RealMental

I wrote this in part (in comments) on Belinda’s post about Kendra’s Law and wanted to elaborate considerably:

My 15 year old cousin is showing severe signs of Borderline Personality Disorder and Bipolar. My grandmother’s mother seems to have had it, my mother had it, and now this (female) cousin.

This isn’t teen angst – we all know what that is – it’s clearly, most certainly, 100% Borderline Personality and possibly Bi-polar. BPD isn’t often alone.

She has left home, is living in a drughouse with her 18 year old boyfriend, is violent to the point of knocking my 26 year old female cousin out with a glass mug. She skips school, swears at everyone, yelling, screaming death threats and worse, and at times is docile, shy and sweet.

There are rumors flying through her small town that she has been promiscuous and involved in sexual experimentation with more than one person at a time, been filmed, and possibly took money for favors.

Her parents (my uncle is the brother to my mother) have gotten her an appointment with a psychiatrist at a high financial cost and just tonight, she agreed to go. Here (we aren’t in the states) there are no laws to force anyone of any age into treatment. Even despite my cousin having hurt family members and completely outlining to her sisters how she is going to kill them in their sleep – detail by chilling detail. The only way they could force her into help should she change her mind now is to call the children’s aid authorities and place her in a group home — and obviously that is a mess they don’t want to bring on to the family, reason one being that they would lose her trust and possibly lose her forever.

We tiptoed around her at Christmas, with my grandmother agreeing to send food with her to the boyfriend’s drug house, just to avoid an eruption. Had she said no, we are certain this cousin would have gone crazy for not getting her way.
Everyone in the family is terrified of what she will do if her parents force her to give up the boyfriend and come home. She is a time bomb at all times.

If she hadn’t agreed to see this professional, I really don’t know what my uncle and aunt would have done. I do hope she gets the help she really needs, which will include therapy and drugs, probably for the rest of her life.

Her appointment is in January and all of us are holding our breath, waiting for her to blow up at her parents the next time around and refuse to go. If she does go, this could all go sour anyway – she is an expert liar and we have no idea what will come out of her mouth. Her recollection of angry outbursts are minimal, or she claims to remember nothing. She takes no accountability for any of her actions, she owns no blame for her situation and everything is someone else’s fault. She would rather live in the boyfriend’s drug filled, filthy, dangerous apartment, where his female roommate deals crack cocaine, and have the boyfriend’s roommate (another female) pick on her, use her toothbrush to clean the toilet and be abused in the house she is in, then go home and be without boyfriend. We as a family simply don’t understand this self abuse.

When I reached out to her, I was slapped in the face with “I’m smart and strong. If I need help, I’ll tell you. Stop worrying.”

I’m trying hard to understand how both my mother and my cousin ended up this way — both have been raised in loving homes, free of abuse and full of family time and lots of love. I welcome any insight, advice, whatever.

My next therapy session is mid-January and my focus has shifted to my cousin so I haven’t really thought too much about the re-telling of history I have been doing with the therapist. She did mention EDMR as a therapy we might try for me.

Reading Belinda’s thought-provoking post about forced commitment and medication, and the thoughtful comments people have since made, caused me to think a little bit more about how medication, while a lifesaver when appropriately prescribed, is only the first step.  Once you’ve gotten past the big ifs of a proper diagnosis and a proper prescription, you’ve got to be willing to use the equilibrium that the meds bring you to eradicate the mindset that meds are a “cure,” rather than merely a means toward maintenance and repair.  It’s my personal opinion that even the mentally ill person whose “only” life trauma is the toll of the disease itself has serious mental work to do, adapting to the concept of being “mentally ill,” redefining their sense of self around the diagnosis, and adapting to the medical and emotional features of their long term diagnosis.  The grief, regret, relief, anger and confusion that come with a proper diagnosis can’t be overstated, and it’s not something to be gone through without the aid of a therapist.  Too, medications don’t work forever– even once you’ve hit on a good combination, it may not work indefinitely– and being able to identify that your mood is changing despite being good about your meds is crucial.

From my own experience, I’ve built up a variety of coping skills to deal with my anxiety, depression, and need to people-please that are very unhealthy and counterproductive as I approach the worst end of my depressive spectrum, and it’s hard for me to recognize, when I am in the midst of a depressive phase, what I am doing.  But once I’ve recovered some stability, I can use that solid ground as a base to look back from the corner I’ve worked myself into this time.  I can look back and try to figure out when I first started the most recent downslide, and see if there were any causes.  I can then try and map out what I did and didn’t do during that period, identify whether anyone tried to warn me (and if they didn’t, possibly why not), and look at what coping mechanisms came into play, and what resulted.

