Podcast: Answering Common Questions about Mental Illness (David Murray)

September 25, 2023 by: Crossway

This article is part of the The Crossway Podcast series.

A Christian Approach to Mental Health

In this episode, David Murray responds to questions regarding anxiety, depression, and other forms of mental illness. He also offers advice on how to know if you're struggling with normal feelings of sadness or anxiety versus when it might be time to seek out more help.

A Christian's Guide to Mental Illness

A Christian's Guide to Mental Illness

David Murray, Tom Karel

This accessible resource answers 30 commonly asked questions about mental health from a Christian perspective, providing caregivers with the biblical wisdom necessary to care for those with mental illnesses.

Subscribe: Apple Podcasts | Spotify | Google Podcasts | RSS

Topics Addressed in This Interview:

01:12 - What Is Mental Illness?

Matt Tully
David, thank you so much for joining me again on The Crossway Podcast.

David Murray
Matt, it’s always a pleasure. Thank you for inviting me on again. It’s always a challenging subject that we’re addressing, mental illness, but I think you’re very sympathetic to that whole area, and I always enjoy our conversations.

Matt Tully
This is such a difficult topic. It’s a difficult topic to engage in our own lives and to deal with in the lives of those around us that we love, but, obviously, it can also be very difficult just to talk about as Christians in the church. And so I’m so glad that we get to have this conversation today. My hope is that we can look at common questions that Christians might have about mental illness—questions that they wrestle with themselves, questions that maybe loved ones also wrestle with, and my hope is that you can help us to think a little bit more biblically and a little bit more Christianly about some of these things. So maybe just to start off, give us a succinct definition: What is mental illness?

David Murray
It really is hard to define, partly because there are such a wide range of mental illnesses, and partly because people’s own experience is so different, even of one disorder, like say depression. You can speak maybe generally and say it’s a malfunction or a disorder of the emotions and the thoughts, but then you avoid addressing issues like spiritual causes as well. So it’s always difficult to really get a comprehensive yet brief and simple definition of mental illness. Maybe it just suffices to say it’s one of the consequences of living in a broken world, a world broken by sin, and as a consequence our bodies, our minds, our emotions, our souls, are fallen. They are affected by the curse, resulting from sin, in different ways—resulting in imbalances, resulting in excesses, resulting in gaps and malfunctions that manifest themselves sometimes in sin, sometimes just in disordered thinking, disordered emotions, and disordered actions.

Matt Tully
I notice in that definition that you mentioned mind, body, and soul as contributing to mental illness. Is that an intentional way to incorporate those three components of what makes us human?

David Murray
Definitely, Matt. The approach I try to take, both in diagnosing the problem and in coming up with solutions, is what I call a holistic approach. In other words, we’re trying to avoid the extremes of maybe a body-only approach (medication), a soul-only approach (repentance and faith), or a mind-only approach (cognitive, therapies). We’re trying to really address the whole person because mental illness affects the whole person. Therefore, the broader we can look at this I think the more accurately we’ll address it and the more people it will help as well. I think that’s why we need so much of the Lord’s help in discerning, in ourselves and others, the different mix of contributing factors, whether it’s our genes, our upbringing, our decisions, just illness, a broken body, trauma, abuse—so many factors play into it with so many different affects.

05:02 - Changing My Mind about Mental Illness

Matt Tully
And that’s one of the most difficult things about mental illness is it is so, as you said before, hard to fully capture in a succinct definition, and then the contributing factors, the causes, can be so diverse. And so it’s really hard to just nail it down in any way. But maybe as another initial question for you, David, you speak obviously as a pastor, someone who has a lot of experience counseling and ministering to Christians. You also speak as a father and a husband, and you also speak as someone who has himself struggled with mental illness in the past. I wonder if you could just share a little bit about your own experience there and how that factors into your thinking about this topic.

