Editor’s note: The following is a transcript of the episode. It's been edited for clarity.

Boyd Matheson: Diseases of despair, including depression, anxiety and suicide, seem to be destroying individuals while decimating families and communities. Social media creates constant comparisons and outsized expectations. Many ask the question, "Am I good enough?" Or "Will I make it?" Elder Devn Cornish of The Church of Jesus Christ of Latter-day Saints shares his unique perspective on this week's episode of Therefore, What?

Therefore, What? is a weekly podcast that breaks down the news while breaking down barriers, challenges you and the status quo, explores timely topics and timeless principles, and leaves you confident to face what's next. I'm Boyd Matheson, opinion editor for The Deseret News, and this is Therefore, What?

We're very pleased to be joined today by Elder J. Devn Cornish, a general authority seventy of The Church of Jesus Christ of Latter-day Saints. Elder Cornish received a Bachelor of Arts in biology from Johns Hopkins University in 1975, and in 1978 received a Doctor of Medicine also from Johns Hopkins University. He completed his pediatric residency at the Boston Children's Hospital at Harvard University. He also served as chairman in the Department of Pediatrics in the Emory University School of Medicine. His church service includes being a full-time missionary in the Guatemala El Salvador Mission, a bishop, stake president, president of the Dominican Republic Santiago Mission and an area seventy. Elder Cornish, thanks for joining us today.

Elder Cornish: It's a pleasure to be with you, Boyd.

BM: Well, this is one of those topics, these diseases of despair. The challenges of anxiety and depression continue to plague the nation and plague individuals in our communities. We often refer to these as getting comfortable with some of the uncomfortable conversations. As you've ministered throughout the church, as you've traveled the world, what have you learned about mental health and dealing with some of these diseases of despair?

EC: It's an important question. First of all, I've learned that disease is no respecter of persons. People become depressed and have mental illness, whether they are rich or poor, whether they live in advanced cultures or in depressed and difficult cultures. People are susceptible to mental and emotional difficulties, whether they have a background of those things in their family or not. So the first message is this is no respecter of persons, people get these things.

BM: I think sometimes we do feel like, what's wrong with me? I think people often ask themselves that very question of is there something wrong with me. What else have you seen in terms of how do we come to grips with that? That, hey, it's OK, this is normal, it is no respecter of persons.

EC: It's an important question again. Let me see if I can frame it in a way that is useful to the general thinking. When was the last time you were concerned about the moral soundness, the character strength, the goodness of a person who had diabetes? Were you ever embarrassed to say, Oh, this person with diabetes is my friend? Do you know why you get diabetes, you get diabetes, because your pancreas stops making insulin. Well, other organs have biochemical deficiencies, they sometimes don't do what they're supposed to. One of the organs that can do that is your brain. The problem is that if your brain stops making a chemical that transmits feelings, your feeling system may not work right. But now you're depressed for no obvious reason, nothing sad happened. You just have a gloom and a sadness, and inertia around you. And people start to treat you differently. They think, what did this person do wrong? What sin did they commit? There must be some defect in that person's character. When in truth, there is no more moral meaning to having depression because your brain doesn't make the right chemicals than there is moral meaning having diabetes because your pancreas doesn't make the right chemicals. But in our culture, and in fact, across the world, depression, anxiety, emotional problems bear the moral overtone of deficient character. What a tragedy.

BM: Yeah, that feeling of being less than I think probably adds to that downward spiral as it relates to those feelings of depression that we do think there's something wrong with us. And for so long I think the solution has been that people just say, well, you just need to buck up. You just need to choose to be happy. You just need to, you know, have a positive mental attitude. But it's more than that, isn't it?

