I Trust When Dark My Road

Darkness Is My Only Companion: A Christian Response to Mental Illness, by Kathryn Greene-McCreight

This is a book I am currently reading. It is written by an Episcopalian priest. Consider this your theological disclaimer. I’m certain that there are elements to the book that don’t fit a nice little Lutheran orthodox niche.

Having said that, I have found it about the best book on mental illness from a Christian perspective I have read thus far. She seems to have a pretty firm grasp of the theology of the cross and suffering, doesn’t gloss over the ugly parts, and finds hope in the resurrection.

Her lens through which she views mental illness is bipolar disorder. This is a very different beast than my own sickness, major clinical depression. This illness at different times has been called manic depressive, and many other titles which I won’t try to list. While clinical depression has lows and more lows, bipolar disorder is basically a roller coaster of ecstasy and despondency, bouncing from the two in a way which is nigh impossible to fathom for the outsider.

Here are a couple paragraphs from Greene-McCreight which I found poignant and insightful:

So, during mania, I felt completely different from the way I did at the depressive pole. Mania doesn’t hurt the way depression does. Depression meant that every breath, every thought, every moment of consciousness hurt. Every particle of my consciousness ached, throbbed, stung. Mania was the opposite: every breath, every movement, every image before my eyes, every thought sparkled, glittered magically, filled me with ecstasy. Centrifugal motion, bliss.

At this point, thanks to the medicine, I am not filled with ecstasy. Neither am I in agony. I just want to end my existence. I am tired-not physically,, no, because the medicine is working. HEaven forbid I should be physically tired. Leave it to American medicine to make a drug that provides productivity even during depressive episodes. But I am tired of existed inside of myself, I don’t want to be inside my own skin, am tired of feeling and talking and figuring out why I feel this way and that way, tired of putting off the inevitable, that I should return to the earth from which the muddy Adam was shaped. (p. 55)

Obviously this is not the portrait of a shiny, happy, victorious Christian. This is the picture of the sufferer, who struggles with the medication which continues existence and yet hates the existence it gives. I personally find it refreshing. I just get so sick of fake, infused happiness and joy. This false happiness isn’t as prevalent in Christianity now as it was ten years ago, but it is still very much there.

As I wrap up the book, I’ll try and offer a few more citations that will be of benefit, particularly looking at where we put our trust, and the interaction between medication, faith and therapy.

-DMR

I am currently laid up with a physical illness. Nothing serious, so don’t fret, but it reminds me again of how differently we treat physical and mental illness. Here’s a little compare and contrast:

1. In physical pain, we seek to find the cause and solve it. In mental pain, we try to suppress it.

2. In physical pain, the one in pain receives sympathy and care. In mental pain, the sufferer is avoided because they are somehow tainted or weird.

3. In physical pain, the congregation prays for the afflicted. In mental pain, the afflicted suffers alone because mental pain is never shared.

4. In physical pain, the assumption is that this is not the sufferer’s fault. In mental pain and illness, the assumption is that there is something wrong with the person.

Those are my initial comparisons. What’s on your mind?

-DMR

I read Untreatable Online pretty regularly. It’s not particularly Christian from my perspective, but the author has great wisdom in understanding mental illness. Here is today’s post:

BPD Awareness Month – Best Parts About Having A Mental Illness

To his list I would add the following:

6. Recognizing God‘s mercy. I would never have as deep an understanding of God’s mercy and care without my illnesses.

7. Seeing God’s people in action. In the same vein, God works mightily through the smallest and strangest of places (and people!). It really is a joy to watch God at work, even in the midst of great sorrow and pain.

Those are mine. What are yours?

-DMR

(Via Untreatable Online)

I read Untreatable Online pretty regularly. It’s not particularly Christian from my perspective, but the author has great wisdom in understanding mental illness. Here is today’s post:

BPD Awareness Month – Best Parts About Having A Mental Illness

To his list I would add the following:

6. Recognizing God‘s mercy. I would never have as deep an understanding of God’s mercy and care without my illnesses.

7. Seeing God’s people in action. In the same vein, God works mightily through the smallest and strangest of places (and people!). It really is a joy to watch God at work, even in the midst of great sorrow and pain.

Those are mine. What are yours?

-DMR

(Via Untreatable Online)

One of the questions that regularly come up to me has to do with the ons and offs of medication. When and why do you go on medication, and when and why do you go off of them? While the two are related, they are not the same.

Why go on medication?

We go on medication simply put because we need it. There may be many factors which go into that decision. It may involve mood, basic functionality, self-image, the ability to handle situations or stress, being able to interact with other people, to keep us safe from ourselves or others. You know your own list. For myself, I knew I had to go on medication when I found myself hating the things that I love: my family, my wife, my vocation as pastor, even my hobbies and the things that I enjoy became a burden. I couldn’t handle living any longer, and so something had to change. While one can go the route of simply counseling or natural remedies, in my view and after much reading on the topic, I simply haven’t found any cure or natural remedy or counseling method that is more effective than anti-depressants. Can you go other routes? Yes. Can they be effective? Yes. But I don’t believe that they will work as quickly or as well as modern anti-depressants or anti-anxiety medication, and the body of research seems to continue to support that view.

That’s why I went on medication, both initially and that’s why I went on them the second time.

Why go off medication?

