An Episcopalian priest shares the story of her own bipolar disorder, and gives advice on what the spiritual and unspiritual alike can do to fight mental illness.
Last year, Katharine Welby, the daughter of the Archbishop of Canterbury, began to speak openly on her blog about her long struggle with depression — a condition that remains stigmatized despite being the world’s leading cause of disability. Soon after, a Bishop of the Church of England recommended a book to the Archbishop: Darkness Is My Only Companion: A Christian Response to Mental Illness, by Kathryn Greene-McCreight. Welby was initially skeptical, having been bombarded with suggestions for supporting a child with mental illness. But he ultimately found the book so profound that he wrote the foreword to its second edition, and invited its author to dinner with his family at his 13th century home of Lambeth Palace.
Greene-McCreight is a feminist theologian, associate chaplain at the Episcopal Church at Yale, Elm City National Alliance on Mental Illness (NAMI) board member, and mother of two. Darkness is My Only Companion is her poetic and painful account of her struggle with bipolar disorder. Part memoir, part theological reflection, the Archbishop of Canterbury called it “one of the most profound and eye-opening reflections on the grace and love of God, and above all the nature of human relationships, that I have had the pleasure of reading.”
Greene-McCreight looks at mental illness through a theological lens, but her insights transcend creed; even hardened atheists might see something supernatural in her resilience. We spoke with Greene-McCreight about how mental illness affects one’s sense of self, and how meditation and mindfulness can help believers and non-believers alike deal with their depression.
What was it like when you were first diagnosed with bipolar disorder? How did you initially cope with it?
It was absolutely horrid: for my career, for my studies, for my family. I had two really little kids, and my husband traveled about every other week at the time. I didn’t reach out to enough people, just one or two friends, which was too bad, because you cut yourself off if you don’t reach out. Before I ever went to a psychiatrist, I went to a friend and told him that my mind was playing tricks on me. He said, “You need to get to a doctor right away.” That was the first part, around 1992, when I was diagnosed with postpartum depression, before later being diagnosed with bipolar disorder. I started going to therapy and later went to a psychiatric hospital.
That was the first time I was diagnosed, but looking back, there were times in my childhood, young adulthood, and college years during which I was depressed. It’s only now that I recognize what was going on. There were symptoms of depression that I didn’t know to categorize as depression. My parents took me to a medical doctor, but I never went to a psychiatrist. When I was 12, for example, I was sick and missed school for a month, staying in bed. I attributed it to an incident in a pool: people said I’d dived and hit my head, but in fact I hadn’t hit my head. That period of staying in bed happened after the death of a friend of mine. And then later, when I was 17, I again stayed in bed for four weeks . We chocked it up to mononucleosis, but I hadn’t tested positive for mono. It seems to me now that these times [of staying in bed] were depressions. But there was far worse shame then about [seeking help from a psychiatrist].
I initially coped with [the diagnosis] by just keeping as busy as I could. I used my waterskiing analogy: when you’re waterskiing, if the boat slows down, you’ll fall over and sink, but if it goes too fast or hits a wave too hard, you’ll also fall. By keeping the boat going fast enough, I could stay above water. If I slowed down, I felt pain. Over the years, I [developed a support system.]
Many people who struggle with any given diagnosis — but especially a diagnosis of mental illness — can have a hard time separating the illness from their sense of self. There’s often a feeling, when ill, that you are your illness. At this point in your life, how does your diagnosis of bipolar disorder factor into your sense of identity, of who you are? How has this changed over time, and how has your theology affected this understanding of yourself?
That’s a very good question, and a very important question, one that comes up often in my work on the board of NAMI. The answer is always no, we are not defined by our illnesses.
Recently I found myself at a loss for words, which for me is very odd, when speaking to members of the NAMI council. I was saying how hard it is to have a chronic illness, and one of the men on the council turned to me and said, “But you’re not defined by your illness.” And I said “Well, uh, that’s a good question.” Because a chronic illness doesn’t define us, but obviously it impinges on our lives. There are all sorts of things I cannot do that quote-unquote “normal” people can do. A diagnosis changed my self-perception: Some people just grow up with [mental illness] as part of their identity from time immemorial, but that wasn’t my experience. Mine was of being a very strong, capable person, then all of a sudden I was in this pain and a state where not only could nobody understand it, but it affected how I saw myself and how everyone else saw me once they knew what was up. But I think a lot of people would get angry at me if I said I was defined by my illness, because it’s not politically correct.
The answer is always no, we are not defined by our illnesses.
I recently said something that was really not PC, which was that part of me would rather be in a wheelchair and have a handicap that was visible than have a mental illness. Because then I wouldn’t have to continually be trying to hide it, because my mental illness is hideable. It would be a type of handicap that was socially acceptable. We had a president who was in a wheelchair, for example, and he was incredibly effective. But if you have a mental illness, you’re lumped into a group of people, some of whom commit heinous crimes, some of whom can’t work because they’re so debilitated by their depression or the voices in their head. The idea that I almost wish that I had a broken leg instead is linked to this question about a sense of identity. At one point, in a phase when things were very bad, I said to my psychiatrist, “Who is the real me? How do I know who I am?” And he said to me, “you are you.” That wasn’t the most helpful thing to say, but at least he was trying.
