Mental illness. It’s not something Chris­tians like to acknowledge or talk about openly, but it is an issue we perhaps need to think about, because Christians are no more immune to manifestations of this illness because they are Christians, than they would be immune to cancer or dia­betes because they are Christians. When the world was cursed, the brain was not exempt, and in practice it means that some people will be more vulnerable to mental illness simply because of the way their particular brain works – its thought patterns, its processing rate, its inability to understand the world rightly, and some or all of these factors exacerbated by the sinfulness of the heart. What I call the Big Ones – Schizophrenia, Bi-Polar, severe depression, for example, are hor­rific illnesses. They are not something we would wish on anybody, least of all on our loved ones.

Recently our daughter experienced a psychotic episode. They called it a “mixed affected state”. We’d never expe­rienced anything like this before, although we knew she had lived through numerous times of depression, usually characterized by intense activity followed by a period of lethargy. Always she had come through – in time – although over the past few years we did wonder if it was getting worse. No matter, we thought. By the grace of God we would cope, as we always did. And then the unthinkable happened and suddenly we were totally out of our depth. It caught us by surprise and we were completely unprepared. Hence this article, for there is nothing new under the sun, and what we ex­perienced will be similar to what many others have gone through, and if you think you might be vulnerable or know somebody who is vulnerable, you need to be aware – at least more aware than we were.

We had noticed in the past that M. (daughter) frequently went through a hard time when something went wrong, when big changes occurred, or when something happened that she didn’t know how to cope with. It caused stress. Big time. This last situation was also triggered by a major stress issue of greater severity than ever before; we kind of expected her depression phase to happen and were waiting for the usual intense activity to “kick over” into the lethargy state, but this time it didn’t. She withdrew from everyone, spending most of her time outside in the garden swinging on the seat. She didn’t get out of her PJs for three days, and at that stage, we thought, we HAVE to take her to a doctor. She needed help and we were pretty desperate ourselves. The doc­tor said she seemed “a bit flat” and pre­scribed Arapac, which the Pharmacist assured us was extremely com­mon – “Lots of people are on this”. ‘At last’, I thought. ‘Maybe things will start picking up now’. Two days later it was murder. Our usually quiet daughter was scream­ing at the top of her voice, banging the table with both fists, telling us that she hated us and to leave her alone. Then I rang a Christian counsellor I knew who said we really needed to take her to a psychiatrist. “GPs,” she said, “are not trained enough in the kinds of drugs and their effects, whereas a psychiatrist specialises in both mental illnesses and their treatments”. Then I rang our pastor, who fortunately had had experience in this area, and he suggested calling in the crisis team from the hospital, who would come to our house if necessary and make an assessment. Our pastor’s wife also had good advice. “Just trust them”, she said. “These people are trained and they know what to look for. They know what they are doing. Trust them. The Lord uses these people.” Those were words I needed to hear because I didn’t trust the state or the medical profession one iota; and if they took what our daughter said seriously our whole family would be up before the courts and answerable to all sorts of accusations. In desperation I rang the doctor back and said I was calling in the Crisis Assessment Team and then rang Mental Health. Wonder of wonders, there was a “highly unusual” cancellation and I could bring M. down.

Our pastor’s wife was right. These people were totally unfazed by what was coming out. I told them that she had been on Arapac for two days. The conversation after a time ran something like this:

“It sounds like you have lots and lots of thoughts going round in your mind at the moment, M. Is that right?”

“Yes”.

The psychiatrist turned to me and told me to cease Arapac immediately – it would be making the symptoms worse. He was certainly right on that count!

“Do you hear voices, M?”

“Yes”.

“Tell me about them”.

“They are all black”.

That, he said, was ‘highly significant’. They prescribed an anti-psychotic drug which he said would slow the brain down and begin to sort out the jumbled thoughts.

Home we went, and gave her the new drug. Four hours later she was taken to hospital in an ambulance, after suffer­ing a reaction which almost looked like a fit and in which she seemed to lose consciousness.

The cry of my heart was ‘Lord, how much more are You going to ask us, and her, to bear?’

The Psych team saw her the next day and she came home on Lorazapam, which is a sedative, and a sleeping pill to help her get a good night’s rest. At 3:00 am she was awake, and she stayed awake till morning, terrified, whimper­ing, and all I could do was stroke her and softly assure her that she was OK, she would be all right, and that noth­ing could hurt her. It was one of the most horrifying experiences I’ve ever endured, seeing somebody we loved so much undergoing such agony and being unable to help.

