When I hear of someone struggling with mental illness who is discouraged from taking medication for religious reasons, I want to weep. Also beat my breast, rend my robes and generally make the kind of display that most of the Bible is full of, and that white Western culture (especially the church) tries so hard to avoid.
I want to do this because, firstly, it breaks my heart that someone in pain should be prevented from seeking relief, and secondly, because I think the (Western) church’s powerful aversion to negative emotional expression is a huge problem. We don’t like to dwell on the dark stuff. You can’t shed tears at the state of the world without someone throwing out an injunction to “be joyful” and “trust God” – as if feeling the desperation of our times is incompatible with knowing God to be all-powerful, all-loving and always good. (Allow me to point out that when Jesus came to Lazarus’ tomb with his sisters, he did not say, “Pull yourselves together, people! I’m here to fix this!” He wept. And then he raised his friend from the dead).
Let me state at the outset that I have lived with mental illness for over ten years, and been on medication for most of that time. It hasn’t been the final answer to my condition or the challenges that brought it on, but it has been essential to my healing. It did not ever occur to me to resist pills for reasons of either pride, theology or social opinion – I was in a great deal of pain, desperate and just so relieved that there was help at hand. If anyone has ever tried to dissuade me from taking them, I have blocked it from memory. It makes no more sense to me to resist medical treatment for mental illness than to refuse antibiotics or polio vaccines (not to open another can of worms).
I know however that I might be in the minority here. Many, many Christians I know have had serious struggles with the decision to take pills for depression, anxiety or other mental illness, whether from their own convictions or those of their partners, friends or church family. While I don’t fully understand those convictions, I would like to put forth my own stance here, for what it’s worth.
First is the fairly obvious argument that mental illness has been found to have a strong biological basis and can often successfully be treated using Western biomedicine. If we accept this as at least part of the picture, why would we treat mental illness differently from diabetes or cancer? If you accept that medical treatment for more obviously physical illness is sane and appropriate, why should depression or bipolar disorder be different?
Obviously that is not the whole picture. We know that mental illness, especially depression and anxiety, generally has roots in our life circumstances and often also our pasts. These things certainly can’t and shouldn’t be addressed with pills alone, and there usually are things we need to deal with, work through or change for healing to happen. Emotional pain, like physical pain, is usually there for a reason, and is healthy insofar as it tells us there’s a problem. And yes, if you are a person of faith, God will be at the centre of what needs to happen. But this does not mean we should not get other help as well – or that things like pills are not sometimes absolutely necessary for those other things to be possible. Sometimes the pain, whatever its origins, is too much, and renders us incapable of the things we need to do to fix it.
The lines I hear most often about mental illness and medication in relation to the church are “You need to have more faith and God will heal you” (read: it’s your fault because you are crap) and “The Bible commands us to be joyful and not to worry! It is unbiblical to be depressed or anxious” (read: try harder. And it’s your fault, because you are crap).
There are a few things about the state of depression itself that unfortunately leave us vulnerable to these lines of attack. Firstly, depression generally will make us feel guilty and worthless. It’s kind of a hallmark, as anyone who has taken a depression self-rating test will know. It feels true that we are doing something wrong, that we are somehow failing to live up to our faith, that we are probably to blame for our own condition. We don’t feel deserving of help or care or kindness – despite the depth of real suffering we may be experiencing. In this way, depression takes away our ability to defend and look after ourselves. If you told someone with a freshly broken leg to forego pain medication in favour of trusting in God’s healing power, she’d probably kick you in the shins with the good limb and carry on with the morphine. But depression robs us of that perspective.
Another key characteristic of the state is often an inability to feel God’s presence. I haven’t seen this written down anywhere, but all of my Christian friends who have struggled with depression have said the same: in those dark places, God feels a million miles away, and our prayers seem futile and unheard. It’s easy to conclude that he is angry with us, and has rejected or forgotten us. Or still worse, that he does not after all exist. We can’t “feel peace” about any decision, (for example going on medication), because peace is by definition gone from us. (Important to note that when medication does its work, that becomes possible again).
Finally, depression includes a loss of hope. We no longer believe things can get better, or that we can get better. This can make it extremely difficult for anyone (not only Christians) to seek help, because it seems pointless. The trouble for Christians in this position comes when we also feel guilty for having no hope (or being anxious or miserable or whatever) because we are not supposed to feel this way if we truly trust God. The added layer of guilt about all the horrible things we feel, on top of those horrible things themselves, makes mental illness especially painful for people of faith.
