St. Teresa of Calcutta may be one of the most recognizable saints in modern history. Known worldwide as Mother Teresa, her dedication to serving the poor and the marginalized gained her international recognition, while her kind smile and prayerful presence marked her early on as someone who was close to God. Her holiness was so well known that her cause for sainthood was opened only two years after her death in 1997, accelerating the regular 5 year waiting period. However, when her private writings were published in 2007, in the book Come Be My Light, Mother Teresa’s complex interior life was revealed. While it is impossible to know for sure what Mother Teresa suffered, her story brings to light questions about the relationship between faith and mental health.

How Can We Tell the Difference Between Spiritual and Psychological Suffering?

Underneath her countenance of radiant light, Mother Teresa suffered from a sense of spiritual separation from God, an experience that stayed with her for decades. Many see her experience as a purely spiritual one, described as what St. John of the Cross called the “dark night of the soul.” Others view her experience through a psychological lens, postulating that she might have suffered from depression.

According to Beth Hlabse, a counselor and program director for the Fiat Program on Faith and Mental Health at Notre Dame, “the dynamic is complex.” She explained, “It would be a false fragmentation, however, if we failed to recognize the spiritual and psychological present in both experiences. We’re an integral unity of body-soul; hence, the Lord is present with us in depression in a manner which for many is not unlike the ‘dark night,’ in that it’s hard to perceive His presence.”

In order to distinguish between the two, Hlabse puts the primacy on experience. “The question of distinction is often asked by those trying to discern whether their experience – or the experience of someone they care for – is one or the other.”

Where Does Mental Illness Come From?

In a passage from Matthew’s Gospel, Jesus tells His disciples, “For this reason I say to you, do not be worried about your life, as to what you will eat or what you will drink; nor for your body, as to what you will put on. Is life not more than food, and the body more than clothing?”

At first glance, it would seem that Jesus is commanding us to choose to not be anxious. However, for those with a mental illness, making that choice is not so simple. Hlabse explained that the emergence of mental illness, as with many other physical illnesses, begins with certain genetic predispositions.

In her words, “The predominant theory to explain the emergence of mental illness is that of epigenetics, meaning that all people have certain genetic vulnerabilities to disease and illness.” However, these vulnerabilities aren’t the end of the story. Hlabse said, “Whether or not these genes are expressed (versus remaining dormant) is a function of the amount of stress placed on our person – primarily our nervous system – through our environment and development. Hence, it’s not nature or nurture; it’s both.”

Perhaps the most prevalent of these stressors have to do with our relationships. Hlabse explained that relationship is one of our most basic needs, and what’s more, “we never mature out of these needs.” This need for relationship is not only psychological, but also spiritual. We were, at our most basic level, created for it. As Hlabse put it, “To be made in God’s image and likeness means to be created in the image of God, who is Love, who is perfect Relationship: Father, Son, and Holy Spirit.”

However, with the introduction of original sin, human relationship became fractured, meaning that this need of ours could no longer be met fully. Hlabse calls this fracturing our “original woundedness.” She said, “Today, we still long for communion, but we live in the reverberating effects of original sin, of our fractured relationships, and we continue to sin – to wound our relationships.”

This loss of connection also plays a part in the expression of mental illness. Hlabse said, “If we consider original woundedness and its reverberating effects – together with the theory of epigenetics – we behold the reality of why we still hurt, despite all our technological progress as people.”

Is Mental Illness My Fault?

The reality of both the beauty of the relationship we were made for and the hurt we experience when it’s broken is expressed acutely in the Psalms. Jesus Himself used the Psalms to express His profound suffering on the Cross, exclaiming the beginning of Psalm 22: “My God, my God, why have You forsaken me?” Even though He was sinless, Jesus felt a kind of separation from God, His Father, which He chose to express using the words of Scripture.