Next day, another psychiatrist came with another nurse and they talked again with M. and found more evidence of psychosis – voices, hallucinations, jumbled thoughts. So they prescribed another drug, this time in a very low dose since her brain was “very sensitive”; probably, they thought, due to a mild intellectual disability she had had since birth. This time, it worked. Thoughts started unjumbling. The extreme fear and hyperactivity disappeared. M. started smiling again. Yes, there is a long road ahead, but the first steps had been made, and at last the pit had a shaft of light shining in the darkness.

So how do you handle psychosis in the family? Many people don’t want to know. And yet, in one of her lucid mo­ments, M said to the psychiatrist and the nurse, “I don’t think I’m making sense. You must meet some strange people in your work.” The nurse smiled. “Not really”, she said, “One in four people in New Zealand suffers from mental illness at some time in their lives”. ONE IN FOUR. Translate that into the church community. That means 25% of families and victims have to come to terms with this and deal with it.

What is psychosis? Baldly and very simply, it’s insanity. It is a time when the imagined world of the mind, usually horrifying, becomes more real for the person than the real world. Insanity is a defence in law, because the person is not responsible for what they are doing, or thinking. (That is one reason why it is wise not to talk to a person recovering from a psychotic episode about what they said and did during that time. They probably will not remember it, and to tell them will only compound their guilt, to no purpose.) When a person is hearing voices in psychosis it is vital they get help, because without it, the voices become more and more demanding, and can end with the person taking their own lives, or harming someone else, all the while genuinely believing they are doing a good deed.

When a person is in a psychotic state, you can’t argue or reason with them because the brain is not able to think logically – all you can do is gently soothe, reassure, or if a person is in a paranoid state, perhaps not say anything at all! M. said it felt “as though her brain was fused together”, and that is probably a good illustration, because what are usu­ally separate thoughts and events become completely jumbled.

What causes psychosis and/or mental ill­ness? There can be a number of things. Firstly, genetics can play a part. If your family has a history of mental illness, you are likely to be more prone to it. In our extended family, there are two diagnosed cases of bi-polar (disease). One of my cousins – a Christian with Christian children – had one of his sons commit suicide after suffering from prolonged, severe depression. How can relatives come to terms with something like that? It seems that our families carry genes which could make us more likely than others to develop mental illness at some time in our lives. Then, some people are just more vulnerable – their nervous systems are more highly developed than others. It’s no accident that the words “lunacy” and “lunatic” came into being – the full moon can aggravate or overload a sensitive system and pull it down. And for women, the psychiatric nurse told me, hormones can also play their part. The human body is incredibly finely tuned, and if something like hormones get out of balance it can wreak havoc with the nervous system and the brain.

Misuse of drugs and alcohol can also cause psychosis. People are such a com­plicated mixture of genes, backgrounds, abilities, experiences; and every person is unique. One of the psychiatrists told us that in the early stages of treatment it can very much be “hit and miss” until they find the right drug which works, because every person is different and presents differently. They are barely scratching the surface of how that complex mechanism, the brain, actually works. It is one area of medicine where there is still so much to discover, and it is so important to have Christians work­ing in this area because Christians bring their spiritual understanding to the mind and the person. We are more than blobs of gunk that just happened to come together over time and space.

What about treatment? Quite frankly, I am very thankful for anti-psychotic drugs. Not too far in the past, our daughter would have progressively worsened and ended being locked up in an asylum. “Bedlam” was one such institution, and the word conjures up a horrific set of associations. As far as I understand, drugs are administered because of the Dopamine theory, in which various receptors in the brain are blocked off to stop the electrical signals being received from neuro-transmitters. The brain usually does this itself naturally but sometimes these signals and receptors can go into overload and connect far more often than normal. Alcohol and drugs like marijuana can also interfere with the normal processes of the neuro-transmit­ters and their receptors. For a psychotic person, it is like an explosion has gone off in the brain. When confronted with such intense suffering, it is wonderful that there is a way to alleviate it. The scriptures say. “Give strong drink to him who is dying”. Drugs alleviate pain, and in the right circumstances we should use them.

