Demons or Diagnoses? Helping Souls Escape the Darkness

an essay by Jennifer Jill Schwirzer, LPC, EdD

Navigating the murky waters between mental health disorders and demonic activity can be challenging. We don’t want to cast supposed demons out of people experiencing symptoms of organic brain disease. We also don’t want to underestimate the psychologically deranging power of dark forces. As a mental health provider in the faith space, I want to provide some guidance for coaches, counselors, Bible workers, evangelists, pastors, and other helpers facing complex human struggles.

It is essential that we help people holistically. This means balancing all the dimensions of human life, namely physical, psychological, and spiritual. For years, health ministries have recognized the overlap between the physical and the psychological, teaching that, for example, excess sugar can cause brain fog. We must similarly understand the overlap between the psychological and the spiritual. 

Failing to maintain this connection can cause unnecessary distress. A person with schizophrenia, for example, might be assumed demon possessed when in fact their delusions come from a genetically-acquired brain disease. Reductionism can go the other way, too. People experiencing demonic activity can be assumed mentally ill. Finally, in situations involving erratic human behavior, both dimensions may be involved—a person with schizophrenia can, for example, experience demonic possession or harassment. It is for the purpose of shaping our approach to helping humans holistically that I offer this essay. 

Demons Are Real

Nothing is easier to prove from scripture than the existence of supernatural evil. Here is a brief overview of its development: 

Lucifer’s apostasy, expounded in Isaiah 14 and Ezekiel 28, led to war in heaven, portrayed in Revelation 12. The war resulted in Lucifer, “the dragon,” being cast down to earth, whereupon he acquired the names “the devil” and “Satan” (Rev 12:9). With him he took “a third of the stars” (v. 4). Stars, metaphorizing messengers (Rev 1:20) are understood to be apostate angels, who carry out Satan’s bidding. God has destined “the devil and his angels” for destruction in hell (Matt 25:41) but allows them to live for the present time. 

All believers find themselves foisted into a struggle with these agents of hell: “For we do not wrestle against flesh and blood, but against principalities, against powers, against the rulers of the darkness of this age, against spiritual hosts of wickedness in the heavenly places” (Eph 6:12). These forces of darkness can do many things, including: 

• Hinder prayer- Daniel 10:10-14

• Afflict- 2 Corinthians 12:7

• Deceive- Matt 24:24 Galatians 1:6-9

• Devour- 1 Peter 5:8

• Tempt- Matt 4:1-11

• Oppress- Acts 10:38

• Harass or torment- 2 Cor 12:7

  
  

While evil entities impact all people, some become their special targets. Experts suggest that the most accurate verb for this is “demonization” from the original Greek daimonizai. The following stories describe demonized people:

• The Sabbath worshipper in the Capernaum synagogue—Mark 1:21-28; Luke 4:31-37

• The demoniac whose blindness and deafness was a physical manifestation of his underlying demonization—Matt 12:22-29; Mark 3:22-27; Luke 11:14-22

• The Gadarene demoniac(s)—Mark 5:1-20; Matt 8:28-34

• The daughter of the Syrophoenician woman—Matt 15:21-28; Mark 7:24-30

• The boy presenting with seizures—Mark 9:14-29; Luke 9:37-43

• The woman bound by Satan with a spirit of infirmity for 18 years—Luke 13:10-17

• The mute demoniac—Matt 9:32-34

• Mary of Magdala, out of whom Jesus cast seven devils—Mark 16:9; Luke 8:2

Diagnoses Are Real, Too

To assume that erratic, irrational behavior stems only from demon possession passes over clear scriptural indications of both demonization and sickness as antecedents for human brokenness. David, Elijah, Job, Jonah, and others clearly wrestled with depression. These passages from the New King James Version should also be considered:

• In Deuteronomy 28:28, the consequences of rebellion against God are, “The Lord will strike you with madness and blindness and confusion of heart.” 

• Jeremiah 50:38 says the Babylonians are “insane with their idols.” 

• Jeremiah 29:26 cites a delusional state of a certain individual “who is demented and considers himself a prophet.”

• In Daniel 4:33, Nebuchadnezzar experienced an apparent seven-year-long psychotic episode during which he ate grass like a cow and ceased personal grooming. 

• Matthew 4:24 and 17:15 speak of epilepsy, which is from the Greek seleniazomai and literally means “moonstruck.” It is translated “lunatic” in the King James Version. 

• In Acts 26:11, Paul speaks of being “exceedingly mad” (KJV) in his persecution of Christians. 

• In 2 Peter 2:16, Balak’s condition is spoke of as “madness.” 

