Written By Karen Kwek
A lifelong scribbler, Karen enjoys the company of friends, a great cup of tea and seeing the gospel transform hearts and lives. She worked as a book editor until she and her husband traded peace and quiet for parenthood. It seemed a good idea at the time.
*Simone and I were college-mates at university in England many years ago. Smart and popular, with a sarcastic sense of humor, she seemed to have it all: a strong Christian faith, a close circle of friends, top grades, and a guaranteed place in a prestigious postgraduate music program. As co-chair of our college Outdoor Activities Club, she was always brimming with ambitious ideas for weekend trips to conquer this or that peak, hiking through the forest, long walks along the coast, or summer boating races.
It wasn’t until our third and final year, when Simone and I were sharing a student flat with two English girls, that I started seeing a different side to her. We had always known that she had trouble sleeping, but I usually ran into her only in the dining hall and at club meetings. I had never noticed how tired and withdrawn she could be in private.
One evening, she scared us by locking herself in the bathroom, where we could hear her crying uncontrollably. But from the next day, she seemed to get through the week just fine. It happened a few more times, but as we were all facing final exams and under a great deal of stress, I assumed that was the explanation. I often stayed up late to study with her, and we prayed together whenever she was distressed. On Sunday mornings, we attended church together. We graduated that summer, staying in touch but going separate ways to different postgraduate institutions—she in France, and I in the United States.
Perhaps you may be wondering how Simone’s story is relevant. Maybe you think, as I did then, that nothing in her experience really warranted the label of “mental illness”.
The truth is, mental health issues are far more common than we suppose. In my country (Singapore), a 2010 study revealed that one in every eight people here suffers from mental health conditions. In the United States, that number was one in six in 2016, with the highest prevalence (22.1 percent) among younger adults (aged 18–25). The World Health Organization estimated that in 2017, more than 300 million people, or 4.4 percent of the global population, were suffering from depression.
Apart from depression and anxiety—the most common forms of mental illness worldwide—many also suffer from complex mental conditions including Autism Spectrum Disorder (ASD), Attention Deficit and Hyperactivity Disorder (ADHD), and epilepsy.
I am not writing all this from the comprehensive perspective of a healthcare professional, however, but as a flawed fellow believer who has known to some extent the struggle of friends. And as one who has personally lived through periods of depression and anxiety, I can say that there is no “us” and “them”.
All of us will almost certainly face challenges to our mental health during our lifetime; the difference is only in degree. I am deliberately recounting Simone’s story in some depth because she first helped me understand this better and taught me to be a better friend and sister in Christ.
If you have a friend with mental health concerns, here are a few helpful first steps you can take:
1. Empathize and encourage him or her to get help if necessary.
Heart palpitations, panic, nausea, vomiting, excessive crying, extreme risk-taking behavior, violence, self-harming—these and other physical symptoms can all be triggered by stress, anxiety, and forms of mental illness.
Your friend may be going through a temporary time of adjustment to a particular loss or trauma, and if so, you being there to talk through his or her feelings may be all that’s needed.
If, however, the problem is more serious or chronic (recurring), suggest seeking help from a pastor, counselor, or doctor. Symptoms that people may be too embarrassed or disturbed to mention include hearing “voices”, hallucinating, even having paranoid, suicidal or murderous thoughts.
Your presence is crucial because there is a social stigma attached to mental illness, even in Christian circles. People fear what we don’t understand, so the mentally ill are usually cut off from the meaningful relationships that “normal” people enjoy at home, at work and in church. They are often ignored or dismissed in jokes, tolerated in embarrassed or exasperated silences, “outsourced” to the care of “experts”, and so on.
So, if your friend has been open with you about his or her mental health issues, please recognize that this is the first sign of him or her placing trust in you. He or she is very likely feeling alone and misunderstood, or has felt that way in the past.
My friend Simone coped with her condition in silence for more than 10 years before the periods of gloom became so intense that she was repeatedly hospitalized for trying to end her life. Her then-boyfriend (now husband), convinced that something was very wrong, took her to seek help. She was diagnosed with bipolar disorder only in 2015. The diagnosis helps her family and friends understand a little better what she has been struggling with since adolescence.
2. Be informed. Resist “Bible-bashing” and making assumptions about mental conditions.
While Simone has been diagnosed and possibly labeled as a mental health patient by some, to me, she is still Simone. Just Simone, my friend. It means a lot to her that I can see past her illness.
