The Shame of Mental Illness

In titling this blog post, I chose the words “mental illness” instead of “mental health” because that’s how it’s talked about. People with depression, anxiety, PTSD, schizophrenia or bipolar disorder are categorized as the mentally ill. Throw them all in an asylum—not just any asylum but an “insane asylum.” If someone doesn’t say it, they think it. And if you aren’t personally thinking it, then the person who is facing the struggle is thinking that you’re thinking it and so the person struggling is believing it.

Words are powerful. And so words can be harmful.

This is stigma.

And the stigma arises from a silent enemy, the culprit called shame.

Today I want to dive a bit into the shame of mental illness.

I believe that talking about mental illness in honest and healthy ways can lead us down a path toward mental health, treatment, and recovery.

I believe that the worst thing anyone can do is bury, hide, or cover up issues related to mental health. Just as I believe the worst thing anyone can do in a relationship is to bury, hide, or cover up what needs to be known in order for there to be peace and harmony in the relationship—or even reconciliation if need be.

As a Christian, I believe in an old story told very long ago. And this story informs me of some of the deeper dynamics at play surrounding mental illness.

The story goes like this.

A married couple lived in a garden, and they are described as being both naked and unashamed.

But in that garden, they were tempted and they sinned. Once they sinned, they wanted to hide—for fear of being found out. So they covered up their nakedness with fig leaves and they go into hiding. Hearing the sound of the Creator in the garden calling out, “Where are you?” they remain in hiding.

Well in the story, the God who made this couple asks them, “Who told you that you were naked?” (Genesis 3:11). The implication of this question is that their unashamed-ness has now become shamed-ness.

Shame told this couple that they were naked and needed covering up. Shame told this couple to become hush-hush about their sin, and to instead put a blanket over it and press on.

This ancient story has a lot to teach us about how we approach mental illness and journey into the realm of mental health.

We tend to do the same thing that they did when it comes to mental health. We cover up. We hide. We are hush-hush. And people suffer all the more because of it. By evaluating psychology autopsy’s, one study has shown that over 90% of those who have died by suicide had a mental health condition. By not talking about mental health, we encourage people to go it alone and ignore treatment which in turn leads to a greater risk for suicide.

Instead of burying, covering up, or hiding, we need to press into the uncomfortable if we are ever going to experience healing, or help others to experience healing.

Like the age old story, shame tells a person who is facing a mental illness that they are “crazy.” If they ask for help, others might think of them as “weak.” If they share what they are really dealing with, then they might face work discrimination or others might view them as incompetent.

Or maybe there are people who don’t believe the person and for whatever reason they just can’t accept that they’re suffering. This adds to the shame.

If they are a Christian, there might even be a deeper shame associated with a mental illness because the community they are around is telling them to trust God more. “If you take medicine, you’re not really trusting God.” “Have enough faith!” And the shame piles on.

There is a better way for all of us.

We can start to believe the message that it’s okay not to be okay. We can start to have healthier conversations about mental health. And this can lead us to share the burden we carry of our real struggles, our deepest pains, our nursing wounds—and by doing this we can begin to break down the stigma and remove the fig leaf of shame that keeps us away from experiencing healing.

Words are powerful. Let’s use our words to save and enrich lives.

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If you would like to learn more about shame, I highly recommend the work of Curt Thompson. You can read his book, The Soul of Shame, to understand more about shame and how it impacts us and the world around us.

Give Us This Day Our Daily Pill

A few years ago I was initiated into a club that I never thought I’d be a part of. And no, it’s not the Breakfast Club. (I wish!)

This club is made up of one in four Americans, who like me, experience regular appointments with psychiatrists, therapists, LCSW’s, mentors, and who might have a whole list of prescribed cocktails to get our bodies back into good health.

Welcome to Club Mental Health—where we all need a whole lot of empathy, and a buttload of grace!

Jesus taught us in the Lord’s Prayer to “give us this day our daily bread,” recognizing that it is God who provides us with our daily meals even if we get our bread from the baker. Some of us, well, at least 26% of us, have to also ask God to give us this day our daily pill. We pray for relief from anxiety and depression, and God uses means, just like he uses Ralph’s or Von’s bakery for fresh-baked bread, he helps us find relief.

