Mental illness occurs in all cultures, including the Jewish community. “There isn’t any group that has a free pass or an additional risk,” says Eric Schindler, a clinical psychologist who is president and CEO of Tucson’s Child & Family Resources. Psychological disorders stem from environmental causes, genetic makeup and stress, and a new precipitator, he says, “is now being traced to the prenatal environment.”
Regardless of the contributors to mental illness, “everyone is able to benefit from protective factors,” says Schindler. Meaningful stress reduction techniques, exercise, calming hobbies, meditation and prayer, he says, can better the quality of life for people with psychological disorders.
Are Jews more or less likely to struggle with psychological disorders? The percentage of Jews involved with Child & Family Resources programs “is around equal to the [percentage] of Jews in the Pima County population,” says Schindler.
The diagnosis of a mental illness is probably “seen through the lens of culture,” says Ray Lederman, a child and adolescent psychiatrist, who is associate medical director of the Community Partnership of Southern Arizona Regional Behavioral Health Authority.
The Jewish population “might have a tendency to minimize mental illness,” he says. “We see ourselves as the chosen people, so why not the perfect people?
“For many years, the belief was that the incidence of alcoholism, substance abuse, spousal abuse and mental illness was lower in the Jewish population,” says Lederman. “That’s absolutely not true.” In fact, “for the past four years or so, more than in all the previous years combined, we’re receiving more behavioral health referrals from the Jewish population.”
“Gritting our teeth and moving forward has been a Jewish survival tactic,” he says, “but we’re letting that [guard] down.”
Lederman told the AJP about a small study that cites teenagers from affluent families as more susceptible to depression, likely due to academic pressure from their families. Other studies have suggested that Jews may suffer more frequently from affective disorders, such as serious depression and bipolar disorder; although these studies haven’t been substantiated, he says, they’re still interesting.
In 1989, studies of Jews in the United States and Israel showed that “Jews were found to undergo more psychotherapy than any other group,” according to the Israel Journal of Psychiatry and Related Sciences. Whether that’s still the case is unknown. “While the prevalence rate of schizophrenia seems to be lower, neurosis seems to be higher in Jews than among non-Jews,” says Child & Family Resources’ Schindler.
Current research being conducted at Johns Hopkins Medicine Epidemiology-Genetics Program in Psychiatry notes that the risks for schizophrenia and bipolar disorder seem to be about 1 percent for any population, but its Schizophrenia and Bipolar Disorder Family Studies project is specifically studying Ashkenazim. “Due to a long history of marriage within the faith, which extends back thousands of years, the Jewish community has emerged from a limited number of ancestors and has a similar genetic makeup. This allows researchers to more easily perform genetic studies and locate disease-causing genes,” which will help to improve treatments and medications for severe mental illnesses.
Plus, “we hope that a gene discovery will lead to a better public understanding of mental illness and a reduction in stigma,” states the Johns Hopkins website www.hopkinsmedicine.org/epigen/ashkenazim.htm.. It adds that individuals and family members who have suffered due to mental illness in their family and participate in the study “often feel good about having performed a mitzvah for society.”
Here in Tucson, “parenting issues and marital discord are more acceptable in the Jewish community” than psychological disorders or serious mental illness, says Shoshana Elkins, MSW, LCSW and vice president of clinical services at Jewish Family & Children’s Services. On Oct. 13, she gave a talk at Congregation Anshei Israel, “We Are Not Immune: Abuse, Addiction and Anger in the Jewish Community.” Elkins notes that “it takes, on average, six to eight years for Jewish women to report [spousal] abuse” compared with three to five years in the general population.
“A lot of times in the Jewish community by the time people come in for help,” she says, “things have gotten to the crisis or breaking point.”
“Growing up Jewish in this community,” says Elkins, 37, “as an adult talking with friends now I see that issues with any emotional or mental struggle are more prevalent than people let you know. If we normalize that experience and don’t see it as something weird or uncommon, a shanda (scandal) or failure, it makes it easier to get help and heal.”
Dr. Kevin Goeta-Kreisler, M.D., specializes in psychiatry for treatment-resistant patients, he says, and is one of two doctors in Tucson who accept Medicaid for shock treatments.
“I see quite a few indigent patients. I’m the only psychiatrist in town who goes to five or six nursing homes,” says Goeta-Kreisler, speaking to the AJP on his way to Handmaker Services for the Aging.
“I use spirituality in my practice every day. As Jews, Torah tells us we’re supposed to bring spirituality into the world,” he says. “A lot of older people of the Holocaust era have questions about Judaism and God. Some of them were brought up not trusting much, or brought up trying to assimilate. As they get older that Jewish spark [emerges more]. They want to be closer to their roots.”
Dealing with the elderly and their families is a major part of Goeta-Kreisler’s practice. Spiritual as well as psychological issues inform his treatment for all his patients, he says. “Doing tzedakah is important for everyone. Lots of people in the world have a great sense of loss. It’s good to keep that in mind; respect your parents and the elderly,” says Goeta-Kreisler. “See them from the perspective that there’s so much to learn from them. So many patients just need someone to talk to. They’re so isolated.”
Society has made strides in dealing with mental illness, notes Lederman. “Advertising meds on TV has created a more open environment and has some benefits,” but at the same time the success in selling Prozac may be due to the “glimmer and glitz of the model,” he notes.
Lederman is alarmed at the statistics for adolescent suicides, which “is the third leading cause of death in kids 10 to 21. Most of those kids have mental illness and the majority of them are not receiving services,” he says. “The visibility of mental illness is growing in our culture. Understanding is lagging behind.”
Some people are fearful of those with serious mental illness, notes Lederman. But, he points out, “people with mental illness are more likely to be victimized by violence than being the perpetrators of violence.”
Among Jews, the obligation to save a life, pikuach nefesh, “is way up there,” says Lederman, adding that “there is greater hope for people with mental illness. We’re learning about the biological component. There’s more peer support for people with mental illness, who are working with agencies. That’s clearly happening in Tucson.”