Are Mental Disorders Sinful?
Many people struggle because of the overlap between mental disorders and spiritual problems. This article uses a sample question from a patient among thousands of patients whom I have seen throughout my career as a psychiatrist and hundreds of those that I have seen as both a psychiatrist and a priest since I was ordained five years ago. The question poses an inquiry about the culpability of the affected person for the emotions resulting from his mental disorder symptoms. The answer is very detailed and discusses three main points:
- Normal Godly Emotions
The first point explains the normal God-created human emotions. These are the emotions that we share with God Himself, being created in His likeness and image. The purpose that God created these normal emotions is to relate to Him and to His creation.
Then the article identifies two types of abnormal emotions (namely sinful emotions and mood disorders) that are considered a shift from the normal state of Godly created emotions.
- Sinful Emotions
The second point, discusses the sinful emotions that resulted as a consequence of the fall of our original parents Adam and Eve, which led to the corruption of human nature. The process of this corruption and its transmission throughout generations is described scientifically and supported biblically.
III. Mood Disorders
The third point sheds light on what confuses many people, including the question-writer. There are some emotional problems that bypass the level of being under the conscious control of a person and represent medical problems caused by chemical imbalance in the brain.
This article reassures patients of anxiety and mood disorders that they are not fully spiritually culpable for their symptoms. However, it encourages them to seek both psychiatric as well as spiritual help from a professional person who understands the distinction between the two essential needs.
Many of us suffer from anxiety, depression and other mental disorders. Others are fearful and excessively worry.
We wonder and we ask many questions, such as:
- How do we stand before God with these conditions?
- Do we lack faith?
- Are we not real Christians, because we cannot appreciate the love of God? etc…
So many questions keep haunting the children of God who suffer from mental illnesses and are not able to find a healing answer.
I have recently met a young man who is suffering from an anxiety disorder. He has sent me this question, which I share with you after taking his permission:
Dear Abouna… I have a spiritual question for you:
“While I am being treated from my condition, I always have in my mind the verses that condemn the fearful and cowardly like this one:“But the cowardly, unbelieving, abominable, murderers, sexually immoral, sorcerers, idolaters, and all liars shall have their part in the lake which burns with fire and brimstone, which is the second death.” (Revelation 21:8) I used to think to myself that I am far from God because those who are close to Him lack nothing and are afraid of nothing as it says in many of the psalms… I also talked to you about my fearful character how I am scared about a lot of things and how I worry… I am afraid of many things and I always consider myself to have a cowardly and unbelieving heart and that I lack confidence and faith in God. I do not want to lose my eternal life because of it… is this a sin against me or is this not my case?”
I answered him saying:
- There are normal emotions that human beings experience due to their interactions with day-to-day events and situations of life. These are God-given emotions that are the result of the normal function of our nervous system. These normal emotions, such as joy, sadness, peace, anger and others, are gifts given to us by God that reflect His image and likeness. That is why there are many biblical examples of human emotions attributed to our Lord, God Jesus Christ “Who is the image of the invisible God” (Colossians 1:15) such as:
- “He is despised and rejected by men, A Man of sorrows and acquainted with grief. And we hid, as it were, our faces from Him; He was despised, and we did not esteem Him.”(Isaiah 53:3)
- “Therefore, when Jesus saw her weeping, and the Jews who came with her weeping, He groaned in the spirit and was troubled. (John 11:33)
- Jesus wept.” (John 11:35)
- “And He took with Him Peter and the two sons of Zebedee, and He began to be sorrowful and deeply distressed.” (Matthew 26:37)
God has given us all these normal emotions to interact with Him and with others in love, joy, and peace. He has also given us the capability of the feelings of sorrow towards sin, anger towards evil and fear of God.
In his writings, St. Paul clearly indicates that there is a place for negative human emotions, while still keeping the strong faith that supports us from inside.
- “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— always carrying about in the body the dying of the Lord Jesus, that the life of Jesus also may be manifested in our body.”II Corinthians4:8-10
- “As sorrowful, yet always rejoicing” (II Corinthians6:10)
He also teaches that these are godly emotions, given for our spiritual benefit.