There are lots of good books on the subject of eradicating bad mental habits out there, but I think a good therapist is really key.  (The subject of finding a good therapist, with whom you can work, is a whole post unto itself.)  Working with friends or family to identify your “bad behaviors,” your mood cycles, your triggers, just won’t be complete, because they’re not objective, and inclined to either overlook unhealthy or exaggerate healthy behaviors.  While friends and family can be the best first defense against a recurrent episode, and have the concrete experience of your past episodes to guide them, you need these folks to be focused on the micro level, not the macro/meta level.  A therapist outside your circle, however, is objective, has training, and is someone in whom you can confide and to whom you must be accountable.

Support groups outside your circle can also be therapeutic– because they don’t know you, and take you at face value when you take part, there’s an objectivity there that allows a freedom of expression you might not have with friends or family.  Hearing others say they’ve gone through something similar, and come out on the other end, is tremendously encouraging.  And knowing that someone else understands the swirl inside your own head lends credibility to their advice and encouragement that a “normal” source doesn’t have.

The most important thing to be gained from therapy is a firm sense of your self, knowing what you need and what you don’t need.  Personally, I’ve never joined a bipolar support group because the way my bipolar has manifested itself has been primarily anxiety and depression, and the course of my illness was and is usually very different from that of others in the groups I’ve tried.  Having never been frankly manic, psychotic, or delusional, much less hospitalized, I knew I didn’t “need” what these groups are offering.  But depression and anxiety sufferers?  I crave their company, search regularly for a group that meets after the end of the business day, eagerly read posts by others suffering from the same symptoms– because in hearing their stories, I learn something new about myself.  And by collecting these tidbits, I can hope that the next episode won’t be as long, as bad, as deep, because the work that I’ve done will allow me to see that it’s coming, and know that it’s arrived.  The meds provide the viewpoint, but I’ve still got to be willing and able to look around me– the therapy allows the rest.

Yesterday I read this amazing post by Chris at Serendipity Mine, called “The Silly Little Girl and Her Magic Closet.”

It’s a brutally raw piece I could relate to, very much. Chris speaks about her being a people pleaser and a peacemaker and how she has always put ‘stuff’ she needs to deal with into a closet, for later. But later never comes…well, until now.

A snippet:

Part of the problem with this was that over the years I took all the ‘stuff’ others did to me and just shoved it in a closet. Better to be a good girl and sit there and shut up and keep everyone happy than to cause waves of upset, hurt or disappointment. I was strong (with a big dose of stubborn) and I could get over it. I expected that with time it would all just magically disappear and make itself better. My own self cleaning magic closet.

The problem is…it never did. The hurt and the pain grew. It festered. It became infected. I started suffering from depression and then social anxiety.

Tomorrow will be my 2nd meeting with my therapist, where we pick up the story of my life at 19, having glossed over my childhood in an hour last time I was there. She wanted the run-down, then we’re going to go back and take our time over things I need to deal with.

My closet is kind of like Chris’ closet, and because I’m very much a Mental Tupperware sort of person, the things in my closet are put into boxes, all the good stuff in the front, when you first open the door, and all the bad things I don’t want to or can’t remember are in ratty old boxes shoved in the back of the closet. It’s very much like The Lion, The Witch and The Wardrobe, where the closet just keeps going back and back and back and gets very cold once you reach that other world.

The other thing about this closet is that it’s in it’s own Mental Tupperware too, and when I find little snippets of therapy seeping into my life, I shove it back, like it has it’s time and it’s place and I do not want the two worlds to collide.

Therapy (even in theory) is becoming very much like a sandbox for me, a place to visit, to knock down, to build up and sometimes just to plunge my fingers, heart and soul into but only while I’m there. I’ve played the last 5 minutes of my 1st therapy session over and over in my mind and each time I walk out of the therapy building, I take a deep breath of cold winter air and snap the lid shut. I don’t really acknowledge the hour of telling the doctor the details of my life.

