Let’s begin by remembering that not everything that can be diagnosed or makes us stand out as unique is a problem.
- An “ideal graduate student” has mild OCD qualities – great attention to detail and drive for certainty.
- Many police officers say if they lost the hyper-vigilance of PTSD (persistent tendency to look for what is wrong), they would be less effective at their job.
- Mild mania – expansive thinking and energy for big goals – can be a very adaptive quality and is found in many great leaders; those who struggle with bipolar frequently have highly successful siblings or close family members.
So, as we look for the cause of particular struggles, we do not need to be exclusively problem-oriented. This is always an important caution for problem-oriented professions like counseling.
Additionally, because our weaknesses are often just exaggerated strengths, we can often feel shame where it is not needed and want to eliminate qualities God would prefer to see us refine.
- Without the ability to be anxious we would have a hard time anticipating the needs of others.
- Without depression our capacity to empathize with the struggles of others would be non-existent.
- Also, consider again the strengths in the examples of OCD, PTSD, and mild mania described above.
But whether we are looking for strengths or weaknesses, illness or health, it is still helpful to be able to distinguish between the biological, environmental, and volitional source of a trait. The first step in this process it to let go of our pre-set assumptions. Ed Welch’s critique of medical explanation is true for spiritual and environmental explanations as well. Whenever we “know” where the “real answer” is found, it will make other questions seems silly.
“The problem with immediately opting for a medical explanation is that, once the decision is made, every other perspective seems superficial or irrelevant (p. 30).” Ed Welch in Depression, A Stubborn Darkness
After you’re open to the possibility of each causal explanation, begin with these questions (the order is intentional). Use these questions to guide conversations with your trusted friends, counselor, pastor, or doctor.
- When did this struggle begin?
- What events or changes occurred just before and after the struggle began (for children and teens include changes in their physical-emotional-social developmental stages)?
- Have I experienced this struggle before? If so, when and what did I learn?
- What are the most common / obvious / simplest explanations of this struggle?
- What potential causes can I most easily eliminate by simple life changes (i.e., getting more sleep) or tests (i.e., going to the doctor for a broad spectrum blood exam)?
- Who should I pursue to come alongside me in this assessment process?
To provide guidance as you answer these questions, consider the following characteristics indicative of struggles rooted in each of the three causative areas. Remember that often a particular struggle may have its cause rooted in more than one area.
Indicators of Volitional Causes
- Natural consequence of a sinful (immoral) or foolish (unwise) choice.
- Result of over commitment in order to please people or achieve goals on an unrealistic time table.
- Lack of clear life systems (e.g., budget, schedule, etc…) to allow you to make informed, cohesive decisions.
- Conflict between life goals (e.g., healthy marriage) and temporal choices (e.g., continuing unhealthy dating relationship).
- Destructive choices (e.g., inadequate sleep, substance abuse, etc…) which have a cumulative negative effect.
- Struggles over which greater self-control or concerns for others would legitimately reduce its impact.
- Expecting a level of satisfaction or meaning from activities or relationships which on God can provide.
What are other possible indicators of volitional causes for mental-emotional-relational struggles?
Indicators of Environmental Causes
- Onset of the struggle near a traumatic event or major life transition.
- A family history that models unhealthy ways of handling relevant emotions or relationships.
- The presence of an unhealthy or unsafe dynamic in your environment or relationships.
- Bullying and rejection, especially when based upon characteristics over which an individual has no control.
- Physical or emotional stress can be an environmental trigger for struggles to which someone is genetically predisposed.
What are other possible indicators of environmental causes for mental-emotional-relational struggles?
Indicators of Biological Causes
- A family history can reveal where an individual is predisposed to particular struggles.
- A side effect of many diseases, medications, or major surgeries can be changes in one’s emotions.
- Aptitudes and attractiveness impacts mental health via the pportunities and acceptance these qualities provide.
- Onset of a struggle after the age of 40 with little to no history of the particular struggle.
- A significant change in an individual’s personality with no circumstantial explanations.
- Chemical imbalances and neural pathways in the brain both cause and respond to emotions and choices.
- General health factors (i.e., stamina, weight, strength, diet, etc…) impact mental health and neural functioning.
What are other possible indicators of biological causes for mental-emotional-relational struggles?
If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Mental Illness and Medication” post which address other facets of this subject.