What’s the difference between mental illnesses and demonic possession?

Q. What is the difference between mental illnesses and demonic possession? I read the post on your blog about whether the “evil spirit from the Lord” that tormented Saul was “an actual spirit-being” or “a dark and foreboding disposition of the human spirit,” and I’m hoping you can expand on that distinction.  I’ve read in Acts about the girl who was possessed and could predict things until Paul cast the demon out. Is one sign of possession the ability to do supernatural things like that?

Let me say first, in light of the recent discussion on this blog of “metaphysical naturalism” and its denial of the supernatural, that I do believe, according to the Bible, that there are supernatural evil beings who seek to oppress people and keep them from turning to God and experiencing the life that God offers.  Anyone who doesn’t share this belief will not find your question, or my answer, meaningful, and so it probably would not be worth their time to read any further.

Second, also by way of background, I think it’s important to observe that the Bible itself distinguishes between mental illness and demonic possession.  It’s not the case that the biblical writers simply assumed that everything we would recognize today as mental illness was caused by demons.

For example, when Matthew describes the beginnings of Jesus’ ministry, he tells how “people brought to him all who were ill with various diseases . . . and he healed them.” Among those Jesus healed, Matthew says, were the seleniazomenoi and the daimonizomenoi.

The first term, seleniazomenoi, comes from the Greek term for “moon,” selene, and it can be translated literally as “moon-struck.”  The English equivalent is “lunatic,” and that is how many English Bibles translate the term.  Some translate it as “epileptic” instead, but I think it does refer to people with mental illnesses, which were thought in the ancient world to be caused by the influence of the moon.

The second term, daimonizomenoi, means to be oppressed by a daimon or demon, which the New Testament writers understand to be an evil spirit.  It’s important to note that they don’t actually use the term “possessed,” although they do depict Jesus and the apostles casting demons out of people, as if these had occupied and controlled them.

So then what is the essential distinction between mental illness and demonic oppression?  The Theological Dictionary of the New Testament offers a helpful insight into this, in its article on daimon.  It says that in the case of demonic oppression, “What is at issue is not merely sickness but a destruction and distortion of the divine likeness of man according to creation. The centre of personality, the volitional and active ego, is impaired by alien powers which seek to ruin the man and sometimes drive him to self-destruction.”

In other words, we can think of someone with a mental illness driving a car but having trouble finding their way through thick fog and drizzle.  Someone oppressed by a demon, on the other hand, is having to wrestle with the demon for control of the steering wheel to stay on the road.

This volitional aspect of demonic oppression is also seen in the way that many, thought not all, who suffer from it may have “opened the door” in some way by choosing to become involved in the occult.  (Or they may have exposed family members by doing this.)

The girl you mention in the book of Acts who could tell fortunes illustrates another distinction: demonic oppression may be characterized by the demons doing supernatural or superhuman things through the person affected.  Another biblical example is the man described in the gospels as “Legion,” who “had often been chained hand and foot, but he tore the chains apart and broke the irons on his feet. No one was strong enough to subdue him.”

A final observation I would make is based once again on an insight from the Theological Dictionary of the New Testament.  After confirming the observation that “in the NT not all sicknesses are attributed to demons,” it continues, “Nevertheless, it may be said that the existence of sickness in this world belongs to the character of the [present age] of which Satan is the prince.”  In other words, we suffer from illnesses, including mental illnesses, because the creation has not yet been redeemed from its bondage to evil, sin, and decay.

That being the case, we may rightly suspect that an evil influence is at work to aggravate a mental illness.  Even when it is not a situation of outright demonic oppression or possession, there could be demonic harassment. Throughout the centuries, in fact, many outstanding Christian leaders, writers, artists, and so forth have struggled with depression and similar mental illnesses.  Beyond the natural medical causes, there may well have been spiritual opposition designed to discourage and disable these people from fulfilling their God-given vocations.  Both the natural and the supernatural dimensions need to be kept in mind.  But spiritual opposition is not, in and of itself, demonic possession.

In conclusion, from a pastoral perspective (I was a pastor for over 20 years), I would encourage a person (or their family and friends, on their behalf) to seek spiritual deliverance from demonic oppression through the help of mature, reputable, qualified Christian leaders in cases where a sharp internal conflict of the will is evident (i.e. something “makes” the person do unpleasant and uncharacteristic things that they don’t want to do), where the person’s health and life has repeatedly been put at risk (like the boy described in the gospels whom a demon often tried to throw into the fire or into the water), and where superhuman phenomena are present.  These are not infallible indications, and each one individually could have a different explanation, so in-person, real-time discernment by experienced and spiritually mature advisors is required.

On the other hand, I would encourage a person to seek counseling and treatment for mental illness if they experience persistent symptoms such as depression, anxiety, confusion, troubling or irrational thoughts, etc.  Particularly if the person can’t just “shake it off,” they should get professional help and be open to the benefits of therapy and medication.  But I also believe that spiritual resources such as prayer and community support are vital for relief from mental illness and that they can make a big difference in the lives of those who suffer from it.

Those who are delivered from spiritual oppression or who find God’s grace to cope with mental illnesses are  able to offer encouragement to many others through the gifts God has given them.  To give just one example, Joseph Scriven wrote the hymn “What a Friend We Have in Jesus” out of his experience of long struggle with depression.  I hope and pray that any who read this post and recognize that they need help from God will find it through the loving community of God’s people and so become a blessing to others in the same way.