The reason we go off medication should be fairly simple: we go off medication because we no longer need it. Now that sounds very simple, but we often invest massive amounts of emotion and other negative energy into the decision to go off of medication. Here are a few that I see and hear pretty regularly:

1. I don’t want to become addicted.
2. I don’t want to be on medication for the rest of my life.
3. Taking medication makes me feel weak or out of control of my own body.
4. I don’t like the side effects.
5. I can’t afford to take them anymore (iow, money or insurance problems).
6. I have found a better alternative way of treatment.

Now out of that list (and I look forward to hearing yours), four of them are basically emotional responses to medicine (wants and likes and feelings), one is money based, the the final one is experimenting with others ways of treatment.

But remember that initial reason on why we go off medication: we go off medication because we no longer need it. Unless you are a doctor, it is very unlikely that you will be able to determine when you no longer need it, since the medicine working is what makes you have a normal, functional life in the first place.

So how do you know when you don’t need the medication? Here’s a tip: you can’t know by yourself. You’re not a doctor, you’re not a pharmacist, you’re not God. It takes outside evidence. It takes some level of expertise that most of us do not have. It’s why God gives us doctors and nurses and medication in the first place.

If you think you want to try going off your medication, I would suggest the following steps:

1. Wait a month.
2. Talk to your doctor about the possibility of going off medication.
3. Wait another month.
4. Talk to your spouse about it, and anyone else whom you trust that may have some wisdom on the subject.
5. Wait another month.
6. Talk to your doctor about it AGAIN.
7. Then come up with a reasonable timetable and a way of evaluating what changes happen as a result of going off the medication.

One thing is for sure. Don’t willy nilly try to do this. Don’t just decide you are going to “see how you feel” by stopping to take it for a while. That is just not wise.

If you are desperate, send me an email and we’ll talk about it directly. I’m happy to pool my wisdom/foolishness with yours.

Be at peace,
-DMR

Jeannelle over at Midlife by Farmlight just posted a link in a comment to the following blog:

Necessary Therapy

It’s the blog of a pastor with bipolar disorder who has served a small parish for about 14 years since his diagnosis. If I read the information correct, he is now on some type of disability. I don’t think he’s Lutheran, but I haven’t gone through and read all the back posts yet. But it looks very promising. Please check it out!

-DMR

The link below is from the blog Untreatable Online, which I read pretty regularly. As a Christian, my question is this: how should we as the Church serve these people? How do we demonstrate or mercy for the needy in care here? Talk about a tough question! I wish I had a good answer…

Frontline The Released Article

This is not any kind of great insight, but simply a realization I had this morning. I just had two nights in a row where both my wife and I were present to take care of the kids and get them to bed. Reading, catechism, prayers, etc. It is the first time we’ve had that for two nights in a row in WEEKS. AND we get to do it again tonight.

Wow.

I can just feel myself relax and settle into the normalcy of life when such things happen. I feel like I have been wound up since before Lent, and that things are just now starting to rebound and come down to the usual chaos.

It is so important to simply have time to be a family, to gather together, to sing and pray, play outside, chase around, and do whatever you do in your family. I am grounded when these things happen. My mood improves, my patience improves, everything is better.

But I can’t see that when I don’t have it. I get so obsessed with GETTING STUFF DONE that I forget who I am as a child of God, as a husband and father and pastor and neighbor, etc.

Be at peace, friends. Get some rest. Don’t try to get everything done, for you may lose yourself in a series of tasks that seem important at the time, but ultimately don’t really matter.

-DMR

Here’s a helpful article commenting on this large Christianity Today issue on depression from March:

courier-journal.com | Faith & Works blog | The Courier-Journal

It is hard to overestimate how important preaching the resurrection is to the mentally ill, including the clinically depressed. That’s the illness I know best, but I firmly believe that this holds true for anxiety, manic depression, schizophrenia and a host of other mental illnesses.

The reason is simple. For the mentally ill, you are trapped in your own mind and body. Your brain is not processing as it should, and so the chemical changes in your body interact in a very bad way with the sinful nature which infects us all. If your sickness is telling you that things are far, far worse than they really are, and your sinful nature is telling you that God hates you, put these two together and you have a recipe for personal and spiritual disaster.

Mental illness works as a magnifying glass and amplifier for so many of the doubts and fears which infect us all. Everyone has doubts about the future. Everyone has moments of despair. Everyone has fears about what they cannot control. Everyone questions their own worthiness before God and before their fellow human beings. We all go through these. But for the mentally ill, especially the clinically depressed, these feelings are all consuming. The physical illness can easily lead to anfectung, the struggle of the soul.

So why does preaching the resurrection matter to the clinically depressed? It matters because in the resurrection of the body, there is a future and a hope that is real, that is concrete, that will happen to matter what may be going on today or yesterday or tomorrow. St. Paul puts it best:

“If in this life only we have hope in Christ, we are of all men most miserable.” (1Corinthians 15:19 KJV)

For the depressed, there is no tomorrow.
For the depressed, there is only thick darkness.
For the depressed, there is only more misery.
For the depressed, there is no escape except the grave.

But not so the Christian!

There is a tomorrow in Christ.
There is light that shines in the darkness.
There is joy in the body of Christ.
There is escape not in the grave but through the resurrection of the body.

So, my fellow preachers, give us the resurrection. It is my only hope out of the darkness. Give me Jesus Christ risen from the dead. Nothing, nothing else will ever satisfy.

Easter is coming. I can’t wait.