Mental Illness as a Spiritual Issue: A Reflection on Matt Walsh's post about Robin Williams

I read Matt Walsh's blog post "Robin Williams didn't die from a disease, he died from his own choice," and I wanted to hate it. Ok, well, I hated most of it. I vehemently disagree with most of what he wrote, and find parts of it far too shaming of people who die by suicide. In fact, I don't particularly like most of what he writes on his blog in general. We just don't line up politically, and that is fine.

I don't think arguing with him is the best course of action, but I do want my own readers to know where I stand on the basics of some of what Walsh said.

I disagree with Walsh where he says:
"First, suicide does not claim anyone against their will. No matter how depressed you are, you never have to make that choice. That choice. Whether you call depression a disease or not, please don’t make the mistake of saying that someone who commits suicide “died from depression.” No, he died from his choice. He died by his own hand. Depression will not appear on the autopsy report, because it can’t kill you on its own. It needs you to pull the trigger, take the pills, or hang the rope. To act like death by suicide is exactly analogous to death by malaria or heart failure is to steal hope from the suicidal person. We think we are comforting him, but in fact we are convincing him that he is powerless. We are giving him a way out, an excuse. Sometimes that’s all he needs — the last straw."

I think this is too simplistic a look at the disease of mental illness. I do believe mental illness is very much like cancer, and that the disease has the ability to take over our mind enough that we do not have a choice. Just like cancer can progress so far that no amount of radiation or treatment will save a person, the mind can be so compromised that people can no longer save themselves. I have seen people get at that threshold. The mind can break, just like any part of the body can.

Our mind is what controls everything. Our mind controls our ability to choose, and if the mind is ill enough, then it makes sense that such a choice may at some point become unavailable to us. From Williams' recent stay in rehab, we can tell that he was reaching out. He was trying to intervene with his illness early enough and trying not to get to that threshold where suicide would claim him against his will. We don't understand mental illness enough to know if a person is safe being left alone for five minutes, or not. We don't have a test to show how broken the brain is at any point, and if a person is at risk of death by suicide. Death by suicide is not an "excuse." Talking with compassion, rather than shame as Walsh's post does, about people who have died by suicide does not increase the incidence of it. Having a compassionate stance on death by suicide, just like we have with death from other illnesses, gets us talking about it. This allows people to know that it is safe to reach out before their mind has completely shut down so that they have more of a chance of recovery.

I could go into more details of the other parts of Walsh's post I disagree with, but I think this gives a basic overview: I fundamentally do see mental illness in the same way as other illnesses, and I take a hard, shame-free stance, when talking about death by suicide. (Here is a great post on how mental illness is not selfish.)

Rock balancing, spiritual practice taught to me by my therapist. Photo Copyright Katie Norris.

The one point Walsh brings up that I do think is worth taking a deeper look at is this:
"I can understand atheists who insist that depression must only be a disease of the brain, as they believe that our entire being is contained by, and comprised of, our physical bodies. But I don’t understand how theists, who acknowledge the existence of the soul, think they can draw some clear line of distinction between the body and the soul, and declare unequivocally that depression is rooted in one but not the other. This is a radically materialist view now shared by millions of spiritualist people."

First of all, I know a lot of atheists, and I have ministerial colleagues who are atheists, so I won't even argue how Walsh's definition of atheism that supposes atheists have nothing to do with spirituality is inaccurate. Theist or not, I do think there is a point here that mental illness is also a spiritual issue. I define the spiritual or divine as that which you feel is greater than yourself. For some people the spirit is a personal soul, for others it is God, for others it is the energy of the Universe that created us and holds us all together, and yet for others it is the connection between humans or even our own connection to our deep inner selves. All things are connected, and I would say that all disease is spiritual as well as physical. Most of the world's religions understand there is a connection between mind, body, and spirit. We need to treat all illnesses from a spiritual perspective, as well as a physical one, and that is why I think Walsh does bring up a good point about mental illness being a spiritual issue.

I love the line from the musical, Next to Normal, (about a woman, Diana, with bipolar disorder) where Diana sings "What if the cut, the burn, the break, was never in my brain, or in my blood, but in my soul?" This was referring to the fact that, while she had a lot of medical intervention, part of her illness was triggered by the death of her son, This was a spiritual loss, which her husband refused to address, and which was not a main part of her treatment.

www.owningpink.com

I do think that one of the things missing in mental health treatment is the spiritual aspect, and that is one reason why we have such low success rates for treatment.

