Understanding Mental Illness
About the Guest
Matthew StanfordMatthew Stanford (PhD, Baylor University) is CEO of the Hope and Healing Center & Institute in Houston, Texas, and he teaches in the Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine and the Department of Psychology at the University of Houston. He is the author of Grace for the Afflicted: A Clinical and Biblical Perspective on Mental Illness and The Biology of Sin: Hope and Healing for Those Who...more
Matthew Stanford believes if Christians want to help those struggling with mental disorders, they have to understand what they are.
Understanding Mental Illness
Bob: We often think about mental health very differently than we think about our physical health. As Matthew Stanford has observed, we also relate to people differently when we hear about a mental disorder than we do when they’ve been diagnosed with a disease.
Matthew: We often refer to mental illness as the no-casserole illness; because when you have cancer or anything, people bring you a casserole at church. It may not heal you, but it certainly makes you feel like someone cares. Tell someone at church that you 28-year-old son just got out of a psychiatric hospital and just got diagnosed with bipolar disorder; there won’t be any casseroles showing up at the door. People tend to kind of run for the hills.
Bob: This is FamilyLife Today for Monday, June 25th. Our host is Dennis Rainey, and I'm Bob Lepine. How should we think about mental illnesses/mental disorders, and how should we love our friends who are wrestling with these issues? We’ll talk more about that today. Stay with us.
And welcome to FamilyLife Today. Thanks for joining us. We’re going to be revisiting a subject today that we have touched on occasionally over the last many years—but a subject that—well, if this is present in a family/in a marriage, you’re facing some challenges.
Dennis: You know, I don’t think the community of faith—those of us who embrace the Bible—give enough credence to just how sin impacted our emotional wellbeing. The Bible begins in Genesis, saying we’re made in the image of God. A part of that, obviously, is God’s character; but our personality, our emotions, our intellect—all of that—is a reflection of who God is. When man sinned, unfortunately, that—which had been perfect—now is flawed.
We’ll talk about that today as we discuss the subject of mental illness.
We have a doctor who has worked both for Baylor University but also taught for a number of years at the Baylor School of Medicine in Houston and has founded a ministry called The Hope and Healing Center and Institute in Houston, Texas.
Dr. Matthew Stanford joins us on FamilyLife Today. Matthew, welcome to the broadcast.
Matthew: Great; thanks for having me.
Dennis: You’ve written a book called Grace for the Afflicted—I love the title. Where did this come from? Did this come from your own personal faith, just interacting with people in the church, or did it come about more through the professional arena, where you’ve taught and given so much focus of your life?
Matthew: No; it mainly came out through stories that people would come and tell me or questions they would ask me—as a person of faith that was in mental health—when I was in churches. When I was leaving the church, or they saw me at Sunday school, or a Bible study, they’d pull me aside and ask me questions of, you know: “My son has ADHD. What do you think about that, as a Christian, who’s also a provider?” or, you know:
“A pastor told me that my bipolar disorder is a lack of faith.” Those were very shaping and molding for me. I really started to wonder, “Why was the church not able to answer those questions for people effectively?”
At that point, I really just decided that somebody needed to kind of try to bring this all together. I think my original thought was that I would find what the odd theology was behind this, and I would kind of show it to be wrong; but the reality is—there is no real theology; it’s a lot of fear and naiveté. It’s not unlike what you find in the general public—a stigma associated with mental illness—but in the church, we just kind of wrap it in kind of an ugly spiritual crust. Unfortunately—instead of showing people grace, and drawing them in, and giving them an opportunity to heal—we really hurt them.
Bob: Well, there is a sin connection between our physical health / our mental health, as Dennis said. The image of God was marred when humanity fell into sin. We are broken people because of our sin. I think the problem you’re describing is—
—when somebody says, “It’s because of your active engagement in some sinful activity that your mental health has been affected,”—that’s what you’re pulling back and saying, “That’s not what the Bible teaches.”
