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Mental Health: A Response to the Liahona Article

Content warning: depression, anxiety, suicidal ideation, mental illness

This is in response to the Liahona Article “New Hope for Deeper Healing from Depression and Anxiety” by Jacob Hess, PhD

Since my teen years I have coped with depression and anxiety. Reading back on my journals from high school this pain is evident to me now, though at the time I didn’t realize it wasn’t just typical teen angst.  It was only as a Freshman in college that I realized something was seriously amiss with me.  I found myself deeply wanting to cut my wrists with a razor, or to throw myself out of my fourth floor dorm window to end it.  I also was very drawn to trying to overdose with pills. It was scary.  My immediate coping strategy was to promise myself to get in bed and not get out again until that feeling ebbed to keep myself safe.  I lived across the street from the University Health Center and was (miraculously, considering the paucity of resources) able to get a regular appointment with a therapist.  My rigidly orthodox teen thinking led me to interpret these feelings as a temptation from Satan that I had to learn to fight and overcome – that they were in some sense sinful because wanting to kill a person is a sin.  So I also went through the repentance process that I had learned in Church.  Things got better after awhile.  I thought I had “overcome” – the narrative at Church is one where trials come, you endure righteously, and then they go away and a different thing happens to you.  So I thought I was done.

            I served a mission.  I now see that throughout my mission I was struggling with depression and anxiety.  It manifested itself in rigid adherence to rules, hoping that would ease my psychological pain, and feeling physically sick in ways that were (clearly, in retrospect) psychosomatic.  I just didn’t want to face another day.  I did, I forced myself to try to be exactly obedient.  But it was really really hard.  But I had overcome the trial, right? All that Freshman stuff was a situation specific trial, so I was not depressed anymore!

            But I was struggling mightily with depression.  And in graduate school there was no denying it to myself.  Eventually I joined a group session for Cognitive Behavioral Restructuring, then I was able to see a therapist again for about six months. She was really helpful to me coping with some traumas both past and present, and helping me reframe some of my thinking.  I still reflect on some of our conversations today, a decade later. Things got a bit better. But honestly I look back on graduate school/my twenties as a time of feeling really bad.  I remember once having a conversation with the other doctoral students about suicide, and what would be the best method.  It immediately became clear that everyone in that room had given a lot of thought to this question and, in fact, had a plan.  This speaks to an issue with graduate school that should probably be addressed…

            After completing my doctorate, I was pregnant with my first child and the depression was overwhelming.  My suicidal ideation went beyond thinking, beyond generally planning, to active intent and timeline.  The depression was not situational. I wanted to have a baby and all other circumstances in my life were fine. Fortunately before I acted I called my best friend, and she told me to hang up the phone and call my doctor immediately, and that she would be following up.  So I did, and (to my surprise, though it shouldn’t be) my doctor wanted to see me immediately.  She prescribed anti-depressants and worked her magic to get me in to a therapist immediately.  The therapy wasn’t a good fit at that time, but the fluoxitine? It was like magic.  I felt like I could function, like I could experience happiness and excitement and a normal range of human emotion.  I didn’t curl up and sob on the floor for hours at a time.  Since that time I have consistently been on anti-depressants for the last eightish years, and it has changed my life.  I periodically have to adjust dosage, switch medications etc., and the side-effects are no picnic, but it beats what my life was like before.  I am here today because of medication.  I had honestly thought for many years that I would inevitably die at my own hand.  That my goal was to hold out as long as I possibly could but that I would not be able to hold on for seventy years.

Now my mental health regimen is as follows: I go to bed and get up at the same time every day.  I make sure that I am outside in direct sunlight for at least 20 minutes every day, ideally much more.  I aim to exercise vigorously six days a week, with moderate exercise on Sunday.  I take several anti-depressant/anti-anxiety meds.  I am keenly aware of my “canary in the coal mine” red flags for when my meds are not working and try to respond quickly by reaching out to my doctor to work on adjusting them.  I have found that seeing a psychiatrist is my best fit because having someone who specializes in mental health medication has worked better than conversations with my general practitioner.  I do not read sad books or watch sad movies. I do not go to parties or other unnecessary events that will cause me to have an anxiety attack. I’m doing okay.

