Mental Illness Is Real...But It Isn't True

Thanks to John MacArthur’s recent comments on mental illness, and the controversy that ensued thereafter, I’ve felt compelled to further explore this topic through the lens of Scripture.

Understandably, MacArthur’s take that “there’s no such thing” as mental illness is not sitting well with many, especially those who personally struggle with mental illness or who have the charge of caring for someone who does.

I know his commentary certainly gave me pause when I first heard it.

As the granddaughter and great-granddaughter of women who suffered from Alzheimer's disease and schizophrenia, I’ve always been sensitive about the overall topic of mental health. Growing up, I was told that mental health conditions could be hereditary, so I did much to monitor myself and do whatever work necessary to guard against the conditions that plagued my family’s matriarchs.

By God’s grace, my mother and I are thus far in the clear. My mother, a healthcare professional who is aging gracefully, has also done well to counsel me on reducing the risk of a myriad of health conditions, including Alzheimer's - which is a brain disease, not a mental illness. And while the medical field says there is no way to prevent schizophrenia, studies show that 75% of mental illnesses like schizophrenia usually develop by one’s early 20s, which means the statistical risk has substantially declined for my mother and me at this point.

Nevertheless, I retain great interest in the subject of mental health, continue to prioritize my mental wellbeing, and I have considerable compassion for those battling mental health challenges. As such, I don’t know that I can get on board with all MacArthur recently had to say on the matter.

But I must admit, I don’t think he’s totally wrong, either.

While I wouldn’t agree with his sentiment that mental illness is not real, I do agree with what seemed to be the heart of his point, which is that, ultimately, mental illness diagnoses are not true.

Please bear with my attempt to flesh out the distinction as I think through this subject with the help of God’s word.

SIN IS REAL

Like MacArthur, I have my thoughts about how some mental health conditions are categorized or diagnosed, however I do believe that mental illness is real.

Described as a “disorder” or “significant disturbance” in behavior, emotional regulation or thinking, mental illness has been just as “real” as physical illness since the fall of mankind in the Garden of Eden.

The fall ushered in all manner of disorder!

Scripture is clear that all that God had made and declared “good” on days one through six of Creation would soon thereafter fall short of His glory “through one man”, Adam (Romans 3:9-18, 3:23, 5:12-14). Through the fall, Creation was “subjected to futility” (or rendered useless) and “the whole of creation” now “groans and labors with birth pangs together” (Roman 8:20, 8:21-22). We are subject to loss, grief, sickness, and pain, and it is appointed to all men to die once (Hebrews 9:27; Romans 6:23). The world knows wars, famines, inclement and violent weather and various other troubles and trials (John 16:33). Everything about our human existence is now imperfect, as the fall has rendered our intended design (and the world we live in) faulty and corrupted (Genesis 6:5, 6:11-12).

Contrary to how the world views sin, the “bad news” that necessitates the Good News is that sin indwells the hearts and minds of mankind even before we have the opportunity to act sinfully (Ecclesiates 9:3; Proverbs 4:23; Jeremiah 17:9 Matthew 12:35, 15:19; Mark 7:21-23). Sin is of the human condition, hence why the adage, “no one is perfect” rings true even amongst unbelievers. And because sin indwells us, it has a myriad of ways it can be made manifest in our lives, especially when we are ruled by the law of it (Romans 6, 7 and 8). Those who count themselves “Reformed” or “Calvinists” will certainly agree that the human condition is now totally depraved.

As such, it is reasonable to posit that mental illness is real because sin is real - because total depravity is real. And like those suffering from physical illness, one doesn’t necessarily suffer from mental illness as a consequence of some outwardly committed sin, but our subjection to it is indeed one of the consequences of our fallen state.

THE SPIRIT IS REAL

It must be noted, however, that mental illness is a different beast from those health conditions that might affect us physically.

Alzheimer’s, for example, is a neurodegenerative condition that can be objectively observed. A scan of the sufferer’s brain will show the degeneration of brain tissue, and this condition can be seen progressively over time. Objective evidence for a mental illness diagnosis, however, cannot be obtained. Instead, a mental illness diagnosis must be gleaned subjectively - practitioners must rely on the individual’s description of his thoughts and feelings along with accounts of his behavior. And while neurosciences have done much research on the physical brain to assess the psychiatric aspects of the mind (ie; disordered moods, thoughts or behaviors), a link has yet to be found.

