Guest Post: Mental Health, Mortal Life, and Accountability Part 2: Causes and (Mis)Attributions

January 15, 2013 | 23 comments
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[This is the second in a series of guest posts on Mental Health, Mortal Life, and Accountability. The other installments are available here: Part 1:”Exceeding Sorrowful, Even Unto Death” (Mark 14:34)Part 3: Fractured Images of God, Self, and OthersPart 4: Accommodations in LDS Activities and Meetings, and Part 5: The “Greater Sin”/ Sane Repentance & Forgiveness]

The church’s web page about mental illness includes a brief list of potential causes.  These can include physiological and/or behavioral factors.

Mental health or functioning can be compromised due to heredity; birth defect; oxygen deprivation at birth or later; biological trauma (concussion, brain clot, hemorrhage, tumor, seizure activity, bacterial infection); medication, drugs, food, additives, environmental hazards, or other substances that effect brain function; nutritional deficiencies, sensitivities, and anemias; sleep deprivation and its opposite–prolonged bed rest or other immobility/ limitation of physical movement…

Behaviorally, mental health can be hampered by child, spousal, or elder abuse, neglect, or abandonment; untreated mental illness in, or substance abuse or poor modeling by a parent or other caregiver; an extreme mismatch between parental and child personality or temperament; food insecurity; prolonged or extreme economic hardship; being a witness or participant in war, violence (including rape and other forms of sexual attack), accident, illness, injury, or other trauma; imprisonment, forced relocation, theft, or other curtailment of liberty or autonomy; divorce and other losses; a variety of continuous stressors; and (yes) guilt over personal sin & transgression.

Usually, difficulties stem from a combination of these, and include both known and unknown factors.

Reviewing a list like this, it is amazing that any of us are mentally whole! Oh, wait, none of us is, completely. But mental illness signifies difficulties severe enough to interfere with “normal living” (church website terminology).  Some individuals can endure amazing trauma, loss, injury, or illness without losing their ability to function on a day to day basis, and these are not always  those perceived as the “most spiritual” among us.  Yet when someone does NOT seem to be doing well emotionally, we often assume that shaky spirituality is at fault.

We can easily see why.  Gospel living is designed to give us a measure of happiness and peace in this life as well as in the world to come.  I believe that the core doctrines of Mormonism strengthen mental health.  Consider these:

We are children of perfect, loving, beneficent Heavenly Parents who desire our progress and growth

Our agency is valued–even essential

Our lives have purpose and our efforts are not fruitless (those who keep the commandments are blessed)

Grace is available for our wrongs and hurts

Those without law are not condemned

We’re not expected to run faster than we have strength

Illness and hardship are part and parcel of the mortal condition, not punishment

We are each only accountable for our own sins

Justice and mercy will be perfectly served by and by

But sometimes, because of these helpful truths, we erroneously assume that individuals who are not happy, hopeful, or functional have reached that state specifically because they are not living the gospel as they should. While sin and transgression can be one cause of despair, it is only one of a myriad of potential causes. As for functionality, while we don’t expect the gospel (or God’s power) to cure every other ailment that impairs functionality, we do expect that it should cure every mental one, whether physiological or emotional. I think this is a mistake, and believe this is why the church now recognizes the importance of not “blaming the victim,” the reality that in some cases, mental illness is lifelong or terminal, and the need for those with mental health struggles to obtain skilled professional help.

 

*Author’s name has been changed due the sensitive nature of this series of guest posts

23 Responses to Guest Post: Mental Health, Mortal Life, and Accountability Part 2: Causes and (Mis)Attributions

  1. Jill on January 16, 2013 at 12:09 am

    Demaris–I left another comment on your previous post. I think you nailed it–in LDS circles, people tend to judge someone with depression as not living the gospel as they should. Nothing could be farther from the truth. My clinical depression is simply a genetic chronic illness the same way someone else may have diabetes for a lifetime. Often people like myself miss church meetings enough that it is noticed. (The snap judgment is we are going inactive.) The problem is compounded because we often don’t tell people why we’re not there because we know most don’t understand what depression is but think they do and will misjudge us. I had missionaries show up “challenging” me to commit to being at Sacrament the following Sunday. I wound up explaining to the boys what I don’t want everyone knowing but didn’t give it a name. I said I have an illness that most people don’t know about and I want it to remain private. But winter is my hardest time of year–I am really fatigued. The Second Coming could be this Sunday and I can’t say I’ll be there because I won’t know until that morning how I am energy wise. That’s the reality.