This is my context.  Today I read the article “New Hope for Deeper Healing” in the Liahona.  It struck me as really problematic and tone deaf.  Perhaps for some people who have a situation-specific form of mental illness that will go away over time it is helpful.  Certainly parts of the advice are also part of my mental health tool kit.  But the author does two things that I believe are the wrong approach.

First, the author really deemphasizes the professional help available to people who are suffering. In the final suggestion (7. Increase Your Capacity and Resilience) the author mentions seeking outside supports including “qualified medical and mental health professionals offering medication or counseling” which is the only reference to this key part of responding to mental health issues.  This is in the same sentence as family, friends and the Church’s emotional resilience course.  The emotional resilience course is led by random members of your ward who likely do not have a professional mental health background, and includes whoever the Bishop suggests, regardless of what mental health issues they might have or not have. I’m not saying it’s useless. I’m saying it is not an appropriate resource to equate to professional help for severe mental health issues. The author doesn’t even endorse seeking help, he only says that some people do.  Barely mentioning a medical response to a medical condition is deeply troubling.  Many Church members see what is printed in the Liahona as gospel truth and act on it accordingly.  It is irresponsible to give so little space to something crucial, and hide it late in the article.

Second, I strongly object to the overall tone of the article, that the goal is “long-term healing” – that is to say, that you “overcome” mental illness and it becomes a trial with a tidy bell-shaped curve that you can dust off your hands and say you’re done.  The author repeatedly uses language suggesting that mentally ill people should focus their hope on having mental illness completely eradicated.  He uses phrases like “lasting relief,”  and “lasting healing.” He also says “Many with mental illness have been told their condition was permanent.  This was based on the belief that the adult brain doesn’t change.  We now know better… fundamental shifts are possible, including for those facing mental illness.  The possibility of profound changes shouldn’t be surprising to those who believe in Christ.”

I have a testimony of Christ.  I believe that Christ can heal all afflictions on earth.  But I also know that for most people, a miraculous complete healing is not part of God’s earthly plan for us.  Christ healed several people who were blind.  It was miraculous.  Billions of people with vision problems across millenia have not been healed while on this earth.  I wear glasses.  My son has a congenital vision issue that will be part of him for the duration of his life on earth.  These facts do not in any way diminish the reality of Christ’s power, nor do they negate my own faith.  But it is reality that though Christ can heal all things, for most of us He doesn’t right now.  The phrasing the author used implies that people with faith in Christ should frame their experience of mental illness around an expectation of complete and permanent healing.  The logical inference then is that if you don’t anticipate relief in this life, you must not have much faith in Christ.

It is not realistic for people with a genetic predisposition to mental illness to expect to be cured for life, no longer requiring medical intervention.  It is dangerous to suggest this.  If I suddenly stopped taking medication, I would return to the mental place that I was before.  I know this because anti-depressants lose efficacy over time and need to be adjusted, so about every year or so I get reintroduced to what my brain is like when it isn’t getting help.  I can go for vigorous walks in the sunshine until my legs fall off and it won’t change the fact that my father is mentally ill, my grandfather was depressed, and my great-aunt took her own life.  Genetically, the odds are not in my favor.

