Everyone’s talking about suicide…

and I hope we know some things about how to talk about it.

Seriously, the prevalence of this topic in culture, media, social media, and just my own life this week has been astounding. The passing of celebrities Kate Spade and Anthony Bourdain this week have been attributed to suicide. In the midst of that, a CDC study was released Thursday, identifying “suicide rates rising across the U.S.”

At a personal level, on Monday a great church I used to attend launched their annual pub theology series, this year with a focus on mental health issues. (A video clip of my friend Fr. Ryan Waller speaking on mental health and the church is available here, and the article that he went on to publish for the Dallas Morning News is available here.) On Tuesday I started seeing patients at a psychiatric hospital, as part of my summer internship in hospital chaplaincy. On Wednesday I finished watching Season 2 of the recent Netflix series “13 Reasons Why,” a series which details the “reasons why” fictional high school girl Hannah Baker took her own life — and the ripple effects of her death on her community.

Add this all up, and it can feel overwhelming. Hence why I basically had ice cream for dinner last night and plan to take a walk to a pond later today. #selfcare

18121830_1184811074998309_8128000097639833509_oI imagine if this is an overwhelming topic for me (someone training in mental health care), how much more complex it might be for people not accustomed to talking about suicide openly, fearful of it, traumatized by it in the past or present, or currently experiencing suicidal thoughts in their own lives or the lives of their family or friends.

We have to talk about suicide. We have to do so kindly, clearly, and quickly (i.e. as soon as we notice concerning statements or behaviors). And those of us not currently experiencing symptoms of mental illness must be involved.

One of the most important exhortations I’ve seen floating around social media this week is the reminder that it isn’t enough to tell people who are struggling, “Speak up. Get help.” Rather, it can be important for friends, family, and others to speak up and be the help. That’s because a hallmark of depression, as well as some other mental illnesses, is social withdrawal. By this, I mean not just a preference for being alone but a profound psychosocial incapacity for reaching out. That all requires much more physical energy, cognitive decision making, and social connectivity than depression typically allows.

One way that we can speak up and be the help that people may need is by enacting the “QPR” method. Taught widely by the QPR Institute, this method is like CPR, which rescues people having trouble breathing, but in this case aims to rescue people having trouble finding the will to keep living.

  1. Question: Ask the person you’re concerned about as clearly as possible something like, “Are you having thoughts of killing yourself?”
  2. Persuade: Encourage the person you’re concerned about not to act on their suicidal thoughts — at least not today or not this week. For example, in crisis counseling, I sometimes tell people, “Let’s make an agreement that you you won’t act on those suicidal thoughts today. We can check back in tomorrow and go from there. How does that sound?” In addition, if they have access to a gun, rope, pills, sharp objects, or other instruments that they’ve identified as a way they might kill themself, persuade them to get rid of that object(s) at least until their crisis has passed.
  3. Refer: Refer the person you’re concerned about to a local mental health professional, a hotline like 1-800-273-TALK or Crisis Text Line (just text “home” to 741-741 to chat with a trained crisis counselor!), or a local emergency room if they are in imminent risk. Stick with them while they contact one of these referral sources.

Take care of yourselves, friends. And take care of your loved ones. This week and always.

“Welcome to the world. Beautiful and terrible things will happen. Do not be afraid.” – Frederick Buechner

 

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Get Up and Eat: A Sermon on Depression

As Mental Health Month draws to an end…here’s a sermon on depression that I offered toward the end of my preaching class Fall 2017. I don’t suppose it’s perfect, but I do believe it reflects something of God, God’s Word, and God’s activity in my life.

***

A reading from 1 King 19:1-8.

“Ahab told Jezebel all that Elijah had done, and how he had killed all the prophets with the sword. Then Jezebel sent a messenger to Elijah, saying, “So may the gods do to me, and more also, if I do not make your life like the life of one of them by this time tomorrow.” Then he was afraid; he got up and fled for his life, and came to Beer-sheba, which belongs to Judah; he left his servant there.