How does the language we use to discuss mental illness affect people’s perceptions of it and the stigma that surrounds it?
We’re always trying to say we want parity. But the problem we run up against is that advocacy agencies that are meant to help, like the National Institute of Mental Health (NIMH) and the NAMI, in the interest of trying to lessen stigma, often actually [end up increasing stigma with ill-chosen words]. The NIMH decided about a decade ago to move from the language of calling [the mentally ill] “patients” to calling us “consumers.” During a conversation about this with the board of NAMI, I said, “Look, I am a patient. The word ‘patient’ is derived from the Latin word for ‘to suffer.’ I suffer. I am not a consumer–a consumer buys things. I choose the car I consume, the food I consume. I would never ‘consume’ the services of a psychiatrist.” The word ‘consumer’ is so materialistic, so capitalistic. It becomes a little bit of a joke. They don’t call cancer patients “consumers.”
There’s also recently been a movement to stop using the term “mental health” and instead call it “behavioral health.” I’d rather have it be called mental health, because it’s more accurate. We’ve pretty much established the scientific fact that mental illnesses are brain disorders. They’re caused by structures in the brain, synapses malfunctioning in the brain. In that regard, they’re no different from something like kidney disease. But by calling it behavioral health, in an attempt to destigmatize “mental illness” — it implies that, now, if I’m mentally ill, that means my behavior is bad? That seems to me very problematic.
You write a lot about the power of prayer in helping you with your depression. How do you pray? What prayers do you find provide the most solace in your darkest hours?
I think first I would back up and ask, what is prayer? As I see it, it’s a conversation with God… When I think about how I pray, I think about how was I first taught to pray—with short, easy prayers for specific times and places, like table graces said with my family before a meal. Those were often for little kids. One was, “Come Lord Jesus, be our guest and let these gifts for us be blessed.” There were also prayers in church, like the Lord’s Prayer. These are forms of set prayers, which I still use — like in the Book of Common Prayer, which I find very helpful. But it doesn’t always have to do with set prayers. I think prayer is mostly being encouraged to let God know what’s on my mind and in my heart.
For me, the prayers I find provide most solace are often the psalms: Psalm 27, “The Lord is my light and my salvation, whom then shall I fear” Psalm 139 talks about God knowing me even before I know anything about God, which is a very helpful one for me. A lot of people use Psalm 23 — “The Lord is my shepherd, I shall not want.” The Psalms about the Lord being our all, and satisfying our appetites, and also the ones that talk about joy — those provide the most solace.
How have attitudes and approaches to mental illness changed in the church in recent years? What still needs to change?
I think we have a long way to go. Trying to get rid of stigma is important, but we need to go farther than that. What we’ve been focusing on in the church is a lot like what [evangelical pastor] Rick Warren and his wife have been doing [after their son committed suicide] — trying to get rid of stigma. Trying to simply say “don’t be afraid of admitting to struggling with mental illness” is great, but it’s reactive—I think we need to be proactive.
Creating beauty and being around beauty is really important.
There are some basic things pastors need to know and do — they have to know the symptoms of mental illness. Some very high percentage of religious people who suffer from mental illness go to their pastor or clergy first for help, but unfortunately, most clergy don’t know anything about this. We need the clergy to be educated about the symptoms, to know how and when to refer parishioners to psychologists or psychiatrists. Our job is important, but it’s not to diagnose and treat people who are mentally ill. It is to stand by them and pray with and for them and treat them with spiritual care, but sometimes pastors think they know more than they do. I think the clergy should have a list of professionals in the community with different types of expertise. And I think the church should do suicide prevention training with clergy. That’s something I’m trying to do in my church.
What do you recommend for non-believers suffering from mental illness? What secularly spiritual practices do you think are most effective?
Mindfulness meditation is really important. I do it, it’s very helpful. I’d also suggest group therapy — it’s been very helpful to be in a group of people with similar problems. It offers a reality check — they’ll say, “You weren’t like that last week, it’s not true that you always feel this way.” And getting out with other people is very important, which group therapy helps with. Isolation is very bad for any mental illness — whether it’s bipolar disorder, schizophrenia, even anxiety — it’s way bad. Exercise is also very important — probably, number one, actually — but sometimes it’s very hard to do that if you’re depressed. If that’s the case, take an exercise class, which also helps decrease isolation.
Any kind of art-making, even if you’re not an artist, can be therapeutic — splashing watercolors around on paper, dancing, working with clay, pottery, making music. Creating beauty and being around beauty is really important. That’s what the whole religious life is about.
Another one: Volunteering. Giving your time to someone else can be very helpful. It’s a way of practicing the art of compassion, even if you’re not religious.
Kathryn Greene-McCreight’s books about faith and mental illness can be purchased on Amazon.