RealMental

I was at dinner last night over at my father’s house, and a friend of his was also in attendance. This friend is a well-intentioned person, but he never shuts up, he talks out of his ass, and he never listens. He’s irritating as all get out, and I often feel badly about not being able to really engage much with him in conversation, but he’s just too much stimulation for my misfiring neurotransmitters.

I forgot how we got on the subject, but at some point during dinner, he started going on about how he was sure that most depression diagnoses these days were over-medicalized and over-medicated, and that most of it was stuff that people “just had to deal with” as part of one’s life experiences. That simple proposition? It’s possible. There are probably some people who don’t need antidepressants, and just need some cognitive/behavioral therapy to learn some coping skills or change their conduct. But I tend to give people the benefit of the doubt. Whatever works, really. If medication gets you through a hard spot? Go for it.

But of course, it didn’t stop there. He started going on about how all mental illnesses were so subjectively diagnosed, and that a lot of things could be just gotten over. He started talking about how he would just talk himself out of funks as a teen, or make a change of scenery– as if his experiences settled the question. My dad tried to push him off with a subtle “what the hell are you talking about?” but that didn’t work. He continued, acting as if his personal experiences were sufficient empirical evidence to solve the human condition. That, and the experiences of one or two people he’d known. At that point, he started questioning biochemical and hormonal imbalances, which got my brother, the pharmaceutical researcher, into the fray. My brother was trying to explain the science of the SSRI’s, the dopamine inhibitors, the MAOIs, the typical and atypical antipsychotics. I chimed in with facts about how the brain electricity is sufficiently different in bipolars and schizophrenics to be detectable on MRI. You can see it, I said.

Neither my brother’s objective expertise nor my own hard-won knowledge could cause this person to admit his lack of foundation, set aside his skepticism, or admit he needed to learn more before issuing blanket statements. I shut the argument down, finally, by saying “I don’t care what you say, lithium rocks.” Everyone else laughed, he finally realized he needed to shut up, and we moved the conversation to another topic.

As we were driving home, my husband asked me if I was upset by this man’s know-nothing bloviating. I told him I was and I wasn’t, in part because I knew he didn’t mean any personal harm, and in part because I was so used to this dolt’s utterances on any topic that I knew there was no use in really engaging with him about it, because he’d continue as he always did until something happened personally to him to change his mind. What I am more upset by is the general reductionist attitude that far too many live by—“if it’s never happened to me or anyone I know, then I don’t believe it.”

There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy.

The problem with this attitude is not just the impact on the people around them who do have different experiences—although that’s bad enough, since it affects the way they vote, the way they educate their children, and the way they affect the general level of human happiness. Denying someone else’s experience just because it’s never happened to you is reckless cruelty of the highest order. The insistence on personal experience not only connotes a lack of imagination and empathy– it also connotes a lack of preparation.

When these blinders-on pragmatists are faced with something never dreamt of in their philosophy, they deny it, ignore it, misname it, suppress it, and otherwise completely fall apart. Having never experienced real depression, or mania, or delusion, there is shame, fear, anxiety—because their unwillingness to be curious about and open to other experiences than their own impairs their ability to deal with something new when it comes along. It draws the process out longer than it needs to be— all us believers end up having to take care of them in the meantime, and then listen to them preach to the choir when they do come around to their real condition.

There’s a Buddhist principle called “beginner’s mind.” Essentially, the idea is that you should always be open and accepting of new ideas, new possibilities—to close your mind, and consider yourself an expert, is to fail to be open to all the experiences life can show you—if you’re willing to look for them. I try to practice beginner’s mind, and it’s hard, because it means I have to re-think previous opinions, and even discard things I thought I believed. The temptation to be a never-believer is thus understandable—it’s much easier. But I’d rather be open, and uncomfortable, and evolving, than closed, negating, and nullifying.

What would you rather be? A blue sky, or a black hole?

You know how in action movies, when there’s a bomb set to detonate any minute, and they call in the bomb squad, there’s always that tension-heavy scene with the guy defusing the bomb? You know the one I mean. He’s got all these wires, and he has to cut one to de-activate the explosive device, but there always seems to be some doubt as to which wire it is. He hovers his snippers over one, then the other, having a debate with himself: “Is it the red one? No, I think it’s the blue one. No, definitely red.” He looks like he’s on the edge of a heart-attack, and rightfully so, because if he snips the wrong wire, then KABLOOEY.

Well, I feel like a bomb squad guy sometimes. Only I seem to have MUCH less information about the construction of the bomb, and even if I do manage to snip the right wire, it may stop the immediate threat, while merely re-setting the bomb to go off at another time. And here’s the Big Stupid: Sometimes I see the right wire, know what I can do to at least make the clock stop ticking…and I don’t do it. Because it would hurt my pride, or my feelings, in some way. Most usually it would require me to, you know, SHUT UP. And I’m not such an expert at the shutting up.

