On Confessing Your Illness

I recently had a conversation with someone that centered around the question of what to confess if you suffer from depression or other mental illnesses. So many of the symptoms which we face that are bio-chemical in origin also find their origin in our fallen nature. In other words, I can look at certain manifestations of my illness(es) as being the disease “talking” but at the same time it can be my sinful nature “talking”. Here are a few examples:

  • Laziness, sloth, incapacity to work
  • Boredom, lack of interest in anything, indifference
  • Isolation from others, unfriendliness, dislike of crowds
  • Inability to handle children

Now these are just a few examples. I think that any of those three categories could be easily attributed to sin or clinical depression/anxiety.

So what do you confess?

The real mess of depression and mental illness is that they are so intertwined. My general approach is that if you are in doubt, confess it. But it is also a matter of real pastoral care, so that when I am confessing something that isn’t sin, my pastor tells me that.

Probably the dilemma comes from the fact that when you are in the throes of the darkness, you aren’t in a position to be making subtle theological distinctions. I just want relief. And at some level, I don’t really care where it comes from. IT it comes from my pastor forgiving my sins, great. If it comes from my doctor or counselor reminding me that this is biochemical and not a character flaw, great.

So how do you approach this question?

21 thoughts on “On Confessing Your Illness”

  1. A failing to live in love is a failing to live in love, no matter what its cause. I think you are wise to lump them all together. I remember Dr. Luther's words in the SA III, III:36:

    Such repentance is not partial and fragmentary, like that which does penance for actual sins. Nor, like that, is it uncertain. ***For it does not debate what is and is not sin. Rather it hurls everything together and says: Everything in us is nothing but sin.*** What is the use of always investigating, dividing or distinguishing? This contrition is certain. For we cannot think of any good thing to pay for sin. There is nothing left. There is only a sure despairing about all that we are, think, speak, do, and so on.

  2. I can see the difficulty of the question, however, since the remedy for sin and the remedies for mental illness are not the same. Proper diagnosis leads to proper treatment.

    Nevertheless, Absolution is always appropriate because we're always sinful and sinning, as Weedon and Luther so nicely say. It seems to me the tinkering and uncertainty of remedy come more on the drugs and therapy side of the equation.

  3. This is almost like a "Which came first: The chicken or the egg?" question.

    On the one side, we all know the theological answer. The sins associated with the illness are exactly that: they are sin. An offense against God, no matter what their root cause. A reflection of the world infested by the overarching disease: original sin. It is clear that we are guilty and should confess those sins against God without any excuse, be it a mental disorder/illness or a slight case of the common cold. In that respect it makes perfect sense to confess the sins stemming from illness and all other sins that we are guilty of that we are aware of and then include the fact that we know there are sins we aren't aware of and that it leaves us in a pitiful state begging for mercy from the Almighty God pleading for Him to make it right because we cannot.

    But then we complicate the matter further. Like St. Paul we look at the fact that the sins we do not want to commit we do and the good that we want to do we find ourselves unable to accomplish. Then the despair of thinking about the fact that we didn't have a chance from the get-go. "What did my parents or I do? What sin did we commit that I should be stricken with such an illness that my very being is offensive to God no matter my good intentions and in spite the fact that I am baptized?"

    So the answer lies in not what you do to separate the disease from the sin nor does it lie in showing penance but in the very act of repentance itself. Confess and receive absolution *and* work with doctors and medicines to work on both facets of the disease.

  4. I have wrestled with this subject a lot and for many years. I came to these conclusions.

    1. Depression can deceive my mind in a lot of ways (eg: I can feel guilty if someone trips over lint on the floor) and I can fall into a trap of false guilt and increase my illness/distress. Been there, done that, many times.

    2. I know that self-talk is important, so I try to remember that I am both saint and sinner. I have to reason with myself and not listen to the accuser of my soul.

    2a. I no longer read books like, Acedia and Me. I do not find them helpful. I'm already frustrated by my inability to get the things done that I used to be able to do and I think the Roman Catholic view of acedia invites mawkish monkery (as Luther might say?). I have found that I cannot dwell on sin or try to examine myself. If I do this, the enemy of my soul seeks to use my illness to incapacitate me even further than I already am.

    2b. I try to focus on the doctrines like: the theology of the cross, the grace of God, and what Christ has done. I try to remember whose I am. In Christ I am made whole and complete. In Christ my soul is safe and my illness cannot change that. My rest is in Christ and I seek to find rest in his love and faithfulness. Whether I live or die – I am His. I am a sinner saved by grace alone, in Christ alone, and his promises.