But he himself went a day’s journey into the wilderness, and came and sat down under a solitary broom tree. He asked that he might die: “It is enough; now, O Lord, take away my life, for I am no better than my ancestors.” Then he lay down under the broom tree and fell asleep. Suddenly an angel touched him and said to him, “Get up and eat.” He looked, and there at his head was a cake baked on hot stones, and a jar of water. He ate and drank, and lay down again. The angel of the Lord came a second time, touched him, and said, “Get up and eat, otherwise the journey will be too much for you.” He got up, and ate and drank; then he went in the strength of that food forty days and forty nights to Horeb the mount of God.”

The Word of God for the people of God.

***

It sounds strange even to me, but when I was a teenager, this passage from 1 Kings 19 was one of my favorite stories in the Bible. Honestly, I think I opened a concordance one day out of curiosity, looked up the word “depression,” and there it was. That’s the only way I can imagine coming across this story, because I don’t remember hearing it preached on or taught anywhere in particular. I certainly don’t remember it being in my colorful children’s Bible. Talking about what amounts to suicidal thoughts isn’t exactly something we’re likely to do in our churches, in our pulpits, in our lives.

But it’s in the Bible. And, I thank God for that.

See, when I was a teenager, I was slowly starting to figure out how to live with chronic clinical depression. Showing symptoms by the time I was 14, diagnosed at 18, and managing bouts of different durations and difficulties off and on ever since. Journeying periodically into the wilderness like Elijah and laying down under a broom tree – or, more likely, under my bedcovers – and sometimes, just sometimes, wanting to die.

Church seemed to have nothing to say to this experience – or at least nothing helpful, nothing sustainable. Church, to me, seemed to be about singing joyful songs and hearing about love, joy, peace, patience, kindness, goodness, and so on. When I wasn’t experiencing those things? I was ashamed to say so…so I just wouldn’t.

The Bible, though, when we really look into it, gets incredibly honest and allows us to do the same. The Bible, in this story from the life of the prophet Elijah, spoke of my depression – even when no one else would – and gave me a holy permission to experience my depression, talk to God about it, and try to seek God in it.

***

Let’s take a closer look at how Elijah does this – how he encounters the Lord in his despair.

First things first, Elijah tells God about the despair. “It is enough; now, O Lord, take away my life.”

This is a very serious thing for a person to say, and I want to acknowledge that. I want to acknowledge that some of you, your loved ones, or your parishioners or CPE patients may have said, are saying, or will say something like Elijah has said. I want to acknowledge, in fact, that someone in your life may have died by suicide.

That someone who has passed away is not to be condemned but is loved by God, now and forever. They are not terrible; rather, at some point in life they felt terrible. It’s important to remember that, according to recent psychological literature, suicidal thoughts and actions tend to come to a person not so much because death sounds good but because life, at least for the time being, feels very, very bad. In a very real way, the person’s brain perceives that they’ve had enoughtoo much – to carry in life and the brain can’t conceive of carrying any more.

And so the prayer of Elijah comes: I’ve had enough, Lord. Take it all away.

How does the Lord respond?

I notice God responding to Elijah in this story with persistence and provision.

An angel of the Lord – a mysterious but palpable, present being – comes to visit Elijah. Maybe not unlike a pastoral visit to an isolated parishioner.

What’s more, the angel comes twice with food.

With the angel’s help, Elijah’s healing process consists of two surprisingly simple things: eat and sleep. Sounds nice, right? Sounds like what we students are going to do a lot of once finals are over.

But, really, these instructions are deeply significant. The Bible is full of images of eating and sleeping – especially eating. These are two of life’s most fundamental day-to-day needs. And two of depression’s most common difficulties, whether in the form of eating or sleeping too much or too little.

Most health professionals will say that changes in sleeping and eating are two of the key symptoms of depression. And, honestly, I’ll tell you that this couldn’t be truer. During a bout of depression one Saturday some years ago, I spent hours struggling to get out of bed – only to spend almost an hour in my kitchen cutting an apple and finding some peanut butter so that I’d have something to eat. If only an angel had placed that apple and peanut butter by my head!

