The girl I planned to room with in college one year had to withdraw before school began because she had a mental health crisis. Around the same time I had been reading the book, None of These Diseases, by S. I. McMillen. My memory is that one of the book’s major premises was the connection between the spiritual and the physical. What struck me most forcibly at the time was that illnesses, especially of the mind, were often caused by spiritual problems. The suggestion seemed to be that if we prayed hard and long enough, were spiritual enough, or willed ourselves strongly enough, we could cure ourselves. I’m pretty sure I wrote a letter to my friend expressing my sympathy about her mental health problems and recommending that she read the book. I really hope she didn’t read it! I had no clue about the realities of mental illness in those days.
In the 1980s and again in the early 2000s, when I felt like my own world was crashing down around me, I sought the help of trained therapists and was able to identify and acknowledge my own tendencies toward anxiety and depression and understand some of the causes. I also came to the strong belief that even though there are psychosomatic components to illness, including mental illness, it’s a lot more complicated than that. Further, it’s not helpful to make judgments or assumptions about the possible causes of someone’s mental illness, especially if those judgments include blaming the person. And even further, any guilt one might have about feeling depressed and anxious is not helpful or productive.
That’s why it is distressing to me that the notion sometimes still persists that mental illness is often caused by some spiritual deficiency: if people got their spiritual lives in order, they wouldn’t be depressed or anxious. In an article some years ago, a Christian therapist said, “The predominant root of depression has a spiritual first cause, not a physical one.” By the time I read the article, I understood the nature of anxiety and depression well enough, both by personal experience and by what I had learned in my job with the PA Office of Mental Health and Substance Abuse Services, not to be thrown too badly by the article. Nonetheless, I remember feeling that familiar twinge of guilt – first the guilt for being depressed at all, and then for not being able to pray it away.
In another article years later, a pastor tried to explain the root causes of gun violence. Among other things, he said, “We try to blame it [violence] on mental illness or anything that shifts the focus off the true problem. Christian psychologists tell us that 80 percent (or more) of those on psychotic drugs and/or in facilities for mental illness would be cured, or nearly cured, if they straightened out their spiritual lives, asked for forgiveness of their sins and developed a personal relationship with Jesus Christ. You can trace the roots of many mental illnesses to spiritual problems.”
Again, statements like this are way too simplistic, not to mention potentially damaging to people who struggle with mental illness. The causes of mental illness are a complex combination of factors, including not only emotional/psychological/spiritual factors but also biology/physiology, genetics, environment, and trauma, and sometimes we just don’t know the cause. People with mental health challenges don’t need the further stigma and guilt that come with being labeled spiritually immature, not “Christian” enough, or to blame in some other way for their “weakness.”
For all the improvements that have happened in the mental health system over the last decades, there are still so many deficits, and so many ways people are still stigmatized and/or treated with a lack of compassion and humanity. Salaries for lower level mental health workers are often very low, and direct care staff don’t always receive adequate or appropriate training. Waiting lists for treatment are often long, and trained professionals, especially both adult and child/adolescent psychiatrists, are in short supply.
There is also still not parity in all ways between mental and physical health. Generally, we don’t tell people they need to straighten out their spiritual lives to be cured of physical illnesses; rather, the medical system goes to work. Illnesses and injuries are seen to be natural consequences of living. Even when the disease or injury might have been prevented with better diet or driving less aggressively, for example, our first response isn’t to blame the person. We treat the illness or injury, we care for the person with compassion, and we don’t usually stigmatize him or her for being ill. Why not view mental illness the same way?
If you had a broken leg, would you be left to languish over a weekend in a hospital room until a doctor came on Monday to set your leg, as sometimes happens in psychiatric inpatient units? If you had a broken leg, would you have to call on all your community contacts to get someone in authority to demand that you be treated in a timely manner? If you had a broken leg, would you feel free to share your situation on the church prayer chain or ask the pastor to include you in his pastoral prayer during the Sunday morning service? On the other hand, what if you or a family member had experienced a mental health crisis? Would you feel much more private and worry about what people might think and about the stigma of having a mental health problem? It’s relatively easy to talk about a broken leg or a cancer diagnosis, but it’s much more difficult to talk about being seriously depressed or anxious because we fear judgment or lack of understanding. There is generally no stigma in having a physical illness or injury, but there is still stigma related to serious depression, anxiety, or other mental illnesses.
When we hear about people with depression, anxiety, bipolar disorder, schizophrenia, or some other mental illness, rather than judge them as spiritually or morally deficient or just plain weak in some way, we should think about how we can make the mental health system more effective in treating them and how we can support them and their families. Mental illness is way too complex to dismiss with easy answers and solutions; doing so is a tremendous disservice to the millions of people who struggle with it every day. I wish I had understood that better all those years ago when my friend had to drop out of school because of a mental health crisis. I know I wanted to be compassionate when I wrote to her, but it was compassion tinged with ignorance that might have done more harm than good. In the intervening years, I’ve experienced and learned a lot that has made me far more understanding now than I was then, and for that I am grateful.
*Another version of this post was previously published in 2014.