No One Dies From Mental Illness

RobinThis morning news has traveled around the globe of the death of Robin Williams.  Already, mixed with the sadness, the “social sneer” has appeared.  Robin Williams was weak.  He was selfish.  How could he do this to his family?  What a jerk, to only think of himself.  On and on. On his death certificate it will read that Robin died from suicide due to asphyxiation.  It will not list the actual cause of death.  Officially no one ever dies from mental illness.

According to the Center for Disease Control 1,500 Americans die every day from cancer.  1 in 4 deaths can be attributed annually to heart disease. According to the National Alliance for the Mentally Ill, adults suffering from a serious mental illness die, on average, 25 years before a mentally healthy person.  And yet no one dies from mental illness. 

If someone shoots himself in the head, his cause of death will be “self inflicted gunshot wound”, even though everyone knew he suffered from Depression.  Rather than face the social stigma of a “crazy” diagnosis, some of the mentally ill self-medicate.  If someone drinks themselves to death, the contributing factor will be alcoholism, not schizophrenia.   Obesity is a common side-effect to many psychiatric medications. Cause of death?  Heart attack, not Bipolar.

The idea of how a “Mental Illness” is diagnosed has come under fire of late.  There’s a legitimate debate to be had about exactly what is “mentally ill” in a world of for-profit medicine.  And of course not all alcoholics or obese people are mentally ill.  Right now let’s stay focused on just this fact – no one dies from mental illness.  Which makes the tears of this clown particularly tragic.  If you want to honor this man who brought the world so much happiness, please start a conversation about mental illness.  It’s time to be rid of the social stigma surrounding this issue.

Goodbye Robin Williams. I’ll miss you.

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There but for the grace of God

police line

This is the graphic they used in the media when describing my friend

In August 2011 a friend of mine shot and killed her abusive husband.  When she was arrested she was allowed a mental health evaluation only if her own private insurance would pay for it, even though she told them at the time of her arrest that she was mentally ill.

Last November, after a fifteen month wait, she was convicted of “voluntary manslaughter and possession of a firearm during the commission of a crime.”  This was a deal – her original plea was “Guilty but Mentally Ill”.

My family and I have tried for a year and a half to contact her.  Almost everything we sent was returned, though the more expensive items like Christmas gifts simply vanished.  We have no evidence she ever received anything, and never heard a word from her.

Until now.  We’ve received a letter.

It’s nothing fancy.  Just a few lines to let us know she’s surviving.  She wants to tell us what happened, but all her mail is read before it’s sent.  All she could do it tell us that she’s alive, she loves us, and where she was – or at least where she was when the letter was written.

cat heavenIt was enough.  We’ve been in overdrive ever since.  All the letters sent to that address were returned – she was transferred.  Again.  A call to the prison she was sent to resulted in more red tape.  Transferred yet again.  But finally, this morning, I think I have her address.  I spoke to the sweetest lady who was so exasperated.  Not by us – apparently I’m not the first person who called!  But by the system that can’t even give a straight answer about the location of a prisoner.  I *think* I know where she is.

I’m sending her this picture.  She loves cats – she had about a dozen at the time of the shooting.  They’re all gone now, of course, along with everything else she ever knew.

Why did it come to this?  I keep thinking over and over that had things gone slightly different for me, it could be me in that cell, not her.  I’ve been on the wrong side of the locked door 5 times.  But I was always let out in the end.   I got the help I needed.  I was given the time and space to try to heal, without anyone threatening me.  I had a strong support network in my family, and those friends strong enough to remain in my life.

She had no one except a guy who beat her, and her cats.

If “there but for the grace of God” means anything to you, give your family a hug tonight, and an extra cuddle to your pet.  When one is mentally ill, so little stands between you and her fate.

Cheats, liars and frauds

Hello.  My name is Mori.  I am the most articulate homicidal maniac you’ll ever meet.  I suffer from a serious mental illness as well as a crippling physical disability.  And no one believes me.  Why?  Gary Thompson.

“Friendly Lexington beggar is a fraud”

Gary Thompson“Gary Thompson has a mental disability and is confined to a wheelchair — at least that’s what he wants you to believe when he’s begging for money.  In reality, Thompson is a fraud, raking in $60,000-$100,000 per year (so he says) by panhandling in Lexington.

The friendly, recognizable face from some of Lexington’s most popular shopping centers was exposed this week for his money-making scam, but that doesn’t mean he’s slowing down.  Thompson told LEX 18′s Kristen Pflum he’s “the best” at what he does and plans to continue doing it as long as he’s making money.”

Put another way:

Gary Thompson, Kentucky Beggar Who Fakes Having a Disability, Earns $100,000 a year

One of the last jobs I held I was working commission sales for a food company.  I was driving to meet a potential client when I saw a beggar on the corner.  He had the obligatory sign:

ph “Homeless Vet Anything Helps God Bless!”

I thought to myself “If the people in the car ahead of me gives him something, this guy will have made more today than I probably will.”

