The Church treats mental illness as real illness affecting the whole person, body, mind, and soul. Seeking professional help isn’t a failure of faith. It’s often necessary care.
We’re not Gnostics. We don’t believe the body is bad and the soul is all that matters. When Christ healed people, He healed their bodies. When He raised Lazarus, He brought back the whole man, not just a disembodied spirit. The Incarnation tells us that matter matters, that our physical and mental health are part of what God cares about.
So when someone struggles with depression, anxiety, bipolar disorder, or any other mental health condition, the Orthodox response isn’t to say “just pray harder” or “you must have unconfessed sin.” Sometimes prayer and confession are exactly what’s needed. Sometimes you also need a psychiatrist and medication. Often you need both.
The Whole Person Needs Healing
St. Basil the Great built hospitals. He didn’t tell sick people to skip the doctor and only come to church. The Church has always understood herself as a hospital for souls, but that’s never meant we ignore the body or the mind. An Orthodox psychiatrist interviewed on Ancient Faith Radio put it clearly: we use a biopsychosocial-spiritual model. Biology matters. Psychology matters. Your relationships and circumstances matter. Your spiritual life matters. None of these alone covers everything.
This matters practically. If you’re in Southeast Texas and you’re dealing with depression that makes it hard to get out of bed, hard to pray, hard to feel anything at all, that’s not just a spiritual problem. It might involve brain chemistry. It might involve trauma. It might involve isolation or grief or a dozen other things. Your priest can’t prescribe medication, and your psychiatrist shouldn’t be hearing your confession. You might need both.
The same goes for anxiety. I’ve known people who white-knuckled through panic attacks thinking that admitting they needed help meant they didn’t trust God enough. That’s not how trust works. If your kid breaks an arm, you take them to the ER. You don’t say “we’ll just pray about it.” Trusting God includes using the means He’s provided, including doctors who’ve spent years learning how to help people with mental illness.
What About Spiritual Warfare?
Some people worry that talking about mental health in medical terms means we’re ignoring spiritual realities. Can’t depression be demonic? Can’t anxiety be a spiritual attack?
Sure, sometimes. The Fathers knew about demonic influence. But they also knew the difference between illness and possession, between a medical condition and a spiritual battle. The problem comes when we make everything into spiritual warfare and ignore the fact that brains are organs that can malfunction just like hearts or kidneys.
Here’s the thing: even if there is a spiritual component to what you’re experiencing, that doesn’t mean medical treatment is wrong. God can use medicine to heal. He can use therapy to restore. Saying “I need help” isn’t admitting defeat. It’s being honest about being human.
Confession, Therapy, or Both?
Confession isn’t therapy, and therapy isn’t confession. They do different things.
In confession, you’re reconciled to God and the Church. You’re receiving absolution and pastoral guidance for your spiritual life. That’s irreplaceable. But your priest probably hasn’t been trained to treat clinical depression or help you process childhood trauma using evidence-based therapeutic techniques. That’s not his job.
A good therapist can help you understand patterns in your thinking, work through past wounds, develop coping skills for anxiety or depression. That’s valuable. But your therapist isn’t going to give you the Eucharist or guide you in prayer or help you grow in the life of Christ. That’s not their job.
You’re not choosing between them. You can have a spiritual father and a therapist. You can take medication and go to confession. You can be in counseling and receive Communion. The goal is healing of the whole person, and that takes a team sometimes.
When to Seek Help
If you’re thinking about hurting yourself, get help now. Call someone. Go to the ER. Don’t wait.
If you can’t function, can’t work, can’t take care of your kids, can’t get through a day, that’s urgent too. Talk to your doctor. Find a counselor. Don’t let shame or fear keep you stuck.
If you’ve been struggling for weeks or months and it’s not getting better, that’s a sign you need more help than you’re currently getting. Maybe that’s medication. Maybe it’s therapy. Maybe it’s both. But don’t just tough it out indefinitely.
And talk to your priest. Not instead of seeing a doctor, but in addition to it. He needs to know what you’re going through so he can support you spiritually. He can pray with you, help you stay connected to the sacraments when everything feels dark, remind you that you’re not alone.
The Church as Hospital
We call the Church a hospital because we’re all sick in various ways. Some of us have sick souls. Some have sick bodies. Some have sick minds. Usually it’s some combination. The point is that we come to be healed, not to pretend we’re already fine.
That means there shouldn’t be shame around mental illness in Orthodox parishes. We don’t shame people for having diabetes or cancer. We shouldn’t shame people for having depression or anxiety or PTSD. We should support them, pray for them, help them get the care they need, and keep them connected to the life of the Church.
If you’re struggling, you’re not weak. You’re not failing at being Orthodox. You’re human, and humans need help sometimes. The Church is here for you, and so is the medical community. Use both. Let God heal you through whatever means He provides.