Interestingly, Scripture also doesn’t speak on such a link. Though, it does speak to a link between our mind and our spirit, which are both intangible and often referenced interchangeably.

God, who is Spirit, made us in His image and likeness (Genesis 1:27; John 4:24). Yes, He formed man from the dust of the earth, but man did not become a living soul until God breathed His breath of life into his nostrils (Genesis 2:7). Our physical bodies are how we experience and relate to His physical Creation. Our physical bodies are also how we experience Creation to perceive the existence of God (Romans 1:20). Yet, the intangible aspects of our being are how we experience and relate to God, Himself. God is invisible (Hebrews 11:27), so our being made in His image and likeness refers to the invisible attributes that complete our being - our spirit, our logic, our capacity to love and create, our sense of morality, our sense of eternity, etc. With our invisible attributes we were meant to commune with, walk in agreement with, and reflect the glory of our Creator. Hence the Lord counting His true worshippers as those who worship Him in spirit and in truth (John 4:23). Hence the call for the righteous (those in right-standing with God) to live by faith, not by sight (Romans 1:17; Hebrews 10:38-39; 2 Corinthians 2:5-7).

The fallen man is incapable of such worship or faith, as he surely died in the Garden (Genesis 2:17). Even as his physical death in the flesh would be eventual, his spiritual death was immediate - it occurred “that day”. He became a merely “natural man” just as all mankind born of him since (John 3:6; 1 Corinthians 15:49). His immediate spiritual death not only separated us all from God, it made us His enemies (Ephesians 2:1; Isaiah 59:1-2; Romans 6:23). Though we remain the pinnacle of His Creation, sin inhibits our ability to spiritually commune with, walk in agreement with, and perfectly reflect our Creator as He intended (Psalm 8:4-9; Isaiah 59:1-2).

The Lord declared this as mankind began to increase in the earth.

“And the Lord said, ‘My Spirit shall not strive with man forever, for he is indeed flesh; yet his days shall be one hundred and twenty years’” (Genesis 6:3)

“Then the Lord saw that the wickedness of man was great in the earth, and that every intent of the thoughts of his heart was only evil continually. And the Lord was sorry that He had made man on the earth, and He was grieved in His heart” (Genesis 6:5-6).

But God is good and faithful, and He made a way for communion between Himself and man to be restored. For while we were yet sinners, Christ died for the ungodly (Romans 5:6). While we were still enemies of God, we were reconciled to Him through the death of His Son, Jesus Christ (Romans 5:10). Though all men sinned and died through Adam - the first man created, many are redeemed and now live through Christ, who atoned for our sin and is the first-born over all Creation (Romans 5:12-21; Colossians 1:15-20). “For the wages of sin is death, but the gift of God is eternal life in Christ Jesus” (Romans 6:23).

Of course, this truth, which is the Gospel of Jesus Christ, is foolishness to the natural man, who is perishing (1 Corinthians 1:18, 2:14). He not only remains ruled by the law of sin, his being spiritually dead to the things of God keeps him under the sway of Satan (1 John 5:19). So, as much a the secular world mocks the premise that mental illness could be a form of demonic oppression or a “spiritual attack”, Scripture affirms that such can indeed be the case (1 Samuel 18:7; Matthew 12:43-45; Mark 1:32-34, 5:1-20; Luke 8:2 Acts 16:16-18, 19:13-16).

Yet those of us who believe the Gospel are reconciled to God through Christ. We have become a new creation and have received new life by being born again of the Holy Spirit (2 Corinthians 5:16-19).

We won’t receive our glorified (perfected) bodies until His return, which is why Christians can still suffer physical sickness and disease, and the healings of such in this life are not guaranteed to each Believer (1 Corinthians 15:42-53; 2 Timothy 4:30; 2 Corinthians 12:7-9). However, our spiritual renewal in Christ is immediate and ongoing.

“Even though our outward man is perishing, yet the inward man is being renewed day by day” (2 Corinthians 4:16b).

We are no longer slaves to our sin nature, nor are we any longer under the sway of Satan.

“We know that whoever is born of God does not sin; but he who has been born of God keeps himself, and the wicked one does not touch him” (1 John 5:18).