I also think it is demeaning to suggest that “permanent healing” means some kind of end destination where there is no more affliction.  I prefer to think of “permanent healing” as an ongoing state for the rest of my life.  I will permanently be in need of healing, of mental care, of succor.  I will be in an ongoing state of mental fragility requiring help and vigilance.  That isn’t something to be ashamed of, or to see as some kind of failure.  To we castigate people with diabetes for not “overcoming” their insulin issues through faith? No, that would be ridiculous.  Diabetics will need insulin for their lives.  I am depressed.  I will need serotonin and dopamine for the rest of my life.  And that’s okay.  I’m not falling short either in my efforts to heal or in my faith in Christ by admitting that I have a chronic condition.  Rather, by admitting it will not go away I’m able to consistently care for my body in a way that allows me to thrive and live a meaningful, happy, faith-centered life.  I no longer believe I will inevitably die by suicide.  I imagine myself being able to live to old age.  I don’t see my goal as “well, I’ll try to stick around until my kids are adults but then I can’t take it anymore.”  This was where my brain was.  Now my brain is in a place that says “I’m doing okay.  And I’m going to keep working hard doing what I know works to be okay.”

For Christmas my husband got me a little sign that says “It’s okay if you fall apart sometimes.  Tacos fall apart, and we still love them.”  And that’s the truth.  Being mentally ill is not wrong, it is not a trial to overcome, it is not a sign of lack of faith.  We do a great disservice to people with genuine medical problems to offer exactly the same advice as we would to someone dealing with deep disappointment about losing the student body election, or being dumped by their dating partner.  Being temporarily blue and being mentally ill are different things that deserve a more thoughtful treatment from a publication that many see as a source of guidance endorsed by God’s chosen spokespeople.

30 COMMENTS

  1. I agree completely. Thank you for speaking up. I don’t have mental illness to a point of daily medication but I have family members who have for most of their lives. Without antidepressants in the world, I know I would be divorced. It’s much easier to treat each other kindly, with less depression and anxiety to contend with. Kindness is a necessity for successful family relationships.

    And again, it is less anxiety and depression. My observation in my loved ones is that mental health will always be an important concern, to be cared for carefully.

    • I likewise question whether I could stay married without medication — in part because I would be so very hard to live with, and in part because my mind conjured up wildly inaccurate interpretations of the smallest things and blew them to monster proportions before I was medicated. He went to bed without saying goodnight. He hates me. We’re getting divorced. This is not a mental pattern that leads to harmony and marital well-being. Thank you, fistful of medications, for enabling me to be the person I really am, and not the wild-eyed misery blob I otherwise tend to be.

  2. There was a huge discussion of this article in June on the By Common Consent blog, with many comments similar to yours.
    https://bycommonconsent.com/2022/06/16/liahona-depression/
    However, author Hess (or the Liahona editors, based on negative feedback) actually changed the online version of the article from the print version, which I noticed when I compared the two. My comment is #59…
    “As of today (June 29–though it may have been modified earlier), item #7 in the Hess article has been changed substantially in the online version of the Liahona as compared to the print version, which I have in front of me.” The original version (and still in the print version) is titled “Decrease Dependence” and quotes 2 Nephi 2:26, “Act for yourselves and not to be acted upon.” (Each of the 7 sections in the article begins with a scripture.) The revised online version is now called “Increase Your Capacity and Resilience” and says,
    “We are more than conquerors through him that loved us” (Romans 8:37).
    The original and print version says, ““It’s natural for anyone facing depression or anxiety to rely on a variety of outside supports: from professional therapists and family or friends to medication and food. Some unfortunately turn to illegal substances and alcohol while trying to navigate painful emotions. While many sources of help can provide short-term benefits, people who find longer-term healing consistently speak of a decreasing dependence on external resources. The Church’s emotional resilience class is one resource that helps people develop that kind of growing freedom.“ The revised, online version says, “Painful mental and emotional challenges can limit our natural capacities in various ways. That leads many to seek additional help from a variety of outside supports as needed. These include qualified medical and mental health professionals offering medication or counseling, family, friends, and other helpful resources such as the Church’s emotional resilience course. Some unfortunately turn to illegal substances, alcohol, and other unhealthy escapes that may provide temporary relief but ultimately can be detrimental to long-term healing. When used appropriately, outside resources can support us as we seek deeper healing. People who find more sustainable recovery report experiencing incremental growth in their emotional capacity and resilience over time.”
    It’s still incomplete and inadequate, but it’s somewhat improved–and shows that someone somewhere pays attention to complaints.