Matthew: Right; absolutely. I mean, certainly, from an original sin perspective, we get ill because we are broken. We live in a broken world and a fallen world; so you can look at any illness—strep throat, cancer, diabetes—and you can talk about it from a sin perspective—at a high level of original sin—but very few, if almost no one in Christendom / in the church would say to somebody with diabetes: “You have a spiritually-generated diabetes. Your weak faith…” or “…lack of faith…” or “A sin you committed yourself…” or “The demonic is causing you to be diabetic.”
But when it comes to mental illness, we treat it very, very differently. We say to people, with mental illness, those types of things; and we hurt them. I think what we need to do is—we need to step up and say: “We do have a role to play / a huge role to play in helping people heal and recover from these things.
“We just need a more grace orientation. We need to treat people with mental health problems the same way we would treat people with any type of health problem.”
These things happen just as often in the church as they happen outside the church; research has shown that. These don’t just affect the person that’s struggling with the illness; they are like a bomb going off in a family—they destroy families. If you have a spouse that has depression, that’s going to reverberate through the entire family—it’s going to affect the marital relationship / the relationship with the children; it’s going to affect their finances.
We need to be compassionate in the same way we would be compassionate if we found out that the person sitting next to us in the pew was suddenly diagnosed with cancer. We would show compassion towards them. Unfortunately—because of the stigma and kind of fear that we have in the general public around mental illness—when you find out somebody has a mental illness, you tend to have more of a feeling of fear or concern for yourself or the situation you’re in as opposed to, when you find out someone has cancer, it’s all about compassion and care.
We often refer to mental illness as the no-casserole illness; because when you have cancer or anything, people bring you a casserole at church. It may not heal you, but it certainly makes you feel like someone cares. Tell someone at church that your 28-year-old son just got out of a psychiatric hospital and got diagnosed with bipolar disorder; there won’t be any casseroles showing up at the door. People tend to kind of run for the hills.
Bob: Matthew, we look at behavioral kinds of issues and all of us, as parents, know that part of our job is to help mold and shape our children’s behavior. It’s a cause-effect—we discipline them; they behave correctly. So when we see someone, whose behavior is erratic, is unusual, is destructive, we default to thinking: “Somebody has not taught this person correctly. They just haven’t been disciplined into this. Their circumstances / the environment they grew up in—this is what shaped this behavior.”
With mental disorders, what does shape the behavior?—is this biological?—is this the effect of traumatic stress? What is shaping schizophrenia or bipolar disorder?
Matthew: Well, every mental illness / every mental disorder is a combination of biology and environment. Now, the balance between those is going to vary between the different illnesses. It could mean everything from the prenatal care that your mother received or problems during birth—to the way that your parents responded to you, emotionally, or disciplined you—or “Did you grow up in poverty?” “Did you grow up in wealth?”—all of those types of stressors, in combination with the kind of temperament you’re born with, and things like that.
For instance, schizophrenia—one of the things I tell people, that they often don’t understand, is: “If a person has schizophrenia, and they don’t receive any treatment, they can lose up to five percent of their brain mass a year, because it’s degenerative; literally, their brain is dying. That’s not something that you just pray away; that’s not something that you just need to read the Scriptures more.
Now, something like depression or anxiety disorders, certainly, those exist in subclinical senses. We often say we’re depressed when we’re sad. When I say, “depression,’ I mean a disorder that has a certain set of criteria—it’s more than just sadness; it’s a debilitating disorder. So, it’s a combination of both biology and environment or situational—things that come on—certainly, we understand that a child could be traumatized and that that would bring about later mental health problems.
I think—back to the original aspect of your question—we don’t have any problem understanding that your heart is an organ; and it pumps blood; and that, if it doesn’t pump blood right, then you have problems related to your heart. But when it comes to thoughts, and feelings, and the control of behavior, we like to think of those in a very, kind of nonmaterial, kind of ethereal way. We forget that the brain inside of your head—you know, when it comes right down to it, you have three pounds of meat in your head; and it can be damaged.