    3. Pastors can stress me out with formal confession and absolution (and do more harm than good), so I do not participate in this anymore. I cannot bear up with a pastor who suspects that God is 'chastising' me for some 'unknown' reason and wants to use those scriptures with me. After many years of experience in trying to confess my entire history of sin from my earliest memories to present (prior to becoming a Lutheran), I know I have confessed every real and imagined sin possible. Trying to find sin to confess can become a tyranny or hamster wheel. I no longer worry about sin in my life (please do not confuse this with antinomianism).

    4. I confess to God that I am helpless, my thinking is distorted, and I cannot tell up from down. I confess that I cannot confess because I cannot see or think properly. I can only confess that I am a sinner in thought, word, and deed (usually no specifics) because that is all I know. I can only ask God to take care of me and convict me of real sin and protect me from false guilt. I confess that God knows and I do not. It may sound dumb, but this always gives me a sweet release and comfort. I feel free after what most would probably consider a stupid confession.

    I guess basically, I no longer try to figure it out beyond this: I am a great sinner with a Greater Savior. Period.

    1. I can relate to a lot of what you have stated. If anything, people who have a mental illness are already judge by ourselves, as well as others. The Stigma that is associated with this illness is beyond belief in society, as well as in the church. Comments like he or she is a loaded cannon, can't be trusted, sinful being, trouble maker, and others, I've heard over the years. ____Pastors are not trained counselors, therapist, mental professional, and many of them just blame the person instead of the illness. They blame your sins, as if God gives you all of these new sins they come up with. Does a Loving God make you commit sin? We are under Christ's Grace just like any other Chistian, we are saved through him, as he said he that believes in me, shall be saved. He didn't say but, if, he said you are saved. ____

  5. So what do we confess? "Before God we plead guilty of all sins, … but before the pastor we confess only those sins which we know and feel in our hearts." It doesn't matter if the sins of laziness or idolatry or worry are biochemical in origin or not: we confess what troubles us. The pastor will help us and guide us if we are making excuses and not taking responsibility for our sin. The pastor will also help us and guide us when we confess what is not sin; it is his job to help us see what IS the sin/unbelief so that the Gospel might be applied with precision to sweetly comfort what is actually troubling us when we are too blind to see it.

  6. I agree with Susan. I struggled with this question in the midst of major depression this past summer. The conclusion I reached is that sin is sin, no matter its source. This is true not only for those who struggle with depression, but also other genetically or biochemically based troubles. For instance, alcoholism or any type of abusive behavior is a sin whether or not there is a genetic predisposition to it. Just as I am guilty of my original sin even though I was helpless in the "making" of it, so am I guilty for my actions and inactions even when I am virtually powerless to avoid them. Although my grasp of this truth was at times tenuous, I came to realize that through my depression God's grace was made all the more abundant, for I was made even more helpless to redeem myself. Truly, "My grace is sufficient for you, for My stregth is made perfect in weakness."

  7. Susan, I did not mean my comment as a dismissal, or an attack, or to be disrespectful to pastors. I do apologize if I came off that way.

    Some parishioners, like myself, have to face the reality that not all pastors are suited to help persons who struggle with depression and can cause more harm than good at times – even regarding confession – especially if they are new to the pastorate.

    I do question the reality of the pastor described in your comment. He sounds like a god who has all of the answers and never misses the mark in his analyses. I sincerely doubt that man exists.

  8. SjB- I am thinking that there is a healthy mix of both in this thread. There is the realization that pastors are sinners, too, and that sometimes in trying to help us deal with our sin in regards to our disorders, they can actually make things worse. One pastor I knew asked me why I worry so much when Matthew 6 obviously tells me not to worry at all and that God is in control. I told him that I knew that, but that my anxieties weren't fixed right away because of it. He didn't understand. He said that it was like faith- God gives faith and that faith is free from anxiety because part of that faith is knowing that God is in control.

    That helped out plenty. I spent way too much time obsessing and worrying over whether or not I had faith. I know he was well meaning, but he definitely caused more harm than good.

    However, this is not to say that I should become complacent about my worries, since worry is against the First Commandment. This is where it is important to get treatment and work through the means that God has put in place for such disorders not just for my physical and emotional well being, but my spiritual as well The more I work to cut down my own worry the more it stops attacking my faith. A good pastor will, as they get to know you, learn how to help you in your mental illness journey and how to put the proper amount of Law and Gospel into your conversations, or Confession and Absolution. He may not be good at it at first, and it may be a learning process for both of you, but it can (and has!) happen.

  9. Believe me, SjB, that pastor is no god 🙂 he's quite human and has plenty of his own sin. But I recognize that I am indeed blessed that he is my confessor.

