mental illness issues
The Mind-Brain Split and Enlightenment in Mental Illness
I wrote a rather popular piece a while back called A Damaged Brain and a Mind Trying to Deal with It. If you follow me on Twitter, you might have seen this before as it’s part of my bio. If not, then it might be the first time you’ve heard that turn of phrase.
Commenter Reply
And recently a commenter replied:
I do not believe in this mind/body duality. I believe that you are your body.
OK, no problem. I don’t expect everyone to agree on such things. I have nothing invested in making the world agree with me.
But the thing is, I know there is a brain-mind separation. And how do I know this? Perspective. It’s your free gift with a purchase of 10 or more years of bipolar disorder.
How to Tell Someone They Have a Mental Illness Part 2/2
Continued from part one of How to Tell Someone They Have a Mental Illness.
Thirdly, I recommend printing out information about the disorder for the person. There are plenty of resources online that will tell you the basics about a disorder and if you have this information ready, the person with the illness doesn’t have to go searching for it. Books are another good option. But know the person with the mental illness may use this information in dribs and drabs as information overload is a real possibility and will help no one.
Fourthly, look up places and ways the person can get help. There’s no point in pointing out a problem if you can’t offer a solution. In this case the solution is help. The easiest place to get help is your family doctor so maybe you could make an appointment for the person. You family doctor can do an initial assessment and refer the person to the appropriate person (probably a psychiatrist) for a full evaluation.
Additionally, there are all sorts of mental health and addiction related resources available and they are listed by location here.
How to Tell Someone They Have a Mental Illness Part 1/2
When someone has a mental illness it can be very difficult for them to see it. The very nature of a brain illness is such that the brain itself has a hard time recognizing it. We are often so wrapped up in the symptoms that we can’t see that what we’re really suffering from is an illness and not just a bad day, bad week or bad month. This is to say nothing of anosognosia, the clinical condition wherein people don’t possess the insight necessary to understand that they are sick.
Sometimes Others Can See We Have a Mental Illness
So sometimes the people around us are the ones that realize we’re sick before we do. Sometimes it’s our loved ones that can clearly see a pattern of behavior that goes beyond unusual into pathological.
But if you know someone who you suspect has a mental illness, how do you tell them?
Mental Illness – What is “Normal” Anyway?
A pet peeve of mine is when people say, “normal is just a dryer setting.”
Um. No, it isn’t. Normal is a word that means “conforming to the standard or the common type; usual; not abnormal; regular; natural.”
Normal is not just a freaking dryer setting and pardon me for stating the obvious, but I am bipolar and I am not normal.
Overcoming Bipolar Disorder at University
The Bipolar Burble welcomes guest author Daniel Bader, Ph.D of Bipolar Today for today’s post on dealing with bipolar disorder in university. Bader proves again that you can do anything you want to do with bipolar disorder, you may just need a bit of help.
I was a student for a very long time, having just finished up my doctorate after nine years of study, not counting my two years of parental and medical leaves. It was quite a challenge, and most of those challenges came not from the program, but from my bipolar disorder.
However, having gone through it, I wanted to discuss some of the challenges of being a student with bipolar disorder and some of the tricks that I picked up along the way. Hopefully, it can help others who might be presently in university or considering going there.
Challenges as a Bipolar University Student
There were a lot of challenges with being bipolar as a university student, but there were definitely three issues that dogged me through most of my program:
- Isolation: Studying is an isolating experience. There’s endless research, reading and writing that is done entirely by myself. I found being alone with my moods was rarely a pleasant experience.
- Fluctuating Self-Esteem: It’s hard at the best of times to evaluate the quality of our writing. With bipolar disorder, my work would often seem incredible or terrible, making it hard to do revisions.
- Depression: Depression is awful, and it just crushed my ability to work efficiently. As a result, I often found myself falling behind.
My Strategies as a Bipolar University Student
Over time, however, I was better and better able to deal with these problems, ultimately finding my experience a satisfying one.
- Finding Ways To Be Social: For my entire university experience, I never once lived alone. I lived in residences with shared meals, with a good friend, with my parents and ultimately with my wife and children. This kept me from slipping into the infinite regress of self-reflecting moods that isolation brings.
- Finding Someone Whose Opinion I Trusted: I was able to develop a good rapport with my dissertation supervisor, who would help me see what was working and not working in what I was doing, when I wasn’t able to get the proper perspective. Before my dissertation, I would often show papers to friends to get their opinions.
