Depression, Bipolar, & Anxiety Living as a Latter-day Saint - LDS

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Podcast #18 Anxiety Behind Closed Doors

In today’s podcast I wanted to highlight an illness that often goes unnoticed, undetected and too often relegated to the shadows of the mental illness community. But is just as problematic and difficult as clinical depression or bipolar.
A group of mental illnesses often related and connected to depression and bipolar are referred to as anxiety disorders. Anxiety is actually a broader term for a set of illnesses that all revolve around extreme worry, concern and fear, the fight or flight kind. This is not your I’m nervous to speak in sacrament type of anxiety but rather a more consistent broader and deeper feeling of fear and worry that paralyzes someone physically, mentally, socially and spiritually. As in the case of most mental illness there exists a genetic, traumatic event and random component to the illness. You are more likely to have it with a family history but then again you can have it without any known family link. It is not likely to come upon you suddenly but it the case of traumatic events it can move from a little worry to cloistered in your bedroom in a matter of a short period of time. Most people who deal with the illness do not see it as an mental illness simply because it does not always manifest itself in a manner that would be recognizable and everyone gets nervous and so it is often disregarded as nervousness. And in our society we deal with anxiety and nervousness more often with a jump into the deep end of the pool learning approach. While the just jump in approach often works with typical nervousness, it can be problematic and even detrimental to someone who has anxiety disorder. Many people with the illness do not always have symptoms that they would associate with anxiety. Symptoms such as rashes, ulcers, loss of hair, loss of appetite, additional appetite and so forth can actually be anxiety rather than a physical illness.
As far as spiritual matters it can be debilitating in any number of ways including simply anxious fears about guilt, callings, speaking, teaching, serving and even going to activities. Often individuals who do not know they have the illness will simply walk away from church activity because it reduces their symptoms. I know that it might sound strange but it isn’t the gospel or the teachings that are causing any issues. It is the administration of the outward gospel with its activities, teaching, service and so forth that cause such a deep paralyzing effect. It is not a doctrinal issue but a procedural and administrative one. And one that can be remedied given a diagnosis and just a little help.
Most often you find anxiety as a mental illness discussed in connection with long term clinical depression. This doesn’t mean that anxiety doesn’t exist on it own because it does and it can be just as debilitating as any other mental illness. Anxiety can even lead to depression.
However, I believe sometimes that these lesser known disorders and so many others are relegated to the outskirts of the mental health community. Depression and Bipolar have such a tendency to take over community governance due to their frequent occurrence within the overall community and simply because more individuals popular in culture have come forth to education others about the illness. This does not make anxiety disorders any less problematic or any less real but probably more hidden. They possess a similar ability to create disturbance, disability and dysfunction in one’s overall life. They affect employment, relationships, activities and spirituality.
I have found that in many cases, perhaps because of lack of education, they have become less believable than depression and bipolar. It is difficult to understand why someone all of the sudden has to stand up and leave the church building and not return. How can something just come upon someone without their consent or ability to control it at a moment’s notice. It is difficult to imagine for someone who has not experienced it. The only thing that I could even relate to it would be seeing a snake, spider or mouse when you have a phobia. You’ll lose control. However, in the case of these mental illnesses the feelings can and often come without necessarily a cause.
Yes, anxiety disorders can be activated in a number of ways but it doesn’t mean that they always have contributory factors. Crowded rooms, airplanes, tight spaces, tight clothing, rooms with people in them, traumatic events and so forth are often triggers for the disorder but doesn’t mean that it will always occur in every situation or even the same situation and there is really no particular way to know when. Certainly you can say that it might happen in particular situations and so there is some predictability but there is always a moment that it isn’t. The disease might stay the same for a long time or progress rapidly. Like other mental illnesses it is somewhat unpredictable as far as progression especially without treatment.