When we look at people with Alzheimer’s disease, we don’t look at them and say:
“Oh, you know, if he just prayed more…” “If he just studied the Scriptures more…” or “If he was just a better husband, he wouldn’t have that.” But when you look at somebody with OCD, obsessive-compulsive disorder, I do hear people say that. In both instances, it’s a brain disorder. We have to remember that our brain can be dysfunctional.
I would add to that—people with mental health problems—they have the same spiritual needs / the same spiritual wants and desires that everyone else has; but they’re trying to fight through an organ—the same organ that we think with, feel with, connect with is the same organ we pray with—that they’re trying to fight through that. Their perceptions of the world are off; their perceptions of God are off.
Just to give you an example—so many people that I’ve worked with, that have depression, tell me: “Well, I don’t feel like I can pray anymore, because I don’t feel worthy to come before God. I don’t feel like He hears me. I can’t hear Him; I don’t feel Him.” A lot of that’s because of the negative feelings that are generated in their brain or the lack of emotion that they feel.
But they have the same kind of spiritual needs that everybody has; it’s just that they’re amplified and distorted.
That’s where the church, really, can step in, I think, and really give people a foundation for the healing and recovery that can happen.
Dennis: I would say, speaking of depression: “What if you’re married to a person, who really struggles with depression? What’s your responsibility, besides loving?” Obviously, you have to be compassionate, caring, loving; but, just practically speaking, what can a wife do for a husband…” or “…a husband do for a wife, who has this debilitating…”—and again, how’d you describe depression, again? It’s not just a sadness; it is—
Matthew: It’s an overwhelming sense of worthlessness or lack of pleasure in things that you found pleasurable before. You literally have negative thoughts and feelings that occur that are outside of your control. You’re constantly feeling as if you’re worthless; you feel disconnected, emotionally, from the world; you just feel numb; and you simply aren’t able to function normally.
I think that’s really the key—when you cross over the line of disorder, you go from being able to function to not being able to function anymore. That’s really the difference here between just being sad and being depressed.
As far as a couple goes, as I said, mental illness is like a bomb that goes off in a family. In couples, where one of the individuals has a mental illness, the divorce rate is extremely high. That’s not because it’s some type of absolute prophecy of doom. The problem is that, typically, people don’t get help. The majority of people in the United States today with mental health problems receive no treatment.
So what happens is—say a husband has depression—and now, he’s having trouble holding a job; and he has relational issues with his wife; and she’s trying to hold everything together herself. He’s not getting any treatment, so he’s not getting any better. She doesn’t understand what’s going on; because it’s not like he just wakes up one day and says, “I think I have depression,”—he doesn’t know what’s going on either. She thinks he’s lazy / just doesn’t want to work; arguing in front of the kids; and then financial problems; and that leads to the divorce.
If you’re struggling with that kind of situation, where it seems like your spouse / something has changed in your spouse—they’re acting in a way they weren’t acting before / they were a provider before and now they’re not; they sleep all the time now when they didn’t do that before—they’re having symptoms that you may relate to some type of mental health problem. What I would say is: “You need to get them to a physician to have a physical; and then you need to have them talk to that physician about what they are experiencing and see if they need a referral to a mental health provider.”
As far as the loved one goes—the wife or the husband—you need to get yourself into a support group. You need to educate yourself about the problem that your loved one has. Research shows that, if an individual family member just gets into a support group—a psycho-educational group, where they learn about the illness—even if the loved one is not getting treatment for their illness, the loved one will show improvement. You can’t do this on your own; there’s no need to. You also need to get connected with a faith community that’s supportive of people that are struggling with mental health problems.
Don’t try to do this on your own; there’s no reason to do that. Treatments are effective and they’re available. They’re difficult to access, but they are available.
Dennis: I’m glad you mentioned that, because it seems there are treatments that are available for those who are depressed and need the help. But if you’re married to someone like that, that person is impacted, like you said, dramatically. The idea of a faith-support group that—isn’t just spiritualizing the problem but practically talks about the impact of this on a marriage/ on a family—and hopefully, can provide understanding to know how to really love in a biblical way in the midst of that crisis.
