No credible Christian I know of says that all instances of depression, anxiety, etc., are always mental illness and never the result of personal sin. Yet sometimes that impression is given because of language and emphasis.

Similarly, no credible Christian I know of says that all instances of depression, anxiety, etc., are caused by personal sin and are never the result of mental illness. Yet sometimes that impression is given because of language and emphasis.

As we saw yesterday, part of the reason for these false impressions is the absence of mutually agreed terminology that would cover both physical and spiritual causes. However, there are steps we can all take to bring Christians who disagree on these matters a bit closer together.

I’m going to ask “mental illness maximizers” (those who speak mostly in illness/disease categories) to reach out to “sin maximizers” (those who speak mostly in moral categories), and then I’m going to reverse the process. I realize that these are not two totally distinct groups and that most of us fall somewhere on the spectrum between them. But, wherever we fall, we can all make an effort to bridge the divide and work more cooperatively and respectfully.

Mental Illness Maximizers

Christians who use mainly “mental illness” language and fully accept the possibility of physical damage and disease in the brain’s ability to process thoughts and emotions, should:

1. Be careful not to give the impression that “mental illness” is all we believe in. While offering compassionate help to those who suffer due to having fallen bodies and brains, or because of factors outside of their control (Job 1), or because of direct divine intervention (John 9), we must also carefully identify where people have brought much or all of their suffering upon themselves due to sinful personal choices, and adjust our language, counsel, and help accordingly.

2. Even where there is a physical cause or element to a person’s suffering, we should still allocate time and energy to helping sufferers respond to these physical issues in a spiritually beneficial manner, reserving an important place for God’s Word in the healing process.

3. We should usually not run to the “medical model” too fast, too over-confidently, or to the exclusion of spiritual factors. Where medical intervention is necessary, we should make clear that it’s very rarely a full cure on its own.

4. Even if there has been physical damage to the brain, undermining its ability to process thoughts and emotions, in addition to medical treatment, we must also have confidence in God’s Word playing a role in reversing bad thinking and feeling patterns, and substituting them with biblical ones.

5. We need to be sure that we are also helping people to get spiritual benefit from their suffering. While we do not agree with the idea of somebody suffering depression to the maximum to get the maximum spiritual advantage (who would do that with a broken leg or cancer?), yet we must question the common demand for the speediest and most complete deliverance that can be found in this world.

6. While being open to medical research, we should be more discerning in reading and believing it due to the secular assumptions that drive most scientific work.

7. If we involve other caring professionals we must stay involved in the caring package and ensure that people are not led astray by false philosophies or dangerous therapies.

8. We must keep the local church, Christian fellowship, the means of grace, and prayer central in all care packages.

Sin Maximizers

The vast majority (95%+) of biblical counselors I speak to accept the existence of “mental illness” to some extent. However, some of them are (understandably) so afraid of losing biblical categories of “sin,” “redemption,” “sanctification,” etc., that they sometimes give the impression that there is no such thing as “mental illness,” or that it’s so extremely rare that it’s hardly worth a cursory glance.

I know this  impression is often unintended and sometimes denied, but it’s the impression I and many others have at times received. As someone who sadly used to be 100% in the “denial of all mental illness” school, I’m probably more sensitive to this impression than others, but I know that the impression is widespread among a wide range of people. And we’re not all dummies.

As the effect of this impression is that many people who desperately need at least some spiritual help turn away from Christian pastors and counselors, and go to more “compassionate” secular counselors, I would offer the following suggestions to lessen this impression and hopefully increase the involvement of biblical counselors in these situations:

1. If you accept the possibility of mental illness, try not to state that in very small print, with very few words, and with a very quiet voice. If you do, don’t be surprised if people think that you in practice deny it.

2. If you accept the possibility  of mental illness, don’t allow any other statements in your speech or writing that seem to deny it. People will see the inconsistency and make their own conclusions about what message is really intended.

3. If you accept the possibility of mental illness, don’t limit root causes to one or two glandular problems. This not only makes it look like the last medical research you read was 30 years ago, it also effectively reduces the number of “genuine” mental illnesses to a negligibly small number.