    • I think church publishing has a lot to answer for when they give a platform to people who have a harmful agenda which Hess has clearly demonstrated on multiple issues. We blocked him from an LDS group I admin for because of his stance on issues like mental health. Thanks for outlining the changes–wish the church would learn not to publish people who don’t actually know what they’re talking about.

  3. People “getting better over time” is an arrogant assumption. They usually either got help you’re not aware of or, more often, stopped saying anything because it was obvious no one actually cared.
    As much as I wish I didn’t need my antidepressants, any steps to increase or decrease are going to be in lockstep with a medical professional. I’m getting better at remembering the hard times when I thought I could do without.

    • Love your point – either the person is getting help or isn’t being honest with you anymore. Only if the sadness is situation specific does it get better as the situation changes. That isn’t the same thing as mental illness.

  4. Your conclusion says it perfectly. Thank you for sharing your own experience and challenging that harmful, dangerous narrative. I can’t count the number of people I know who have needlessly suffered through being told to pray their mental illness away or lacking access to medical care because people doubted they needed it or didn’t support policies that made mental health care affordable… the list goes on. It’s well past time the Church changes its narrative on mental health and uses its platform better.

    • Agreed. I would love more thoughtful talks/articles on the way prayer interacts with mental illness, from people who actually know what they’re talking about. For example, when I’m depressed I’m emotionally numb. I am not able to feel feelings of any kind, except sadness. I don’t feel joy or fear or comfort or anything. Just a complete inner numbness. But the Spirit speaks to me through feelings. So when I’m depressed, it’s like the phone line has been completely cut. I am not physically able to pick up whatever signal might be coming, which can feel spiritually devastating. I’d love more articles that actually talk about THAT kind of thing. How can you have meaningful prayer when your brain has convinced you that you are alone in the cosmos and no one loves you? Or you believe in God but are categorically not capable of making a connection? “Just pray” feels like a mean joke in that context.

  5. Thank you for your thoughtful response. Jacob Hess is a savvy writer who is trying to subtly disseminate his beliefs through as many outlets as possible by presenting his personal medical beliefs as simple common sense solutions to the many, many healthcare problems we experience today. He believes that the “medical establishment” is a corrupt, money-grabbing machine that keeps patients sick enough to continue profiting off of them indefinitely. “Big pharma” apparently has no interest in making people better, since they can’t make as much money off of healthy people. This somehow leads him to believe that alternative medicine is the way to go (I’m sure he would just say it is one of many options that people should consider, but still he would nudge you down that path more than others), since energy healers are somehow, in his mind, not influenced by the same profit motives that medical corporations are. He is becoming quite popular among a certain group of medically disaffected types who are frustrated by our healthcare situation.

    • I had no idea who he is. That is interesting background that further cements my feeling that this isn’t an appropriate stance in a church publication

  6. I’m usually a “criticize the argument not the person” fan, but Jacob Hess is wholly unqualified to speak on these things, totally homophobic (routinely trolls LGBTQ spaces), and super right-wing biased. The Liahona should never have published this garbage.

    • Yuck. I didn’t know him. And now I dislike his “PhD” tagline even more. I mean honestly I almost always hate it (having one myself) because I think it is pretentious. I either think you’re in a context when it should be self-evident (say, your profession that requires the degree) or else it doesn’t need to be emphasized. If you do bring it up, there should be a reason and you should give the audience some further information about why your specific field is relevant. In this context it gives him authority, but we don’t actually know what his PhD is in, or where he got it, or how he is using it. It just makes him sound authoritative in ways that may not be appropriate.