Matthew: Absolutely. I mean, really, in a sense—you know, one of the things we talk about is, depending on where your loved one is in this recovery process—if they’re in the distressed part of this—where they are not functional, and they’re really not able to care for themselves right now, and they’re not getting mental healthcare—the spouse has really become nothing more than a caretaker—
—you can’t have a normal marital relationship. You’re caring for this individual in a very physical way. You’re having to take care of their finances / having to take care of them, physically.
Matthew: You’re not going to be able to move forward until the loved one begins to get some care, and you’re not going to be able to move forward until you get the support that you need. A lot of times, what I find is that the loved one is trying to relate to the individual, who’s in distress, just in a normal—either as a wife, or a mother, or whatever—when the individual is actually needing them just to be a caretaker and care for them.
These are the kinds of things you learn in a support group. I mean, there are all types of faith-based support groups out there that are available, probably, right around the corner from you—that will really make a huge difference. I’ll often say that individuals—the loved ones / the caregivers—they are the forgotten victims of mental illness. We don’t do that with other—you know, for instance, we’re very good now with dementia caregivers. There are lots of support groups, and it’s very accepted.
But for mental health problems or even addiction, a lot of times, we just kind of let those people go. We just don’t think about the impact it has on their family.
Dennis: Why is that, though, with somebody who has dementia? Why does that get a preferential pass by the Christian community / the community of faith; and someone—who’s married to a person, who’s deeply depressed, doesn’t?
Matthew: I’m not sure why. I think perhaps because dementia happens at an elder state—the person’s older. I think people can understand that, in a sense, their brain is kind of breaking down. But when you’re younger, you know—and you’re in your 40s or 50s, and you’re struggling with depression—they look at you, physically, and they say: “Oh, look! He’s not frail. He should be able to work. He should be able to do whatever. He just needs to get over it.” Whereas, you know, if you’re an 85-year-old man, struggling with dementia, people think: “Oh, well that makes sense. He’s just getting old.”
But you’re right; there is no difference. It has the same effect on the caregiver that someone with depression, bipolar disorder, or schizophrenia would. When I say that—you know, we’re talking about marital relationships right now—
—it’s the same thing for parents with adult children. One of the most things we deal with at the Hope and Healing Center and Institute are the parents of adult children with mental illness—so a 28-year-old or a 30-year-old individual, who has schizophrenia or bipolar disorder—and now you have an individual whose brain is literally not functioning correctly; their perceptions of the world are off, and they’re an adult. In our society, we allow an adult to make their own decisions for care, even if they’re delusional.
I have a client, right now, that is a 33-year-old woman, who has schizoaffective disorder, which is probably the worst of all mental illnesses—it’s like having schizophrenia, where you are psychotic and delusional / you have hallucinations; and bipolar disorder at the same time—her moods swing between high, euphoric states and real low depression. She doesn’t believe she’s ill—even though, in the same week she told me there was nothing wrong with her, she told me she had wood nymphs living inside of her. She also often thinks she has demons living inside of her, and that’s why she’s having problems in her life.
But she doesn’t believe she’s ill; and because she doesn’t believe she’s ill, we can’t force care on her unless she’s a danger to herself or others. Her parents struggle; because here they are—they want to care for their daughter—their daughter says she’s not ill. The way we have our HIPPA and our law set up, we can’t make her get any treatment. She lives in a delusional nightmare; and her parents suffer, and she suffers.
Helping the parents [is] something we can do. I can only help her as much as she’ll allow me to; but the parents—I definitely can get them a support group / offer them support—and that’s, again, where the church can step up and just really say: “We’re going to be with you in this. We’re going to walk through this nightmare with you until your daughter gives us the opportunity to get her some help.”
Bob: One of the people who has affirmed your book is Kay Warren. We’re all aware of the suicide of their son. That kind of a situation causes every parent to go:
“What could I have done? How could I have known this or prevented this?” What do we do in situations, where these kinds of things happen; and as parents we go, “Surely, I did something wrong here or could have made this better for my child.” How do we deal with that?
