Welcome to Emotional Wellness Daily, a project of SIMHA, the Sephardic Initiative for Mental Health Awareness. In the previous lesson, Dr. Katzenstein spoke about the difference between what we'll call normal anxiety or healthy anxiety, versus anxiety that is at the level of a disorder.
I have a nice, simple pneumonic to use anytime you want to know if something is a disorder: IDF: look at the I, the intensity, the D, the duration, and the F the frequency.
-If something is very intense, even though it might not last long,
-If something is not so intense, but its duration lasted pretty long,
-or if it didn't necessarily last too long, but it's quite frequent,
It becomes a point of concern. If a person is intensely anxious when they see a spider and they start shrieking, that’s intense.
If they're worrying for a very long time about something or it keeps on coming up, these are reasons for concern. But what's the difference? Who cares if it's a disorder or if it's just normal anxiety? I'd like to make a very important point that I heard from both mental health professionals and Rabbis. Rabbi Ruben Leuchter, among others. said that people make this mistake- if someone has a mental health disorder, which is a mental illness, they think they can just talk to the person. If someone has an eating disorder, you can't say, “Why don't you just eat?” They have an illness. It's like if somebody has a kidney stone, you don't just say, “Why doesn’t the kidney stone just go away,” because it's an illness. It's something that's real. It's something that's physical. It's not something they can control that simply.
Yes, therapy often helps with mental health disorders, but that doesn’t mean that you can just tell them to stop. It doesn’t work that way. It’s a real sickness. And it’s important to know that doing this can sometimes make a person's condition worse. If someone is clinically depressed and you say, “Why don't you just get out of bed already,” iyou might be making it worse.
I have heard the following from Rav Eliyahu Brudny, Rav Uri Deutsch and many other great rabbis who are involved in the area of mental health: There's a certain point where a person does not have freedom of choice.
They can't just change. They are at a point where they are mentally ill. I heard from Rav Yehuda Ades that it's very accepted, that if, lo alenu a thousand times, someone commits suicide and has a mental illness, they will be buried with everybody else.
We don't say they committed suicide. They don't have a choice. This is a very important point, and again, only a professional can decide.
Rav Wolbe says there's a danger in this, however. People who don't have mental health disorders may think, “Okay, I'm patur/excused from anything, because I'm a little anxious.”
Another important point is that a person cannot just say, “I have Emuna and Bitachon and that’s going to get rid of my anxiety.”
If the anxiety is at a point of a disorder, it won't work. Take the person who has an anxiety disorder and sees a cat and thinks it's a lion. Very few people can use Emunah and Bitachon to alleviate their fear of a lion. Even the best people that I know, if they were to see a lion, they're going to run. Well, when a person sees a cat as a lion, they can't just use Emunah and Bitachon. They see a lion when you see a cat. That's at a point of a disorder.
Min Hashamayim, I stumbled on an unbelievable source for this concept. There was a great Rishon called the Tashbetz, who wrote a commentary on Pirkei Avot called Magen Avot. In Perek יא Mishna ב the Tanna talks about something called Sinat Haberiut. The Rambam calls it Mara Shechora; today we call depression.
But the Magen Avot says that we cannot say that the Tanna in Pirkei Avot is talking about depression, which he calls melancholy. “Because, if this is the case, this is something that it's in the way of doctors. It's not in man's ability to save himself from a mental illness. The Mishna is not telling you things that you need a doctor for.”
This Magen Avot is telling us, pretty clearly, that there's a point where depression is an illness.
Interestingly, the Rambam, in his Perush Mishnayot, offers advice for somebody that has depression.
He doesn't say, read Musar books on Simcha, or be happy with what you have. He says, “Listen to songs, take walks in gardens, take a look at nice buildings. Look at nice pictures…all things that will alleviate your depression, and will cause the soul to expand, and remove that (depression).”
I am stressing this point because when people hear of a great rabbi that might be suffering with mental illness, they wonder, “How could that be? He's a great rabbi!”
And the answer is, it's no different than a great rabbi suffering from a kidney stone or anything else. An illness is an illness. Just because it's in the brain, it doesn't mean that the person is responsible for it.
This is an extremely important point. Many people might not agree with me. I hope that's okay.
All the best.