It’s hard, but I’ve heard it said before: When you’re not sure what to do next, just do the next right thing.

Sleep. Eat. The next right thing. And the next and the next. Little by little. With God’s persistence. With God’s provision.      

***

The Reverend Kathryn Greene-McCreight has illustrated this well. Rev. Kathryn is an Episcopal priest, chaplain at Yale University, and writer who has documented her personal experiences with Christian faith and mental illness. In her 2015 memoir Darkness Is My Only Companion, Rev. Kathryn describes being hospitalized and instructed, while on the ward, to set one simple goal for herself every day. She writes:

“My goal was always to say the Daily Office, something that took at most only twenty-five minutes twice a day in the ‘real world.’ In the hospital and in my ill brain it took most of the day. This lent new meaning to the phrase ‘Daily Office.’ Reading the Psalms, collects, Scripture, and prayers was nearly impossible. Concentration was no longer a faculty I possessed. Each word seemed to swim in front of my eyes. But I was determined…”

As hard it was, Rev. Kathryn was determined, like Elijah, to tell God of her despair. To receive God’s provision of a simple thing like Daily Office prayer and to receive God’s persistence of a repeated thing like Daily Office prayer.

Such a simple and repeated practice, like the regularity with which we eat meals or perhaps in our churches eat the Great Meal of Communion, has the capacity to meet a weary soul right where we are and nourish us body, mind, and soul.

***

IMG_5390 “Get up and eat,” says the angel to Elijah.

“Get up and eat,” say our pastors and priests Sunday after Sunday. Eat and drink of Christ’s body and blood.

The Eucharist is salvation writ small, placed into our hands, brought into our bodies. The Eucharist is chief among the spiritual practices that sustain us when we cannot possibly sustain ourselves. That offer us bite-size portions of life when we think – and even wish – that life should be no more.

Meals of all kinds – small and big – can do that. The Thanksgiving meal that many of us experienced last week. The meals that we might bring over to someone’s house when they’re recovering, grieving, or otherwise struggling. Even the snacks that we share in this preaching class. They keep us going.

To be clear, though, I’m not saying here that food – including spiritual food like Communion or like prayer in general – cures depression. Not at all. What I am saying is that God uses surprising, simple, and tangible things to meet us right where we are. To meet Elijah in the wilderness. To meet me in the pages of 1 Kings 19. Giving us physical and spiritual food.

“Get up and eat. Otherwise the journey will be too much for you.”

Get up and eat, friends, whether you are joyous, stressed, depressed, or somewhere in between. Get up and eat physically and spiritually. Receive the food of God’s angels in your own life … and likewise offer sustenance to others as God’s angels in their lives.

“Get up and eat. Otherwise the journey will be too much for you.”     

Amen.

Prayers for Mental Health

I love that the Book of Common Prayer has specific prayers and thanksgivings for just about anything — for travelers, for artists, for the unemployed, for the aged, and so on. But, I don’t see many prayers looking closely at mental health. So, I decided to write a few.

For a Person Experiencing Anxiety

Heavenly Father, you know what we need. Teach us, when we worry about all manner of things, to seek first your kingdom and your righteousness and to find that all these things will be added unto us. Calm the churnings of our minds and bodies, as you calmed the sea, so that we might know your grace and spread forth your peace, through Jesus Christ our Lord. Amen.

For a Person Considering Self-Harm

Almighty God, you created us and called us good. When there is guilt, grant us grace; when there is self-loathing, love; when there is loneliness, communion with you and with our neighbors. Guide us to care for our bodies as tenderly as you did wash the feet of the disciples; through Jesus Christ our Lord. Amen.

For a Person Considering Suicide

Lord Christ, who faced death fully and rose to new life, enter into our thoughts of death and breathe into them life. Restore to us assurance of your good plans and purpose for our lives, grant us courage and resources to seek help, and prepare those who might help us; that we might continue to live for you, who did prepare for us in advance good works to do through Jesus Christ our Lord. Amen.

I hope these prayers could be words of comfort for individuals who wrestle with mental disorders, which can all too often leave us at a loss for words to say — much less words to pray.

