I don’t like to publicly criticize church leaders. Problems are best handled in the organizations and congregations they serve. However, I can’t stay silent about the recent comments by pastor John MacArthur. He purports that psychology and psychiatry are built on nothing more than major noble lies and that mental illness is not real.

MacArthur goes on to quote a psychiatrist from the 1950s who questioned mental illness and then wildly claims there is no such thing as PTSD, OCD, ADHD, adding that the purpose of these diagnoses is to make people addicts. And this is not his first rodeo speaking out against mental health. He has also said that depression can be fixed if people focused on more positive things, kept their expectations low and were grateful.

How naive. Sad. Uniformed.

However, beyond sadness is a real concern that conservative evangelical Christians will listen to this uninformed opinion and not get the help they need. MacArthur’s words bring shame and stigma to those suffering with mental illness and may prevent people from getting help from Christian physicians and therapists.

PTSD is real and tied to a specific stressor. If you see a soldier blown up by an IED, a mother physically assaulted and left for dead, a tragic motor vehicle accident in which people in your car died, these are traumas. The brain doesn’t process them easily or well in some people. The major treatments are trauma-focused therapies to process the trauma and alleviate the associated symptoms. The therapies are effective.

People with OCD have unwanted thoughts though and fears. Current theories see it as a biological disease in which there are heightened activity in several parts of the brain that create a neural loop of thoughts. These thoughts (obsessions) are unwanted and the person desperately wants them to stop. Some people respond to a therapy used to retrain the brain called exposure with response prevention. But those treatments do not always work on their own and medication may be needed. The combination of medication and therapy has helped many people with OCD.

ADHD is also not made up. It is caused by a combination of genetics and the environment. Through imaging, we can see a differences in brain circuitry and structures in people with ADHD from those without. Some people can make accommodations in their lives without medications. However, that might not be enough. Medication may be needed and there is no evidence this leads to becoming a future addict.

The brain is an organ like the heart, the liver, and the lungs. It can be damaged, afflicted and broken due to genetics, epigenetics, and behavior. No one is saying that choices or experiences do not matter. However, there is also a biological component to many mental illness diagnoses. So, to tell a Christian parent with a schizophrenic son that he doesn’t need psychiatric help including medications is unconscionable. There are certain mental illnesses like bipolar and schizophrenia where medications are needed to stabilize the person.

Mental illness is real in our fallen world just like other biological diseases. Chronic illness doesn’t stop at the neck. The brain can be problematic. Would we tell a diabetic to think more positively to treat his disease? Of course not, but biblical principles like positive thoughts, gratitude, trusting God, having faith and hope help people tremendously no matter if there is physical or mental disease.

But do not tell people their suffering is not real and is only a lack of faith or poor choices. Mental illness is more complex. For example, poor choices are involved when someone uses substances. But when use continues, some people are more genetically predisposed to develop addiction. And once addiction is in play, the brain is rewired and you have a chronic brain disease. Treatment for addiction requires body, mind and spirit approaches. But brain chemistry is significantly changed by the chronic use of substances.

MacArthur’s comments about mental suffering remind me of prosperity preachers who believe that suffering in a fallen world can be alleviated by positive thinking and strong faith. This is not consistent with the words of Christ in John 16:33, “I have said these things to you, that in me you may have peace. In the world you will have tribulation. But take heart; I have overcome the world.” Jesus acknowledges our suffering this side of heaven and promises an eternity with no pain or disease.

In the meantime, we suffer, but God’s grace and presence get us through our tribulations.