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Will God Hold What A Mentally Ill Person Does While In A Psychotic Episode Against Him? by David Lee Chu Sarchet

“For all who have sinned without the law will also perish without the law, and all who have sinned under the law will be judged by the law. For it is not the hearers of the law who are righteous before God, but the doers of the law who will be justified.” -Romans 2:12-13 

I would like to start this blog by first stating that I fully understand that this topic will be controversial. People likely have their minds made up about this before even reading further. The people who think that, yes, mentally ill people are still held responsible for their actions while in a psychotic episode will think my argument is weak. The people who agree with me will think that my argument is solid. Whatever side you fall on please understand that I am doing my best to be faithful to the text and I truly desire to honor Christ in everything.

This Is Not A Salvific Issue

We can feel free to disagree on this topic and still consider one another friends and family in Christ because of the Gospel.

Now, as you can already tell I do not believe that the Lord will hold a mentally ill person accountable for what they do or say while in a manic or psychotic episode. My proof text for this is Romans 2:12-13 (quoted above). Before you say that I am taking that scripture out of context, please hear me out.

I understand that the context of this scripture is about how both Jews and Gentiles alike are responsible for their sin because even while the Gentiles do not have the written Law (like the Jews do) they do have the Law written on their hearts. So they know that they are violating God’s Law. Even while they suppress the truth in unrighteousness like the Apostle Paul says in Romans 1.

I hope that you can see that I understand the context of that scripture.

However, do you notice what exactly that scripture implies? It implies that we will be judged by what we know.

Hear Me On This, Please.

The people about whom Paul is talking are either those who know the Law either by what is written down for them or what is written on their hearts. In both circumstances this requires the two types of people to be cognizant of what they know. This raises the question of what about people who are not cognizant?

I know that when I am in a manic episode, I am not fully aware of what I am saying and doing. It is like I am on autopilot and the lights are on but nobody is home. I do not think that while I am in these episodes that the Lord will hold me accountable for stuff that I am not even aware I am doing. The people who claim that He will, I believe, are guilty of defaming the character of God.

Now, I am not saying that this automatically makes the mentally ill person guiltless. I fully believe in the Total Depravity of man. This means aside of anything we do in a psychotic episode we still are sinful beyond measure and commit sinful acts even while in our right mind. So, The Lord will judge us for the sinful actions we commit while still in our right mind! 

Also, I would like to address another topic that this issue raises and that is the states of man.

According to the Bible, there are really only two states of man: those who are in Christ and those who are in Adam. For those who are in Christ, the Lord will not count our sins against us no matter what because of what Jesus did for us on our behalf on the cross. This means that when Jesus took our punishment upon Himself on the cross, our sinful nature was imputed onto Him and His righteousness was imputed onto us.

Now, for those who are in Christ our sins are covered no matter what. This includes our past, present, and even future sins and we can never lose our salvation. So, what this means is that for Christians who struggle with mental illness who wind up going into psychotic episodes even the “sins” we commit in that state are covered by the blood of Jesus Christ.

Now, this raises the question of what about the unregenerate Christians who struggle with going into psychotic episodes? Again, Romans 2:12-13 applies here too.

The Lord will judge even them by what they are consciously aware of knowing. So, God will hold them accountable for the sins they commit while they are in their right mind and not while they are unaware of what they are doing and saying. 

Finally, I want to end this blog with a strong recommendation.

If you are someone who struggles with mental illness, whether you are a believer or not, it is never a wise decision to not take your medication. You may feel like you are better, but trust me that it is only because of your medication that you are better. If you go off your medication, you will spiral out of control and end up either dead, in prison, or locked away in a psychiatric facility.

This is no joke.

You need to stay on your medication. The Lord has richly blessed psychiatrists and psychologists with the wisdom and knowledge to know how to treat the human mind that is plagued with mental illness so we can trust in His providential care in providing us with the proper means to treat our mental illnesses. There is absolutely no shame in taking medication so do not feel ashamed about it. If you had diabetes would you be ashamed to take insulin? Absolutely not because that is a medical condition. Well, mental illness is a medical condition too and it is degenerative. This means that the longer it goes untreated the worse it will get and psychiatric medication and counseling has been proven to be the absolute best method for slowing down the progressive disease of the mind. 

In conclusion, the Lord will not hold a mentally ill person accountable for what they do while in a psychotic episode but He will hold us accountable for what we do while in our right minds. We all are under sin and guilty before a Holy and Righteous Father and the only way to be saved is through the life, death, resurrection, and ascension of Jesus Christ.

Jesus Christ is the only way for salvation and those who are in Christ, whether they are mentally ill or not, He will never hold anything we do or say against us because it is all covered by the blood of His Son. 

-David Lee Chu Sarchet 
Mental Health Advocate and Christian Apologist 

For 24 hour peer support, please call the Christ-Centered Mental Health ministry line at 567-343-3727 or email me at

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