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.

It drives my husband nuts when we’re out driving, and the empty tank warning noise comes on.  “Why do you do that?  It’s so easy to fill it earlier!” he fumes.  The short answer would be that in my brain, it’s not time to fill it yet– it’s not yet necessary.  Our definitions of when refueling needs to to happen are just different.  He’s worried I’ll run out of gas– I think that I’ve managed it fine so far, and that I have some emergency gas in the back anyway.

But now I’m at an emotionally empty point, and I realize that the way I treat my car is the way I’ve been treating myself.  I push myself to the very limit before stopping to refuel– and why?  I’d readily agree my car needs gas to run.  I wouldn’t argue that running out of gas is mightily inconvenient, and potentially dangerous, especially if I run out someplace deserted, or unlit, or in the middle of a snowstorm.  Of course, in the abstract, I think I’d know enough to fuel up before such a trip, but there’s a difference between life and a road trip.  Road trips are usually planned– you have some idea of where you’re going, and how long it will take.  Life?  Not so predictable– you can’t always tell when you’ll run out of gas in the middle of the wilderness.

I haven’t been maintaining myself well. I don’t know when I last did yoga, despite the fact that it contributes mightily to my emotional equanimity, and makes me feel less like a pretzel.  I haven’t been reaching out to friends in hard times, and taking comfort from the love they’re more than willing to give me.  I haven’t been saying no to too much work, because I want to prove myself capable– even though once taken on, I have no one below me to delegate other work to.  I haven’t been telling people when they’ve crossed the line, emotionally or professionally, and have been allowing myself to be walked all over– except when I have a temper tantrum after things have gone too far, and that’s not effective boundary-creation– kind of like shooting the unwanted house guest after leaving the doors and windows open.

I almost found myself stranded in the wilderness at work this month.  It’s a close call, and I don’t know yet what I am going to do next– but I am currently taking some time off to try to recharge.  I mostly have lots of sleeping, reading, and taking baths on the agenda, but I am also planning on doing some yoga and walking, and trying to restore myself mentally and physically.  Hopefully I will find myself in the process, and internalize the lesson of regular refueling.

I’m posting this from an airport terminal in Little Rock, where our flight to Orlando has been canceled because we’re fogged in. I can’t access the post I had prepared for today, so I thought I’d pop in and just ask for some feedback.

One of the challenges of keeping things on an even keel for us is STRESS MANAGEMENT. So, events like this can really put us into a tailspin. Alex does great during the crisis, but sometimes, after the fact, when the immediate distress is over, it kind of catches up to him and bowls him over, and we get what we just refer to as a “crash.” So right now, I’m hoping to avoid that. He’s already been pushed into what I’d consider a pre-hypomanic state by all the frenetic activity of the last 24 hours, and these new complications are just prolonging that, which is not good. The number one thing that is difficult for us but so important is the ability to remain FLEXIBLE. And my husband is a planner, so while he absolutely “takes care of business,” rolling with the punches when things get shaken up takes a lot out of him.

So, what are some stress management techniques that y’all have found to be successful, particularly as relates to managing a mental illness and preventing potentially stressful situations from throwing you all off-kilter?

By Kay

One of the ideas that scares me the most (and, unfortunately, gets stuck in my head most often), is that there’s nothing wrong with me at all.

The basic premise of this idea is that while I was still lost in the heartbreak and despair of breaking up with my first love, someone suggested to me that I was depressed, and I latched onto the idea. At some level I know that I’m using it both as a convenient excuse to stay in bed as long as I want and as a ploy to get attention, but consciously I have become so wrapped up in this lie that I believe it to be true, and identify and exaggerate possible “symptoms” of depression in order to make the story more convincing. In short, I am a lazy, attention-seeking, manipulative bastard who is using a mental illness as an excuse, and has become so caught up in this out-of-control lie that I don’t even realize it any longer.

Whenever I consider this notion, a voice in my head breaks through and sarcastically congratulates me on taking my unhealthy practices of self-loathing and negative self-talk to a whole new level. But that seed of doubt is planted. And it’s the closest I’ve come to a rational explanation of the irrationality of my emotions.

It makes me feel so crazy to think like this. It makes me feel like I don’t know myself, and that I can’t trust myself. It also undermines what I believe most of the time to be very real trials I’ve been through, and the effort I’ve put into making things better, because how can I be getting better when nothing’s wrong with me? I wish I could shut it out once and for all, end the vicious cycle, but as long as that niggling idea is still somewhere in my mind, the silent arguments over it can’t be closed.

Originally posted here.

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 a classic Adult Child. I need to please everybody, and my self-worth is measured by my ability to make everybody happy/calm/sober/sane. Between my alcoholic dad and my depressed nonfunctional mom, I was the adult of the family. I spent a lot of time being quiet, being good, being busy, being helpful growing up, but it didn’t make a dent in my parents’ behavior. All it did was make me wonder why they didn’t love me enough to see how hard I was working to make them happy– which then, of course, made me both more depressed and more determined to be better, smarter, nicer, more. (And really, really, angry. But it took me years to figure that part out.) I tried to take care of my younger brother, and mothered/smothered him right into resentment, which is only now beginning to heal. I tried to take care of my mother, but those attempts bounced off the teflon shield of her narcissism. And I tried to please my dad– though this, in part, was “rewarded,” and kept me coming back for more.

None of this helps me have healthy relationships. I am the best, most caring, most sympathetic friend ever, until you don’t reciprocate in a perceived hour of need, when I, exhausted, heart-hurt, depressed and angry, will lash out at you in a sobbing, choking, waterfall of grief and accusation. I am the ideal employee, until the father-figure mentor falls short of my expectations in some way, at which point I will cease to give a shit and start self-sabotaging. I work myself into the grave, then get exhausted, manic/depressed, and start messing stuff up, all the while lacking perspective because I was trying to be perfect and denying that I was falling short. I’m the best boss– always available to help you sort a situation out, giving credit where credit is due, and being truly constructive with my criticism– until I fall apart and am utterly unavailable to you. And I am a pretty good wife, mothering, cleaning up, nudging along, until I get pissed off at whatever it is that I’m annoyed by, because isn’t it enough that I work, and do the shopping, and do the cooking, and do the family organizing, do I have to do everything? All of these traps are hard to avoid, and keeping out of them is as much work as remembering to take my pills every day. That’s why practicing the fine art of Letting Go has been so crucial to keeping my sanity.

Before I met the Better Half, long before my bipolar II diagnosis, it would be safe to say that I was a Serious Person, well on my way to being a Bitter Bitch. I was a prime candidate for a Sense of Humor Transplant. But the Better Half made me laugh, makes me laugh, helped me rediscover my laugh and my sense of humor. And the joy that he brings me every day allows me to lighten up, to realize that my house doesn’t have to be perfect, to let the dishes sit another day, and to air my grievances in a way that will not win me Battleaxe of the Year. It’s still a struggle– decades of being a Control Freak are not easy to let go, and a little bit of perfectionism is OK. But maintaining the balance? Oof. Letting go of getting it right, and just practicing, even if I never make perfect– that’s what’s needed.

Republished from BipolarLawyerCook.