By Rabbi Chaim Steinmetz

As Printed in the Jewish Press Health Supplement of December 29, 2010

Nineteen-year-old Nechoma has been in Israel for a year in Seminary. Nechoma is on her way home for a sister's wedding and to visit her family for Chanukah. On the whole, her time in seminary has been great. Nechoma has tried to make the best of all the new opportunities that the institution has to offer, while balancing academics and social life. The only problem is that Nechoma is often anxious, and this hinders her ability to relax. She is constantly worrying about things that others do not worry about. This has led her to spend more and more time alone in her room. At times, the anxiety becomes so great that she cannot enjoy the Seminary experience.

When Nechoma arrives home, her excited parents want her to share her new experiences, activities and friends. Nechoma obliges them with a few stories, but knows deep down that she is describing things more positively than she actually experienced. She finally attempts to broach the subject of her anxiety and how it affects her daily life. Her parents listen, but minimize the problem as part of the normal adjustments to the Seminary year. This gives Nechoma some comfort, but soon she begins feeling overwhelmed and anxious again.

Little do any of them know that Nechoma's reclusiveness and symptoms are early warning signs of a much larger problem. Her parents' reaction has invalidated her feelings, which has made her feel like she is imagining things. What Nechoma has tried to express is actually one of the warning signs of mental illness, but it is not uncommon for parents to reject the idea. "Not my child" is an all-too-common reaction, but mental illness can happen to any child of any family.

Nechoma and her parents celebrate Chanukah and the family wedding together. It soon becomes clear, though, that there is "something the matter" with Nechoma. She is either spending an unusual amount of time alone in her room, or she is in the house, cleaning vigorously and chattering away at an unusual speed. Her parents are concerned by this behavior. They do not understand why she is not out socializing or shopping with her friends. They try to talk with Nechoma and express their concern, but Nechoma has now convinced herself that she doesn't have a problem. Her parents want to believe her and try to agree, and the whole family tries to ignore Nechoma's dysfunctional behavior. They become steeped in denial. One sister comments hopefully that "Nechoma is just overly stressed out from school." Her aunt states that she is in high gear because she is trying to get a lot of things accomplished during the short time she is here in America. Nobody in the family is willing to admit that Nechoma might have a serious issue that needs more help than they can provide.

This is the point where Nechoma's parents need to see past their denial and consult a professional. An evaluation is needed to help determine what may ease Nechoma's anxiety and her constant suffering. Yes, help may mean accepting a therapist's suggestion of medication as part of an appropriate treatment plan. While that may be difficult to accept, such a decision could avoid a graver situation and avoid greater suffering for Nechoma and those who love her. Such an intervention is Nechoma's best chance for a brighter future.

However, many parents would let such a problem go on for much too long, adding to their child's emotional suffering. There can be many reasons for such a tragic decision. It can be denial or pure ignorance about mental illness. Sometimes it can be pride, concern for shidduchim, or just wishful thinking that the child is simply going through a passing phase.

Whatever the case may be, the earlier mental illness is detected and treated, the less damage it does. Nechoma is showing classic symptoms of Bi-polar disorder, which can quickly lead to more serious consequences unless treated.

The unfortunate reality is that too often, a person suffering from mental illness hits rock bottom before he or she gets the proper treatment that can relieve their suffering and lead them back to emotional health. The person him/herself doesn't understand that they have a serious problem until the pain becomes so great that it overpowers the denial. The problem is that once such a low point is reached, it takes even longer to get relief or to recover. As with many medical problems, the longer we wait to start the treatment for a psychological disorder, the longer it will take for the treatment to be effective. Denial is a serious problem, as is lack of education - and the two go hand in hand.

That is why there are several organizations in the Jewish community today which promote awareness of mental illness. If you or a loved one is exhibiting unusual behavior that seems as though it might be a mental illness, contact one of the organizations listed here as soon as possible for a suitable referral. Don't let denial keep you or your loved ones sick and suffering.

Rabbi Chaim Steinmetz is the director of Darkah, which provides transitional housing to Orthodox Jewish young women between the ages of 18-30 who suffer from mood and behavioral disorders. He can be reached at 718-431-0539, or via email at [email protected] .