Category Archives: mental illness

The Ongoing Journey with Depression (book idea from Kleinig)

So what should the next book be about?

My wife and I had the pleasure of attending the last session in the DOXOLOGY training seminar this past weekend. The main speaker was Dr. John Kleinig from Australia, an incredible scholar and pastor whose insight into human nature and Christ’s ministry to us sinner is, well, just amazing.

We had dinner with him one night. He gets depression, understands it as well as anyone I know I’d say. The one thing that he suggested to me was to write a book about what it is like living with depression on a day to day basis. How does one recognize the signs? How does it impact your prayer life, your ministry to others, etc?

I’m letting the idea percolate right now, but I would like some insight from you. What would be the most helpful to you and why?

-DMR

Why Pastors Hide Their Depression

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I’ve had a lot of conversations this week with the release of the book. They have been online, telephone, email, wherever. The contacts have been from pastors, teachers, spouses, friends from college, and pretty much across the board. I’ll comment on some of those at another time.

One theme that resonates through so many of the conversations is that pastors don’t want to reveal that they are depressed. This is also true generally, and especially in other service fields. But it seems particularly true with pastors. They mask their illness.

I know I did. I worked my tail off to put on a happy face, a “game face” with my congregation and family. It took incredible amounts of energy, and really made things worse.

But if possible what is even sadder than our self-inflicted super-pastor mindset, is that we are afraid of reprisals. I am afraid that I might lose my job, be kicked out of my congregation, that my district president won’t support me. So the very people who can and should and generally would try to help, are the ones who are kept in the dark.

Why? Why do we hide? And what will happen if we reveal to our families (Who probably already know), our congregation, and our brother pastors what is going on?

-DMR
aka Todd Peperkorn

Why the Church Drives Away the Mentally Ill

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In the last few years I have had the opportunity to speak or correspond with many people who struggle with depression or other mental illnesses. Pastors, teachers, DCEs, laity, each story is different, yet there are common themes.

One of those themes is how often the church, either at the congregational level or at the district/synod level, has failed these people. In all too many cases, their faith has been shaken to the point of disappearing. Now I don’t believe that there is any malice on the part of congregations or our church body. Far from it. But the sad reality is that we are driving people away from Christ by how we approach the mentally ill.

Why?

I have several theories about this. Here they are, in no particular order:

1. Because we so often equate clinical depression (or any mental illness) with some sort of character flaw, it is viewed basically as a sin. I think people instinctively know that this isn’t quite right, but they don’t have any other categories in which to place mental illness.

2. Everyone has weaknesses, and we work very hard to hide them. For many, depression unmasked is too close to home. It forces us to view our own struggles and failings, and that may just be too painful.

3. If we view the church as a place for the spiritually strong to work out, and not a hospital for the sick, then the mentally ill have no place.

4. The fundamental notion of “depression is in your head, get over it!” is so strong that we can’t help but judge others whose weaknesses are in public view.

5. Lutherans just aren’t very good at areas which aren’t “spiritual” in nature. If it isn’t about justification, then we just don’t get it. Hence, we try to place depression and mental illness simply into the “spiritual” box, and it doesn’t fit there.

Those are off the top of my head. What’s on your list?

Darkness Is My Only Companion, with thoughts on Bipolar Disorder

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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

Physical and Mental Illness, and how we treat them differently

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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

The Bright Side of Mental Illness

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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)

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The Bright Side of Mental Illness

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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)

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Why do you go on medication, and why/when do you go off of it?

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.

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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