- Getting Help: It took me a while to get proper help as a student, in part because I kept being put on the wrong medications (long story). However, once I had a proper regime of medication and therapy, I found that my depression improved significantly, and I was able to zip through the last few years of my doctorate, even while teaching half-time and starting a family.
Final Thoughts on Overcoming Bipolar Disorder at University
Being a student with bipolar disorder, especially a graduate student, provides a lot of challenges. The isolation and fluctuating moods can wreak havoc. However, by figuring out what those challenges were and finding strategies to deal with them, I found I was able to complete and even often enjoy my experience.
Daniel Bader, Ph.D., is a recent graduate and works as a university instructor. He now runs his own website on bipolar disorder called Bipolar Today.
Why Natasha Tracy? Why a Nom de Plume?
Last week on HealthyPlace’s Breaking Bipolar I mentioned that I use a nom de plume. Yes, that’s right, Natasha Tracy is not my legal name. I don’t think this should come as a gigantic shock to anyone given as writers have been writing under pen names since the beginning of the written word.
But apparently it did come as a shock. And apparently people felt betrayed by this piece of information. And apparently some people felt like being rather nasty about it. And apparently some people felt like becoming ex-readers over it.
Well, OK, fine, that’s your prerogative. But I have my reasons for not using my real name. Here are a few.
I don’t want people knowing where I live. I don’t want stalkers.
Allow me to relay a short tale to you.
Writing and Death Threats
I have a good friend who is a writer. He writes on sensitive, emotionally-charged subjects similar to mental illness. And is the case with us online personalities, he got death threats. Horrible, but not something that isn’t expected in the world of the internet.
My friend was the kind of person who did share real details about his life and family and he did use his real name. So when it came time that a stalker really hated him, the stalker found out where his kids went to school and made threats against them.
Yes, that’s right, threats against his kids. Deplorable. Unthinkable. And illegal.
And if you think I’m going to facilitate that type of behavior where I’m involved you’re downright batty.
No, I’m not in the Book
The reason that I don’t use my real name and I don’t tell people exactly where I live is because I don’t want a real-life stalker. It’s because I don’t want someone to make death threats and easily have the capacity to follow them through. It’s because my privacy is important to me. It doesn’t mean I’m not open, or honest, or even make public appearances and videos, but it does mean that you don’t get to be able to easily find me. That is not your right.
I want to be hirable in fields other than mental health.
Again, a short story.
Health Problems and Stigma
I was working for a very fancy software company. One that makes the software you’ve probably got on your computer right now. I worked among some of the smartest people you can imagine. Their big brains were barely contained in our building.
And while I was working there I had a vagul nerve stimulator implanted. The details aren’t important but suffice it to say that when it activates it cuts off my throat and makes it difficult to speak. So if I was in the middle of a conversation with a co-worker I would wave a magnet in front of the computer implanted in my chest to turn it off so I could continue speaking. I never told people what it was or why I did that, trying to make it as inconspicuous as possible.
However, my co-workers decided on their own that the device must have to do with my heart and that every time I waved something over that area of my body it must be because I was so stressed in the conversation that something was going wrong with my heart. My co-workers assumed that I couldn’t take the stress of the job due to something that had nothing to do with stress.
They just made a judgement without facts.
(I didn’t know this for a long time. Eventually one of my co-workers told me.)
And once I found this out I realized that’s why people had started treating me differently – not because there was anything wrong with me but simply because they perceived that something was.
Employees Judge You
And you can bet the judgements would have been worse if, heaven forbid, they thought I had a mental illness. People suggest that others don’t judge you for your differences when this blatantly isn’t true. I had a slight difference that produced no change in my behavior and yet it changed the way other people treated me. People can be biased and bigoted and small-minded. If nothing else, it’s a subconscious thing.
Employers Judge You
And even worse, in the same environment one of the employees was assumed to be bipolar. And he had to leave the country (and finally the company) to get a fresh start because of how it affected how people treated him.
These are not things I made up. These are things that I have witnessed, things that I have lived. If your experience has been different that is great, but I wouldn’t risk having that kind of experience again. I just wouldn’t.
(Keep in mind that I’ve work in very-corporate America where backstabbing and politics run extremely amok.)
Employers Google You
And let’s not forget that before any techie geek is hired the employer Googles the heck out of them and if they were to find my writings, judgements would run rampant.
Why I Use a Nom de Plume
So, quite frankly, death threats, stalkers, prejudice, hirability and other reasons are why I use a nom de plume.
