Love Thy Neighbor

“Can I ask you about your experience with mental illness and the church?” I asked my friend. I’ll call her Barb.

Barb agreed, but she added, “I’ll probably swear.” I wasn’t surprised, based on the little I’d already learned about her struggle with PTSD.

When I asked this question, she immediately thought of last January, when she tried to commit suicide and landed herself in the psychiatric ward. Barb’s experience in this ward forced her to realize how important community is for her, because isolation only fed her suicidal ideations.

“You feel so alone and you’re in this ward with a bunch of crazy people,” she described. But even in a mental hospital, people gravitate toward each other. Some of the patients, the mostly functioning ones, formed a group and called themselves “the norms.” Barb laughed, thinking about the crazier people, like the one who shouted death threats and the woman who likely had rabies. “I found community there, but it was a very temporary, very weird community because it’s like, we’re all in this awful situation…and you still cry yourself to sleep at night ‘cause it’s just lonely and sad.”

Daily visiting hours, though very strict, ensured that Barb still connected with people who knew and loved her. “When I get low, my instinct is to implode and hide,” she explained. “[But] we’re designed to be in community.” Emailing her pastor, asking him and his wife to come and visit, went against these instincts, but Barb prevailed. Yet their response discouraged her.

To be fair, her pastor did agree to visit, just as his whole family became sick, and thus the visit never actually occurred. But the Sunday she returned to church, the pastor seemed too busy to speak with her, surrounded as he was with others, and his wife barely spent ten minutes talking to Barb. Attempts to set up another meeting kept falling through, since the pastor and his wife were too busy. In addition to meeting with the pastor, Barb wanted to speak to the church about her struggles, hoping to find the community she knew she needed.

“I realized in January that I have to be honest,” Barb told me. “Saying the words is kind of my check on myself. Because otherwise I won’t let anything show.” It’s her form of accountability, and her church family was logically the place to start, particularly because the church had previously rallied around another congregant who had cancer. Since the church was small and close, Barb wanted to go before them during the service and say, “I’m broken, please pray for me.” But she never had the opportunity, and she had the feeling that the pastor and his wife did not like the idea.

“When you’re suicidal, or at least when I’m suicidal, one of the big things is feeling worthless,” she said me as we sat on the floor of her room, finding comfort in the numerous pillows. “Like, no one would really be affected if I wasn’t here. No one would care that much. And then also feeling like you’re being a burden, because you’re making a fuss.” When her counselor sent her to the ER, Barb tried to convince the doctors that she was okay, and they should let her go, but the doctors refused.

“There’s something very validating about having a whole bunch of doctors say, ‘You need to either sign yourself in or we’re going to [admit] you involuntarily.’ Because you realize, ‘Oh, this is a big deal and I do need to take care of it.’” But her pastor and his wife seemed to refuse to acknowledge her struggle. They didn’t want to address it, and they didn’t see the need to address it. That may not have been their intention, but that’s the way Barb interpreted their actions and words, because they didn’t take the time to focus on her struggle, to love her as a sister in Christ. This dismissal isn’t limited to Barb’s experience, either. LifeWay Research claims that “mental illness remains [a] taboo topic for many pastors.”

The lack of support is one reason she quit attending that particular church, but she also can’t handle church anymore. A room with that many people, even in a small church, can be harmful for her because of her PTSD diagnosis. Though PTSD is often associated with military veterans, it actually develops from a variety of traumas. For Barb, it is the result of childhood abuse, but even she had trouble getting past the stereotype.

“It took me a long time to even agree with my counselor that that was my diagnosis because I felt like I hadn’t earned it,” she said. She didn’t engage in military combat, but her situation was a different kind of battle, one she still fights today. This battle means refusing to see her father again, despite her mother’s attempts to dissuade her. It means enduring panic attacks regularly and suffering in large crowds, like those at church. Most people can’t imagine why. Even I am not able to put myself in Barb’s place. I can walk through the grocery store without any anxiety. I can attend massive conferences at my college without thinking about it. Sitting in a seat, surrounded by thousands of people and the roar of every one of them talking is not a problem for me. But Barb has a hard time just going to church.