EC: Well, it's useful to understand that the depression is kind of a spectrum of diseases. Sometimes people are sad because they've been through a sad experience, your mother died, you lost your job, you became ill. It would be surprising not to be depressed when something depressing happens to you. Some people have this overwhelming depression, as I said, without any obvious cause. And then there are people in between. There are people who've, in fact, had a difficult experience but can't seem to pull out of it. The reason it's important to understand that this is a spectrum of illness is because it helps you understand how to respond. When a person is having difficulty adjusting to a sad experience, encouragement and in some cases even professional counseling can be very helpful. We've often thought in medicine that the people on the other end of the spectrum, who have what has been called major depression or depressive disorder, do often have a genetic biochemical defect in the way their brain makes and processes chemicals, and we think, well, they don't need counseling. It turns out that both people with this more minor situational depression, and people with major biochemical depression benefit from counseling and often from medications. Sometimes the people who have more situational entry into depression may need medications longer than was expected. That's a good thing to do. Sometimes people who have family history, major biochemical depression, get on good medications that work for them, get counseling and the counseling is so effective it seemed to literally change their brain chemistry and they don't have to stay on medications on a long-term basis. So understanding that depression is a spectrum of problems, and that both the emotional support in counseling, and in many cases, the biochemical readjustments can be helpful in either category.

BM: That's such an important insight for everybody listening today, that we do have this spectrum to work from, that there are a wide range of ways to address it and engage it from medicines to counseling, and everything in between. And looking at it, whether that's coming off a specific episode, as you mentioned, whether that's a death or a loss of a job or a loved one or a relationship, and how we really move that forward. I want to shift now in 2016, you delivered an address in the general conference of the church which has a title that to me is really the theme for our day today in this discussion around mental health and that is this question: "Am I good enough?" Am I good enough? I think we all ask that. Can I make it? Can I get through this? And so I want to talk for a minute about what drove you to writing and delivering that address, what inspired you? And then I want to really drill down into what was the process of learning for you, as you wrote and then delivered that address.

EC: Well, thank you for asking that. You know, it's a wonderful thing when you have an opportunity to interact with the members of the church. When you get into a question and answer kind of an open conversation setting and you invite questions, the questions that come are the softball questions. Because people don't want to be seen as raising their hands and asking something that might be embarrassing to them. Right? If you ask for written questions, anonymously submitted, this question is one of the ones that comes up most frequently. Can I make it, can I really have hope of happiness in this life and in the afterlife? It's a sad thing that we somehow have a misunderstanding of who God is, how he feels toward us, and what he wants for us. The God of heaven, who controls and governs all things everywhere happens to also be our Father in a very personal and intimate way. He wants real happiness, growth, joy, glory for all his children forever. And he knows how to help everybody grow in ways will allow them to have that. So a sense that I just I'm not going to make it, it's not going to work for me, is really a misunderstanding of who God is and what he wants for us. If he can create us, he can govern us and he can bless us. We should have a little more hope

BM: And a little more confidence in who's in charge.

EC: You know, what I've learned from practicing intensive care medicine for so many years is that one of the saddest delusions of this mortal experience is the belief that we're in charge of our lives. We are not in charge of our lives. We do not control our lives. We are responsible for our lives. But we don't control our lives. But God knows how to manage the experiences for our lives in ways that will change and bless us. And rather than worrying about whether I'm good enough, what we should be asking is, am I trying and I do I believe that God wants to help me.

BM: Yeah, those are great, great questions. And I think so often we forget that all we can do is all we can do, but all we can do is enough.

EC: President Gordon B. Hinckley used to say, and I've heard him say this in person on many occasions, brothers and sisters, all God asks of you is to try. But you have to really try.

BM: Has to be real try. I love that President Russell M. Nelson said when he was speaking up in Seattle to 50,000 members and members of the community there, he said, you know, God loves effort. He loves our effort. And then he blesses our effort. And I thought that was an important thing you shared. You shared an experience in your talk in 2016 about some of those days when you had some of those questions in working towards your medical career in those early days. Tell us about that.