We’ve recently had a bomb squad incident in our life. Everything’s OK now, crisis averted, no one went off the rails, nothing exploded (well, maybe some small explosions, but nothing nuclear). But while it was going on, it was miserable. We were both miserable. And I couldn’t help, which is frustrating. I could keep from making it worse, but that was about all that was in my power. Part of the reason that I couldn’t help is because I was faced with thought processes that, to me, just did not make any sense. There were questions I couldn’t answer, because I simply could not view them in a rational light. Most frustrating of all, things kept going in circles–there was no logic which could prevail that would lead, in a linear fashion, to a CONCLUSION. For someone like me, this is crazy-hard.

I like to think I learned a little from our recent difficulty, and I hope that I can utilize it in the future. But, MAN, is it ever not easy. I have long known that there are certain “symptoms” of what I think of as “bipolar logic,” and also that there is no use in trying to circumvent that thought process in my husband. It won’t last long, and if I can just SHUT UP and ride it out, and not feed into it or make it worse, it will be over even faster. Have I mentioned how difficult that last part is for me? The shutting up part? Because it is. Particularly suppressing the impulse to say, “You are acting like a CHILD,” which, as you can imagine, really helps things get resolved. /sarcasm.

For me, dealing with a problem goes something like this: See problem. Recognize source of problem. Evaluate whether anything can be done toward solving problem. Take what steps I can to actively accomplish those things, including engaging the assistance of others who might be able to help with problem. Move on. Admittedly, with me, there’s a lot of anxiety and stress wrapped up in this process, but I don’t waste a lot of energy on things I can’t control–I concentrate my anxiety on the things I can do something about.

This is not far from my bipolar husband’s approach to problem-solving, either…eventually. But first, for him, a stressor is a “trigger.” It puts his brain into a fight-or-flight mode that is counter-productive to the problem-solving process. He stalls after that first stage, and gets caught in a loop of arguing with the problem, usually about how unfair it is. He gets combative, first railing against the upsetting thing itself, then eventually at me, because, you know, I’m THERE. I’ve gotten better at not taking this personally, though I won’t lie and say it doesn’t hurt. In my mind, I’m his ally, his supporter, his #1 fan, me and him against the world, but for a little while in his mind, I am “other,” and I am, like everyone and everything, “against” him. I really hate that part.

After this last storm passed (and you know, I should mention here that TREMENDOUS progress has been made by my husband in the last few years, and that things that would have previously sent him into weeks-long tailspins now maybe just partially derail him for a day or two), and Alex was apologizing to me for his misplaced anger and hostility (he doesn’t call me names or abuse me in any way–he just directs some of his anger at the only other person around: me), I took the opportunity to ask him, “When this was going on, and you were going around and around in circles with your thinking, and lashing out about things–like the weather–that no one could control, what would have been a response from me that would have helped in any way?” He didn’t have an answer for me. I asked, because, when a storm in brewing in his brain, there really seems to be no “correct” response that I can make–no matter which wire I snip, something’s gonna get asploded.

I’d like to think that I’ve at least gotten better about not making the explosions BIGGER, which I used to do with no small frequency, pushing buttons that I should have been mature enough not to push, especially since I was supposed to be the “rational” one, whatever that means.

Support groups, online forums, and written resources everywhere are full of advice about how not to escalate irrational behavior, or at least how to remove yourself from the equation. I’m pretty much all set there. I know all the buzzwords and phrases: Detach, Do Not Engage, Take Care of Yourself. That’s all fine and good. But–and here is where I expose my inner co-dependent who never really goes away–when someone I love is in pain, and is suffering due to non-productive anger and frustration…isn’t there something, anything that I can do to alleviate that at the time, instead of just retreating to an emotional storm shelter and waiting it out?

Ironically, these questions have only just begun plaguing me since the “bad times” have become far less frequent, less lengthy, and with less lingering aftereffect. Maybe I’m fooling myself into thinking, since things are so much better, that if I just had a better bomb squad, we could avoid this kind of tension altogether.

Does any of this make any sense at all?

NAMI sent a questionnaire to presidential candidates, asking them their positions on mental health issues, including access to care for the poor, and these are their responses so far. Thanks to Emily at On Call for Life for the link.

Cross posted at BipolarLawyerCook.

Several years ago I was having a chat with a family member when they asked me about my decision to stop pursuing a career in music- what made me decide to take a more practical route. I told them that it was a hard choice, but that I’d realized that a) I was an okay musician. Not great, but fair- and that fair wasn’t going to cut it, and b) for a long time I thought, melodramatically, that music defined me as a person, that it was the essence of my being. As I got older I realized that music was something that I loved, loved doing, but that whether I played music as a profession or as a hobby I was not going to let it make me feel defeated or unhappy.

My relative looked me straight in the eye and without any conscious ill-intent said, “Well Amanda, you know Allison Krauss isn’t attractive and she has a career in music.”.

Yesterday, the same relative expressed concern that I might one day feel resentful towards my child, “Because she’s so cute and pretty.”.

———————————————

I have trained myself to listen to my inner voice and to what it’s saying to me. After about a decade of of awareness and gentle correction I have learned to pay attention to that voice, to be diligent, and ultimately to be kind to myself in thought and action. It has made a world of difference in the way that I live and the way that I feel about myself.