- Now I rejoice, not that you were made sorry, but that your sorrow led to repentance. For you were made sorry in a godly manner, that you might suffer loss from us in nothing. For godly sorrow produces repentance leading to salvation, not to be regretted; but the sorrow of the world produces death. For observe this very thing, that you sorrowed in a godly manner: What diligence it produced in you, what clearing of yourselves, what indignation, what fear, what vehement desire, what zeal, what vindication! In all things you proved yourselves to be clear in this matter.” (II Corinthians7:1, 9-110)
- “Therefore, having these promises, beloved, let us cleanse ourselves from all filthiness of the flesh and spirit, perfecting holiness in the fear of God.
As for the abnormal emotions, it is very important for us to realize that there are two different types of them. One falls under the category of a spiritual weakness only, and we will call it here “sinful emotions.” The other falls under the category of mental illness and we will call it “mood disorders”
Many of us experience emotions that go beyond the normal godly feelings; those include excessive ungodly sadness, anger, worry and fear. These emotions reveal spiritual problems and are usually related to weakness of faith—which distances one from the life of grace—materialism, or dependency on man’s power.
In this situation, the person’s broken spiritual life causes a disturbed emotional life. The bible verse you mentioned in your question counts “the cowardly” as an example of people experiencing abnormal emotions indicating, that their broken spirit is the cause of their disturbed soul.
Solomon the Wise explains that in the Book of Proverbs as follows:
- “The spirit of a man will sustain him in sickness, but who can bear a broken spirit?”(Proverbs18: 14)
Also, St. Paul mentions ungodly anger as a sinful emotion, saying:
- “For the wrath of man does not produce the righteousness of God.” (James 1:20)
You may ask:
How did these sinful emotions enter humanity that is created at the image and likeness of God?
It is important to note that the source of these sinful emotions is not God and that they are not God’s intention for us from the beginning. However, there is a clear relationship between these sinful emotions and the corruption that happened after our forefathers sinned. The proof of that is the clear emotional instability that affected Adam and Eve after they have sinned.
- “And he said, I heard thy voice in the garden, and I was afraid, because I was naked; and I hid myself.” (Genesis 3:10)
This corruption was transmitted from generation to generation through the inheritance of the sinful nature carrying corrupted genetic elements. Throughout generations, this made us vulnerable to sinful emotions such as fear, anxiety, depression and others.
Modern genetic studies have proven that genetic mutations can indeed occur due to effects of mental and behavioral changes and experiences on humans. Therefore, after our first parents sinned and their lifestyle dramatically changed, their godly genes (initially created by God at His image and likeness) could have possibly started to change through genetic mutations as a result of the change in their behavior.
Pope Athanasius the Apostolic clearly described in his book, Against the Heathen, that humans had a dramatic shift in their mindset after the fall. They changed from focusing and contemplating on God to focusing on themselves and their created material pleasures.
According to modern genetic studies, this dramatic change in behavior could have lead to a change in the genes of our first parents. This scientifically explains how human nature corrupted and how each person’s behavior during his/her lifetime can contribute to all humanity’s corrupt nature!
In the opening of the Book of Genesis, chapter five, God reminds us that the first human, Adam, was created in His likeness, and therefore, with an untainted genetic code. Then, the scripture clearly indicates that during 130 years of Adam’s lifetime, something happened that resulted in Seth, Adam’s new son, being born in Adam’s likeness, rather than God’s.
- “This is the book of the generations of Adam. In the day that God created man, in the likeness of God made he him; male and female created he them, and blessed them, and called their name Adam, in the day when they were created. And Adam lived a hundred and thirty years, and begat a son in his own likeness, after his image; and called his name Seth.” (Genesis 5:1-3)
From that point, we understand how the human nature deteriorated tremendously throughout generations, until it reached a very corrupt state—one that is vulnerable to the sinful negative emotions as a part of vulnerability to illness in general.
- “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.”(Genesis 6:5)
The continuous decline in the stability of human emotions due to the transmission of sinful behavior from generation to generation is explained by God’s words, saying:
- “You shall not bow down to them nor serve them, because I am the Lord your God, a jealous God, repaying the sins of the fathers upon the children to the third and fourth generationof those who hate Me.” (Deuteronomy 5:9)
However, some of these sinful emotions are not necessarily genetically inherited, but are developed through living among others who practice them, making them acquired behavior.
It is important to highlight that we are still speaking here about the type of sinful emotions (inherited or acquired) that did not reach the level of clinical medical conditions.
