Magazine Article

You’ve got issues!

Can the faithful experience mental health issues?

Ron Coffen
You’ve got issues!
Photo by Nik Shuliahin ?? on Unsplash

Dolly, a pastor’s daughter and a pastor’s wife, faithfully spent hours reading the Bible each morning and The Adventist Home each evening. Yet she battled severe, unrelenting depression. She viewed compliments in her mother’s weekly letters as veiled criticisms, and her distress, amid her faithfulness, nearly ruined her marriage and family life.

Spiritual Giants Faced Adversity

Hebrews 11 lists Bible heroes commended by God—people of faith. A list worthy of our meditation. What does it mean to be a person of faith? Were they flawless? focused? fearless? “By faith,” did they avoid all physical adversities, emotional turmoil, and cognitive distress?

Let’s do a quick check on physical adversities.1 Did Abel, the faith chapter list leader, avoid all physical adversity? No, he was murdered—an extreme physically adverse event. Did Abraham avoid all physical adversity? No, he headed off to Egypt when his family was starving (Gen. 12:10).

What about Isaac? No, his eyes ailed him so he could not visibly distinguish between his sons. Moses? No, he could not hold up his arms, but trusted advisors supported him. Hebrews 11:35-38 makes it clear that there is no promise, this side of heaven, that physical adversity bypasses the faithful.

Across the hundreds of generations since humans let sin into the world, the ravages of sin’s general toll on the Edenic human body have diminished physical functioning, in many cases through no direct action by those who suffer—Abel died at another’s hand, Abraham did not create the famine, and Isaac did not blind himself.

Emotional Turmoil, Cognitive Distress

But what about emotional turmoil2 and cognitive distress?3 Did Noah avoid all emotional turmoil or cognitive distress? No, preaching 120 years with only mocking distressed him.4 What about Jacob? No, for decades Joseph’s loss caused heart-wrenching grief.5 Did Joseph avoid emotional turmoil when betrayed by his brothers or cognitive distress when falsely imprisoned, then forgotten by the cupbearer he’d encouraged? No, he emotionally pleaded to his brothers, wept when handed over to slave traders, and felt betrayed by the cupbearer.

Did Moses avoid stress? No, Jethro saw how overwhelmed Moses was judging every problem among the Israelites, until Jethro helped him obtain support. Was Jephthah emotionally unruffled? No, he was religiously impulsive; he wept grievously, wracked by regret (Judges 11:35).

Did David, a man after God’s own heart, avoid mental health challenges? No, numerous psalms testify to his struggles with anxiety and depression. “The troubles of my heart have enlarged,” he lamented. “Bring me out of my distresses!” (Ps. 25:17). “For the enemy has persecuted my soul; he has crushed my life to the ground; he has made me dwell in darkness, like those who have long been dead. Therefore my spirit is overwhelmed within me; my heart within me is distressed” (Ps. 143:3, 4). As with physical adversity, Hebrews 11:35-38 makes no promise that the faithful will bypass emotional turmoil and cognitive distress.

And then there’s Elijah. He had just demonstrated God’s domination over Ahab, one of the worst kings in Israel’s history, paired with arguably the worst queen in Israel’s history. Exceeding Elijah’s faith-based request to Yahweh for fire to consume the waterlogged sacrifice, God sent fire that vaporized sacrifice, water, dirt, and rock! Talk about empowering! It was so empowering that Elijah ran faster than Ahab’s horse-powered chariot for perhaps 15 miles! Yet the next scene presents Elijah anxious, suffering, deeply depressed, and feeling alone. A man of faith, the prophet of the Lord was hardly worry-free.

Besides having faith, we would identify the Bible’s faithful in modern language as also having issues with sibling rivalry (Joseph), social anxiety and speech challenges (Moses), mood disorders (Elijah), anger management and impulsivity (Peter, James, John), parenting problems (Eli),  suicidal ideation (Job, Elijah, Jonah), and the list goes on.

Yet God praises them in the faith chapter; describes them as having a heart like His; collaborates with them in a celebration of their faithfulness while they simultaneously faced daily unrelenting, unrelieved emotional turmoil and cognitive distress. Similarly, Jesus indicates that those who die in tragic accidents are no more sinful than anyone else (Luke 13:4), and rain (both physical and metaphorical) falls on the just and the unjust. In a world embroiled in the great controversy’s pull to chaos, time and chance bring distress to everyone (Eccl. 9:11). Can the faithful experience mental health issues? It seems the biblical answer is, definitively, “Yes.”

Contributing Factors

So what are the causes of mental health distress? Living in a world hundreds of generations away from God’s perfectly ordered creation puts us all in a battleground in which three major factors are behind mental health distress: long-standing factors, triggers, and maintaining factors.