The greatest gift I’ve received from this practice is the realization that the voice in my head, the one that calls me names, tells me I’m not good enough- the one that is so hard and cruel- it’s not my voice. Those thoughts were placed there by other people and for a long time I let other people control the way I feel about myself.

These days, more often than not, the voice is mine. And it thinks I’m more than just okay.

So I wrote about my cousin’s issues here.

Last night I get a phone call from her older sister and those rumours flying about her doing sexual favours for money have escalated.

We’re terrified, of course.  I feel like my Aunt and Uncle should know this stuff but older sister is afraid – she is trying to protect her parents.  Meanwhile the troubled cousin is likely going to end up pregnant, with an STD or worse.

My husband says I should tell her parents.  That he would want to know.  Hell, I would want to know.

I know my Uncle.  He will be very upset that a) his daughter is involved in this sort of situation (obviously the two of them are in denial and will not investigate her actions any further than letting her do whatever she wants) and b) very hurt that oldest daughter told me but not him.

My Aunt is a mess, crying herself to sleep every night.  Troubled cousin goes to see an expensive psychologist tomorrow, her father is taking her.  I think she needs to be tested for drugs and STD’s, but what do I know?

I wish I could do more but we are a family that is very full of pride, and “what happens in these four walls, stays in these four walls.”

It’s very frustrating to be on the outside and the inside all at once, handcuffed by fear and worry.

Last week I was asked by a Real Mental reader to write about my decision to continue taking my antidepressants during my pregnancy. I’ve been reluctant to do so but if there was ever a place where I’m safe to write about these issues, it’s here. (Thank you Leah)

My depression was my main concern when my husband and I first decided to try to have a baby. I did a lot of reading and up to the point that I found out I was pregnant, I still hadn’t made a decision. I knew what my gut was telling me though and that was to stay on my medication.

I had two very distinct opinions from the doctors I saw during the first few weeks of my pregnancy. The first doctor I saw was a GP who I saw for the initial “just to be sure” blood test. When I asked him for his opinion about remaining on my antidepressant he was very firmly against it. I tried explaining some of my history to him but he wasn’t receptive- which was fine, it wasn’t his job to listen to my life story- but it left me feeling guilty and afraid. The most embarrassing part was his subsequent refusal to refill my prescription.

Based on the research I’d done I had a hard time understanding his reaction. There are risks associated with taking antidepressants during pregnancy but that risk is thought to be minimal. After having suffered through years of untreated depression, I knew what the risks would be if I stopped taking my medication.

A week after the initial doctor’s visit, I went to see my OBGYN. When I posed the same question to her she waved her hand at me and said, “Stay on you medication.” I started down my list of questions regarding the risks. She listened for a bit and then stopped me. She told me that there were risks no matter which decision I made but that she highly recommended that I continue to treat my depression.

That’s exactly what I did. I had plenty of fears about the possibility that the antidepressants might harm my baby, but I was more afraid of what might happen to both of us if I stopped taking them. I was afraid that halfway through the pregnancy I would end up a non-functioning, emotionally irrational, suicidal wreck. My fears were based on hard won experience.

I was also terrified that if I allowed myself to regress to this state I would not be able to care for my child once she was born. In retrospect I think that my decision to stay mentally healthy was most heavily influenced by my instinct to stay healthy for my baby.

It was a difficult decision but I am infinitely grateful that I chose to continue to treat my illness during my pregnancy. My baby is healthy and happy. Thankfully, I am in pretty good shape as well and am able to be an attentive and nurturing mother. I’ve said it before and it is worth repeating- I shudder to think where I’d be if I had made the decision to stop treating my illness.

It was the best decision for me, but I would never assume that it is the best decision for everyone suffering from depression. I think that I had to follow my instincts and not let guilt or social pressure influence me as I weighed my options. I had to stick to the facts.

For more information from actual professionals do a quick web-search on the topic. There is a plethora of helpful information out there.

By Dad Gone Mad

I’m sitting here this morning wondering when our senses of compassion and respect deteriorated to this point.

When did we become so callous and heartless that we started to view a young mother struggling with a mental illness as entertainment?

When did we stop trying to empathize?

When did we find ourselves so miserable with our own existences that we started to distract ourselves by watching someone else fall apart live on TMZ?

I hear the feeble attempts at logic.

When she decided to become an entertainer, she gave up her right to privacy.

Oh, I see. So because she’s makes her living in a spotlight, she can never leave it. Even when that light irrefutably reveals that she’s unwell, that she needs help, that the decent and humane thing to do would be to turn the light off and leave her alone, we refuse.

And let’s not stop at simply broadcasting her breakdown; let’s taunt her on her way down. Let’s call her “Unfitney” and repost pictures of her crotch and act as though we have been personally effected by someone else’s breakdown.

If it bleeds, it leads.

Better her than me.

I’m sitting here this morning wondering if anyone else sees more than one tragedy here.

Originally posted here.