On Shame and Mental Health

Having the courage to struggle

Photo by @felirbe on Unsplash

To begin the process of healing and restoration, whatever that may look like for you, you must first come to terms with the struggle. And to some extent, that means being public about your struggle. The first time I truly tried to get help for my OCD, I made an appointment with my pastor to talk about my thoughts. A few days before the appointment, I canceled. I had to hit rock bottom before I sought help. And even then it took 8 or so more years before I got the help I needed. There remained a great deal of shame leading up to the phone call when I canceled that appointment. Shame that I couldn’t deal with my problems on my own. Shame that I needed help. Shame that I wasn’t “alright.” Shame that I was out of control of my life. That shame didn’t go away, even when I sought help from a counselor. Because then there was the shame of getting “professional help.” Was I broken? Was there something wrong with me? And what about medication? Were my body and mind not right? Didn’t I have it in me to fix my problems without the help of medication? And on top of all this was the harm I was causing, the people I was letting down by ruminating, the family members, friends, professors, and students. Shame upon shame upon shame.

There is no end to shame, if we allow it to build. It just echoes through our lives. And even after there has been some healing and restoration, there can be a sense of shame at having caused harm in the past, the weight of harm you can’t ever fully undo, which you can only repent of. And all this shame holds you back from the very thing you need, which is to heal. The more shame you feel, the more likely you are to fall into despair that you will never get better, and the less likely you are to advocate for yourself. So how do we move beyond shame over mental afflictions?

At its core, shame is the belief that we are not good enough, that we are not okay, that we are not affirmed. And when you are struggling with a mental affliction, those are the voices you are likely to hear from your mind, whispers that you are flawed, broken, hopeless, a failure, and so on. You may be hearing those whispers because of the affliction itself, for example depression, or you may think those thoughts as a consequence of your affliction (“because I’m so anxious, I can’t do anything right, which makes me a failure”). But either way, these thoughts are common to those who struggle and they prevent you from doing the thing you need to do to move forward, which is advocate for yourself. The less you believe you are loved, worthy, and cared for by God, the less you will believe that you deserve proper treatment and healing.

Which means that foundationally, you must ground yourself in the reality that God desires you to take care of yourself. It is honorable and good for you to pursue your mental health, just as it is good for you to pursue your physical health (and most often the two are intertwined!).

Shame tries to convince us that at our core we are condemned. But the reality is that at our core we are redeemed and beloved by God because of Christ’s finished work on the cross! Now, sometimes shame travels in place of guilt. Guilt tells us when we have done something wrong. And it is valuable for us to acknowledge when we have done something wrong, even when it is related to our mental affliction. For example, just because you are anxious, doesn’t give you permission to be unloving or abusive to other people. You are still responsible for your actions. When our mental afflictions incline us to sin against our neighbor, we may feel shame as a result, thinking, “See, this is who I am, I am hopelessly broken. I can’t do things right.” At that moment, we need to correct our thinking with the gospel, reminding ourselves that we are a new creation, set free from the bondage to sin by Christ. We don’t need to feel that sense of shame, although it is appropriate to feel guilt and repent for our sins!

That said, most of the shame I’ve witnessed in others who struggle with mental affliction and have experienced myself does not center around actual issues of sin. It has centered around fears of being fundamentally broken as a person or being a drain on family or friends. So let me address those points.

First, you are and you are not broken. Because of the Fall, we are all broken in one way or another. All of us suffer in this life. All of us face struggles and setbacks and difficulties. You are not alone in that. You should not feel ashamed or unique or different. And yet, before God, you are not broken. You are redeemed.

Also, behind the fear that you are broken, I think, is the fear that you must be “fixed” in order to be accepted. God accepts you and loves you. He desires you to be well. But he loves you right now.

Second, to be a human is to depend on other people. There is no escaping this fact. You are born dependent. You will die dependent. This is not a failure on your part. This is not a flaw. This is a glorious design by God! Do not feel ashamed for depending on your family and friends while you walk through mental affliction. Let them sacrifice for you. And as you can, sacrifice and serve them in turn. This is just how life is done. When you feel creeping shame for their sacrifices for you, say a prayer of thanksgiving to God for them instead of entertaining those thoughts. Practically this means we need to open up to people about our suffering. We need to reach out and rely on others, professionals and clergy and friends, to support us. We need to take that initiative, to have the courage to open up.

In the end, if we allow it, shame will hold us back from pursuing the thing God desires for us. As we assume agency over our lives, we glorify him. Shame surrenders agency by folding into despair. When we have the courage to struggle with our afflictions, we give hope to others, the shame decreases, and we move toward healing. But all of that is dependent upon recognizing that God loves us because of the righteousness of his Son.