These are the conditions that, if not corrected through our faith and fellowship with the work of the Holy Spirit, we will be judged for, as it is clear in the verse above mentioned in your question (Rev. 21:8)
- “But the cowardly, unbelieving, abominable, murderers, sexually immoral, sorcerers, idolaters, and all liars shall have their part in the lake which burns with fire and brimstone, which is the second death.” (Revelation 21:8)
Many of our church fathers describe the process of God’s solution to treat our souls from these sinful emotions and heal our souls, which, God willing, we will talk about separately in detail in another article.
We can only summarize this process here as the willful submission to the Holy Spirit and fellowship with Him to abide in our Lord Jesus Christ, and slowly by slowly return to His likeness.
Pope Athanasius the Apostolic mentioned in his book, The Incarnation of the Word, that one of the reasons of incarnation of the Word was to give humans the capability to regain God’s likeness.
St. Basil the Great notes in his book, On the Human Condition, that God has honored humans by enabling them to become “fashioners of the divine likeness within themselves”. He then adds that we can acquire this “through participation in Christ by using our freedom to cooperate with the Holy Spirit.”
Another question people commonly ask is:
What is our responsibility for inherited sinful emotions?
Even though these sinful emotions may be obtained through the inheritance of the corrupt human nature, it is still under the control of the person and his freewill.
Therefore, each one of us takes his turn in freely choosing between improving these emotions through the fellowship of the Holy Spirit and not passing them on to another generation. Otherwise, he would be defeated by them, just like Adam and Eve were, and pass them on to another generation.
It is very encouraging for those of us who are struggling with these sinful human emotions to see biblical references, for the great St. Paul repeatedly writing about his own weaknesses. However, he immediately writes about the power of Christ, the Word of God, who came to fix our troubled human souls.
- “For we do not want you to be ignorant, brethren, of our trouble which came to us in Asia: that we were burdened beyond measure, above strength, so that we despaired even of life. Yes, we had the sentence of death in ourselves, that we should not trust in ourselves but in God who raises the dead, who delivered us from so great a death, and does deliver us; in whom we trust that He will still deliver us,”(II Corinthians1:8-10)
- “But I see another law in my members, warring against the law of my mind, and bringing me into captivity to the law of sin which is in my members. O wretched man that I am! Who will deliver me from this body of death? I thank God—through Jesus Christ our Lord! So then, with the mind I myself serve the law of God, but with the flesh the law of sin.” (Romans7:23-25)
Now, we will move to speak about abnormal emotions that have reached the level of being clinical mental disorders due to chemical imbalance of the brain. These are considered clinical medical conditions, which include anxiety, phobia, depression and other mental illnesses. These need medical attention by a specialized physician, and possibly pharmacological treatment, just like any other physical disorder that affect other organs of the body.
- “Honor the physician with the honor due him. And also according to your need of him, For the Lord created him. Healing comes from the Most High, and he will receive a gift from the king. The physician’s skill will lift up his head, and he shall be admired in the presence of the great. The Lord created medicines from the earth, and a sensible man will not loathe them.” (Wisdom of Sirach 38:1-4)
Now, your question becomes in its right place, as you ask:
What is God’s position towards these conditions and their symptoms? and What is our responsibility for them?
Here, we have to emphasize that God is fair and merciful. He will ONLY judge us according to what we CAN DO to fight these conditions. That is ONLY according to how much we can handle them, whether they are inherited or acquired conditions.
- “Fathers shall not be put to death for their sons, nor shall sons be put to death for their fathers; each shall be put to death for his own sin.” (Deuteronomy 24:16)
- “Who will render to each one according to his deeds.” (Romans 2:6)
- “For each one shall bear his own load.” (Galatians 6:5)
People with these conditions often feel guilty about their emotions and behavior, which are mere symptoms of their condition. Also, they are often blamed by those around them for such behavior.
Therefore, it is very important to note that their abnormal emotions and behaviors are simply symptoms of an organic disorder due to a chemical imbalance of a vital physical organ in their body, and that organ happens to be the brain.
To explain this point further, we need to highlight that one difference between the brain and the rest of the body organs is that while the brain is a physical organ that is supplied by blood carrying chemicals, the symptoms of brain disorders are often not physical but are emotional, intellectual and behavioral in nature.