I would encourage people to read Lissa Rankin, MD's book "Mind Over Medicine" for a great resource on the current research on how the mind, body, and spirit are connected. It is the perfect mix of how a medical and spiritual model can meld together. I love her "Whole Health Cairn," which depicts stones balancing on top of each other that show what you need for whole health. The stones are housed within a bubble of service, love, pleasure, and gratitude. Many of the "stones" we need to balance for whole health are spiritual, such as the biggest base stone being our "inner pilot light." Rankin says: "Your Inner Pilot Light is that ever-radiant, always-sparkly, 100% authentic, totally effervescent spark that lies at the core of you. Call it your essential self, your divine spark, your Christ consciousness, your Buddha nature, your higher self, your soul, your wise self, your intuition, or your inner healer. The minute sperm met egg, this part of you ignited, and it’s been glowing away ever since."

So yes, I see mental illness as a physical and spiritual issue, and in order to have a good treatment plan, one must work on the spiritual side as well. For each of us that is different. For some it will be a deep belief and connection to God or Jesus, for others of us it will be a focus on spending time in nature. I strongly believe though that all of us need to have a connection with our own inner pilot light in order to heal. You will notice this being important even in Walsh's post, where he says, in struggling with his own depression,: "When we are depressed, we have trouble seeing joy, or feeling it, or feeling worthy of it. I know that in my worst times, at my lowest points, it’s not that I don’t see the joy in creation, it’s just that I think myself too awful and sinful a man to share in it."

If we do not have a connection to our soul, our inner pilot light, our deepest selves, then yes we see ourselves as awful, sinful, or bad. I would say, we feel shameful, as Brene Brown, PhD defines shame as the belief of: "I am bad." In all the people I work with who have mental illness, this is the sticking point, the core belief, that few people seem to understand, and medications have a very hard time treating. I believe this is the extra work, the spiritual work, that we need to do in order to decrease the rates of death by suicide. I also believe this is why we can not talk about death by suicide as a "choice," "excuse," or "selfish." Such shaming talk reinforces the core belief that we are bad, which worsens mental illness. Plus, shame is the opposite of empathy, and as Dr. Brene Brown says, shame cannot survive empathy." So what we really need is an empathetic response to suicide, suicidality, and mental illness if we are ever to help people heal. That is the spiritual work we need to do as a community.

Blessings,

Rev. Katie

P.S. If you or someone you know is suicidal, please reach out. Call the National Suicide Prevention Lifeline at 1-800-273-TALK. I have called, I know many like me who have called, and they help. 

Body Shame Triggers Mental Illness, Body Love Heals

I have a great TEDx talk to share with you all today: "Change Your World, Not Your Body," given by Jes Baker at TEXx Tucson. It is a fantastic talk about how embracing body love is not just good for us personally, but it can have a global positive social impact. One thing I love about the talk is that Jes addresses something that few people talk about in relation to body love- how our culture of body hatred contributes to mental illness.

Mental illness is a two part illness having both chemical and environmental factors that can cause, trigger, and/or exacerbate it. All of the body hatred we learn in our society contributes to the increasing rates of mental illness, and not just of eating disorders. Depression is hugely effected by the relationship we have with our bodies. If you are prone to depression, you do not need the body hatred messages that say you are not good enough, no one loves you because of what you look like, and you do not deserve to have relationships with other people. That increases the depression, loneliness, and isolation.

My cocktail of mental illnesses are highly tied in to my view of my body. In the beginning, I thought that I was depressed and unable to do anything because I was disgusting and lazy, because I was taught by our society that overweight people are lazy and unsuccessful. That contributed to me spending more time trying to loose weight, and less time actually finding the right professional help for my mental illness. My treatment was put on hold due to my body hatred. Jes talks about this in her TED talk, that "We put our life on hold, we stunt it, because of our bodies." This is a huge problem for everyone, but a serious problem for people with mental illness who forgo focusing on mental health treatment because we are taught that the real problem is just that we are fat or ugly. If we just lost the weight or got rid of our acne, we would be happy and successful. In fact, our whole beauty industry revolves around this message, that a happy and balanced life can be obtained by being beautiful.

