How should we understand the effects of the Fall on the mind and brain? We know our bodies age and die. We know all of our organs are susceptible to disease and deterioration. We have “norms” for the frequency, duration, onset, and prognosis of these effects of the Fall; what are the equivalent expectations for the mind and brain?

When engaging a difficult and highly personal subject, it is better to start with good questions than a list of answers. The better our questions are, the more responsibly we will utilize the answers of which we are confidant, the more humbly we will approach areas of uncertainty, and the more we will honor one another in the process of learning.

As I’ve read, counseled, and thought about the subject of mental illness, here are some of the questions that have emerged.

The purpose of these questions is to expand our thinking about mental illness. We all bring a “theory of mental illness” to this discussion. This theory, whether we can articulate it or not, shapes the questions we ask. Exposing ourselves to important questions from other perspectives is the first step in becoming more holistic in our approach.

Don’t allow these questions to overwhelm you. All of these questions existed before you read them. Speaking them didn’t create them. Actually, an appropriate response to this list would be the generation of more questions. Take a moment to write down the additional questions you have.

1. Is mental illness a flaw in character or chemistry? Is this the best way to frame the question? What do we lose when we fall into the trap of either-or thinking?
2. Why do we think of genetic influences as if they negate the role of the will or personal choice? Substance abuse can have a clear genetic predisposition, but every addiction program – even those most committed to a disease model – appeal to the will as a key component to sobriety.
3. In the modern psychological proverb, “The genes load the gun, and the environment pulls the trigger,” where is the person? How do we best understand the interplay of predisposition (genetics), influences (environment), and the individual making choices (person)?
4. What percent of those who struggle with “normal sorrow” are labeled as clinically depressed? What percentage of those who think their sorrow is normal are actually clinically depressed? How do we communicate effectively when the same word – depression – has both a clinical and popular usage?
5. Would we want to eradicate all anxiety and depression if we were medically capable of doing so? What would we lose, that was good about life and relationships, if these unpleasant emotions were eradicated from human experience? Would that be heaven-on-earth or have unintended consequences that are greater than our current dilemma?
6. Can we have a “weak” brain—one given to problematic emotions or difficulty discerning reality—and a “strong” soul—one with a deep and genuine love for God? If we say “yes” to this question in areas like intelligence (e.g., low IQ and strong faith), would there be any reason to say “no” about those things described as mental illness? C.S. Lewis in Mere Christianity says, “Most of the man’s psychological makeup is probably due to his body: when his body dies all that will fall off him, and the real central man, the thing that chose, that made the best or the worst of this raw material, will stand naked. All sorts of nice things we thought our own, but which were really due to a good digestion, will fall off some of us; all sorts of nasty things which were due to complexes or bad health will fall off others. We shall then, for the first time, see every one as he really was. There will be surprises (p. 91-92).”

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