I Trust When Dark My Road

Recently there was an article in USA Today about a pastor in the Carolinas who committed suicide. Here’s the article. I would urge you to go and read the entire article, but here is an except:

Those who counsel pastors say Christian culture, especially Southern evangelicalism, creates the perfect environment for depression. Pastors suffer in silence, unwilling or unable to seek help or even talk about it. Sometimes they leave the ministry. Occasionally the result is the unthinkable.

Experts say clergy suicide is a rare outcome to a common problem.

But Baptists in the Carolinas are soul searching after a spate of suicides and suicide attempts by pastors. In addition to the September suicide of David Treadway, two others in North Carolina attempted suicide, and three in South Carolina succeeded, all in the last four years.

Being a pastor — a high-profile, high-stress job with nearly impossible expectations for success — can send one down the road to depression, according to pastoral counselors.

For the most part the article is really quite good in nailing the problem. One sentence in particular really grabbed me:

Society still places a stigma on mental illness, but Christians make it worse, he said, by “over-spiritualizing” depression and other disorders — dismissing them as a lack of faith or a sign of weakness.

Isn’t that the truth! Christians are horrible at addressing mental illness, because we equate the mind with the soul, and presume that if someone has a mental illness that it is at the root a spiritual problem. Now I will be the first to grant that mental illness always has a spiritual component, but arguing that clinical depression or other mental illnesses are simply spiritual is irresponsible, and borders on a denial of the First Article.

God created us, body and soul. Because of sin, we feel the effects of the Fall throughout our entire existence, body and soul. It is entirely right to say that sickness and disease are the results of sin, but it is also true that God has given us many tools to heal, body and soul. The chief of these is the healing Word of God. But there are also many other methods of healing that God has provided, including medication, doctors, therapy, etc. Can these be misused or abused? You bet! At the same time, I would suggest that the “spiritual card” can also be horribly abused. If I tell someone who is mentally ill that they need to pray more, or spend more time in the Word, or come to Church, and that this will simply heal them apart from these other tools, I am saying that God only works through the Word and not at all through any other means. I’m not sure what to call that. But it isn’t right.

We pray for the families and congregation of this pastor, and hope that God will use this as an opportunity to bring healing and help to so many who are in need.

Be at peace,
DMR

Friends,

As many of you know, the book has gone extremely well thus far.  So well, in fact, that they are already out of print!  We were able to offer them at no charge thanks to the generosity of LCMS World Relief & Human Care.

This brings me to my plea.  Every box or book that went out included a donation envelope.  They are currently trying to figure out how to do a second printing, but I expect it will come down in part to dollars and cents.

If you received a copy of the book and found it of benefit, I would ask you to consider making a donation to LCMS World Relief.  You can send it and ask if they would consider reprinting it.  I know that everyone want to do so, but finances are tight everywhere right now.  Obviously I am biased, but I believe that a copy of this book ought to be sent to every pastor in the LCMS, or at least every circuit counselor.  But to do this will cost several thousand dollars.

I’ll keep you all informed as I learn more.  Thanks again to the good people at LCMS World Relief and Human Care for making this resource available!

-Pastor Todd Peperkorn

In the last few years I have had the opportunity to speak or correspond with many people who struggle with depression or other mental illnesses. Pastors, teachers, DCEs, laity, each story is different, yet there are common themes.

One of those themes is how often the church, either at the congregational level or at the district/synod level, has failed these people. In all too many cases, their faith has been shaken to the point of disappearing. Now I don’t believe that there is any malice on the part of congregations or our church body. Far from it. But the sad reality is that we are driving people away from Christ by how we approach the mentally ill.

Why?

I have several theories about this. Here they are, in no particular order:

1. Because we so often equate clinical depression (or any mental illness) with some sort of character flaw, it is viewed basically as a sin. I think people instinctively know that this isn’t quite right, but they don’t have any other categories in which to place mental illness.

2. Everyone has weaknesses, and we work very hard to hide them. For many, depression unmasked is too close to home. It forces us to view our own struggles and failings, and that may just be too painful.

