Friday, October 2, 2009

Crazy in Church

Scrupulosity is a particular form of Obsessive Compulsive Disorder (OCD) that focuses on religion and spirituality. I have OCD, and when I was younger and religious, I used to have irrational fears of future sins that I might commit against my will. (Kind of like my current irrational fear that I'll become a cult leader against my will.) Because of my family's religious practices (faith healing) I didn't get my OCD diagnosis until I had a spectacular nervous breakdown in front of 300 fellow algebra students at age 21, but that's another story for another time.

Scrupulosity was the one of my many mental afflictions that earned me the most praise. (If you don't think having OCD has been an asset at more than one job, you're crazy.) Because we as a society think that faith is a virtue, our moderate religious members don't seem to know what to say to people who exhibit extreme faith. If I'd stayed a believer, even as I got help for other disorders, I think the scrupulosity would have gone unchecked. Most of the therapists and psychiatrists I've seen over the years were Christian, and few people think religious devotion is a problem. (Atheists, you were right. It *is* a problem!)

One of the greatest harms of religion is its ability to inhibit mental health services for those who need them, based on its position of influence and authority. While my family's complete abstinence from medicine was extreme, many denominations and congregations teach against the use and/or effectiveness of psychiatric medications and cognitive therapy. Since, for certain conditions, such as bipolar disorder, this is the only treatment protocol that really works, it's a big deal.

2% of Americans have OCD, ranging from mild (maybe running back to check if the stove is on, two or three times in a day) to severe (Howard Hughes). I'm somewhere in between, but closer to Howie. 7% of Americans will have moderate to clinical depression at some point after age 18; 1 in 8 adolescents will suffer from moderate to clinical depression.

In a given year, 26.4% (just over 1 in 4, or 57.7 million) Americans will have a diagnosable mental illness. Of those, 45% will meet the criteria for two or more distinct mental illnesses (like me) "with severity strongly related to comorbidity." (In other words, if you have depression and anorexia, each one is likely to be more severe than is typical for people only showing one of these disorders. I've had both. Plus OCD, PTSD, and generalized anxiety disorder. I rarely leave the house these days.)

What these figures show is how prevalent mental illness is in our society. (So we need to quit acting shamefaced about it and just say - "Yes, I have this problem. Let's find ways of fixing it and/or dealing with it, instead of pretending it's not real.") About 80% of Americans are Christian, which means that even if every non-Christian was included in that 26.6% with psychiatric conditions, at least some Christians have gotta be crazy.

That's why it's so dangerous when churches mock science and keep their flocks ignorant, or conflate mental illness with demonic possession, and give an already vulnerable person more reason to put off getting treatment. When churches and church leadership suggest that prayer is preferable to psychiatric help, or that listening to the voices in your head is a good thing, they risk creating another Timothy McVeigh or Scott Roeder or Roland Robideux. Crazy people do crazy things - that's why sometimes we get locked up, and sometimes we get medicated. (The demon exorcisms, on the other hand, were NOT helpful.)

I've always been crazy, but I didn't know there was a name for what was going on in my head. Getting my diagnosis was this strangely empowering moment. Now that I knew what the problem was, I could start to actually deal with it. Early treatments were spectacular failures - Prozac made me hallucinate and think that I was melting, on campus - but it's better than doing nothing and infinitely better than trying to "cast out" my craziness through loud, authoritative prayer.

I think that we in the skeptical, secular humanist, ethical community need to start talking more about mental health issues, and we need to call what churches do abuse. I don't just mean exorcisms, although my personal experience with them brings gang rape to mind. When the church says that the voice in your head is real and is someone else, a demon or a god or the holy spirit, people who have problem voices *put off getting help, or try to get the wrong kind of help. When the church says that God gives comfort, people wait a lot longer - sometimes forever - to talk to someone about the incredible well of sadness inside them.

Mental illness is not "spiritual". It is largely the result of genetics, trauma, and chemical imbalance. It is not the fault of the afflicted person; it is not a generational curse brought down through the family line; and it is not rare. More than 1 in 4 Americans will have a mental illness at some time. That may mean periodic reoccurring bouts of bulimia, a single episode of severe depression, or a few months in intensive therapy dealing with PTSD, but it does mean that someone you know is likely to be affected.

If people get help, they're significantly less likely to commit suicide. Since this is the one shot at life people have, I would hope they'd get a long, good run out of it. I hate to see anyone cut their time short, for lack of simply knowing someone cared or lack of the ability to calm and comfort oneself. A person who gets mental health services is also less likely to hurt someone else.

I used to work typing up reports for a psychiatrist who did SSI disability determination, so the people in his office usually had pretty severe problems. Without fail - every. single. person. who talked about hearing voices in their head said the exact. same. thing. "They tell me to do bad things." No one ever goes to a psychiatrist for a voice that tells them to pet kittens. No, it's the person hearing a voice telling them to do "bad things" that we need to get help for - soon.

Here's a link to the 1.5 hour long Atheist Experience episode on Religion and Mental Health. (Skip ahead to 12:05 to bypass the several years out-of-date announcements.)

* All facts and figures are from the National Institute of Mental Health.