Sneak Preview from "Let's Talk About Religion and Mental Health"
CHAPTER 1
Depression, Sickness, Sorrow, and the Gospel of Jesus Christ
“If ye have no hope ye must needs be in despair.”
—Moroni 10:22
During the Saturday afternoon session of the October 2013 general conference, Elder Jeffrey R. Holland shared what has become a “balm in Gilead” (Jer. 8:22) for many Latter day Saints troubled with mental and emotional illness. In his address, entitled “Like a Broken Vessel,” Elder Holland acknowledged the distinction between being “downhearted,” experiencing “discouraging moments,” and suffering from “depression.”
Elder Holland also included a candid description of his own personal experience with the “dark night of the mind and spirit”: “At one point . . . when financial fears collided with staggering fatigue, I took a psychic blow that was as unanticipated as it was real. With the grace of God and the love of my family, I kept functioning and kept working, but even after all these years I continue to feel a deep sympathy for others more chronically or more deeply afflicted with such gloom than I was.”
Having a member of the Quorum of the Twelve specifically mention “major depressive disorder,” “neuroses and psychoses . . . genetic predispositions and chromosome defects . . . bipolarity, paranoia, and schizophrenia” in a general conference address was unprecedented. Elder Holland’s acknowledgment of these psychiatric disorders and his own experience with emotional suffering have helped many Latter-day Saints better understand the Savior’s words (mentioned earlier) “For he [God] maketh his sun to rise on the evil and on the good, and sendeth rain on the just and on the unjust” (Matt. 5:45). Elder Holland’s personal account illustrates that the Lord allows even one of the most faithful among us—even one of the Lord’s Apostles—to experience mental distress and emotional affliction.
The history of the Lord’s covenant people, both ancient and modern, includes many examples of individuals who have experienced mental and emotional suffering. The following examples from the life of President George Albert Smith (1870–1951), the eighth president of The Church of Jesus Christ of Latter-day Saints; and King David (1040–970 BC), the shepherd boy who became the King of Israel, illustrate that depression has unique expressions in the lives of a wide range of individuals, families, and communities.
President George Albert Smith
While it is difficult, and in some cases unethical, for a mental health professional to make a clinical diagnosis of someone without having met with him or her face-to-face, it is well established that President George Albert Smith suffered from multiple physical and mental health problems during his lifetime, including what may have been “clinical depression.” Many of the symptoms described by President Smith in his own writings and by those closely associated with him are consistent with many of the clinical criteria mental health professionals refer to as “major depressive disorder.”
When thirty-three-year-old George Albert Smith was sustained as an apostle on October 8, 1903, his father, Elder John Henry Smith—also an apostle—expressed concern for his son’s health and stated, “He’s not healthy. He won’t last long.”3 Six years after his call to the Quorum of the Twelve Apostles, Elder George Albert Smith received the following letter from his uncle Dr. Heber J. Sears, a physician practicing in Chicago, Illinois. Dr. Sears’s letter provides insight into some of the details of the challenges faced by the young apostle:
April 12, 1909
My Dear Nephew,
A letter from your Mother brings the sad intelligence that you are down with nervous prostration. I take no satisfaction in saying “I told you so” but I do wish that I could say something that could bring you to a realization of the danger you are in. For years I have seen the necessity of a period of complete relaxation and have endeavored to warn you of the consequences that are sure to follow such a prolonged tension. Nature is now giving you a warning which you will do well to take. When the nervous system is once broken down the patient is too often a wreck for life. No class of diseases resist so stubbornly the efforts of the physician as nervous diseases. In fact, there is but little hope after they reach a certain stage. Their manifestations cover a wide range—from slight nervous instability to insanity. I need but call your attention to the number of good people who have gone insane in your own locality and in the same field of usefulness that your own efforts are directed in. Insanity is largely on the increase as statistics will show. And let me whisper a very significant fact in your ear—it is only a step from nervous prostration to insanity. For Heaven’s sake George—“sidestep” or step backward not forward. Cheat the asylum of a victim. Dump your responsibility for a while before the hearse dumps your bones.
Once more I will make the plea. If you are doing all this for humanity stay with humanity as long as you can and administer the [medicine] in broken doses. If the church requires your life, give it to The Church in a thinner layer spread over 30 or 40 more years instead of 3 to 5. Could you not do more good in this way?
There are more ways of keeping the word of wisdom than by abstaining from tea, coffee, [and] beer. You are an apostle. While I have only one foot in the church yet in my opinion, I keep the Word of Wisdom better than you do. Should there be any dispute on this point I would offer in evidence a body of 48 years young, in a splendid state of preservation—free from disease—and capable of great endurance.
Now George! Wake up. We can’t afford to lose you. Give the “other fellows” an inning while you drink lemonade in the shade. Call “Casey to the bat” and you watch the game while the others run the bases for a while. Or you’ll be hauled off in the ambulance before the game is half over.