David Murray
My experience has very much played into my interest in this condition, this problem. First of all, it came really through my wife, Shona, who’s a very bubbly, extrovert, energetic, type A personality. But twenty or so years ago she fell into a really deep depression around the birth of our fourth child. My whole world was turned upside down because—I have to be honest—up until that point I’d always viewed things like depression and anxiety as sins and the result of sin. And yet I knew from knowing my wife and her godliness that that was not the issue here. It was actually much more to do with burnout due to multiple strains upon her and upon us in our family and church and friendships and things like that. And so I had to really learn fast in trying to help her. That resulted in me realizing this is a much broader problem than just addressing a Christian’s spiritual condition. And then, as you know, Matt, because we’ve had many conversations about this online and offline, this led into a ministry of writing and speaking on it. But then a few years ago I ended up falling into depression and anxiety myself. And in some ways that’s embarrassing to admit, because here’s the depression/anxiety expert, or somebody who’s written a lot about it, at least. Surely if he can’t avoid depression, what about the rest of us? But I think it just shows that we’re all vulnerable. None of us are too strong, too confident that we can’t, due to a combination of factors, end up in the midst of this. And I think that verse addresses that age-old problem of pride: “Him who thinks he stands, take heed lest he fall.” And maybe I was overconfident. Maybe I was thinking, I’m here to help others, but I’ll never need help. And then I realized, Well, David, you’re just as weak and vulnerable as everyone else, and this is more of God’s education of you. And I have to say that, as it was with Shona, it’s ended up being a blessing as well.

08:00 - How Common Is Mental Illness?

Matt Tully
How common is mental illness today? I know we hear a lot of stats, and I think the general impression is that it’s on the rise in our culture and in the US, but are there any other facts or figures that you can give that help paint a picture for how common it is?

David Murray
It is hard to be really accurate. I think, obviously, the media tends to distort these things and exaggerate them. But even at the conservative end of the statistical spectrum, everyone admits this is an increasing problem, especially amongst the young. The overall figures are something like 15–20% of people will have some kind of anxiety disorder in their life. Somewhere between 10–13% of people will have a major depression at some point in their life. So you’re looking at something like one in five, maybe even up to one in four people will have some kind of depression or anxiety in their life, the most common mental illnesses. Amongst young people, the numbers are getting close to things like, conservatively, 40% (maybe more) on the extreme end of the scale. And the reasons for that may be more willingness to talk about it, for sure, but I think there are also cultural factors that are playing into it as well. And maybe we can talk about that at some point also. But I think the way I try and just keep it simple is I think of every fifth person as someone who is struggling with mental illness at some point in their life.

09:45 - Differentiating Mental Illness from Typical Emotional Highs and Lows

Matt Tully
All this conversation about the prevalence of mental struggles like this among the people that we know and interact with, and maybe even people listening right now, that raises the question of, How do we exactly define a mental illness versus the ordinary emotional struggles that we can sometimes face? We all feel sad sometimes, we all feel anxious sometimes and confused in different ways. How do we know if our emotional struggles qualify, so to speak, as a mental illness?

David Murray
I think that’s one of the most important questions to address today, because I personally do feel it’s over-diagnosed that ordinary sadness, ordinary anxiety is being treated as a disorder rather than as a normal abnormality in an abnormal world that we simply seek the Lord’s help to persevere through to the other side. So how do we distinguish between the blues and depression? How do we distinguish between reasonable fear and an anxiety disorder that is debilitating? I always speak in three degrees, or three measurements. The first is breadth. So you’ll often find a list of symptoms for anxiety, depression, borderline PTSD, whatever, and you have to really take a broad range of these symptoms, not just one or two. And then I like to talk about depth, which is the intensity of the feeling. So this is not just, Oh, I feel a bit down today, but it’s really coming to that point of incapacitating a person. It’s lingering. It’s causing a person to break down into tears. And then really speaking of the length, how long it’s gone on for. Usually, in most articles and websites, they’ll talk about two weeks of these symptoms going on. Again, I think that could be normal, but I think more likely to look at three to four weeks. By that time we should be thinking about seeing our doctor. That is unless there’s some kind of suicidal element to this, an idea of committing suicide. Then you don’t wait. You really have to treat that very urgently.

Matt Tully
And I want to get into that topic a little bit later in our conversation as well. How much of the assessing whether or not we’re struggling in a more serious way relates to just assessing the cause of it? I can imagine someone who’s just maybe lost a loved one. They might have these feelings of sadness or grief that would certainly last longer than two weeks or three weeks. How big a factor is that in assessing, Is there a good reason for me to be feeling these ways, or is this something doesn’t make a lot of sense to feel?

