Line in the Sand
Where does mental end and spiritual begin? There is no definitive line. You’re going to sin in sickness and be soul-sick in sin. The two (the heart and mind) operate in tandem.
As a caseworker, I had a client at one time who was being seen at my clinic for mental health issues she had. Let’s call her Mary. Mary was also diabetic. On her way to town one day, while her husband drove her to an appointment, Mary started to frantically undo her seatbelt, screaming threats at her husband, and opened the door of the truck to fall out. She just about accomplished this act of defiance, but her husband’s quick response and grasp saved her life.
At that time, Mary appeared suicidal. Mary appeared out of her mind. Arguably, Mary was in a state of rebellion. Mary appeared to be in a mental state of duress. However, neither was the root cause of her behaviors. Mary was in delirium.
Because Mary had not eaten and was not treating her diabetes in the last few days, she entered this state. It was not a direct choice to try to end her life in direct rebellion to God, nor was it a “mental” choice to be sick. Indirectly, was she disobeying and sinning against God? Not yet…had she accomplished this, then she would have. Indirectly we see she is attempting to break a commandment to murder. Yet, just as important to note: indirectly she is experiencing a mental state of confusion – a symptom of delirium. And the root of this inner struggle and subsequent outward behavior? Low blood sugar levels causing her body to respond thusly.
Such scientific studies and research surrounding what we’ve commonly referred to as “mental illness” is catching up to reveal that the brain is an organ that is prone to sickness, and results in behaviors that can be classified as symptoms of a disease. Ultimately, all souls are sick with the root cause of illness being sin. And not every sickness or disorder is directly caused by someone’s sin – as Jesus points out in John 9:3 with the man born blind – “It was not because of his sins or his parents’ sins,” Jesus answered. “This happened so the power of God could be seen in him.”
Unlike sin, when it comes to addressing behaviors stemming from mental illness, there is no law or precedent in the church to reprimand or correct the behaviors. There must be understanding and love, compassion, and care.
Reframing Symptoms and Sin
Let’s reframe symptoms of brain illness (or the more familiar term “mental” illness). There can be behaviors that appear like sins, especially serious brain disorders that left untreated, keep people from functioning normally. Here are a few examples that manifested in my episodes of bipolar mania and psychosis:
- Hyper-sexuality:
In bipolar disorder, this is a symptom that can manifest. If it is manifested within a marriage, it may create an idol out of sex and tend toward obsession. Outside of marriage, then what? If literally acted upon, this can become sinful in the context outside of marriage carried out in the form of lust.
- Hyper-religiosity:
Another symptom of bipolar disorder. If it is manifested to cause someone to become pharisaical or legalistic, that has the appearance of sin. If someone believes they are a literal character from the Bible, there’s an identity issue there. But what if it causes me to fall more in love with my Savior, or call people to repent? Is that a sin?
- Paranoia:
In illnesses like schizophrenia and bipolar disorder with psychotic features, paranoia feels like someone is out to get me. According to the Word of God, someone is out to get me – the enemy of my soul—Satan. But also according to God’s Word, I am not to fear that enemy. When my brain puts me in this state of mind because of the sickness therein, I do not have control over whether I’m fearful or not. This is not a sin.
- Anxiety:
Many clients I had worked with in an outpatient clinic struggled with over-analyzing their lives to the point of losing sleep. I do not agree with the theology or doctrine that believes all anxieties are sin.
Worry is an act that we are tempted and can choose to “indulge” in. I personally believe there comes a point where, since medication can eliminate and help these anxieties, it is more of a conditioned habit that can turn into a crippling clinical condition.
Are we to trust God and turn from our sin of worry? Yes. Is there a point that we fall into this sin in our brain illnesses? Yes. Should I fault the brain illness or myself? That depends.
- Depression:
There is undeniable evidence in the Bible and in life that our hearts are prone to depressed states. Numerous times in the Psalms, the psalmist cries out, “Why are you cast down, O my soul, and why are you in turmoil within me? Hope in God; for I shall again praise him, my salvation and my God.”
While we have responsibility for our heart’s attitudes, when in a state of clinical depression, we aren’t expected to suddenly come out of depression. God never ignores the state of mind and heart we are in. Based on the Psalms he wants us to acknowledge our state, but also fix our eyes on Jesus. Ezekiel’s suicidal ideation and God’s ministering angels sent to care for him confirm God’s attitude toward our depression.
God doesn’t command us to be happy or rid of depression. He doesn’t expect us to struggle and suffer indefinitely, either. He cares, and he wants us to heal. Healing comes through many avenues, including the grace of medication for those who have a clinical reason for it.