Maybe this sounds confusing, that I’m saying my therapy stays at therapy yet I’ve played it in my head over and over, but just like the abuse, the yelling, the endless reels of absolute shit that I lived through as a child, it’s as though it’s someone else living through therapy for me. Some other little girl’s head was pushed down into her step-father’s lap, some other little girl’s mother told her that she was a selfish little bitch, some other little girl saved her brother from being murdered and some other little girl grew up and sits in that office and tells her story.

I wonder when I will own it. Do those of us who pulled a full disconnect ever own our childhoods again or is it a survival tactic?

For the record Chris, your inner little girl is anything but silly.  I hope you find your way.

See Why I Saw My First Psychiatrist, Part One and Why I Saw My First Psychiatrist, Part Two and Why I Saw My First Psychiatrist, Part Three for the full story.

And so, I found myself at twenty years old in a small office with Dr. Ragu, the psychiatrist to whom my medical doctor had referred me. I had no belief whatsoever that he would be able to help me, but nothing else had saved me from my hallucinations, paranoia, anxiety, and depression – not alcohol, not marijuana, not LSD, not food – and I was finally willing to pursue the officially accepted avenue afforded to those who do not know where else to turn. He handed me a styrofoam cup filled with water.

Why are you here? he asked.

I have to be. I’m depressed, paranoid, I said.

You don’t have to be. You wanted to come. Why are you here?

I’ve been depressed my whole life, but I can’t deal with it anymore. My voice sounded unconvincing and hollow, but that may have been the cheap office walls.

Is there more than just the depression? he asked.

Yes, but I don’t want to talk about it, I said. I had never spoken openly about it before, and I was not sure that I wanted to start now. I felt like an idiot sitting across from him in that chair. I suddenly did not know why I was there.

But that’s what you’re here for, isn’t it? The sooner you open up the better.

I guess, I said to my knees, which I noticed my thumbs were massaging compulsively.

Well? Why are you paranoid?

I decided to give in and tell him about the hallucinations. I needed to come clean, and his lilting East Indian accent was comforting.

I hallucinate. The words blew in tumbled breath past my lips.

Dr. Ragu’s eyes lit up as though this were an exciting turn of events, and I could not help but smile at him. His face made the idea of hallucinating seem like fun. It wasn’t, but I liked his enthusiasm. I told him about the six-inch aphids I saw crawling through his spider plants, the snow that fell softly most days despite the fact that it was July, and the bodies in vehicles at night. I still did not believe that psychiatry held any promise for me, but I liked letting my stories out into the air.

For the first time, I was not hidden and locked in a struggle to maintain a veneer of normalcy.

(This is also posted at Schmutzie’s Milkmoney Or Not, Here I Come)

There many positive side effects to getting healthy minded and being present in your own life.

I think back on all those appointments I canceled because I would think I was “all better now!” and no longer needed any help. Or, the times as I was actually driving TO therapy wishing I were on my way to somewhere else, anywhere else but there.

My personal favorite, that creepy scratchy high pitched voice in my head that would mimic and taunt me with things like, “look at so and so, she doesn’t have to do therapy and SHE’S JUST FINE!”, or “why can’t you just let this stuff go and quit whining already!” “You are so fat; maybe if you just lost weight you’d be cured!”

Somehow, I got to therapy and somehow it worked. Without a doubt, it saved my life and it was worth all the hell in getting through it. I must say that the only reason that I even began digging around is that it affected my life and all my personal relationships. If it had not affected my daily living, why else would I have bothered? Truth is, I wouldn’t have.

With Thanksgiving down and Christmas and New Years just around the corner, I’ve been thinking about the down side of becoming healthy minded. One of those is trying to be around family members that are highly toxic and painfully poisonous to me.

Much like when I began dating again after my first leg of “serious therapy” was complete, my dating pool got smaller and smaller. I could see the “bad boy” and think lustful thoughts but I would think it through, and realize that it just wasn’t worth it to go down that road. I cared enough about myself not to even bother.

I figured I had no problem being single because for the first time in my life, I was having fun. And, not only fun but also I was sober. I got the job of my dreams, I could pay all my own bills, I came and went as I pleased and my life was mine.

All mine for the first time.

This leg of mental health work is more about other issues, more about the relationship I had with my mother and more about my codependency.

Holidays are just another word for codependency.

I wanted to ask the real mental community for some suggestions. How you handle being around people that you know are toxic and will bring you down if you just give them a moment of your time.

How do you handle this, and what are your escape plans?