Just as I thought that the window slid down and a dollar appeared.  The beggar approached with just the right combination of humility and gratitude, took the cash, and added it to a neatly folded wad in a nylon fanny pack. My sale fell through.  I didn’t make a dime that day.  Was he a fraud?  I’m not prepared to say one way or the other.  Many are, but many are not.

Fake panhandler makes $100,000 a year.  Scumbag or good businessman?

My partner is a college professor.  One of the classes she teaches is Cultural Diversity.  There’s a week dedicated to the disabled.  Every class, the stories are the same.  “My cousin/boyfriend/parent/aunt hasn’t worked in 20 years.  They think the world owes them something.  All they do is fill out some forms and everything’s paid for!”  “I saw a guy begging next to the train station.  At the end of the day he walked over to a nice car and drove away!”  “I HATE Social Security!  I work to pay for those bums.”

hungryI’m sorry.  Yes, you do.  You pay taxes not only to take care of granny and wounded vets, but also so that scumbags can take advantage of the system.  But I pay for it too.  There may come a day when I am confined to a wheelchair.  When I must beg on the streets and hold a cardboard sign.  I’ve even thought what I’d write on it.

“I was like you once.  You might be like me someday.  Please help.”

If the worst case scenario happens, it will have been made even more difficult than it has to be.  Why?  Gary Thompson, and all others like him.

The well-intended, completely pointless TWLOHA movement

I just found out that March 1 is “Self-Injury Awareness Day.”  I thought that was interesting.  March 1st is my biological birthday, and I’ve got hundreds of scars across my arms and legs due to cutting.  I thought I could do an interesting tie-in for a new blog post.

While I was looking up information on “Self-Injury Awareness Day” I saw a link pop up to the “To Write Love On Her Arms” site.  I’ve seen this phrase all over the place.  I had no idea what it meant.  In fact, I thought it had something to do with “Twilight”.  It seemed like something Edward would say to Bella … “I love you SO much I’ll write LOVE on your arms!”  “I love YOU so much I’ll wear LOVE on my arms!”  *shudder*  So I didn’t really look into it.

This morning I followed my nose to the “TWLOHA” site.  The folks running this site seem like very nice people.  Here’s their mission statement:

“To Write Love on Her Arms is a non-profit movement dedicated to presenting hope and finding help for people struggling with depression, addiction, self-injury and suicide.  TWLOHA exists to encourage, inform, inspire and also to invest directly into treatment and recovery.”

Yes.  Very nice.  Pointless, but nice.

And yes, I really do know how that sounds.  So let me clarify – it isn’t pointless to those who wish to offer support.  I’m thrilled they are investing in treatment and recovery.  It’s desperately needed.  But let’s be very specific about what this, and movements like it are.  TWLOHA does not support people who suffer from “depression, addiction, self-injury and suicide.”

TWLOHATWLOHA is a support group for supporters.  It’s a place where well-meaning people can join together with like-minded souls to talk about how they want to help people.  And I’m all for that.  Those who suffer benefit from talking to their own kind.  People offering support suffer.   Their job is thankless and so difficult it seems next to impossible.  Talking to other care-givers will help them.

But does it help those who are diagnosed with Depression?  No.  At least, not initially.  Would it help me now?  Over 10 years into my recovery?  Maybe.  I’m seeing a lot of blog posts from people who, like me, used to cut.  I can see the benefit in that case, sharing your stories with others to help them learn, to help you grow.  But for someone actually going through it right now?  No.

Let’s look at the mission statement to see why.  They’re a movement “dedicated to presenting hope…”

STOP.  Right there.  That’s far enough.  If you’re “presenting hope” to care-givers, this is a good thing.  If you’re “presenting hope” to the diagnosed, it’s almost insulting.  I wrote about this before in a larger post.

“Under normal circumstances human beings occasionally suffer from “depression”.  Lower-case “d”.  They’ll get the blues or mope around for no good reason.  They feel sorry for themselves.  They have a bad day now and again. A person with depression can be cheered up by things around them.  If you tell them to “look on the bright side” it makes sense, even if they’re bummed out.

“Depression” (capital “D”), one half of bipolar,  is a non-negotiable chemical imbalance in the brain. It is not a “case of the blues”.  It isn’t a lack of perspective.  Rather, it is the absence of hope.  Depression is physically painful.  The only thing I’ve experienced similar in feel is a car accident.  It causes the entire body to ache, even blinking hurts.  Also, I found that everything seemed heavier, and in some cases I couldn’t lift everyday objects.  Even my own limbs were sometimes too heavy to manage.  Consequences be damned, there was no reason on earth to move, except to try to end the pain.”

The root cause of mental illness is a physical impairment, not a character flaw.

This cheerfully optimistic, determined, extremely well-intended group goes on to say:

“We live in a difficult world, a broken world. My friend Byron is very smart – he says that life is hard for most people most of the time. We believe that everyone can relate to pain, that all of us live with questions, and all of us get stuck in moments. You need to know that you’re not alone in the places you feel stuck.