And I will not apologize for that. You can judge me and feel it discredits me if you like, but I believe my work speaks for itself and your judgement speaks considerably more about you than it does about me.
Do Objective Diagnostic Criteria Matter in Psychiatry?
One of the criticisms antipsychiatry folks like to make of psychiatry is its lack of objective diagnostic criteria. In other words, there’s no blood test that says you have bipolar disorder or schizophrenia.
And this is true. While today we do have blood tests for biological markers indicative of mental illness diagnosis, there is no hard and fast test that can diagnose a psychiatric disorder (except Huntington’s, for which we have discovered a gene).
The fact of the matter is no matter what is written in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or what blood we draw or which scans we do nothing diagnoses a person properly except a trained psychiatric professional.
But that doesn’t mean there’s nothing objective or meaningful about it.
Objective Diagnostic Criteria and Psychiatric Illness
In fact, using the diagnostic criteria from the DSM or even from a clinician’s clinical experience allows two experienced clinicians to arrive at the same diagnosis for a patient. (Is this always true? No, of course not. But there are second opinions in all of medicine so this is hardly rare.)
Psychiatric Diagnosis and Treatment
However, even if two clinicians were to arrive at slightly different conclusions, for example, one says unipolar depressive and the other says bipolar not otherwise specified, I would argue that it hardly matters as alleviating suffering is the goal and the diagnosis is only a way of getting to that end.
As Dr. Joseph Pierre has brilliantly said,
. . . clinicians do not in general fret over what does or does not constitute a disease. . . . If, for example, a patient’s arm is broken in a car accident, a doctor doesn’t lose sleep pondering whether this represents ‘broken bone disorder’ or simply an expected response to an environmental stressor—the bone is set and the arm is casted . . . mental disorder or not, clinicians working in ‘mental health’ see it as their calling to try to improve the lives of whomever walks through their office door seeking help.
Similarly, it is objective as to whether a person is suffering or not and thus it is obvious the person needs help regardless as to what the ultimate diagnosis is.
Do Psychiatric Diagnoses Matter?
Yes, of course psychiatric diagnoses matter as they direct treatment, however, just because there is no hard and fast test governing that diagnosis doesn’t make it any less valid nor does it mean that psychiatry doesn’t have a place in its healing.
Lights, Camera, Bipolar in Action
As many people know from my last post on hypomania, last week I was filmed for a documentary by Andy Fiore. The documentary is about bipolar disorder and I was one of three people interviewed. Michael Schratter of Ride Don’t Hide, an international tour and movement to battle mental illness stigma, was also interviewed.
What’s It Like to be in a Documentary?
So, what was filming the documentary like? Well, there was some talking and some acting, but mostly acting like a version of me, a version of me that walks in girl shoes, that is.
I met Andy at the Vancouver Central Library and we enjoyed a latte in the gorgeous, cobblestone courtyard. He’s a bright enough filmmaker to know that being on film requires the energy of caffeine (although truthfully I’d probably had enough already).
Then we began to shoot “b-roll” which is, “supplemental or alternate footage intercut with the main shot in an interview or documentary.” Alternate footage contains scenes of me walking on the stairs, walking across the courtyard, looking at flowers and so on. If you like watching Natasha Tracy walk up stairs, then this documentary is for you.
We then moved into one of the glass meeting rooms of the library where I checked my makeup before shooting, getting loose powder all over the table and floor (sorry janitorial staff). Andy then proceeded to ask me about two hours’ worth of questions. He asked and I answered while attempting to maintain good eye contact with the camera. A wandering gaze is bad in such scenarios.
Somewhere in the middle of the interview I found that all my happy energy from the hypomania had simply vanished. My brain slumped; I can only hope it wasn’t visible on film.
We then finished off with more coffee (thank-you Andy; thank-you caffeine) and a few more b-roll shots with me walking in downtown Vancouver.
Thoughts on the Bipolar Documentary
Overall I think the shoot was really positive and I hope Andy got everything he needs for his final cut. He’s deep into the editing of another film right now so I won’t be seeing a rough cut of the bipolar documentary for a couple of months.
While it’s nerve-wracking to have someone ask you questions for two hours while looking into the abyss of a camera lens, I will say it’s absolutely worth it. It’s a powerful way to get positive, real information about mental illness out and I’m honoured to be a part of Andy’s work.
Speaking out – it dispels fear and stigma.
PS: Pictures from the shoot are coming.
Emotional Overreactions and Depression
Yesterday I was having a good day. This doesn’t happen to me all that often but I was being all productive and downright cheery. Miracles. Every day.
