Mental health and choice: A plea for some people to say less

Philosophy Social Issues

Facebooktwittergoogle_plusredditpinterestlinkedinmail

If you kill yourself, then the only reason you did it is that one day you made a choice to do it. Are things really that simple?

Popular Christian blogger Matt Walsh has been getting a bit of flack lately. In a blog entry that was, in my view, a pretty bad idea, he offered what he took to be a correction to the many messages of sorrow about the recent death by suicide of actor Robin Williams. People have been drawing attention to Robin’s struggles with substance abuse and, more prominently in people’s comments, with the mental illness that is depression. I think it’s right to draw attention to this, and for Robin’s sad passing to be a reminder to us all how debilitating depression can be, and to reach out and help those who battle it. Sometimes you know about it, a lot of the time you won’t.

I agree with some of what Matt says. He, like others, raises a concern over portraying suicide as a path to peace and escape. The widely circulated picture of Aladdin telling Robin Williams’ character, “Genie, you’re free,” is troubling, painting a potentially attractive picture to those looking for a way out. But Matt’s message is that Robin wasn’t killed by an illness. People who die from cancer are killed by an illness. But Robin Williams made a choice, as, presumably, does everyone who kills themselves when battling depression. That’s why he committed suicide – because of a choice. “Robin Williams didn’t die from a disease, he died from his choice.” The apparent take home message is that if a person makes a choice, then it didn’t happen because of an illness. Personal responsibility is the theme here. Matt also said some potentially concerning things about depression as a “spiritual” issue. Because Christians are dualists (oh really?), we should readily believe that depression is a spiritual as well as a physical issue. “Atheists,” Matt says, of course would have no trouble thinking that it’s really a physical issue (don’t drink from the well, it’s full of poison). I’d also like to stop talking about this as a claim that Matt Walsh in particular made, because it’s a view that any number of people might have expressed (and not everything I will say relates directly to anything Matt has said – he simply raised the issue). It just happens that Matt said it on his blog. It’s a way of thinking that needs to be discussed in its own right, not just as part of an attack on a blogger. As far as Matt goes, I only hope that he changes his mind and publicly says so.

some people are so ideologically wedded to the notion of libertarian free will (and as much of it as possible) that virtually any attempt to bring a bit of realism to the issue is shunned as “mechanistic” or “naturalistic.”

What may well be driving thoughts like these is a shockingly naïve – and just as shockingly common – view of free will that plenty of Christians hold, unfortunately, for theological reasons. I don’t tend to invite debate about the Calvinist / Arminian divide largely because of the heat it often generates, and I am not inviting it here. But I will say that some people are so ideologically wedded to the notion of libertarian free will (and as much of it as possible) that virtually any attempt to bring a bit of realism to the issue is shunned as “mechanistic” or “naturalistic.” Or even worse, questioning somebody’s prized conception of free will might actually sound…. like something a Calvinist would say. And that’s the last thing we would want. True, it’s a view that would be at home in Augustine or Aquinas too, but never mind that.

Yes, everyone who commits suicide makes a decision to do so. But the claim that if you make a decision then you don’t do something because you are sick rather obviously implies that your decisions stand alone, apart from the condition in which you find yourself. This is a flatly false view of human decision making. Why is it that we outlaw drink-driving? Sure, people might be drunk, but ultimately how they drive is their decision, right? Perhaps so, but the quality of decision that a person can make when they are drunk is not the same as when they are sober. But what if a person had an illness with all of the same effects as being drunk? Would we say that whatever they decided to do in this state had nothing to do with the fact that they were sick – because they decided? Quite apart from specific states of affairs like having an illness or being drunk, Libet and others have shown us that the physical symptoms associated with a choice being made exist in the brain before we are even conscious of making that choice.1 The state of our brain drives decision making in ways that we’re not even aware of.

When you say that you have free will, the question to ask yourself is “free from what?”

This is why the term “free will” conceals so much that is not simple. When you say that you have free will, the question to ask yourself is “free from what?” If you’re a Christian you’ll ask “free from sin?” The answer is no. But even if you’re not religious you should ask “Free from my brain? Free from my neurons? Free from my chemistry? Free from my past? Free from my body? Free from the total set of circumstances in which I exist?” Here too, the answer is no.

Saying that people like Robin Williams did not die because of an illness but simply because of a choice is either to deny that mental illness is really a thing that affects our brains and decision making at all (and surely no informed and compassionate person can say this), or else to appeal to an extraordinary conception of freedom that disconnects our decision making faculties from our very selves. Yes he made a decision. But it’s just not true that if somebody makes a decision then they didn’t do it because of a condition or illness. He made an affected, afflicted decision, and before we sit at our keyboards and condemn decisions like these, we should be moved with compassion for those that suffer as he did.

