Bipolar disorder and the church’s response
By Joanne Klassen
Ben’s parents were mystified and deeply concerned. They had received a call that their 22-year-old son was being taken to the local emergency room for a psychiatric exam. Ben was a regular kid: bright, creative, fun loving and caring. Now he was acting in ways that were unusual for him—making wild accusations, seeming paranoid and going without sleep for days at a time. Ben had complained about school pressures, and his grades had suffered this past term. He wasn’t keeping up with his friends, because he was working on a secret project.
When his parents arrived at the hospital waiting room, Ben was sitting handcuffed between two police officers. He had a wild look in his eyes, but his body was slumped in defeat. He glared at his parents and accused them of trying to have him arrested.
Ben’s parents were shocked that their son would say and think such things. They were worried about Ben’s mental health and well-being, and they were mortified since they knew many of the families sitting in their small town emergency room.
When Ben’s behavior was diagnosed as bipolar disorder, he and his parents found themselves in unexpected territory. Bipolar disorder can give people with this mental illness and their families and friends experiences they never imagined: run-ins with the law, devastated relationships, involuntary hospitalization and a lifelong diagnosis that may require lifelong medical treatment.
Since mental illness occurs at the same rate in Christians as in the general population, it is important for congregations to learn how to interact with people affected by bipolar disorder.
What is bipolar disorder?
Bipolar disorder has two components: depressive episodes and manic episodes. There are several types of bipolar disorder, with different expressions of the depressive and manic episodes.
Symptoms of a depressive episode include a depressed mood, loss of interest or pleasure in what used to be enjoyable, an irritable mood, dramatic change in weight or appetite, insomnia, fatigue, feeling worthless, feeling guilty about everything, difficulty thinking or concentrating and recurring thoughts of death or suicide.
Symptoms of a manic episode include an abnormally elevated or irritable mood. The person feels larger than life, needs little sleep, is more talkative than usual, has racing thoughts, is easily distracted, has bursts of goal-directed activity or is physically agitated and acts impulsively, doing things that may have painful consequences (spending sprees, sexual indiscretions, gambling or driving recklessly).
Sometimes a person with bipolar disorder will also have psychosis, which is hearing or seeing what the rest of us don’t see or hear or having bizarre or unusual ideas. Usually these symptoms are disturbing enough that a person can’t function or may require hospitalization.
Problems for the church
What can shock church folk is that people with bipolar disorder may act out of character or do things the church considers sinful, like stealing, lying, boasting, sexual behaviors and substance abuse. The church may have a dilemma knowing how to respond morally.
There may also be a great sense of loss, especially before a person is diagnosed or stabilized. It may feel like the person is no longer him- or herself; family and friends struggle to cope with changes in their loved one.
A great problem in the church is that people with mental health issues often disappear—sometimes by choice and sometimes because they are ignored or misunderstood. A common belief among Christians is that mental illness is the result of sin or Satan’s influence. These beliefs make it hard to walk compassionately alongside a person with mental health challenges and may increase people’s fear of relating to someone with bipolar disorder.
Another issue a congregation faces may be the time and care required to be with a person in the most painful parts of their illness. Caring may be difficult when the person doesn’t change—or doesn’t change fast enough. Caring can also be difficult when the illness causes the person to be unpleasant or challenging to be with. Congregations may tire of going through a cycle of care, intervention, assistance or crisis.
Strategies to introduce
There is no cookie cutter strategy for meaningful connections with people with bipolar disorder. While the illness may affect the brain in similar ways, the effects and outcomes of both the illness and the treatments are individual. Here, though, are some strategies that congregations can introduce into church life:
Many people are afraid of those who have bipolar disorder: Will this person act strangely or be violent? How do I handle unusual thoughts and/or experiences a person might talk about? What do we do if the person talks about suicide and other fears? By acknowledging these fears, a congregation can address these concerns by gathering information and knowledge. For instance, people with mental illness are less likely to be violent than the general population. This is helpful to know.
Organizations like the Mood Disorder Association offer information, reading materials, factual brochures, small groups and one-on-one meetings. A counseling agency, mental health facility or mental health professional might offer an adult education option Sunday mornings or provide information or suggestions to pastors, deacons or other congregational caregivers.
When I worked in community mental health, I welcomed calls from a client’s support network. While I respected a client’s confidentiality, there was still general information I could share.
People with any medical problem, including mental illnesses, tend to do better when they have social and family supports. A congregation that asks, “How can we help?” is a great resource for health in a person or family member’s life.
The fear of having to deal with someone who is, or may be, suicidal, is profound. Most of us know someone who committed suicide and the horrible pain that comes in the aftermath. Most of us cherish life and find the possibility of another’s suicide foreign and frightening. It is important to know what emergency resources are available nearby. Check into local information by consulting the phone book or regional health lists. These are helpful in an emergency or when caregivers and friends don’t know how to respond.
Sometimes we look for theological hints or biblical clues when it comes to understanding mental illness. Most of what is known about mental illness has been learned in about the past century. In biblical times there were few ways to explain or understand mental illness.
Some common stories or sayings from the Bible have influenced the way we think about mental illness: “Go and sin no more.” “Be healed.” “Choose the good things.” “Don’t be anxious.” These sayings reflect a lack of understanding of what mental illness is and how to be with people who have a mental illness.
Misusing these phrases and attitudes implies that people with bipolar disorder and other mental illnesses are choosing sinful behaviors and attitudes, and that they should be able to triumph over their illness through confession, their spiritual relationship with God and willpower.
Forgotten, at times, are Elijah’s and Jonah’s stories. Both men begged God to let them die. Forgotten are the Psalms in all their raw humanity: “My tears have fed me day and night” and pleas for God to intervene while the psalmist is down and out. Forgotten are Paul’s “thorn,” a burden he had to bear that would not go away, and his admission in Romans 7 that he is unable to control his behavior. These, and more, are examples of passages of understanding and mercy that we can identify with when we or a family member suffer with mental illness.
Far beyond these stories, the Bible contains powerful theological precepts that are more fundamental to Christianity than specific exhortations. The Bible is clear that God’s people are to be a light to the world. We are to be leaders in compassion and justice.
When does the church seek to be a compassionate light to individuals and families affected by bipolar disorder? A church community begins by acknowledging and identifying with a person’s suffering. It works to include people with mental illnesses in the congregation.
The Bible urges us to care for those who have less. Many urban street people have mental illnesses. Many with bipolar disorder are on disability or social assistance, which provides only substandard and even dangerous housing and not enough money to make ends meet. People who have a higher level of functioning may need support to finish schooling, return to work or find suitable work. Can our congregations find ways of helping people help themselves? So much more could and needs to be done in caring.
The list of fundamental Christian values goes on: love, forgiveness, restoration, inclusion and not judging. The applications of these virtues to people struggling with bipolar disorder and other mental illnesses are endless. As the church, we are limited only by our imagination and determination.
Joanne Klassen is the director of Recovery of Hope, a counseling program offered by Eden Health Care Services in five communities in southern Manitoba. She has completed master’s degrees in marriage and family therapy and theology. Klassen wrote this article for Meetinghouse, an association of Mennonite and Brethren in Christ publications.