The people who say these things to other people are not being intentionally cruel. Unless you have experienced mental illness yourself, or gone through it with someone close to you, you cannot imagine it. You can only liken it to your own darkest moments, which were no doubt terrible, but essentially normal and healthy reactions to terrible circumstances (like losing a loved one). Also, mental illness is frightening and poses scary questions about God and ourselves and the world. Most of us would far rather blame the sufferer (unconsciously or otherwise).
I think much of the difficulty in the church around dealing with depression is that we struggle with the dark side of life (as aforementioned, this comment is most relevant to the Western & upper/middle-class – who are by no means the majority in the global church family). We struggle to reconcile faith in God with acknowledgment of pain and struggle. People don’t like facing tears, doubts, despair or pain – their own or anyone else’s. We’d rather downplay them, or offer quick solutions that negate their seriousness (cue for the depressed person to think, it’s true, I really am making a fuss about nothing, I don’t deserve to be listened to or cared for. Other people cope with life, so there must be something wrong with me. Etcetera, etcetera…). However, as my weeping-and-gnashing-of-teeth example illustrates, this is not what’s in the Bible. It’s a dark book, full of people who suffer and wrestle and rant and doubt, and the full range of human emotion is richly expressed. Ecclesiastes is pure existential soliloquy. Job spares nothing in capturing the apparently meaningless tragedies of life, and the utter ineptness of human beings (even our dearest friends) in helping us through them. And David would almost certainly have been a candidate for some judicious Prozac.
Does mental illness arise from our lack of faith? Probably yes, that does have something to do with it – just as it does with so many of our struggles as human beings. Jesus has been retrospectively assessed by secular psychologists as among the most mentally and emotionally healthy people on record, and his faith in God was also the most perfect we have witnessed. But if we mentally ill are to be judged for that, so should everyone be who has ever had a sleepless night over something. We have cracks and flaws, and they hurt us and we hurt each other because of them. We are not yet perfect. But – and here is my biggest point – THERE IS GRACE. God has promised us peace and wholeness. He can offer us joy and hope. But none of us are perfect in our capacity to take up those promises, no matter how shiny we look on the outside, and sometimes we will need other help on the way.
What if people pray for us to be healed from our mental illness, but we aren’t? I must confess that although I have welcomed prayer for my condition, in my heart I never wanted instantaneous healing. Why not? Did that mean I was wallowing in my misery, enjoying the attention it brought me? Hell no. But I realised that more than I wanted relief, I needed to understand why this thing was there. If it had simply been whisked away by a few well-chosen words and some laying on of hands, the previous months or years of suffering would have made absolutely no sense. I needed more than that.
And so God, in his infinite grace, has allowed me to observe and be part of my own healing. It has taken years, and is still ongoing, but it has brought far more joy and wholeness and hope than a twenty-minute miracle could have done. It has brought me so much nearer God, and it has also helped me empathise and even sometimes help other people struggling with similar stuff. If I’d had a magical instant healing, I would be that annoying person telling other people to have more faith…
And here is the main thing I have learnt: he really, really loves us. While I still don’t understand why he allows us to suffer (including through mental illness), I know beyond a doubt that he suffers with us, that his eyes are upon us in those darkest times with a tenderness and compassion that blows even the best human parents out of the water. He is not the one judging us for our lack of faith, or requiring us to man up. And if we don’t always take the glorious high path of unwavering trust and holiness, I know that he still has only grace and mercy and compassion for us.
“For he understands how we are formed, he knows that we are dust” (Psalm 103: 14)
“He is close to the broken-hearted, and saves those who are crushed in spirit” (Psalm 34:18)
I can’t tell you whether using medication for your pain is the right thing. But I want you to know that whatever you decide, it should not be because you feel guilty for feeling the way you do, or because you believe God to be watching you with a judge’s eye, waiting for you to screw up. I believe that when we suffer, whether it is for chemical or emotional or spiritual reasons, God is not standing at a distance judging us: he is right by our side, and holding on to us tight. Make your choice in the light of knowing, even if you can’t feel it right now, that you are loved and treasured and forgiven by the One whose judgment counts.
And if anyone tries to tell you otherwise, kick them in the shins.
This post was requested by my wonderful doctor, for the many people she counsels who struggle with this thing. I hope it contains at least some of what they need to hear.