Accounting for Sin and the Curse

One of the things that makes talking about mental health difficult as Christians is that we have to account for both sin and the curse.[i] To ignore either is reductionistic. We are sinners, and our sin can contribute to our lack of mental health. But we also live in a world that is broken. Life is full of thorns and thistles, futile work, and conflict not directly related to our sin.

The difficulty is that we can’t always tell where the curse ends and sin begins.[ii]

How do we differentiate between various causes? Can we? Should we?

It’s hard, but we should acknowledge both sin and the curse as potential factors and address both where appropriate as we discern each individual’s situation.

Physical and Spiritual Symptoms and Causes

Ed Welch notes how necessary this is: “If we confuse physical for spiritual symptoms, we are liable to hold people morally responsible for physical symptoms. …If we confuse spiritual for physical symptoms, we are liable to excuse sin or have little hope for spiritual growth when someone has a psychiatric diagnosis.”[iii]

Even so, not every spiritual symptom is sin-related. As Zack Eswine writes in Spurgeon’s Sorrows, “Though sins can result from it and temptations intensify because of it, depression itself is not a sin… Sometimes what threatens God’s absence in our life is not our hard heart but a physiological prankster.”[iv]

What happens in our bodies affects our mental health and how we address distress. If the root of a problem is nutritional deficiencies, thyroid imbalances, hormones, or other physical and circumstantial factors, counseling is good. Yet you can make use of all the counseling you can get and while you may learn to struggle well, you’ll still be struggling because the root cause has not been helped.

This was true of my perinatal anxiety in 2019: the counseling, prayer, and other “soul-work” I did helped me fight it well, but did nothing to alleviate the frequency and intensity of the anxiety. But at three months postpartum—right at the end of the “fourth trimester,” after 9 months of wrestling anxiety—it vanished without me changing anything. The same is true of my seasonal depression. I seem vastly more sanctified in April than I do in February, but the change has nothing to do with suddenly becoming more holy and everything to do with temperature and sunlight (if anything, I coast through the warmer months, growing lazy about my sin because it’s less blatant).

But to say that depression and other mental illnesses are not sinful in and of themselves doesn’t mean that sin is never a factor. If you’re depressed due to idolatry, medication and lab work won’t help. Sin can’t be medicated. Likewise, there have been times when my anxiety stems from blatantly sinful things, like attempting to be God by trying to take control. In other cases, our sin feeds and worsens physiological and circumstantial factors.

There are also times when mental health exacerbates sin without one causing the other. According to Ed Welch, “Physical symptoms test our hearts and expose them. This is different from saying that the physical symptoms caused these heart issues. They might accompany them rather than cause them. It is as if the pressure of difficult circumstances pushes the true condition of our heart to the surface. When the depressed person deals biblically with these issues, she is freed to grow in faith and obedience.”[v]

Welch continues, “Will the depression be alleviated by dealing with these issues of the heart? We have no guarantees from Scripture.”[vi]  The complexity of our humanity and the world around us means that we must replace simplistic answers with careful counsel.With both sin and the curse in mind,“Whether a person takes psychiatric medication or not is not the most important issue. Scripture is especially interested in why someone is taking medication or why someone is not taking medication. And it is clear that medication is never the source of our hope. With these guidelines in mind, there is biblical freedom to try, not try, psychiatric medication.”[vii]

Whatever the root, God is at work.

However we address the roots of our mental illnesses, we cannot let mental ill-health excuse sinful behavior. In other words, while we push back on the curse, we must also let our suffering sanctify us, whether the suffering stems from our sin or not. We can glorify God even when anxiety, depression, OCD, and more assail us. While I benefited from the sanctification they brought, my PMADs were not caused by my sin. They did not go away because I “outgrew” them and was sanctified beyond them. But in them I did have to fight my sin. When overstimulated, I had to tame my tongue. When anxious, I had to dwell on what was true about God and what was real—not my imaginings.

Whether it’s caused by our sin or the curse, God is at work in our mental health struggles. And His work extends beyond our sanctification. Mike Emlet writes, “Don’t be too quick to cast off suffering as though immediate relief from trials is the only good God is up to. And don’t think it’s more “spiritual” to refrain from taking medications, as though character refinement through suffering is the only good God is up to.”[viii]

Christians cannot be reductionistic in our approach to mental health. God is doing more in our lives than we can see. The psychosomatic unity of our humanity—that we are embodied souls—cannot be ignored. Both our bodies and souls must be considered. Likewise, sin and the curse must both be taken into account as we seek to alleviate suffering. We may not be able to tell exactly where the curse ends and sin begins, but we can carefully, compassionately work to address both.

Life in a fallen world means that even when mental illnesses are healed, life will not be easy. On this side of glory, we’ll never see an absence of sin in our lives or be free from internal and external malfunctions and brokenness. But one day— “He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away” (Rev. 21:4). He is making all things new, and that all things includes us and our mental health.