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Writer's pictureLiz Millican

Discerning Between Spiritual Warfare and Mental Health

I have heard a variety of approaches to how to resolve issues for life’s problems based on whether they are mental health problems or if they are considered spiritual problems.


Note: I am going to assume that most readers have an understanding of what the Bible says regarding spiritual warfare. If you are unfamiliar a list of Bible passages can be found at the end of the post.


Some people say that mental health problems and spiritual problems are distinctly separate issues. Mental health problems require therapy and/or medication, while spiritual problems require prayer and spiritual discipline.


Others say that there is no such thing as mental health problems. They believe that mental health problems are problems that arise from unrepentant sin and have been mislabeled as mental health.


I don’t think that viewing issues as exclusively mental health or exclusively spiritual represent the entirety of what we see happening in the world. I think there is an overlap between spiritual warfare and mental health problems, and that it is difficult, if not impossible to make clear distinctions between the two. For example, if we were to define the source of the problem based on which “treatment” provided the best outcome; there are people who testify that they were freed from alcoholism through prayer alone, there are those who have overcome alcohol addiction using a mental health approach and there are those who recovered through prayer, spiritual and mental health support (a combination).




Since mental health and spiritual support are both able to assist people in healing, we should learn when it is best to use each approach, but when possible, an interdisciplinary approach can be very useful. First, mental health approaches are often very compatible with a Biblical approach to the same issue. For example, CBT techniques that involve replacing distorted thoughts with more reasonable thoughts are compatible with Bible verses that talk about renewing our mind with the truth of scripture. If we use scripture to help us challenge false beliefs then we are able to connect the spiritual with mental health.


Mental Health Approaches Through a Spiritual Lens


Any mental health approach that can be used in a way that is consistent with scripture should be used when it is appropriate to do so. Mental health approaches, specifically the ones that help us challenge and change sinful thoughts and behaviors can be useful no matter what the person is dealing with, these techniques are not exclusive to mental health problems.


For example, someone could use the three column technique from CBT to help them identify false beliefs and replace them with more Biblical ones. In this technique the person creates three columns. The first column is for situations, the second for feelings and the third for thoughts. This technique can be very useful for distinguishing between thoughts and feelings. This allows people to see how their thoughts impact their emotions and can create more meaningful change when false beliefs are identified and replaced.


Taking medication to help with a mental health problem can be a useful tool to assist your brain in forming more positive approaches to your problem. For someone who takes anti-anxiety medication, they can also use scripture to help renew their mind and reduce their anxiety. This combination can create better results since the focus on scripture reinforces the changes in the brain made by medication and the medication reinforces the relief provided through encouraging scripture.


A Multidisciplinary Approach


The seminary that I attend recommends that if someone is dealing with a spiritual affliction that they should see: (1) a Christian counselor to help them change sinful behaviors and thoughts, (2) a spiritual director to help them with their relationship with God, and (3) seek deliverance prayer.


Using these three approaches benefits the Christian by strengthening their faith and to guard against a return of spiritual attacks that is mentioned in Luke 11:14-28.


Could this be spiritual?


I have had conversations with Christians who are skeptical of spiritual warfare. Some say that they think Biblical passages reflect a poor understanding of mental health and they didn’t know how to explain it. I find this unsatisfying, because even if you assume that Jesus was only healing people, when the Bible speaks of demons causing people to scream when they leave, this seems to suggest something else. If this was a straight forward healing, why did it involve screaming?


I’ve also spoken to people who believe that spiritual warfare occurs only in places like Africa, but not in North America or places that are primarily Christian. I wonder if this is simply a statement made from a lack of experience. I and others I know have seen manifestations of demonic activity in Canada and the US. I have been witness to people being thrown to the ground, shaking and involuntary screaming that was relieved through prayer.


Any problem that has become repetitive and difficult to break could have a spiritual basis. Things such as anxiety and grief can be the result of a spiritual attack. I was once telling a friend a story of an unpleasant experience I had and he began to weep. I was shocked because he was in tears over something that I myself was not upset about. I prayed that he would be filled with a spirit of joy and he stopped crying and became calm. If you see some odd or out of place behavior it doesn’t hurt to stop and pray, “Lord, what shall I do? How should I pray?”


What to do if a problem could have a spiritual basis?


My recommendation is very simple. Pray the positive: healing, peace, joy, patience, freedom, life, etc. Whether or not a problem is specifically spiritual or not it can still be improved by prayer that focuses on the positive.


From people I have spoken to who lead spiritual deliverance ministries, there are two ways demonic spirits can be removed from a person; one is through specific prayer for them to be removed, the other is through being filled with God’s spirit so that the demonic spirit has no choice but to leave. Trying to cast out a spirit will only work if there is a demonic spirit and even the disciples had difficulty casting out some spirits. When we pray for the positive then God is able to act in ways we cannot see or understand.


Acts 19:13-16 describes the experience of men who came under spiritual attack when they were praying against demonic spirits. Spiritual warfare appears to be quite complex and certain approaches carry less risk than others.


Suicide: Demonic spirit or Mental Health problem?


From my observation, I think there is one exception to the idea that a mental health problem could be a spiritual or mental health problem. I think when it comes to suicidal thoughts, behaviors, and actions it is 100% mental health AND 100% spiritual. Any time I have been in the presence of a person who recently or subsequently made a suicide attempt I discerned the presence of a demonic spirit. If someone you know is suicidal they should seek mental health AND spiritual support as quickly as possible.


Scriptures that I would recommend for people experiencing suicidal thoughts are the ones about God’s love, forgiveness, mercy and blessing towards us. Other helpful topics are verses about purpose, healing, and transformation.


For additional support you can book a consult here.


Liz Millican is a Registered Psychotherapist in Ontario, Canada. She has a master of divinity in Clinical Counseling from Tyndale University, a private Christian University.


Scripture References


Exodus 20:4-6; 34:6-7 Generational punishment for sin and blessing for obedience.

Matthew 8:16-34 Jesus heals people of illnesses, casts our demons, calms the storm and casts demons into animals.

Matthew 9:27-34 Jesus heals the blind and mute.

Matthew 17:14-21 Casting out demons requires faith and some disciples were unable to do it.

Mark 1:21-34 Spirits manifest physically in people.

Contrast: Mark 1:40-45 Jesus heals a man of leprosy without mention of spirits, suggesting some sickness is not spiritually caused, but still able to be healed.

Mark 6:13 [NIV] They drove out many demons and anointed many sick people with oil and healed them. (Healing of sick seem somewhat separated from those with demons.)

Mark 16:9 Mary Magdalene had been freed from seven demons.

Luke 4:31-37 Man thrown on the ground by a spirit.

Luke 8:26-39 Many spirits can make someone strong and “out of their mind.”

Luke 9:37-43 Demon causes screaming, foaming and throws the person to the ground.

Luke 11:14-28 Pray and obey God to avoid demonic attacks from returning.

Acts 16:16-18 Paul waited several days before casting a spirit out of a fortune teller who was annoying them.

Acts 19:13-16 Stronger demonic spirits can attack someone who tries to cast them out.

Ephesian 6:10-18 Put on the armor of God and be prepared for spiritual warfare.

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