  2. grego on January 16, 2013 at 3:22 am

    #1,
    Our newly-moved-in RS president “went inactive” one winter… We found out it happened yearly, and it was more or less similar to what you’re saying. She finally got over it, they were happy! One day, one day… ;)

    I’d like to propose another cause of emotional problems: emotional/ energetic inheritance. Just as one inherits physical traits from parents, and “inherits” learned behavior from parents, one also inherits energetic traits from parents. Do you notice how some people in the same family have similar traits, but have never been around each other much? Just like physical problems can be passed down, these can, too.

  3. Doug G. on January 16, 2013 at 5:51 am

    Substance abuse, depression, and many other illnesses are co-morbid; they cannot be parsed, one from another. They may be attributed to genetic predispositions or nurturing, but in the end they are often excuses used to paper over a life wasted in the pursuit of worldly satisfaction, or because we are paralysed with fear and guilt. A massive medical/psychological/pharmacological industry makes immense profit from treating the symptoms, which, once documented, are life long. Once we wear the mantle of being ‘mentally ill’ it is all too easy to embrace the label, succumb to Satan’s embrace and give up. Mental illness is simply a manifestation of ‘the world’ that has reached toxic levels, and the only antidote is to trust in the supernatural grace found in Jesus Christ.

    I battled depression, and substance abuse all my life. Every time I sought treatment I was diagnosed as bi-polar, or manic depressive, or with PTSD, anxiety; etc, etc. Faced with life – or death, I stopped taking the pills and turned to the Lord. I put as much effort and discipline into a spiritual life as I used to put into treating the illness. The only way I could break free of the darkness was to embrace the light. All of our trials have but one purpose: To turn our hearts towards God. Only in the Lord will we find the answers.

  4. Demaris on January 16, 2013 at 10:43 am

    Again, great examples. I appreciate everyone’s candor and contributions.

    Doug-remarkable experience. Glad you were able to get help. It sounds like your experiences have led you to disagree with the LDS church’s current teachings about mental illness.

    I agree that reliance on the Lord is essential to all of us, regardless of the type of distress we are experiencing, and that Satan and those who choose to follow him definitely exploit physiological, spiritual, and emotional weaknesses. I hope you can recognize that others’ experiences can and do differ from yours.

    In my experience, in addition to mercifully forgiving our sins, comforting us when we have experienced losses, and strengthening us spiritually, the Lord also inspires and directs us to take care of the physical temples with which we have been entrusted. For me, that means not only getting enough rest, good nutrition, adequate exercise, and avoiding harmful substances where possible, it also means getting a cast when my arm is broken, counseling when I am subject to unproductive or depressing thought patterns, and medication when I can’t cope at all. Blessedly, these helps have worked together in my life, enhancing my ability to devote my life to Christ, rather than detract from it.

  5. jennifer reuben on January 16, 2013 at 11:52 am

    I have experienced the lack of information about mental illnesses from the other side. The well meaning but uninformed leader ( me) who does just the wrong things in an attempt to help the sister or brother suffering not knowing the nature of their illness. If someone under my stewartship was physically ill I would have been informed why does it seem that mental illness is not similarly shared. Of course, I do not need or want complete details just guidance of how to best to serve. I am frankly, suprised that in our modern day and age anyone would view a mental illness as other than an illness and assign any moral judgement to it but I suppose from the comments it happens too often. Please understand that I am only asked that individuals and families be more informative about their health issue with leaders directly considered and only so that support can be provided. personally, in my life, I have made some very hurtful blunders because of the lack of proper information.

  6. Jared vdH on January 16, 2013 at 11:54 am

    Doug, I hope you can understand why your comment can be seen as hurtful to those struggling with things beyond their control, including mental illness. Your statement, “Mental illness is simply a manifestation of ‘the world’ that has reached toxic levels, and the only antidote is to trust in the supernatural grace found in Jesus Christ” while possibly applicable to you and your personal experience is not universal.

    Take for example my uncle. He was an active, contributing member of the Church throughout his youth. He left on a mission at the appropriate age and served well and faithfully. Then at about his 17th month into his missionary service, he experienced a schizophrenic break. He began to struggle with his very perception of reality. Understandably he was sent home from his mission since he was unable to continue to perform his duties in that state. He came home a completely different person than when he left. Both my mother and grandmother have expressed the sentiment that it felt like my uncle died on his mission and someone else came home in his place. He has now struggled with his schizophrenia and the medication that barely keeps it under control for 40 years. The medication, while helping his mental condition, has now damaged his neural system to the point where he has Parkinson’s like symptoms and cannot dress or feed himself.

