B

y now I’d heard some version or another of this story more times than I can count.

A young man with lots of potential is doing great, when all of a sudden he experiences his first episode of mental illness. Both he and his family are shocked, of course, but after one or two hospitalizations, he eventually finds a treatment plan that works for him and is stabilized. Baruch Hashem, he’s back to school, and pretty much back to his old self.

And then the questions come: What does all of this mean? Why did this happen to me? What did I do to deserve this? Unfortunately, his doctor’s answers about neurotransmitters and other chemical imbalances can’t comfort the deep crying pain of “Why me?”

The search for a deeper level of spirituality as the young man tries to grasp the greater cosmic understanding that Hashem’s plan is bigger than just “me” might lead him to a heightened yeshivah experience, but then comes the yetzer hara that tells him to suddenly ditch his psychiatric medications. I’ve personally heard from three individuals learning in different yeshivos telling me essentially the same line: “I don’t need a mood-stabilizer when I have Hashem!”

Thankfully, there are highly professional and wise rabbanim who have the wherewithal to handle these situations. One rabbi I’m close with who is dean of a kiruv yeshivah has a degree in psychology, and another friend, Rabbi Avrohom Willig, is a popular Gemara rebbi at Aish HaTorah in addition to being a licensed social worker and psychotherapist.

I’ve gotten used to getting referrals from rebbeim of students who are “on fire” after stopping their medications. As they’re in need of urgent psychiatric evaluations, I often ask to see them together with their mentors in order to discuss the relevant halachos of receiving quality medical care and accepting a physician’s recommendations.

I’m grateful to have developed relationships with exceptional mashgichim, roshei yeshivah, and rabbanim. I’ve been proud to work with them as a team in helping their students to understand that the Torah doesn’t forbid psychiatric treatment, but rather it helps the treatment to be more effective — as the power of prayer and hishtadlus is infinitely greater than the strength of either in isolation.

And so, I was flabbergasted to hear from a social worker colleague that Reb Itche had told his patient to stop treatment with his antipsychotic medications. The poor young man had become acutely paranoid and was saying all sorts of bizarre things, fearful that his every movement was being recorded by unseen cameras.

By the time I saw the patient, his parents were already on the way to pick him up and bring him back home for treatment. In our meeting, the young man told me that since he’d become religious, Reb Itche told him “Shabbos is better than medications,” and he’d subsequently stopped his meds. When I saw him, he was certainly paranoid but he wasn’t dangerous and didn’t need to be hospitalized, but he did require continued treatment. In fact, I was only willing to sign off that he was safe to fly home on condition that he’d restart medication treatment that very day.

I called the patient’s therapist immediately after the visit in disbelief. “I can’t even begin to fathom that Reb Itche told our patient to stop his medications. What was he thinking?”

“I know,” he responded. “Totally irresponsible. Are you going to speak with him about it?”

“You’d better believe it,” I said.

Now, Reb Itche wasn’t known as the most mainstream rabbi, and his talmidim were an eclectic bunch of ex-hippies. Still, I’d known him for the better part of a decade and he’d never given anyone such a reckless eitzah before. And the boy’s family would probably blame frumkeit for inspiring their child to irresponsibly stop psychiatric treatment.

“Reb Dr. Yaakov!” Reb Itche answered when he saw my caller ID. “I hope everything is well with you and yours?”

“Baruch Hashem, Reb Itche. Things are going great. Listen, there’s a reason I’m calling—”

But Reb Itche cut me off. “Reb Dr. Yaakov, it’s really bashert that you called. Before you say anything, I need to ask you something. Nebach, I have a student who isn’t the healthiest kid — actually he’s got a pretty rough history of paranoia and other bad stuff. So when he told me that he wanted to stop treatment because it was ‘against the Torah,’ I told him that the Torah mandates following doctor’s orders and that I couldn’t sanction his stopping meds cold turkey.”

A wave of relief swept over me as Reb Itche continued. “…I told him that while mitzvos make medications more effective, they don’t work in place of necessary medical treatment.”

“But he didn’t listen to you and now he’s had a relapse and is heading back to America?” I asked.

“Hey, when did you become a navi, Reb Dr. Yaakov?”

“Probably the same time you became a psychiatrist, Reb Itche,” I countered.

“Well, you’ve known me long enough to know that I don’t just tell my talmidim to stop their meds,” Reb Itche said. “Even when I think they might be misdiagnosed or overmedicated, I never make that call on my own. That’s why I send them to you — I know my own limits.”

I felt terrible for having listened to the lashon hara I’d believed up until a moment ago. Not only was it not true, but Reb Itche had actually handled the situation in the most appropriate manner.

“Reb Itche,” I said, preparing my apology. “I gotta let you know that I heard some bad lashon hara about you, that you’d given this kid some bad eitzah to stop his meds.”

“Ha!” Reb Itche laughed wildly over the phone. “Did you also believe his stories about the security cameras? Reb Dr. Yaakov, you know me better than that! You know, he told me the same narishkeit about you. He told me he’d seen a frum psychiatrist who told him that he didn’t need his meds because he was keeping Shabbos, but that his parents were taking him home anyway.”

“Did you believe him?”

“That kind of lashon hara about my good friend Reb Dr. Yaakov? No way! Especially not with the Three Weeks coming up.”

“You’re a better man than me, Reb Itche. Those boys of yours are in good hands.”

Originally featured in Mishpacha, Issue 716. Jacob L. Freedman is a psychiatrist and business consultant based in Israel. When he’s not busy with his patients, Dr. Freedman can be found learning Torah in The Old City or hiking the hills outside of Jerusalem.  Dr. Freedman can be reached most easily through his website www.drjacoblfreedman.com