Religious Life

Accepting Mental Illness

Accepting Mental Illness
4 Adar I 5779 | February 9, 2019
Cantor Audrey Abrams

The snow glows white on the mountain tonight
Not a footprint to be seen.
A kingdom of isolation,
and it looks like I’m the Queen
The wind is howling like this swirling storm inside
Couldn’t keep it in; Heaven knows I’ve tried

Don’t let them in,
don’t let them see
Be the good girl you always have to be
Conceal, don’t feel,
don’t let them know

Well now they know
Let it go, let it go
Can’t hold it back anymore
Let it go, let it go
Turn away and slam the door
I don’t care
what they’re going to say
Let the storm rage on.  The cold never bothered me anyway

In the Disney movie, Frozen, Queen Elsa sings “Let It Go” just moments after her dark secret has been discovered. For years, she’s tried to hide  her ability to create snow and ice. She even cuts herself off from her little sister whom she loves. Elsa can’t control her power, and on the day of her coronation, by accident, she turns her entire kingdom to ice. Then she runs away. And it is only then, in hiding, that Elsa learns to shed her shame and accept the things that make her different.

A few weeks ago, MPR aired a story about this song and how it has become an anthem for many marginalized groups – especially those with both mental and physical disabilities. For those who have feelings of being misunderstood, isolated or excluded, ‘I don’t care what they’re going to say,’ has helped build confidence and an ability to let go of other’s opinions. Elsa’s dramatic revealing of her hidden condition feels like permission to accept one’s disabilities as a piece of oneself…fully. This is who I am. And it’s in this acceptance that one finds strength.

In the MPR story, a woman diagnosed with Bipolar II who saw the movie with her 5-year-old son, was deeply affected by the song. She said:

“‘a kingdom of isolation and it looks like I’m the queen,’ … that was exactly what I was going through. It gave me words that nobody had given me before to describe this diagnosis of bipolar II disorder that I had.”

‘The wind is howling like this swirling storm inside’ — that’s exactly what it felt like to me, this swirling storm of emotions and thoughts and feelings going on inside of me that no one else understood. But Elsa seemed to get it.”

At the end of the movie, Elsa learns to manage her special ability and can see it as a gift that she can share with her kingdom. She can feel pride – celebrate her uniqueness and not hide it away. “Let It Go” seems to have a power that helps individuals take pride in who they are, the way they are.

February is Jewish Disability Awareness Month and today starts our 3-part series of panel discussions on living with different types of health challenges. These sessions, which will take place after lunch in the learning center, are an opportunity for our community to learn a bit more about personal struggles and triumphs and in general, raise awareness to situations that many of us either are affected by or may be in the future. We hope these discussions can encourage us all to not hide our struggles, our secrets, and let them go.

I’d like to thank Jan Hamilton, Beth El’s congregational nurse, for putting together this series and for being a resource, listening ear and support to so many in our community.

We begin our series focusing on accepting mental illness. Of all the health issues we will discuss this month, this one is probably the hardest. It’s scary for those struggling and scary for friends and family who often feel helpless. It’s a hidden problem that can be marginalized. It’s hard to find help or the right help. There is a shortage of psychiatrists. Insurance often doesn’t pay. Navigating the mental health system can be a nightmare with little direction on where to turn for help. There is a stigma that keeps individuals from getting the help they need and families from getting the support they need. It’s a hush hush category of diseases surrounded by shame, fear and isolation. Those with mental health challenges may identify with Elsa, and want to let go, but it’s not that easy.

I’m giving this d’var today because this is a topic in which I relate on a very personal level. I have a Mental illness. I also have crohns disease, a liver condition, and reflux. Those are easy for me to say to you today. I have mental illness is not. I don’t even like saying “Mental Illness.” It seems so severe. What about “disorder”? “challenges”? “Wonky brain?” Perhaps if I say “I have mental health challenges”. But it is, by definition, Mental Illness…

According to the American Psychiatric Association, mental illnesses are health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities.

On the APA website they write in very large print:

Many people who have a mental illness do not want to talk about it. But mental illness is nothing to be ashamed of! It is a medical condition, just like heart disease or diabetes. And mental health conditions are treatable. The vast majority of individuals with mental illness continue to function in their daily lives.

Mental illness is very common. In a given year:

  • nearly one in five (19 percent) U.S. adults experience some form of mental illness
  • one in 12 (8.5 percent) has a diagnosable substance use disorder
  • More than 75 percent of all mental health conditions begin before the age of 24 and is on the rise on college campuses
  • Approximately 1 in 5 youth aged 13–18 experiences a severe mental disorder at some point during their life. For children aged 8–15, the estimate is 13%.
  • 1.1% of adults live with schizophrenia.
  • 2.6% of adults live with bipolar disorder.
  • 6.9% of adults will have at least one major depressive episode
  • 18.1% of adults will experience an anxiety disorder such as posttraumatic stress disorder, obsessive-compulsive disorder and specific phobias.
  • Among the 20.2 million adults who experience a substance use disorder, 50.5% will have a co-occurring mental illness.

