Tag Archives: mental health

Poor? Mentally Ill? Sorry, You’re on Your Own.

Poverty and mental illness have something in common.

There is a stigma attached to both.

Both are seen as moral failings. If only people tried harder, worked more, improved themselves, they could lift themselves out of poverty. Without relying on anyone else’s help, which would be shameful.

And if only people stopped being so negative, looked on the bright side, smiled more, thought more about others, their positive mental attitude would make all those shrinks and pills unnecessary. They wouldn’t be shooting people with assault rifles and sucking up tax dollars for disability payments, which is shameful.

Society can’t afford poverty and it can’t afford mental illness. Why should we make the effort when the poor and the mentally disturbed don’t?

Why should these two conditions both be associated with such stigma and for such similar reasons? It’s simple. People don’t want to think that poverty or mental illness could happen to them.

The truth, however, is that a vast number of Americans are living one paycheck or one illness away from poverty, and one in four or five Americans will face a mental or emotional disorder at some point in their lives. And they are afraid. So they tell themselves that the conditions only affect Other People. And those people must be stupid or lazy or unmotivated or something, or they wouldn’t be poor or mentally ill in the first place.

And that’s where stigma begins.

And what are the consequences of stigma?

Well, first of all, it means that no one wants to spend money alleviating either condition. If these Other People can’t pull themselves up by their bootstraps and improve, the thinking goes, why should we pay them not to? Job training programs, child care, higher minimum wage, insurance coverage, community mental health centers, treatment programs for addiction, need to be paid for some way, but not with our tax dollars, by God!

And it means we don’t want to look at the Other People for fear of seeing ourselves. Don’t put halfway houses, group homes, unemployment offices, treatment centers, psychiatric hospitals, and other reminders in our neighborhoods. Not In My Backyard!

It’s not just a failure of compassion, though it’s that too. It’s not just a failure of the social “safety net,” though it certainly is that as well. It’s also a failure of the imagination – what would it be like if poverty or mental illness should happen to me? The reality is too unpleasant to think about, so don’t.

And while we’re talking about unpleasant, let’s mention the place where poverty and mental illness intersect – homelessness. Don’t we assume that homeless people are both poor and mentally ill? As such, spending money on them is doubly wasted. Why bother? It’s not like it’s going to help. Poverty, homelessness, and mental illness are incurable, after all. (Unless a person can cure their problems without outside help, of course.)

So what’s my stake in all this? Am I a bleeding-heart liberal do-gooder who wants to cure society’s ills and make us all foot the bill for it?

Well, yeah.

But I’m also living month to month on my income. My husband makes only a bit over minimum wage. We have both, at one time or another during our lives, been on unemployment and/or food stamps. We have no nest egg or emergency fund. It wouldn’t take much in the way of reversals to wipe us out. Even at that, we’re relatively privileged.

And I have a mental illness – bipolar disorder 2. Without insurance, I could not afford to see a psychiatrist, or buy medication (one of mine costs $800 per month), or get inpatient treatment if I ever need it. Right now my condition is moderately well controlled, but if I should suffer a setback, I might not be able to work at all. And there we are, back at poverty.

These two unfortunate conditions – poverty and mental illness – affect me directly, so I can’t look away and say they only happen to Other People. I know that they affect others more severely than they do me, and I don’t know how those people make it through.

But I do know that stigma isn’t helping any of us.

When Your Friend Is Depressed

…And by “depressed,” I mean clinically depressed – the sort that has no apparent reason and lasts for weeks or even months. Your friend is not just sad, but feeling hopeless, helpless, discouraged, defeated. even immobilized. She or he may not want to go anywhere or do anything that used to bring happiness. You may even detect a dullness – called “flat affect” – in the person’s voice, a lack of animation, often combined with monosyllabic responses.

What can you do to help your friend?

At first it may seem like the answer is “not much.” And that’s partly true. What your friend really needs is probably help from a mental health professional and possibly from antidepressant medication.

There are, however a few things you can do to help your friend – and a few things you shouldn’t do, not because they will make your friend’s condition worse, but because they simply won’t help.

Let’s start with the things you can do.

Keep reaching out. Even if your friend doesn’t respond, refuses your invitations or doesn’t show up, know that the simple act of staying in touch says that you like the person even though she’s having a hard time and that you won’t abandon her. Make no mistake, many people will. Even if your friend is unable to respond, when she finally does get some relief from the depression, she will realize and remember who stuck by her during the depths. Surely you can spare a minute or two for a phone call or email a couple of times a month. You may think it won’t make a difference, but it will.