Though we might still be tempted by the cares of this life, God guarantees His people “perfect peace” - a peace that surpasses all understanding - when we trust Him and keep our minds on Him (Isaiah 26:3; Philippians 4:6-7).

MENTAL ILLNESS ISN’T TRUE

The law of sin suggests that mental illness is indeed real, but the Gospel encourages us that such a condition isn’t true for the born again Believer, as we now “have the mind of Christ” (Romans 8:1-2; 1 Corinthians 2:16). And thank God that His ways are higher than our ways, and His thoughts are higher than our thoughts (Isaiah 55:9)!

Not only does the Holy Spirit now indwell us to help us refrain from submitting our physical members to sin, we are encouraged and aided by His Spirit to commit our minds to the things of God.

“[F]or it is God who works in you both to will and to do for His good pleasure” (Philippians 2:13).

“Set your mind on things above, not on things on the earth. For you died, and your life is hidden with Christ in God” (Colossians 3:2-3).

“For God has not given us a spirit of fear, but of power and of love and of a sound mind” (2 Timothy 1:7).

“I beseech you therefore, brethren, by the mercies of God, that you present your bodies a living sacrifice, holy, acceptable to God, which is your reasonable service. And do not be conformed to this world, but be transformed by the renewing of your mind, that you may prove what is that good and acceptable and perfect will of God” (Romans 12:1-2).

Thus, the Believer who hopes to keep the natural reality of mental illness at bay would do well to crucify his flesh and walk in God’s Spirit. The ways to do this are to meditate on God’s truth daily, to maintain fellowship with other Believers, to pray without ceasing and, of course, to live according to our faith. Not only are we invited to Believe the Gospel, we are encouraged to grow in the grace and knowledge of Jesus Christ, which comes through the consummation of His full counsel as we are edified in the Body of Christ (Psalm 1:1-3; 2 Peter 1:3-7, 3:17-18; 2 Timothy 3:16; Hebrews 10:25; Ephesians 4:12-24).

In other words, just as we are called to faith and thus saved by grace through it, we are subsequently called to spiritual maturity and thus rooted in our faith by it. When we are rooted in Christ, we are not overtaken by the devices of the world, the devil and the flesh, which easily ensnare those who are carnal (of the world or spiritually immature).

“Because the carnal mind is enmity against God; for it is not subject to the law of God, nor indeed can be. So then, those who are in the flesh cannot please God. But you are not in the flesh but in the Spirit, if indeed the Spirit of God dwells in you. Now if anyone does not have the Spirit of Christ, he is not His” (Romans 8:7-9).

“And you He made alive, who were dead in trespasses and sins, in which you once walked according to the course of this world, according to the prince of the power of the air, the spirit who now works in the sons of disobedience, among whom also we all once conducted ourselves in the lusts of our flesh, fulfilling the desires of the flesh and of the mind, and were by nature children of wrath, just as the others” (Ephesians 2:1-3).

The Believer in Christ is not only no longer ruled by sin, Christ has set him free from placing his identity in it or being identified by it (Psalm 19:13;John 1:20, 8:32-36; Galatians 2:20). As we grow in Christ, we are progressively fashioned into His image - a return to God’s intention for us (Romans 6:6-7, 8:29).

“[K]nowing this, that our old man was crucified with Him, that the body of sin might be done away with, that we should no longer be slaves of sin. For he who has died has been freed from sin” (Romans 6:6-7).

“As was the man of dust, so also are those who are made of dust; and as is the heavenly Man, so also are those who are heavenly. And as we have borne the image of the man of dust, we shall also bear the image of the heavenly Man (1 Corinthians 15:48-49).

LET GOD BE TRUE, BUT EVERY MAN A LIAR

I am not a mental health professional, and it hasn’t been my goal here to speak as one. Instead, I’ve hoped to encourage Believers who might identify with mental illness to trust God and to press into Christ’s peace and identity, which is available to all in His Body.

Even as one may opt to utilize medically-prescribed treatments for their condition, this encouragement remains the same. For if man shall not live by bread alone, but by every word that proceeds from the mouth of God (Matthew 4:4), certainly one’s well-being or quality of life should not depend on medication alone. The Lord formed us with a physical body, but He also designed the intangible, spiritual aspects of our being. Nourishment and care also need to be supplied to those areas, and His Word is the medicine sufficient for our whole being (Proverbs 4:22).

