Rosh Hashanah Day 1 2018 - Mental Health Awareness

Rosh Hashanah Day 1 - 2018/5779
Vayishma Elohim - And God Heard: Mental Health Awareness

About a month ago The Washington Post ran a poignant article about Stephen and Janna Marks who are the owners of Bike and Roll DC. They’re based downtown and they live in Maryland. Their business is quite successful providing bike rentals and tours downtown and it would seem that they should be very happy. But tragically, on January 4, 2015, they buried their 15 year old son. He had committed suicide three days earlier. Noah Marks was a bright student and aspiring actor. He had a leading role in Walter Johnson High School’s production of “The Crucible”, unusual for a sophomore. He was a fancy dresser, often wearing a bow tie to school. In addition to  excelling in all academic subjects, he also enjoyed art, poetry and theater. 

Despite seeming happy, Noah struggled with mood swings, had trouble sleeping and had suffered psychotic episodes. His iphone case had an inscription on it that read, “a smooth sea never made a skilled sailor.” He had been hospitalized and had been in therapy and despite all these warning signs, no one mentioned to Stephen and Janna that suicide was a possibility, least of all Noah who never wanted to talk about his illness. So it was a tragic shock when on New Year’s Day 2015, Noah killed himself.   

Around the same time the Washington Post published that article about the Marks family, ESPN - a national sports network - published an article featuring Kevin Love. The Cleveland Cavaliers basketball player suffers from a severe anxiety disorder and has been undergoing treatment and therapy for several years. In that article he openly and honestly shared his struggles which threatened his relationship with his teammates and his fans. 

When Kevin Love revealed at a press conference before the NBA all star game last winter that he had sought professional counseling, a flood gate opened up. Other players, some of whom are just as much a star as Kevin Love, came forward as well. Though Kevin Love in that article shared many details and examples of how his anxiety disorder affects his game, he was still hesitant to reveal all.

Aside from these stories about Marks and Love there were also many others that appeared after the suicides of celebrities Anthony Bourdain and Kate Spade. In almost all the reports and detailed accounts it was tragic how close friends and family never knew the depth of the struggles these people endured. Though they may have exhibited some signs, many people have been reluctant to open up about the pain they feel and the illness with which they are coping.

According to the Mayo Clinic’s website “Mental illness refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors. Many people have mental health concerns from time to time. But a mental health concern becomes a mental illness when ongoing signs and symptoms cause frequent stress and affect your ability to function. A mental illness can make you miserable and can cause problems in your daily life, such as at school or work or in relationships. In most cases, symptoms can be managed with a combination of medications and talk therapy (psychotherapy).”

Despite the fact that nearly 20% of adults in America, nearly 44 million people, have a mental illness there is still a stigma associated with it. People with an anxiety disorder appear to act normally most of the time so when a crisis erupts people cannot understand why it has happened. Though a physical ailment like a broken leg is readily obvious and relatively easy to cure, the causes of (let alone a cure for) mental illness despite years of research is still unknown. The brain is a mysterious organ that is difficult to study. Though some anxiety disorders and other mental illness respond to drugs and therapy there are others that do not. Health insurance plans don’t adequately cover the high cost of therapy and medicine leaving many people and their families with a tremendous financial burden.   

It is no wonder then that those who suffer with mental illness especially those who can’t adequately control the symptoms to enable them to have quality of life, sometimes resort to desperate measures. Perhaps the ongoing pain, the isolation and the effect mental illness has on their ability to maintain strong relationships lead some people to choose suicide. According to statistics from the Centers for Disease Control, suicide is the second leading cause of death for people ages 10-24. Every day in America over 3,000 teens in grades 9-12 attempt suicide. How can we respond to this rapidly expanding epidemic? What can we do to offer help and guidance? What can we do to make those suffering from mental illness feel that they are not alone; that we care about them?

As a rabbi I always turn to our rich heritage as I begin to tackle such important and tragic issues. Our 2,000 year old rabbinic tradition and modern Jewish thought is surprisingly rich in nuance and ideas about many ethical and moral dilemmas. As we are gathered together here in shul on the high holidays the rabbis developed a liturgy, a sacred text, that would provide some insight into those issues with which we are grappling. Though the text is centuries-old, it is remarkably layered and relevant. In fact the Torah reading which we read a little while ago has an important lesson about reaching out to those who are suffering and who feel alone.  

