I don’t think we know what we are doing. This is true about a lot of things in life, but especially issues of mental health.
In just the past 15 years, I have witnessed a massive shift in how evangelicals, and Americans in general, understand Mental Health, and for the most part this has been a very good thing. Mental health has lost so much of its social stigma that it is not uncommon for people to post frank confessions about their depression, anxiety, PTSD, or specific disorders on social media. Psychotropic drug use is normal and healthy and nothing to hide. To a limited extent, society has begun to accept that mental disorders are like other diseases or ailments. They are things that happen to us.
But I also suspect that for the vast majority of people, despair, trauma, sorrow, and mental illness remain hidden. Yes, some people are talking about mental health quite loudly and openly in public, but the day-to-day experience of adult life has not changed much. “We each suffer our own ghosts,” and mostly alone.
Get to know someone really well, and almost without fail you will discover a person who routinely struggles to get out of bed in the morning, or someone who suffers panic attacks every time there’s another mass shooting, or someone who cannot stop obsessing over how they may have failed as a parent, or someone who cannot eat or who cannot stop eating because of the guilt they feel from being sexually assaulted, or someone with a nearly debilitating mental disorder that only fully manifested after they were married and had kids and now their spouse seriously considers divorce on an almost monthly basis, or someone who is stuck in the habit of living even though they feel terribly alone and bored. None of this is abnormal.
And most of these people will show no signs of the despair that follows them around, or at least those signs will be extremely subtle and brief. They might surface in a prayer request (“Can I just ask you guys to pray for a stressful situation at work?”), sudden moodiness, or proclivities towards diverting addictions like social media or porn or games, but mostly they are high functioning adults. We’re all high functioning disorders. We may go through periods where our functioning breaks down and we stare blankly at our email inbox or debate whether to get out of bed, or we feel we can’t physically move, but for the most part, we function. We get up. We eat. We work. We buy things. We are entertained. We are stimulated. And we sleep. But it’s there, waiting for the right moment to assert itself.
Living in a society governed by technique inclines us to imagine life is easier than it ever is. Technique is the use of rational methods to maximize efficiency, and we see it everywhere: Time saving technology, apps that maximize our workouts, medicines that drown out irrational thoughts, ubiquitous entertainment in our pockets, and scientifically proven methods for parenting, working, eating, shopping, budgeting, folding clothes, sleeping, sex, dating, and buying a car. The promise of technique is that we are collectively overcoming all the challenges to life through research, technology, and discipline. All you have to do is find the right self-help book or life-hack or app or life coach or devotional.
And this is exactly why technique’s promise that life is easier than ever becomes just another source of dread: if life doesn’t have to be this hard, if there are answers and methods and practices that can solve my problems, then it’s really my fault that I’m overwhelmed or a failure. Sure, systems can be corrupt, nobody is perfect, and not everyone is born with the same gifts, but we have methods for overcoming these hindrances. So if I am not living to my full potential, I am to blame.
But what if our contemporary society is not built for us, for humans as God designed us? If that is the case, then sometimes anxiety and depression will be rational and moral responses to a fundamentally disordered environment. (For more on this, see this lecture and / or give me a grant so I can have the time to finish my next book).
Regardless of the causes, contemporary life is marked by widespread psychological and spiritual despair and the sense that answers are available, particularly through proper mental health.
There is a danger, however, in relying too heavily on language of mental health.
I’m not going to argue that psychology and psychiatry are godless fields and that you just need to pray harder. I believe there is great value in both fields and I have personally benefited from them. This is the place where I share my psychological history to establish my mental health bonafides, but I’m not going to do that. I just want you to understand that I am not opposed to counseling or medication.
