Knowing the Illness
Through growing in my medical understanding about the symptoms and types of bipolar disorder, I find myself growing in my empathic understanding of the experiential, lived pieces of people who are diagnosed with this illness too. Medical knowledge develops my sensitivity towards the real impacts of the illness on one’s education, work, functioning, life stages and transitions, family and marital relationships, etc. As Jamison writes: “It is, after all, not just an illness, but something that affects every aspect of life”; “lost years and relationships cannot be recovered, that damage done to oneself and others cannot always be put right again”.[1] Hence, I find that medical information is not only personally useful for me in knowing and caring for the person and the family, but also for the person and for the family themselves. For example, I have witnessed their sense of relief derived from an epiphany that the destructive and chronic behaviours are actually medically explainable. The subsequent introduction of treatment to stabilise patients’ moods instil a glimmer of hope in them.
Knowing the Person
However, as bipolar disorder is a chronic illness, it is important for patients and families to learn how to live with the condition and treatment within their specific, unique contexts. To a huge extent, this reveals the limitations of understanding patients using a medical model because every individual is unique, and so is their recovery journey. In short, the medical model merely describes the behavioural symptoms, and categorises behavioural symptoms into diagnoses. Whereas, a person-centric model contextualises the illness to the life of a unique person. What this looks like for me is to consciously resist temptations that arise whenever people approach me for advice to problem solvetheir illness. Instead, having listened to their pain and sufferings, together, we try to identify their triggers, onset, relapse signatures and pathways that differ across individuals. Meanwhile, I often find myself eventually disappointing them with my honesty that there is noquick fix to their illness – even if and when a particular psychiatrist is consulted, a certain medication is prescribed, or a certain therapist is engaged. This is as even the person-centric model, on top of the medical model, are insufficient to make sense of a person’s illness if it is not seen through our Creator’s lens and through Christian, progressive growth.
Knowing Scripture
The Bible convicts me that while biological factors may predispose and make one susceptible to have a mental illness, environmental factors are what trigger the onset of a mental illness and reveal our hearts’ desires. Proverbs 4:23 writes: “Above all else, guard your heart, for everything you do flows from it.” Modern psychiatry merely describes behavioural and thought patterns, but it does not necessarily and fully explain the reasons why. By implication, as a Christian, I must look beyond the symptoms and behaviours during a bizarre mania or an inconsolable depression by asking deeper questions, such as: “How does this person put his/her world together? How does s/he view these difficult circumstances? How does s/he view God in these challenges? How does s/he interpret one’s sense of self? What is the function of this behaviour?” The answers to these questions will be telling of one’s theology of oneself, of Christ, and of suffering and victimisation in a broken world. And the Bible will help us live with our illness in this broken world, where there are limitations to modern psychiatry. “All Scripture is breathed out by God and profitable for teaching, for reproof, for correction, and for training in righteousness, that the man of God may be complete, equipped for every good work.” (2 Tim 3:16-17)
Knowing Ourselves Through Biblical Lens
Ultimately, we are all accountable to a living God, who completely reverses and reframes degrading words that we so often use to describe others, including people diagnosed with bipolar disorder, but hardly for ourselves. The Bible describes our default state as being poor, sinful, weak, sick, insane, foolish, delusional, and mad. Put bluntly, “The hearts of the children of man are full of evil, and madness is in their hearts while they live, and after that they go to the dead” (Ecclesiastes 9:3). Proverbs describes a fool as one who does not listen to wisdom and does not follow the Lord’s good commands. Jesus points out humanity’s irrational, insane minds for hating and rejecting Him without a cause (John 15:25) even though “what can be known about God is plain to [us], because God has shown it to [us]. For his invisible attributes, namely, his eternal power and divine nature, have been clearly perceived, ever since the creation of the world, in the things that have been made. So [we] are without excuse.” (Rom 1:19-20)
And so, what else is left, but to pray that we would know that our most troubling insanity and delusion is man’s rejection of Jesus Christ? Because that surely leads to eternal death and judgement. Also, we must learn to carefully distinguish what is humanly perceived as odd and mad from sinfulness; only then can we biblically guide others in the knowledge of their illness and relapse symptoms with a collective aim that “by the mercies of God, [we] present [our] bodies as a living sacrifice, holy and acceptable to God, which is [our] spiritual worship. Do not be conformed to this world, but be transformed by the renewal of [our] mind, that by testing [we] may discern what is the will of God, what is good and acceptable and perfect” (Rom 12:1-2).
I love what Emlet writes: “At the end of the day, “normal/abnormal” is not the only (or best) binary to categorize people because it doesn’t, in and of itself, reference the reality that we are image bearers who stand before the living God as responsive and responsible people (Genesis 1:26-27; Romans 1; Colossians 3:10). A person without a diagnosed mental disorder (“normal” according to the DSM) may in fact be living a life oriented away from God (and thus “abnormal” as it relates to God’s design for humanity). A person with a diagnosed mental disorder (“abnormal” according to the DSM) may in fact be living a life oriented toward God (“normal” as it relates to God’s design for humanity).”[2]
Conclusion: Bipolar disorder is a lifelong suffering and testing allowed by our sovereign God. Meanwhile, we can be sorrowful but also rejoicing in hope. God sanctifies us through our pain. His Word is all sufficient; it comes to life and becomes felt truths, rather than remain as head knowledge, thanks to such experiences. As caregivers, friends, and families, we will also grow and learn to see people beyond their mental illness just as God does.
Modern psychiatry can only do so much to serve us. It can and will neither diagnose nor treat man’s greatest need. Jesus said, “Those who are well have no need of a physician, but those who are sick. I have not come to call the righteous but sinners to repentance.” (Luke 5:31-32) May we thus move towards the sick not only because we too are sick, but also because we have tasted Christ’s grace and goodness for ourselves.
[1] Jamison, K. R. (1996). An unquiet mind. 1st Vintage Books ed. New York: Vintage Books. p.200 and 6.
[2] Michael, K. E. (2017). Descriptions and Prescriptions. New Growth Press. p.28