With these symptoms and others, it’s key to ask ourselves: am I doing all that I can actively do to turn to God and away from sin, and walk in the strength of His Holy Spirit to overcome? And am I also enlisting the help of psychiatry, medication, and psychotherapy, that can help these processes slow down and help “rewire” my brain circuitry and neurological processes?
Looking at these symptoms of a brain illness, am I disobeying God by being subjected to this sickness? No–this is a chemical or circuitry response to the fallen world and broken body I live in.
Perhaps I am sinning and feeding into that fear, having no sense of how to resist temptations because I’m out of my right mind. But is that weakness reason enough to correct and condemn my behavior?
There are differences between sin and symptoms. There are similarities. The key to distinguishing them from each other is to understand how they intertwine. And where the root cause is.
Like A Tandem Bicycle
The two – mind and heart, mental and spiritual, mental health and faith – operate in tandem with one another. I’d liken them to a tandem bicycle.
Like a tandem bicycle, your mind and heart must be aligned to work together to come out of depression. Think of hope as the chains on the bicycle that work together to keep the efforts of mind (front) and heart (rear) riders going in the same direction with power and swiftness.
Like a tandem bike, the mind steers itself and the heart. I believe then that to move forward, the heart must follow in the direction of the mind, with the living spirit of the person driving. If the heart isn’t doing its part to pedal and enjoy the ride, it’s weighing the mind down and holding it back from moving forward at the normally expected rate.
The heart must keep up, but not disingenuously since it’s the earnest hoping heart that will make the pedaling from the rear that much easier for the mind to steer and get going.
If your mind is strong and dwelling on positive, reasonable thoughts, but your heart is weak, you may be sad, disappointed, or disheartened. You haven’t given up complete hope. You may be calloused and jaded, but hope may still reside within your heart as your mind can be determined to move along in the right direction.
Contrarily, if your mind is weak, dwelling on negative thoughts, and yet your heart is resilient, your mind can still lead your heart into hopelessness. A clinically depressed state (like crashing your bike or going in the wrong direction or the chains falling off the bike) could follow.
To add more depth to this illustration, I want to clarify something. Faith in Christ and the new life He generates in a born-again spirit gives us a compass to follow, and the divine help we need to get off the blocks and drive the bicycle. Outside of that, there is no generated eternal value to the equation.
Therefore the soul riding the bicycle is essentially going nowhere, and stationery.
They are trying to “do good” or live life fully but will never get anywhere when they are a bicycle whose tires never hit the ground. They’re still on the blocks.
Apart from God, we go nowhere. With God, we move mountains and move over mountains. That is the key to a born-again life going the distance and moving in victory.
So What Do We Do?
When someone comes to you seeking help with a seemingly sinful desire or likeness, what can you do? Here are a few suggestions:
- Listen carefully to discern whether they are exhibiting signs of a mental illness or actual sin-rooted desire/behavior. Ask them their medical/mental health history if it’s not apparent. This may indicate whether they’re dealing with more of a sin-issue or a brain-issue.
- If they are exhibiting signs of suicidality, get them to talk to you about their ideas on that. If they have a plan (method and date) call 988. If they have a method, call on natural supports and develop a prevention plan. If you don’t feel equipped, call on a mental health professional to help with this.
- If they have come back to you repeatedly, encourage someone safe to keep them accountable like a trusted natural support, peer support, hope coach, or case worker
- Recognize that the only applicable, appropriate scriptures to apply are those of love, care, and compassion. If they are in an episode of severe depression, mania, or psychosis, be careful to address any sin or issue of morality. If it is a true episode of mental illness, they need medical attention. In that case, save the preaching and sharing of Scripture for another time, when they are able and ready to hear and apply. If their sickness is untreated, they need to have it treated first.
Sometimes, the best help we can offer a person in their sickness is a referral. Their hearts and minds are heavy, and we’ve done all we can do to address their broken hearts. But there is always hope –like the chains of the bicycle—that when they take heart, in Christ, they can overcome and be more than victorious.
Encouraging someone with a mental illness in their hope and faith in Christ, plus giving them tangible help with medical treatment, is the way to get them on the road to recovery.
Bottom Line
If Jesus threw no stone, neither do we.
Blame is appropriate to take on when you are coherent and recognize the sin that manifested in your symptomatic behaviors, or when you sinned while you’re stable. Against God and usually God alone do we sin, so confessing and repenting of those sins is completely in line with Scripture to deal with that.
Turning away from our sin in an acute episode is not so easy. Not that it isn’t possible, but sin may happen, and in some situations if it goes too far outside bounds of societal norms, the sin and behavior both need to be addressed.
Realizing that this is a sickness that throws us into a downstream of sinful currents is the approach we must take toward ourselves or others who are in the midst of a clinical episode. Onlookers must throw a rope of hope to save them, not a rope to hang by.