My concern is that sometimes medical and scientific language obscures or replaces the very thing it is supposed to be treating. Sometimes getting a diagnosis puts your despair in a discrete category. Or we wish a diagnosis could provide concrete and discrete answers. The unknown is so much more frightening than the known, so it can be a great relief to receive a diagnosis. If there is a diagnosis there must be a treatment. And with a diagnosis we can objectify our suffering. We can set it on a table, examine it, and communicate it to others. I am not depressed. I have depression. It is over there and I am over here. Your experience has a listing in DSM-5. You can name it. So, maybe it’s manageable after all?
If you have ever been to counseling long term or been medically treated for a disorder, you know that such concrete answers are few and far between. The best mental health professionals are not scientists who offer precise, scientifically objective diagnoses, but students of the human heart and soul. They do not provide a taxonomy and rational explanation for your suffering, but intuit with wisdom and compassion. By grace they may sketch out the contours of your suffering, but little more than that. They offer a sympathetic ear and wise advice, but rarely ever anything approaching a “cure.” Psychiatrists can sometimes prescribe a medication that helps lessen your suffering, but disturbingly, we don’t actually know how or why many popular antidepressants work. And some drugs seem to have a higher likelihood of producing awful side effects than doing the one thing they are supposed to do. When you realize all of this, it’s not hard to fall back into despair.
Let me be clear: If you are suffering, get professional help, but accept two facts:
First, life is hard, and during some periods it is all-but unbearably hard. Life can become so difficult and painful and soulless that you cannot comprehend it. Even if you have experienced these seasons, you almost certainly cannot remember them accurately. You might be able to objectively recall the dates when you were unable to work because of depression, but that experience of depression remains inaccessible, unless it returns in force. For all of human history we have known this truth. Human existence is inescapably tragic. But it’s hard to recall this truth when we are surrounded by forces that promise us greater and greater ease. So, remember: Tremendous suffering is the normal experience of being in the world. Beauty and love and joy, too, but also: suffering.
Second, there are rarely clear, definitive answers to depression, anxiety, and other disorders. You can and should pursue professional help, but just remember that there are limits. And at those limits we are thrown back on ourselves, God, and our neighbor for the task of living. All the counseling and medication in the world cannot replace the existential decision to live and rely on God and your neighbor. Professional help can guide you and medication can assist you, but in the end it is always just you and God and your neighbor and the present choice to act, which at root is actually the choice to worship. And that is okay. Really, it is.
Which brings me to the point of all this: What does it mean to live?
We quite rightly hear regular appeals for people who are struggling with suicidal ideation to get help. And few serious people advise us to resist the tragedy of human life by ending it early. But there remains the question of what it means to live. Why is it meaningful and good to live?
You need to know that your being in the world is a witness. It testifies. There is no mitigating this fact. All we can do is decide what our existence is a witness to and how we can share the burden of witnessing.
Life will inevitably crush you, at one point or another, and your response to that suffering will testify to something. There will be times when subjectively you will be convinced that life is not worth living and that existence is not beautiful or good, but onerous and meaningless. When those times come, your obligation is to acknowledge the objective reality, that life is good, and that despite our distress, we must get up and carry on.
Your existence is a testament, a living argument, an affirmation of creation itself. When you rise each day, that act is a faint but real echo of God’s “It is good.” Rising out of bed each day is also a decisive act. Living is a gamble. It is a severe gamble. You do not know the suffering and sorrow that awaits. You do not know the heartache. But you know it is coming for you, of that history and literature have testified without counterclaim. To choose to go on is to proclaim with your life and at the risk of tremendous suffering that It is Good. Even when it is hard, it is good.
Understood this way, life becomes an awesome responsibility and burden. Suicide becomes a slightly more viable option for people when someone they respect succumbs to it. Like it or not, if you give up, it will open up the possibility for others to give up. You have the solemn responsibility to bear witness to the goodness of life by living despite suffering. But life is also a gift. As it turns out, the greatest gifts are always also burdens: love, children, wisdom, beauty, salvation. Our being is a result of gratuitous love by God, and we honor that gift by participating fully in it, even when participating in being feels unbearable.