So the same truth about “daily bread” applies in the area of medicine. When we receive a pill from the hand of a doctor, we know that ultimately, it is God who is providing us exactly with what we need for our bodies to work properly and be healthy.

Depression is an illness, it’s not a sin. It requires treatment just like any other sickness.

In this article, I hope to provide some useful guidance for those who currently need to get help, and I hope to provide some words of encouragement for those who know someone with a mental health condition.

How to Get Help for Yourself

*Note: Before I say anything more, this part is really directed at those who are beyond “self-care” treatment. If you’re trying all of the typical things—diet, sleep, exercise, or if you’ve just totally slipped for the past few months and—life happened—and you fell off the bandwagon and are in a really bad spot, then this section is for you. If you are reading this as someone with no personal experience with mental health, then I’d encourage you to still read this but probably pay more attention to the following section.

1. You need to know and be assured that it’s okay to get help.

This is something that’s very hard for Americans—it’s the classic guy who can’t ask for directions sort of thing. We don’t think we need help, so we don’t ask for help. So I’d first say, especially if you’re someone who believes that the message of Christianity is true:

“We can’t help ourselves, God helps those who cannot help themselves.”

As those who profess faith in Jesus Christ, all the more should we be leading by example in this. It’s okay to get help. We know this to be true spiritually, why can’t we embrace this bodily? Recognize that if you need help, you’re not weak. You’re a person. People need help. This is true for spirituality and it’s true for mental health.

2. You need to know that having a mental Illness is not your fault. 

If you’re reading this right now, know “It’s not your fault.”

It’s not your fault, any more than heart disease or diabetes or being diagnosed with cancer is someone’s fault. We don’t blame a person then, so why do we think it’s okay to fault someone with a mental illness or make them feel bad for having a mental health condition? 

3. You need to know that getting help for a mental illness is a lot harder than it looks.

People who mean well, and who catch some signs of depression or anxiety in someone often say, “Get help,” but where does a person actually go to “Get help?”

It’s not as simple as calling 911 when you break your leg. And the other thing is unless a person who has a mental illness has a strong support group (a spouse, a close friend, or a church with caring people and resources), it’s that much harder for a person to figure out how they can even get help.

The mental healthcare system is super confusing. There are lots of terms to learn: psychiatrist, therapist, psychologist, psychotherapist, LMFT, counselor. Which doctor or therapist should I see? How do I even get an appointment? What if the appointment isn’t for one to two months from now when I need help right now? And what if I’m in such a state that I can’t even figure out how to call the right number. And where do I even go? If I go to this provider, is it covered under my insurance?

This gets really confusing for anyone, let alone for a person who has a mental health condition. So the best advice I can give for people, generally speaking, is to try to work with what you have and with who you know. The best place to start is with your healthcare provider and try to stay within your network. This will be the least expensive option, and it should be the simplest option for you.

So for example, I have Kaiser Permanente, and they have a phone number for psychiatric needs. That’s where I start. Because if I go to the ER, they aren’t really going to help me much for what’s going on with my brain—they usually don’t have a psychiatrist on hand in the ER.

4. You need to come up with a Mental Health Action Plan with your family and provider once you’re feeling better.

This doesn’t need to take very long, but it should take place at some point. Speak to your psychiatrist about what to do in a future emergency situation, or an urgent situation. This includes names and phone numbers of people close to you to call for help, it includes action steps, etc. So have this ready before you ever get to a low point again. 

5. You need to continue with follow-up care.

Your life is very precious. You matter. You have been created by the Maker of all things, and he has made you intricately and wonderfully, even if you don’t feel all that intricate or wonderful all the time.

So make sure to schedule a routine appointments with your psychiatrist and/or therapist. It helps to ask a spouse, family member, or a close friend to help you with follow-up care so they can be up to date on your current treatment plan. This is something I’ve learned by experience, but treatment changes from time to time and varies greatly from individual to individual. Those who are caring for you need to know these changes when they occur, because again, you matter.

6. You need to know that it’s probably not a “spiritual” problem.

Far too many people assume mental illness is a “spiritual” problem when in fact it’s something that is happening to the human brain and/or body. 

For example, what sort of thoughts are you thinking about? How are you feeling? How have you been sleeping? What foods have you been eating (food affects mood)? How much regular exercise have you been getting?

It’s harmful to think something is spiritually wrong when physical solutions haven’t even been tried or tested.