We all wake to the human condition. We wake to mystery and beauty but also to tragedy and loss. Millions of people live with problems of pain. Millions of homes are filled with questions – moments and seasons and cycles that come as thieves and aim to stay. We know that pain is very real. It is our privilege to suggest that hope is real, and that help is real.

You need to know that rescue is possible, that freedom is possible, that God is still in the business of redemption…”

screamMust.  Control.  Primal.  Scream.

Note to readers – I just deleted my first three attempted responses to this “Vision Statement”.  It has taken me over an hour to write all this.  Please understand I’m REALLY trying here.

Maybe expanding on that idea will help people who are not diagnosed understand why statements like this are so infuriating.

roaring_lionMy hands are shaking.  My heart is pounding.  I feel a tightness in my chest and a sincere desire to physically lash out.  The Beast is clawing inside me, raging for a chance to speak, to howl until it IS heard.  I’m controlling it by an act of will, but I am grateful, so grateful, that my partner isn’t awake yet.  Because of the destruction of our apartment (thank you SO much HOA… that’s another blog post…) her desk is only inches from mine.  She would be very upset to see me so agitated.

But now The Beast within is calming.  He’ll have his chance to speak.  My heart is slowing, though my chest still aches from the attempt.  I don’t need to take my blood pressure, I know it’s still through the roof.  But it’s getting better.

Ok, folks.  You may not have understood that reaction, but rest assured it’s very real.  I will do my best to explain.

hulkThe fury within me is the definition of Bipolar.  When the fury lashes out I’m in manic phase, as I am right now.  When it turns inward, that’s Depression.  But, like the Hulk, the fury is always present.  And the best way to trigger it is to attempt to invalidate my struggle.  Especially by telling me that if I just see things from a different angle I’ll suddenly cheer up and understand the light at the end of the tunnel.

TWLOHA is the finest example of that I’ve seen in quite a while.

“You were created to love and be loved.”  Thank you.  I know that, you really don’t need to tell me.

“You were meant to live life in relationship with other people, to know and be known.”  I know that too.  The fact that you put this in a vision statement tells me that you do not understand why a person suffering from Depression pulls away from the world.  If only you remind me that I should be in a relationship with others, I’ll suddenly say “ooooh, wow, I never thought of it like that before!”  Really.  No.  People with Depression pull away from the world because of the cataclysmic lack of understanding, combined with well-meaning people who try to offer us a “perspective check”.

“You need to know that your life matters”.  My eyebrow is starting to twitch.

“We live in a difficult world, a broken world.”  And?

“My friend Byron is very smart – he says that life is hard for most people most of the time.”  Good for Byron.  If I meet him I’ll give him a gold star and a cookie.

“We believe that everyone can relate to pain, that all of us live with questions, and all of us get stuck in moments.”  That’s nice.  In return, I believe that if you have never suffered from Depression (as opposed to “depression”) you can not relate to the pain I feel, as it is utterly irrational.  It is based on a chemical imbalance in the brain that does not allow me to operate as a typical human being would.  I do not suffer from a lack of perspective.  To say that Depression is similar to being “stuck in a moment” is like telling a blind person that they just need a fresh perspective and they’ll suddenly see the colors of the rainbow.

(I’ll skip the next paragraph – I’m sure you get it by now)

“You need to know that rescue is possible, that freedom is possible, that God is still in the business of redemption.”

WHAT?

sugar-addicts-total-recovery-program-kathleen-desmaisons-paperback-cover-artThis is NOT a 12-step program.  If I just cast my doubts aside, my worries to the wind and believe in a power greater than my own, I’ll somehow, suddenly understand hope?  That doesn’t even work for addicts, as most of them are also caused by a chemical imbalance – EXACTLY like mental illness.  Look up “sugar addiction“.  You’ll see what I mean.

Please try to understand.  Please.  I know you’re trying hard, members of TWLOHA.  I really appreciate the effort.  But… there’s a commercial out there that has a person stranded on the side of the road.  They call for a tow truck, a pizza delivery guy shows up.  Please try to understand I do not need pizza.  You can bake the most delicious pies all day long.  They’re lovely.  They’re yummy.  But I’ve still got a flat tire.  No matter how fabulous your pie is, what I really need is a mechanic.

I do not need a “Perspective check”.  I need a doctor.

Get it?

lovePS – My partner woke up as I was editing this post.  She asked what was going on.  When she saw me turning colors she patiently sat down and listened to me read the entire post aloud.  Then she nodded and offered thoughtful suggestions about how I could make it better.  That’s how you do it folks.  That’s how you make it through the day.  She is love.   No writing of arms required.

Oh, those wacky bipolar performances!