4. If you accept the possibility of mental illness, provide holistic help to people by going beyond searching for sin and calling to repentance.

5. If you accept the possibility of mental illness, do not indulge in generalized criticism of psychiatrists, psychologists, pharmacists, etc., unless you really know what you are talking about. If there are things to critique – and there are – be specific, but also recognize the valuable contributions that these other caring professionals can make.

6. If you accept the possibility of mental illness, build relationships with trustworthy professionals in those fields, so that you can confidently involve them (not “punt” to them) in caring for sufferers God has brought into your life.

7. If you accept the possibility of mental illness, don’t insist that a person who is suffering in this way endure it as long and as deep as possible in order to get maximum spiritual advantage. You wouldn’t do that if he had cancer. Remember that the person’s family members and churches are often suffering the consequences of waiting for the sufferer to get his “spiritual growth.”

8. If you accept the possibility of mental illness, be open to reading current medical research and learning about the knowledge God is sharing with scientists for the benefit of His church. Try to avoid latching on to a few pieces of research that prove your prejudice against, say, medication. If you are going to quote research, make sure you read a breadth of material and stay mainstream. There are quacks on both extremes of this divide.


If there’s one thing we can all do, it’s to avoid making our own experience the rule for others. That’s the most common mistake I’ve seen people falling into here (and I’ve done it myself as well). Just because medication worked for you, does not mean it will work for everyone else. Just because biblical counseling alone worked for you, doesn’t mean it’s the answer for everyone else. Just because you’ve never been depressed, doesn’t mean depression does not exist. Cases are so different, and causes are so complex, that we need to exercise charity, sympathy, and patience in all our dealings with one another.

What else can we do to bridge the gap and communicate more clearly? This is no academic question. It’s sometimes a matter of life or death.

Previous posts in this series
The problem with “mental illness”
Pastoral thoughts on depression
Mental illness and suicide: the Church awakes
7 Questions about suicide and Christians

  • Bea L

    Thank you so much for your ongoing thoughts on this subject. I continue to be greatly encouraged as I read your blog, and find myself going back to various posts to re-read them. I also find myself sharing your posts quite often. God’s blessings on your work!

    • David Murray

      Thanks Bea. Glad it’s a help.

  • Martin Woodier

    Fantastic blog, David. This is really, really helpful. It is great to read someone who is so Biblically sensible on this subject.

    • David Murray

      Thanks Martin. I’ve still got a lot to learn, I can assure you.

  • Wairimu

    This makes more sense than the previous post for me. Thanks David. There are many, many questions that remain unanswered, but this sheds a lot more light.

    • David Murray

      Good. Glad I managed to make it clearer.

  • Ed Blackwood

    Dr. Murray – I appreciate the compassion with which you are addressing these matters. I notice in this post you start out with the two opposing (and invalid) sides – “all instances of depression, anxiety, etc., are always mental illness and never the result of personal sin” vs. “all instances of depression, anxiety, etc., are caused by personal sin and are never the result of mental illness”.

    But the matter I face pastorally is not quite either of those – but rather “the things I DO are the result of my mental illness and I can’t help it.” So, I wonder if you might address that question in a future post?

  • Scott Kalas

    Very insightful blog David. Once I find print link I’ll be adding it to my library

    • David Murray

      I’ll get that print link eventually!

  • Pingback: Maximizing and minimizing mental illness | rejoice in the Lord always (:

  • Barbara Thayer

    I sincerely want to thank you David for your helpful post on this subject. Many years ago, I suffered from a deep depression, anxiety and panic attacks after a traumatic situation. With Christian counseling and medication, I have been restored. I am grateful to both means of addressing my issues. Too often, I have had Christian friends tell me that medication is a sign of weakness and lack of faith. However, for some of us, there is a chemical imbalance which predisposes us to having episodes of depression and panic. The medication helps to keep that in balance just as diabetics need insulin…some of us need medication to help. However, the Christian counseling also helped me see areas that needed to be dealt with. For me, it was a win, win situation. To God alone be the glory! Again…thank you for addressing this important topic.