    Can you really be of the opinion that all of this was because he simply didn’t have enough faith in Jesus Christ? Interestingly enough, that’s what his stake president thought when he came home early from his mission. The stake president told my grandmother that because he had come home early, he did not serve an honorable mission, despite his illness.

    I’m grateful that the Church is doing more institutionally to recognize the reality of mental illness and trying to educate the leaders of the Church in how to better deal with it. I would hope that the same stake president that once condemned my uncle for coming home early would now recognize him for the service he was able to render before mental illness wreaked havoc on his mind and body; that the illness did not necessarily have root in his soul.

  7. Erin on January 16, 2013 at 4:01 pm

    “Faced with life – or death, I stopped taking the pills and turned to the Lord. I put as much effort and discipline into a spiritual life as I used to put into treating the illness. The only way I could break free of the darkness was to embrace the light.”

    Just because this approach worked for you, don’t assume that it will work for everyone. That thinking is a little egocentric and pretty damaging for other people (myself included) who simply cannot embrace the light because they are in the darkness.

  8. Demaris on January 16, 2013 at 4:18 pm

    Wow, Jared. That just breaks my heart.

    Jennifer, you’re not the only one, and I’ll address this more fully in my 4th post on issues to consider as we seek to apply the church’s recommendations for helping individuals with mental health problems. But to answer your question about why individuals don’t disclose their struggles, just a few possibilities: Perhaps an individual doesn’t have a handle on it themselves. Perhaps they’ve been burned before (like Jaren’s uncle). Perhaps they don’t think it’s your business, or that you should be making assumptions or judgements about their behavior in the first place.

  9. meg on January 17, 2013 at 12:38 am

    The most spiritual Christlike man I know of was my bishop and he had
    depression which was genetic in his family. It happens just like
    any other physical illness. If he weren’t on medication, he wouldn’t be functional. And he never was a substance abuser either which with Doug seems to have been his problem–not depression.

  10. Let's say, Mark on January 17, 2013 at 1:05 pm

    Jennifer, I don’t talk about my depression because, in spite of the official Church stance given in the OP, members of my family still view it as a moral failing. Consider that sharing with an understanding person, such as yourself, may bring a minor benefit to the one afflicted but sharing with less enlightened souls can bring a severe and detrimental response. A quick cost-benefit analysis usually endorses silence. One day I plan on asking the Lord why I suffered with this ailment in mortality, and I have hope that His answer will be sufficient in scope, certainty, and purpose. “Answers” that others have given, however well-intentioned (see: Doug G.), have certainly fallen short on those characteristics.

  11. jennifer reuben on January 17, 2013 at 5:44 pm

    as I am not familiar with the terms and titles used to label those with mental illnesses I would never suggest that a victim of those illnesses share their diagnosis with me. Having worked for many years with special needs children and young adults I know first hand Mark #10 the kind of response that is common to disclosures and how detrimental it can be. However, I do feel suggestions of ways to support and aid would help to guide gospel leaders with stewardship responsiblities.example in my case a polite,I have a large personal space and am not comfortable with hugs. Few and very close are the individuals who I would share the details of the reasons and background involved in that request to shake hand and not hug me but the result is the same. I am comfortable. A simple example not any where as difficult as the issue you must face.

  12. jennifer reuben on January 17, 2013 at 6:53 pm

    I just re-read my own response to Mark #10 and found it stuffy and not very realistic. from my own experience an advocate , trusted friends, parents, spouse who serves the roll of explainer and defender to the outside world is the very best things a person with any illness can have. It most be so important to the mentally ill. Also a social atmosphere where they feel accepted and valued. I am looking forward to seeing the suggestions provided by the next article on this subject. and thank you hubby for standing between me and the huggers and always giving me the outside seat.

  13. Demaris on January 17, 2013 at 6:55 pm

    Jennifer- I’ve had (and heard about from friends) both helpful and really hurtful experiences/ responses as a result of sharing these types of issues, or even suggestions for helps with church leaders and friends in the church, and I have responded positive and not so positively myself, even with personal and family experience in this arena, so I know how difficult it can be! Would you be willing to share an example of a situation in which a leader might benefit from knowing about a mental health issue? One example given on the church website is someone who has panic attacks when speaking publicly being allowed to serve in other ways. I would guess that many individuals with anxiety would prefer to simply make some excuse like being out of town rather than disclosing that they have a legitimate reason for being excused from public speaking. And since posting yesterday, I thought of some situations in which an individual might not obtain need help (such as church welfare assistance) if health concerns are not included in factors explained to a bishop or Relief Society president.