David Murray
That’s a really helpful distinction, Matt. Some of the questions I will often ask people in trying to assess is, Has there been a painful loss? Has there been a stressful event? Has there been a great disappointment in their life? And if so, then these things should really, if that’s all it is—a normal grief reaction—then it’s better to let it play out than short circuit it, medicate it. It’s part of really processing pain and disappointment and loss in this world, that we seek God’s help to persevere through it, that we don’t try and just escape from it, whether that’s with self-medicating or professional medication. And therefore, finding out what’s going on in a person’s life is very important in the assessment of distinguishing between a normal sadness and a serious depression. But even when there have been painful losses, painful disappointments, hard events, really by six months, if the person is not getting back to some kind of normality—not perfectly normal, but some kind of normality—then, again, we should begin to intervene there and get some expert input.

14:03 - What Causes Mental Illness?

Matt Tully
You’ve already started to hit on the different causes, if we can call them that, of mental illnesses that we can experience. I wonder if you could help summarize what are some of the categories of causes? Again, understanding that it’s not always just one thing, it can be multiple factors that come together. But how do you think about that question? When someone comes to you and says, Why am I feeling this way? what would your response be?

David Murray
Obviously, you can have a bit of a checklist in your mind in terms of assessment, but I don’t like using a checklist when I’m talking to people because it just seems too clinical. I know some people like it. I personally don’t. I prefer somebody just to tell me their story, and, of course, I’m listening out for things that I’ll maybe get them to expand upon. But I prefer to hear it more naturally, more normally, more relationally, so I try to build a picture of the person. I’m looking at things like, for example, biology. I want to know if this person has mental health issues in their family. Is there a genetic issue? Mother, father, brother, sister, and so on. I think that’s important to find out. I do want to explore a person’s life in terms of will they acknowledge any sinful attitudes, desires, or actions that have maybe contributed to this. And from what I’ve seen, things like pornography addiction, that is very commonly linked to anxiety and depression. I think it’s a large part of the cause amongst young people today, although they probably don’t realize it. I’m looking for things like bitterness, lack of forgiveness, overwork—things like that can be causes of depression. And then I’m looking for things like abuse. Has this person had wrong done to them either recently or in the distant past? There can be lingering effects of that in people’s lives. Looking at things like their relationships. Are there any stresses in their marriage and so on? What about work? Any conflicts going on there? Somebody’s described it as it’s like walking down a hotel corridor, and on different doors there’s health, there’s lifestyle, there’s life events, there’s genetics, there’s conflicts, your working habits, your sexual life or whatever. You’re opening the door and seeing what’s in there. But keeping going, never just saying, Okay, well, we’ve opened one door and we’ve found a problem. That must be what it is. No, we need to explore the whole life so that we don’t miss out any causes.

17:04 - Is Mental Illness a Result of Spiritual Failure?

Matt Tully
I think sometimes certain Christians can approach this issue maybe with some of the same perspectives that you once had when it comes to struggles with anxiety or depression or what have you. If there’s not an obvious traumatic or sad event that’s just happened in someone’s life, and yet the person is still struggling, or maybe they themselves are still struggling, it can be really easy to run to, Well, this is just a lack of faith. This is just maybe evidence of a lack of spiritual vitality. I need to just buckle down, pray more, read my Bible more consistently, and this should go away. And if it doesn’t, I’m somehow failing in my spiritual life. What do you think about that way of thinking about this?

David Murray
It can be an accurate way of thinking. If somebody is backslidden—they’ve been far away from the Lord, they have not been using the means of grace, they’re choosing sinful lifestyle—then it’s actually one of God’s mercies to chastise with depression or anxiety in order to bring someone back. And I think king David in the Old Testament is a classic example of that. But I have to be honest, the vast majority of Christians that I deal with or have dealt with over many years, it hasn’t been that. Now, there have been some, but the vast majority are very diligent in their Christian lives. They are very conscientious, involved in the church, maintaining a personal walk with the Lord, they’re not falling into any sin. And yet for these conscientious Christians, it’s often the first thing they will go to: Oh, I must have done something wrong or, God must be really angry with me or, Maybe I’m not a Christian after all. Therefore, exploring causes really does help that person begin to shift away from that default of It’s all my fault. I’m more guilty than ever which only increases the depression. You can begin to see the impact of just life upon a person, or the impact of genetics. Maybe it’s not one big thing, or even two big things, but just multiple little things. I’ll often ask people, Tell me about your last two years. And when a person starts to do that, it begins to dawn on them that, Wow! Man, it’s been tough. It’s been hard. No wonder I’m down. So I think, obviously, the Bible calls us to rejoice in the Lord, and the Bible calls us to have no fear. And I think these are very appropriate exhortations to Christians going through ordinary life. But just as we would not expect somebody with a broken leg to run 100 meters, we wouldn’t expect somebody with a broken body, a broken brain, a broken chemistry to have all the emotions and the thoughts they need to have joy and have fearlessness. So we have to temper, or adjust, our approach depending on the person. To the one we’re saying, Hey, come on. You don’t have cause to be so down or Come on, take this fear to the Lord and seek to conquer it in his strength. And then you’ve got the other person who you’re trying to help them see, Well, there is a cause for this depression. There is a reason for this anxiety. The response to it is not going to be the same. This is not an ordinary life in which we should be ordinarily rejoicing and ordinarily fearless. No, there is good cause here. And therefore, we’ve got to go deeper and further in trying to address it.

