Marlene Winell was 18 years old and sitting in church when she decided she wanted to leave.

“The pastor was holding up a newspaper about the Six-Day War in the Middle East, and everybody cheered because war is one of the end-of-times prophecies,” she told HuffPost. “He was happy the war had broken out. And that to me was the last straw. It was one of my last days in church.”

(This might sound familiar if you’ve been paying attention to comments circulating in the early days of the current war with Iran.)

Winell’s parents were fundamentalist Christian missionaries in China and Taiwan, and after she grew up in Taiwan, they sent her to a missionary boarding school in Southern California. Winell was part of the Jesus Movement — an evangelical Protestant revival that was popular in the 1960s and 1970s — living in a commune with those she described as “Christian hippies” and “Jesus freaks.”

That is, until she graduated from high school and started to question things.

“More and more things just gave me doubts — especially finding out about how the Bible was actually written,” she said. “There was an intellectual process going on where I didn’t want to just buy it. I want to know myself.”

Winell left the church, attended college, and now helps people recover from intense religious upbringings and experiences. In 2011, she coined the term “Religious Trauma Syndrome” to describe how people who have experienced certain extreme religious communities can be emotionally and mentally harmed — a lot of fear, a lot of low self-esteem and a feeling of no control.

“They get told what to think, what to believe, how to behave, what to wear, all these things that they have no control [over],” she said.

Winell recalled wanting to focus her studies on religious trauma after noticing that “nobody was concerned about the mental and emotional damage done by religion” in her classes. She pointed out that even people experiencing religious trauma might not fully understand they’re going through it, depending on their environment.

Most religious beliefs are healthy and sustaining for their members. But experts say there is a point at which devotion can tip into something else: isolation, delusion, a break from reality that often gets rationalized as “good faith.” Sometimes it’s an underlying mental health condition; sometimes it’s pressure from the community itself. Either way, crossing that line can leave people dealing with real, lasting trauma.

“Religious psychosis” is not a formal medical diagnosis, but a common term used to describe when someone is dealing with a break from reality — like experiencing delusions or hallucinations — and using religion and faith as a means of justifying it.

For example, someone who is considered to be under religious psychosis could be a person who truly believes they are a divine figure — a prophet or a messiah — and/or that they have supernatural powers or control over other human beings.

“Religious psychosis” is a very extreme descriptor, Winell noted. “Some of these things can get very severe without necessarily being called psychosis.”

There is a spectrum at play, “from healthy religious beliefs” to more “psychotic symptoms,” Harold Koenig, a professor of psychiatry and behavioral sciences at Duke University, told HuffPost. Koenig personally identifies as religious and is the founding co-director of Duke’s Center for Spirituality, Theology and Health.

These extreme psychotic symptoms are commonly found in adults who already have mental health disorders — it’s been estimated that around 25% to 39% of schizophrenia patients have experienced them. (Although in recent years, medical and scientific communities have advocated that there needs to be more research done in understanding the relationship and connection between schizophrenia and religion.)

“You typically not only have psychotic religious beliefs, but you’ve got other symptoms with regard to people with a psychotic disorder [such as] their ability to process, their ability to relate to others,” Koenig said. “[These people] are different because, again, it’s a disorder — it causes dysfunction in various areas of life, including engagement within a faith community and engagement within a family.”

Winell also points out that for a lot of these cases, children can be victims.

“Most extreme believers grew up in it,” she said. “You’re not supposed to have your own opinion; you’re not supposed to ask questions. You’re supposed to be devoted to the authority of your parents, your pastor, a priest or the scripture, or what God is telling you. It’s all externally focused.”

There is no concrete list of definite signs to look out for, especially since religious psychosis is not a formal medical diagnosis. However, experts do point to recurring characteristics and habits that should indicate to family members or fellow members of the faith community that something is wrong.

“It’s typically not all that subtle,” Koenig said. “Unless you’re very familiar with the religious beliefs of a group, you have to be very conscious if you’re outside the group. But if you’re within the group, you’re going to be able to pretty much detect when someone is different.”

Recovery from religious trauma comes with obstacles that other trauma survivors rarely face.

“There’s a really interesting difference between recovering from this trauma and other kinds of trauma, such as sexual trauma or physical abuse,” Winell said. “If you were sexually abused, you’re not encouraged to go to that person and forgive them. Whereas, in the religious context, a lot of pressure is put on the victim to forgive and forget. And in our society, we have religion all around us as if it’s fine.”

“It’s hard to get support from people in the same way,” Winell added. “People don’t tend to believe you or feel that sorry for you. If you say your parents made you go, it’s like, ‘Oh, poor you, your parents made you go to church.’”

Many psychiatrists and psychologists may not have a personal religious experience or knowledge of how certain faiths operate, Koenig said, so there is a limit to the traditional diagnostic tools available to evaluate someone on the extreme side.

“The religious illusion sometimes makes it difficult for a doctor to see through it to really get to the bottom of what the problem is,” he said. “Sometimes it doesn’t take care of the problem leading the person with some residual symptoms that they may need to seek help [for].”

Koenig recommends that anyone affected, or who knows someone affected, by extreme religious beliefs should seek care from a doctor who is “sensitive” or “sympathetic” to those beliefs.

Decades after leaving the Jesus Movement, Winell has built her career helping people recover from similar religious experiences. For her, the path forward starts with something simple.

“It has to do with learning some self-respect, growing up, and learning to trust your own thoughts and feelings, and believe what you intuitively are thinking about — trusting yourself more,” she said.

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