Is suicide the only possible option for someone with depression? No, of course not. Nobody claims this. We need to provide support to people in this sort of condition so that self-destructive decisions are not the only options looming large in their troubled mind. But the appearance of saying that people suffering from mental illness can simply choose to be free of the pressures and pains of their experience is the appearance of being pretty callous. I understand that the real culprit is probably ignorance, possibly even wilful ignorance at the hands of a way of thinking about free will that is ideologically important to the speaker. But for what it’s worth, please take more care than that.

As a father shows compassion to his children, so the LORD shows compassion to those who fear him.
For he knows our frame; he remembers that we are dust.”
Psalm 103:13-14

I wish that those commenting on Robin Williams’ suicide remembered this too.

Glenn Peoples

Similar Posts:

If you liked this post, feel free to help support this project.

  1. B. Libet et. al., “Time of conscious intention to act in relation to onset of cerebral activity (readiness-potential). The unconscious initiation of a freely voluntary act,” Brain 106:3 (1983), 623-642. []
{ 16 comments… add one }
  • Giles August 24, 2014, 1:18 am

    Thank you for this. I have bipolar disorder. A friend of mine used to try to help by saying “stop being mad!”. Which would save our health service a fortune if it worked. As doctors say, “if you can snap out of it it’s not clinical depression”.
    There are certainly choices one can make that help one on the path to mental health, but clinical depression itself is not a choice. If it was who would choose it? I’m a libertarian, but that just means I think we can sometimes choose otherwise, not that we can simply choose to be happy and healthy.

  • Max August 25, 2014, 10:46 am

    Indeed. And if it worked for depression and bi-polar, then such an exercise could be extended to other areas of health care: stop having diabetes! Stop having a broken arm! etc.

    Being in a state of depression, and despite all of one’s efforts being unable to shake it off, is a hard thing to explain to people who are not, and have never been, in that state. I honestly don’t know how much of it is biological, and how much environmental/social etc…. but whatever the state of the nature/nurture debate…. when a person is in that state they have certainly not chosen to be there. Anymore than one chooses to have flu. And when all of one’s reasoning is done from a state of despair, decision making can be severely altered.

    I think the analogy with a disease which mimics drunkeness is a good one in SOME ways. A lot of people can remember being very drunk and wanting the feeling to go away… but no matter how many people say “sober up!” in an encouraging way … it is beyond the person’s power to instantly become sober.

  • James August 27, 2014, 7:30 am

    I don’t think that your comparison to drunk driving works out all that well. Intoxication is directly related to motor skills in a way that depression is not related to suicide. If someone is in a severely compromised state that they do not know what they are doing, then I don’t think I can hold them accountable for something like suicide. But that is not the relationship between depression and suicide. The sickness of clinical depression does not directly cause suicidal thoughts, it causes mental anxiety. Then, there is a rational process which leads one to realize that the ending of one’s own life can end the mental anxiety. There is another train of thought that despite this, it is better to endure the suffering and not end one’s life. If there is a mental sickness that overrides these thought processes, it itself is not depression. No matter how much depression is a sickness, and no matter how great that sickness is, it cannot do anything beyond making suicide desirable. Jesus expects us to do many things which are against our initial desires.

  • Max August 27, 2014, 9:36 am

    >”Intoxication is directly related to motor skills in a way that depression is not related to >suicide.”

    Is a word missing in the above sentence? Did you mean: “Intoxication is directly related to motor skills in a way that depression is not DIRECTLY related to suicide.”

    The statistical data clearly shows that depression IS related to suicide. I assume you do not deny this? There is not a one to one correlation, nor a direct causation sure, but they are related.

    > The sickness of clinical depression does not directly cause suicidal thoughts,

    Yes. It does. The idea that someone who is depressed is going through a rational process and weighing up whether to kill themselves or not is, I suspect, rare. It is a despair which leads directly into a need to end it all. The reasoning you talk about is possibly post-hoc rationalization where the person tries to convince themselves that the terror and despair they feel is reasonable.

    “If there is a mental sickness that overrides these thought processes, it itself is not depression.”

    Yes it is. Depression does override normal thought processes and makes what would seem unthinkable in another state of mind seem like the only possible option when depressed.

    I do not think you really understand how depression is experienced by some people. Maybe what you describe is true for some people, but no one I have ever met who is suffering from depression and suicidal thoughts.

    “Jesus expects us to do many things which are against our initial desires.”

    And thereby you turn what are the symptoms of illness into sin. I cannot think of a less compassionate move.

  • Glenn August 27, 2014, 8:07 pm

    James, I think you’re missing the point by noting that drunkenness has different effects from depression or affects motor skills in a way that isn’t the same as how depression affects our thoughts. Quite right, it does have different effect. The point was simply that we acknowledge – in legislation – that the physiological and mental state a person is in makes a difference in terms of what we can expect from them. This is true of drunkenness and it is true of other things too.