EC: Well, I talked in that particular address about being a resident at Boston Children's Hospital in pediatrics, accepting one after another after another admission from the emergency room. I remembered about 11 o'clock on a Saturday night, a 10-year-old boy with pneumonia was admitted. I'm a young intern and fresh out of medical school, I can hardly spell pneumonia. And here's a young boy who's really sick, and it matters. And as I was falling asleep, writing orders for him and trying to stay awake, because I've been working for, I don't know, 16, 18 hours by then and had a whole night ahead of me. I was so discouraged. I don't know how to take care of this boy, I don't know what to do for him. What am I doing here? I'm never going to make this. Fascinatingly, one of the senior residents came around as I was struggling between my discouragement and my fatigue, put his arm on my shoulder, shocked me awake as my pen was dribbling down the page as I fell asleep writing orders. We talked about my concerns about the boy, he helped me work through it. He said, don't you know that all of the senior residents and the faculty think you're one of the very best we've got? You are going to be a wonderful doctor. Well, I'm not sure whether anybody ever thought that about me. But his encouragement made all the difference. You see, what God expects of us is to try. What he expects of us is to not rationalize when we're not doing right. He expects us to repent and then to try again. But to think that we can't do this underestimates God, and underestimates what he's put in each one of us. Our goal is not to be better than somebody else. Our goal is to be the best of who we are. We have a wonderful 34-year-old son with Down syndrome. One of the most important things I ever learned was that the goal is not for him to be like somebody else. The goal is for him to develop into his best self. That's a good goal.

BM: That's a good lesson for all of us. I think, just listening to you share that experience, I think there are lessons for those of us when we do have those discouraging days, or as I like to say, some days you leave the office with a very haunting refrain of "Have I done any good in the world today," am I going to measure up? But I think that senior resident, you know, putting a hand on your shoulder and saying, Hey, we believe in you. I think that's important for all of us to recognize that there are a lot of people around us who may be having one of those awful, difficult kinds of days and realizing that we often run out of energy before we run out of opportunity or capacity. I think it should make all of us think a little more of who can I help today?

EC: Wouldn't it be wonderful if I can be that person in someone else's life today? I remember the senior resident now, decades later, he changed my life in five minutes. Wouldn't it be wonderful to do that for somebody else? There's another message here. No matter what you're struggling with, the second you do that kind of thing for someone else you're better too. You're happier too.

BM: Yeah, excellent. That's great. You know, as we look at the ever-increasing number of young people who seem to be struggling with these diseases of despair, the anxiety, the depression, discouragement, what do you think is driving that? And how do we get out in front of that a little bit?

EC: It's hard to know whether the incidence, the frequency of anxiety and depression among youth is increasing because it's a hard thing to get a sound measurement of. But think about this for a minute. With the pressure of grades, homework, sports, countless lessons, and practices and competitions with adults warning them about getting into college, getting a scholarship, getting a career, with the pressures of dating, drugs, sex and adolescent society in general. How could our teens not be anxious? They also worried about the financial future, terrorism, school shootings, environmental degradation and much more. Plus many don't get enough exercise, proper nutrition or enough sleep. It reminds me of W.C. Fields, who is reputed to have said smile first the in the morning and get it over with. So I don't know if it's increasing but the pressures are certainly intense and we as adults ought to take a better look at what we're putting our children into and what we're expecting of them and ask does another sport really make a difference in this person's realizing their potential becoming the best of who they are? Does another set of expectations? Does higher grades really connect to this person's development and happiness? In some places it does. But in some it doesn't.

Sometimes I think the anxiety our youth live through is the anxiety we're imposing on them. We could give more thought as a society. Now I have to say, the wonderful article that the Deseret News produced in June 2018 about anxiety in youth really was a landmark for me. The mention that a fourth of teens today have some kind of anxiety disorder and that such things go along with depression, the review of where this is coming from, how we manage it, was just extraordinary. So I would refer our listeners back to that article. I think that was as well done as anything I've read.

BM: Yeah, there was a great, great piece and the InDepth team here at the Deseret News has been doing such great work that everyone can go to at DeseretNews.com/anxiety, there's great resources there and that very article that really paints the picture of where we are and how we march it forward.

