HELPING INDIVDIUALS COPE: MENTAL ILLNESS

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MYTHS AND MISCONCEPTIONS ABOUT MENTAL ILLNESS
By Alexander Morrison

As many myths and misconceptions about the cause, course, and treatment of mental illness unfortunately are found among Latter-day Saints as they are in the general public. These harmful and destructive attitudes include the following:

1. All mental illness is caused by sin

      I reiterate what was already stated in chapter 1: sin-the deliberate breaking of God's commandments-does indeed result in much behavior that is hurtful to self and to others. To every transgression there must needs be-by reason of the law of the harvest-a consequent punishment. The demands of justice are inexorable, unless the person concerned invokes the power of the mercy provided by Christ's atonement, by repent­ing of the sin involved, forsaking it, and accepting Christ as his or her personal Savior.

      The power of sin to torment and harrow up the soul is vividly described by the repentant Alma: "But I was racked with eternal torment, for my soul was harrowed up to the greatest degree and racked with all my sins. . . . I was tor­mented with the pains of hell; . . . the very thought of coming into the presence of my God did rack my soul with inexpres­sible horror. Oh, thought I, that I could be banished and become extinct both soul and body" (Alma 36:12-15).

      Those, like Alma, who experience sorrow and feelings of remorse during the repentance process are not mentally ill. But they do require confession and counseling at the hands of their bishop. As part of his calling, each bishop receives special pow­ers of discernment and wisdom. No mental health professional, regardless of his or her skill, can ever replace the role of the faithful bishop, as he is guided by the Holy Ghost, in assisting Church members to work through the pain, remorse, and depression associated with sin.

That being said and fully acknowledged, however, it must be reemphasized that in many instances aberrant thoughts, actions, and feelings result from mental illness and not from sin. They come, as I have said, from mental illness, not trans­gression. They are not God's way of punishing the sinner. To assume they are is not only simplistic but also contrary to the teachings of Christ's Church. The bishop's first task in this matter is to discern whether a deeply distressed member of his congregation is suffering the effects of sin or of mental illness. He is able to do so effectively as he understands the nature and symptoms of mental illness and is guided by the Holy Ghost in his questioning and counsel. With a little fac­tual knowledge, and the guidance of the Spirit, the faithful bishop will know how best to assist those in his care who are having problems. If they are mentally ill, he will refer them to a health professional for treatment, with his blessing, advising them to remain faithful.

The truth is that many faithful Latter-day Saints, who live the commandments and honor their covenants, experience personal struggles with mental illness, or are required to deal, perhaps over long periods of time, with the intense pain and suffering of morally righteous mentally ill family members. Those involved often carry the resultant pain, anxiety, and burdens without loving acceptance or understanding from others. I assure you that Church leaders are in no way exempt from the burden of mental illness, whether as victim, caregiver, family member, or friend. In the geographic area of ever and stake there are severely depressed men and women; elderly people with failing memories and reduced intellectual capacities; youth or adults struggling with substance abuse; persons of all ages, both sexes, and every walk of life, who exhibit aberrant, even bizarre behavior. Their burdens-and they are and painful-can be lifted only by love, understanding (both intellectual and spiritual), nonjudgmental acceptance appropriate, and appropriate assistance.

Not long ago, for example, I met a man, a gifted physician in his mid-forties, who began about five years ago to exhibit the intense, excessive, and painful mood swings of bipolar disorder. His problem is mental illness, not sin. Fortunately now is receiving effective medical treatment for his malady.

Closely related to the idea that all mental illness is by sin is the equally false notion that if you're living should, you won't have problems. Life, for you, will I proverbial "bowl of cherries": after all, "men are, that might have joy" (2 Nephi 2:25), and if you're keeping the commandments you can reasonably expect to be joyful all the time. In fact, God owes it to you, or so you might think. But you would be wrong.

Life doesn't work that way. Were there no opposition, spir­itual advancement would not be possible. If there were no opposition, "righteousness could not be brought to pass, nei­ther wickedness, neither holiness nor misery, neither good nor bad. Wherefore, all things must needs be a compound in one; wherefore, if it should be one body it must needs remain as dead, having no life neither death, nor corruption nor incor­ruption, happiness nor misery, neither sense nor insensibility. Wherefore, it must needs have been created for a thing of naught; wherefore there would have been no purpose in the end of its creation. Wherefore, this thing must needs destroy the wisdom of God and his eternal purposes, and also the power, and the mercy, and the justice of God" (2 Nephi 2:11-12).

Without misery there can be no joy. Tragedy, sorrow, afflictions, all are part of living. And it is a blessing they are, though often we have difficulty in understanding why it is so. Through the grace of a loving Father in Heaven, whose very purpose is to bring His children back to Him, none of us is exempt from tears and sorrow. All of God's children can expect to experience them. 