None of this is to imply that suicidal ideation and depression are trivial matters that we can just pray away or will to disappear. But it does mean that for Christians who understand that being is an essential act of God’s love for us, suicide is not an option. It’s just not. We can admit that we and many others have struggled and will continue to struggle with suicidal ideation — some thorns in the flesh won’t come out this side of paradise— but part of facing despair is knowing how we can respond. And if our life is a witness to the goodness of life, and therefore the goodness of the Creator, ending your life can never be a possibility, no matter how strongly you subjectively feel dread or alienation, or fear, we have an obligation to live in the truth. Even when it feels impossible.
This is no stoicism, but an acknowledgement that an essential part of life is bearing with suffering with the knowledge that suffering does not have the final say. And that even when our minds deceive us into hopelessness, we cannot shake the intuition that life is still precious. Perhaps we cannot sense the preciousness of our own lives, but the lives of our loved ones inherently feel sacred. We love them and feel the goodness of their existence even when we can’t feel the goodness of our own. Then we must remember that the decision to scorn the goodness of life by ending our own is always an invitation for others to follow suit.
I understand that what I am speaking of is painful and difficult. And yet, this is our calling: To glorify God by honoring his creation — you. And in so doing, you honor your neighbor’s being, and your child’s.
When you cannot believe that existence is a sacred gift from God, when you can no longer even believe in the objective goodness of other people’s lives, then you must surrender to the grace of your neighbors, particularly in the church. You must learn to accept their wise love for you, their words of assurance, which may not heal you but can carry you when you are incapable of carrying yourself. Sometimes your duty in life is simply to trust and rely on the love of others. Sometimes the right use of your agency is to surrender your agency to others for a time.
Ultimately, the only reason to keep living is if you live unto God. If His Word is true, then we were divinely created to glorify Him and enjoy Him always. And our creation was a fundamentally good act — good and prodigal.
The only other reasons to live are for the World, the Flesh, or the Devil, and they only want you to live so long as you are useful to them.
Once you stop being productive and your credit dries up so that you can no longer consume, the World does not care if you are alive — unless your existence becomes a drain on those who are still producing and consuming, in which case the World would very politely ask that you cease inconveniencing the rest of us, thank you very much.
Once your body primarily experiences pain rather than pleasure, your Flesh has no reason to keep alive. When sex loses its thrill and you’ve come to the end of porn, and entertainment all bores you; when your quality of “life” is diminished by mental illness or physical ailment; when you cease to believe that you’ll ever not be alone, then assisted suicide seems reasonable and moral.
And when the Devil no longer finds you useful for undermining goodness, beauty, or truth, he doesn’t care if you live.
Usefulness is the sole criterion for the World, the Flesh, or the Devil. But you have no use value to God. You can’t. There is nothing He needs. You can’t cease being useful to God because you were never useful to begin with. That’s simply not why He created you and why He continues to sustain your being in the world. It was gratuitous, prodigal. He made us just because He loves us and for His own good pleasure. Every other reason to live demands that you remain useful, and one day your use will run out. But not so with God. To God, your existence in His universe is an act of creation, and it remains good as creation even in its fallen state.
We all suffer silent crises, carrying burdens that are utterly invisible to those closest to us, and occasionally even opaque to ourselves. Yet it is good. Even when we can’t feel it, it remains good. While suffering is a normal part of human life, it is not the essence. At the center of being is not suffering, but grace. We will forget this fact many times throughout our lives. The task before us is to hold each other up, to remind one another of the truth that is truer than our deepest misery, to attend to the gift God has given us, to accept that it is good even when we do not feel that goodness at all. Despite the ease of contemporary life and its promises of even greater peace and efficiency, life is terribly difficult. And while we may hesitate to name the mundane “courageous,” it seems undeniably true to me that day-to-day life demands great courage. That courage speaks loudly, it confesses the nature of creation and of God. It is our burden and our gift. And when we are faithful to it, there will be peace, one day.