“I have a mental illness.”
This statement is at the same time true and misleading, helpful and unhelpful.
It is a statement that evokes feelings of discomfort for those who say it and for those who hear it.
And it is a statement that often raises many questions that are not easy to ask, and sometimes very difficult to answer.
I am a college professor, a clinical psychologist, and I have served as a minister in the church; and “I struggle with mental illness.” As you may have just noticed, I changed the words I used from “have” to “struggle with.”
The reason is that words matter. They matter because they reveal how we understand extremely complex realities like the ones we call “mental illness.”
To say “I have” suggests that I possess something or that something that wasn’t mine is now mine. This is a helpful word to use when we think of many medical conditions that involve an invasion of the body by something foreign. For example, I might say “I have the flu” in which case I mean that my body has been invaded by a virus that wasn’t there and is now there—something I “caught” from someone else.
This is not the case with the conditions we call mental illness. I cannot “catch” them from someone else, and they do not describe a virus or bacteria that has invaded my body.
Rather, mental illnesses are names we give to clusters of symptoms that seem common to people in certain circumstances. Some of those circumstances are linked more to a person’s genetic inheritance and some to their environment and life story; however, most often they involve a combination of multiple factors.
That is why it is much more helpful to say “I struggle with mental illness.”
What I mean is that I experience a cluster of symptoms that are similar to others whose lives are impacted by similar causal factors. It is the cluster of symptoms and sometimes the causal factors that a person needs help with. It is not like needing an antibiotic to rid the body of a flu virus that I “have.”
Our words also matter when we think of the term “mental illness.” Mental illness has been defined by the Mayo Clinic in this way:
Mental illness, also called mental health disorders, refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors.
Many people have mental health concerns from time to time. But a mental health concern becomes a mental illness when ongoing signs and symptoms cause frequent stress and affect your ability to function.
The Mayo Clinic uses terms like “conditions,” “disorders,” and “concerns” to explain the meaning of “mental illness.” What I find so helpful about the definition they offer is the recognition that concerns “become” illness when the suffering associated with them reaches a certain level of impact on a person’s life.
I’ll address this more in just a moment.
What I find a bit disappointing about the definition is the statement that “many people have mental health concerns from time to time.”
The truth of the matter is that everyone experiences mental health concerns from time to time (we all experience times when we are anxious or down or feel overwhelmed, etc.), but not everyone experiences every concern or experiences their concerns reaching the level of disruption to life that we call illness.
Part of the challenge is in the meanings of the words we use. The word “mental” communicates certain things to us that evoke questions of the relationship of the mind to the body or the mind to the soul.
When we think in those terms, we often want “mental” to refer to our thoughts and our experience of ourselves that is somehow separate from our emotions and behavior or separate from our physical bodies.
The mental health field uses the word “mental” to relate to all of those and more. For example, the American Psychological Association has stated:
A mental illness is a condition that affects a person's thinking, feeling or mood [and] …may affect someone's ability to relate to others and function each day… Genetics, environment and lifestyle influence whether someone develops a mental health condition… Biochemical processes and circuits and basic brain structure may play a role, too.
Their definition recognizes that mental illness is a condition that involves thoughts, feelings, behaviors, and relationships. In that sense, the word “mental” can be misleading.
The historic language of the church is actually so much more appropriate and helpful in thinking about the realities we call “mental illness” today. Throughout history, pastoral writers have referred to these realities as “wounds of the soul.”
Actually, a literal meaning of the Greek roots from which we get the word psychology would be “the study of the soul,” and the roots from which we get the word psychopathology (the study of mental illnesses) would be “the study of the wounds of the soul.”
So, to return to my first statement, it would be better to state that “I struggle with a wound of the soul.”
We live in a time when spiritual realities and psychological realities are generally viewed to be separate phenomena that need to be kept apart from each other and that warrant areas of specialization completely distinct from each other.
Therefore, we have spiritual experts who know very little about psychology and psychological experts who know very little about spirituality. In that way, we have compartmentalized the study and treatment of the soul.
That, in my opinion, is a tragedy of our time. But that is a discussion for another time. For the purposes of this article, suffice it to say that what we call mental illnesses are conditions that are much more than “mental,” and they describe clusters of feelings, thoughts, and behaviors that impact the fullness of a person’s life.
I mentioned earlier that the idea of “becoming” is important when we think of mental illness. With so many of the conditions we call mental illness, there is a basic human experience or concern that has intensified to the point of becoming overwhelming in a person’s life. That particular concern has “become” a condition that we call an illness.
The American Psychiatric Association publishes the classification system from which we get the names of all the mental illnesses or disorders that are treated today (e.g., Depression, Anxiety, PTSD, etc.). For a condition to be named a “disorder” or “illness,” it needs to meet a certain threshold that impacts one or more of the “4 D’s.”
In short, is my condition at this time one that causes significant enough pain (distress) to be treated; does it cause enough disruption to my daily life (dysfunction) to be treated; does it put me or others at any risk (danger) to be treated; or does it make me different enough from societal expectations (deviance) to be treated?
In my case, the answer is yes to two of these. I have struggled with anxiety all of my life to a degree that causes me significant enough distress and significant enough dysfunction to warrant treatment or help. That is the definition of “mental illness.” That is the reason that I say “I struggle with mental illness.”
So many people experience distress and dysfunction to varying degrees but never seek help. Too often this is because of a stigma that still surrounds the idea of “mental illness.” This should not be the case, especially in the church. Paul wrote about his own distress and dysfunction in his second letter to the church in Corinth: “We were under great pressure, far beyond our ability to endure, so that we despaired of life itself.”
And in his letter to the Galatians, he wrote, “Bear each other’s burdens and so fulfill the law of Christ.”
It is the very law of Christ that we meet each other in our distress and dysfunction, in our wounds of the soul, so that we might experience the comfort of God through each other that Paul described in 2 Corinthians:
Praise be to the God and Father of our Lord Jesus Christ, the Father of compassion and the God of all comfort,who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves receive from God.
So, for this psychologist who experiences anxiety to a level that causes distress and dysfunction (mental illness), my hope is that we in the church can understand wounds of the soul well enough that we move beyond the stigma we have associated with “mental” illness and simply ask ourselves and each other:
“Am I, or anyone I know, in enough pain that we could use some help?”
Barrett McRay, Psy.D., teaches in the Christian Formation & Ministry Department at Wheaton College. He also serves as clinical director of Alliance Clinical Associates in Wheaton, IL.