I think about chapel, which my school requires us to attend three times a week, and the auditorium’s stressful atmosphere for people with PTSD. Bodies pressing in, voices echoing in your ears. Yet my college also repeatedly emphasizes the need to come to chapel, to find a home church and attend every Sunday. I understand the importance of this, the necessity of community, but Barb can’t attend, for her own health. What other option does she have?

Her PTSD interferes with more than just church and large gatherings. Sometimes she has to walk out of class because of a panic attack, which are all too regular in her life. She even has a designated spot where she goes on such occasions, which means that multiple people have found her huddled in the stairwell, trying to breathe. Most of the time, the stairwell is empty and quiet, the perfect place for a meltdown.

“I do not want people around me. More than two people is going to make me more overwhelmed, and I’m going to start panicking,” she explained. Where else can she find solitude on a busy college campus? Sometimes people do stumble across her, however. On one such occasion, the person felt the need to lecture her, as it felt to Barb, for fifteen minutes about how she is a princess of God, and she should have more faith. He meant well, but his point didn’t matter much when she couldn’t breathe. From that day on, she has experienced an awkward tension when she sees him. He asks if she’s OK, and she’ll tell him she is even when she’s not, because his actions have proven that he can’t be trusted with her struggles.

Another person posed a different problem. She was again hiding in the stairwell, watching SNL videos on YouTube and trying to breathe, when a professor, knowing what was happening, banged the door open and abruptly asked, “How’re you doing?” Suddenly, despite her sensitivity to loud noises and the fact that she was the one in crisis, she felt the need to make him more comfortable. Though he wanted to make sure Barb was all right, he simply didn’t know how to respond to her panic attack, and that made it much more difficult for her in that moment. It’s obvious when watching people that some are more capable in certain areas that others, but how often does Barb encounter a Christian who is able to handle the situation?

I think back to the one time I have seen Barb in the middle of a panic attack. The woman at the chocolate shop, who we’d made friends with previously, responded beautifully. She just asked if Barb needed anything and provided it without panicking herself. Hearing my friend talk about her other experiences with frustration and hurt, I can’t help but think about the commandment to love our neighbors. This includes the ones suffering from mental illness. But we don’t know how. We teach people how to perform CPR, we know to do the Heimlich maneuver if someone is choking, but how many people know how to respond to a panic attack? I asked Barb for some practical steps to take, since I don’t know myself, and she gave me a simple yet comprehensive rundown.

The key to dealing with a panic attack is communication. If they can respond, they probably won’t need an ambulance. But if they are unresponsive, someone should call 911. For those like Barb, who is familiar with panic attacks, simply asking what they need, which could be something as simple as water, is helpful. Offering to count their breaths is a very important way people can help, providing a way for the person panicking to focus their breathing and get it under control. Space is also essential to consider. Crowding a person generally makes things worse, so keeping everyone away except for one or two is critical.

“Let them know you’re there and that you’re praying for them and you’re not going to leave them… Tell them that they are doing nothing wrong,” Barb adds, because they might try to apologize for their own crisis. These actions are easy to remember, but not many people know them. In fact, the people who can’t respond well to Barb’s panic attacks represent a large majority who don’t know the proper way to help someone when they’re suffering a crisis. Christian culture reveals an ignorance of mental illness beyond poor responses to immediate crises. While the rest of the world realizes these are major issues, Christians can’t seem to reconcile depression and suicide with the abundant life Jesus promises to his followers. It’s as if, somehow, life as a Christian shouldn’t involve prolonged struggles like mental illness unless they’re doing it wrong.

Once, when Barb was riding to church, the driver of the car was playing a Christian radio station. The topic was depression, and one caller felt the need to say, “I think they just need to focus more on Jesus.” And the host, instead of acknowledging that clinical depression is very real, responded, “There you go.” I know from my own experience with depression that focusing more on Jesus is not a solution that miraculously fixes the situation. To Barb, this exchange discouraged her immensely, because it dismissed her problem as not a big deal or just a lack of faith.