In a recent article I addressed the challenges of “coming out” in public.  Do you tell people you’re mentally ill and face the resulting backlash?  Or do you pretend that everything is normal while still displaying symptoms?  Neither seem like a good option, and there’s no third choice.  I’ve also mentioned how much I admire Carrie Fisher (as well as many others who speak in public about mental illness).  Her straightforward attitude regarding her struggles gives me a great deal of courage.

carrie fisherMs. Fisher was briefly hospitalized recently after an incident on a cruise ship.  According to reports she appeared drunk, her behavior erratic.  Was she drunk?  Maybe.  Or she might have been on one of any number of mood-altering drugs commonly prescribed to bipolar patients.   Look at these headlines:

Carrie Fisher Heads To The Hospital After Her Wacky Bipolar Performance On A Cruise Ship! (Perez Hilton)

Carrie Fisher briefly hospitalized after bipolar episode during bizarre performance on cruise ship (NY Daily News)

Vs.

Carrie Fisher briefly hospitalized (CBS News)

Carrie Fisher discharged from hospital after bipolar episode on cruise ship (Toronto Sun)

Arg.

I can not speak for Carrie Fisher.  But I have taken a drink more than once. I don’t like alcohol and I hardly ever drink socially.  But when the anxiety of a manic phase becomes too much, when the buzzing gets too bad, I have few options.  Narcotics?  Sure.  I have bottles full of the things, a different color for every occasion.  Problem is, one pill can last for hours, sometimes days, long after the symptoms have worn off.  In almost all cases the side effects from a tranquilizer are much worse than the symptoms of mania.

bacardiberry5 Alternative?  A shot of Bacardi.  I was doing that LONG before I was diagnosed – all through college in fact.  For a while I was worried about becoming an alcoholic.  I used to just grab a fifth and down a few swigs.  Yeah, Janice Joplin lite.  The effect is nearly immediate, it doesn’t last nearly as long as pills, and I can FUNCTION.  The buzzing emotions calm down.  Now that they’ve started flavoring the rums, it almost tastes good.  Sort of.

Of course, there are a few downsides to this.  Empty calories for a start.  During my heavy drinking period I pudged out quite a bit.  Not pretty.  And, of course, alcohol is addictive.  Once you reach the point of addiction any benefit a person may receive from doing a shot is negated.  Now you have two problems – you’re still bipolar and now you’re an alcoholic.  Joy.

There’s also a third downside which only becomes apparent as the cycle progresses.  I only need to drink when I’m manic.  I get the jitters, I start to spaz, I need to calm down  fast.  But when the mania phases into depression… then what?  I start to feel awful, I reach for a shot.  And I immediately feel worse.  What makes the manic phase bearable makes the depressive phase a living hell.  But it’s not always obvious when the phases have switched, except in retrospect.

 
we Carrie Fisher, wherever you are this morning, I salute you.  As always you give me courage.  Courage to write, to get the word out, to continue to champion the cause of those who struggle with mental illness.  It’s not a sexy fight, but hey – someone has to do it.

“Coming Out” as Mentally Ill – the psychiatric Catch-22

c22If you enjoy black humor or satire, you’ve probably read Joseph Heller‘s classic “Catch-22“.  Published in 1961, it describes the paradox of a situation that is contradicted by its very nature.  In the story a soldier wants a doctor to declare him unfit, because he does not want to fight.  The problem is that anyone who wants to fight is insane, and so by definition is “unfit”.  If you do not wish to fight, then clearly you’re sane, and “fit for duty”.

These days, “Catch-22” has expanded to cover just about any no-win scenario.  In the case of the mentally ill, one of the basic questions every person diagnosed must face is “do I tell anyone?”

prideAnother commonly used phrase in pop culture is “coming out”.  Usually it is applied to someone who’s gay.  If they don’t tell anyone, they’re “in the closet” and subject to a great deal of speculation, along with a fair amount of contempt.  However, if they “come out”, let the world know they’re gay, the inevitable reaction from many becomes “why don’t they keep that sort of thing to themselves?  Why involve “normal” people?  Who cares?”   Catch-22.

Applied to the mentally ill, it’s even worse.  Currently there is a strong push toward social acceptance in the LGBT community (Hurray!!).  There is a determined support network out there that refuses to be denied.  But among the mentally ill, while there is a support network, there is only a very limited attempt to raise awareness.  Usually it’s only temporary until the next crisis comes along.

6032ed90_01-its-a-secretFor the first several years after my diagnosis I made a determined effort not to tell a soul outside my immediate family and circle of friends.  It was our “dirty little secret”.  Of course anyone who knew me even in passing understood there was something “not right” about me.  I just wasn’t “all there”.  It was acknowledged, but never openly discussed.  I was “just that way”.

I can’t remember making a conscious decision to “come out”.  I do remember being very frightened to say “I’m bipolar” out loud.  But at the time it seemed the best of bad options.  Do I let people continue to talk about me behind my back?  Or do I take the bull by the horns and essentially say “Yes.  I’m crazy.  I have a chemical imbalance that affects my brain, which in turn affects my behavior.  This is who I am.”?

bipIf I never admitted it, it does not give society permission to address it either.  Even though people would talk behind my back, no one said anything to me directly.  I used to think that was easier.  But by saying “I’m bipolar.  I’m trying to deal with it.  If you’re in my life then do the same” I took a small measure of control.  It opened up opportunities for dialogue.  I don’t feel ashamed of what I am anymore.  I’m not bad.  I’m sick.  BIG difference.