7. You need to know that getting help isn’t only to help you, but it also helps others around you.

There’s a reason why the flight attendant tells every parent on an airplane to “Please put on your own mask before you assist your child with a safety mask.” You have to be in good health yourself before you can take care of others.

Now the inverse applies in the area of mental health. If I am not mentally healthy, it affects others around me. So it’s expedient that I take my mental health seriously enough to get help as soon as I need it, so that others aren’t affected greatly. Of course, sometimes we are past the point of return, and we just simply need help. When that happens, others are happy to help. Just know that we are all interconnected.

And yes, if you’re wondering if you are a burden to others around you—you are. And that’s more than okay!

Each one of us is a “burden” to someone else in different ways and during different seasons of time. The apostle Paul says about the church, “If one member suffers, all suffer together; if one member is honored, all rejoice together” (1 Corinthians 12:26). And he encourages us to “Bear one another's burdens, and so fulfill the law of Christ” (Galatians 6:2). Each of us bring our own set of burdens with us to church, and all of us need encouragement, love, support, and grace. Don’t let your burden of depression, anxiety, or another mental health condition keep you away from church. Instead, find a church family where you can meet Jesus and his people who say to you, as often as you need to hear it:

“Come to me, all who labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. 30 For my yoke is easy, and my burden is light." (Matthew 11:28-30)

What Others Need to Know About Helping Those With Mental Health Conditions

1. People need to know and regularly hear that it’s not their fault.

Way too often I hear people saying statements like, “Oh, she must be a drug addict.” or “He must have smoked pot.” or “There’s definitely substance abuse going on there,” when someone with a mental health condition is being discussed, and what this does is it further casts blame upon the person. A mental health condition is not someone’s fault. Rather, it is part of living in a broken, sin-cursed world where our bodies and minds don’t always work properly. We get sick. Christians believe that all of us are “sick,” which is why we need Jesus, the Great Physician (Doctor) to heal us.

In Good Will Hunting, there’s a segment where Robin Williams tells Matt Damon, who was a survivor of sexual abuse, “It’s not your fault.” The same encouragement can and should be repeated to someone who has a mental illness. Let them know and hear that their depression, anxiety, PTSD, bipolar disorder, OCD, panic attacks, or other mental health condition is not their fault.

2. People need to know that the person you know who is struggling is a person, not a patient.

Unless you are that person’s psychiatrist or therapist, they are a person and you need to treat them with full dignity and respect. It also means, try showing them empathy. Be their friend. Spend time with them and show them that you love them and want them to know this.

There’s no better way to do this than by walking with them through their darkest days. I love the song “Walk Me Home” by Pink for that reason. “Walk me home in the dead of night, cause I can’t be alone with all that’s on my mind.” It’s a perfect description of what it means to be with someone who is struggling and battling a mental health condition.

3. People need to know that a person with a mental illness is not clueless or out of touch with reality.

In fact, a huge majority of people in the U.S. who struggle with mental health are silent sufferers. You won’t even know it but a lot of people you know are already on anti-depressants. And they’re functioning just fine. Two-thirds of people with mental illness live normal lives. Some even live highly functioning lives

So when someone you know shares with you that they suffer from depression, don’t assume that they are incapable or lazy or are somehow unproductive. Those are myths, not facts about people with mental health.

4. People need to know that the road to mental health Is a marathon, not a sprint.

Be patient and show lots of grace With those who are suffering from a mental Health Condition. The road from mental illness to mental health is a marathon, not a sprint. People need to have realistic expectations about someone who suffers from depression or anxiety and should be able to demonstrate patience. 

This also means that if you have a timeline on when the person should be getting better, it’s best to just lay that down. Drop the timeline and instead opt to be there for the person no matter how long it takes them to fully recover and be themselves.

5. People need to know more about Mental Health in America.

Educate yourself on mental health, especially if you know the specific mental illness that affects your loved one, family member, or friend.

6. People need to ask, “How would you like to be cared for?”

Ask the person how they would like to be cared for specifically. Treatment plans will vary from person to person, and everyone will have different needs in general and at different times or seasons of their life. So the only way to know for sure is to ask. Get to know the person you are trying to care for better by asking them how you can better care, and then do it.

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Further Reading

If you or your loved one, family member, or friend are living with a mental health condition and you need help, you are not alone in this.

