Mental Health Bias in the Church (Part 2)

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(Editor's Note: This blog was written by Dr. David Smith, M.D., who practices family medicine in North Carolina.)

Let’s take a walk through the Bible to see that there are many who struggled with mental health. Moses (Numbers 11:15), Naomi (Ruth 1:20-21), Hannah (1 Samuel 1:1-20), Elijah (1 Kings 19), Job (Job 1-42), David (Psalm 6, 13, 31), Heman (Psalm 88), Jeremiah (Lamentations), Jonah (Jonah 4), and even Jesus (Luke 22: 41-44) all suffered from various forms of mental anguish. More contemporarily, Charles Spurgeon stated,

“My witness is that those who are honored by their Lord in public have usually to endure a secret chastening or to carry a peculiar cross lest by any means they exalt themselves and fall into the snare of the Devil. ….This depression comes over me whenever the Lord is preparing a larger blessing for my ministry. The cloud is black before it breaks and overshadows before it yields its deluge of mercy. Depression has now become to me as a prophet in rough clothing, a John the Baptist heralding the nearer coming of my Lord’s richer benison. So have far better men found it. The scouring of the vessel has fitted it for the Master’s use. Immersion in suffering has preceded the filling of the Holy Ghost. Fasting gives an appetite for the banquet. The Lord is revealed in the backside of the desert, while His servant keeps the sheep and waits in solitary awe. The wilderness is the way to Canaan. The low valley leads to the towering mountain. Defeat prepares for victory. The raven is sent forth before the dove. The darkest hour of the night precedes the day-dawn.”

I’ve never heard someone with hypertension be advised that if their faith was strong enough, they could stop taking the medication. I’ve never heard anyone advise a diabetic to stop their insulin or other medications because they should be healed if they had enough faith and truly knew God. The same could be stated for many conditions from which people still suffer. Yet the same people who realize this do not practically apply that recognition to those with mental illness.

I’ve noticed for many years that many Christians are very reluctant to continue to take anti-depressant medication. They fail to realize that there is both a physical and a spiritual dimension to be considered for any illness. All medical problems are either a combination of physical and spiritual causes, or purely due to either a spiritual or physical problem. Due to ignorance of the physical causes of mental illness, many Christians unfairly attribute mental illness entirely to a spiritual cause. It’s easier to understand something like hypertension or diabetes, and there is not an instant bias of thinking someone has a spiritual problem when they talk about having those conditions. Many cannot accept that they need medication to help them due to this bias. The same people would not hesitate to take medications for other illnesses that are not considered primarily mental.

I’ve seen the harm that occurs in churches when those with mental illness refuse treatment and bring many problems to themselves, their families, and others, which would not occur if they understood the nature of their condition better. Wounded people wound others, and the health of the body of Christ suffers unnecessarily. A psychologist I met many years ago told me once, when we were discussing how people get to a point of suicide, that “if the pain of change is less than the pain of staying the same, you’ll change.” Prior to getting that desperate, many try to effectively self-medicate by turning to alcohol or other drugs. In trying to escape their mental prison, addictions can follow that are even worse. Too many cannot find relief and eventually give in to suicide when the pain is so great that the pain of suicide seems less than the pain of staying like they are.

I’m not trying to state that any mental illness should always be treated only with medications and without concern for the spiritual. Anyone who practices medicine knows that the best treatment for depression combines medication and therapy. Sometimes people have temporary problems, and their condition can resolve. It is certainly possible to recover and not need medication any longer. For some, it’s mild enough that they only need the right type of therapy with no medication required. One person’s treatment is not everyone’s treatment. The truth is that those who have a family history of mental illness are more likely to have genetic causes that they cannot control and need medication. It’s hard for many to accept their need for medication chronically, and they will typically cycle on and off medications for many years before they can accept their need for it.

From my experiences, I’ve seen a lack of understanding among many Christians and a sparsity of holistic treatment. This results in Christians refusing chronic treatment with medication more frequently than non-Christians. Medication should be viewed as a form of grace from God and not indicative of a lack of faith or some other spiritual deficit. That acknowledged, it is also not wise to immediately jump to a medication for everyone, especially a new mental health problem. It can certainly be that God is working in that person through their health struggles, just like with a heart attack or stroke or any medical condition. Trying to remove all pain from their life then short-circuits what God may be trying to do in their life. That’s why there is not a one-size-fits-all or cookbook approach that works for everyone. To consider the complexity of it, one has to be aware of the complexity.

Following from that foundation, let’s look at one extremely common genetic cause of mental illness. It’s called an MTHFR mutation. Affected individuals have less efficient MTHFR enzyme activity and is associated with being susceptible to cardiovascular disease, dementia, neural tube defects, several malignancies, pregnancy effects, autism, and mental illness. Individuals who have a strong family history of mental illness, possibly also heart disease and stroke, and have a personal history of unexplained mental illness have a greater than normal chance of having an MTHFR mutation identified if testing is done. Care has to be individualized, so it’s recommended to always see your personal physician and consider a functional medicine practitioner to discuss and guide any treatment.

I learned many years ago the frailty of the human mind upon witnessing the mental decline of a friend who also happened to be a minister. Having known him for several years and knowing his good character, I was shocked to hear certain words and thoughts he said when he was near the end of his life and not in his normal mental state. I struggled to understand what seemed like contradictions. If you have cared for someone ill before, you may have witnessed that, too. When our minds are not functioning properly, our words and actions are not fully in our control. After he passed away, I was asked to handle the graveside ceremony. While standing there at the graveside, I was holding my Bible and reading from Revelation. At the moment I started talking about resurrection, a butterfly came up and landed on my right thumb, which held the Bible in front of me. I stood there in awe observing that butterfly, which stayed on my thumb for maybe a half minute. I directed my comments for those listening to notice that butterfly and the symbolism it brought to that graveside service. There is so much we don’t understand. We should practice more compassion and love towards those hurting with mental illness, remembering always to address both the physical and spiritual components of a holistic approach to ministry for those with mental illness.

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