  
  

Clearly mental illness exists apart from direct demonic activity. Since the mid 1950s the behavioral science field has expanded our cultural understanding of psychological disorders. The Diagnostic and Statistical Manual of the American Psychiatric Association, 5th Revision (DSM-5), and the International Classification of Diseases, 10^th Revision (ICD-10) list mental disorders in detail. Diagnoses, imperfect though they are, help organize the mental health system and direct treatment. Here I will list the diagnoses most likely to be mistaken as demonic activity. They’re called “psychotic disorders.” Their primary feature is losing touch with reality: 

• Schizophrenia- a chronic brain disease characterized by delusions, hallucinations, and disorganized speech

• Bipolar Type 1 Disorder- a chronic disorder of mood regulation sometimes manifesting as delusions and hallucinations during the manic phase  

• Schizoaffective Disorder- a disorder featuring a combination of schizophrenic and  bipolar-type symptoms  

• Major Depressive Disorder with Psychotic Features- a mood disorder compounded by delusions and hallucinations  

• Delusional Disorder- a shorter-term disorder featuring delusions without hallucinations

• Brief Psychotic Disorder- sudden, short-term psychosis of less than a month, often triggered by severe stress 

• Schizophreniform Disorder- short-term disorder otherwise similar to Schizophrenia

• Substance-Induced Psychotic Disorder- a psychosis caused by either illicit drugs or sometimes prescription medications 

• PTSD with Psychotic Features- a psychosis that can occur long term as a feature of severe trauma

Other conditions that can cause psychotic symptoms include: 

• Infections like meningitis and encephalitis

• Neurological conditions like Parkinson’s, Dementia, Temporal Lobe Epilepsy, brain tumors, electrolyte imbalances, stroke, traumatic brain injuries 

• Metabolic and endocrine issues such as Thyroid Dysfunction, Cushing’s Disease, and deficiencies like B12 and thiamine 

• Postpartum Psychosis 

A few more conditions that can be characterized by extreme instability include: 

• Dissociative Identity Disorder (DID)- a rare disorder involving dramatic shifts in consciousness, memory, and identity 

• Borderline Personality Disorder (BPD)- a disorder characterized by extreme relational and emotional instability and impulsivity

• Antisocial Personality Disorder (APD)- a disorder involving exploitive, even criminal behavior, often called “sociopathy” or “psychopathy”

A person with psychotic or other severe symptoms will benefit from an evaluation by a licensed professional. Many of these disorders involve organic brain conditions not under the direct control of the individual. Telling them to change their thoughts and feelings may feel dismissive. Worse yet, attributing their symptoms to demonic activity can unhelpfully supernaturalize their condition, eliciting a sense of spiritual failure. Looking for demonic access points when the symptoms come from compromised brain functioning will only heighten their sense of isolation. The faith community often provides the only social connections such a person has, and if they feel shamed into confessing spiritual failure, even that connection can weaken.

But we must remember that all humans, whether diagnosed with a disorder or not, are the special target of the enemy. He would inhabit every human on earth if he could. Failing that, he will harass and oppress us.

Those with compromised brain conditions may be easier for the wicked one to prey upon than healthier people. Our prefrontal lobe, the rational, agentic “crown” of the brain, houses the “kingly powers,” our spiritual shield. Brain disorders often involve frontal lobe circuitry compromises, thus potentially weakening sufferers to the onslaughts of the enemy. It is possible for the faith community to both accept the diagnoses and the spiritual vulnerability of such a person, coming around them in a posture of support rather than accusation.

Deliverance Ministries 

Conrad Vine said, “Deliverance ministry may be best understood as delivering an individual from the influence of personal, malevolent fallen angels.” Jesus engaged in this ministry and charged his disciples to do the same. In Matthew 10:8 He said, “Heal the sick, cleanse the lepers, raise the dead, cast out demons. Freely you have received, freely give.” In Mark 16:17 He said, “And these signs will follow those who believe: In My name they will cast out demons; they will speak with new tongues.” Clearly, believers following the Great Commission should deliver people from demonization.

But we must do so wisely. Satan works differently in different contexts. He uses two primary modes: intimidation and deception. Among animist people who embrace the existence of the supernatural, he engages in more open activity, hoping to intimidate. Western, more secularized people often deny the existence of the supernatural, so he conceals himself in those contexts, drawing victims into bondage rather than openly terrorizing them. Because this paper will more often be used in the latter contexts, fewer cases of open demonic activity will be seen. Yet, even in the West, Satan can be found “stalking about, seeking whom he may devour” (see 1 Peter 5:8).

To deny or minimize the presence of evil in our world makes us far more vulnerable to its insidious influence. Conrad Vine points out that, “In any warfare, it is fatal to underestimate the enemy.” To believe that every time a human acts erratically or experiences unseen torment, a handy-dandy diagnosis and medication will solve the problem, is to fall prey to this underestimation. Satan and his minions are real and active, even in our educated, medicalized world.