Even though the label doesn’t define your friend, try to understand as much as you can about his or her particular mental health concern, because not all conditions are the same. Ask your friend to describe what he or she faces. Read relevant pamphlets published by institutions that support mental health.
The most destructive myths are that only weak people have mental health issues; that someone can “snap out of it”; that it is a punishment that the person deserves; that someone’s faith is not strong enough; or that truly spiritual Christians will either never suffer from mental illness or will always be cured.
The causes of mental illness are usually a complex interplay of genetic, biological, psychological and environmental factors. In many chronic cases, the triggers are unknown. Physiological symptoms can also occur randomly, as if the body simply disregards instructions from the brain and goes out of control. Be sensitive when sharing Bible verses with your friend, so as not to discourage or hurt someone by implying that he or she is being disobedient or faithless!
Simone suffers from a mood disorder caused by an imbalance of brain chemicals. When she is upbeat, her thoughts are flighty and unrealistic—“disorganized, scattered all over the place”, in her own words. More frequent than those episodes are her lapses into hopelessness. During these periods, she can recall Bible passages about rejoicing in the Lord and finding refuge in Him, but they feel hollow. She cannot feel any positive emotions or muster any prayers except to beg God to end her life because she feels utterly cut off from everything. Panic attacks can also hit her unexpectedly and for no apparent reason. Simone has experienced sudden, paralyzing fear, a racing heartbeat, breathlessness, and crying fits, even in the middle of having a good time with friends.
3. Offer companionship and Christian hope.
If you are anything like me, you may hesitate to get too involved in your friend’s suffering—not because you don’t care, but because you worry about messing up. Yet Simone reassures me, “You could never make it worse by showing care.”
Galatians 6:2 tells us to “Carry each other’s burdens, and in this way you will fulfill the law of Christ.” The law of Christ is love for God and love for our neighbors, so we are being told how to love others in concrete terms. The ultimate burden-bearer, of course, is Jesus, who carries our sin and died that we might live (Galatians 2:20).
Simone has been prescribed lithium to balance her brain chemicals, and taught not to allow the negative voices in her mind to overwhelm the truths that she is loved and saved by God. Still, she finds it hard to be sociable when she is depressed, and worries about not meeting other people’s needs or not being able to share our joys.
But when she can receive and accept our company, she finds great encouragement in Christian love, care and community. While Bible-bashing is judgmental and ultimately unloving, the Word of God, shared in a caring context and studied together in Simone’s Bible study group, is her lifeline. It teaches and reminds her that she can look forward to an eternity when she will not only be healed but also made whole.
In fact, the brokenness of Simone’s mind is not so different from the brokenness of spirit common to all us sinners. When she falls into the depths of despair, the hope that sustains me also helps her; it is the certainty of an inheritance that can never perish, spoil or fade, as it has been won for us by Jesus (1 Peter 3:3-7). How precious is the knowledge that this gift is kept in heaven for us and that God’s power protects us through faith, even if our present grief is great! When Jesus returns, our trust in Him, proved all the stronger for having suffered, will glorify God.
4. Look after yourself.
If you are the only person walking this journey with your friend, try asking other trusted friends to walk alongside him or her, too. You need physical rest as well as time to strengthen your own relationship with God. Remember that because your friend’s ultimate hope is in God, your role is to reflect His care and point your friend to Him. Trying to have all the answers or making your friend unhealthily dependent on you will not help in the long run.
5. Pray for and pray with your friend.
Simone is sometimes too sad to pray, but she has the Holy Spirit to intercede for her at times like this. Do we pray for God to heal her bipolar disorder? Certainly! However, He has not chosen to do so yet, and we may not understand His reasons in our lifetime. Yet, knowing Christ has given Simone meaning in life, purpose and hope even as she lives with mental illness. With medication and the support of friends, she has been able to return to her job teaching music.
Life remains full of ups and downs for all of us, but ultimately, we are blessed because we can truly say, in the words of 1 Peter 1:3-7:
Praise be to the God and Father of our Lord Jesus Christ! In his great mercy he has given us new birth into a living hope through the resurrection of Jesus Christ from the dead, and into an inheritance that can never perish, spoil or fade. This inheritance is kept in heaven for you, who through faith are shielded by God’s power until the coming of the salvation that is ready to be revealed in the last time. In all this you greatly rejoice, though now for a little while you may have had to suffer grief in all kinds of trials. These have come so that the proven genuineness of your faith—of greater worth than gold, which perishes even though refined by fire—may result in praise, glory and honor when Jesus Christ is revealed.
*Not her real name. Changed for confidentiality purposes.