However, there’s an unexpected downside to this public announcement.  By making it known I’m mentally ill, it gives people permission to speak freely.  Sometimes they forget that even though they can now talk about the illness in my presence, that does not make it any easier for me to deal with.  At first, when I started talking about it, it opened a dam.  I heard a veritable flood of stories that usually started with “Remember when you…” followed by a vivid description of my irrational behavior, accompanied by much laughter and eye-rolling.  Guys, I appreciate that you’re still in my life.  Thank you.  And I’m glad you can let off a little steam.  But… I’m still in the room, ok?  And I’m not cured.  I never will be.  So please think before you speak.  Let’s take this in small steps.

blue_meanie_chief_and_jeremy_by_mothmanboris-d4bd4g0While “normal” people can lose their temper or become frustrated, when I do it It’s often cause of immediate alarm – I’m “acting out”.  Err, no, at least not always.  Sometimes, yes.  But at times I’m just frustrated.  The world is an ugly place and sometimes I want to jump up and down like the proverbial Blue Meanie.  Now everything I do is subject to intense scrutiny. Is my behavior due to a manic phase?  A depressive phase?  Should I adjust my meds?  Should I call a doctor?  Which, of course, just adds to the frustration.  Arg.  In addition, the people who have dealt with me longest now have their own set of coping issues.  Being the support network to an out of control mental illness is #1 on the list of noble but thankless tasks.  So a bit of overreaction is to be expected.  Unfortunately, again, because of my illness, I’m not in the best position to deal with their overreaction of my reaction.  But I’m trying, and thank heavens so are they.

Another unexpected paradox is in the medical profession.  If I’m meeting a new doctor (my life is a constant succession of doctors) I’ll be very frank with them – here’s my diagnosis, here’s what it means, if you have questions ask.  Even though they’re doctors, unless they’re in psychiatry they probably don’t know how to deal with a bipolar patient.  Most are relieved I’m so up front about it, and many ask me questions not only about how I’ll react to something, but just how to address a bipolar patient in general.  Though we’re all different (of course), hopefully I can at least offer some insight – that’s cool.

The downside is that doctors can use this information like a weapon.  In my last blog post I wrote about how I was taken away in handcuffs early one morning because of this.  It has happened to me with medical doctors as well.  The latest incident was during a trip to a local Emergency Room.  Before I realized that the degenerative disc disease had spread to my neck, I wasn’t sure what was causing the blinding pain.  I felt as though I’d been shot through the shoulder, and it never stopped.  My doctor told me to go to the ER and get an MRI.  Ok.  I went to the ER and I described my symptoms.  I also, as usual, mentioned I’m bipolar.  This normally aids in communication.  When they asked me to describe the level of pain I was in from 1-10 I replied “11.  It’s so bad I could kill myself.”

3qedboNow, normally either they’d blow that off as hyperbole (which it was) or think it was a stupid joke to try to ease an otherwise tense situation (which it was).  But because I’ve admitted I’m bipolar, this team decided to inform me that any further statements of that kind would result in a one-way ticket to the nearest secure facility where I would be put on an involuntary 3 day psychiatric hold.  Then I was asked formally if I wished to revise my statement.  Grinding my teeth I simply said “my shoulder hurts”.

I understand their reaction.  In the days of happy-go-lucky lawsuits they have to be careful.  But guys, the knee-jerk automatic response isn’t required either.  A little common sense goes a long way.  Like – you could have just asked if I was kidding around.  And yes, I agree, under the circumstances I selected my words poorly.  I was attempting to describe the worst pain I’ve felt in my life, I wanted them to know I wasn’t wasting their time by being there.  I wanted the damn MRI.  Instead I was told they weren’t going to give me any painkillers of any kind (did I ask for any?  No.) and that I should return to my doctor.  If she thought I needed an MRI she could schedule one.

*sigh*

I don’t have a good solution to this.  Because my behavior affects every relationship I have, I maintain that telling people up front is a good idea if I’m going to spend time with them.  But some people do get weird about it.  Saddled with my own weirdness I’m not in the best position to help them deal with theirs.

And so it goes.

The night of “The Voice” or Why I Don’t Trust Therapists Anymore

“Even in the wizarding world, hearing voices isn’t a good sign.”  Hermione Granger, speaking to Harry Potter.

HermioneI hear voices.  As in “I’m hearing the voices” type voices.  And no, I do not admit this very often.  Why?  Hermione said it beautifully.   Even people who know I’m mentally ill will give me “The Look” <tm> when I mention hearing voices.  You know, the nod, smile and don’t make any sudden movements look?  That look.

The specific psychiatric term for hearing voices is “auditory hallucinations”.  In other words, you register a physical sensation that isn’t actually there.  There’s two main types.  If you experience physiological hallucinations, sometimes called “sane” hallucinations, you may not suffer from any other mental health issues.  It’s thought that 1 in 25 will “hear voices” at some point in their life.