    Similarly, nobody denies that there is a mental process of some sort from anxiety to thoughts of suicide (but if you think that depression is no more than anxiety, you’re mistaken). The question is not “is there a mental process” any more than the question is “is suicide a choice?” Of course there is, and it is. The question is whether or not there is a false dichotomy between an outcome resulting from a choice and the outcome resulting from the decision. It is an affected process and an affected choice. There should be no either/or. I get the feeling that you think we have fairly direct voluntary control over the feelings that grow in us and the thoughts that come to mind as a result of them. This view of how our thinking and feeling happens seems not to reflect reality. The person suffering from mental illness does not step away from their mental environment and then switch off the depression and think: “OK, now rationally, how should I react to these feelings?” They are in the midst of them the whole time, unable to escape their influence throughout any thought process they go through.

    I think your remarks about depression simply making suicide a desire in the same way that we are tempted by sinful desires (e.g. sexual impropriety, greed, violence etc) show something that I don’t quite recognise in the world around me. I cannot tell if you fundamentally misunderstand the relationship between depression and wanting a way out on the one hand, and being a sinner and desiring to indulge in sin to satisfy our appetite on the other. Hopefully you’re very, very clear in your mind that the former is not simply a species of the latter, but unfortunately your remarks suggest otherwise.

  • Frank August 28, 2014, 2:40 am

    “I get the feeling that you think we have fairly direct voluntary control over the feelings that grow in us and the thoughts that come to mind as a result of them. This view of how our thinking and feeling happens seems not to reflect reality. The person suffering from mental illness does not step away from their mental environment and then switch off the depression and think: “OK, now rationally, how should I react to these feelings?” They are in the midst of them the whole time, unable to escape their influence throughout any thought process they go through.” -Glenn

    I have been married for 12 years to someone who suffers from “clinical depression” and I have to agree with what Glenn (and Max & Giles) said. Struggling with depression is not akin to struggling with a sinful desire, it’s rather more like being kidnapped and held against your will in a dark cell while being mentally and emotionally tormented. From my vantage point the depressed person desperately wants to escape, to be free and not be in torment anymore – but there is something keeping them imprisoned. It is physiological. Unlike the draw and “slavery” of sin, depression is most assuredly not a prison of their own making.

    As an aside, it seems to me that many Christians have an idealized, sanitized view of man’s condition after The Fall, and minimize what the effects of sin are. Forgive the crudeness, but we are, every one of us, effed-up. Pain in childbirth, working by the sweat of our brow, and physical death aren’t the only effects of sin. Disease of every kind (including depression) are visited in some form or degree on every person East of Eden. We tend to think of the more nebulous effects in the same way we think of a broken bone: put a cast on it and move on, and maybe don’t do things that might result in broken bones again. Problem solved. If it were only that simple. We are not what we were meant to be, and the worst thing we can do is fault or shame someone for it. Job needs better friends.

  • John August 28, 2014, 6:38 am

    I’ve suffered with depression of varying intensity for over 10 years now, up to and including serious considerations of suicide. I’d squabble with some of the details in Walsh’s article, but for the most part I think he’s right and the hysterical response to it has bordered on the absurd (not referring to Glenn’s post, but the responses to it in general).

    “I get the feeling that you think we have fairly direct voluntary control over the feelings that grow in us and the thoughts that come to mind as a result of them. This view of how our thinking and feeling happens seems not to reflect reality. The person suffering from mental illness does not step away from their mental environment and then switch off the depression and think: “OK, now rationally, how should I react to these feelings?” They are in the midst of them the whole time, unable to escape their influence throughout any thought process they go through.”

    You can’t switch off the depression but it’s not true that you can’t isolate the feelings from your thoughts and decisions. In fact that’s exactly why I’m not worm food right now: because I did just that. Even though it FELT like I was deciding to continue a pointless, hellish existance, I KNEW it was just the disease talking so I removed my feelings from my decision making process. When battling depression it is imperative to have your rational mind holding the line at the front, rather than providing support to the disease, in part because it’s the only part of you that can genuinely fight back and in part because suicide really isn’t that irrational of a choice when you’re living in constant agony. If your rational mind is wallowing in self pity while the rest of you is screaming in pain then it’s only a matter of time before you ragequit life.

  • Glenn August 28, 2014, 10:53 am

    John, I do not agree at all that succumbing to the effects of depression is just the same as “wallowing in self-pity,” but I think you’re right about something important: working against depression is work. It requires effort. You don’t have to make a choice or take action to fall under its influence (including thoughts of suicide, which some are saying are simply a choice). The reverse is true: You need to work to rise above its influence. For some people it will require more effort than for others. Co-operating with depression isn’t the choice. Fighting against it – that’s the choice, and we need to help people to make that choice. It is more in reach for some than others. Thanks for your comments, in which I find more agreement than disagreement.