I ask you to raise your hand if you have a loved one, know someone, or even yourself who has dealt with:

  • Addiction and Substance Use Disorders
  • ADHD
  • Anxiety Disorders
  • Autism Spectrum Disorder
  • Bipolar Disorders
  • Borderline Personality
  • Depression
  • Eating Disorders
  • Obsessive-Compulsive Disorder (OCD)
  • Postpartum Depression
  • Post traumatic Stress Disorder (PTSD)
  • Schizophrenia

We are all touched in some way by mental illness.

I’ve had a mental health diagnosis for half my life but can trace symptoms as far back as my teens. I have challenges that I will always live with and have learned coping strategies through the years and ways to deal, when things are out of balance. I’m not always great at it, but I can recognize when things are awry and understand my needs and try to be gentle with myself. I’m not ashamed and I firmly believe that chemistry has been a huge help in my life.

I’m also blessed. I have found great doctors and therapists in a medical world that is difficult to navigate. And I have a wonderfully understanding and tolerant husband who has helped me greatly over the years with his love and support. And I’m now well into my 50’s so I’m wiser and don’t care as much anymore what people think. I can talk about my journey and own it.

But when I was younger I felt alone and scare and out of control. I didn’t know I needed help. I just knew something wasn’t right.

I remember when I received my first diagnosis, I cried. A lot. I had worked in a psychiatric hospital and saw so many people with mental illnesses and thought, “now I have it?” I felt embarrassed. Like I was bad. But there was relief too. Like when you put glasses on for the first time and realize you haven’t been seeing what the rest of the world sees. Knowing I had “something” – with a name – helped me to stop beating myself up. I had an illness. Now I could get treated.

Mental illnesses are not easy to treat. Much like other health issues, it’s not a science. Trial and error with medications until you get things under control. Monitoring changes. Readjusting medications.  And through it all, your brain is out of whack.

And on top of the physical symptoms, there is a huge stigma with this illness. And because of the stigma many of us with these challenges are fearful of the repercussions if we let people know. I debated giving this d’var long and hard out of such a fear. I speak with many people who themselves are struggling and so many parents with young adults battling these issues – and there is always worry about outside reactions. What will people think? How will they will look at me? If I’m having a bad day will people think it’s because I’m mentally ill? Might an employer think I won’t be able to do my job?

And there are internal dialogues: what’s wrong with me? Am I bad because I have this? Am I bad parent because my child struggles? What did I do wrong? Why is this happening? Why do I have this? Why can’t I be like everyone else? And on and on.

Physical disabilities can be seen. Mental Health disabilities are invisible. So…people wonder…are they really real? Can’t you just snap out of it?

Many times I wish I could just snap out of it, but it doesn’t work that way. This is a brain thing. I need to be patient and nurturing with myself and try to let go of the external and internal dialogues.

I haven’t told you my exact diagnosis because in truth it doesn’t matter. It’s a name. It’s only the diagnosis my psychiatrist gave me because the medication that works for me often works for people with this illness. My therapist on the other hand thinks I have a different diagnosis. I’ve had a few different ones over the years. And the reason I need one at all is because insurance won’t pay if I don’t have one. We don’t want our kids labeled and I don’t want to be labeled either.

I am not my diagnosis, so it really doesn’t matter. That is not how I see myself. That is not how I identify. I see myself as a successful, caring, loving, creative, artistic woman who is in her 12th year as the cantor in this synagogue – one of the largest conservative congregations in the country. What I am is someone with a bachelor’s degree, a master’s degree and a cantorial degree. What I am is a wife for 31 years, the mother of 2 grown children, a daughter, sister, aunt, niece, with wonderful friends. What I am – just like every person in this room – is made in the image of the divine, special and unique and holy and broken. We all have challenges. This is one of mine but it does not define me.

A wise woman told me that we must go through our wounds to find our gifts. I know I am who I am in part because of my mental illness. I believe it has helped me find many of my gifts – including my creativity, empathy and self-awareness. By accepting my diagnosis and doing what I need in order to manage it, it’s less of a big deal.

In this week’s parasha God says,

“In this sanctuary the Israelites are to bring me gifts. The gifts can be of any kind from any person whose hearts moves them in a giving way”

Over the course of these next few weeks, brave members of our community will talk about their challenges. Their hearts are moved to bring the gift of themselves to our community – to be willing to speak their truth so that perhaps we can realize that it’s okay to speak our own.  We need to celebrate different abilities and recognize the unique gifts each of us bring to the table because of our “illnesses, challenges, disabilities”. We can be inspired and allow ourselves to be vulnerable, we can learn how best to help, we can support and ask for support, we can keep our hearts open and mostly, not judge.

I’m no different than I was 10 minutes ago. But now you know my “secret.” It is human nature that when we leave today you might be tempted to say to someone, “Did you hear that Cantor Abrams has mental illness?” However, if we are truly going to make it OK, destigmatize something common and prevalent, then it doesn’t matter what “Cantor Abrams has…”.

On the other hand, if you think that telling someone can help them, then please do so.  I’m here to talk with anyone who struggles with Mental health challenges, has family members who are going through difficult time or who genuinely want to understand a bit more about my experiences. I won’t pretend to have the answers, but I can be present, listen, empathize, support and encourage.

It is my hope and prayer that in my lifetime stigma of mental illness will go away. I want it to be OK. I don’t want anyone to be ashamed or embarrassed or worried to admit they are struggling. I want anyone to be able to whole-heartedly sing out loud and strong:

Sing: I don’t care what they’re going to say