Physical and Mental Health during the High Holy Days

Image: A woman holds one hand to her head, another raised as if to say, “Stop!” Photo by RobinHiggins/Pixabay.

Before I learned to read Hebrew, the High Holy Days could wreck me. The language of “sin” and “repentance” that I learned as a child sent me into a tailspin of despair.  Avinu Malkeinu [Our Father, Our King] was a fearsome image before which I cowered, a failure. A whole day of that, plus fasting, sent me into a black pool of depression. Even the relatively lighter “hit” of Rosh Hashanah was hard.

I have several students who are diabetics. Each has a highly personal way of managing their blood sugar, and it is critical to their well-being. Allowing the blood sugar to get out of whack isn’t just uncomfortable, it can be life-threatening.

I know a woman who struggles with eating disorders. For her, the talk about fasting for Yom Kippur has a siren edge to it. The Rosh Hashana table, laden with sweet dishes seems to her like a giant honey trap.

For those with a physical or mental illness, the High Holy Days can be a difficult time. The basic and most important rule is that we must choose life: in other words, do what we need to do to survive. Without life, there is no holiness.

Here are some things I have learned. I share them for the benefit of anyone who needs them:

PIKUACH NEFESH (pee-KOO-ach NEH-fesh) means “preservation of life.” It overrides nearly every other commandment. Do whatever you need to do to take care of your body/soul this week. If that means go to the beach for your Yom Kippur “service,” do it. If that means eat, take your meds, go to a meeting,  or call your therapist, DO IT. Don’t wait to collapse, or for permission – just do whatever it is you need to do for your health.

FASTING – Fasting isn’t good for everyone. It’s bad for diabetics, pregnant women and people with a history of eating disorders. If there is some reason fasting isn’t good for you, DON’T FAST on Yom Kippur. (Again, pikuach nefesh!) All you have to say to anyone is “health reasons.” (They should not be quizzing you, anyway.) One strategy for dealing with feeling left out of the fast is to take one or more meals with someone else who doesn’t fast. Trust me, there are many Jews in that category. You are still welcome at the Break-the-Fast, don’t worry!

The Yom Kippur fast is not a weight-loss opportunity. The point of Yom Kippur fasting is holiness; we can seek that holiness in the discipline and humility required to follow medical directions.

MEDICATION – If you are on medication, take your meds and take them as your doctor has directed. If you are supposed to have food or water with meds, take what you should take. Messing around with medications is sinful: take them the way the doctor says to take them. There is no shame to taking them, and they have saved lives. I take mine every day, including Yom Kippur, and I say a blessing when I take them.

LANGUAGE – If you grew up in a Christian household, the language of prayer of the High Holy Days can be intense. “Sin” is an English translation for a range of Hebrew words, which mean everything from “mistake” to “malicious wrongdoing.” “Repentance” is the English translation for teshuvah, which covers a much larger concept than merely being sorry. It means turning, changing course, and sometimes, coming home.

If you find the language of the High Holy Days upsetting, I can suggest two things to do, one immediate and the other long-term. One is to schedule some time with your rabbi  or another teacher to talk about Jewish approaches to “sin” and “repentance.” The long-term solution that worked for me was that I studied Hebrew and set myself free from clumsy translations. This doesn’t require full fluency in Hebrew, just enough to let you say and understand the prayers.

DON’T BE SHY – Don’t be shy about taking whatever action you need to take about your self-care. Remember it is a mitzvah, a commandment, to take care of yourself and to stay alive! If services are too upsetting, don’t go. Go for a walk, go to the beach. Maybe this year your teshuvah, your turning, will be to give your rabbi a call after the holy days are over and get the name of a good therapist.

Whatever your situation, know that you are not alone! Many of us deal with some health issue over Yom Kippur. Help is available if you reach out for it.

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Rabbi Ruth Adar is a teaching rabbi in San Leandro, CA. She has many hats: rabbi, granny, and ham radio operator K6RAV. She blogs at and teaches at Jewish Gateways in Albany, CA.

14 thoughts on “Physical and Mental Health during the High Holy Days”

  1. I appreciate this reminder that rachamim is a focus during Yom Kippur and taking care of one’s medical needs with meds, food, and or water is all part of pikuach nefesh.

  2. People with heath concerns really must take proper self-care during these serious, mindful holidays: I’m glad you, a Rabbi, took the time to remind your readers of this. Some people don’t give themselves this permission, and they need to hear/read it from an external source. Thank you.

  3. I read advice that if you need to eat/drink during Yom Kippur (or other fast days), try to do it out of sight from others who fast. Not out of shame (no need to be ashamed for performing the mitzvah of pikuach nefesh), just to make the fast not unneccessarily hard for others.

    I hope, G-d will give me the wisdom to decide well how to navigate this, this year. I plan to go by listening to my body, based on I’ll fast, but use a bit of fluid for meds and if I feel the need, for health purposes; so I hope I’ll really notice those feelings when they’re there and actually manage to heed them.

    1. Yes, it’s a matter of kindness not to eat or drink in front of those who are fasting – thank you for mentioning that!

      Listening to your body is a great strategy. Be sure to anticipate likely issues so that you can deal with them as they come up.

  4. Thank you for this post, Rabbi. I’m unable to attend services this year and am on medication — both things worried me greatly. But this post has sort of given me permission to do what needs to be done and has helped to alleviate guilt so that I can enjoy the high holidays for what they are.

    1. Oh, Heaven, I hear you! A few years ago I spent Yom Kippur in the hospital, and even though it was clearly a matter of preservation of life, I felt odd about it. My rabbi pointed out that it was a mitzvah to be exactly where I was, and I am happy to pass on her kindness.

      I wish you well with your health challenges, and hope that you are able to participate in the holiness of the day in other ways. You’ve given me an idea for a post – thank you!

  5. Worry about HHS because of evening services.

    Tomorrow will try Lyft.

    Don’t like running around at night for safety reasons.

  6. Thank you for this loving and extremely important post. I am not personally concerned, but read with interest because I work with clients who are. I have bookmarked this excellent advice and pinned to my Saved to Mental Health & Chronic Illness Awareness board.
    (Madelyn Griffith-Haynie – ADDandSoMuchMORE dot com)
    ADD/EFD Coach Training Field founder; ADD Coaching co-founder
    “It takes a village to educate a world!”

    1. Thank you, Madelyn! If you have any topics you’d like me to address as a rabbi, I’m always glad for suggestions.

      Thank you for doing such challenging and important work!

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