My husband can tell you that when I have a "bad body" day, a day when I hate my body, my rapid cycling bipolar disorder cycles even faster. Body shame, which teaches us "I am bad, because of my body," is a very dysfunctional message to send to your mind. If we walk around in a state of shame, of believing we are bad, then we are reinforcing negative pathways in our brain. If we keep those pathways going, neuroplasticity says that we will make shameful beliefs about ourselves a pattern, and a reality for us.

If we believe we are bad, our mental health is harmed in many ways.

If we are bad, there is no hope for recovery. If we are bad, there is no hope for a better life. If we are bad, we have no choice and no agency in our lives. If we are bad, neuroplasticity is a lie, treatment is a lie, and we will be sick forever. If we are bad, we deserve to be punished, which leads to body harm for many of us, as it did for me.

Jes Baker and me at her Readers Dinner in San Francisco.

Body shame and hatred also significantly contribute to, or can cause anxiety. If we believe that our bodies are disgusting, need to be hidden, and we do not deserve to be in the world, we will become anxious. Some people become obsessive over choosing what to wear to leave the house in order to be sure that they encounter the least amount of name calling or shaming from others as possible. Many people live in a state of fear of physical violence when they are out in public, because of what they look like. People have been abused to do being thin, fat, for the color of their skin, their acne, rosacea, hair, clothes, and more.

I have a panic disorder that actually was triggered due to body shaming. I have Irritable Bowel Syndrome (IBS) and Lactose Intolerance. When I was just a child, six years old, people used to make fun of me for not being able to go out because I was sick. They mocked my lactose intolerance and said I was making it up. People were relentless in saying that what my body was doing was not real and that I was only trying to get attention. That is body shame of another kind- shaming someone for how their body works. Some professionals have told me that the way to "get over" my anxiety was to learn that no one will make fun of me and most people are genuinely nice. That is not really a world that we live in, when we have a culture that constantly makes fun of bodies that do not work "correctly." I have talked to many people with Celiac Disease who are constantly made fun of. I don't trust that people will be kind if I get sick in public, so I live every day, every moment when I am with others and often even when I am alone, deathly afraid of getting sick.

Embracing body love is essential to good mental health. Body love does not mean only accepting your weight, but everything about your body- how it ages, what it looks like, and how it works. Embracing body love and using that philosophy with the treatments my therapist provides, like Emotional Freedom Technique (EFT), has been very important in the treatment of my mental illnesses and my ability to get well. Plus, I had to accept that my body works differently than most peoples in order to accept my mental illness. I also had to accept my body in my treatment plan, because I was very upset that medications kept making me sick and I could not take them. I was very upset that I had to change the way I ate, slept, and functioned every day because my body (which includes my mind), is "different." If I don't love my whole body the way it is, then I don't follow through on treatment and I get worse.

This is definitely something we need to be talking about more and we need to start changing our world.

Blessings,

Rev. Katie

Depression: When It All Falls Apart

There are no words adequate to describe depression. Unless you have gone through it, you never know what it is like. And there are different kinds for different reasons. Many of us will go through situational depressions in our life that may even last a few years from an illness or grief from loss of a loved one. The depression I am talking about is the one that is a mental illness which just lasts and lasts your whole life. Where you go out in public and you look at other people and wonder how they look so normal. How do they get through their day? Why are they smiling? Is life so excruciatingly painful and hard for them as it is for you? Do they live every moment of every day doing only what they have to do to keep their jobs and not look like a freak? Do they count down the seconds and hours until they can go back to bed and stay there until their next required task comes around? Do they wish they enjoyed time with family and friends? Do they have no motivation to wake up in the morning because they know every day will be agonizing and joyless? Soulless almost?

It is sad to have depression because you wish you enjoyed all the things you love, like family, friends, and work. But when you are depressed you want to spend no time with anyone, doing anything. It can also make you mad that you are required to fake a smile and pretend to be happy just so you don't make other people uncomfortable.