Matt Tully
David, would you say that a mature Christian could struggle with mental illness for a prolonged period of time? Is that something that is compatible with mature Christian living? Even if it’s not a result of sin, is it still a sign of spiritual immaturity?

David Murray
No. I really believe, Matt, that mature Christians can suffer from depression, anxiety, bipolar, PTSD for prolonged periods of time, because their bodies are no different to other human bodies. Their brains are no different. In some ways, from what I’ve seen, Christians can actually be more liable to fall into these things, partly because we have that in our life where we see our own evil. We have eyes that see evil in the world a lot more than other people. We are specially targeted by the evil one, more than non-Christians. And we feel things more deeply. We are more sensitive and sympathetic. Therefore there are more provocations, there are more catalysts of mental and emotional distress in our lives, especially as we mature, because we get invited into more people’s lives and they’re pain to try and help them as people see Christ in us. We are tested by God as well. I think we can be like Job was—the godliest person in the world maybe— and yet God chooses us to be a stage on which he shows his grace. Some of my greatest heroes are Christians with mental illness. They are holding on to Christ, they are holding on to faith with the fingernails of their little fingers. When everything else is saying let go—all their senses, all their thoughts, all their circumstances are saying let go—and yet they will not let go, and God will not let go of them. And therefore they have an opportunity to really show the power of God, the sufficiency of grace. Just as somebody who’s going through cancer or somebody who’s dealing with diabetes every day.

Matt Tully
In terms of addressing these struggles with mental illness that we can face, that sometimes even as Christians we can face, how should we think about prayer and Bible reading? Again, that’s one of those that it can be easy to either feel that’s where we should go first, or it’s easy to point people there. How should you think about those two responses? Where do they fit in the order of priorities?

David Murray
I think the first thing to say is we have to try and build reserves, spiritual reserves, when we are well. And that’s true whether it’s a mental illness or a physical illness, that we use the health and the strength and the time that we have to build our vault of truth and our experience of the Lord in prayer so that when these trials do come, we’re not starting from ground zero. We’ve already built a strong theology and a strong connection with God. And that’s especially important because often times in mental illness, especially the worst kinds, like in bipolar and schizophrenia, it is well nigh impossible to get the thoughts in any kind of order so that we can read and process what we’re reading, or that when we pray, we are speaking sensible sentences. Therefore, it’s very important to have these reserves and that connection before this happens. So what I usually say to people is better a little than nothing. Oftentimes, again, if it’s very conscientious Christians, they’ll say, Okay, I’ve got to pray more. I’m going to pray for an hour and I’m going to read my Bible for two hours. And it’s actually making things worse. I’ve sometimes had to tell people, Look, you need to actually shorten your Bible reading. You need to limit your time in prayer because it’s just ending up as a multiplier of this pain. It’s almost like you’re torturing yourself. Read one verse and pray for one minute. Make them count. Walk away, and trust the Lord to keep you. Don’t build guilt. But over time, maybe the next week, try two minutes a day. Then the next week, three minutes a day, and slowly rebuild. And hopefully, as other measures are taking place, not just Bible reading and prayer, but other measures as a package of care, then that Bible reading and prayer will begin to really grow and increase. And it’s a time for really gathering other Christians around you to pray for you and to read with you and to interact with you in the Scriptures. It’s very hard when you’re down to do that on your own, but to have fellowship around you, in the word and in prayer, is just such a therapy.

26:10 - I’m Experiencing Symptoms of Mental Illness—What Do I Do?

