RealMental

I’ve been thinking a good bit this weekend about the issue of “forcing” treatment upon mentally ill people, particularly those who are in immediate and ongoing danger of being hurt by their illness, or at risk of causing others to be hurt. OK, I confess–“Grizzly Man” is playing on cable this weekend, and Treadwell‘s story rips at my heart, because when you watch the footage of him, he is so obviously ill. Brilliant, creative, with a big heart…but sick. He was diagnosed with bipolar disorder and other things, but always refused treatment, and, I feel, ultimately died as a result of that refusal.

Have you heard or read about “Kendra’s Law?” If not, go check out this story, and see what you think. I’m really interested in hearing others’ thoughts on this topic. When I hear the term “forced treatment,” my mind immediately conjures up images from Ken Kesey’s novel “One Flew Over The Cuckoo’s Nest”, and Jack Nicholson’s consequent film portrayal of its main character, who has “treatment” forced on him right up through lobotomy. But from what I can see right now, it apears that the goal of Kendra’s Law is just about the opposite of the nightmare created in”Cuckoo’s Nest.” It’s not about institutionalizing people, locking them up and keeping them in chemical straitjackets. It seems to seek to help people live connected, fulfilling, and maybe ironically, independent lives.

Consider the very nature of disorders like bipolar disorder and schizophrenia…they deny their own existence. That is actually a diagnostic criteria sometimes, which boggles my mind: “Oh, you don’t think you’re sick? Well, that PROVES you are.” Yikes! But in bipolar support groups, I have seen more heartache than I can stand to reflect on much, coming simply from the sick person’s lack of insight. I don’t really even like that term, “insight,” because it implies something you can choose to have, and for many mentally ill people, that choice just does not exist without medication. And to complete the catch-22, without insight, medication is never going to be chosen. So there you are, stuck in a truly vicious cycle. I’m not talking about people who don’t like meds, resent having to take meds, etc. I mean the greater-than-80% of affected people who cannot recognize that they have an illness. If you could, somehow, get proper medication into these people, then they would be able to achieve the insight they would need to recognize the need for the medication…see the problem, here?

So, what say you all? At what point do we have the right to step in and mandate that someone else take medication–of any kind? Do we wait until they’re harming themselves and/or others? That seems to be what happens currently, and results in involuntary commitments…what if we could get to the problem and treat it before someone had to crash hard, possibly taking other people down with them? And at what point do “we” step in? I’m wondering how you get a diagnosis on someone who is totally non-compliant in the first place. Seems like someone would have to have run up against “the system” at least once, resulting in, at the very minimum, a 72-hour hold, in order to be diagnosed with a mental illness. I can easily see a “slippery slope” argument here, too. If we can mandate treatment for one thing, then why not another, and another, until we’ve reached Brave New World status?

But then, I see so many people homeless, sick, miserable, addicted to drugs and/or alcohol, having lost everything…when just straightening out some brain chemistry might have given them completely different lives, if only.

It’s a good topic for discussion, and I’m going to be doing some more research into Kendra’s Law, to try and figure out the details. I don’t know what kind of “teeth” it has, or what the consequences are for non-compliance, or what criteria must be met to have it put into play. I thank God regularly that my husband is one of the “lucky” ones (Yeah, I know–funny, huh? Ha, ha.) who doesn’t have any compliance issues…but you know what? When he was undiagnosed, unmedicated, and unstable? He didn’t HAVE any insight, wasn’t capable of recognizing his illness. He had to first “hit bottom,” and be involuntarily hospitalized and medicated first. Even then, he was not initially treated correctly in the beginning, and suffered a relapse, and yet another involuntary hospitalization. That was the one that saved his life, and he’s been pretty stable for almost 4 years now. And I have to ask myself, is what he went through back then really that different from what Kendra’s Law proposes? The only real difference I can see is that once my husband was released from the hospital, there was nothing in place to ensure that he kept taking his meds–he was free to get off them and start cycling again at any time, as he is now. Fortunately, he doesn’t misinterpret “feeling better” with “being well.” But he’s not in the majority there.