While describing the various factors that predispose someone to mental illness, Hlabse concluded that, like with any illness, “Perhaps, most simply, we can remember that mental illness is not the result of a personal or familial deficit.” Jesus said something similar in an encounter with a blind man. In the Gospel of John, it says, “As he passed by he saw a man blind from birth. His disciples asked him, ‘Rabbi, who sinned, this man or his parents, that he was born blind?’ Jesus answered, ‘Neither he nor his parents sinned; it is so that the works of God might be made visible through him.’” Jesus declared that bodily illness is not the result of someone’s moral weakness or a consequence for their sins, but rather an opportunity for God to show His glory.

Not only does Jesus proclaim that the man’s illness is not the result of a personal failing, but He further proclaims that the man is worthy of healing. John’s Gospel continues, “When [Jesus] had said this, he spat on the ground and made clay with the saliva, and smeared the clay on his eyes, and said to him, ‘Go wash in the Pool of Siloam’ (which means Sent). So he went and washed, and came back able to see.” Jesus offered the blind man a personal, intimate connection that — when accepted by the man — resulted in his physical healing.

This healing, in turn, helped restore the blind man’s relationship with God. After the man was thrown out of the temple for calling Jesus a prophet, Jesus sought him out and asked him, “‘Do you believe in the Son of Man?’ He answered and said, 'Who is he, sir, that I may believe in him?’ Jesus said to him, 'You have seen Him and the one speaking with you is He.’ [The man] said, ‘I do believe, Lord,’ and he worshiped him.” As the man’s physical health was restored, so too was the even deeper wound of his fractured relationship with God.

Does God Want to Heal Mental Illness?

Hlabse explained that Jesus offers the same healing to us, providing physical and spiritual avenues to restore those with mental illness.

The first of these avenues is written into our biology. Hlabse said, “Across the board, persons’ experience of illness – their capacity to experience interior freedom amidst chronic diagnoses – changes. This is reflected neurobiologically through neuroplasticity (the change of our neural architecture over time).” With the help of a counselor and good tools, a person with mental illness can start to alleviate symptoms and suffering through retraining the brain.

Hlabse also stressed the importance of relationships in this process. “Neuroscience helps us to understand that relationships are centrally important to the neuroplastic change that supports our living a meaningful life amidst symptoms. The ‘relationship’ with a therapist should bear fruit in helping us cultivate healthier relationships within our families and communities.” The support of family, friends, and other loved ones is critical for encouraging the brain to heal and the suffering individual to find peace.

Another place where those suffering with mental illness can find relationship and healing is in the Church. Hlabse said, “Our faith also upholds a vision of healing, which includes but is not limited to miraculous cure – the remission of symptoms. Our Catholic faith tradition understands healing as the restoration of the communion that was fractured with original sin, and from this communion, new fruit is born. There is not just recovery but transformation.”

For Hlabse, the Eucharist is a primary source for restoring relationship. She explained, “As I prepare to receive the Eucharist, I uplift my wounds and illness – and the wounds and illness of those I love – praying for the restoration of communion.” By embracing the sacraments and spending time with Jesus in prayer, our need for relationship can be fulfilled as God intended it to be from the beginning.

We Should Embrace Faith and Science When Healing from Mental Illness

How, then, can we understand Jesus’ command to “not be anxious” in light of the rest of Scripture and the reality of mental illness?

Hlabse responded to this question by remarking, “As people, we cannot prevent worry or anxiety or another form of mental illness. We are vulnerable to it – by nature of original sin and epigenetics – and we cannot become invulnerable. Our Lord is asking us to respond to our worry, our anxiety, our illness through a posture of trust.”

She went on to reiterate that this trust happens through embracing both faith and science. “Our Lord is inviting us still to utilize these resources, but at once to trust ultimately in Him. No technology nor scientific finding can eradicate fully our vulnerability to illness. . . .Our Lord reminds us that the ultimate horizon is communion with Him, Love itself.”

Hlabse concluded our interview by offering Psalm 139 as a source of support for anyone suffering from a mental illness, saying, “In the midst of mental illness, we can feel as though our illness is all of us, consuming our identity because of the way mental illness impacts our self perception – and that it is determinative of our future. Neither is true. The psalm reminds us of our ultimate identity as God’s beloved, created in, through, and for Love. It teaches us that ‘even the darkness is not dark for [God].’”