3. If we view the church as a place for the spiritually strong to work out, and not a hospital for the sick, then the mentally ill have no place.

4. The fundamental notion of “depression is in your head, get over it!” is so strong that we can’t help but judge others whose weaknesses are in public view.

5. Lutherans just aren’t very good at areas which aren’t “spiritual” in nature. If it isn’t about justification, then we just don’t get it. Hence, we try to place depression and mental illness simply into the “spiritual” box, and it doesn’t fit there.

Those are off the top of my head. What’s on your list?

I am currently laid up with a physical illness. Nothing serious, so don’t fret, but it reminds me again of how differently we treat physical and mental illness. Here’s a little compare and contrast:

1. In physical pain, we seek to find the cause and solve it. In mental pain, we try to suppress it.

2. In physical pain, the one in pain receives sympathy and care. In mental pain, the sufferer is avoided because they are somehow tainted or weird.

3. In physical pain, the congregation prays for the afflicted. In mental pain, the afflicted suffers alone because mental pain is never shared.

4. In physical pain, the assumption is that this is not the sufferer’s fault. In mental pain and illness, the assumption is that there is something wrong with the person.

Those are my initial comparisons. What’s on your mind?

-DMR

One of the questions that regularly come up to me has to do with the ons and offs of medication. When and why do you go on medication, and when and why do you go off of them? While the two are related, they are not the same.

Why go on medication?

We go on medication simply put because we need it. There may be many factors which go into that decision. It may involve mood, basic functionality, self-image, the ability to handle situations or stress, being able to interact with other people, to keep us safe from ourselves or others. You know your own list. For myself, I knew I had to go on medication when I found myself hating the things that I love: my family, my wife, my vocation as pastor, even my hobbies and the things that I enjoy became a burden. I couldn’t handle living any longer, and so something had to change. While one can go the route of simply counseling or natural remedies, in my view and after much reading on the topic, I simply haven’t found any cure or natural remedy or counseling method that is more effective than anti-depressants. Can you go other routes? Yes. Can they be effective? Yes. But I don’t believe that they will work as quickly or as well as modern anti-depressants or anti-anxiety medication, and the body of research seems to continue to support that view.

That’s why I went on medication, both initially and that’s why I went on them the second time.

Why go off medication?

The reason we go off medication should be fairly simple: we go off medication because we no longer need it. Now that sounds very simple, but we often invest massive amounts of emotion and other negative energy into the decision to go off of medication. Here are a few that I see and hear pretty regularly:

1. I don’t want to become addicted.
2. I don’t want to be on medication for the rest of my life.
3. Taking medication makes me feel weak or out of control of my own body.
4. I don’t like the side effects.
5. I can’t afford to take them anymore (iow, money or insurance problems).
6. I have found a better alternative way of treatment.

Now out of that list (and I look forward to hearing yours), four of them are basically emotional responses to medicine (wants and likes and feelings), one is money based, the the final one is experimenting with others ways of treatment.

But remember that initial reason on why we go off medication: we go off medication because we no longer need it. Unless you are a doctor, it is very unlikely that you will be able to determine when you no longer need it, since the medicine working is what makes you have a normal, functional life in the first place.

So how do you know when you don’t need the medication? Here’s a tip: you can’t know by yourself. You’re not a doctor, you’re not a pharmacist, you’re not God. It takes outside evidence. It takes some level of expertise that most of us do not have. It’s why God gives us doctors and nurses and medication in the first place.

If you think you want to try going off your medication, I would suggest the following steps:

1. Wait a month.
2. Talk to your doctor about the possibility of going off medication.
3. Wait another month.
4. Talk to your spouse about it, and anyone else whom you trust that may have some wisdom on the subject.
5. Wait another month.
6. Talk to your doctor about it AGAIN.
7. Then come up with a reasonable timetable and a way of evaluating what changes happen as a result of going off the medication.

One thing is for sure. Don’t willy nilly try to do this. Don’t just decide you are going to “see how you feel” by stopping to take it for a while. That is just not wise.

If you are desperate, send me an email and we’ll talk about it directly. I’m happy to pool my wisdom/foolishness with yours.

Be at peace,
-DMR