I suffer from experience pathological hallucinations.  In the past, conventional wisdom associated pathological hallucinations with a severe mental illness – usually schizophrenia.   With time the diagnosis has gradually extended to include such disorders as bipolar.

Auditory hallucinations usually mainfest in one of three ways.  The first is very dangerous.  Called a “command hallucination“, this is a very clear, distinct voice that offers a specific direction.  The command can be very simple, such as “stand up” or “sit down”.  However, they can also be threatening, such as “kill your boss” or “burn the house”.  Sometimes the threat becomes personal.  “Stab that guy, or I’ll stab you.”

Then there is “Exploding Head Syndrome“.  For example, I’ll hear a gunshot, or a rocket taking off, or sometimes impacting. It’s not distinct.  Let’s say there’s a tv on in the next room.  There’s a cartoon on and it features rockets and a gun.  That’s pretty much what it sounds like.  I can hear it, but it’s not alarming.

Generally, I hear crowd noise – the sound of a large crowd at a distance.  Imagine that you’re approaching a large room full of people, but you’re not quite there yet.  You’ll have a subconscious awareness of the sound of many voices, but none are distinct.

In addition to the “crowd noise” I can hear people speaking.  They don’t talk to me, or about me.  They’re just having a conversation, and none of them are in English.  There are two women who speak Japanese.  Maybe they’re out shopping.  I have no idea – I don’t speak Japanese.  I also hear two men talking.  These are older gentlemen, and they speak Russian.  My mental image is of two guys in a park playing chess, but again as I don’t speak Russian I couldn’t tell you what (if anything) they’re really saying.  They seem friendly, and they’ve been with me as long as I’ve been aware of “me”.

The study of voices has come a long way since I was diagnosed.  In 2001 there was only one reason to hear voices – severe mental illness.  A very dangerous kind.  But recently, the “Hearing Voices Movement” has taken off.  They reflect the new understanding of mental illness – while illness of this kind can be dangerous and harmful, there may also be aspects that are beneficial.

This is a very welcome trend!  No illness should be treated in absolute terms.  Here’s why.

It was a normal night, I was in bed, asleep.  Then, around 1 am or so, I was startled awake by a voice.  At first I thought someone had turned on the television, or the radio, or an alarm had gone off.  But then I heard it again.  This was the only time I ever heard a Command voice.  It was male, but strangely flat and devoid of emotion.  It said one single phrase.

“Children are a nuisance, and you should be rid of them.”

Um, what?

My therapist had just started a 24 hour “hotline”, which he encouraged his patients to use.  I talked it over with my current partner.  We reasoned that I might need to increase one of my medications, and I should ask sooner rather than later.  So I called.  We spoke for a while, then she asked me to call my current partner to the phone.  That was weird, but I handed it over.  They spoke for a time, then she frowned and covered the handset.  “Hey,” she whispered, “I think she called the police!”

I couldn’t believe it.  Not even 10 minutes later, two cops walked in.  They asked what was going on, and if any children were in the house.  I said no, there were no kids anywhere around us – the community was mostly of retirees.

“But you’re planning to get rid of them?” the cop insisted.  I had to admit, that was what the voice said, but I had no plans to act on it.   At all.  None.  No children lived with us.  None of my friends had kids.  None of my relatives had kids.  See?  NO kids.

handsAfter 45 minutes they explained that I needed to come with them to the hospital.  We’d sort it all out there.  Which was how, at 3 am, in front of a few curious neighbors, I was led out of my home in handcuffs and placed in the back of a police car.

They took me to the hospital ER.  They took my purse and my clothes.  It was around 4 when we arrived.  I didn’t see a doctor until 8am.  I was not given any food, I was only allowed to drink water in the presence of a guard.  I was not allowed to move even when I explained I had ruptured disks in my back and I needed to walk every so often.

When the staff psychologist arrived I told her what had happened, and I was sure that finally, with a qualified professional present, someone would see reason.  After I told her my story I waited for another 2 hours.  When she returned she informed me that I would be taken from the ER and transported to a secure facility.  I was being placed on a 72-hour involuntary hold.

I went ballistic.   I was so mad I’m pretty sure I was turning colors.  I demanded to see my own doctor, who was on staff at the hospital.  But he wasn’t scheduled to be there until the following day.  And that was that.

GROUP-THERAPY-SMALLAt the facility, in a group therapy sessions of 30 patients, the doctor asked me why I was there.  I told him “I don’t know”.  He looked at his clip board and said, in front of everyone, “It says here you attacked a child.”

From that point forward it didn’t matter what I said or did.  Every patient heard I had attacked a kid, and I was given a wide berth.  If I lost my temper again it would get even worse.  So I gritted my teeth and just stopped talking.   I stopped moving.  I sat still and waited.

My doctor arrived the next day, 36 hours after I heard The Voice.  I told him what had happened and demanded to be released or explain why not to a judge.  This is not something a patient on a 3 day hold can say.   I was released within 2 hours.