If you have someone in your life who suffers from a mental illness, but who can’t recognize that fact, and it drives you to distraction, there are two sources I strongly recommend, both from Dr. Xavier Amador. One is his fantastic book, “I Am Not Sick; I Don’t Need Help,” and the other is this amazing lecture on the topic of anosognosia (lack of insight). This video can honestly change the way you look at mental illness, and in my opinion, applies in good measure to addiction, as well. Amador is inspirational, and speaks not only as a healthcare professional, but as the loving brother of a schizophrenic who refuses treatment. Do yourself a favor and block off a couple hours of time to view this lecture. Heck, even if you have to view it in 15-minute chunks here and there, it is SO worth your time.

Nauseous
Dizzy
Too many smells
Sweaty
All backed up
Got the runs
Spaced out
Shaky hands
Shaky legs
Shaky handwriting
Thirsty, always thirsty

Sleep
Laugh
Smile
Write
Think
Do
Feel
Nightmares are gone
Tears have dried
Rage subsides
Calmness resumes

Life returns.

They’re working. My drugs are working. After months, MONTHS, of going through hell, I feel…almost normal. Whatever the hell normal is, that is.

I saw my doctor two weeks ago and told her what happened with the high dose of Wellbutrin. I had already knocked myself down to the half dose, expecting that she’d take me off it altogether, but that’s not what she did. Instead, she kept me on the low dose and added a low dose of Celexa to the mix. She said that because I did not react well to any one drug thus far, mixing two different classes of drugs was the next course of action.

I was skeptical. If one drug could screw me up, what on earth were two going to do?

Starting on the Celexa was not fun. Nausea, migraines, diarrhea, exhaustion. Hours would go by without me noticing. It felt as though the world was spinning so fast and I was moving in slow motion. It was almost impossible to get even the simplest tasks done. By the end of the second week on the half-dose, the symptoms were beginning to abate and I was starting to feel as though the depression was lifting a little bit. Then, I started taking the regular dosage and the side-effects dealt me another blow to the head and gut. Physically, I felt like hell. But emotionally…I was happy.

Happy.

I had forgotten what it was like to feel happy: to laugh, to smile, to make an effort to go out, see my friends and have fun.

Fun.

I was finally having fun. After being miserable and zoned out of life for so long.

What amazes me about this disease is how easy it is to forget what it feels like to feel good. When you have a bad day or week or month, you feel as though this is what life is going to be like from now on. On the flip side, when you start feeling better, it’s hard not to think, “Hooray! I’m cured! I’m never going to be depressed again!!”

Right now, I’m trying to find the balance between those two extremes. Things are looking up, but part of me wonders, “How long until the other shoe drops?”

Jon Armstrong wrote a particularly open and informative piece at his blog, Blurbomat, regarding being married and a partner to a person who suffers with mental illness. I highly recommend it.

By jb

Being crazy is not a cheap endeavor. In fact, it is such a complicated endeavor that my health insurance provider has a separate branch for psychological care. So complicated, so expensive that every visit has to be pre-approved.

And apparently, even things that have been pre-approved can be denied.

I am currently in a rough-and-tumble battle with my health insurance provider over my psych testing. You know, the psych testing that led to be being diagnosed with, and promptly treated for, bipolar II. The psych testing that helped me answer some important questions in my life, although it was no quick fix, and never any excuse. It just gave a start.

In any case, this is the psych testing that made my year so much more healthy, so much happier, so much better. The psych testing that helped me uncrack my mind, that helped me start to pull together the pieces.

I take my Lamictal like communion bread, knowing that something was broken in me, doing this in remembrance and preservation of my real self.

When I talk about the cost of crazy, I’m talking about the monetary cost, the thing that can be most easily fixed. Crazy can cost a lot more than that: I lost friends, sleep, grades, my own morals, and I almost lost the person that means most to me. All of those things were hard–and in some cases–impossible to regain. Those are the things that should hurt, that should be hard to get together, that should take a concerted effort on my part to put back together because they are worth that time, that effort.