Therefore, they often seem to the patient and people surrounding him/her as if they are willful choices of behavioral lifestyle that the patient has chosen to live by. That is why the blame can easily fall on the patient for his/her symptoms, as you wondered in your question above.
On the other hand, the responsibility for symptoms of any other chemical imbalance affecting any other organ of the body would never be attributed to the patient. Rather, the symptoms of physical conditions are normally sources of sympathy and pity for the patient.
I affirm, from my experience in serving in this field for quite a long time, that this myth—the idea that symptoms of mental illness are chosen, willful behaviors—is nothing but most people’s mere lack of understanding of mental illness. In reality, these conditions are caused by dysfunction in the brain as a physical organ that functions through chemicals transported via the circulatory system.
But here we have to remember that God, our great Creator, who is full of love, compassion, and knowledge, He alone knows all the details of our complex beings. He will surely put into consideration our defects and limitations when He judges us with mercy.
- “You know my sitting down and my rising up; You understand my thought afar off. You comprehend my path and my lying down, And are acquainted with all my ways. For there is not a word on my tongue, But behold, O LORD, You know it altogether…
- My frame was not hidden from You, when I was made in secret, And skillfully wrought in the lowest parts of the earth. Your eyes saw my substance, being yet unformed. And in Your book they all were written, The days fashioned for me, When as yet there were none of them.” (Psalms 139:2-4, 15-16)
Another important point in answering your question is that since these conditions and their symptoms originate from the mind, they definitely affect the patient negatively while he attempts to practice his spiritual activities.
St. Paul comments about the importance of using the mind while praying and says:
- “I will pray with the spirit and I will also pray with the understanding, I will sing with the spirit and I will also sing with the understanding” I Cor. 14:15)
Here, I would like to assure you my friend that God, who allowed this illness and knows exactly how it affects you, will not unfairly judge you for it!!
On the contrary, our Lord Jesus Christ, to whom all glory, had taught us that He would put into consideration each person’s variables when He judges him.
For example, He says: “But he who did not know, yet committed things deserving of stripes, shall be beaten with a few (Luke 12:48)
But here I have to add the importance of the spiritual aspect of treating mental illnesses hand in hand with pharmacological and psychotherapeutic treatments.
This is because, as we discussed earlier, all illnesses resulted from the corruption that was transmitted down from generation to generation, “because all sinned” (Rom 5:12)
And since there is a close interrelationship between the mind and the spirit, therefore, there has to be serious spiritual work through continuous participation in the Holy Eucharist, abiding in the person of the Lord Jesus Christ Himself, the Word and “Second Adam,” to get rid of the root causes of these conditions and their symptoms.
It is really marvelous to recognize that in the recent years, contemporary psychiatry scientists have discovered that it is essential to add the spiritual component of psychiatric treatment. Hence, the recommended treatment model now is called the“ Bio-Psych-Socio- Spiritual Model ” which consists of four components:
- Biological Treatment (Pharmacotherapy)
- Psychological Treatment (Psychotherapy)
- Social Treatment (Social interventions)
- Spiritual Treatment (Repentance and abiding in Christ)
Even though these conditions are behavioral in nature and may negatively impact one’s spiritual life, that should not be an excuse for not seeking to unite with God, in addition to seeking specialized treatment.
- “The spirit of a man will sustain him in sickness, but who can bear a broken spirit?”(Proverbs18: 14)
We thank the Lord for His compassion and great Love, as He sees our infirmities and sicknesses and has mercy upon us by moving towards us as we move towards Him and lift up our sufferings.
- “He Himself took our infirmities and bore our sicknesses” (Matthew 8:17)
And we sing in Friday’s Theotokia, saying:
- “He took what is ours and gave us what is His”
Therefore, for the longest, our church acknowledged the psychiatric disorders singing in prayer to the Lord in the Hymn of the King of Peace, saying:
- “Heal the sicknesses of our souls and our bodies”
May the Lord, the true physician of our souls, bodies and spirits, heal all our iniquities, infirmities and diseases? Amen.
Fr. Luke Istafanous, MD
Priest, St. Mary & St. Mercurius Coptic Orhtodox Church, Belleville, NJ
Clinical Assistant Professor of Psychiatry – Voluntary Faculty
Rutgers University/New Jersey Medical School