Matt Tully
I think that’s so true. I think we’ve all experienced that, in probably greater and smaller ways, the incredible encouragement and power that comes from letting other Christian brothers and sisters into our struggles, letting them speak truth to us when we’re having a hard time. But then speak to that next step, the step of going to see a counselor or a psychologist, a professional to help with something. How do we know when that would be a good, wise next step when we’re struggling?

David Murray
I think a good first step is usually your general practitioner, your family doctor. Unless it’s extremely serious, but even then, we need help in terms of guidance to whom we should go. Our family doctor will usually have a list of trusted people—counselors, professionals—that can be of immediate help to us. It’s better than going on the internet and just doing a Google search. Here’s somebody we have a connection with, somebody who knows us to some degree, somebody who’s built a network of people he trusts—that’s a good place to start. Ideally, not necessarily, but ideally, you want a Christian. You certainly don’t want someone who’s going to undermine Christianity. That’s why, again, I think it’s important for people to approach their pastors at the same time as they approach their doctors, because the pastor should also have a network of people. He himself will be able to help to some degree, depending on his age and experience, but he should also have a good range of people, of male and female, dealing with different specialities, that he can confidently recommend to his sheep and work alongside them. Not just delegate and walk away, but walk alongside them. And again, depending on the severity of the situation, you want your pastor involved, you want your doctor involved, you want maybe a mental health professional involved, maybe a biblical counselor involved. Again, just put together a package of people that will vary, depending on the person and the situation, that will be able to bring their own expertise and address each of the dimensions of our humanity.

28:23 - Advice for the Pastor in Helping the Sufferer

Matt Tully
David, you’re a pastor, and I wonder if you could speak to pastors just briefly about this issue. When you think about your own ministry and the way you’ve grown in your ministry and learned about this topic in particular, mental illness, and how to help people who are suffering, have you learned any lessons? Do you do things differently now than maybe you once did earlier in your pastoral ministry? Are there mistakes that you’ve made in the past as a pastor trying to help people that you could counsel other pastors listening to avoid?

David Murray
Oh, many, many, many mistakes, Matt. As I said, I approached this in a completely wrong spirit with wrong thoughts initially in my ministry. And I’m afraid probably, if I’m honest, I harmed people by blaming them, by accusing them, by not listening to them, by jumping to conclusions. And I’ve apologized to some people if I’ve been able to do that, and learned, hopefully, from my mistakes. I do think pastors have a very important role, one of which is on a congregation-wide level, so just bringing it into congregational life, into sermons, into prayers. We talk a lot, and rightly so, about the challenges the church faces with things like abortion, homosexuality, transgender—these things are increasingly common. But they’re nowhere near as common as mental illness in our communities and in our churches. And therefore, in terms of proportion of time given, this should be one of the issues pretty near the top in our prayers and in our preaching and in our application. And so we want to, again, just generally teach the Bible, because we really believe that these are resources that will help people with the struggles of life so that they don’t fall into different kinds of depression or anxiety. Then, speaking specifically on mental illness. One of the surveys that I commissioned through Lifeway and Focus on the Family found that 65% of family and friends, and 59% of sufferers—about two thirds of people—want their church openly talking about mental illness so it’s not so taboo. And yet very few do. Maybe once a year. Some people have never heard a sermon that’s even referred to it. Fifty percent of pastors rarely or never speak to their church about mental illness. So, a pastor might say, But I’m not equipped to do that. Well, get someone in who can. A Christian, another pastor, maybe someone who’s gone through it themselves. Why not have a personal testimony from someone within the congregation or someone from outside? Definitely include it in prayer. Maybe not naming people unless you have permission, but certainly praying for it in general. And then counseling, learning how to do this well to your own ability, knowing your own limitations, and having that network in the community that you build up over years of people that you can bring in, that you can get advice from, or you can co-counsel with. I think maybe the most important thing I could say to pastors is to listen and not jump to conclusions. Try and really listen and give people a real chance to speak without them fearing that you’re going to jump in with Bible verses or judgment. Really fight against that. The time may come for these things, but to give people help to build their trust in you and that you care for them, that you you love them, you want to spend time with them, you don’t just want to pass them on to others, and that you want to learn from them as well. They are some of the best resources we’ve got.

Matt Tully
I’m not a pastor, but I could imagine that at times when a pastor is sitting there with somebody who’s struggling, their desire is to help that person. They want to see them make progress and flourish in their lives, and so the temptation could be to try to have a solution that you could kind of give to them—something that they can do or change that will make things better. But it sounds like you’re kind of saying maybe the posture should be a little bit slower, a little bit less ready to give the right answer, so to speak, but instead carefully take the time to assess the full situation.