Moreover, I hope you might try to write your own prayers for the concerns that you or your loved ones face. I found it to be a very challenging and very rewarding experience, especially since I tried to follow the traditional pattern of collects, which goes:

  1. invocation of God as Father, Son, or Holy Spirit
  2. acknowledgement of a divine attribute related to the petition
  3. petition for a specific needs/s
  4. aspiration (the desired result)
  5. conclusion

 

If you write one or find an interesting one written, let me know!

 

Choose Life: Because Christ Is "Coming My Way"

This has been a hard week for a lot of people.

About 2 Fridays ago, megachurch pastor Rick Warren’s son committed suicide at 27. Last Friday, author Brennan Manning passed away at 78. Monday, Boston happened. Tuesday, Virginia Tech was commemorated (perhaps especially at Virginia universities like mine). Although there’s lots that I could read and lots that I could write about any of these things, I don’t know these people or situations well personally, so I don’t want to be so bold as to write much about them.

However, I do know I can pray for people directly involved.

I do know I can pay attention to how news of tragedy is affecting those indirectly involved or not involved — myself and others. (If news of tragedy elicits suicidal ideation, this recent article can help: “6 Ways You Can Respond to Suicidal Ideation” from Mental Health Grace Alliance)

I do know that today is “Word-of-God Wednesday” on my blog, and whatever happens the “the grass withers and the flowers fade, but the Word of our God remains forever” (Isaiah 40:8).

In Rick Warren’s letter to his congregation, informing them of Matthew’s passing, he expressed deep admiration for his son’s perseverance — and rightly so. In so doing, he said something I find intriguing:

“I’ll never forget how, many years ago, after another approach [to treating mental illness] had failed to give relief, Matthew said, ‘Dad, I know I’m going to heaven. Why can’t I just die and end this pain?’ But he kept going for another decade.”

What on earth can we say to this line of thinking? What did Pastor Warren say? I have no idea. More importantly, what does the Bible say? I have some idea.

The Bible tells us that we should choose life:

“This day I call the heavens and the earth as witnesses against you that I have set before you life and death, blessings and curses. Now choose life, so that you and your children may live and that you may love the LORD your God, listen to his voice, and hold fast to him. For the LORD is your life, and he will give you many years in the land he swore to give to your fathers, Abraham, Isaac, and Jacob.” – Deuteronomy 30:18-20

According to this passage, we should choose life because:

  • choosing life will help our children — or potential children or potential legacies in general
  • choosing life allows us to continue growing toward loving God, listening to His voice, and holding fast to Him
  • “the Lord is your life”; He made us to begin with (Psalm 139:14)
  • “the Lord will give you many years”; He is making our futures (Jeremiah 29:11)

What’s more, the Bible tells us that we should choose life as opposed to choosing death because the kingdom of heaven has come, can come, and is coming again to earth. As is sometimes said around Easter time: “Christ has come. Christ is risen. Christ will come again.” Because of this, we have hope that the Immanuel (a.k.a. “God with us”) who was with us still is with us and again will be with us. In the meantime, we can connect with God through the Bible, prayer, and through the “deposit” of himself that Christ left us in the form of the Holy Spirit.

One way to summarize this is the way that Christ teaches his followers to pray in the “Lord’s Prayer”: “Our Father, who art in heaven, hallowed be thy name. Thy kingdom come, thy will be done, on earth as it is in heaven…”

This suggests that we aren’t supposed to desire to get to heaven temporally sooner. Personally, I don’t think it suggests that we’re supposed to desire heaven to get here temporally sooner. I think the Lord’s Prayer calls us to pray for — and act on — bringing the kingdom of God to earth by loving God and others right here, right now.

This song, “Coming My Way” by The City Harmonic, featured in a video about Brennan Manning, has helped me understand and reflect on this concept:

As this song suggests: Christ is coming toward us in this life. We don’t need to wait till death or usher in death to come to him.

He’s here. He has a mission for us. He has a kingdom for us. And that’s something to live for.