness, but there are quite a few passages that we can apply to this topic.
Before looking at these passages, the reader needs to understand a basic concept: the world is tainted by sin. When Adam and Eve sinned, it affected everything inside and outside of man. It is important that we keep that concept at the forefront of our minds when addressing the problems of life, including mental illness.
“And He was saying, “That which proceeds out of the man, that is what defiles the man. For from within, out of the heart of men, proceed the evil thoughts, fornications, thefts, murders, adulteries, deeds of coveting and wickedness, as well as deceit, sensuality, envy, slander, pride and foolishness. All these evil things proceed from within and defile the man.””Mark 7:20-23 NASB
Jesus tells us here that evil thoughts and actions come from within us. Because of original sin, we have a tendency to be evil and sin against God, ourselves, and those around us. Jesus points out here that evil thoughts happen because of this original sin. This means that when it comes to mental illness, we have to keep in mind that there is evil in our minds. If there is evil in our minds, then that is obviously going to cause us some problems. We cannot ignore this fact.
“To the woman He said, “I will greatly multiply Your pain in childbirth, In pain you will bring forth children; Yet your desire will be for your husband, And he will rule over you.” Then to Adam He said, “Because you have listened to the voice of your wife, and have eaten from the tree about which I commanded you, saying, ‘You shall not eat from it’; Cursed is the ground because of you; In toil you will eat of it All the days of your life. Both thorns and thistles it shall grow for you; And you will eat the plants of the field; By the sweat of your face You will eat bread, Till you return to the ground, Because from it you were taken; For you are dust, And to dust you shall return.””Genesis 3:16-19 NASB
Here, we see God pronouncing judgement over Adam and Eve after they sinned against Him. The specific judgement here is over the physical realm. The creation is being twisted by sin into something darker than what God originally created it to be. Life will have physical pain now because of sin. Adam and Eve’s sin affected their physical bodies. In the context of mental illness, this means that our brains can be affected by sin as well. Things can go wrong and not work the way God intended them to.
What does science say?
Science is a great gift that God has given us to better understand our world. One thing that I have noticed often happens in the Biblical Counseling movement is that aspects of science that try to explain the brain and mind are ignored or devalued. God gave us science, including neuroscience and psychology, for a reason. We need to study it through the lense of Scripture, but we should not ignore it. It may not be infallible or all-knowing, but it is a tool that we need to take advantage of, particularly when addressing the issue of mental illness.
A key biological cause that has been linked to mental illness is brain trauma. Damage to the brain is bound to cause problems. One famous example of this is Phineas Gage. He worked for the railroad in 1848. One day his tamping rod accidentally ignited gunpowder, which thrust the rod straight through his head. He lived and fully recovered from an outside perspective. The strange thing was that his colleagues said that his personality shifted drastically. He became “restless, disrespectful, and unreliable following the accident.” The hole through his brain obviously impacted his mental state. There are multiple other examples of brain trauma causing this kind of outcome.
Another biological cause of mental illness is neurotransmitters. We know that things like dopamine and serotonin can affect mood. We don’t fully understand how they work, but science has shown their affect on the human mind. Dopamine regulates mood and is vital to the brain’s pleasure and reward systems. Serotonin also regulates mood, as well as appetite. If something is off about either of these two neurotransmitters, it can make one more susceptible to depression and anxiety.
There are multiple other physical issues that can play into mental illness. Hyper-thyroidism causes symptoms of depression. Hormones affect anxiety. There are many other things just like this that affect how our mind operates.
Mental illness can be both a physical and/or a spiritual issue. Scripture obviously shows that the spiritual world plays into mental illness in a key way. PTSD is trauma as the result of people sinning against us or us sinning against others. OCD can be caused by our fleshly need for control. The list goes on and on. Sin affects us in many ways that result in symptoms of mental illness. One of those ways is by how sin affects how our physical bodies, which we observe through science. We see how the brain functions differently when a patient has schizophrenia or autism. We recognize the physical influences on anxiety and depression. We can see how there are spiritual and physical aspects to mental illness, both being rooted in how sin affects our lives.
“Because of the surpassing greatness of the revelations, for this reason, to keep me from exalting myself, there was given me a thorn in the flesh, a messenger of Satan to torment me—to keep me from exalting myself! Concerning this I implored the Lord three times that it might leave me. And He has said to me, “My grace is sufficient for you, for power is perfected in weakness.” Most gladly, therefore, I will rather boast about my weaknesses, so that the power of Christ may dwell in me. Therefore I am well content with weaknesses, with insults, with distresses, with persecutions, with difficulties, for Christ’s sake; for when I am weak, then I am strong.”2 Corinthians 12:7-10 NASB
I think this passage on Paul’s “thorn in the flesh” is the most comprehensive to apply to how we should view mental illness. We aren’t told what the thorn in the flesh is, but we do know that it was a serious struggle for Paul to deal with. It may have been physical, but it also could have been a sin struggle. It doesn’t really matter what the thorn in the flesh was (Paul would have told us if it was); what matters is how Paul responded. When it comes to mental illness, it ultimately doesn’t matter whether or not it is caused by physical or spiritual struggles. This is not say that we shouldn’t treat mental illness based on what the cause is. We should treat the physical issue and/or the spiritual issue. What is most important though is how we respond to mental illness.
When God refuses to take away Paul’s issue, Paul responds with humility. He sees God’s purpose for the thorn in his flesh and accepts it. This purpose is God’s glory. Our struggles, whether physical or spiritual, can be and should be used to glorify God. Our response to mental illness should be finding a way to glorify God through it. Christ is shown strong when we are made weak, and we need to display this in our lives. This means that mental illness is a gift from God, though it is the result of sin, because it can be used to glorify Him.
We see that there are physical and spiritual issues that cause mental illness. It is important that we recognize this so that mental illness can be treated in the best way possible. Ultimately, we need to focus on Christ with this issue though. How do we respond in a way that glorifies Him best, whether our mental illness is physically or spiritually caused—-that is what we need to be thinking about when it comes to mental illness.