I have heard this illness described as simply someone who can’t control their worry, a worry wart. But having had this one, sometimes there isn’t even anything causing it. You just feel deeply anxious and you ask yourself why and you say to yourself, I don’t know but the feeling is still there. Anxiety is debilitating on many levels. It runs your body crazy for days and weeks at a time leaving you feeling desperate for good sleep, good thoughts and any type of good feeling. Exhaustion, fear, sleeplessness, sometimes nightmares, all form a terrible vortex that simply consumes life. I have heard someone say why don’t you just snap out of it. If individuals who have this illness could simply snap out of it, I would think that they would do it. The problem is not often thinking patterns but a matter of chemistry that creates the thinking patterns that are reinforced by the chemistry and time. It is a terrible compounding illness. Good men, women and youth become almost confined to their home and rooms because of it. This type of illness is incredibly susceptible to self-medication and drugs which have a more calming affect upon the body. Having experienced this problem on a smaller scale during both depression and mania, I could not even imagine a more developed illness.
How do these illnesses affect members of the church?
As members of the church, we expect to feel the Spirit as a voice of calm, peace, love and in a still small way. Anxiety at its core is just the opposite of these feelings. It can make it nearly impossible to feel the Spirit and to receive personal revelation which is so critical to our conversion and our daily travels through this life. The doubt, concern and constant pressure to think about things out of our control is overwhelming to soul and body. Sometimes it is not even about things out of our control as it is a feeling of dread or fear that is inescapable.
All of us get nervous when we have to do things that are new and difficult but when you are already overburdened with deeply anxious feelings and then are asked to give a talk in sacrament meeting you can actually get very ill, physically. Your physical body deals with mental illness in unique ways and one of the ways that it effectively self-medicates is that it makes you physically sick. The physical sickness caused by chemicals in the brain is actually just a response to the difficulties associated with the new environmental incursion. But it is a subconscious uncontrolled response and so the person actually feels sick and experiences symptoms of a physical ailment where none exists.
In the church we are taught that we don’t decline invitations, callings or counsel from our leaders. This is good advice for those who are little tentative and need a little push of confidence to do things that are difficult. So the teaching is good for the majority of the church where most of us are just nervous, maybe really nervous about what others will think of us, or that we won’t be as good as someone else, we might get embarrassed and so forth. Sometimes this nervousness is very real and can take some time to overcome but it is manageable with time and some encouragement. Anxiety as an illness is not something that just needs a little push of confidence or even some guidance. It is a chemistry that just isn’t right. It may be extreme or more moderate but it is not something that can be controlled like a bad mood. Yes part of the treatment is to work through counseling with the illness and temper some of the symptoms but most individuals need at least some type of help through medications or other sources.
So while the Nike advice, just do it, is good for most people, it can be a body blow to those suffering with anxiety. Often you will find that those who suffer, don’t enter Sunday school or priesthood meetings until the prayer is already said. They avoid leadership who might ask them to do something. They are likely to stay home if they think that they might be asked. If they think that there is even a slight chance that they might be called to give a testimony they will leave the meeting. They won’t attend interviews if they think that they might be asked to be in a calling. They are frequently sick and even avoid activities, meetings and other places where their anxiety might get to the fight or flight mode. They often seem nervous, anxious, sometimes evasive, shy and so forth. However, my experience with these individuals is that they are often spiritual and have strong testimonies because they have to work at it. They have to really work to feel the Spirit, to receive revelation, to understand the gospel. They have a tendency to read a great deal and so they are often full of knowledge that they simply can’t teach others because their body won’t allow it. When they let someone into their close circle, it takes a great deal of time and effort on both parts of the relationship. It is not that they don’t trust people, it is a natural reaction of the illness. This may make them seem standoffish, sometimes snobbish, perfectionist, elitist and so forth. The reality is far from what you see on the outside.
You will find that these individuals will take hours choosing clothing, makeup, shoes, and anything that presents them to the outward world. Small mistakes are very large in their eyes. What we may not ever see they can magnify into a mountain. If they are noticed, they worry that it was because of a mistake and if they aren’t noticed their body tells them that no one cares and they worry as to why they weren’t noticed. Sometimes they get up take hours to get ready and then can’t leave the house. I guess what I am saying is that it is a miserable illness. However, what I am also saying is that these individuals are compassionate, knowledgeable, often very funny, loving, thoughtful, devoted and conscientious about others. They notice simply things and even the smallest of things. If they can they give generous praise and are empathetic.