Furthermore, our communion with God is predicated on our love for Him, which the first and greatest commandment requires we do with “all your heart, with all your soul and with all your mind” (Matthew 22:37-38). This then makes mental illness (a disorder in thinking, emotional regulation and behavior) a challenge to overtake the Believer.

Which is what I believe was at the heart of MacArthur’s commentary on mental illness. It seems this is why he characterized various mental illness diagnoses as “noble lies”. He perceives man’s motive for such diagnoses is for financial gain/pharmaceutical profit, and this motive is ultimately powered by Satan, whose aim is to devour whomever is in his wake. He is most successful with those who aren’t self-controlled or of sober mind (1 Timothy 6:10; 1 Peter 5:8-10).

The “noble” aspect of the lie is that at least mental health professionals acknowledge that one can be ill within the unseen, intangible aspect of his being. Whether they realize it or not, they have done well to recognize a disorder with the individual’s “inner man”. Yet, the lie has been in their pretense to understand the disorder such that they present themselves as the only or principal hope for addressing it. Rather than dosing discipline, diet and doctrine, the mental health field seems to default to drugs as the answer to what ails a man.

Now, having normalized this approach, the mental health profession has deceived unbelievers and Christians, alike, into placing more trust in the authority of psychologists or psychiatrists (who can only attempt to study the mind) than in the Creator of our minds (who knows the depths of our being). Rather than submitting our mental weaknesses to God’s promises of comfort, hope, joy, and peace, it is our immediate reaction or temptation to surrender to these weaknesses and allow them to define us and dictate our quality of life for the rest of our natural lives.

This isn’t to wholly negate the benefits to conventional medicine, of course. God has certainly blessed us with this resource through the intellect He gave mankind. But when mental health practitioners begin to admit that they actually don’t fully understand what it is they’re treating, when their treatments come by trial and error ,or when they cause more harm than good, that might be a sign for us to look up!

Though, again, the Believer is expected to keep his mind on things above. We are expected to look to God first and seek Him throughout our concerns, rather than as a last resort. “Do not be anxious about your life…But seek first the Kingdom of God and His righteousness and all these things will be added to you” (Matthew 6:25,33).

Perhaps I’ve taken too many liberties with what MacArthur hoped to convey, but this is what I gleaned from the context of his sentiments. If this is what he ultimately meant, I can agree with him there.

Yet, whether one agrees with MacArthur or my attempt to explore the topic of mental illness, the takeaway is that God has the power to heal any illness - physical or mental- according to His will. Again, His will does not guarantee each person’s healing on this side of heaven, as our promised perfection is scheduled for the Day Christ returns for His Church. Yet He is the only true source of healing available, so one has nothing to lose by seeking Him and hoping in Him for it (Philippians 1:6; 1 Corinthians 1:8, 15:42, 15:52; Psalm 147:3).

Even if it isn’t God’s will to grant one healing in this life, His healing will come and every Believer is guaranteed His strength and power to peacefully endure all things in the meantime (Philippians 4:13; 2 Corinthians 12:9; John 16:33; Romans 8:37-39).

I SAID ALL OF THIS TO SAY…

Mental illness is real, but it isn’t true. It doesn’t define the Christian; it doesn’t rule the Christian; it doesn’t dictate the quality of the Christian’s life; and it cannot overtake the rooted Christian. Even in the moments a Believer might be tempted to think, feel or behave contrary to God’s Spirit, God’s graced us with a way of escape, which is to simply place our trust in, and put our focus on, Christ Jesus.

To do this, one might begin by meditating on the promises of our God…

“You will keep him in perfect peace Whose mind is stayed on You, Because he trusts in You” (Isaiah 26:3).

“The Lord is my rock and my fortress and my deliverer; My God, my strength, in whom I will trust;bMy shield and the horn of my salvation, my stronghold (Psalm 18:2).

Therefore humble yourselves under the mighty hand of God, that He may exalt you in due time, casting all your care upon Him, for He cares for you (1 Peter 6:7).

One might consider how Jesus encourages and prays for His disciples…

“Therefore I say to you, do not worry about your life, what you will eat or what you will drink; nor about your body, what you will put on. Is not life more than food and the body more than clothing? Look at the birds of the air, for they neither sow nor reap nor gather into barns; yet your heavenly Father feeds them. Are you not of more value than they? Which of you by worrying can add one cubit to his stature?

