I know missionaries who struggle or have struggled with mental health issues, and yet are here, serving in Japan. It's not easy, but with the right support, they're able to use their gifts for the Lord here. In many ways it's not much different to someone with well-controlled asthma serving in mission (i.e. me). But I also know missionaries who have had to leave the field due to mental health (or, for that matter, physical health) issues with themselves, or their kids.
Mental illness still holds a stigma and it's not easy to talk about these things openly. This is especially the case for missionaries who are unfortunately often held up as something like super-Christians.
Mental illness is also beset by stereotypes. So if a missionary tells their supporters about their particular struggle they are opening themselves up for misunderstandings from the very ones who are supposed to be supporting them. Understandably that is not an easy place to be.
I like what the author of the above article wrote about pretending:
Whether we pretend we’re fine, pretend we’re holy, pretend we don’t need help … The life of pretense sets us up for failure and separates us from ourselves, from God and from others. Whether we face mental health issues or not, we must learn to stop pretending. Our only hope to deal with the challenges of life is to learn to come to the Father and rely on him in our lack.We are a body, not individual units. Let us each care for the members of the body, giving grace and providing a safe place for transparent and honest living.
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