As the story unfolds in Genesis chapter 21, we see that Sarah has become annoyed with Hagar and Ishmael to the point that she demands Abraham to expel them from their household. God tells Abraham to listen to Sarah and then the story continues: “Early next morning, Abraham took some bread and a skin of water and gave them to Hagar. He placed them over her shoulder, together with the child, and sent her away. She wandered about in the wilderness of Beer-sheba. When the water was gone from the skin, she left the child under one of the bushes, and went and sat down at a distance, a bowshot away; for she thought, ‘Let me not look on as the child dies.’ And sitting thus afar, she burst into tears. God heard the cry of the boy, and a messenger of God called to Hagar from heaven and said to her, ‘What troubles you, Hagar? Fear not, for God has heeded the cry of the boy where he is. Come lift up the boy and hold him by the hand, for I will make a great nation of him.’ Then God opened her eyes and she saw a well of water.” (Genesis 21:14-19)

Hagar and Ishmael are alone in the wilderness. Their lifeline - bread and water - has been depleted and their ties with their family have been severed. The situation is dire, if not hopeless. What is Hagar to do? There is no one around to help. She has a child to care for and yet she can’t provide for him. What can she do? She puts him in the shade under a bush - to at least make him comfortable - and she walks away and starts crying. She can’t look at her son as he nears death. 

Yet is Hagar alone? Is there no source for help? An angel appears. The angel opens her eyes, and she sees a well of water. Why didn’t she see the well before? Where was it hiding? Perhaps her desperation blinded her in the moment so that she couldn’t see or think clearly? 

And what about the boy - Ishmael. The story tells us that “God heard the cry of the boy.” But the story didn’t tell us that he was crying! The clever narrator makes it seem as if the boy must have been crying because Hagar didn’t want to look at him as he neared death. Surely in his agony Ishmael must have been crying or moaning. But the text doesn’t say so. How did God know that Ishmael was crying?

And finally the messenger/angel tells Hagar to “lift up the boy and hold his hand for I will make a great nation of him.” What does making a nation have to do with holding the hand? What power is there in holding hands?  

The Hagar-Ishmael story is a powerful lesson of love, faith and support. When Hagar places Ishmael under the bush and walks away and then cries we feel her pain. We can imagine being around the bedside of a loved one and wanting to exhibit strength and optimism. We don’t want to cry in front of them for fear of causing anguish and despair in our dying loved one. So we cry somewhere else instead. 

While providing care, especially after an initial diagnosis, we can also feel like Hagar - so focused on the task at hand yet so lost at the same time. Where can we turn for help? Who is out there to help? Where can we turn for answers and guidance? What can we do? Only when that help comes can our eyes be opened and we can see the well of water right in front of us.

And Ishmael himself suffers silently. He doesn’t cry out in the story but he is clearly suffering. He has run out of food and water yet he doesn’t want to be a burden or to add further to his mother’s grief and anguish. God is aware of Ishmael’s pain and God answers his cries.

The holding of hands is also a powerful moment in the story which is also partially lost in translation. Not only is the holding of hands symbolic of the willingness to share in the struggle and to provide support but the Hebrew word adds another layer. The word to hold is “le-hach-zeek” from the root “chazak” meaning strong. Holding hands therefore implies a sharing of strength or a strengthening of one another. When we hold hands with our loved ones or when we lend a hand to a stranger in need we are strengthening that person and ourselves in the process. We are empowering the other person, helping them realize that they have strength when they didn’t realize they had it before. And when we give of ourselves we would think we would be weakened in the process. Giving something away should logically imply that we are lessened and depleted. But this teaches quite the opposite. By sharing something of ourselves with another we are strengthened. Our love and compassion increases.

These elements of the story - God hearing Ishmael’s cries and Hagar holding Ishmael’s hands - are inspiring and motivational. They serve to teach us to be ever vigilant not only of the needs of our loved ones but also to the needs of everyone in the community. In an age where the gap between rich and poor is widening, when there are more hungry and homeless people needing our help, when our own family members are ill, we are empowered by the phrase “ba-asher hoo sham - where he is”. We need to be aware that someone is there and that someone needs our help. If we think we are powerless then we just need to be reminded that simply holding someone’s hand can provide strength. 

But now let’s focus on the silent cry of Ishmael. It is empowering to read how God heard a silent cry - like the proverbial riddle, if a tree falls in a forest and no one is there to hear it, does it make a sound. What is the nature of Ishmael’s cry? Was he in pain? Was he about to die? Was he expressing concern for his Mother? And how was his cry answered? The angel/messenger doesn’t talk to him in the story, only to Hagar his Mother. Somehow his silent cry was her cry because after the text says that God heard his cry the angel asks Hagar what troubles her! So what is going on - and what lies deeper beneath that silent cry? 