EC: Let me say one other thing about this because I think it needs to be said. One of the greatest philosophers I've ever encountered was my mother, 5 feet tall, a hundred pounds soaking wet, but very wise. Early in my experience in kindergarten, I came back very hurt because of some things people had said to me and she said what I'm not sure the people today have ever heard. She said, sticks and stones may break my bones but words will never hurt me. She said, son, get over it. They didn't hurt you. Just ignore it. Now that's simplistic I realize, but there is much of self-inflicted injury among our youth by social media. The tendency to compare the worst of your characteristics to the proposed or supposed best of somebody else's characteristics is simply not an honest comparison. When someone bullies or criticizes you in social media you have every right to ignore them, which they so richly deserve. Or to not go to that site or to unfriend them. Much of the anxiety that social media imposes on our youth who are on social media so often, so much of their day is self-inflicted. If that person doesn't like you, that's their problem. We can sit back, we can disown some of these sources of anxiety that are, in fact, not real and not necessary.

BM: Yeah, let's take it a little deeper on that. We often say that viewing life through comparison is always fatal vision. And I think we see that a lot of young people. You've mentioned social media. I think this is particularly challenging for young women. As you look at body shaming and a lot of the competitive things that happen there on social media. What else can we do to help young people get past that view of the world, that comparison view?

EC: Let me suggest one strategy that I think is very powerful. We can change what we talk about on social media. It isn't healthy to gossip, even if it's true. Talking about other people when they're not involved in the conversation is high-risk emotional territory and the integrity of that process is in question. How would it be if friends in their social media conversations we're talking about principles, about values, about how to do good in society, about threats from the weather, about political philosophies, if you don't talk about people most of the pain of social media disappears.

BM: That is great counsel, that is really great counsel. It's so important to get past that. When we center in those principles that does change the conversation immensely because we're not worried about who got invited to what party. Or whose dinner plate looks perfect when you're grabbing yours from McDonald's or whatever it may be.

EC: Now, if you want to slip in a nice compliment about somebody here and there, that's OK. But frankly, if we talk about principles and things more than about people, much of the damaging power of social media is removed.

BM: There's a lot of talk out there in the world in terms of the role of religion in creating those kinds of feelings, those feelings of guilt, those feelings of less than and it's very easy for the broader world to blame, you know, to blame all of this because it's always about blame, right, to go beyond the blame game that this is a problem with religion or with faith in general. How have you seen that play out?

EC: Boyd, I really appreciate you asking that question. This question comes in the context of a very lively conversation over recent years about the suicide rate in Utah. It is something we should all be concerned about. We should be concerned about suicide, whatever the rate is, and everywhere. But it's been pointed out that Utah has the fifth-highest suicide rate in the country. And some of the pundits have said, the reason is obvious. The Church of Jesus Christ of Latter-day Saints is such a predominant factor in that culture that it imposes guilt and anxiety on its members, especially on its youth. Well, that's easy enough to say. Has it been studied? It turns out it has. It's been studied in detail by very competent people looking at religions in general, at specific religions, and at The Church of Jesus Christ of Latter-day Saints and its members in specific, in detail. In fact, I was delighted to read a study that summarized 540 articles looking at Latter-day Saints and looking at religion. That and many other studies have come to the same conclusion: an active religious life, especially if it involves personal worship experiences, is strongly correlated to many of the important indicators of mental health and of emotional well-being.

So the argument that religion in general or the culture in Utah, the religious culture in Utah, result in some deficiencies in mental health is simply not substantiated by literature. Let's go to the suicide question in specific. Guess what the other states are that have high suicide rates? Setting Alaska and West Virginia aside, which are outliers that have been well-explained. The suicide rate in the United States is highest in Wyoming, Montana, Idaho, Colorado, Arizona, the Intermountain states. Now a lot of studies been done on this. This is hot stuff. And so it's all over the literature. What they found was that there is a remarkable correlation between the altitude at which people live and the suicide rate. In fact, a wonderful study from the Harvard Review of Psychiatry recently showed a strong association between the altitude at which people live and the risk of suicide. Based on both animal models and short-term studies in humans, there is reason to believe that the lower oxygen levels at altitude could increase levels of depression and suicide by altering the metabolism of key brain chemicals and the way the brain uses energy. So the evidence is that religion can exert a positive effect on mental health and that living at higher altitudes may substantially increase the risks of depression and suicidality. In fact, the lead study in this Harvard Review broke it down by county. So you can look at the effects, the relationship between the altitude of a given county and the suicide rate in that county. The correlation is very strong.