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  • Bob Kellemen

    David, As I mentioned in our email exchange, I’ll be posting some blogs interacting with your post. My first post is “live” now. It addresses the question, Are Biblical Counselors “Sin Maximizers”? I’d be interested in your thoughts and the thoughts of your readers. Here’s the link for those who are interested in that questions:

  • Pingback: Counseling Built Entirely Upon Christ’s Gospel of Grace

  • Pingback: Biblical Counseling: Promoting Compassionate, Comprehensive Care for the Whole Person

  • Pingback: Friday’s 5 to Live By—The Biblical Counseling and Mental Illness | Biblical Counseling Coalition Blogs

  • Pingback: Mental Illness & Medication vs. Spiritual Struggles & Biblical Counseling – ReBlog | The Peanut Gallery

  • Haley Parks

    I just wanted to say thank you for this article. I have struggled with mental illness and I have been told that I am sinning or that medication isn’t necessary and God will fix everything. I think God definitely has his place in getting better but people must realize that mental illness is not just sin. I have been very confused and actually pushed away from Christianity because many people will not acknowledge that research does in fact show that people with mental disorders have chemical imbalances as well as abnormal brain scans, hyperactivity or abnormally low activity in certain regions of the brain as a few examples. I think your explanation of both sin as well as factors beyond our control makes perfect sense. Most Christians that I have spoken with are quick to judge my struggles as me giving into sin. This is definitely a quick way to push people away from Christianity, instead they should offer help and support rather than pass judgment on circumstances beyond their, and even my understanding. Even for the mentally ill person it can be very difficult to understand what is sin and what may be beyond your control. For the people claiming that mental disorders are just an excuse for sin, I do acknowledge that some things classified as disorders are a bit ridiculous, such as newly named disorders for disobedient children. I really think some labels do take away from the people that really are suffering and as well as support the stigma towards mental disorders. I am really glad I came across these articles. You provide a refreshing view that does not wholly condemn or excuse. I still have many specifics that I am still questioning about my own illness but your article has definitely helped immensely.

    • David Murray

      Thanks for your testimony, Haley. So sorry to read about your suffering. I do believe that the climate is changing and that things will get better as people are educated and become more willing to think and talk about this.

  • Pingback: A Biblical Counseling Perspective on Mental Illness | Biblical Counseling Coalition Blogs

  • Mike Reidland

    Outstanding article! As Pastor of biblical counseling at our church, I regularly deal with these subjects. Clearly, if I have a broken leg, I need a physician to treat it, but I have the scriptures to guide me in my moral choices in the midst of the pain. And I’ve also found that Novocain makes it easier to make Christ honoring decisions during a root canal! I’m so grateful to God for the medical assistance we have today to help us combat the devastating effects of “the fall”, but as you’ve stated in your article, we must continue to examine our spiritual lives in light of whatever affliction God may allow us to experience. As Job 36:15 says “affliction opens the ears” and Romans 8:28-29 says He will conform us into the image of His Son if we will trust Him in our responses to the tests and trials of life, even “mental illnesses”. Again, thank you for your balanced perspective…it is greatly needed today in the church!

    • David Murray

      Thank you for the kind words and encouragement, Mike.

  • Pingback: David Murray > Mental health experts on faith and mental illness | Innovate For Jesus | Grow the Church

  • Josh Kappes

    David, what would be some reputable research you would recommend?

  • Erin Kelly

    Wow. That’s a lot to take in whew! So i didn’t know such an opinion existed. I love our god he is good but isn’t all this closer to stereotyping or being biased?

  • Adam

    Once I found this article, I was greatly anticipating reading through it. However, I can’t understand how a person formerly in denial of all mental illness still puts it in quotes as if afraid to legitimize any mental illness. I also can’t understand how the compassion of secular counselors is also in quotations, as if God can’t work through a non-believer, also made in the image of God, to manifest his goodness by way of compassion. To top it off, the sin-maximizers are appeased repeatedly by the phrase “if you accept the possibility of mental illness”. Again, this is coming from someone who had previously denied all mental illness, and I wish those divides were omitted from the article in order to make a more genuine attempt at bridging the gap and communicating more respectfully.