When Barb, suffering from grief and PTSD and depressive tendencies and suicidal thoughts, comes to a service and the congregation sings about victory in Jesus, it is not encouraging or honest about her situation. In fact, she endured three months where she couldn’t sing, because victory was so far from what she felt. I’ve experienced the disconnect between what I’m singing and what I’m living even on days when I am absolutely exhausted from work or homework. When I arrive at chapel and the worship leaders want us to sing an upbeat song I’ve heard before at high school retreats, my attempt to sing it genuinely turns into a false reality. If I have no capacity for it when I am simply tired, how much more is that true for those suffering from depression and such mental illnesses? The problem doesn’t end with songs either. We love to talk about Philippians 4:4 and claim that we need to be rejoicing at all times, but the ways that we frame this discussion can be detrimental to some people.

“If you’re not in the joy of the Lord, you’re failing. That’s the rhetoric I was brought up on,” Barb shared with me, and I can sympathize. How can we love our neighbors if we don’t acknowledge grief and despair? The Bible commands us in Romans 12:15 to weep with others, not just rejoice, and we can’t weep together if we don’t share the pain. As Barb has discovered from experience, we need to live in community or we will suffer the consequences. This means speaking honestly and accepting the honest experience of others. But the cultural stigma surrounding some problems makes vulnerability hard.

Barb has a friend named Jo, who’s a full time missionary suffering from depression. Jo is very open about her depression and the fact that she’s medicated for it, but her sending missions board was not happy about her honesty. They even thought about not sending her back and requesting her to delete her social media account. When Barb first considered speaking publicly about her struggles through a blog, this is the kind of response she feared. Her determination overcame that fear, but she knows that there will likely be backlash when she does share, and some mission agencies may not want to work with her. Jo’s example, however, has encouraged Barb.

“God’s still using her,” Barb said, reflecting on Jo’s ministry in Malawi. Jo reminds Barb that she isn’t alone in her struggle. She doesn’t need to be perfect to still engage in ministry. I’ve definitely felt the weight of that false reality, because no one wants to talk about their struggles, to admit that not everything is all right. It’s a strange cycle: the people who suffer try to hide it, because they think they need to be fine, and no one tries to find out if they really are fine, which just perpetuates the problem.

“We as a church…need to be more proactive about reaching out to people with mental illnesses because they [generally can’t ask for help],” Barb insisted, and I agree. When I stood on the other side of a major depression episode, all I wanted to know was why no one had bothered to see how I was doing. I realize that they probably didn’t see the problem, since I was determined to hide it, but that only made me agonize more. Didn’t anyone care enough about me to sit down and find out what it going on in my life, regardless of whether it seems to be going fine? I don’t believe people didn’t care, but I do think they never tried to understand what was happening because we don’t know how to have these kinds of conversations.

The inability to have open discussion is a major problem in the church. We don’t often make room, make space, for people with mental illness or even those going through a tough time to share about their lives.  Not to educate us about their illness, because it isn’t their responsibility to teach others. When Barb is actively suicidal, she’s barely staying afloat. She’s just trying to stay alive, and she doesn’t have the time or energy to educate people about what’s going on. The church should reach out those suffering from mental illness, fully prepared to wade into the mess. We need to make time for these conversations and stop expecting people to respond with “Fine” when we ask how they are. We might actually believe they are fine, but more people struggle with mental illness than we would think. In fact, the National Institute of Mental Health and other researchers suggest that nearly one in every five adults in America, almost 45 million, suffer from mental illness a year. How many of them sit in a church every Sunday and feel as if they must hide their problems?

Barb owns a shirt that attempts to demolish the limitations people sometimes put on the definition of “neighbor.” “Love thy neighbor,” it proclaims. “Thy homeless neighbor, thy Muslim neighbor, thy black neighbor, thy gay neighbor, thy immigrant neighbor…” I’d like to add another neighbor to this list: love thy mentally ill neighbor, the one who suffers from large crowds and panic attacks and depression and suicidal ideation. Love them by trying to understand their illness and investing in their life. Love them by taking the time to listen to what’s actually going on. Love them, because their mental affliction does not comprise their worth. The only way these suffering neighbors will continue to stand is through the borrowed strength of a community who loves them.