Spirituality and religion in psychiatry

Meet the patient — the man who refuses his medication as a spiritual test

A 52-year-old devout man with bipolar I disorder stops his lithium, telling the team his mood swings are "a test from God" and that taking tablets would be "a lack of faith". His wife is worried but deferential. The registrar wants to know whether to challenge the theology or accept the refusal. The viva question is live: how do you respect faith without abandoning medicine?[2][6]

The move is neither theological debate nor psychiatric override. Take a respectful spiritual history, distinguish a faith-shaped explanatory model from a delusion with religious content, complete the risk and capacity assessment, offer treatment alongside — not against — the person's framework, and bring in chaplaincy or faith leaders with consent. Most of the time the patient wants both prayer and pills.[1][2][14]

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