  • Mick August 28, 2014, 9:50 pm

    Glenn, seeing as this blog and your life revolves around biblical and spiritual matters, where is the spiritual response to someone who is depressed?

    Compassion for the afflicted can look like holy sympathy, a nice gesture, but otherwise useless. Some maladies are admittedly biological in origin, treatable by clinical psychologists, and that is a practical step

    Jesus though, took the bull by the horns and cast out demons that were oppressing the afflicted. He delivered them. Why not today?

  • Glenn August 28, 2014, 11:07 pm

    Mick, I can’t tell: Are you agreeing or disagreeing with the basic claim that if a person with depression commits suicide, then they only did it because they made a choice?

  • Mick August 29, 2014, 9:09 am

    I don’t know, and I don’t know if they do. Depressed people often get to a stage where they don’t know which way is up. They are capable of going through the steps to accomplish the act, so there is a mechanistic choice to turn the gas on or load the gun or whatever.
    My question relates to solutions to prevent that step. Medical, psychological, and/or…?
    NT scripture gives clear example of the demonic realm that looks to kill, rob and destroy. It also gives the means to people of Christian faith to counter this assault.

  • Glenn August 29, 2014, 6:48 pm

    “NT scripture gives clear example of the demonic realm that looks to kill, rob and destroy.”

    Mick, you haven’t quite made the connection of “the demonic” to depression clearly enough for me to be certain of what you’re saying, and I’m almost afraid to ask, but here goes: Are you suggesting that people who are suffering from depression might in fact be possessed by a demon, or some similar thing?

  • Mick August 29, 2014, 9:43 pm

    I do not know if you can separate influence from results. Scripture seems clear that there is a demonic realm, and it is able to oppress. Whether spiritual mental oppression is the same as depression or not I do not know. If one part in a number of causes of it is spiritual, then it requires a spiritual answer. But it would be simplistically undiscerning to state that if someone is chronically depressed that they are demonically possessed, hence I understand your fear in asking.

  • James September 3, 2014, 12:24 pm

    Glenn, concerning your last paragraph in your response, it was not my intention to compare suicide to hedonism, but that does not mean it isn’t sinful. For example, many women seek abortion in attempt to find a way out of an understandably difficult situation. There is an unfortunate tendency in people to not consider voluntarily facing a hardship to be a valid option under any circumstance. Such a mindset is not the way of the cross. Killing a human being is profane because human beings are made in the image of God as stated in Gen 9:6. The hardships of depression or an unplanned pregnancy [even one forced on a woman] are not valid justifications for this.

  • Glenn September 3, 2014, 2:46 pm

    James, my concern was not that suicide is not like hedonism (although of course it isn’t). My concern was that you were talking about suicide as something tempting, like sin in general may be tempting, like something desirable. I think your comparison to abortion is probably closer to the mark but it still misses it by quite a margin.

    One obvious difference is that in the case of a woman in hardship who has an abortion is responding primarily to external pressures (I say primarily, not exclusively), while the person with a mental illness is not sitting apart from his illness and responding to it, but actually his very response is part of the functioning of an ill mind. His very ability to respond is part of the problem.

    If a woman was drugged against her will with drugs that induced destructive behaviour and as a result she had an abortion while under the influence (if left to her own devices), then the analogy would be closer. It would also change your assessment of her actions, I suspect. It would also enable you to see why a person who appreciated her condition would take a dim view of somebody who stood by and said that she was failing to choose “the way of the cross.”

  • James September 4, 2014, 12:44 pm

    I am taking a course in abnormal psychology and today we went over a case with a man who had violent outbursts due to a cyst in his cranium. Once that was surgically removed, his outbursts stopped. He appeared to receive a lenient sentence for a crime he committed before the surgery, if he got any at all, and I think I can agree with that. Should this man still ask God for forgiveness for his actions? I still think probably so. There is obviously a link between mental illness and certain behaviors typically considered to be sinful. That still does not make it certain that mental illness makes these behaviors impossible to resist rather than far more difficult to resist. You may be right, but I’m not certain. I would really hesitate to say that a person who failed an attempt at suicide would not need to ask forgiveness for disobeying God.

    I would like to point out that even if you are right that sometimes people cannot be held accountable for suicide, that is certainly not always the case. I don’t think you disagree that Satan encourages suicide and that many times people simply succumb to that. Even if a point exists where a person cannot help but obey the influence of depression through suicide (which I doubt), many people who commit suicide have probably not reached that point.

Leave a Comment

Remember: All comments should conform to the blog policy and you must use your real name. Comments that do not conform may be removed in whole or in part. You can review the blog policy here.

 Characters remaining