Anointing of the Sick for Psychiatric Disorders?

ROME, OCT. 12, 2010 (Zenit.org).- Answered by Legionary of Christ Father Edward McNamara, professor of liturgy at the Regina Apostolorum university.
Q: Could someone who has mental problems/disorders receive the anointing of the sick? For example, people who battle an illness such as anxiety/panic disorder, bipolar, depression, schizophrenia, etc. I would think that these types of illness are not in and of themselves necessarily life-threatening, but they could be and could lead to life-threatening situations. I have a friend in Nova Scotia who visited a shrine in Quebec last summer. The shrine held a special anointing of the sick, but the priest announced that it was only for those truly ill and/or with a life-threatening illness. My friend was truly upset and didn't know whether to receive the anointing. She has had cancer and now suffers an anxiety/panic disorder, always living in fear of the cancer returning. -- T.O., Vermont
A: In general the sacrament of the sick is reserved for serious (but not necessarily life- threatening) physical illness which significantly affects one's health and well-being. It can also be administered before a serious operation or one that requires complete sedation, even if the underlying condition is not in itself life-threatening. It may also be administered to those over 65 if notably weakened, even if they do not suffer from any particular illness.
Historically the Church has not administered this sacrament for less serious illnesses, even if chronic. Until relatively recently, mental illnesses were not usually considered as subjects for anointing.
Medical science, however, has discovered that some hitherto mental illnesses are in fact symptoms of physical imbalances. For example, the dementia associated with Alzheimer's is apparently mental, but it is also a fatal, and still incurable, disease.
Even if the serious mental illness is not caused by known physical phenomena, No. 53 of the introduction to Pastoral Care of the Sick: Rites of Anointing and Viaticum (PCS) opens up the possibility of the use the sacrament in such cases. To wit: "Some types of mental sickness are now classified as serious. Those who are judged to have a serious mental illness and who would be strengthened by the sacrament may be anointed. The anointing may be repeated in accordance with the conditions for other kinds of severe illness."
The minister should proceed with some caution with respect to anointing for mental illness. There is no clear cut standard to determine "seriousness." For this reason, such situations should be handled on a case-by-case basis and in consultation with the person's physician. As stated in PCS, No. 8: "A prudent or reasonably sure judgment, without scruple, is sufficient for deciding on the serious of an illness. If necessary a doctor may be consulted."
Also PCS, No. 52: "Those who receive this sacrament in the faith of the Church will find it a true sign of comfort and support in time of trial. It will work to overcome the sickness if this is God’s will."
Finally, while it is possible that anxiety and similar mental strains could reach a stage of seriousness that would warrant anointing, it is also important to recall that the Church's habitual sources of grace such as frequent recourse to the sacraments of reconciliation and Eucharist, closeness to the Blessed Mother, as well as prayer and seeking spiritual guidance are of great benefit in helping us to overcome these burdens or at least bear patiently the trials permitted by God.