2. Someone is to blame for mental illness.

Closely related to the myth that mental illness is caused by sin is the equally dangerous misconception that someone is to blame for mental illness. It is, I suppose, a common human tendency to blame others, or oneself, for whatever goes wrong in life. Many victims of mental illness wear themselves out emotionally by repetitive futile attempts to remember something they, their parents, or someone else might have done, sometime, somewhere, that resulted in the terrible suffering they are forced to endure. Some blame their problem on demonic possession. While there is no doubt that such has occurred in very rare instances, let us take care no devil credit for everything that goes awry in the world! Generally speaking, the mentally ill do not need exorcism; they need instead love, care, understanding, and support from everyone else, including their ecclesiastical leaders, as well as appropriate therapy from a skilled health care provider,

Most often, lacking an understanding about the causes of mental illness, victims blame themselves, and many seem unable to rid themselves of terrible though undefined feelings that somehow, some way they are the cause of their own pain-even when they're not. Parents, spouses, or other family members of mentally ill persons too often needlessly harrow up their own minds, trying futilely to determine where they went wrong. They pray over and over again for forgiveness, when there is no objective evidence they have anything of note for, which to be forgiven. They may try to bargain with God, offering Him anything, even their own lives, if only He will "cure” their beloved child or family member. Of course, in the vast majority of instances none of this works, for the simple reason that the victim's thoughts and behavior result from disease processes, which are not caused by the actions of others, including God.

Those who play the "blame game" with themselves, believing their mental illness is somehow their fault, almost inevitably end up harboring intense though unjustified feelings of guilt and shame. They may go to great lengths to conceal the taking of medication, visits to a therapist, and so on. "What if my bishop finds out?" cried a woman taking Prozac for her depression. She was frightened and full of guilt for what she considered, falsely, to be shameful or weak behavior. Somehow, she thought in her confusion, she must be lacking in faith. She had prayed often to be rid of her depression, and when her prayers weren't answered as she longed for, she became convinced that was evidence of divine disapproval of her and tangible proof she was without faith and merely receiving her just deserts.

A wise bishop would not, of course, consider that a person taking Prozac or any other drug prescribed by a doctor for mental illness is any more likely to be guilty of wrongdoing or shameful behavior than if he or she were taking insulin for dia­betes. Having determined, with the aid of the Spirit, that the person involved is suffering from mental illness and not the effects of sin, the bishop should encourage the member to continue to pray; attend appropriate meetings; participate in sacred ordinances; fulfill all other religious obligations; and get appropriate professional help-either from a physician or a skilled psychotherapist.

Ascribing blame for mental illness causes unnecessary suf­fering for all concerned and takes time and energy that would better be used in other ways: seeking to obtain a complete assessment and proper diagnosis of the illness involved, under­standing its causes, learning behavioral and cognitive tech­niques that are part of the healing process, and obtaining proper medication that will help control the disorder by reversing the resultant chemical changes. As victims, loved ones, and all the rest of us come to understand mental illness more dearly, patience, forgiveness, and empathy will replace denial, anger, and rejection. 

3. All that people with mental illness need is a priesthood blessing.

I am a great advocate and supporter of priesthood blessings. I know, from many personal experiences, that they do inestimable good. I know too that final and complete healing in mental illness or any other disease comes from faith in Jesus Christ. In any and all circumstances, in sickness an in health, in good times and bad, our lives will improve and become richer and more peaceful as we turn to Him. "Can all ye that labour and are heavy laden," He said. "Take my yoke upon you, and learn of me; for I am meek and lowly in heart and ye shall find rest unto your souls. For my yoke is easy, and my burden is light" (Matthew 11:28-30). He and only He has ownership of the healing "balm of Gilead" needed by all of God's children.

However, without in any way denigrating the unique role of priesthood blessings, may I suggest that ecclesiastical leaders are spiritual leaders and should not be expected to take on the roles of mental health professionals. Almost all of them lack the professional skills and training to deal effectively with deep-seated mental illnesses and are well advised to seek competent professional assistance for those in their charge who are in need. Remember that God has given us wondrous knowledge and technology that can help us overcome grievous problems such as mental illness. Just as we would not hesitate to consult a physician about medical problems such as cancer, heart disease, or diabetes, so too we should not hesitate to obtain medical and other appropriate professional assistance in deal­ing with mental illness. When such assistance is sought, we must be careful to ensure, insofar as possible, that the health professional concerned follows practices and procedures that are compatible with gospel principles

