“Even before a word is on my tongue, behold, O Lord, you know it altogether.” Psalm 139:4 (ESV)

There are lists. There are lists of symptoms for depression and lists of the observable behaviors of mania. In fact, such episodes have elements so universal they can be succinctly delineated in bullet points.*

For depression the symptoms include:

• Feelings of guilt, worthlessness and/or helplessness
• Feelings of hopelessness and/or pessimism
• Persistent sad, anxious or “empty” feelings
• Thoughts of suicide, suicide attempts

For mania, one list has items such as:

• Needing less sleep in order to feel rested
• Talking very rapidly or excessively
• Inflated self-esteem or grandiosity; may be delusional
• Reckless behaviors (lavish spending sprees, impulsive sexual indiscretions, abuse of alcohol or drugs or ill-advised business decisions)

Even though most of the points on the lists are true for most people with these conditions, the specific symptoms are actually nuanced in very individual ways. When you live with someone dealing with these mental health challenges (as we do with our son who struggles with bipolar disorder) you begin to recognize the unique expressions manifested by your loved one.

For example, my husband, Nelson, and I give each other the here-we-go-again glance whenever Douglas tells us he is feeling “terrific.” “Terrific” is a well-used word, but the only time Douglas says it is when mania begins to surface. Others who deal with their loved ones’ manic episodes report other idiosyncratic behaviors. Sharon** says of her daughter, “when she brings out the paints I get scared.” Gracie tells me she knows trouble is ahead when her husband grabs a sponge and cleanser and heads to the kitchen to scrub it down.

These words, these behaviors, are so generally common that they could seem perfectly usual to most observers. Only those who know someone well would notice the subtle implications. Only the ones who love someone well would understand what it all means.

Scripture tells us God knows His loved ones so intimately that even before the word “terrific” forms on Douglas’ tongue He has already heard it. Fully aware Jill is pulling out the paints, God loves her fully. When Ed heads to the kitchen with the cleaning supplies, God is already there waiting for him.

Someone once quipped, “One thing you’ll never hear God say: ‘Wow! Didn’t see that coming!’” As we learn to understand specific indications of the onset of episodes in our loved ones, we don’t have to be taken by surprise. Instead, by God’s grace, we can be prepared to respond with wisdom and compassion.

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*webmd.com
** All names have been changed.