However, all these drugs have powerful side effects. We have to decide whether the side effects are better to live with than what would happen if we were to come off the drugs. After a psychotic episode, most people are on medication for between 1-3 years. It is interesting that with mental illness, a number of people feel so much better on the drugs they try and take themselves off them, possibly because the side effects are unpleasant, but also I think because there is some stigma, some sense of weakness or inferiority associated with mental illness than other diseases. Why would someone with heart disease suddenly decide he feels so well, he’ll stop taking his blood pressure tablets? Or someone with diabetes, stop taking his insulin? Most people with those illnesses take their pills because they know without them, they would be in trouble very soon. The same is true with mental illness. Mental illness is no respector of persons. Bi-Polar (disease) can strike very talented people (like Stephen Fry). Winston Churchill called his depression, “The Black Dog”. Sufferers may need encouragement at times to accept themselves the way they are and even live with the stigma if necessary, if they have to take ongoing medication. Sometimes terrible damage has been done in people’s lives through trying to get people off medication when they are not ready for it. They might never be ready for it. It is not only the person themselves, but their families who suffer as a result. Jesus knows all about stigmas and do they worry Him? Not at all! If you are struggling with this issue, think about Jesus. That same Person who reached out His hand to touch an outcast leper, spoke for a considerable time to a Samaritan woman (Jews hated Samaritans and didn’t regard women highly either. This woman, moreover, had had five husbands and was currently living in sin with another man!), ate with the hated tax collectors, accepted the ministry of a prostitute, and welcomed children when the disciples wanted to send them away. I have no doubt at all He would stretch out His hands to those of His children who suffer from mental illness and surround them with His unconditional love and tenderness. I think they would be special to Him because of their vulner­ability and helplessness. Jesus came for those who were sick and couldn’t save themselves. He loved outcasts!

As well as treating the physical symp­toms, however, it is vital with psychiatric illness that the spiritual issues are also dealt with. This is where Christian coun­selling comes into its own. Edward T Welch in his excellent book, Blame it on the Brain? says that psychiatric problems are always spiritual problems and sometimes physical problems.

You will never find a psychiatric problem where biblical counsel – counsel directed to the heart – is anything less than essential. At the very least, psychiatric problems usually indicate that the diagnosed person (and the family) is suffering in some way. And on the problem of suffering, Scripture is the expert. Through it, God offers hope, compassion, and the power to grow in faith and obedience in the midst of suf­fering. For families, it provides practical guidelines on how to love and serve the person who is struggling. p.106

The psychiatric ward in the hospital is filled with people who have suffered and they have not been able to cope with it – suffering from broken relationships, job loss, bankruptcy, failure, abandonment, loss, guilt. Something traumatic happens and they end up over the edge. Good Christian counselling will help the Chris­tians in this situation understand where God is, His presence in their lives, and His purpose for their future.

Families suffer along with the victim. We have to deal with our anger, despair and a sense of helplessness. The person may well accuse us of terrible things, but we need to constantly remind ourselves that this is NOT the person we know and love. It is the illness speaking. Like blood flowing from a wound, the words are the symptom that there is something dreadfully wrong that needs attention. We need patience. This situation is not going to change overnight. Change it will, but maybe not any time soon. I remember one of the nurses saying to me, “Look. I’ve been in this business for over 20 years and I can assure you that your daughter WILL get well.” How I needed to hear that! But it takes time. Just like a person after a major operation will take time to heal. For some reason the brain takes longer, perhaps because of its complexity.

Someone who experiences mental illness will always be vulnerable in the future, because like a cancer in remis­sion, it can come back at a later time. So the sufferer and his or her family need to be alert to possible signs of recurring illness and take steps to deal with it as they arise. With suffering comes intense periods of learning and blessing. Sometimes it is easy to forget that! Yet, having experienced what we have, we have also been richly blessed by the love and caring of those in the church. Every two or three days my sister-in-law would ring and ask, “How’s it going?” Offers of help, loving concern, and above all, prayer, kept us going through the dark times. There is nothing like family and church in time of need. I praised and thanked God that people were there for us. What was especially precious was when people shared their own suffering with us, their struggles with depression, their living with the pain, their faith in God. I could see that we were not alone, and in sharing one another’s burdens we fulfilled the law of Christ.

Christians are also a witness through their suffering. The nurses said to us that our daughter was “lucky” to have such a family where she was loved and cared for. So many people don’t have that these days. Sometimes the affliction is so great and so hard to live with, families may turn their backs and the ill person has nowhere to go and no one to turn to. When illness like this strikes it can be a wonderful opportunity to show the world that we have the love of Christ in our hearts. However imperfectly, it is there and it grows by His grace. Suffering is a sterling means of growth, because we have to rely on His strength, not our own.

God has His hands on our lives, and we can rest in His care knowing that one day this world, with all its suffering and brokenness, is going to be no more. Then our once mentally-ill loved ones will see us in heaven, and they will be whole, perfect, pure, and glorified, along with all others who call upon His name. The tears then, will be tears of joy.

In the meantime, we walk the path in faith.