4. Mentally ill persons just lack willpower.

Some there are who, in their lack of understanding and empathy, mistakenly believe that the mentally ill just need to "snap out of it," "show a little backbone," and "straighten up!" These insensitive souls subscribe to what others have called "the Sock School of Psychiatry" -just pull them up and get on with it! Unfortunately, such bravado just doesn't work. Those who prescribe such an approach display a grievous lack of knowledge and compassion. The facts are that seriously men­tally ill persons simply cannot, through an exercise of will, get out of the predicament they are in. They need help, encour­agement, understanding, and love. Anyone who has ever wit­nessed the incredible, well-nigh unbearable pain of a severe panic attack knows full well that nobody would suffer that way if all that was needed was to show a little willpower. No one who has witnessed the almost indescribable sadness of a severely depressed person, who perhaps can't even get out of bed, who cries all day, retreats into hopeless apathy, or tries to kill himself, would ever think for a moment that mental illness is just a problem of willpower. No one who has witnessed the bizarre delusions and frightening hallucinations of a schizo­phrenic would ever think that a little willpower is all that is needed to restore that person to health. We don't say to persons with heart disease or cancer, "Oh, just grow up and get over it." Neither should we treat the mentally ill in such uncom­passionate and unhelpful ways.

None of this should be taken to suggest in any way that all persons with mental illness are helpless victims, unable to do anything to help themselves. In many, many instances, sufferers can do something to help themselves and must be encouraged to do so.

5. Mentally ill persons are dangerous and should be locked up.

Sensational and grossly inaccurate and incomplete media reports have conjured up stereotypical portrayals of the men­tally ill as crazed and violent lunatics, dangerous to others as well as themselves. The truth is that the vast majority of people with mental illness are not violent. The great majority of crimes of violence are not committed by persons who are mentally ill, in any generally acceptable sense of the term. In the relatively few instances where mentally ill people do become violent, the incident typically results from the same causes as with the gen­eral public, such as feelings of being threatened or the effects of drugs or alcohol or both.

Furthermore, over the last forty years, as effective medica­tions for mental illness have become available and successful programs of behavioral and cognitive therapy have been devel­oped, it has been shown that most mentally ill people-like those with physical illnesses-can live productive lives in their communities. They do not need to be "locked up." Like every­one else, mentally ill persons who are receiving proper treat­ment have the potential to work at any level in any trade or profession, depending solely on their abilities, talents, experience, and motivation. I need hardly mention, for example, Mike Wallace of the CBS television program "60 Minutes,” who has had several bouts of severe depression but with appropriate treatment has gone on to live an accom­plished life as a distinguished journalist. Similarly, Tipper Gore, the wife of former Vice President Al Gore, has successfully struggled with depression and has courageously chosen to discuss her problems publicly.

6. Mental illness doesn't strike children and young people.

As noted by the National Mental Health Association ("Stigma: Building Awareness and Understanding"), the truth is that an estimated six million young people in America suf­fer from a mental health disorder that severely disrupts their functioning at home, in school, or in the community. The majority of children who kill themselves are profoundly depressed, and most parents did not recognize that depression until it was too late. I reiterate: no one is immune from mental illness.

7. Whatever the cause, mental illness is untreatable.

As mentioned, during the past forty years numerous med­ications, effective against one or more forms of mental illness, have been developed by the multinational pharmaceutical industry. These potent products have proven to be of in­estimable worth to millions. Not that they are perfect, or work effectively and specifically in every instance. Far from it, unfor­tunately. But we are getting closer to the dream of a "silver bul­let" that will zero in on the specific cellular or even subcellular site to correct the disturbances of brain cell functioning that seem to lie at the root of most mental illnesses. Advancements in research on brain chemistry and physiology and on the func­tion of chemical neurotransmitters in the brain are speeding the day when physicians will have available effective drugs that are specific in correcting the biochemical lesion or lesions con­cerned, for the patient concerned, without the deleterious side effects which too often limit the effectiveness of therapy today. I have no doubt that such discoveries, which we are already beginning to see, will result in striking advances in the therapy of mental illness over the next decade. I long for that day to come.

Fortunately, there are a number of non-medication tools that can be used in the treatment of brief or even chronic forms of mental illness. Such therapies most often involve psycho­therapy. Examples include cognitive behavioral therapy (CBT), in which a therapist works with a patient to help him or her understand incorrect thought patterns and to reroute the patient's mental energies along more profitable lines. This therapy enhances the patient's potential to endure or possibly recover from a bout of mental illness. Supportive therapy, in which the therapist focuses on providing hope and encourage­ment for the patient, is yet another useful form of non­medication therapy.

Tragically, the myths surrounding mental illness impede understanding and foster bias, prejudice, and social stigmati­zation against those who suffer from this grievous problem. At times, individuals burdened with mental illness may victimize themselves by believing these myths, further intensifying their despair. Dispelling the myths requires their replacement with truth and proper perspective. With knowledge and understanding come love, acceptance, and empathy. These things enhance the ability to endure and foster hope. May God bless us to love all His children; to abandon none; to bear each other's burdens; and to lift up, strengthen, and dry the tears of those in pain and suffering.

 (Chapter two: Myths and Misconceptions from the book Valley of Sorrow: A Layman’s Guide to Understanding Mental Illness. © Deseret Book, 2003.)