David Murray
Yes, because usually it’s been a long-standing problem. It’s not something that arose this morning, you see your pastor in the afternoon, and you’re cured by the evening. In the vast majority of cases, people who eventually come to their pastor, they’ve thought about doing that a dozen times over many years or at least many months. Therefore, it’s a deep problem, it’s a longstanding problem, there has been a lot of processing by the person, and they want to tell you. They want to get that out. They want to get a chance to tell you the whole story without you jumping in. Often, for like the first hour or so that I’m with someone, I’ll hardly say a thing. I’ll just ask the right questions, hopefully, that will get that story. You really affirm them, really communicate that you’re listening, you’re caring, you’re suffering with them, you’re sorry. Maybe at the end of it you can share general verses about God’s sustaining grace, God’s power, God’s wisdom, God’s providence. Not jumping in with solutions, but just trying to build a foundation of truth about God to trust and how the word of God is trustworthy. And even during the second and third time of meeting, just gently and patiently moving towards maybe more specific scriptures, maybe some, Okay, I know this counselor that can deal with this kind of thinking pattern much better than I can and can help you retrain that thought—a trauma expert who can help you talk about this in the right way and respond to it in a biblical way. So you’re just beginning to gently move a person, because it’s a long term. It’s not going to be fixed quickly and easily. If it’s taken a year to get into, it’s going to take a year or two to get out of. And that’s why, again, pastors need to involve their elders and other people in the congregation. They cannot be the sole caregiver, but they can be the person that really organizes and really puts together a good package of care.

35:07 - What about Medication?

Matt Tully
Perhaps one of the most common questions that Christians have about these topics is the question of medication—when it’s appropriate, or if it’s ever appropriate, for the Christian to turn to medication to help to treat different kinds of mental illness that we might be suffering with. And I think sometimes it’s easy for us to look at the broader culture and maybe, as conservative Christians, have the mindset of, Look, everyone is prescribing medication all the time. It happens so much. Doctors can sometimes be so ready to do that and numb away the struggles that people are having that might have multiple spiritual causes. So what’s your perspective on medication? How should Christians think about that as one possible way to help treat this?

David Murray
Yeah, you’re right. There is terrible overprescription of these medications, and people are not willing to spend any time exploring causes and getting long term solutions. They just want that quick fix. Doctors are under a lot of pressure just to give the quick fix, and the pharmaceutical companies want you to take their quick fix. So it’s a fatal combination, really, of people, unfortunately, working against the interests of the sufferer. But having said that, just because people misuse something which I believe is a good gift of God (all of God’s good gifts are misused or abused), doesn’t mean we shouldn’t use them at all. It just means we look at them differently, we approach them differently. Maybe our timing of our use of them and our reliance on them should be different. We shouldn’t go to them first unless there’s a real life-threatening situation. There are so many other measures that I’ve tried to cover in my books that we can go to. Even just simple things like diet, exercise, sleep, friendships, hobbies, recreation, getting fresh air and sunshine—just a number of basics that we should be trying and are often missing from people’s lives. Even things like a weekly Sabbath. But sometimes when even all these things are tried very diligently and put together, there’s no movement. Maybe a person’s really sinking. And that is when we mustn’t rule out that extra help that I believe God has provided. These medications are not perfect. There’s still a lot of research to be done, and we shouldn’t approach them thoughtlessly but prayerfully. And I view them more as a rope to somebody down in a pit. The person’s tried all these other ways to get out, and here comes this rope ladder, and it brings you up to maybe at the surface or near the surface where you can begin to use these other things. Counseling can begin to stick. Bible reading can begin again. Prayer is now possible. And now the motivation maybe to do exercise. I’m beginning to stop doing some of the things that were harming me and start doing some of the healthy things I’ve stopped doing before. So it gives you an ability to use other measures that you didn’t have the ability to use before, or that you couldn’t profit from before because you’d got to such a low ebb. So I think viewing it as an assist rather than as the whole solution, and praying for God’s blessing. Without God’s blessing, even our ordinary food will not be blessed to us. But I’ve seen medication have wonderful results in my own life, as well as in the life of others around me. I actually tried to come off my own medication after being on it for two years, thinking I’d processed some of the trauma that I’d gone through and suppressed for many years. I did some other things. I thought, Okay, I think I’m up and at them again. I came off it very slowly, as you have to, very graduated. I didn’t actually tell my wife, because she’s a doctor, and I knew she wouldn’t approve of me doing it. So I thought, I’ll come off it. I won’t tell her. I’ll wait and see if she can objectively tell the difference. So two months in, she says to me, David, there’s something wrong. There’s something wrong. She’d noticed irritability, lack of focus, just a general downness, lack of motivation. She said, You may need to up your medication. I can see you slumping. I said, Well, honey, actually, I’ve been off my meds for a couple of months. She said, David! Are you serious? I said I just I wanted to make sure that this was still necessary in my life, because I’ve got a much healthier lifestyle. I’m doing all the things I should do. But obviously, the damage is so deep that it looks like I’ll be on this for the rest of my life, for the benefit of those around me. And, obviously, my own benefit too. And I think that’s often the case with medication. People say, No, I don’t want to do it. I’m too proud. But the people around you are suffering hugely. And it can be a very selfish decision to say, Oh, I’m too holy to take medication.

