Crippling Assumptions: Disability, Mental Illness, and the Myth of the Able-Bodied Disciple

Depression and anxiety are widespread among individuals with intellectual disabilities. One study showed that the rate of “psychiatric comorbidities with affective and anxiety disorders was approximately 11 times higher for people with an intellectual disability” (Mrayyan et al. 2019, 1). Furthermore, older individuals with intellectual disabilities especially suffer from “advanced and complex somatic and psychiatric comorbidities” (Mrayyan et al. 2019, 2). 

Despite its prevalence, depression and anxiety among persons with intellectual disabilities remain challenging to treat, as communication barriers can inhibit the expression and articulation of mental distress. As a result, depression and anxiety in the intellectually disabled often go unnoticed or untreated until escalated behavior manifests (McGillivray et al. 2010). Even when individuals are diagnosed, healthcare care providers are significantly underprepared to understand persons with intellectual disabilities or have not had adequate experience in dual diagnosis (Barron and Evensen, 2022). Consequently, the presence of “affective and anxiety disorders with other comorbidities might be hidden and thus underestimated by healthcare providers” (Mrayyan e. al. 2019, 6). In the author’s experience, this resulted in a relentless cycle of trial and error – experimenting with various psychiatric medications, consulting multiple psychiatrists, and attempting to manage environmental factors. While these efforts did eventually offer relief, the process was arduous and far from ideal for the author, the primary caretaker of a son with Down Syndrome diagnosed with anxiety and depression (Barron and Evensen 2022)

The intersection of anxiety, depression, and intellectual disabilities remains largely overlooked in medical discourse. In the author's initial search for answers regarding his son, he found that studies on depression and anxiety in individuals with Down syndrome had consistently small sample sizes (McGuire and Chicoine, 1996). Twenty years later, despite ongoing research, sample sizes in these studies have remained largely unchanged (Dykens et al. 2015). This persistent limitation underscores the need to explore additional interventions, including those that have traditionally been disregarded for individuals with intellectual disabilities.

Over the past two decades, the medical community has increasingly examined what spirituality could offer toward the psychological care of persons with depression and anxiety (D’Souza 2007; Büssing and Koenig 2010; Lassi and Mugnaini, 2015) The integration of spirituality as part of treatment provides avenues of protection against depression and anxiety. Researchers have shown a correlation between spirituality and the acceptance of limitations, better impulse control, increased life expectancy, improved quality of life, and subjective well-being (Bertelli et al. 2020). Others propose that spirituality in the intellectually disabled is essential for daily activities, linked to self-esteem, motivation, and relatedness (Bertelli et al. 2020). But despite this recent openness, some still dismiss spirituality as a viable asset for the intellectually disabled. Some would argue that certain intellectual limitations leave them unable to engage in the necessary conceptual thought about their spiritual interior in relation to God (Bertelli et al. 2020; Wilder 2018, 38). This paper will argue that such prejudices are based on a narrow understanding of the intellectually disabled person’s capacity for spirituality, as well as the nature and agency of God to “meet” people in their unique capacities.

By employing a hermeneutic of disability-enabling theology (Swinton, 2011; 2010; Cooreman-Guitten & Armand Léovan Ommen, 2022), this article will engage with narratives present within the Old and New Testaments to provide a framework for understanding the capacity for spirituality that exists within all human persons and what is characteristic of spiritual forces, noted here as “God,” and as referring to the God presented in the Old and New Testaments. “Jesus Christ” and “God” will also be referred to and referenced interchangeably. In these texts, one encounters a God that a) engages with humanity through a vast assortment of modalities and somatic pathways (Luke 24:13-35; Acts 2:6, 11); b) is deeply involved in the lived reality of disability and offers both accompaniment and accommodation (Exodus 4:10-17) (Eiseland, 1994); c) commands spiritual communities to care for and integrate persons with intellectual disabilities as vital pieces of their community (2 Samuel 9:8; Luke 14:15-24; Mark 5:1-20); d) and invites all members to participate in the mystical unity of the “body of Christ” (Col 1:27; 3:3; 1 Cor. 3:16). These theological insights challenge the assumption that intellectual ability is a prerequisite for meaningful spiritual engagement and affirm that persons with intellectual disabilities are not excluded from the spiritual life.  

This paper aims not only to substantiate spirituality as a meaningful resource for addressing anxiety and depression among persons with intellectual disabilities but also to advocate for Church reform – challenging how Christian communities understand and engage with the spiritual experiences of people with disabilities. Hyper-cognitive worship practices and spiritual growth frameworks – such as creed-reading, lyricism, liturgical prayer, contemplative devotionals, and small group discussions – often assume a level of intellectual engagement that inadvertently excludes those with cognitive disabilities. This leads to a broader discussion of discipleship, a central aspect of Christian communities, and the rigid categories placed around it – both in defining spiritual growth and in limiting access to it. The exclusion of individuals with intellectual disabilities, rooted in prejudiced assumptions about their spiritual capacity and the privileging of hyper-cognitive practices, not only marginalizes them but also contributes to heightened anxiety and depression (Barron and Evensen, 2022). Furthermore, we note that the rise of White Christian Nationalism can exacerbate exclusionary, and consequently, ableist attitudes within Evangelical communities (Upenieks and Hill, 2023). The prevailing emphasis on power, strength, and intellectual prowess obscures other dimensions of God that individuals with intellectual disabilities can identify with (Swinton, 2003). These factors highlight the urgent need to broaden our understanding of spirituality so that the Church can move toward a more inclusive and theologically sound vision of the Christian community (Reynolds 2008).