  7. “We do a great disservice to people with genuine medical problems to offer exactly the same advice as we would to someone dealing with deep disappointment about losing the student body election, or being dumped by their dating partner.” Thank you for this vulnerable, effective example of why our conversation around mental illness needs to change. We all need support of some kind. Demonizing mental illnesses, or discounting the tools we have to help us manage a mental illness, harms all of us. Beautifully written.

  8. Thank you, thank you, thank you, for such a clear, well-written, articulate article on such a difficult subject. Although my journey with depression wasn’t/isn’t nearly as severe, it has most if not all the same components. It can be really hard to comprehend if you haven’t experienced it. For me, meds gave me a floor to stand on, so all of the other things I was doing, could then help lift me into a better place, rather than just keeping my chin on the edge of the pit so I didn’t fall all the way in. I loved that Em clearly laid out that she isn’t merely just taking a pill, although that’s the crucial foundation, she is actively doing a lot of essential self-care to go along with it. And I loved her analogy with diabetes and taking insulin. Again, thank you, thank you….

    • Thanks. And yeah, the pills don’t make me happy. Fortunately people in my ward have stopped making the kind of comments that are dismissive of people “popping happy pills” instead of ____________ that the speaker thinks should be sufficient for joy. My pills make me capable of experiencing happiness. They allow me to have the usual range of emotions that other people do, without devastating lows and able to experience highs. Insulin doesn’t make diabetic people superman. It allows them to have a quality of life that other people enjoy. Anti-depressants don’t make me manically perky. They make me able to have the same emotional responses (proportionate and appropriate) that other people do to the world around them.

  9. ‘@NYAnn Thank you for that info about the changes in the online vs print versions. Some improvements although as others have pointed out, not enough. It seems that it would be responsible for the Liahona to include in a future print version a clarification that the online version was altered (maybe even with an explanation of why). But I’ve learned not to hold my breath.

    @Em Many many thanks to you for your vulnerability in writing this piece. This is a conversation we need to be having with more openness. Straightforward discussions of mental health are crucial for dealing with the issues we have surrounding us and can be lifesaving. Thank you.

  10. Thank you for speaking the truth in a respectful, honest, vulnerable manner. Thank you for shining a light on dangerous ideas included in printed LDS media. I would not be functional without my daily meds.

  11. Thank you for speaking out about this.

    I suffered from moderate to severe levels of clinical depression, social anxiety, and general anxiety in high school and part of my twenties (I’m in my early thirties now). Talk therapy, daily medicine, and LED light therapy treatments were oftentimes the only things that kept me anchored and functioning in the real world during that time. Jacob Hess’ article was ignorant and irresponsible: as you and Robin Litster Johnson said in her comment, people who suffer from depression do all sorts of self-care in addition to the daily medicine as part of their treatment. It was wrong of him to write that off and to make light of how much medication has actually helped people.

    Your part about graduate school and the doctoral students who all had suicide plans was a reminder of why I chose not to attend graduate school after graduating from college. My depression was at its worst shortly after I received my bachelors degree and things didn’t level out for a few years after that. I knew then that I wasn’t in the position to take that on. Even though I’ve been thinking about getting my masters degree lately (I would do it online at a pace that is more flexible and better suited to my needs, and my place of employment would cover some of the cost), part of me is really hesitant to do so because of what the ramifications could be to my mental health. There is a mental health crisis going on amongst graduate students I agree with you that it’s a problem that should be addressed and talked about more than it is.

    • Today I heard an acquaintance is thinking about graduate school and my first response (which I said out loud) was “why?!?!” Fortunately I was not speaking TO the acquaintance at the time. Obviously there are many good reasons for seeking higher education, and many benefits. I had pictured how good it would feel to walk to Pomp and Circumstance to get my hood. It didn’t feel good. I was so miserable and felt so horrible inside I forbade my family from having a party or any kind of celebration. We got some frozen yogurt. So… about proportionate to the accomplishment of finishing a Little League game. Even that was pretty joyless. The whole experience broke me. I feel like good came of it of course. I feel that Christ healed the brokenness and on the other side I was indeed refined by the fire. It stripped me of my pride, probably too much – moving into self-loathing category. But still. Previous arrogance about my intelligence is gone-zo. And I like knowing things, and gaining skills. But overall? I try not to think about it and I would recommend it to exactly no one.