Remember the statistics I shared just a moment ago? Nearly 20% of adults in America suffer from some sort of mental illness. According to those statistics then over 100 of us in this sanctuary today have some kind of mental illness as defined by the Mayo Clinic website. One hundred of us struggle in some way. One hundred of us try to lead a “normal’ life with work, family and other commitments. One hundred of us may be seeking medical assistance, or may be in therapy, or may simply be coping on our own. Not many of those hundred have shared their struggles with anyone outside their immediate family.

And it is for those reasons that the story of Hagar and Ishmael becomes very powerful and inspiring. We learn about  the incredible relief of knowing that someone has heard our silent cry; we learn the power of holding hands and human touch.

 From the story we learn how tragically painful our struggles can be. As Hagar and Ishmael run out of bread and water, as she is left with no choice but to place him under a bush and as she walks away and cries, we feel her pain. We know how lonely it is to be suffering. We know how desperate we become and how hopeless we may feel. In those few short sentences we want to reach out to her, we want to accuse Abraham and Sarah of being so heartless and we want to jump in and help her.

Imagine our relief then one sentence later when God calls out and appears to Hagar. Miraculously it seems as if a well of water appears. Just the fact that someone has responded makes it seem to Hagar as if they were an angel. The narrator tells us that God heard the cry, and the narrator tells us that an angel appeared. But we don’t know what Hagar saw. It could have been a stranger passing by, a fellow wanderer in the desert. But that person in her moment of grief and despair seemed to Hagar to be angelic. That relief is palpable. When someone who suffers, when someone who is coping with mental illness knows that someone truly cares, the relief for them is powerful. Just knowing in that moment that they are not alone provides the strength needed to carry on.

And that relief is transformed to strength and blessing simply by holding hands. God could have simply told Hagar that her son would be a great nation. Why did she have to hold his hands while God gave her the blessing? Because human touch is calming and curative. Studies have shown that human touch, whether it’s parent-child, loving partners, friends or co-workers, all can inspire positive thinking. Touch releases oxytocin which makes us feel good and makes us feel more optimistic. Physical touch increases the levels of dopamine and serotonin which regulate our mood and relieves stress and anxiety. And human touch improves a function of our immune system that can lower blood pressure and reduce the risk of heart disease. So when Hagar held her son’s hands she was not only signaling that she loved him but she was helping to make him feel better too. 

So how should we respond to the epidemic of suicide and mental illness? As our story teaches we need to be aware. We need to rise above the judgments and stigma and recognize that all human beings are created in the image of God. All people deserve the right to health, life and justice. We need to be vigilant in what our teens are saying and doing and intervene when necessary to get them help and support. We need to advocate for them and adults and increase the amount of support health insurance can provide. We need simply to be a constant, loving presence. 

Though Stephen and Jenna Marks know they can’t bring back Noah, they have made their workplace friendlier and more supportive. Their employees are encouraged to discuss mental illness and mental health days are granted without question. They founded the Orange Wednesday Foundation, because Noah wore orange pants on Wednesdays, to raise awareness and encourage people to talk about mental illness. Based on the Marks’ example we too need to advocate all workplaces to allow a more generous leave policy for mental health.

Education and awareness are most important. The articles that are more frequently being published in print and in social media help to emphasize the message that mental illness is common and that people with mental illness need our love and support. As a congregation we need to become more educated and when we say that we are warm and welcoming we must apply that concept to everyone. We have a religious duty as taught in this morning’s reading to rise above the stigma and to be attentive to the silent cry.

Our short story of Hagar and Ishmael, often overlooked, we now learn is a very powerful message for the new year. As the year begins and we sit in shul reflecting on the past and dreaming about the future we can’t help but take stock of our own lives. We also can’t help but have concern for everyone else around us - what are they going through? Do I even know if they are ok? What can I do to make things better? Though the problems and challenges may seem insurmountable, just reaching out and holding someone’s hand conveys so much. 

It would be easy now to ask you to hold the hand of the person next to you. Instead I’d like you to take a moment to reach forward and place your hand on the shoulder of the person in front of you. It doesn’t matter whether you know the person in front of you or not. Gently place your hand on their shoulder and squeeze. If you’re in the front row then you may hold the hand of the person next to you. Think about the care and compassion you want to convey to the person in front of you or next to you. Think about the support you want them to feel and think about how you want to be sure that no one feels alone. As we bless each other through the power of our touch may we this coming year feel both the blessing of the touch of our family and community and the blessings of God. May our cries no longer be silent. 

Shanah Tovah.