Demon Possession or Mental Illness?

When I travel the world and as a psychiatrist talk about mental health with Adventists, there’s one question that, almost without exception, comes up: What is the difference between mental disorders and demon possessions? It’s an interesting yet difficult question. In the Bible we read about people being possessed by demons and about Jesus healing them. As Adventists, we believe in the existence of demonic supernatural beings that are actively seeking to control human lives. We believe in the possibility of people today being possessed by demons, as people were in biblical times. So could it be that what mental health professionals diagnose as mental disorders sometimes actually are demon possessions?

As a psychiatrist, I am trained to be an expert on mental health problems. I’m not an expert on demon possessions, and I have no experience casting out demons. We have a lot of research and experience that helps us understand mental disorders; meanwhile, demon possessions are far less studied. I’m not able to tell you how to clearly differentiate between the two, but I will share reflections that may be helpful in dealing with this difficult question.

My advice is to be very careful. A guiding principle in health care is this: “Do no harm.” This ethical principle is one we may extend to every aspect of dealing with other people. Whatever we say or do should “do no harm” to others. If we agree on this, then my question is: When do we risk doing more harm? Calling a demon possession a mental disorder and treating it as such? Or calling a mental disorder a demon possession and treating it as such?

If we labeled a demon possession a mental disorder and treated it with conventional methods, such as social support, lifestyle interventions, therapy, and medication, what would happen? Not much. Demons don’t respond to antidepressants or antipsychotics. Maybe some of the interventions would still help the person, but they would not directly do much about the demon problem. The person would most likely continue to be plagued by the demon, but beyond that, we wouldn’t have done much harm. One could then move on to dealing with the possession in the appropriate ways.

Now, what would be the consequences of falsely labeling someone as demon possessed who instead is suffering from a mental disorder? For one, a mental disorder is already a heavy burden to carry. Erroneously adding the idea of being demon possessed to the person’s struggle and suffering is not only unhelpful but will cause significant harm. The benefits of proven and helpful treatment strategies that could bring relief and healing would at best be delayed and at worst be altogether neglected. The person would be further stigmatized, in their own eyes and in the eyes of others. Mislabeling a mental disorder as a demon possession is grave spiritual abuse.

Whenever in doubt, we ought to choose the lesser of the potential evils. If I were in doubt about whether something was a demon possession or a mental disorder, I would prefer to err on the side of mislabeling it as a mental disorder and providing appropriate support and treatment for that, until there was evidence for a different approach.

We believe the devil and his fallen angels are active everywhere around the world. There are many ways beyond the typical possessions by which sin and evil get a foothold in our lives. The evil powers probably do not care as much about how they control us as that they in some way or another succeed in subjecting us to the harm and destruction of sin and evil. From this we all need saving. We all need the Savior and His healing power in our lives.