    I did not take your comments to be an attack on pastors. It is good, though, when pastors direct their penitents to the fact that their "real sin" (in the middle of your point 4) is exactly what you commented on in the first sentences of #4. That is ultimately what we need to be absolved of. Our actions and our thoughts flow from the faith of the heart; when the faith is right, the actions follow. When my faith is wrong and turned inward, then sinful behavior and thoughts follow. My pastor has commented on how hard it can be for pastors to trust in the absolution; if a pastor were to see no "improvement" in a penitent's life, he may be tempted to turn to the law instead of continuing to lavish Jesus' forgiveness on those who come in need. I can see how, if a pastor underestimated the gospel's power and instead left a me with some self-improvement advice or penance, it would leave me worse off after confession than before. After all, the whole point is that "we receive absolution, that is, forgiveness, from the pastor as from God Himself." If the pastor doesn't do that, why go to confession?

  10. Where is God when you are all alone and have no one to talk to–no one who would really understand, any way? Where is God in suffering? In our own personal suffering? Where is God when none of it makes any sense any more?

    “God loves you and has a wonderful plan for your life!” Is this really His plan? Why did he even give me life when he knew what would result? Why education, gifts, and abilities if no opportunity to use them? Why would He want part of His creation to live a wasted life? Is such living life “abundantly?” “To the fullest?”

  11. To be sure, sin destroyed the perfection of the garden. My sin was a part of what nailed Him to the tree. But Christ has died! Christ has Risen! Christ will come again! Why am I depressed, unable to do what I need to do, and guilty for all that I am unable to do–one to be pitied? Where is the new creation? The old is gone, the new has come! Where is the disconnect? I don’t mean to be selfish, but might it come also to me? Where is my family of believers when I feel isolated and disconnected? How can I serve when I am but a number on the books and not seen as a genuine brother in Christ, in need of family? How can I concern myself with the failures of others when my own failures rise up, and continue to taunt me and accuse me? Where is the Sinless One on the cross, who lived and shared our pain? In the midst of inability, disappointment, and real life–scars and all–Where is God? Eleison.

    1. God is there, has been there, and will always be there for you and every Christian. I think it takes some one who has this illness to understand and can relate to you. I find reading Scripture helps, praying, taking you medication, and doing what you have to do to take care of yourself mentally and physically.

    2. I hear what you are saying, and I've ask the same type of questions over and over again and again in my own life.

      I have been fighting Major Depression all of my lfe, and have had many failures in my life as a result of the illness. The last failure in a job I really loved, and always thank God for. I lost that job because of stress, being a work acoholic, not taking time for myself, OCD, and forgetting that it was God who put me in that job, however, I left God and put myself above him, to the point I felt I didn't need him anymore.

      After which I went into a deep, deep, deep, depressive mood, panic attacks, mood swings, and all that goes with it.

      All I can say to you is be the best you can be. Put God first in your life no matter what. Take the time to walk and talk to him, pray, study, and remebr that he is always there, even when your mind tells you he isn't there.

  12. Depression cost me my job. As a youth pastor I confessed it to my church leadership and I received very little help. When my youth group found out it was the most embarrassing day of my life. It still haunts me.

  13. It is a brain Disorder, and the DSM IV has all of the explanations about all of them.____One I don't believe its caused by sin nor more then I believe that cancer, TB, Birth Defects, or any other illness is a directly related to sin. Its God's curse that was placed on human kind as a result of the fall of Adam and Eve. He cursed every human, he cursed nature, and etc.____I think many pastors are unable to apprehend, or show compassion for those who have this illness. Many people who have this illness would rather just stay home, then to be out and about, feeling the way they do. ____

  14. Drugs and Therapy are not always the answer either. I've been so drugged up that I couldn't even function. and this what we look forward to now, doctors who think everything be solve with a pill. They treat the person with contempt, pushing medications, switching medications, increasing dosage, I've been through it all. I argee with Tom Cruze, many are only interested in pushing pills, and that's it. If your in a state, program, that's all your going to get. The shrink ask, how are you doing. how are your medications, here is your refills see you in three months. Then they write a one or two page report on you and put in in your file. Its a joke. Maybe you been through this yourself?

  15. .____I confess my sins every day several times a day, I say the Lords Prayer several times a day. I'm not perfect, I'm a sinner who ask God to have mercy on me, a poor miserable that 's me.____It is also stated that Dr. Martin Luther suffered from depression. Of course back then they didn't know what it really was. However, he had his very bad days also.____

  16. Sorry to say most employers think people who have a mental illness are useless. Just because you have a mental illness doesn't mean that your employer can fire you. You have rights now under the American Disability Act, and well as other laws.

    Telling your employer that you have such an illness is also a hugh mistake. I feel that the church who let you go, isn't one that I would want to work for anyway. Where is there Christian Ethics at?

    I wouldn't give up your profession, you may even have a case with the EEOC, for unlawful discharge. I would look into it.

    If you didn't want to go that route, look for new employment in the same field. I'm sure many good churches are looking for good honest Christian people like yourself.

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