Now anxiety affects about 2.7% of the population. So in a hundred members of the church you are likely to find 3-5 individuals that have the illness. I state a little higher number because in the church you will find it at a little higher rate. You will also find that it affects women at twice the rate of men. Although men do have the illness. You will find that each of the sexes deals differently with the illness but you will also find that it is similarly debilitating.
Now you say well what can I do about it. I suppose that they are similar to most mental illnesses and disorders. You have to understand and recognize they exist and are debilitating especially within the structure of the church. Not that there is anything wrong with the structure of the church. It is just that the disorders seem to affect certain aspects of church activity.
It is important to be observant. Most people with anxiety disorder are going to be reserved, shy, often avoid leadership, avoid interactions that might lead to callings and invitations, sometimes they can be belligerent. They will do this as a mechanism of defense. If they know that you aren’t going to ask or push them to do things that elevate their anxiety they can be more open to conversation and friendship. If you are willing to listen without judgment, notice small things, honestly compliment them you can be a help in tremendous ways. They most often just need someone in their life on which they can lean and feel comfortable. If that person is always at church and is beside them, church and activities can become bearable. So a spouse or companion is often the person one which they lean. If they are young, single, divorced, or isolated in some way then they are going to need a good friend that can be a help and what I might refer to as a shield. If you know them well and you know that they really can’t give a talk, teach a lesson, or take a calling then you can be their buffer. This type of buffer can be the most valuable thing anyone dealing with this illness can have and can make life bearable.
There is something important to note about individuals with anxiety. Anxiety can be triggered by traumatic events within ones life such as abuse, accidents, death, su***de and other types of events one would consider traumatic. The anxiety may show up right away or not for years. It can be a frightening illness to someone who has never experienced mental illness. It can shut them down almost completely emotionally, physically and spiritually. They need professional help and that in and of itself is going to create even greater anxiety most of the time. With time professional help can make a huge difference but getting to the point of help may be just as difficult, especially with someone who has never experienced mental illness.
Anxiety comes in many forms, shapes and sizes and in differing variations. Yes our current society creates a more difficult experience at times. I think that some of this is well documented. Social media, public and private education experiences, social events, even being around people on a regular basis often causes anxious concerns. However, society is not likely to change anytime soon, so helping someone with their illness is going to have to happen within the framework we have. Yes we can alter the framework while children are young and help ease them into the cultural framework where they are going to be asked to work and serve. I do believe that we should also work to change the problematic issues of society. But we are going asked to live and interact physically in Babylon and while we live spiritually as though we are in Zion.
This is going to mean that youth and adults with this illness are going to need help to adjust and to find treatment methods and coping mechanisms that allow them to function. We need to do our part with professional help and also petition the Lord. I know that there are many individuals who do not believe in or seek out professional help. There are many reasons. I am not here to convince anyone about what to believe or how to go about the process. What I do say is to have an open mind. That is all the Lord needs to work. If we close out opportunities by excluding certain possibilities we limit what the Lord can do to treat and help others. I am not asking you to walk outside of covenants or to try things that are on the fringes of treatment but simply keep your thoughts open to what the Lord might put there.
If you are a leader who has someone in your organization that struggles. There are a few things you can do to help and they are quite easy and fall within what you should be doing anyway. The first is to look for the signs and symptoms of the illness. Youth are going to be naturally hesitant, nervous, anxious, afraid and so forth but if you find someone with an aversion that seems to be more severe or beyond what would be normally expected then you might consider them as though they might be suffering. Often youth don’t know that they suffer from the illness and it causes all kinds of issues including inactivity. If they feel as though they are going to have to pray, read aloud, or perform in any other manner and their mind quickly resorts to the fight or flight pretext then it is wise to make sure that you as the leader becomes the shield they need to belong.
Instead of a sacrament talk, or even blessing the sacrament there might be other ways the young man or women could serve and still feel as a valuable member of the quorum or class. Leadership for anyone who suffers is not going to be difficult. They are going to have trouble fulfilling assignments and other callings. Not out of lack of desire. They are very desirous but the illness prevents them from moving forward. They are generally going to need someone there occasionally to encourage and help. This doesn’t mean that they can’t teach or do anything in quorum without someone by their side. Their abilities will vary according to the illness and relationships they have developed.