Namaste,

Moonflower

The problem of mental illness is its invisibility– no wheelchair, no boils, no external signal that proves the existence of the condition.  Like a pain syndrome, or a dormant allergy, mental illness exists to the beholder only to the extent that they are willing to behold it—to believe it exists.  The other part of the problem with mental illness is its very mentalness—meaning that mental illness manifests itself it through words and deeds.  Trying to explain what’s going on in your head, to someone who’s not inside with you, makes no sense– literally.  There’s an underlying assumption that our thoughts and actions are under our control—such that the products of our thoughts, our words, our deeds, are intended.  From the beholder’s end, the crazy person had to have meant what she said, what she did, because why else would she have done it, unless she was trying to be cruel/mean/whatever? 

“Because I am crazy” ends up sounding like a lame excuse, but it’s true–  unless you are inside the crazy person’s head, you can’t understand that there is a lack of control, a lack of connection between what you intended, and what manifests itself externally.  When the crazy person is expressing thoughts, and acting on thoughts and feelings that are what she felt and meant at the moment, but which are based on a misperception of reality—psychosis, delusion, disassociation—how to explain it away when the episode is past, and say “I meant it, but it wasn’t real?”  How to explain that your lies, your accusations, your hurtful behavior, were based on an unreal paranoid perception, or an anger so overwhelming that the whole world is colored red—but again, that it wasn’t real, you didn’t mean it in the sense of intending to hurt, now that the episode is past?  Add into it the denial, the shame, the fear that we feel when we realize it’s happening again,  and we lie about what were are thinking, what we are feeling before the episode really begins, because we know you won’t understand.  It’s easier to pretend like your feelings and thoughts are connected to your words and deeds, and to not try to express, to in fact suppress, the swirl of emotions, the cycling thoughts, than to try to make you explain what you can’t.  Which can only lead to more explanations of words and deeds to untangle when the world is right side up again.  There’s an enormous leap of faith, of trust, that the outside observer is being asked to take—to believe what the crazy person is saying, afterward, even though the crazy person sometimes can’t trust their own mind.

I wish there were a flash animation online to show how increasing and decreasing hormone levels affect the map of the brain—your insight and memory, speech centers, emotions.  Likewise with neurotransmitters, the electrical impulses that misfire when the crazy brain isn’t working properly.  The analogy of serotonin to insulin works a little bit, and I’ve tried likening the misfiring impulses of the brain to a downed, live electrical line—who would go near it?  No one.  But the crazy person can sometimes lack the low blood sugar signals or the caution tape of the downed wire—making the “I can’t explain what you won’t understand” into a problem of “I can’t warn you about what I lack the insight to perceive.”  Therapy can help, but it can take years to identify the warning signals, to become self-vigilant enough to seek help at the critical point.  It’s better if you believe, and you watch with me, and you tell me I’m getting crazy again.  That is, if I am lucky enough not to have ruined our relationship last time.

Therapy started last week and it wasn’t as scary as I thought it would be.  Right off the bat, I wanted to clear any notion of bipolar because I truly don’t believe my regular doctor is equipped to call a diagnosis like that based on a stupid questionnaire written by a drug company and the therapist agreed immediately.  I was expecting a fight on that one but she reviewed my paperwork and told me that PTSD (Post Traumatic Stress Disorder) often presents as bipolar when memories surface over time.  Then she had me start at the beginning.  My earliest memories.

As I sat and recalled my childhood, I realized (with her probing) that I had definitely (and conveniently) forgotten much of the bad parts of being my mother’s daughter.  Some of the stuff I was recalling was only because there were things my mother or other family members had told me as a kid and some of the stuff I recalled was a result of piecing together scenarios that I only knew because I’d seen a picture and someone had told me.   There were things she asked me about that my mind is so fuzzy on, I had to tell her I didn’t know if some of my memories were real or a fabrication of my mother’s imagination — she tends to lie and embellish and there are things she told me that I later found out to be untrue OR other family members won’t admit/don’t know themselves.  I may never know.

For what felt like 15 minutes (it was an hour), we talked, her asking a few questions about the minefield I was walking in, me tiptoeing around the Things I Wasn’t Ready To Say.  I was surprised at how much I did tell her but she was incredibly easy to talk to and I liked her right away.  I’m grateful for that.

My next appointment isn’t for another couple of weeks but I did decide to start a private journal, if only to tell my story to myself and try and remember more.  Even though I want to get it out on paper, I’m terrified to unlock some of the parts I’ve held down for so long.