My bewildered parents came to pick me up.   I had no idea how to explain any of it.  I’m still at a loss.

The mentally ill are the most stigmatized members of our society.  Within this group, those who hear voices are even more isolated, as it’s one of the least understood symptoms.  But I’m pleased to discover that through the efforts of groups such as the Hearing Voices Movement, attitudes are slowly changing.

Voices carry

There are a lot of unexpected situations that pop up when one is mentally ill.  Some, like rapid-fire mood swings, are predictable – or at least expected.  But what about the more nebulous symptoms?  One of the most difficult to explain to others is “hearing voices”.  If a person has never experienced it, they usually nod, smile and look uncomfortable.

Until now I’ve never seen anyone explain this symptom in a way others would understand.  Here is an OUTSTANDING blog post from Emma White covering this issue in a way I think most will be able to grasp.  For my next post I’ll share what happened when I heard them.

http://www.therealsupermumblog.com/2012/09/hear-voices/

Therapy is not for wimps. True, but…

I recently read an interesting article, “Therapy Is Not For Wimps”. 

In it, author Gerti Schoen makes a few excellent points.  In the modern era there’s a general assumption that anyone who seeks therapy is “weak”.  They’re not strong enough to stand on their own, they have to ask for help.

Be honest.  Have you ever needed help?  Do you know anyone who has never needed it?  The assumption that therapy = weakness is a social bully tactic.  It actually takes a great deal of strength to seek out therapy given the stigma against it.

Very good point, Ms. Schoen!

However…

Like all good things, it’s very important not only to know when to seek out therapy, but when to say “enough is enough”.

First, what’s “therapy”?  It’s a more difficult question than you may think.  Though the stated goal of all therapy is to help the patient better understand themselves, there are hundreds of ways to go about this.  I’ll describe the top three.

  1. sigmund_freud_portraitPsychoanalysis.  When they say “old school”, this is what they’re talking about.  This style of therapy was developed by Sigmund Freud and operates under the assumption that all problems are rooted in the subconscious, usually implanted in your “formative years”.  Usually the libido is involved.  Through the analysis of actions, mistakes, dreams and symbols it’s possible to better understand the root (subconscious) cause of psychological illness and therefore achieve an appropriate treatment.  If you see a character in a movie laying on a couch talking to a therapist about his mother, that’s Psychoanalysis.
  1. Cognitive-Behavioral Therapy (CBT).  This is (arguably) the most popular form of therapy in modern times.  In a nutshell, this type of therapist believes awareness can change behavior.  Rather than delving into the past to focus on the root of a dilemma, CBT isolates a specific problem, caused by an irrational thought process or incorrect perception.  By becoming aware of the incorrect perception through a progression of mindfulness exercises, the patient can overcome, or at least constructively manage, their disorder.
  1. carl_jung-glassesAnalytical Psychology.  There are so many contenders for 3rd place, I’ll just pick my favorite.  Carl Jung was a contemporary of Sigmund Freud.  The two of them met several times, each influenced the other.  The big difference between Freud and Jung is that while Freud placed special emphasis on the influence of the libido in psychological disorders, Jung went in another direction. His approach is famous for it’s focus on dreams and through them, archetypes.  His idea of the “collective unconscious” assumes that people develop through life experience rather than incidents rooted in the formative years.  While the psyche is self-regulating, it can become ill, driving a person to become psychotic.  There must be a balance between the conscious and the unconscious functions of the brain by moving beyond ego, achieving a higher awareness.

Each of these schools of thought has value, and can benefit the patient.  Who can deny that specific events in childhood had a lingering effect in their adult years?  And certainly, becoming aware of the impact of a skewed perception can be extremely helpful.  A greater awareness of the world in which we live, and our place in it, is always valuable.  Therapy has helped me become much more self aware of my behaviors, and to occasionally modify some of them.

Dolores_UmbrigeA medical doctor looks at a tumor and can see immediately that this is wrong.  It should not be located in the body.  It may be painful, but it must be removed so that the body can heal.  The problem I have with therapy is in the application of this philosophy to the human mind.  It is very possible to see a behavior as beneficial or harmful.  But almost all therapists I’ve met moved beyond “this seems to help, this seems to hurt you” and into the language of judgment: simply, “I’m right, you’re wrong.  That’s why you, the patient, are here.  Not only that, but you know you’re wrong, but you may not want to admit it.  Let’s start there.”

Yikes.  It reminds me of Harry Potter talking to Delores Umbridge.

So while it takes strength to seek out therapy, a patient needs to be strong and self-aware while dealing with their therapist.  If they see a benefit from the therapy – wonderful!  But if not, it’s not the patient’s fault.  They need to move into a more constructive situation.  Unfortunately, by the very nature of their condition, most patients are in no position to self-advocate in the presence of a therapist.

