(RNS) — In 2011, when she was 18 years old, Anna Gazmarian was diagnosed with bipolar disorder.

As an evangelical, Gazmarian attended church regularly, was active in her youth group, and went to a Southern Baptist high school; this was a prescription for frustration and anguish. In her new book, “Devout: A Memoir of Doubt,” Gazmarian lays bare how inadequately the church and her church-approved therapists treated her condition and how she struggled to find another way.

Fighting near-constant thoughts of suicide and long depressive episodes, Gazmarian had to leave the church behind to begin to heal. But she never gave up on her faith. Her book offers penetrating insights into the flawed theology around mental health in many evangelical settings and how they might recover a more affirming and compassionate way of attending to people with mental illness.

At its heart, it is an intimate and candid look at the dark night of the soul and how Gazmarian was able to reanimate her faith through doubt, questioning and lament — qualities her church tradition assiduously denied.

RNS spoke to Gazmarian, who lives in Durham, North Carolina, about how she copes and how she’s been able to find stability through medication, therapy, a loving husband and a baby daughter, as well as her faith.

The interview has been edited for length and clarity.

You write compellingly about how evangelical churches deal with mental illness. What were the first messages you got there?

So, when I was growing up, there was a period where I needed to go to therapy. This was prior to my diagnosis. And (church leaders) sent me to a Christian counselor, and they were strictly biblically based. And so everything that they said was in the Bible. There was no psychology at all.

I grew up and saw friends that died by suicide. I remember preachers preaching about Rick Warren’s son who died by suicide and saying it was an unforgivable sin and he was going to go to hell. I also went to a Southern Baptist high school, and I remember in my English class one day, the teacher mentioned that people who die by suicide go to hell. So that was like the common message I got everywhere.

I was someone who always felt like there was something wrong with me because of how much anxiety I had. I was anxious about everything. And I remember my high school pastor saying, ‘Don’t be anxious.’ But everything made me spiral out of control. And I just thought it was a lack of faith. And so I put everything, like all of the effort,  into reading my Bible, into writing, into praying, waiting for my anxiety to go away, and it never did.

Would you recommend Christian therapists or pastoral counseling to people of faith who are struggling with mental illness?

The reason I sought that was because I was really afraid of psychology and I was afraid of modern science because I’ve been taught to be skeptical of those things. I thought if I went to a regular therapist that had no religious background, they would make me focus more on myself. In my mind, focusing more on yourself, being more aware of yourself, that was considered selfish, which was also deemed a sin. So any self-improvement or work I viewed as selfish. And the problem was that the therapist I was seeing did not take mental illness seriously. They thought it could be cured by therapy and by reading the Bible. When I was older I did go to a Christian therapist who did have a medical degree. And for me that worked really well.

So what would you say to people who are struggling with mental illness and want to hold onto their faith?

One of the things that blows my mind is how evangelicals have distorted Scripture basically to mean that living your life means only experiencing happy emotions. And I don’t know how we got to that point because if you look throughout Scripture, there are many people in the Bible that are filled with agony, that are filled with hopelessness, and God is still present through all of those things. When I was in college, I started studying Lamentations. I had never heard a pastor even mention Lamentations. It’s one of those books that everyone overlooks. I don’t understand how we can read the Bible and not support those that are mentally ill, because even Jesus was depressed. And in my opinion, there were moments in Jesus’ life that he was hopeless and questioned God. Understanding and looking at the agony and frustration of people in the Bible was really helpful for me because those were things that were just never talked about. So I think for people that are wanting to be Christians and are mentally ill, I think Christianity is a safe place to come as you are. And if you look at the people that are deemed the most faithful, those people also have immense doubt and immense suffering. And those do not disqualify you from living a faith. And I think the deeper the faith you have, the more that those things come to the surface.

In your book, you describe how at one point you set your prayer journals on fire. Explain why you did that.

I think I didn’t understand the purpose of prayer. I saw it as this thing where I basically apologized to God for everything I had done wrong. And because of all my religious guilt, I constantly just wrote my sins down. I viewed God as someone I needed to please and that I constantly needed to make things up for. That’s how I viewed prayer. It wasn’t a conversation, it wasn’t a relationship. It was more driven by fear. And my journals were basically recalling memories, recalling sins, all the shame and guilt I felt. I realized it wasn’t helpful and it wasn’t the way I wanted to view God at the time.

I still struggle with prayer. I still struggle with what I think about prayer because for so many years, my prayer was to be healed, and that was never answered. And I think having a life of prayer, you have to accept the uncertainty and accept what you don’t know and live in that space. That faith is not about certainty. Letting go of that control is really difficult.

Would you say that writing was the route back to practicing your faith?

I think so. I grew up with a view of men as the leaders and women as submissive and quiet. And the problem for me was that I was never quiet. I always had a lot of opinions, and I thought there was something wrong with me for having all of those things. And I constantly felt myself wanting to be smaller, wanting to take up less space. I thought that is what it meant to be a woman, especially as a Christian.

Writing gave me a voice, and it gave me a space to think for myself and not just trust in what other people told me. For so long, I don’t feel like I was given the space to have a voice. I was just told what to believe. And if I had questions or doubts, I was not supposed to express them. So for me, writing was kind of like a conversation with God. Even writing the book, it felt like there was something really intimate about just my editor and me reading the material and feeling like God was there. So I do think that writing definitely enabled me to experience God in a different way.

You write about your experiences with ketamine, a powerful sedative, and how it has helped you. Is it still helping you?

The hardest thing about writing a memoir is that it only captures a moment in time in your life. After I had my daughter, my mental health kind of collapsed. And it was very difficult for me to work on the book because I felt like a fraud for writing this book about mental health and recovery and grappling with faith because I was living with those things in real time. I struggled with postpartum depression and because I didn’t have ketamine during pregnancy, I did not have the tolerance built up. The last two years have been really hard, and I was resistant to a lot of medications.

It was a reminder to me that my symptoms are always going to be there. It’s tempting to believe there is an endpoint in which everything is under control. You find the right medication and everything is solved. Prior to having my daughter, there was a three-year period when I was doing ketamine, when everything in my life felt stable. Then when I had my daughter, everything was ripped apart, and I actually ended up going to a treatment facility. And when I was there, I remember being so discouraged and scared about my book coming out because, who am I to talk about all this stuff when I’m living this in real time? And while I was there, I met many people with religious trauma (who were) grappling with faith and mental illness. For me that was a reminder of who the book is for. Even if it did not help me get to a more stable place, it might help other people. For me that’s worth it.

A lot of people when they encounter a crisis of faith or feel abused by the church, they leave religion altogether. You didn’t do that. Why?

It is really difficult because there are moments where I think, would it be easier if I walked away. I am friends with a lot of people that are not Christians, and they ask me, ‘This religion has hurt you in so many ways, how can you keep going back to it and what comfort is it providing for your life?’ That is something I really struggle with because I don’t think faith is really about comfort and I don’t think that it is giving me more contentment. I think if anything it is making my life harder. So I continue to struggle with that, and looking at American Christianity, we have gone off the rails and it’s hard for me to call myself a Christian because of that. But I feel like I can’t distance myself from the life of Christ and the way he loved people so radically. And that is why I keep coming back.