Finally, the best thing you can do is to be a good friend who gets to know them on a personal level. Notice those things they do well and their talents. I have found these individuals often have great talents in music, art, spiritual matters, literature and so forth. They are often knowledgeable about a variety of topics and if you hit the right topic you will find them very educational. If you look for them, you will find them and the result will be wonderful. You will be able to help them to use their talents and abilities.
May the Lord continue to bless you in your affliction and your service to those who are afflicted. As always remember the Lord requires the fight and then ha can do his part.

Podcast #17 To the Leaders
A podcast about how leaders can help.
I have found throughout many wards and differing leaderships that mental illness is perhaps one of the most difficult issues to address for one who is counseling in spiritual matters. If you have experienced it yourself you probably have a leg up on someone who has not but I have found even those who have experienced it still have a difficult time counseling someone through else through it. Most leaders simply hand over the number of LDS services and hope for the best. While it is wise to leave the diagnosis and treatment to the professionals and handing over the number for LDS services is certainly a good call, there is still much good a leader in the Church of Jesus Christ can do to help those suffering with the illness.
I have mentioned previously that I have served in several leadership callings including bishop where mental illness was a topic of discussion on many occasions. There are so many individuals looking for spiritual support for their illness and just as many who do not have someone with whom they can discuss spiritual matters in their lives. I know that statistics show about 10-15% of the normal population will have clinical depression sometime in their lives. So one might think that about every tenth person through the bishop’s door would be a possible candidate. The answer in my experience is probably closer to 50% or greater depending upon the ward, culture, environment, social pressures and so forth. My experience tells me that leadership deals with about 20% of the ward at any given time and that is if they are actively working. That 20% are often the most vulnerable to mental illness and the surrounding difficulties and are those most often to not have a stable support network. The leadership of any given ward and that includes those wards that are financially well-off, because depression does not discriminate, are likely to see depression and mental illness on a regular basis.
More often than not because leadership tends to be older and mental illness tends to be more accepted in the younger generations, it is not recognized and discussed as it should be. Leadership is more likely to partially treat symptoms or ignore the underlying problem and simply act only when asked by the individual for help with issues. I admit that it is difficult for someone who has not dealt with the disease to even understand it much less pick up on the subtle clues that would lead to a diagnosis. Even if it is suspected often the leader pushes mental illness to the realm of the Church loony bin, LDS services. I am sorry if that offends anyone at LDS services and I don’t think that way. I have just found many who do. Oh they don’t call it that but to them it is a black box where you send someone dealing with emotional issues so they can get fixed and come back into activity. They do so with love, kindness and every good intention but still to the black box and let me know when you get it fixed.
Now before anyone gets too fired up about what I said. I understand that the bishop, Relief society president, or elder’s quorum president, ministering brother or sister is not professionally trained to deal with mental illness. It is certainly not their job to treat and fix the underlying issue and yes LDS services is the right call. But there are many things leadership can do to help someone who is suffering without relegating to the black box and hoping that LDS services can fix everything. I hope to express some of those things that might be of help to those serving in leadership callings. This includes anyone responsible for another member of the church in almost any capacity but I will be directing the remarks specifically to those individuals who do the most counseling. Now I do so out of my own opinion and while I might make mention of the church of Jesus Christ of Latter-day Saints in my remarks, it in no way implies that I speak for the church in any capacity other than a member expressing his opinion on a topic that is dear to my heart.
So if you are leading a flock of members and you know that you are likely to come in contact with membership on a regular basis that is dealing with some level of mental illness what can you do to help the person? Is there a list that I can check or a manual I can use? Well I wish there was a manual but no such luck. If you have listened to any of the podcasts before this episode you will find that mental illness is a complex issue causing changes in reality, ability, capacity, activity, and spirituality. I do recommend listening to at least a few of them. So what can you feasibly do? There are actually many good things you can do on a regular basis within what you are already doing that can be of great benefit and might only require just a few adjustments. So here we go.
First, recognize that leadership is the most likely to come in contact on a regular basis with individuals suffering from some sort of mental illness. Many of the things we see in the church such as inactivity, lack of capacity, lack of desire, even sometimes simply walking away from the path are not a set of bad choices someone just decided to make. Many times individuals are dealing with issues both internal and external causing such a pressure on the mind and soul that depression or other mental concerns such as anxiety takes over. Often they cannot even tell you that is the problem but the symptoms do show up. My daughter takes an assessment every time she goes to the counselor and it goes something like this. I am going to walk through a few of the items she gets to answer on a scale of 1-4.