But as we look squarely at the reality of demonic presence and activity, another danger arises. We may become obsessed! Seeing demons everywhere, we may lend these dark forces too much power, unintentionally giving them more space to wreak havoc. C.S. Lewis said, “There are two equal and opposite errors into which our race can fall about the devils. One is to disbelieve in their existence. The other is to believe, and to feel an excessive and unhealthy interest in them.”

In psychology we have seen a phenomenon called “reification of diagnoses” or “classificatory looping effect” when the identification of a disorder leads to the proliferation of its diagnosis. For example, the DSM introduction of Multiple Personality Disorder in 1980 led to a spike in that diagnosis from only 200 cases prior, to tens of thousands of cases after the diagnosis was published, and especially after the movie about the Multiple Personality Disorder sufferer Sybil, starring Sally Fields, hit the theaters. 

This same spike of bias-confirming demon exorcisms can occur in the atmosphere surrounding deliverance ministries. Once exposed to an exorcism, some see demonic activity everywhere. In this way Satan can push Jesus out of our minds, enthroning himself in our attentional space. Once he absorbs our attention, Satan begins to dance for us.

Remember that the wicked one can afflict. Sometimes, to glorify himself, he afflicts only to withdraw the affliction. Supernatural manifestations are not evidence that the person performing them is saved. Jesus said, “Many will say to Me in that day, ‘Lord, Lord, have we not prophesied in Your name, cast out demons in Your name, and done many wonders in Your name?’” (Matt7:22). In some quarters of Christendom, miracles borne of a fanatical spirit occur continually. Satan can work miracles, too! 

Ten Guiding Lights

In light of this, we consider 10 distinguishing marks of Spirit-led deliverance ministry. May God bless us all as we try to help his most struggling children.

God is glorified. The exaltation of Jesus marks the work of the Holy Spirit. Jesus said of the Spirit, “He will glorify Me, for He will take of what is Mine and declare it to you,” (John 16:14). If our deliverance ministries are Spirit-led, the glory will not go to the devils or to the minister, but to God.

The community is edified. Ministries whose “brand” becomes deliverance, who are not well-connected to a gospel-centered community with the full array of spiritual gifts such as healing, helping, teaching, and evangelism, tend to become unbalanced and isolative. It should be noted as well that there is no spiritual gift of deliverance or casting out demons in 1 Corinthians 12.

Satan is displaced. Our bodies are the temple of the Holy Spirit (see 1 Cor 6:19). God promises that His Spirit indwells believers who do not walk according to the flesh (see Romans 8:1-8). Unless a believer is given over to sin or Satan, he or she can confidently embrace this truth. Remember that the status of Spirit-filled believer does not depend upon perfect victory over sin. “The character is revealed, not by occasional good deeds and occasional misdeeds, but by the tendency of the habitual words and acts.”

Scripture is exalted. Jesus defeated Satan through a “thus saith the Lord.” Nothing has changed. “For the word of God is living and powerful, and sharper than any two-edged sword” (Hebrews 4:12). God’s words, not Satan’s, must be paramount in our dealings with the enemy.

Choice is respected. A person can’t unknowingly, and through no choice of his or her own, harbor devils. One story is told of a clean-living Christian girl who underwent a deliverance session “just in case” only to find that, unknown to her, she did have a few devils needing to be cast out. Stories like this give the false impression that Satan can indwell us apart from our own choice. No, but rather God places a hedge of protection around a believer, saying “Thus far and no further.” It is true that if we give our will over to sin and Satan, he may hold it fast. But it is our will’s cooperation that opens the door.

God’s children are protected. Anecdotes are shared in which followers of Jesus become demonized through curses pronounced upon them or even through the demonic activity of their ancestors. But when we believe in Him, God breaks our curses in Christ. “Christ has redeemed us from the curse of the law, having become a curse for us (for it is written, 'Cursed is everyone who hangs on a tree')” (Gal 3:13). Not only does Jesus break curses, but He places a wall of protection around us. God is a “wall of fire” and a “glory within” Jerusalem (Zech 2:5).

God fights for us. Even when we’ve become powerless over a demon, we may still cry out to God. In Luke 8:28, we hear the cry of the demoniac: “What have I to do with You, Jesus, Son of the Most High God? I beg You, do not torment me!” This was all the man could manage, but Jesus heard a cry for help and saved him. We do not, and could not, fight Satan alone. Thank God we have a mighty Helper and even when our will is broken, we can still cry out to God.