BM: I know there was also one done by the VA relating to veteran suicide rates and they did find that same correlation between altitude having some things in there which is just fascinating. Now I want to get into what I've been waiting all day to hear you talk about and that is looking at the the lessons from Christ's ministry as it relates to mental health. I think a lot of people just kind of brush past that in a real fast kind of way. But I think there's some fascinating lessons to be learned as we look at the the life of Jesus Christ as it relates to mental health.

EC: This is a wonderful topic. We could talk about for days. It is marvelous to us that the Lord gave his life as a sacrifice for our sins. But he lived this life as an example for our lives, for our happiness, for our health, and relationships and all the elements of life worth living. A great example, Christ teaching that we should love our enemies, and do good to those who persecute us. Think how much it takes away the power of others to hurt or offend or control us. Others can control how they act, but they can't control how we allow ourselves to feel or to react to them. Christ taught us to forgive others who've wronged us, meaning that we release ourselves immediately from the burden of the painful feelings of anger and hurt brought on by someone else's misbehavior. You know what we do when someone wrongs us? We punish ourselves for their sins. They may be feeling fine and be off to another subject, but we're stuck feeling awful because of what they did to us. And so when we forgive them, we let go of all that. We'll stop punishing ourselves for their misbehavior.

BM: Yeah. And you only have to forgive once. To harbor that, you have to relive it every day to recreate that negative energy. It's exhausting.

EC: It is. One more example. One of the things that Christ exemplified and taught most powerfully was the was importance of serving others, of reaching out to the underprivileged, the downtrodden, the needy, the widows and the orphans. It really is eternally true that when we lose ourselves we find ourselves, when we lose ourselves in service to others we find ourselves. President Spencer W. Kimball used to say and there's so much more of us to find. I love the story Sister Bonnie Cordon told in general conference about her friend who had an untreatable, highly lethal cancer, and who in the midst of excruciating chemotherapy, when she just couldn't go on, had her husband say, sounds to me like you need to find someone to help. And it literally saved her life. She lost herself, was able to bear her suffering when she found virtually any way to help someone else. In my own struggles in life, when nothing else helps, if I go find someone else to help life gets better. Christ's examples are wonderful. This is probably a place that I should point out, however, one misconception we have. Sometimes we think that if I follow all of Christ's teachings, I'm a good person and bad things won't happened to me, and particularly not mental or emotional illness. That is not a sound conclusion. And in fact, Christ never taught that. Mortality means living in a physical body. Physical bodies all come with defects and problems. That's not a moral issue. It's not a character defect. So living well will save us from the unnecessary suffering that comes from living badly. But living well does not save us from the suffering that comes from being mortal.

BM: Yeah, it's such a good point. Along those lines. I, I remember hearing a quote from from Elder Neal A. Maxwell who had his own physical suffering as he went through his cancer and his ailments, and someone asked him, you know, why? You're a good person, you're on a good mission. You're trying to help people around the world, why do you have to go through this? And his response was so simple. He said, you know, we suffer so that we can teach with authenticity. And there's something about that, I like to call it the courageous vulnerability component of saying, Hey, you know, I am mortal too. I do have my own doubts and fears and frustration and discouragement. But we have to be willing to have that kind of authentic conversation and I think be authentic with ourselves that it's okay to not be OK some days.

EC: Absolutely right. Absolutely right.

BM: So let's drill down a little bit on that. You were courageously vulnerable in front of an audience of 22,000 in the Conference Center, and millions more around the world watching the General Conference of the church. As you shared that experience of being a young intern, can you share with our listeners, some of who I know are listening today and can feel incredibly isolated and alone, and again, having those feelings of less than, that there's something wrong with them. What can they do? How can they engage? How can they approach this a little different?

EC: Well said. I think that it's easier for most of us to be of help to others than to receive help. I think one of the most difficult assignments in life is to be the person that gets help. It is much easier to be called to serve than it is to be called to be served. And the truth is, it's not either/or. We all have those periods in our lives. And sometimes we need help. Sometimes we need a lot of help. That's not who you are. It's how you are at the moment. This is not about your identity, your value, your character, your goodness, it's about your body, your illness, your needs. The second a person can say I'm a good person, but I have depression. I'm a good person, but I have anxiety, they're empowered to say the next thing, which is the most powerful thing a person can do for any illness, including mental illness. They can own their disease. They can say I have this condition. But there are things that can be done about this. And I'm going to take responsibility to see that they get done.