If you were to give this scale to those with whom you are working and counseling what do you think they would say? I am not asking you to be a doctor or even diagnose anything, but I am asking you to be observant. If it looks like depression and feels like depression then it is probably far more difficult on the inside or the person whom you are counseling. Yes some types of depression come with the pressures and sins of life and adjustments to those pressure and even sinful behaviors should bring a measure of relief and happiness. Depressions caused by external pressures should ease when the pressures ease. Depressions caused by internal factors such as trigger events, abuse, accidents, death and by chemical-genetic factors are more likely to need professional help before they can be managed and it is important to note they may only be able to manage it. There may not be a fixing it. Sometimes we as leaders go about things as if reading scriptures, going to the temple, serving another is the all encompassing answer. The be more, do more, serve more is good for situations where it is lacking but it can be more detrimental to someone suffering from clinical depression. The first thing leaders can do to help is to recognize that depression might be causing some of the issues the person is facing and until they face the depression or other mental illness not much is likely to get better.
The next thing leaders can do is after a diagnosis. Mental illness is not leprosy. And the person is not going to break down every time you talk to them about it. Support is a key element in managing and recovery from depression. Support from a leader can make a significant difference. This doesn’t mean that you are going to have to go over to their house every evening and counsel with them. What this does mean is that you make sure they have the support they need to keep them on track with the treatments. This is going to be tough in many cases. Many individuals are not going to stay on medications and continue to go to counseling and continue to work with other types of treatments. It is common for individuals to have several start and stop moments with the illness. What they need is someone who is understanding nonjudgmental and who will gently lead them back to the treatments that are working. Remember that most individuals who have a mental illness cannot necessarily see the treatments at work and their benefit. Leaders can be a good resource to remind them how valuable they are.
There is also one particular note for bishop’s and stake presidents in the support process as they are the ones who will have to deal with any repentance issues. People with mental illness specifically depression will look to all sorts of self-medication to help with the pain and suffering. They are not intentionally walking away from their covenants or the Lord. It is simply a natural reaction to emotional fatigue and pain. Let me tell you that the type of fatigue and pain they are feeling is beyond what I can express. It is not that the pain is sharp or the exhaustion is always completely debilitating, although it is at times. It is that it never ends. The duration and daily torture can be only described as hell. This doesn’t mean that they will not get addicted to the self-medication but it does mean that during the treatment process they are likely to fall several times before they are able to finally get to a point that they can overcome the addiction. Depression often takes time to heal to a point of management and recovery and until that happens addictions are likely to slowly subside over the treatment process. This means that if the addictions include things that would be considered sin such as drugs, alcohol and po*******hy, that they are likely to continue to fall into the behaviors several times before they are able to claw their way out. This is not often a function of simple lack of resolve or determination or even a lack of love for the Lord. It is just part of the recovery process.
Depression and all that goes with it feels almost identical to sin. Not only can you not feel the Spirit or trust your feelings but heavy guilt and difficult worthlessness is almost universal with the mental illness. So it is no wonder that one might return to self-medications from time to time as one works towards managing the illness. What I am saying is that it is wise to manage sin with a merciful hand as the individual works through the difficulty of the disease, especially if the individual is young and single but even those who are old and married or divorced or widowed. I think you get the picture. Now I am not saying that you give license for sin. But I can say be wise with removal of church opportunities as it can do far more damage than good and the intent of removal of blessings is to inspire repentance not do further damage to an already wounded soul. I know that this can be a difficult needle to thread when you are trying to balance the Lord’s requirements of obedience against a mental illness but if you recognize the illness then you can tailor the repentance experience to be loving and helpful not destructive.
Now I agree that sin causes many of the same emotions as depression. I guess I already might have mentioned that. So separating those who have the illness and those who do not is incredibly important. Their paths to becoming whole are likely to be very different. I have no doubt with the Lord’s help you will be able to do this.