More Articles by Nicholas Davis:

• HELLO DARKNESS, MY OLD FRIEND

• HOPE AND HELP FOR THOSE THINKING ABOUT SUICIDE

Other Websites with Mental Health Resources:

NAMI

MentalHealth.gov

Hello Darkness, My Old Friend

Sometimes, pastors experience much worse than just the Monday Blues or a hard week of ministry.

Every year, six percent of men and ten percent of women suffer from depression. The National Institute of Mental Health defines depression as a “common but serious mood disorder” that “causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working.” Sometimes, pastors suffer from clinical depression and they need to get help too. It shouldn’t be this way, but because ministry is lonely, stressful, raw, and never-ending—and because we live in a fallen world—depression can be a reality that your pastor faces from time to time, or regularly.

Nobody is immune. It can happen to anyone.

As Psalm 30:6-7 reminds us, “As for me, I said in my prosperity, ‘I shall never be moved.’ By your favor, O Lord, you made my mountain stand strong; you hid your face; I was dismayed.”

There can be many contributing causes of depression for pastors. 

I’ll only list five of them.

The first cause could be loneliness or isolation. Loneliness can contribute to feelings of depression, when a pastor feels that he has no one else to talk to. If he cannot share his deepest laments and struggles with anyone, bottled up emotions can become toxic and lead to bouts of depression. 

A second cause is the weight of pastoral responsibility. With everything a pastor sees and hears, being in the trenches of ministry, it’s easy to get jaded and to begin to resent the church. People say nasty things, people do wicked things, and we are on the frontlines of all that activity. Being exposed to the underbelly of the church can be disheartening for pastors. And on top of this, he must continue to carry the emotional weight of the pains, fears, criticisms, suffering, and transitions happening in the body life of the congregation. This is no light task.

A third cause is when ministry doesn’t go as planned. A family leaves. The church budget has dropped over the past several months. Attendance is low. The staff is cut. People in the church you thought you knew and trusted turn on you. Pastors take these changes personally. The feeling of failure can overcome a pastor and lead him toward depression.

A fourth cause has nothing at all to do with the performance of the pastor or successes (or failures) of his ministry. A pastor could be depressed just because. Depression can happen to anybody, and a pastor is no exception. Pastors are truly human, just like you. Some people are more prone to depression than others and depending on life circumstances or genetics, a pastor can get depressed too. 

A fifth cause is that this could be a spiritual problem. Sometimes depression is caused by spiritual warfare. I mention this last cause because all too often Christians jump to this as the first and only reason, when in fact it might be physical or cognitive. Spiritual symptoms do not necessarily mean there is a spiritual cause for depression. 

Some Healthy Steps

If you are a pastor and you are experiencing depression, know that you are not alone. And if you are a church member and you are aware of your pastor’s battle with depression, do not leave your pastor alone in this battle. The single most important thing you can do for your pastor is to pray for him daily. But for some pastors, prayer will not be enough.

Pastors who suffer from clinical depression will need family support, counseling, friendship, pastoral care (from another pastor in the area or a group of pastors), healthy diet and regular exercise habits, adequate rest, cognitive behavioral therapy (CBT), and possibly repenting of any sinful habits (such as substance abuse or pornography addiction—yes, it’s possible for pastors to fall into these categories!) in order to continue to survive in ministry, with the goal of not just surviving but thriving. 

A pastor may need to see a psychiatrist for antidepressants. I would recommend that every pastor—even those who don’t suffer from any symptoms—see a counselor or a therapist regularly to have an outlet to talk about their emotional health and the challenges of the ministry calling. Coaching or mentorship of some kind could also facilitate these healthy conversations and be an adequate substitute for individuals who are otherwise healthy. 

These meetings are confidential and provide a safe space for pastors to vent without needing to worry about their unedited words somehow coming back to them in harmful ways. It also offers personal growth for the pastor to develop emotional maturity and in order to better understand life beyond black. And if for some reason none of these options are feasible (though they should be and it’s important to at least try to find one of these options or several of these options), then find someone (a friend) or a group of confidants (colleagues/friends) to share your burdens, struggles, and frustrations with.

In these ways, pastors who deal with depression and those who seek to care for their pastors can develop a new system for the pastor to learn healthy coping strategies for the calling God has given him.