Myths About Mental Illness

Introduction
        In the Book of Mormon (2 Nephi 5:27) we read that the Nephites, who had, at least in the aggregate, been obedient to God's laws, "Lived after the manner of happiness." What a wonderful and insightful thought: if we are obedient, and follow God's commandments, we will be happy regardless of our circumstances. It sounds like a description of a cause-and-effect relationship, and so it is, or can be. There is plenty of evidence in the clinical literature that amidst all of the problems of life, faithful, believing and behaving Latter-day Saints live, in general, happier and more productive lives than those who squander their time and talents in hedonistic self-gratification. It is important to understand, however, that happiness does not imply the absence of adversity. Indeed, it would be unwise to think that one can go through life without facing trials and tribulation. Every family-indeed every individual-experiences temptation, opposition, suffering, difficult trials which test faith and endurance. One of the great purposes of mortality is to prove our worthiness to receive the choicest blessings of our Heavenly Father through faithful endurance to the end, amidst all of the afflictions life brings to us. No mistake about it, adversity is part of God's plan for His children. "For it must needs be that there is an opposition in all things" (2 Nephi 2:11).
        Among the most painful-and often protracted-trials an individual or family can face is that of mental illness. By mental illness I do not mean the temporary, transient social and emotional concerns experienced as part of the normal wear and tear of living. Included in that category would be the temporary depression associated with the death of a loved one, or the anxiety felt when starting a new job. By mental illness I mean a disorder that causes mild to severe disturbances in thinking, perception and behavior. If such disturbances are sufficiently severe, and of sufficient duration, they may significantly impair a person's ability to cope with life's ordinary demands and routines. They may even threaten life itself-as in severe depression-or be so debilitating that the sufferer is unable to function effectively as an individual or productive member of society. Specialists in the field of mental illness count five major categories of mental illness. They include: Anxiety Disorders (phobias, panic disorders and obsessive-compulsive disorders); Mood Disorders (depression and bipolar disorder); Schizophrenia (a serious disorder that produces hallucinations, delusions, withdrawal and impaired reasoning); Dementias (a group of disorders, including Alzheimer's Disease, which lead to declines in mental functions, including loss of memory and of intellectual skills); and Eating Disorders (Anorexia Nervosa and Bulimia, both of which are serious and potentially life-threatening disorders).
        As one would expect, there is a continuum between social and emotional concerns, which are transient and result (presumably) from the ordinary stresses and strains of life, and mental diseases, many of which are believed to be caused by biological factors, including chemical imbalances in the brain. A case in point: sadness-as occurs as part of the grief of losing a loved one, on one end-and deep, continuous feelings of utter hopelessness, perhaps leading to suicide, on the other. Indeed, about 15% of severely depressed patients kill themselves.
        Though medical science has made marvelous progress in the last century in solving some of the mysteries of the brain, the ineluctable truth is that knowledge in this vital and immensely complex area is still in its infancy. Although generally accepted hypotheses are beginning to emerge, we still do not know exactly how the brain works, nor exactly how and why parts of it may malfunction. One thing is certain, however: mental illness touches us all. More than one in five Americans experiences mental illness in a given year, and one in four Americans has a family member with a mental illness. No individual, family or group is immune. Furthermore, we are learning that many mental illnesses result from chemical disorders in the brain, just as diabetes results from a chemical disorder in the pancreas. That being so, many mental disorders can effectively be treated medically-in some instances more efficaciously than physical illnesses like heart disease.
        Why then is there still such misunderstanding and fear surrounding mental illness? Why do silence, ignorance, alienation and prejudice concerning mental illness continue to abound? Why is it so hard for so many to give up outdated and downright wrong ideas about mental illness and see it for what it really is, the mental analogue of physical disorders?