Boundaries are clear. The focus of true deliverance ministry is God’s glory and the healing of His children.  Stories are told of extended deliverance sessions involving dialogs with the devil. Morbid curiosity about the world of darkness could so easily take over in such cases! While Jesus did address Satan in instances such as the deliverance of the Gadarene demoniac, asking his name, and negotiating with him about entering the herd of swine, the interchange was brief (see Luke 8). If God asks us to have good boundaries with unsavory humans (see 2 Tim 4:14-15), how much more should we be socially reserved with the master manipulator and his minions?

Prayer is central. Many popular deliverance ministries hold protracted deliverance sessions involving rites and ceremonies. However, there are no biblical examples for ritual exorcisms. The only such ritual advised in Scripture is anointing; and central to anointing is prayer. “Is anyone among you sick? Let him call for the elders of the church, and let them pray over him, anointing him with oil in the name of the Lord” (James 5:14). The disciples also anointed the sick (see Mark 6:13). We don’t see complex exorcism rituals prescribed in Scripture, but we do see special seasons of prayer.

The gospel is preached. Once people become ensnared by false deliverance ministries, they lose sight of salvation by grace through faith. Because so much emphasis is put on fending off the forces of evil, people begin to obsess over the demons’ avenues of access. This leads to the multiplication of taboos. The Apostle Paul said, “Therefore, if you died with Christ from the basic principles of the world, why, as though living in the world, do you subject yourselves to regulations— ‘Do not touch, do not taste, do not handle?’” (Col 2:20-21). We have died with Christ, my fellow believers! We do not need to fight the enemy on our own.

A Story

Tom came to counseling with his wife Sherry. He had cheated. His cheating involved interacting with some very dark people from dark places, and he was now hearing voices telling him to take his own life.

Sherry was an avid believer, but Tom was not. Soon after coming to counseling, he was diagnosed with schizophrenia, went inpatient for a time, and began medication. Schizophrenia typically onsets in a person’s 20s, and Tom was much older. Additionally, the medication did not improve his condition, and he continued to hear the voices. Fortunately, Tom cut all ties with the dark world of which he’d been a part. 

The couple came regularly to counseling. Tom often seemed to be somewhere else, and had difficulty expressing himself, so Sherry did most of the talking. But gradually Tom started to develop an interest in spiritual things. Step by step, through the influence of counseling and other connections, he came to faith in Jesus. We organized an anointing service for him, and God was present.

The battle continued. Many counseling sessions consisted of me quoting scripture and praying for Tom’s deliverance. It was most definitely spiritual warfare.

The last I saw Tom he was much better. He was able to express himself clearly, seemed present, and the voices, although still intermittently present, were less impacting. Tom was able to detach himself from them, regarding them as an aggravation, but not as something he needed to interact or identify with. 

This story is not magical. But it is precisely why I share it. Although the miracle of Tom’s recovery was slow, he did come to faith in Christ, experiencing alleviation of demonic harassment, and the healing of his marriage.

Let me close with some additional resource links and a wonderful summary statement from an inspired pen: 

There are Christians who think and speak altogether too much about the power of Satan. They think of their adversary, they pray about him, they talk about him, and he looms up greater and greater in their imagination. It is true that Satan is a powerful being, but thank God, we have a mighty Savior, who cast the evil one from heaven. Satan is pleased when we magnify his power. Why not talk of Jesus? Why not magnify His power and His love?

Additional Resources

Missionary organization Adventist Frontier Missions partners with the ministry Set Free in Christ: https://www.setfreeinchrist.org/ 

Finding Freedom in Jesus: A Deliverance Ministry Manual was released in 2018 by AFM: https://www.setfreeinchrist.org/uploads/1/1/3/7/113721993/finding_freedom_in_jesus_-_final_version.pdf 

Marc Coleman on Ellen White on Confronting Satan: https://digitalcommons.andrews.edu/cgi/viewcontent.cgi?article=1302&context=jams 

“’Spiritual Warfare’ and ‘Deliverance Ministry’ and Seventh-day Adventists” by the Biblical Research Institute: https://adventistbiblicalresearch.org/articles/spiritual-warfare-and-deliverance-ministry-and-seventh-day-adventists 

Adventist Frontier Missions associate Dr. Michee Bade has formed the Set Free in Christ Institute to help people break free from demonic influence. Watch their video here https://www.youtube.com/watch?v=8hKOxS8Iswo

Endnotes

1. Finding Freedom in Jesus: A Deliverance Ministry Manual, Bruce L. Bauer, p. 4

2. Ibid, p. 18

3. The Screwtape Letters, p. IX

4. Ellen White, Maranatha, p. 148

5. Steps to Christ, p. 57

6. Ellen White, The Desire of Ages, p. 493