40:42 - Can Mental Illness Be Cured?

Matt Tully
That kind of ties into another question I had that I think sometimes we can wonder about. Is mental illness something that we’re consigned to live with if we have it? Whether it’s some trauma that’s happened to us in our past that’s affected us deeply, or maybe it’s genetics that we just inherited that we didn’t have any control over, I think sometimes the question can be, Do I just have to sort of let this come when it comes and deal with it the best I can after that? Are there things that I could do proactively to ward it off, to prevent it from happening? If I do start to struggle, are there things that I can do to eventually get past it and not have to deal with it anymore? What’s your thoughts on those kinds of bigger questions?

David Murray
I think there are people, and I’ve known some, who can be cured of their mental illness. It might have been a milder one, or it might have been very situational, in which case easier to come out of if it’s mild situational. The situations can change, or we learn to adapt to the situation better. And so people can come out of it. They may have been on medication, they come off it, and they’re good for the rest of their lives. I would say, though, in the majority of cases, that it does leave us with a vulnerability. Therefore, I know people in the mental health area would prefer to speak of managing rather than curing. I think that’s a Christian way of looking at trial and affliction as well. And, of course, managing involves first of all submitting to the fact that this is who I am, for good or for ill, through no fault of my own, or maybe through my fault, this is where I am. I have to submit to that and accept it and then begin to deal with it. And that might involve, if I’m one out of ten, then using all the means will get me to a six out of ten. And accepting that as part of my life is almost like accepting that disability as part of God’s providence in my life. My thorn in my flesh, as it were, but not a disadvantage in God’s hand, because his strength is made perfect in our weakness. And I’ve seen the most beautiful, wonderful results come out of Christians finally admitting, speaking publicly, encouraging people all around them with it. It’s just like a Christian with autism, a Christian with Asperger’s, a Christian with some kind of mental disability or physical disability, somebody with diabetes, somebody living with extreme asthma or psoriasis or whatever—these are sometimes, usually, just the result of living in a fallen body in a fallen world. And God has called us to serve him in these situations and with these disorders to show his strength in our weakness. And that is what I’ve seen over and over and over again. And tremendous relationships are built through these admissions, through these connections. Great usefulness results from it as well. People outside the church see how Christians deal with mental illness in a positive, constructive way that looks for fruit and good from it. So, some cures, but mostly managing. That doesn’t mean you’re just trundling along the bottom, but seeking to get up to the level, the limits, that we can get to, and then just living sensibly. Learning from what brought us there, learning from what brings us out, and making that part of our lifestyle going forwards.

Matt Tully
Maybe one follow up question. As we do that, as we seek to accept the struggles that God has providentially allowed to come into our life and not try to hide that or try to deny that, what’s the line between doing that, like you’ve just said, how is that different than maybe just sort of being complacent in our struggles not pursuing joy in God, not pursuing faith in God in the midst of life’s difficulties? Because I could hear people maybe hearing what you said a minute ago as sort of giving us a pass to just sort of say, I’m always going to be disappointed and discouraged and sad, and so I don’t really need to try to be joyful in God.