Offer to help with practical matters. If your friend has decided to get professional help, you can make doing that easier. You may not realize it, but the simple acts of getting up, dressed, and out of the house can seem insurmountable to him. Offer to drive him to his appointments or to the pharmacy to pick up his prescriptions. Give him a pill caddy to help him remember to take his meds every day.

Imagine your friend is physically ill. In a way, she is. The depression is a result of a neurochemical imbalance in her brain. What would you do if a friend were recovering from an illness or perhaps surgery, or even the death of a loved one? Bring her a hot meal once in a while or pick up an extra sandwich if you’re getting one for yourself? Offer to do laundry or another household chore? Enlist other friends to help? Pray for her healing and tell her you are doing so? None of this will make your friend magically well, but they can help her through the worst phases of a depressive episode while she’s waiting for medication to take effect (which may take as long as six weeks).

There are also some things that you shouldn’t do for your friend because they simply will not work. Here’s a brief list.

Don’t try to “fix” him. As much as you may care, you do not have the power to make it all better. Trying to do that will only frustrate both of you. Leave your psychological theories and miracle cures at home.

Don’t give “pep talks.” Telling your friend to snap out of it or to smile more or to think of others who have it worse will not alter his brain chemistry for the better. He most likely won’t be able to appreciate jokes and humor, either, even if he did before the depression.

Don’t expect quick results. Clinical depression lasts for weeks or months, or in some cases even years. It’s frustrating to see your friend suffering for that long, but if your friend sees you give up, she may too.

Don’t ignore suicidal talk. Suicide is a real risk for a depressed person, even if he is getting professional help. Most people who kill themselves give warnings – they talk about being better off dead or give away their possessions. Stay with your friend. Make sure he has the number of a suicide hotline. Call his therapist. Take him to an emergency room.

My advice for someone who lives with a depressed person is similar: Do what you can and realize what you can’t do. If you truly care about the person and stick with him or her through the bad times, you may find one day that you have your friend or loved one back – maybe not as good as new, but on the way to getting better.

That’s when you’ll find that all your efforts have been worth it. Helping a depressed friend survive and heal is an accomplishment not to be taken lightly.

I Want My Blankie!

Linus’s security blanket. Radar O’Reilly’s teddy bear. That kid in Mr. Mom‘s woobie (which seems to be where the term “woobie” was invented). (See https://www.youtube.com/watch?v=vSVCQ-NmTac.)

What do all these things have in common?

They’re what psychologists call “comfort objects,” or as Wikipedia defines it, “an item used to provide psychological comfort, especially in unusual or unique situations.”Morgenmuffel

But look again at that list. What’s different about one of the names? Radar O’Reilly is an adult, or at least grown-up enough to be a corporal in the U.S. Army. Some of the characters on the show and in the audience poked fun at him, but most understood – Radar was in a strange and dangerous place and needed a comfort object to remind him of his childhood home in Ottumwah, IA.

And Radar isn’t the only adult who needs a woobie of some sort. Alabama journalist Anna Claire Vollers wrote:

Last year, the hotel chain Travelodge polled about 6,000 people in Great Britain and found 35 percent said they sleep with teddy bears. A surprising 25 percent of men admitted to bringing their teddy bears with them on business trips.

So now I have a confession to make: I own an array of comfort objects and sometimes take them with me on trips. Once I even took a stuffed bunny with me to a sleep study. (Let me be clear: It was not a taxidermied bunny, but what I believe are now called plushies. For taxidermied animals as comfort objects, you should check out The Bloggess.)

My habit started in childhood, when I preferred plushies to Barbies. Every year our Easter baskets contained, in addition to candy and fake grass, a plush bunny. One year I won a plush bunny three-and-a-half feet tall in a raffle. It was wearing a blue and yellow checked dress. My mom found the same fabric and made me a matching one.

Now my collection includes, in addition to bunnies and bears, crocheted armadillos, assorted Beanie Babies (including a crab and a spider), a giraffe, Thing One and Thing Two from The Cat in the Hat, and a Raggedy John Denver doll that a friend made me (the little heart on his chest says “Far Out”).

Nor am I the only one among my circle of friends who treasures assorted comfort objects. Two of my friends have plush animals that could be either husky dogs or gray teddy bears (which they call “huskie bears”). Our friend John had a toy bunny (“Lovie”) to sleep with at home and borrowed a bear my mother had made when he napped at our house after Thanksgiving dinner. My sister had a 12-inch square piece of cloth from her childhood that she named “Tag.” She kept it under her pillow at college. Her roommates teased her unmercifully about it, though really it was a miracle Tag had lasted that long.