“So why do you worry about clothing? Consider the lilies of the field, how they grow: they neither toil nor spin; and yet I say to you that even Solomon in all his glory was not arrayed like one of these. Now if God so clothes the grass of the field, which today is, and tomorrow is thrown into the oven, will He not much more clothe you, O you of little faith?

“Therefore do not worry, saying, ‘What shall we eat?’ or ‘What shall we drink?’ or ‘What shall we wear?’ For after all these things the Gentiles seek. For your heavenly Father knows that you need all these things. But seek first the kingdom of God and His righteousness, and all these things shall be added to you. Therefore do not worry about tomorrow, for tomorrow will worry about its own things. Sufficient for the day is its own trouble (Matthew 6:25-34).

“Peace I leave with you, My peace I give to you; not as the world gives do I give to you. Let not your heart be troubled, neither let it be afraid” (John 14:27).

“I pray for them. I do not pray for the world but for those whom You have given Me, for they are Yours. And all Mine are Yours, and Yours are Mine, and I am glorified in them. Now I am no longer in the world, but these are in the world, and I come to You. Holy Father, keep through Your name those whom You have given Me, that they may be one as We are. While I was with them in the world, I kept them in Your name. Those whom You gave Me I have kept; and none of them is lost except the son of perdition, that the Scripture might be fulfilled. But now I come to You, and these things I speak in the world, that they may have My joy fulfilled in themselves. I have given them Your word; and the world has hated them because they are not of the world, just as I am not of the world. I do not pray that You should take them out of the world, but that You should keep them from the evil one. They are not of the world, just as I am not of the world. Sanctify them by Your truth. Your word is truth. As You sent Me into the world, I also have sent them into the world. And for their sakes I sanctify Myself, that they also may be sanctified by the truth” (John 17:9-19).

One might be encouraged in knowing the Lord is our hope, no matter life’s circumstances or troubles…

“We are hard-pressed on every side, yet not crushed; we are perplexed, but not in despair; persecuted, but not forsaken; struck down, but not destroyed—” (2 Corinthians 4:8-9).

“Be anxious for nothing, but in everything by prayer and supplication, with thanksgiving, let your requests be made known to God; and the peace of God, which surpasses all understanding, will guard your hearts and minds through Christ Jesus.

“Finally, brethren, whatever things are true, whatever things are noble, whatever things are just, whatever things are pure, whatever things are lovely, whatever things are of good report, if there is any virtue and if there is anything praiseworthy—meditate on these things. The things which you learned and received and heard and saw in me, these do, and the God of peace will be with you” (Philippians 4:6-9).

One might submit himself to the work of the Holy Spirit, who fashions us into the image of Christ and is our guarantee of salvation and of God’s promises to come...

“Not that I have already attained,or am already perfected; but I press on, that I may lay hold of that for which Christ Jesus has also laid hold of me. Brethren, I do not count myself to have apprehended; but one thing I do,forgetting those things which are behind and reaching forward to those things which are ahead, I press toward the goal for the prize of the upward call of God in Christ Jesus” (Philippians 3:12-14).

“Therefore, my beloved, as you have always obeyed, not as in my presence only, but now much more in my absence, work out your own salvation with fear and trembling; for it is God who works in you both to will and to do for His good pleasure” (Philippians 3:12).

“In Him you also trusted, after you heard the word of truth, the gospel of your salvation; in whom also, having believed, you were sealed with the Holy Spirit of promise, who is the guarantee of our inheritance until the redemption of the purchased possession, to the praise of His glory” (Ephesians 1:13-14).

Whatever your world view on mental illness and whether you’ve ever been diagnosed with a mental illness, please know that as Believers in Christ Jesus we know God, we are called to live according to our faith in Him and we are called to proclaim Him to all creatures.

While I might not wholly agree with MacArthur’s commentary, I agree with what seemed to be his overall point, and I’m grateful for it causing me to filter the topic through God’s Word. There’s been much controversy resulting from his statements, but very little encouragement or edification in what God’s had to say on the matter. Thus, I pray that we not make this a topic over which to divide, but instead use it as an opportunity to be encouraged in Christ and to be witnesses of Christ to those who are perishing, for this should always be the mind of those who profess Him.