Spot the Difference 

...between Severe Mental Illness and Demon Possession

“…And Lord we pray that you would break this stronghold of the devil in Sharon’s life, that you would eradicate all influence of the demonic and deliver her…”

The prayer ministry team member was passionate and sincere, but she completely freaked me out.  Did she really think that my tremendous suffering was due to demonic forces?  Did she think that I was…possessed?

Alarm bells

My psychosis (hallucinations and delusions – symptoms of a separation from reality) has certain features which may ring alarm bells for well-meaning Christians.  As I get sicker, I speak of an ‘evil presence’ hovering over my left shoulder; I perceive pterodactyl-like creatures flapping their wings close to my face, mocking me (my ‘tormentors’); I sometimes receive ‘messages’ into my brain ‘from the fourth dimension’ commanding me to do things which are really wrong (mercifully, I have always resisted); and I feel weighed down by an ominous force which compounds my depression and terror.

When the brain misfires

I can understand why someone with little knowledge of psychosis could conclude that I am under the influence of ‘the demonic’, but the reality is quite different.  One of my psychologists once explained to me that psychosis is a dysfunction of the brain, and the brain can only conjure up psychotic phenomena which relate to its experience. 

This means that, for someone like me, who thinks a lot about issues of faith and reads the bible daily, it is not surprising that forces of ‘evil’ feature in those times when I am in a dark place psychologically and my brain is misfiring.  Similarly, some people with psychosis may experience the presence of angels or even think that they are the returning Messiah.

The dopamine dimension

If we are going to distinguish between psychosis and demon possession, we also need to think about dopamine, a ‘neurotransmitter’ or ‘chemical messenger’ which carries signals from one brain cell to the next.  It has been shown that dopamine is dysregulated in people suffering from psychosis, so that certain brain pathways are flooded with an excess of the chemical.  Like many others, I find that antipsychotic medications, which work to suppress dopamine, take away my symptoms or alleviate them greatly.  We would not expect a drug to have the same effect on a demon.

A biblical perspective

Let me make a few observations about mental illness and demon possession as described in the scriptures:

First of all, the bible leaves no doubt that demon possession exists, and Jesus made it part of the disciples’ mission to both ‘drive out all demons and to cure diseases’:

“When Jesus had called the Twelve together, he gave them power and authority to drive out all demons and to cure diseases, and he sent them out to preach the kingdom of God and to heal the sick.” (Luke 9:1-2)

Yet there is also a separate understanding of mental illness in scripture.  For example, in 2 Samuel, we see King David, fearing that he is going to be killed, acting in a way which made people think that he was ‘mad’ without any mention of anyone suspecting that he might be demon possessed:
 
“So he pretended to be insane in their presence; and while he was in their hands he acted like a madman, making marks on the doors of the gate and letting saliva run down his beard.  Achish said to his servants, ‘Look at the man!  He is insane!  Why bring him to me?  Am I so short of madmen that you have to bring this fellow here to carry on like this in front of me?’” (2 Samuel 21:13-14)

Recognising the Saviour

In the New Testament there is a notable feature of demon possession which distinguishes it from mental illness: in someone who was possessed, the demon is almost always recorded as having recognised Jesus for who he was – the Son of God:

“In the synagogue there was a man possessed by a demon, an evil spirit.  He cried out at the top of his voice, ‘Ha! What do you want with us, Jesus of Nazareth?  Have you come to destroy us?  I know who you are – the Holy One of God!” (Luke 4:33-34)

 “Moreover, demons came out of many people, shouting, ‘You are the Son of God!’” (Luke 4:41)
 
As a hospital inpatient, I have spent a lot of time with people whose psychosis involves apparently ‘dark’ phenomena, and I am a committed Christian.  Not once has any of these people, with diagnosed mental illness, called out to me that they see Christ in me, as you might expect if they had a demon.  They are not possessed, or under the influence of ‘the demonic’, but simply unwell, living with dopamine imbalances which may torture them terribly.

Learning from ‘Legion’

Finally, I feel that it is important to mention the story of ‘Legion’, a man who lived naked amongst the tombs, who would break the chains which bound him hand and foot, and cried out, cutting himself with stones (told in Matthew 8, Mark 5, and Luke 8).  Jesus cast out many evil spirits from this man, and they entered a herd of pigs, who ran over a cliff and drowned.
 
For me, there are two striking aspects to this story. 
 
One is that the description of the man – aside from his superhuman strength – is not dissimilar to that of someone with mental illness, and these passages have been highlighted as being amongst the first documented instances of self-harm.  I can’t help remembering the times when, gripped by agitated depression, I have cried out and cut myself. 
 
The other is that, once the demons had been cast out, it is written that he was ‘sitting there, dressed and in his right mind’ (Mark 5:15).  If he was in his right mind then, was he mentally ill before?
 
I have agonised about this, but, in the end, the defining feature of this man’s demon possession is that he recognised Jesus and his authority. Mark records that he cried out;

“What do you want with me, Jesus, Son of the Most High God?  Swear to God that you won’t torture me!” (Mark 5:7)

Luke’s record of his words is similar;

“What do you want with me, Jesus, son of the Most High God?  I beg you, don’t torture me!” (Luke 8:28)

Whatever similarities there may be between Legion’s demon-possessed state and mental illness, there are also clear differences.

Compounding stigma

Because mental illnesses – especially severe psychotic illnesses (schizophrenia, schizoaffective disorder and bipolar disorder) – are stigmatising, those who suffer often also experience secondary suffering in the forms of discrimination and social exclusion.  As Christians, we have a role to play in eliminating this stigma and helping people with mental illness to integrate into the church and society.  For this reason, we need to be very careful about ‘diagnosing’ demon possession – which compounds stigma still further, praying for discernment and seeking expert advice (for example, from a Christian psychiatrist) before concluding that there is a demonic element in someone’s mental illness.

A new day

Of course, all illness – physical and mental – is a result of the fall and, in that sense, a consequence of evil.  We are thankful, then, for a great Redeemer, who will one day deliver us from all illness and demonic influence and bring us to live in a new order with him where there is ‘no more death or mourning or crying or pain’ (Revelation 21:4).  A new order with no more psychosis or depression or mania or self-injury is heaven indeed. 
 
In the meantime, we need to exercise care and compassion towards those with psychotic illness.  It took me a long time to recover from that prayer for ‘deliverance’: let’s educate those around us and make sure that the mentally ill are better understood.