      • That was gloomy. Go to grad school if it will help you live your dreams. Go with your eyes wide open and your tool kit for self care at the ready. Grad school gave me many good gifts, though it also felt like walking through the valley of the shadow of death for parts of it. So if you want to go, go. Go with a plan and a support system for self care.

  12. Thank you for this. This may be a bit of a thread jack, but you say you’re aware of your red flags and try to reach out quickly for medication adjustment. I think one of the hardest things to do can be to recognize that things have shifted – would you be comfortable explaining how you identify your flags?

    • Well I’ve just noticed larger patterns. Eventually it becomes obvious when the meds aren’t working — when I’m in my bed crying for hours or find myself on the ol’ national hotline. But working backward there are other symptoms that show up before the full crash. My two big ones are irritability and exhaustion, particularly the latter. Irritability can be harder to pinpoint, because sometimes life is just annoying. But when I find myself annoyed by everything everyone says all of the time? That’s a big ol’ red flag. And for me particularly exhaustion is a biggie. If I’m not otherwise sick and I NEED to nap every day for more than a day or two, I start paying closer attention. Sure there are times when my body might just say “hey, slow down!” or maybe the hormones are up to some little trick. But for me depression tired feels like early pregnancy tired (if that is something you have experienced) – where you have. to. sleep. There is no way around it. When I plan my days around how I can wangle a nap, I know there is an issue. (as I mentioned, I’m pretty diligent about my night sleep – lights out at 10:30, get up at 7:30. This allows some tossing and turning time while still hopefully getting the full allotment). So if I’m tired consistently during the day, that’s depression. Sometimes sadness makes me nearly narcoleptic. I was grieving the death of a friend within the last year (so situational depression rather than med problems) and every time I’d have a crying jag I’d fall asleep, regardless of what time of day it was or how much sleep I had had at night. Sometimes I use caffeine pills if I have to function through a whole day while I’m waiting for an adjustment to work. But usually it’s a highway to nap town until things get adjusted. So those are my red flags — I’m the Queen of B*tch Mountain for no good reason, and I need to be unconscious for two hours every day in addition to ten hours at night.

    • The other part I would say is to have friends around you (or family, or whoever your network is) who are aware of your red flags and who you trust. My friends have often been the voice of warning — hey, you seem to be napping a ton recently. Maybe talk to the doctor? They also pick up on changes in my tone of voice or in my overall mood more quickly than I do – maybe because the friends I’m thinking of are mostly phone conversation live far away friends, so they are paying more attention to that rather than other cues like a fake smile. I also tend to hermit — I’ll self isolate and not want to go to anything or participate in activities I would otherwise enjoy. So if I don’t notice myself doing that, my friends sometimes will gently mention it. So if you have certain symptoms that are characteristic of depression or other mental illnesses for you, talk about it with your support circle and ask them to help you see yourself objectively when you need an outside opinion of how you’re doing.

  13. Thank you for discussing the depths and complexity of depression. I have a family member who suffers from depression and your article speaks to what my family member deals with on a daily basis.

    • Thanks. I know that being on the outside watching it happen feels awful — both because I’ve watched others suffer and been powerless to do anything, and because I can well imagine how awful it feels. It can be really hard if the person isn’t able to come to terms with what is happening. I know that for a long time I was looking for a REASON for feeling so awful. If I was so unhappy surely there must be something wrong in my marriage? Or my friendships? It took awhile to realize that me feeling unloved and unloveable was not the same thing as those around me actually feeling antipathy towards me. That is a hard line to walk when every part of mental illness feels completely real inside the person’s head. Anyway. I’m glad you’re there for your family member.

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