One friend even received as a gift a plushie called “My First Bacon.” As I recall, it talked, though I’m not quite sure what talking bacon could say that I would find soothing, except possibly “Eat me.” (Like the cake in Alice in Wonderland. Get your mind out of the gutter.)

But now someone has gotten serious about the therapeutic effects of comfort objects. Wikipedia notes:

Inventor Richard Kopelle created My Therapy Buddy (MTB) in 2002 as a self-described transitional object to benefit “one’s emotional well-being”. The blue creature speaks to you when you squeeze it and says any of a number of phrases that include “everything is going to be alright.”

Here’s a video: https://www.youtube.com/watch?v=H6kSqSzWr0w. It shows a pale blue, bald, pregnant Smurf-like object being cuddled by various people to a background on New Age-type lullabies. One clip even shows it in the mouth of a giant, leering shark, which does not comfort me and does not appear to comfort the shark.

I will stick with my Pirate Winnie-the-Pooh, thanks. Or my plush Puss in Boots that makes a sound like a cat coughing up a hairball and says, “I thought we were done doing things the stupid way.” In the voice of Antonio Banderas, no less.

I guess we all find comfort in our own way, even if some of them seem stupid to others.

 

The Other Bipolar Disorder

I have bipolar disorder type 2. This is my story.

First, some background. Bipolar disorder used to be called manic-depressive illness, and many people still know and refer to it that way. The term “bipolar” reflects the concept that there are two extremes to the continuum of mood disorders, and some people swing dramatically from one to the other. According to this definition, clinical depression by itself is “unipolar” – occupying only one end of the spectrum.

Depression is to ordinary grief or sadness as a broken leg is to a splinter. Depression sucks the life from a person, mutes all emotions except misery, denies any possibility of joy or even contentment, makes life seem meaningless or impossible. This is hell.

Mania is to ordinary happiness as diving off a cliff is to diving off a diving board. Mania brings exhilaration, ambition, confidence, abandon, and invincibility, with no brakes. It is hell on wheels.

Oscillating between the two extremes – that’s bipolar disorder, type 1. It is a very serious illness. Left untreated, it can cause destruction of families, careers, and more. It can lead to psychosis or suicide.

The treatments for it are no picnic either. Bipolar disorder that severe often requires hospitalization. If the symptoms can be controlled with medication such as lithium or newer formulations, the patients must have frequent blood tests to assure that the drug is present in the right quantity. Electroshock is also a possibility, especially for deep, drug-resistant depression.

When I was (incorrectly) diagnosed with unipolar depression, I used to wish that I were bipolar, on the theory that at least then I could accomplish something. Boy, was I wrong about that. Plans made in mania never come to fruition. They are started, rethought, abandoned, exchanged for something grander, and ultimately fizzle out when the mania wears off.

My diagnosis actually made some sense at the time, as I never experienced anything like the manic highs. All I got were depressive lows.

This leads us at last to bipolar disorder, type 2. Some people think of bipolar 2 as “Bipolar Lite.” The mood swings are not as extreme, the lows less debilitating, the highs less overwhelming. The person with bipolar 2 stays closer to a baseline of normal mood, but still experiences swings back and forth.

Technically the mini-lows are called dysthymia and the mini-highs are called hypomania. In my case, the lows were just as low as in unipolar depression, but I never got the mini-jags of buoyancy that accompany hypomania. Instead, these feelings, came out sideways – as anxiety.

My brain was still racing with little control but in a different direction. Instead of elation and purpose, I was beset by in worries, fears, and catastrophizing.

One of the difficulties with treating bipolar disorder of either type is trying to find a medication or a combination of medications that will level out the person’s moods. Usually this requires more than one drug, and finding the right mix or cocktail of chemicals takes usually requires more than one drug. It takes a great deal of trial and error. In the meantime, the mood swings continue.

At this point, my bipolar 2 disorder is fairly well controlled on medication. I still have spells of depression, but now they last at most a week, and sometimes just a day or two. Untreated, they could last months or years. I still have anxiety too, but I have the medication I take for that, so that I don’t feel like I’m about to jump out of my own skin.

Most of the time I’m fairly high-functioning. I can write, work, earn a living. I have a great marriage and a number of friends, including some who are closer than family to me. I have never been hospitalized, nor have I had electroshock (though that was a near thing). Before I got my proper diagnosis and treatment, I would have not believed this to be possible. My goal in life was simply to stay out of a psychiatric hospital as long as I could, or at least until I qualified for Social Security Disability.

I’m sharing these experiences with you today because I believe that mental disorders should not be hidden or viewed with shame and horror, as they have been in the past and sometimes still are.