Photo by Jeff Norris

It's also annoying because you do the right things and are still sick. I took the medication, which seemed to be working but the side effects were so bad I had to dramatically decrease the dose and see if I can build up more slowly. Any time you change a dose of medication, it can make your symptoms much worse and so my depression now is extremely bad. Also, my Mom has gotten worse and is now in hospice care so I am sure that is adding to my poor mental state. The problem is that normal sad or scary life events are different for people with mental illness. These events may or may not set off your illness and make it much worse. It is not like you can avoid those situations, but you may have to realize you will have months or years of fallout after stressful life events. Even good events like job change or marriage. And right now I have changed medications, changed jobs, and Mom is dying so I should expect that I will get worse, it's just that every time it happens, you have never quite prepared for it.

You are never prepared for how your illness with rear it's ugly head. For me it's how the depression, mania, anxiety, and eating disorder combine to create depths of despair and hell I didn't think were possible.

So, now when all of those things happen in your life, what do you do about it? You have mental illness and can't just "change your mind," "shake it off," "act happy," or "be different." But that does not mean you are lost. Here are a few tips and I know they are not easy to do, but once you do one, it gets easier and easier to do more:

1.  Remember that it is not always like this. It is not always this bad, there are good moments.
2. Ask for help when you need it and will accept it.
3. If you have not exercised, slept, or eaten correctly in weeks, do one of those things right one day, then two the next. Make one good decision every day that makes you feel better, no matter how small it seems.
4. Tell your illness and whatever other factors contribute to it that they won't win. (I would probably use some more colorful language around that to really be firm about that point.)
5. Write about what is going on, that usually diffuses the situation and helps you see things more clearly.
6. Know that you are loved by God or the Universe, whatever you see as greater than yourself. Get in touch with that Spirit of Love through church, prayer, nature, art, animals, meditation, the beauty of science- anything that gives you the "awe factor" and lets you know you are not alone.

Remember that managing mental illness is a process where you will get better and worse. You just can't give up, and that is the hardest part. You are too precious and too important to this world to give up on and you always need to remember that no matter what your illness makes you think or what other people tell you.

Blessings,

Rev. Katie

Lessons Learned

Wow, I have not written a blog post in two and a half weeks! It may come as no surprise to those of you who also deal with bipolar disorder to know that you can probably tell how I am doing based on how frequently I write. When there is a long spell with no creativity, that usually means I am facing some serious depression, which is what has been happening. I have been feeling better the past couple of days and noticed that this recent bout of depression has taught me a few things. What I wonder is why does it take me so long to learn these much needed lessons? Lessons other people around me are often telling me. I guess because my brain is sick and it just does not work rationally at times.

First I learned that depression will go away and I am not always depressed. When I am depressed I think I have been like that forever and I will remain so until I die. Jeff always tells me this is not true, but I never believe him. Recently my therapist asked me if I could just see the depression as temporary and when it happens just do what I need to in order to get through the day and make sure I still do a few things I enjoy each day. Well, she and Jeff are both right. This does not last forever, and in fact it is pretty predictable when it will happen. It always happens the same week each month and it always happens during big transitions, like moving, which we did a week ago.

The sun will always rise after a depression.

The second thing I learned is that I really need to track my moods better. Since the depression is so predictable, tracking my moods means I could often know before it is going to happen and put in place some extra precautions so that it does not get as bad. I can even mentally prepare myself for it so I do not get into thinking I will be depressed and miserable forever. I can rearrange my schedule to have less to do that week. I can ask for more help. I can make sure I have no excuses not to eat right and exercise.

The last thing I learned is that I am actually sick. You see, despite my blog and all of my openness about my illness, I still revert to thinking I am just a bad and weak person who cannot control herself.  I think I should just be able to stop being depressed, force myself to exercise, and almost beat myself up mentally into being a better person. When I do this, I am not really understanding that I am sick. The reason I can't just force myself to stop being depressed and manic or be as perfect as my husband is because there is an illness in my brain. I am not a bad or weak person. When I recognize my illness and take it seriously then I can plan better for it and use my treatment plan more effectively.

While this bout with depression was pretty bad, I am grateful for all of the things I learned this time. I am hopeful this will allow me to better manage the next depressive episode that comes my way. I am especially grateful for the people who kept helping me learn these lessons even though it took so long for them to stick.

Blessings,

Rev. Katie