Matthew: Yes; suicide’s a really difficult thing. I think, first and foremost, I would say that suicide is evidence that people die from mental illness; because 90 percent-plus of people that die by suicide—at the time of their death—were struggling with a mental health problem. Kay and Rick Warren’s son, Matthew—he actually died from a mental illness, and suicide is just the expression of that.
First, I would say this: I’m a provider—I’ve worked with probably hundreds, if not a thousand, people in my life. I’ve had clients die by suicide. If I didn’t see it—I mean, some of them, certainly, were deteriorating; we were concerned—other ones weren’t. It’s a very difficult thing to predict. There are certainly things that you can take into account.
If your loved one has a mental illness, they are at a high risk for suicide; you just have to understand that.
People that are more prone to suicide—or they’re increasing in their likelihood of committing suicide—do tend to talk about death and dying more often; you know, they say, “I wish I’d never been born.” I often tell people: “Look at the third chapter of Job. There’s no better example in any textbook I’ve ever seen of suicidal ideation than that third chapter, where Job says: ‘I wish I’d never been born. I wish You’d taken me; I wish…’ I mean, he is overwhelmed; and he’s expressing that. Those are the same types of things that clients will begin to talk about.”
There are some things you can look for; but ultimately, I would say this—when someone dies by suicide, it’s no one’s fault. That individual, at the time of their suicide, believed that what they were doing was a good thing—it was a right thing. It’s not a reasoned decision; they’re perceptions are off. People don’t try to commit suicide to get attention—that’s a myth.
I think, if your loved one has a mental health problem, then you need to talk to both them and their mental health care provider, if you’re allowed, about their risk for suicide and what you can do to diminish that. Again, that’s a reason that you want to get in a support group. You also can learn—when you start to see that your loved one is deteriorating, and catch it way early—before they get to a point where they might be suicidal.
Dennis: If I had someone, who was struggling with mental illness in my family, I’d have a copy of your book, Grace for the Afflicted. I’d have it open; I’d be reading it—two reasons: number one, I don’t think we, in the Christian community, know how to process mental illness in other people. We look for categories and quick fixes. We don’t put it in the same category—that you just helped us think through—physical diseases. Secondly, once someone is diagnosed or is just troubled, emotionally, we don’t know what to do.
We want a quick, biblical answer for that and just say: “Pray about it. Ask God to fix you. You can do what’s right. You can just will yourself past this.” We’re really flawed in our thinking, from a biblical perspective.
I’m just sitting here, listening to you, and I’m thinking, “What a gift you are to the body of Christ—just to help us, as a community, to think rightly about what’s going on in people’s lives, who were made in the image of God.”
Bob: Well, and to have the kind of information we’ve been talking about this week in a book—that has now been recently revised and updated—I think is very helpful for pastors or for people, who have friends or loved ones, who are dealing with some of these disorders. The book that we’re talking about is called Grace for the Afflicted: A Clinical and Biblical Perspective on Mental Illness. It’s written by our guest, Matthew Stanford. We have copies of the book in our FamilyLife Today Resource Center. You can order from us, online, at FamilyLifeToday.com; or you can call 1-800-FL-TODAY to order.
Again, our website: FamilyLifeToday.com; or call 1-800-358-6329—that’s 1-800-“F” as in family, “L” as in life, and then the word, “TODAY.”
You know, the conversation we’ve been having today—these are the kinds of conversations, where we often hear from listeners, who say, “Thank you for providing us with some real help and some real hope in the midst of an affliction that we don’t find help for in other places.” Our goal, here, at FamilyLife® is to provide practical biblical help and hope for marriages and families on all kinds of relationship issues / all kinds of struggles and stresses that families face.
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Now, tomorrow, we’re going to continue talking with Matthew Stanford about different mental illnesses or mental disorders that people are facing today and how we think rightly about those issues. I hope you can tune in for that.
I want to thank our engineer today, Keith Lynch, along with our entire broadcast production team. On behalf of our host, Dennis Rainey, I'm Bob Lepine. We will see you back next time for another edition of FamilyLife Today.
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