As we approach the 2-year anniversary of life with COVID, mental health statistics reflect that the pandemic has had a profound impact on our minds, bodies, hearts, and souls. Depression, suicidal ideation, and anxiety have all increased among adults, adolescents and children. Appallingly nearly 25% of individuals who have a mental health illness report not receiving the treatment that they need.
Dr. Biana Kotlyar Castro is a psychiatrist, who specializes in electroconvulsive therapy, and is a consultation-liaison services Dr. Castro highlighted the challenges of treating people with mental illness at the High Holiday services of Congregation Knesset Israel in Elgin this year. She gives a moving description of her work: “I see patients, people at some of their lowest points in their lives. They are struggling and suffering from an unbearable burden. I wish more than anything that I could help quickly and completely. But the truth is, despite how far medications and biological treatments have come in the last couple decades for psychiatry, we cannot heal with these treatments alone. It’s a long road and even when psychiatric symptoms do lessen, the aftermath of the experience is often devastating. Patients must mend relationships that suffered, somehow find a way to return to work or school, many have significant consequences that they must deal with while often still in recovery. It’s a hard, uphill road to travel and often takes a long time, consistent effort and support from their village. Dr. Castro continues, despite how far we have come and what we know about the brain-mind connection, neurocircuitry and neurotransmitters; there are still people that believe mental illness is a moral failing or weakness. This couldn’t be further from the truth. Those who have dealt with mental illness are some of the toughest and strongest people I know,” she writes.
Dr. Castro brings up the issue of shame which often follows people with mental health issues. Perhaps that is why few people seek out their Rabbis to talk about their struggles with mental health. We receive calls from friends, relatives and others telling us that someone is in the hospital with a physical illness. Yet we do not hear when people are suffering from debilitating depression or anxiety, from an eating disorder or obsessive-compulsive disorder. We hear about the birth of a baby but not about the mother who is suffering from postpartum depression. We hear about someone diagnosed with cancer but not someone diagnosed with bipolar disorder. As Jessica Evans, a blogger for the Jerusalem Post who identifies herself as a person who has mental illnesses writes, “You do not often see care committees focusing resources to help those struggling with horrible symptoms stuck at home or overwhelmed. There are no cards or brisket or challah sent over. No phone calls, just checking in or encouraging one to keep going.”
Let us not forget that our Bible is full of prophets and leaders who suffer from anxiety and depression. Perhaps the first person in the Torah who clearly suffers from depression is Rachel, Jacob’s wife. She sees her sister, Leah, giving birth to four children, yet she has not been able to get pregnant. She is envious of her sister and distraught about her situation. Her desperation to have a child leads her to plead with her husband, “Give me children, or I shall die.” Unfortunately, she does not get the support and understanding from her husband she needs to cope with her sadness. Rather, Jacob, her husband, answers with anger and impatience. He responds, “Am I God who prevents you from having children?”
The Book of Samuel describes King Saul, the first king of Israel, as suffering from “ruach ra-ah” after he is told by the prophet Samuel that he would no longer be king. Rabbi Abravanel, a medieval commentator, describes “ruach ra-ah” as “melancholia, an illness in which sorrow, severe anxiety over one’s fate, and depression replace imagination and the ability to concentrate”. Meiri, another commentator, defines “ruach ra-ah” as hallucinations from which one flees madly. The Rambam defines it as “depression, where a person prefers to be isolated in a dark room.” In another writing the Rambam, Moshe Maimonides, calls mental illness “marah shehorah”, bitter darkness, and suggests treating it with music and walks in the garden or around beautiful buildings.
Perhaps the most well-known prophet in the Bible is Elijah the Prophet. We invite him into our homes during the Passover seder. We set aside a special seat for him at a bris. We invoke his name at Havdalah.
In the Bible we meet him as a prophet in Northern Israel who fights against idolatry. He flees from the Queen of Northern Israel, who threatens to kill him. Exhausted, he journeys south to the Wilderness of the Sinai and finds rest under a broom tree. There, broken and depleted, he asks God to take his life. He feels he has been a complete failure. He has lost his will to live. He cannot go on. Despite his heroic efforts, he says, the Israelites have forsaken the God of Israel and have turned to idolatry. Judaism, he feels, has no future. He alone remains faithful to the Covenant, and he is the last of his kind.
Elijah wants to give in to his depression, to be alone in the wilderness, to give up eating, to sleep and not wake up. But Elijah gets help. An angel comes to him, touches him, prepares him food, urges him to eat. Elijah does recover and returns to Northern Israel to continue his fight against idolatry.
Rachel, King Saul, Elijah the prophet, and many other Biblical figures – including Moses – suffer from serious mental health issues in their lifetimes. But their illnesses do not prevent them from living full lives and making vital contributions to the Jewish people. Rabbi Nachman, the great grandson of the Baal Shem Tov who died in 1810, famously said “The world is a narrow bridge – do not be afraid”. Rabbi Nachman experienced intense swings of mood during his lifetime. Although he emphasized living life with joy and happiness, he also taught that one could find God even when one was emotionally low. Rabbi Nachman advised, “Struggle with your sadness. Struggle with your soul … the point is not to rid oneself of struggle, but to accept it as a condition of being human”.
When people do struggle with their sadness, and struggle with their souls, it is important that they do not do so alone. Like the angel that reached out and touched Elijah, fed Elijah, and comforted Elijah, we too must not leave the person struggling with mental illness to struggle with it alone. Rabbi Nachman teaches us that, like physical illness, mental illness is part of being human. It is nothing to be ashamed of. In being open about the struggles of Biblical figures, our religion is telling us that we must stop hiding our own struggles from the view of others or from ourselves. We must be the angels that lift them up, remind them we are there for them, encourage them to get professional help. We must be the angels that are patient and loving and compassionate with them and that, above all, do not get angry with them.
Let those who are suffering in our congregation, and those who love them, hear this prayer:
May the One who blessed our ancestors —
Who named us Israel (Yisrael), those who “struggle,”
Bless and heal those among us who struggle with mental well-being.
May they acknowledge their own strength and resilience in persevering,
May they treat themselves with forgiveness and patience,
May they find others who share their experiences,so they know they are not alone,
May they find help, compassion and resources when they are able to reach out for them,
May they find others willing to reach out first when they cannot,
And may they find inclusive and welcoming communities that will uplift and celebrate them.
May the Holy One grant us the strength and resilience to support our loved ones,
May we find the patience and forgiveness we need for ourselves and others,
May we find solidarity and support from other caregivers,
May we find the capacity to listen without judgment and with the intention to help when asked,
May we find the ability to notice when others are struggling and reach out to them first,
And may we create communities that accept, support and keep company with those among us who are struggling.
Let us say, AMEN.
Mi Sheberach Prayer