It’s undeniable that there is a stigma associated with having mental illness. Going public with it entails a risk. I’ve seen the fixed-smile-back-away-slowly reaction. I’ve seen sudden turn-arounds in my work performance evaluations. But I’ve also seen the “Me too!” response. There is strength in numbers. As more of us who live with psychiatric conditions talk about it, and share our stories, the more we build understanding and perhaps encourage those who are roller-coastering to seek treatment.

So that’s the nuts and bolts of it: Bipolar disorder type 2 is a mental illness. I have it and live with it every day. I do not go around shooting people or trying to jump off buildings. I take medication for it and know that I will likely have to for the rest of my life. And I’m okay with that. I hope that eventually the rest of the world will be too.

 

Review: Furiously Happy

Buy this book!

Jenny Lawson, aka The Bloggess
Jenny Lawson, aka The Bloggess

Now I’ll tell you why.

First, despite what I wrote a previous post, Seven Reasons I Hate the Bloggess (http://wp.me/p4e9wS-56), I really respect and admire her and her writing.

Second, Furiously Happy is every bit as funny as Let’s Pretend This Never Happened, Lawson’s first book. It’s as raucous and uninhibited as her wildly popular blog.

Third, it’s something more.

Oh, there’s still plenty of weird taxidermy, ridiculous fights with her husband Victor, and even a bizarre travelogue of her trip to Australia. (She was not allowed to cuddle a koala, even when she dressed in a full-body koala suit, but consoled herself with the knowledge that koalas have chlamydia.)

But threaded through  her comic, idiosyncratic prose is a serious message about mental health: that we should speak up about it; acknowledge our struggles; and be determinedly, exuberantly, furiously happy when we can, in defiance of our illnesses.

Furiously Happy is a book for the millions of Americans – one in four – who struggle with mental illness, and for the millions more of their families, loved ones, and friends. It entertains and educates and defies the stigma that surrounds mental illness, without being preachy or mired in statistics.

Lawson has heard from people who have made it only as far as the parking lot of her signings because they too have severe anxiety disorders. Others have driven as much as five hours to attend one of her appearances. In her blog (thebloggess.com) and her new book, she lets people know that we are “alone together,” that even if we’re broken, we still have the capacity for magic.

At a recent book signing, Lawson was visibly nervous when she read two chapters aloud. One of these chapters was the one in which she and her mother discuss what is crazy and whether Jenny is. During the Q&A session at the signing, she took care to make the point that mental illness need not prevent people from being, as she says, furiously happy – if they keep on struggling, fighting, and trying, and especially if they have people around who understand and help.

After that she signed her book and anything else the audience brought until the entire group – which was quite large – was satisfied. No one was turned away from the signing line.

Lawson’s writing is not for everyone. Some people will be turned off by her use of profanity, and perhaps others may not appreciate the serious message that this second book contains. However, if you are looking for more rollicking, uninhibited, and unlikely (though largely true) stories, you will certainly find them here. But if that’s all you want, you may prefer to skip the serious chapters.

On the other hand, if you want to learn about mental illness with its attendant difficulties, and why it is so important to bring these topics out of the closet, as it were, then you may find the storytelling ridiculous, irreverent, or distracting. Personally, I enjoy the whole package, and it’s clear that many others do too.

Actually, the book hardly needs my endorsement. It’s been on the New York Times bestseller list for weeks now, and her book tour is drawing large and enthusiastic crowds. But I’ll recommend it anyway. You can start with her first book and find yourself drawn into the other. Or vice-versa.

You should also check out her blog, both for the content and the commenters, many of whom have found in Jenny an inspiration and in the other commenters a like-minded group of self-admitted weirdos, social outcasts, and yes, the mentally ill. That’s really been Lawson’s message all along. She just states it a little more directly in Furiously Happy.

My In-Law and My Ink

I expected a total freak out. I really did. So I tried to work it into a phone conversation as naturally as I could.

“Say Mom, did Dan tell you I got a tattoo?”

Instead of the expected shriek, I got a fairly calm query.(1) “Where?”(2)

If I were being a smart ass I would have said “At Monkey Bones Tattoos.” But I took the sensible route for a change and said, “On the inside of my left wrist.”

Then she asked, “What did you get?”

Again, any number of possible responses crossed my mind. But I decided to play it straight and told her the truth: “I got a semi-colon.”(3)

The next obvious question was, “Why?”

I could have said because I’m a huge grammar nerd, which would have been the truth about me, but not about the tattoo.

