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?