Myths and misconceptions
Myths and misconceptions about the causation, 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
        Make no mistake about it: 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 consequence or 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 and accepting Christ as his or her personal Savior.
        The power of sin to torment and harrow up the soul is vividly exemplified by the words of 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. . .1 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 36:12-16).
        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 heath 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, however, it must be emphasized that in many instances aberrant thoughts, actions and feelings result from mental illness and not from sin. They come from disease, not transgression. They are not God's way of punishing the sinner. To assume they are is not only overly simplistic, but also contrary to the teachings of the 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.
        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 pain, anxiety and burdens involved without loving acceptance or understanding from others. I assure you that Church leaders are in no way exempt from the burden of mental illness of biological origin, either as victim, or as family member. In the geographic area of every ward 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 many and painful-can only be lifted by love, understanding (both intellectual and spiritual) and acceptance.
        The other day, for example, I met a man, a gifted physician in his mid- 40's, who began about five years ago to exhibit the intense and painful mood swings of bipolar disorder. His problem is disease, not sin. Fortunately, he now is receiving medical treatment for his malady.

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 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 not to give the devil credit for everything that goes awry in the world! Generally speaking, the mentally ill do not need exorcism; they require therapy and the hands of skilled health care providers; and love, care and support from everyone else.
        Most often, in their lack of understanding about the causes of mental illness, victims blame themselves, and many seem unable to rid themselves of terrible though undefined, feelings that somehow, someway, they are the cause of their own pain-even when they're not. Parents, spouses, or other family members too often harrow up their 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 to be forgiven of. 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.
        Ascribing blame for mental illness causes unnecessary suffering for all concerned and takes time and energy which would better be used to increase understanding of what actually is happening-to get a complete assessment and proper diagnosis of the illness involved, understand the causations-often ultimately, changes in brain chemistry-get proper medication which will help control the disorder by reversing those chemical changes and learn behavioral and cognitive techniques that are part of the healing process. As victims, loved ones, and all the rest of us increase our understanding, 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 much personal experience, that they do inestimable good. I know too that final and complete healing in mental illness or any other disease comes through faith in Jesus Christ. In any and all circumstances, in sickness and in health, in good times and bad, our lives will improve and become richer and more peaceful as we turn to Him. "Come unto me, all ye that labour and are heavy laden," He said, "and 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" (Matt. 11:28-30). He and only He has access to 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 not 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, be careful to ensure, insofar as possible, that the health professional concerned follows practices and procedures which are compatible with gospel principles.

4. Mentally-ill Persons Just Lack Will-Power
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 get on with life." Those who believe that way 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 or retreats into hopeless apathy, or tries to kill himself, would ever think for a moment that mental illness is just a problem of willpower. We don't say to persons with heart disease or cancer, "just grow up and get over it." Neither should we treat the mentally ill in such an uncompassionate and unhelpful way.

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 reasons as with the general public, such as feelings of being threatened, or excessive use of drugs and/or alcohol.
Furthermore, over the last 40 years, as effective medications for mental illness have become available, and effective support programs 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 receiving proper treatment have the potential to work at any level in any profession, depending solely on their abilities, talents, experience and motivation. I need hardly mention, for example, Mike Wallace of the CBS-TV program, "Sixty Minutes," who has clinical depression but, with appropriate treatment, has gone on to live an accomplished life as a distinguished journalist.

6. Mental Illness Doesn't Strike Children and Young People
As noted by the National Mental Health Association, 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 40 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 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" which will zero in, at the specific cellular or even sub-cellular site, to correct the chemical imbalances which seem to lie at the root of most mental illness. Research on brain chemistry and physiology, and on the nature, location and effects on mental and physical function of chemical neurotransmitters in the brain, is speeding the day when physicians will have available effective drugs which 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 advances, which we are already beginning to see, will result in striking advances in the therapy of mental illness over the next decade.

Conclusion
I hope these few remarks about some of the myths surrounding mental illness can help us all build understanding and rid ourselves of stigma and bias about this important problem. With knowledge and understanding comes love, acceptance, empathy and enfoldment. May God bless us to love all His children, to abandon none, and to lift up and strengthen those in pain and suffering.

Personal testimony.

In the name of Jesus Christ, amen,

April 19, 2001