I explained as best I could. The semi-colon tattoo is a symbol of mental health awareness and suicide prevention. I rushed through the grammatical part of the explanation: In writing a semi-colon is a place where the writer could have stopped, but chose to go on. The idea is that someone will see the tattoo (4) and ask about it. Then you can explain the symbolism and how you are trying to combat the stigma of talking about mental illness. Like I just did.

I wrote about this on my other blog, Bipolar Me (https://bipolarjan.wordpress.com/2015/08/09/a-tattoo-is-for-life/) when I first got the tattoo, so if you saw it there, I apologize for the repetition.

Actually, no I don’t. The message is one that bears repeating, as often as we can and in as many ways as we can. You know someone with a mental illness(5) and that person is afraid to talk about it because of the stigma that still exists around the subject. I have bipolar disorder, type 2, and I talk about it all the time on my Bipolar Me blog.

Talking about mental illness is risky. You often get one of the standard reactions: a fixed, awkward smile; unwelcome advice about cinnamon or apple cider vinegar; outright disbelief; a decrease in contact with that person; sudden bad reviews at work. Perhaps worst of all, you get, “Isn’t that what the guy who just shot up the shopping mall had?”

Ordinarily, I post to my blog on Sunday. But this is National Suicide Prevention Week, so I wanted to post now. You can find out more about the tattoos at http://www.projectsemicolon.com/.

As Mom R. said about my tattoo, “It’s for a good cause.”

 

(1) My father-in-law was a Navy man and sported a few of the more common nautical tattoos, so I guess Mom R. had had a while to get used to the idea. Anyway, at least she didn’t go all, “The body is the Temple of God” on me.

(2) Apparently this is the first required question if someone announces a tattoo. Unless it’s on your face, neck or other readily observable spot. I suspect that everyone who asks imagines that it is located some place at least mildly kinky.

(3) Monkey Bones is locally known for extreme, large, and disturbing tattoos, like zombie cows. (I’m not kidding, either.) I think they must have been so embarrassed at being asked to do a pitiful mark of punctuation that they hustled me in and out in ten minutes.

(4) And if we had been Skyping, Mom R. would have, but Skype has been glitchy lately since I changed browsers. So we have our weekly coffee chats over speakerphone. This prevents a lot of Dan handing me the phone and saying, “Here. Say hello to Mom.” Especially when I’m not prepared with any tidbits of conversation, like a new tattoo. Here’s a picture, if you’re curious:

finished
I guess Mike at Monkey Bones isn’t embarrassed after all.

(5) Depression, anxiety, OCD, ASD, whatever. I guarantee it. Someone you know is struggling, and may or may not be getting help for it. A semi-colon tattoo would show you care.

We Don’t Do That Any More, Do We?

Here’s a story that caught my eye recently.

http://www.cnn.com/2014/03/08/us/mississippi-unmarked-graves/index.html?hpt=hp_bn1

It’s long, but worth reading. But for you busy people, I’ll summarize.

Two thousand unmarked graves were found on the grounds of an old hospital. Whose could they be? Civil war dead? Victims of an epidemic?

No. That section of the old hospital was an asylum, and the bodies were those of inmates. The insane. The developmentally delayed. The rebellious. Anyone the family wanted to hide and forget.

Of course, we don’t do that any more. No more locked, back wards. No more Snake Pits. No more Cuckoo’s Nests.

No, the asylums (pardon me, behavioral health residential facilities) have largely been closed and the inmates (pardon me, clients or residents or patients) released.

After their 30 days of insurance coverage run out.

To a group home that has a waiting list longer than the Mississippi.

To outpatient centers that hand out meds that may or may not have an effect or even be taken.

To the streets.

To a society that hates and fears them, lumps them all together as eyesores and NIMBYs, panhandlers, homeless and jobless, and spree killers.

Of course there are mentally ill people who are able to function in society on some level or another. They’re the ones who have likely never been in a locked ward. Those with understanding families, good insurance, nearby therapists, and a support system of friends. People who can hold a job. The ones who hardly ever shoot other people.

Still, the functional mental patients, your coworkers and neighbors and even family members are afraid to “come out” as needing help or getting help. They won’t even admit to taking Prozac, despite it’s being one of the most prescribed drugs in America.

Why is that? Because even if the asylums are gone, largely closed by lack of funding rather than obsolescence, the stigma remains. As a society, we have the impression that all people with mental disorders are psychotics or schizophrenics, lurking nearby just waiting for the chance to get their names in the papers and on TV.

We don’t lock up mental patients much any more. Now we’re humane. We give them apathy, invisibility, fear, and maybe a few drugs.

And the same old stigma.