Bipolar and the creativity connection

There is a great deal of respect given to the medical profession.  I wish equal respect was given to the incalculable value of individual creative expression.  The “triage” reaction in the psychiatric community of “return the patient to a controlled state as quickly as possible, deal with the consequences of the drug’s side-effects later” comes at a considerable, perhaps unnecessary price.

twfWhile there are plenty of articles speculating on the connection between creativity and mental illness, the majority are at least 10, if not 20 (or more) years old.  There’s even a book – “Touched with Fire: Manic-Depressive Illness and the Artistic Temperament” by Kay Redfield Jamison that attempts to connect bipolar with great artists like Van Gogh and Beethoven.  However, the book was published in 1996.  It makes a good case, but it’s not conclusive.

celebrity-bipolar-intro-400The pop culture take on it tries to connect diagnosed celebrities such as Catherine Zeta-Jones, Linda Hamilton and Carrie Fisher with public symptoms exhibited by others, such as Britney Spears, Lindsay Lohan and Kurt Cobain.  They may have a case, but the point is that the connection between madness and creativity is openly acknowledged.

The social assumption that a genius is crazy (or “touched by the Gods”, however you wish to put it) goes back to the dawn of written tradition.  There’s been a clinical theory that connects creativity and mental illness for decades.  But only in the last 3 years have there been large, comprehensive studies on the connection between bipolar disorder and the so-called “artistic temperament”.

In 2011 there was a study of 300,000 patients diagnosed with either schizophrenia, bipolar or Depression.  The results of the study found that there was an “overrepresentation” in creative fields for those diagnosed with either schizophrenia or bipolar, as well as their undiagnosed relatives.  Those who suffer from Depression did not, on the whole, feel compelled to go into the arts.

This is a good start.  Even better, in 2012 there was a study of one million patients by the Karolinska Institute in Sweden.  Their conclusion?  “Creativity is closely entwined with mental illness”.  My favorite quote: “… the findings suggested disorders should be viewed in a new light and that certain traits might be beneficial or desirable.”

NOW we’re getting somewhere.

Pills2In my mind I’m about 15 years behind where I ought to be.  Before I was diagnosed I was writing like a fiend, and it was certainly good enough for publication.  But my mind was firing without direction, and I couldn’t focus long enough to go through the steps necessary to be published.  After my breakdown and subsequent incarceration, I was heavily medicated.  I used to call it “being placed in a creative coma”, but in truth it had more in common with a literal coma.  Unsure what to do with me, my doctor put me on twelve different medications. Lithium, Geodon, Depakote, Thorozine, Topamax, Paxil, I forget them all.  You name it, I took it, frequently combined.  I gained 150 pounds, my hair fell out and I sometimes forgot how to blink.  I could barely walk, much less write.

It took me 10 years to recover enough to be able to think, and a good deal of that recovery was to get rid of the drugs.  I went through a series of doctors, begging to find a less invasive cocktail.  One of them said, to my face, “if you’re alive long enough to complain about the side-effects, you’re a success”.   That… wasn’t constructive.

It was my OB/GYN who finally cracked the code.  She’s the one who figured out the best way to get my symptoms under control while allowing my mind to function.  I won’t offer the specific details here for two reasons.  1. I’m not a doctor and offering anything that might be considered medical advice in a blog is a bad idea.  2. We’re all different.  Even though it worked well for me, it might not do a thing for you.  Sorry about that.

Once the worst of the drugs started to clear my system, a miracle happened.  I started writing again.  My “voice” came back.  Slowly at first, but with growing confidence as the months went by, I regained my former creativity.  Bipolar is incurable, as are all the other illnesses I’ve been diagnosed with.  I’m still on drugs and always will be.  But at the very least I can think again, long enough to pound out a few paragraphs here and there.

That we’re drugging ourselves into oblivion is a given.  We’re starting that trend earlier every generation.  We’re now diagnosing children as young as age two with bipolar.  No doubt I had it since birth.  And yes, had I been diagnosed much earlier my life may have been easier.  But two years old?  Judge Judy notes, with some exasperation, that people aren’t “cooked” until age 18, if then.  Giving a child such invasive drugs during (or before) their formative years fills me with an essential horror.

In the article “Soaring Numbers of Children on Powerful Adult Psychiatric Drugs“, Dr. Peter Breggin notes:

“In a comparison between the years 1993-1998 and 2005-2009, prescriptions of antipsychotic drugs for per 100 children (0-13 years old) rose from 0.24 to 1.83. That’s more than a sevenfold increase. Given that most of prescriptions are for the older children in this age range, the rate would be substantially higher among preteens and 13-year-olds. For adolescents (14-20 years old) the increase was nearly fivefold.”

According to the Karolinska Institute, “… disorders should be viewed in a new light and that certain traits might be beneficial or desirable.”

Drugging patients into oblivion is good business for Big Pharma.  But what are we sacrificing in the process?  How many Van Goghs and Beethovens have been drowned in a sea of Ritalin?  I do understand the need for psychiatric care.  In fact, it saved my life.  But there must be a balance between our “pop-a-pill” social mentality and a creative individual on a destructive mood swing.