As a side note, everyone who wrestles with mental and emotional illness needs to hear that there is almost always a way out, a cure, a treatment, a way to manage, a way to get through it. Counseling from qualified professionals who share your values and integrity to their professions, properly trained and certified medications from people who are experienced and well trained in managing medications, that combination, and sometimes some other well proven treatments, can almost always give everybody, everybody who suffers from these diseases a manageable, happy and usually quite normal life, but they're not released from owning their diseases, from saying, I have this, I will deal with this. I will take my medications, I will keep my appointments. I will go to the counselor, the doctor, the psychologist, I will listen to my wife, my mother, my friend. There's some other things. Let's get more basic. The first and foremost thing is to know that God knows you, that he loves you, that he will provide help for you, if you'll let him. But again, God will not force you to ask for help. You have to reach out to someone. To all those listening who have struggled with mental and emotional challenges, please know God loves you. He wants to help you, but he will not force you. You must reach out to someone.

No. 2 — mental illness is not a sign that you're bad or deficient. We've talked about that. No. 3 — there is help. There's a way to heal. There's a way to be whole. No. 4 — you can get help, or someone else can get you help. We should mention where can you turn. In any place in the United States, you can use the crisis text line by texting home and then 741741. Anyone can call the National Suicide Prevention Lifeline. It's operative in English and in Spanish at 1-800-273-8255. Let me do that again. 1-800-273-8255. If you look at the letters on the keypad that spells 1-800 A R E T A L L. And if you are tall in confronting your disease, call them up. They will help you anytime. There's wonderful information, some uplifting videos and counseling, both for people who suffer from these things and those who want to help them, at suicide.lds.org and any of our listeners would be uplifted by going there whether you struggle these issues currently or not.

BM: Yeah. And it's someone within the family or within the community that can benefit from those as well.

Therefore, What?

So this is my favorite portion of the program. It's our last segment of the program and this is the Therefore, What? moment. So as we think about those who have been listening for the last 25 minutes or so, Elder Cornish, what do you hope people take away from this conversation today? What do you hope they will think differently? What do you hope they will do differently as a result of our conversation today?

EC: No. 1, believe that God loves you and he has perfectly good reason to because you're wonderful each in his or her own way. Your goal is not to be like someone else, your goal is to be the best of you. To be what God knew you could be and to bless your life and others the way he designed you to do. There aren't any little people in this world. There aren't any contributions that don't matter. No. 1 is go be your best self and believe that God made you to do that and he can help you.

No. 2, understand that illness is not identity. The fact that I have something wrong with my body does not have mean I have something wrong with my person.

No. 3 is take ownership. If I have a problem that's affecting my body, my thinking, my feeling, get help. There is help and it works. It works for virtually everybody if you'll stay with it.

And the last, I think, is when things seem hopeless, when you don't know where to turn, find someone to help. And then ask someone to help you. Please remember that these resources, the text line home 741741, the Suicide Prevention 800-ARETALL (2738255), are available. That there are people who want to help you. Reach out and let someone help you.

BM: Thank you. Wonderful. A crucial conversation today. Elder Cornish, we appreciate you spending time with us on this vital matter and wonderful insight for everybody to think of today.

EC: My pleasure. It's a delight to be with you. It's a delight to know that there are so many good people out there listening.

BM: And there are. And again we encourage everyone to get to those resources, all of those are available on Deseretnews.com/anxiety. Remember after the story is told, after the principle is presented, after the discussion and debate have been had, the question for all of us is Therefore, What? Don't miss an episode, subscribe to this podcast on Apple podcasts or wherever you're listening today and be sure to rate this episode and leave us a review. Follow us on deseretnews.com/podcast and subscribe to our newsletter, This is Boyd Matheson, opinion editor for the Deseret News, thanks for engaging with us on Therefore, What?

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