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Monday, July 14, 2014

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Dealing with mental illness

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Rabbi N. Daniel Korobkin

She was frail and emaciated. A feeding tube fed her starving body after she had refused to eat for weeks. Her hands were in restraints to protect her from herself.

This was how I first met Dorothy in a downtown hospital that specialized in patients suffering from anorexia and other eating disorders. This was my first hospital visit after having just moved to Toronto to begin my new rabbinic post, and although I’ve seen a lot in my years in the rabbinate, Dorothy’s plight shook me to the core.

Dorothy was much more than anorexic; for 20 out of her short 30 years, she had endured various physical ailments that left her in constant pain. But the most painful disease of all was the one that could not be detected by any lab test.  Dorothy suffered from mental illness, an illness that left her depressed, confused, suicidal at times, and unable to live with and by herself. A pretty young lady with bright blue eyes who should have been in the prime of a happy life with a husband and children was instead languishing in a hospital bed, where her tragic end had already been scripted.

Four months later, Dorothy was dead.

Dorothy’s family’s efforts were nothing less than heroic in fighting to keep her alive. She was in and out of treatment centres, and no stone was unturned in seeking the best treatment for her. Outstanding doctors and psychiatrists, many of them part of her own community, were administering to her illness and doing the best they could to treat an invisible and elusive disease. But even the best doctors can lose patients. One doctor who specializes in eating disorders spoke at Dorothy’s funeral. He expressed a combination of sympathy, profound sadness, and the beleaguered voice of a soldier who’s been on the battlefield too long and seen too many friends succumb to the battle.

Mental illness can sometimes be the most difficult disease to deal with, both for the patient and her caregivers. The patient suffers not only through her illness but also the skepticism of others who may think she’s “faking” it or can be easily cured if only she’d “grow up” or shake herself back to reality. Her family lives in constant doubt, never knowing if they’ve done too much or not enough to help her get well.

It is also an extremely lonely illness. When a person displays physical symptoms, the community shows compassion and does its best to take care of the physically handicapped, the cancer patient, and so forth. But when a person is mentally ill, some shy away and may even get a bit “freaked out.” It may be because we don’t take it seriously, or that the patient’s illness causes her to say or do hostile and repelling things. Perhaps we’re even frightened when we encounter the mentally ill patient, because we detect a shadow of that very same pathology within ourselves; we’re worried that it’s contagious and that our own mental state might become “infected” if we stick around too long.

Dorothy was a member of an Orthodox shul. She had attended the finest Jewish day schools and came to shul with her parents on Shabbat. Even after her illness set in, she would have lucid moments when she was a loving and sensitive daughter and sister. Despite the loneliness, confusion and pain, Dorothy courageously persisted in her struggle to achieve the normalcy that she could never have.

Although we have wonderful mental health professionals, we still haven’t come completely to terms with mental illness as a community. As embracing and tight-knit a Jewish community can be, Dorothy did not find complete acceptance in her religious surroundings, partially because she was misunderstood by people who were simply uneducated in matters of mental illness.

 At around the age of 10, she began displaying symptoms of the mental illness that would eventually claim her life. Some of her teachers, unequipped to deal with this kind of problem, tried their best to counsel her parents and provide whatever help they could. Sometimes, their “advice” was based on a distorted worldview that assumed that religion had all the answers to one’s mental and emotional problems. One particularly insensitive teacher told her parents that the reason Dorothy was acting out such strange behaviour was because her parents were contributing to her anxiety by allowing this intelligent girl to ask too many questions. All she needed to do was learn to place her faith in God, and that would allay her turbulent outbursts.

We cannot afford to ignore mental illness within the Jewish community. Too many of our friends and neighbours suffer in silence, embarrassed by the stigma to themselves and their families. Some are embarrassed to acknowledge such a problem within themselves or their family, out of a fear that it might adversely affect the family reputation and the ability for the other children to find a good shidduch. But this only speaks to the urgency for the rest of us to react with greater sensitivity and awareness.

If you know someone in your synagogue or community who is depressed or displaying signs of mental illness, reach out. Make sure they’re getting the proper medical attention and that they aren’t isolated from the rest of the world. The Torah tells us that we must not stand by idly as our brother’s or sister’s blood is being spilled. Don’t hide behind your own fears or out of a concern of being overly intrusive. Don’t assume the family has everything under control. You may make the difference between life and death. If you’re not sure how to proceed, seek out your rabbi, Jewish family services or a mental health professional who can guide you.

For those who pretended Dorothy wasn’t there, they don’t need to pretend anymore. May her memory serve as a blessing and inspiration for all of us.

Rabbi N. Daniel Korobkin is the spiritual leader of Beth Avraham Yoseph of Toronto Congregation. The name of the deceased has been changed.

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