Advice to a friend concerning mental health

We are all sinners and subject to natural death, our bodies slowly break down as we age. Many are quite familiar with common physical ailments, yet our minds can also become broken. These are all effects of the Fall. Sadly there is a negative stigma against those suffering from mental illness. And many sufferers never get treatment or delay it for years because of the stigma.

As a Christian I’ve noticed this problem is even worse in the Church; where all forms of mental illness are identified as being caused by sin and need spiritual solutions to “cure” them or “deliver” them. You don’t see Christian pastors telling cancer patients they need to rebuke the spirit of cancer (well you do in charismatic churches, but not in Reformed churches) or telling them God gave them cancer because of unresolved sin in their life. Yet it’s common for pastors, elders, theologians, and well-respected authors to assert that mental illness, even severe mental illnesses, is strictly a spiritual problem with a spiritual solution. One type of system which promulgates this type of retrograde and fallacious reasoning is nouthetic counseling. It has its place in treatment, but as I say below it isn’t the right tool for every single type of mental problem.

Below is recent advice, given in love, to a dear brother in Christ whom I’ve known for many years. I’m also friends with his two daughters and his dear wife.

Brother, I know what it’s like to suffer from untreated severe mental illness. My case is a bit different than yours since I deal with psychosis due to my schizophrenia. But I also have been dealing with major depression for 22 years.

You won’t get any help until you take the first step and resolve to get better. I languished for several years in denial which hurt me.

Next find a good psychiatrist, not a nouthetic counselor. Major depression is a chemical imbalance in the brain. It is not a sin issue so much as a normal medical issue for any other physical disease like diabetes or cancer. Some milder forms of depression can be caused by sin and resolved through spiritual means. So I’m not knocking nouthetic approach, it’s the right tool for a specific class of jobs. But clinical or major depression is another beast and needs the right tools. So once you are plugged into a good psychiatrist (yes Christian psychiatrists do exist!).

Second, find a good therapist you can meet with weekly or monthly (can even do it by Zoom if you can’t get out of the house).

Take the prescribed medication consistently and notice any side effects. Every person’s brain is unique and we react to medications differently. Don’t be alarmed or discouraged if you have to try several different antidepressants before your doctor finds one that is a good match for you.

You also need a good support system at home. I know your daughters and wife will be there for you and assist you as best they can.

Also, I found it helps to talk to other people who suffer from mental illness. So you may wish to join a Facebook chat group for that at some point. Or it could be a church elder/pastor or a brother in Christ who knows you very well.

Lastly, the spiritual component (often overlooked) is crucial. I’ve noticed I’ve gotten the best results for my mental illnesses with a combination of medication, therapy, my support system aiding me, and not neglecting daily prayer, daily Bible reading, and reading great theological works by the Puritans or more modern theologians.

All these things have helped me to function and have a better quality of life.

Please feel free to reach out to me on Facebook or by email at <redacted> or by text message at my cell at <redacted>. Even if you just need someone to listen. Praying for you brother. We have to all get together in person someday! By the way, we both struggle with chronic back issues. My spinal stenosis has limited me such that I can only walk for 2-3 minutes without pain so bad I must stop and sit down. Same with standing for about 3-5 minutes. Hoping to get a bariatric rollator that has a seat so I can sit down anytime I need to!

I was an arrogant, backslidden lukewarm Christian 22 years ago. God mercifully broke me down physically and mentally and I learned to rely on Christ alone. I can honestly say that having mental illness has been used by God in my ongoing sanctification. It has been a blessing, not a curse! Since I became Reformed 10 years ago and have been gaining theological understanding I can see how mental illness can be an instrument of deliverance by God.

By the way, here is an excellent article that discusses chronic pain and mental health, as well as associated issues.

2 responses to “Advice to a friend concerning mental health”

  1. Thank you for this wonderful article, Zach. After everything I’ve been through in the Church, I staunchly advocate for Pastoral ministry to be in alignment with current science and best practices. Anything else will endanger and harm people.


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