Give our best love to your family and accept the same for yourself. With a strong hope that you will be good to yourself. I remain,
Your affectionate Uncle,
H J Sears
Dr. Sears used the term “nervous prostration” to describe and diagnose Elder Smith’s malady. In 1844, Dr. Roberts Bartholow defined nervous prostration as “a state of debility, in which nervous derangements predominate. A man actively engaged in business or in public life presently finds himself unequal to his daily tasks; he suffers odd sensations in his head; his digestion is disordered; he is weak; wakefulness, mental depression, and a thousand and one new sensations of strange character and fearful portent are superadded.”
Elder Smith was called as an apostle at thirty-three and as President of the Church when he was seventy-five. He died at age eighty-one, having faithfully served as an apostle for nearly forty-eight years. President Smith’s journals indicate that he suffered most every day of his adult life, to a greater or lesser degree, from physical affliction and mental distress. The challenges President Smith faced and the afflictions he endured were certainly a part of what identified him as one of “the noble and great ones who were chosen in the beginning to be rulers in the Church of God” (D&C 138:55).
In a letter dated April 9, 1909, the newly called apostle’s father, President John Henry Smith, who had been sustained as second counselor in the First Presidency at the general conference the year his son was called to the Quorum of the Twelve, wrote the following words of encouragement and prophecy, even though he had serious concerns about his son’s health: “Keep up good fortitude and good faith; don’t waiver in your determination to live. The bitter experience through which you are going is but designed for your purification and uplifting and qualification for an extended life work.” The faith and courage of President George Albert Smith and the support of his wife, family, and fellow apostles are important examples of individuals who pressed forward, meeting personal, familial, ecclesiastical, and professional responsibilities, even while addressing the challenges of serious mental and physical illness.
President Smith’s story also introduces several dimensions of dealing with depression that can be helpful in understanding what has been described by many of the leaders of the early Christian church as “the noonday demon,” alluded to in Psalm 91:6.7 Some of the lessons we learn from President Smith’s experiences with depression include:
1. Individuals who have faith in God and earnestly strive to keep His commandments can experience depression. Personal righteousness doesn’t always prevent or cure mental and emotional suffering.
2. Depression is often found in association with serious and chronic physical illness.
3. Depression, to greater and lesser degrees, may be a burden with which some people are afflicted for the duration of their mortal lives.
4. Depression doesn’t necessarily prevent a person from accomplishing his or her life’s mission and from living a meaningful and rewarding life.
5. Depression can be an experience God allows for the qualification and purification of those who suffer.
Depression and Sorrow
President Smith’s experiences also illustrate the qualitative differences between depression and sorrow. In a letter to a stake president, Ralph E. Wooley, President Smith wrote: “Even when things are normal my nerves are not very strong and when I see other people in sorrow or depressed I am easily affected.”8 Speaking of himself, President Smith once told a friend that “he lacked the prowess to be an athlete, that he was too homely to win popular favor, and that his weak eyes prevented him from becoming a scholar, but he could excel in human kindness. So, he made kindness his specialty.”9 President Smith’s writings (and those who wrote about him) reveal his deep sensitivity and compassion for others. His life embodied the covenant disciples of Jesus Christ make “to mourn with those that mourn” (Mosiah 18:9). From his writings, it is clear that President Smith sought out and followed the counsel of his physicians for the treatment of depression, but his writings also reveal that he understood and embraced sorrow and sadness in his own life and the lives of others, believing physical and emotional afflictions to be a necessary part of the human condition.
The scriptural phrase “Jesus wept” (John 11:35) succinctly describes the sorrow Jesus expressed at the death of Lazarus and the mourning of his sisters, Mary and Martha. From my own professional and ecclesiastical experience, it isn’t unusual for someone to apologize for their tears as we discuss personal issues that are painful. In my attempts to comfort them, I often respond, “No need to apologize. ‘Jesus wept,’ and He was and is a perfect being.” It is important to understand that sorrow, sadness, and tears are attributes of God— characteristics to be emulated and embraced and not pathologized. Dr. Allen Frances, a psychiatrist and former chairman of the Department of Psychiatry at Duke University School of Medicine, recently stated:
Sadness should not be synonymous with sickness. There is no diagnosis for every disappointment or a pill for every problem. Life’s difficulties—divorce, illness, job loss, financial troubles, interpersonal conflicts—can’t be legislated away. And our natural reactions to them— sadness, dissatisfaction, and discouragement—shouldn’t all be medicalized as mental disorder or treated with a pill. . . . Our capacity to feel emotional pain has great adaptive value equivalent in its purpose to physical pain—a signal that something has gone wrong. We can’t convert all emotional pain into mental disorder without radically changing who we are, dulling the palette of our experience.
Dr. Frances is one of a growing number of mental health professionals who believe that at least some of the dramatic increases in the incidences of depression in the last several decades can be explained by the conflation of the sorrow experienced by most everyone and the clinical depression experienced by others. Professors Allan Horwitz and Jerome Wakefield explain: “We argue that the recent explosion of . . . depressive disorder . . . is largely a product of conflating the two conceptually distinct categories of normal sadness and depressive disorder and thus classifying many instances of normal sadness as mental disorders.”