  14. Let's say, Mark on January 17, 2013 at 10:24 pm

    Jennifer, I sympathize with your desire to help and feeling a need for some information to do so. I wish more felt like that. In my experience, Mormons (including our leaders) don’t generally believe in problems we can’t see. And we certainly don’t believe in really difficult problems that we can’t see. That makes mental illness like the Higgs-Boson: some really educated people say it exists and is important but, not seeing it in our everyday lives (and not really trusting educated people in the first place), we nod along but secretly we wonder if it’s just a ploy to get more funding. This sentiment is not universal, of course, but it is widespread and that makes sharing difficult at best and dangerous at worst. As the onset of some mental illnesses, like my depression, is not immediate we are often at a further disadvantage of being encultured and indoctrinated to believe that evil, in some way or manner, is the only viable explanation for such ailments. These attitudes are deeply ingrained and hard to shake, even for those who can plainly see that their suffering is without motive. I didn’t seek professional help for my depression until I was in my 30s, in part because I’d heard my father opine that if only so-and-so would read their scriptures more or pray a little more faithfully their depression would go away. If only they’d stop doing whatever bad thing it was they must be doing, life would be all happiness and sunbeams. Be grateful for your advocate, because just as frequently we’re given an (usually well-intentioned, as if that excuses anyone) antagonizer instead.

  15. jill on January 18, 2013 at 12:48 am

    Mark, I think it’s because they don’t understand what depression is.
    It isn’t just feeling emotionally down or having the “blues”. They might say “I feel depressed.” Everyone feels that way at times but soon they feel better again. That isn’t depression. Clinical Depression is different. It’s having problems functioning figuring out the steps to make a peanut butter sandwich and doing them. Feeling
    really fatigued. Crying over anything but everything is fine–nothing
    terrible has happened. You feel intense sadness. Feeling as if life is so much work,such hard work and you’ve run out of energy–as if you’ve run out of gas so the car can’t run anymore. Living becomes overwhelming. It hurts to keep doing what you have to do every day.
    Having fun, doing something for someone else , praying, reading scriptures, going to the temple–none of this makes it go away. If you feel depressed because you just have the “blues” yes, that will make it go away but not a Clinical Depression.

  16. jennifer reuben on January 18, 2013 at 1:06 am

    I was asked for examples of times sharing mental illness would help a church leader.
    may I share some personal incidents without details were the lack of information lead to some hurtful actions on my part and you can see how a little information on the individual’s health could have prevented the outcome. In all cases I learned the individual’s personal situation after the event and from outside sources not the priesthod leadership nor the family nor the individual.
    1. asking a vet with PTS to help with scouting experiences that took him away from his safe quiet environment and professional help for weeks at a time.
    2. calling a depressed mother of five young children to serve as a counselor in a large Primary with many issues. This lead to a public melt down when she was completely over loaded.

    3. a troubled teen placed in a foster home where the mother was unstable. Leading to her hospitalizing for attempted suicide

    I think I will stop confessing my short coming with these three.

    having served as an advocate in my professional life I do understand the statement that you can receive an antagonizer instead of an advocate and I know how blessed I am to have my eternal companion take the role of my advocate with my very small mental health issues.

  17. Ben on January 18, 2013 at 12:30 pm

    As a 30-year Dysthymia/Major Depression sufferer, I think Jill hits the mark very well in #15 regarding how depression is NOT merely sadness, however intense.

    Along the same lines, I’ve always found the following quote by Elizabeth Wurtzel helpful in explaining depression to others:

    “That’s the thing I want to make clear about depression: It’s got nothing at all to do with life. In the course of life, there is sadness and pain and sorrow, all of which, in their right time and season, are normal — unpleasant, but normal. Depression is an altogether different zone because it involves a complete absence: absence of affect, absence of feeling, absence of response, absence of interest. The pain you feel in the course of a major clinical depression is an attempt on nature’s part (nature, after all, abhors a vacuum) to fill up the empty space. But for all intents and purposes, the deeply depressed are just the walking, waking dead.

    And the scariest part is that if you ask anyone in the throes of depression how he got there, to pin down the turning point, he’ll never know. There is a classic moment in The Sun Also Rises when someone asks Mike Campbell how he went bankrupt, and all he can say in response is, ‘Gradually and then suddenly.’ When someone asks how I lost my mind, that is all I can say too”

    Depression is a disease. The brain is an organ and (in some way we don’t understand) is the bridge between our spirit and the world of people around us. If the electro-chemical functioning of that organ is abnormal, then the actions and perceptions of the sufferer will likewise be affected. It is no more reasonable to tell that person to pray their way out of it then it is to tell a diabetic that if he embraces Mormon Instutional Orthopraxy(TM) hard enough his pancreas will start producing the proper levels of insulin again.

