Is Suicide a Brain Issue or a Heart Issue?

What I am writing about will be hard for some to read. Suicide is never an easy topic, especially if someone close to you has died this way. But I am convinced we need more and better conversations about suicide prevention, not fewer. That requires all of us — and especially those of Christian faith — to think carefully about how we engage with people who are tempted to end their lives.

One area that needs more careful thinking is whether suicide is more a problem of the brain or more a problem of the heart. Both are involved, without question. But how we understand, define, and differentiate those terms shapes how we engage with a suicidal person sitting across from us.

A Personal Window into the Question

Suicide is personal for my family. I had a close relationship with an uncle who survived a suicide attempt. He was left with an indentation in his temple where a bullet had traveled through his optic nerve and skull and lodged in his brain. He lived another forty years after the attempt, without eyesight. He likely suffered from PTSD after Vietnam, abused substances, and carried significant relational strife that complicated his story. We were grateful that he came to know and trust Christ, but his ongoing complications kept suicide on our family’s mind — an ugly, lasting reminder of its impact, even when someone survives.

Stories like his are not rare. Every year, pastors, parents, students, and friends are lost this way, and every loss leaves a congregation or family asking the same painful question: Why?

A Counter-Productive Explanation: “Their Brain Broke”

How we talk about suicide shapes how we think about preventing it. We can advocate for better mental health care, and we should. But churches need more specific strategies to be effective in suicide prevention. It matters how we answer the question, Why do people take their own lives?

A common answer is that “their brain broke.” Well-meaning friends often console one another with that phrase or some variation. It feels compassionate because it removes culpability from the one who died. But that statement, in isolation, has a counter-productive side effect: the conversation often ends there, and it shouldn’t.

Most of us feel powerless to fix or improve someone else’s brain. So if the cause of suicide is brain malfunction or disease, our only resort feels like recommending medical help. I think that’s a faulty way of framing the situation, because suicide has more to do with our hearts than our brains.

Our Brains Don’t Act Alone

From a Christian worldview, our brains don’t create the thoughts we think — our hearts do. Our brains house the thoughts we think, but our thinking reflects the values and value judgments of our hearts. It is also true that our brains can distort thinking — through cognitive impairment, mental fatigue, neurological disease, allergic reaction, nutritional deficiency, or traumatic brain injury — and these factors are real and worth taking seriously. But suicidal ideation is more complicated than identifying a brain malfunction that produces suicidal thoughts.

Consider an analogy: your brain can’t make you a racist. Your heart does. A racist has dysfunctional thinking driven by a value system that is proud, selfish, and unloving. Your brain can’t make you hate anyone, but your brain is where hateful thoughts are processed. Our brains don’t make us think lustful thoughts, desire wealth with greed, or fall in love. These are choices of the heart — and our brains house the thinking that turns those values into patterns of thought and action. From a perspective of faith, our hearts are the place where lasting change and true healing happen as we renew our minds with truth. Our brains cannot create hope, but our hearts can.

Our Hearts Are the Strongest Influence on Our Brains

In Scripture and in Jesus’ teaching, the thoughts we think, the actions we take, and the values we embrace originate in and are most influenced by our hearts, not our physical bodies. Jesus used heart to describe the inner person — the spiritual person — as distinct from the body. The heart functions as a control center and the primary influence on our thoughts, feelings, and actions. Three passages capture the heart’s influence on every area of life:

The good person out of the good treasure of his heart produces good, and the evil person out of his evil treasure produces evil, for out of the abundance of the heart his mouth speaks. (Luke 6:45)

But what comes out of the mouth proceeds from the heart, and this defiles a person. For out of the heart come evil thoughts, murder, adultery, sexual immorality, theft, false witness, slander. (Matthew 15:18–19)

Keep your heart with all vigilance, for from it flow the springs of life. (Proverbs 4:23)

The treasures, words, feelings, values, and behaviors of a person all flow through and from the condition of the heart. We do not say this from a posture of judgment; all of us have corrupt hearts and are desperately needy. That is precisely why we need the Spirit of God, the power of God, and the Word of God to navigate life. We need the heart change and life restoration that only Christ can bring. Our hearts will not be fully whole or healed on this side of eternity.

The Mind, the Heart, and the Psychological

When determining “why people do what they do,” people often describe our problematic choices as a problem in our mind (cognitive), a problem in our heart (moral), or a “psychological problem.” Jeremy Pierre, in his book The Dynamic Heart in Daily Life, explains the importance of a biblical understanding of these terms. He argues that trying to distinguish between these terms runs counter to the way that we should view them as a unified whole, in essence, a unified “inner man.”

“Scripture uses different anthropological terms—heart, soul, spirit, mind, and more—to describe a simple, singular human experience. . . . The terms for soul, spirit, and mind describe the same types of function as the term for the heart. In other words, they all do the same thing, indicating the various biblical terms for human experience do not refer to multiple spiritual organs that do different things. The biblical authors understand human experience as flowing from one, unified heart.”   

Heart Patterns in Suicidal Thinking

When we talk with survivors of suicide attempts and ask about the thought patterns that led them to that point, common themes emerge. Every story and every person is unique, but recognizing the heart patterns that can lead to suicidal thinking helps us engage friends who may be at risk. Some of the more common patterns include:

• Some take their lives in vengeful anger.
• Some take their lives to escape the shame of an exposed secret.
• Some take their lives, exhausted by an unrelenting depression.
• Some take their lives in the grip of anxious, disturbing, or intrusive thought patterns.
• Some take their lives, overwhelmed by despair brought on by deep relational disappointment — divorce, breakup, death, betrayal.
• Some take their lives, tired of fighting an addiction that seems to always win.
• Some take their lives to escape the pressure of expectations, performance, and stress.
• Some take their lives believing it will relieve loved ones of the burden they feel they have become.
• Some take their lives to join others who have passed on.

This is not an exhaustive list, but when you suspect someone is suicidal, it is usually because you have watched them wrestle with a pattern like these.

The following infographic captures the risks of suicide in a helpful, visual way.

If we are going to be effective in suicide prevention, no medicine will change the heart patterns of suicide. Medicine can often help people think through issues more clearly and stabilize their thinking about the issues in life that they are dealing with. For many, it can also change the way that anxiety and depression feel. However, a more holistic approach than simply addressing the medical issues of suicide is needed.

If suicide is only a problem of the brain, we will likely engage very little in the recovery of someone who is suicidal. However, when we see the desire/temptation for suicide as an issue of the heart, we have great possibility for helpful conversations. This is where our churches need to come into play and get better at having effective conversations that reach the heart.

Compassionate and heart probing conversations were the ministry model of Jesus. Let’s choose to engage the suicidal like he did.

If you or someone you know is in crisis, the 988 Suicide & Crisis Lifeline is available 24/7 — call or text 988, or chat at 988lifeline.org. For urgent danger, call 911.

Do you or someone you know need counseling? We are passionate about helping hurting people. Biblical Counseling Center offers in-person counseling at our Chicagoland offices and remote counseling for people across the country. [Get Help Today]