David Murray
Yeah, I think these people are there. I think they’re pretty rare. Most people who have true mental illness do not want to stay there. I admit there are some who do. You’re right. But most don’t. It’s awful. It’s terrible. Sometimes, and I’ll just speak personally, you just want to rip the negative thoughts out of your brain. You wish you could disconnect the memories that traumatize you, that haunt you. You wish you could just lift your spirit above that. There are people who take a defeatist, pacifist view, often using it maybe to try and get sympathy and attention. That is, of course, a known fact in all illnesses. I always go back to the man at the Pool of Bethesda. Jesus asked him, “Do you want to be made whole? Do you want to be made whole?” And you think that’s a bit of a silly question. Surely he wants to be made whole. But obviously, he didn’t. Jesus wouldn’t have asked him. And so I will often ask people, Do you really want to get better? Do you want to get out of this? If they don’t, they won’t. You cannot help people who do not want help. And that’s one of the hardest things in mental illness. Often women will say to me, My husband’s really depressed, but he just won’t get help. He doesn’t want help. He won’t admit it. It’s very hard to break through that. But I would say in most cases, people want help.

47:19 - Advice for the Spouse of a Sufferer

Matt Tully
That brings us to our final question, or one of the last couple of questions. Speak to the spouses listening right now, spouses who are married to somebody who does seem to struggle. Maybe it’s not been diagnosed. Maybe they just are suspicious that there might be some mental illness kind of lurking in the shadows. What advice or encouragement would you give to a husband or a wife who doesn’t really know what to do at this point?

David Murray
It’s a very common question that I’m asked, because it’s a very common scenario, and it’s similar to the one I’ve just described, which is usually it’s a wife asking about a husband. It can be asking about a child or a teen. Teens are also pretty often closed, especially guys. First of all, I think try and get the person to tell their story. Don’t say like, You’re depressed. You need help. Say, Look, tell me what’s going on in your life. I’m noticing you just don’t seem yourself. So coming at it in a non-condemning, non-threatening way, and not drawing it back to yourself and saying, You’re making my life a misery. That just makes the person feel even worse. But just say, Look, let’s chat. Let’s talk. Sometimes that won’t work. In which case, I often think it’s best to get a male friend involved in this. Maybe the wife could speak to his best friend to say, Look, I’m concerned about Jim. I tried and I can’t. Do you think you could easily, naturally raise this in a conversation? It’s especially helpful, of course, if the friend has had some problems in the past and could talk about that and hopefully open up the man as well. And I think eventually, if the man is not responding there, to that very gentle wives approach and then very brotherly male friend approach, I think it’s time to maybe get some spiritual authorities in his life involved, because this has serious consequences for that marriage, for that family. Before it gets any worse, I think the wife could ask the pastor to get involved and approach, again, ideally in a non-condemning, non-threatening way. And yet, at the end of the day, the guy can still say, No. I’m not interested. I’m a big, strong do-it-yourself guy. Until he comes to that lowest point, it’s very hard to make any progress, I’m afraid.

49:56 - What Good Comes Out of Mental Illness?

Matt Tully
David, as a final question, at the very end of your new book you have a chapter called “What Good Comes Out of Mental Illness?” It’s an interesting way to end a book about a really difficult topic, but I wonder if you could just give us a little sense for how you answer that question.

David Murray
I have seen a ton of good come out of mental illness—in my wife’s life, in my life, in the lives of many that I have helped over the years. Much spiritual good. Much spiritual fruit. A closer walk with God, greater trust, greater dependence on God, a greater love of the gospel that assures us of God’s love, even when we don’t love ourselves. A greater love of heaven, knowing that we’re going to the place where not just our bodies but our minds and emotions will be perfect. A greater compassion for sufferers, not just those with mental illness but all kinds of weakness. A greater appreciation of Christian joy when it’s restored, and Christian peace when we enjoy it. So there’s a lot of good that can come out of this at the end of an often long journey. But all the sweeter because of the bitterness of the path.

Matt Tully
David, thank you so much for that really encouraging final note, pointing us to the way God can use even our deepest struggles for his glory and for our good. We appreciate it.

David Murray
Thanks, Matt.

Popular Articles in This Series

View All

Podcast: Help! I Hate My Job (Jim Hamilton)

January 06, 2020

Jim Hamilton discusses what to do when you hate your job, offering encouragement for those frustrated in their work and explaining the difference between a job and a vocation.

Crossway is a not-for-profit Christian ministry that exists solely for the purpose of proclaiming the gospel through publishing gospel-centered, Bible-centered content. Learn more or donate today at crossway.org/about.