Back to the idea of support. I know from experience that those most likely to suffer with depression are those who may not have a good support network. They may come from good homes with loving families but are simply not supported in effective ways. This is especially true for youth. Sometimes they need support in different ways to help them through treatment and healing. They are going to need help with friends, family, quorums, classes, leaders as so forth. How can you best help? If you don’t know how best to support them find someone who will. Often this can be another leader, a good friend, even someone else in the ward who has or is suffering. You will find that those of us who suffer have a tendency to be kindred spirits who connect.
This is also true when talking about those dealing with less than ideal situations. Individuals who are divorced, widowed, young single, older single or who are dealing with issues of same-sex attraction. These individuals should be watched over with care as they are the most susceptible to depression and other mental illness concerns. Children of these vulnerable individuals can also be just as susceptible to mental illness. The illness comes in all varieties and forms and levels. Individuals who have recently experienced what would be termed as a trigger event are also very vulnerable to variations of the illness. Trigger events are often events such as death, especially a su***de, abuse in all forms, accidents of a traumatic nature even if it only happened to someone close to them and other types of jarring occurrences in our lives. Sometimes no one even knows that the event has happened. Watching for the signs of depression can give you an understanding that something needs to be addressed. It doesn’t always need to be the leadership and often is might need to be a professional counselor. The key is to be close enough to recognize the changes and to find out what is happening. A normal happy youth whom seems to have become reserved, standoffish, absorbed in music, not desiring to come to activities and church, looks depressed, sad, or is sick frequently without really any community illnesses running around is likely having some depression.
Some other notes are probably important but not sure I really have a category for them. Individuals who suffer often look to someone spiritual they can use as a sounding board. They have great difficulty feeling the Spirit because of the illness so they will often be unsure of themselves ask for frequent blessings and so forth. Just a quick thought on the blessings. I know that there is a prevailing thought in the church that one blessing is sufficient and then you need to somehow claim the promises of the blessing and you don’t’ need another one. I am not sure where it has come from and I don’t think that there is any doctrine to support it anywhere. When someone asks for a blessing, it should be given. Often those suffering from mental illness will ask for blessings of health as many symptoms do show up in the body as ailments. The reality is that they more often need spiritual guidance they are having great difficulty finding due to the effects of the illness. I received a blessing every month during my mission and the effects were miraculous in every occasion. Give blessings and don’t worry about the misconception that blessings somehow need to be regulated. If they ask for a blessing of health, then give that. I don’t’ think that the prophet would have any difficulty with me saying that but if he does I can certainly be corrected.
Leaders can do so much for those they serve by simply listening. I know that it is the nature of men to try and fix the issue and so it might take great restraint for some of you to just listen but sometimes that is all they need. They need to be heard and their promptings confirmed and then allow the person to work through the treatment and healing process. It took me more than decade to finally work through my healing process and that was after I had a blessing that removed the illness. So be kind, loving and understanding when they come to you broken because they have fallen again or the treatments aren’t working quite as quickly as they hoped.
Remember that mental illness has serious impacts to the spiritual abilities of the afflicted person. The illness doesn’t make them inept or incapable but it will affect their spiritual abilities from time to time and make going to church, activities, the temple, or fulfilling assignments very difficult. If they don’t show up a simple call with understanding and love will do the job. Anything more will likely add to an already guilty conscious.
Finally, one of the main reasons that I would hide my illness from my leadership is that I didn’t want to be treated with kid gloves and treated as a patient in a psych ward. I wanted a calling. I wanted to contribute. I wanted to be a full member of the church. Yes my body and my illness didn’t always agree but I still had the capacity to serve. Don’t avoid giving callings to someone afflicted and that means even what we term heavy callings. Allow them to serve just make sure that they have capable counselors, advisers and others who can take over when needed. Yes they are going to need understanding and help but to avoid giving them callings or relegating them to hymn book rearranger is not going to help them feel and better about themselves. Depression comes with sufficient guilt and feelings of worthlessness and self-doubt there is no need to add to that battle. Just make sure they communicate with you and to let you know when things are difficult.
Well that’s enough for today. I hope that I have helped in some small way. I hoped that maybe I have provided something that sparked in your mind. Even a small amount of inspiration can be a match that starts a fire.
And as always the Lord requires the fight and then he can do the rest. Talk to you next week.