Long-standing factors may be genetic or inborn, or occur early in life. Although they may cause distress directly, they often just put one at risk for developing distress. An example of a physical long-standing factor is being seven feet tall—an innate factor that does not cause concussions, but puts one at risk for concussions in a society in which doors are typically six-feet-eight-inches high. Similarly, a psychological long-standing factor is a reactive temperament—for example, infants who wake easily at night have nervous systems that react strongly to relatively small fluctuations in the environment.

Triggers are events occurring just before the onset of distress. If one is seven feet tall and running to escape a burning building, one is likely to forget to duck at doors, and to end up with a concussion. The triggers for getting a concussion are the fire, fearful running, and forgetting to duck. A psychological trigger for someone with a reactive temperament might be the unexpected death of a close friend, which could cause broad emotional distress (reactive nervous system), leading to worries about the potential death of other loved ones, potential illnesses, potential financial crises, or other “what ifs.”

Maintaining factors are events that keep the distress going. For example, being seven feet tall and regularly playing chase in the house with one’s children is a social maintaining factor that makes one more likely to hit one’s head on door jambs and experience concussions. A psychological maintaining factor for someone with a reactive temperament might be skipping work whenever one worries about possibly being judged, not fitting in, or making social blunders at work. When one skips work, the reduction in immediate distress is attributed to avoiding work; so one avoids work more and more when distressed, which maintains anxiety.

Long-standing factors, triggers, and maintaining factors cause cognitive distress and emotional turmoil. God created emotions to strongly alert us about unmet needs. Properly deployed, energy from emotions fuels problem-solving resources to address those needs. Emotions do not tell us how to the solve the problem, but they do signal a problem and provide energy. Neglecting the signal exacerbates distress.

When a person of faith experiences cognitive distress and emotional turmoil, God sometimes resolves the distress miraculously. Yet God does not promise such resolutions for the faithful. Rather, He has called for humans to rule over creation (Gen 1:26, 28)—as beings created in His image, we are, like Him, to bring order from chaos to resolve problems and reduce distress. God declared that being alone is not good, and He has provided for a supportive community of individuals who take care of others with wisdom, knowledge, and discernment for the healing of those who are distressed (Eph. 4:11, 12; 1 Cor. 12:7-11).

Practical Solutions

Helpers generally employ four modes of solutions:

Learn something new: This is internal change. If one does not have the required knowledge, if one is missing a skill, or if a skill has not been sufficiently practiced, then learning is the first intervention to try. It involves learning the missing knowledge or skill. If knowledge is present but the skill is not performed well, then supported practice may improve performance and reduce distress.

Shift to a different skill: This is also internal change. If the knowledge and skills exist as much as possible but performance still lags, use other strengths to compensate—if it is hard to use self-talk to calm anxiety, shift to playing music.

Adjust the environment: When internal change is not possible, implement external changes to enable functioning within a modified environment. Change the environment or task demands, or provide tools so that the need can be met. Medication, exercise, and diet help one’s body and chemicals get back to ideal functioning and are examples of external tools.

Manage: If neither internal nor external changes are possible, the intervention is to develop mental and emotional skills for managing chronic distress. This might involve developing humor related to the challenge, adjusting expectations, or capitalizing on social supports, e.g., regularly talking to supportive people about the difficulties, or meeting with people who share similar difficulties to allow for expression of emotions and to find ways to creatively move forward.

Earth is the battleground of the great controversy. Even when we are people of faith on the winning side, we will experience distress until God brings the battle to the final end. Until then, be a safe support for yourself and those who are under the siege of emotional turmoil and cognitive distress.6

They do not lack faith; may they not lack your compassion as modeled by Christ. For faithful but suffering Dolly, the compassion she obtained from professional psychological counseling, prescription medications, proper diet, exercise, and prayer have resulted in decades of cheerful relationships with her husband, children, and grandchildren.

1 For this article, my working definition of physical adversity is a bodily state interfering with optimal functioning. This working definition describes the opposite end of the continuum of the physical element of the World Health Organization’s definition of health: “a state of complete physical . . . well-being and not merely the absence of disease or infirmity” (

2 For this article, my working definition of emotional turmoil is a psychologically generated physiological state creating behavioral urges and which interferes with optimal functioning. This working definition builds off the American Psychological Association’s definition of emotions: “conscious mental reactions . . . subjectively experienced as strong feelings . . . typically accompanied by physiological and behavioral changes in the body” (

3 For this article, my working definition of cognitive distress is a mental state that interferes with optimal functioning in which one’s thoughts lead one to anticipate undesirable outcomes. This working definition builds off the American Psychological Association’s definition of distress: “. . . stress that results from being overwhelmed by demands, losses, or perceived threats. It has a detrimental effect by generating physical and psychological maladaptation” ( and cf.

4 Ellen G. White, Patriarchs and Prophets (Washington, D.C.: Review and Herald Pub. Assn., 1890, 1908), pp. 96, 97.

5 Ibid., p. 212.

6 Ibid., p. 218.

Ron Coffen

Ron Coffen is a licensed psychologist and professor at Andrews University and director of the Community Counseling Center that provides services with the compassion and care of Christ.