But the actual payment of my fifteen hundred dollar testing psych bill? The one I got pre-approved? The one that is constantly being denied for a whole host of contrived reasons, from “billed from facility instead of provider” to “not approved for outpatient care”?

That should be the easy part. And yet, it’s the one that has proved, somehow, the most difficult.

Originally posted here.

I am so frustrated and exhausted, I have no idea where to even begin. Remember how I was waiting for the Wellbutrin to kick in? Well, it didn’t. Or rather, it did, with disastrous results.

After two months of being on it and noticing no change in the near-crippling depression I was experiencing, my doctor decided to increase the dose. I didn’t notice the change at first, but looking back, I can see that shortly after the increase, I became more and more anxious. I started isolating myself from my friends, believing that they didn’t want to be around me and that some of them were actively turning people against me. I stopped picking up the phone, going out, writing emails. I felt utterly alone and scared.

And then, the panic attacks started. I thought I had experienced these before, but I’ve never felt anything this extreme. Racing thoughts, a barrage of negativity, shaking hands, heart pounding out of my chest, difficulty breathing, inability to sleep, and the intense fear that I was going to lose control and do something I didn’t want to do.

Once they started, almost anything triggered the anxiety. I went to work last week and had to go home after a few hours because everything set me off. A simple assignment, a notice of a meeting taking place in a few weeks, even getting a new email filled me with panic. I was paralyzed by fear, unable to work or even be in that place.

It’s now a week later and I still can’t shake that feeling.

I can’t get into my doctor until Tuesday, but I know she’ll take me off the Wellbutrin, so I’ve stepped myself down to the regular dose. Since I did that, the attacks have stopped and the anxiety has abated (though I’m sure taking work out of the equation also helped), but the depression is back. I’m not sure what she will put me on next, but I’m beginning to dread it, because as we have seen, my track record with negative drug reactions is less than stellar.

I feel like we’re playing chemistry set with my brain, but I don’t know what else to do because I can’t get an appointment with a psychiatrist for three to six months. So, we put on our white frocks and pull out the test tubes and see what happens when we mix up the next batch of chemicals.

Cross your fingers for me.

It’s been almost eleven years since I went to rehab. I spent six of the longest months of my life there trying to build myself back into a human being. It was the hardest and best thing I’ve ever done, the most painful, and by far the most frightening. It was something I did out of necessity not virtue, a decision that thankfully changed the course of my life.

I started drinking and using drugs for one reason. Drugs and alcohol allowed me a brief reprieve from what had been a lifetime of pain and confusion. What I felt when I got high was relief, a literal opiate wave numbing my psyche, a sense of peace, the ability to relax and breathe. For all the anguish I’d experienced since I was a child, I’d finally found a cure. A cure.

But those moments were fleeting and the more I used the more I needed until I was using just to exist, just so that I could get up and walk around from time to time, so that I could pretend to exist among the god damned normal people. My cure had turned into a means of staying one step ahead of the pain, which lurked around ever corner, always waiting, and I knew that if it ever caught up with me it would end me, tear me limb from limb. I used and drank and ran until the drugs and the alcohol just stopped working.

After several months of weeping and screaming and shaking treatment became a safe harbor, a place where I could sift through the wreckage of what had been my life. Once I was able to comprehend feelings and words and regained some semblance of a thought process I realized that I had suffered all my life from depression. I was crazy, maybe, but my illness had a name.

A kind doctor diagnosed me and spent countless hours listening as I talked about things I’d never talked about before, and eventually convinced me that I was not a terrible person. It took some doing. Very slowly, I started getting better. Once I began treating my depression, my need to otherwise medicate became much less of an issue.

Here’s the thing: Even though the abuse of drugs and alcohol almost ruined my life, I know that it also saved my life. That’s a hard thing for people to understand. Drug abuse and alcoholism is often seen as a weakness or an indulgence but I’m living proof that they are sometimes neither. Sometimes self-medicating is all a person has left and that is a terrible and horrifying thing- salvation via destruction. The selling of one’s soul for just a few moments peace.

Whenever I encounter an obvious drug user and they ask me for money I always give it to them. I know how bad, God have mercy, it hurts to run out of your medication.