    As any depression sufferer attempting to live a faithful religious life will tell you, the ability to feel the Spirit and the love of God is one of the first things that depression impairs. To tell such a person that they lack faith or are lazy will simply cause a downward spiral.

    A better plan is to support and love the person in performing whatever actions they feel they can do. Unless, of course, you particularly enjoy seeing people melt down completely in front of you.

  18. Patricia K on January 19, 2013 at 8:20 pm

    But sometimes, because of these helpful truths, we erroneously assume that individuals who are not happy, hopeful, or functional have reached that state specifically because they are not living the gospel as they should.

    I think that those helpful truths are also put into play in the *wink-wink*, nudge-nudge ironic take on the supposedly high percentage of the LDS population said to be on mood stabilizers and other psychotropic meds. In this case, those looking at the church from their angle of view insinuate the cause should be laid to the account of the institution. That’s to say, many LDS are not happy, hopeful, or functional because the church sets them up for trouble.

    Sure–in the course of human interaction, religious language and institutional stances may be employed as weapons. However, holding the church accountable for mental illness among its membership may run the same risks of fallacy of the third cause as the leap to judgment you mention above.

  19. Jax on January 19, 2013 at 10:25 pm

    I’m a fairly recent new-comer to depression. A military injury left me with chronic pain, reduced functions/abilities, and suicidal depression. I often have mental arguements with myself about whether or not I have an illness, or if I’m just weak and unable to handle things. When I feel real down, I sometimes question if it is because I don’t have enough faith; if I need to just “buck up”; if my trials are result of sin. I sometimes feel real sorrowful guilt for being weak/for questioning/doubt. Depression is real and until you’ve experienced it you just don’t understand it… I never did. My wife is struggling with how to make sense of it as well. I thank God that I am getting some good care through the VA, because trying to get through it by just talking to an inexperienced bishop/SP/? just wouldn’t be enough.

    It’s still a hard adjustment to make, and trying to get my new mental state “in-tune” with the gospel, callings, doctrine has been a bit tricky at times. Light does come and ease the burden at times, but the understanding that the light brings is step-upon-agonizingly-slow-step.

    Thanks for the post(s) Demaris… I’ve enjoyed reading the them and the comments.

  20. Lynnette on January 20, 2013 at 5:12 pm

    “As for functionality, while we don’t expect the gospel (or God’s power) to cure every other ailment that impairs functionality, we do expect that it should cure every mental one, whether physiological or emotional.”

    I really appreciate that point, as that’s been one of my biggest challenges when it comes to depression. One of the symptoms, of course, is excessive guilt. And while we wouldn’t expect the church to heal a broken leg, guilt tends to be framed as a spiritual ailment, leading to the idea that you can in fact pray it away. It’s taken me a long time to distinguish between guilt that just beats me down and aggravates my depression, and the more positive, future-oriented feeling that calls you to repent and then let it go.

  21. Ken on January 21, 2013 at 10:34 am

    Lynnette (#20): “It’s taken me a long time to distinguish between guilt that just beats me down and aggravates my depression, and the more positive, future-oriented feeling that calls you to repent and then let it go.”

    That’s a nice insight. Thank you! :)

  22. Suleiman on January 21, 2013 at 6:10 pm

    I always thought depression was for the weak-minded, until I spent three months in a serious state of depression. I could barely function.

    I am happy that I had that experience because I now know a small portion of what so many go through. And I pray I never have to go through that again.

  23. Demaris on January 21, 2013 at 9:12 pm

    I’ve been reading and thinking lots about each of your responses as well as my own experiences. I’m really glad my posts have resonated and perhaps been helpful to some.

    The reality that Jax and Suleiman point out–that until you experience it for yourself, you just don’t get it–is key for me in letting go of the hurt caused by hurtful and simply untrue comments made by and attitudes of ignorant others.

    Jennifer-I don’t think you did anything wrong in asking others to serve. There’s no way you could know of their individual circumstances. As difficult as it is, individuals with disabilities, including mental health issues, must decide what they can handle or not. Our current bishopric has done a great job asking about our current situation before extending callings, and we’ve been more open about challenges in our family, and let them know when callings aren’t working out and why so adjustments can be made. It helps that they’ve honored the input. I know this is not always the case, but I hope new leadership training and materials will help. As for the foster care situation, I’m not sure what role you played in the placement, but I’m guessing this girl had pre-existing issues if she needed a foster home?