But then something happened. It wasn’t an earth-shattering thing, it was just a thing. A life thing. A thing that your average person would feel bad about but not the end of the world.
Just the end of my world.
Acceptance of Bipolar Disorder is a Process
I remember the day, or rather, the night, about 13 years ago when I discovered I had bipolar disorder. I did exactly what I tell people not to do: I went online and diagnosed myself. In my case, I happened to be right.
I remember the extreme pain, fear and shame I felt at realizing I had a mental illness. I remember the indignation I felt at the idea that I would have to take medication for the rest of my life. Mostly though, I remember the tears. I remember the candy apple-red face stained with hundreds of tears. That’s what I remember the most.
But that was 13 years ago and a lot has happened since. One thing I have learned though is that I didn’t accept my mental illness that night. Nor the next. I didn’t truly accept my mental illness for years.
Reader Discretion is Not Advised
Recently a couple of my posts / links / images raised eyes with some of my readers. Some complained and others requested that I put content warnings in front of them.
Well, I don’t do content warnings.*
In this case, one post was about self-harm and had a picture of a cutter’s arm. Another post contained a link to the TV-promo for a Dr. Oz show on electroconvulsive therapy, in which a person gets ECT. Images of self-harm and ECT, it was argued, are very upsetting to some people.
Well, yes.
Nevertheless, in neither case did I think a warning was appropriate.
Here’s why: you’re an adult. Grow up.
Reader Warning on the Bipolar Burble
And just for the record, on the homepage there actually is a content warning for the whole blog. It warns that there may be graphic and disturbing subjects and elements to articles. And this is quite reasonable because if you haven’t been here before you should know what you’re in for – and it might be something you don’t like.
Why No Content Warnings?
There are no content warnings for a simple reason: I don’t think there should be any. There is no reason to warn people about an image of a cutter’s arm.
Why?
Because there is nothing shocking about seeing the evidence of a medical problem. I talked in the comments of that post about how people who self-harm should not be ashamed because what they are suffering from is an illness. By posting a warning about an image of their illness, I am suggesting there is something wrong with these people. I am doing a disservice to their reality, to something they live with every day. They don’t deserve a content warning thrust on them.
And as a writer I think it’s considerably more fitting and I refuse to post a picture of a person forelornly looking at a sunflower because it’s just so damn disingenuous.
And as for electroconvulsive therapy (ECT), yup, it’s desturbing to some people, particularly images of ECT conducted in the past. And I rather think it’s tacky for a TV promo to feature images of a procedure that is no longer conducted in that manner. But you’re watching a promo for a TV show on ECT it’s hardly unreasonable to think you might see an image of ECT.
Here’s a Content Warning
You’re an adult. You are going to see and hear things you don’t like. You need to deal with that.
If You’re Feeling Sensitive
And to be fair, I understand sensitivity, I really do. I get sensitive sometimes. Sometimes there are subjects I’m sensitive about. Sometimes I not strong enough to read about things that I might find activating.
So I do this: I don’t read / watch that stuff.
I protect myself. Because it isn’t up to the rest of the world to devine what I might find upsetting and warn me of it. It’s up to me to make the right choices for myself and understand the risks I choose to take. There are lots of things I choose not to read. That’s my choice. That’s my responsibility.
Content Warning Proviso
* I will say that there is content I would warn people about, but that would be a fairly extrardinary circumstance and it certainly wouldn’t include an international TV promo or an image pulled from Wikipedia.
Update: I’m sorry for the flurry of strong feelings. I honestly didn’t think one picture out of the hundreds over the years here would cause such a stirring. While my feelings on the matter are my feelings on the matter, I am sorry it caused so much consternation for others.
Stopping Self-Harm Urges Using Dialectical Behavior Therapy (DBT)
If you feel you may harm yourself, get help now.
I talked about dialectical behavior therapy (DBT) in the last post. Dialectical behavior therapy is designed to work specifically with borderline personality disorder and part of this disorder is often self-harm so DBT uses specific techniques to try to stop self-harm urges and prevent self-harm.
What is Self-Harm?
Image provided by Wikipedia, author: Hendrike
Self-harm is a huge problem for many people. It is typically a sign of borderline personality disorder (BPD) but it can occur with any disorder (or no diagnosis at all). Self-harm, also known as self-mutilation or self-injury, can be any form of self-abuse including cutting, burning, hitting and statistics often include those with eating disorders as well. Millions of people in the US practice some form of self-harm.
Self-harm is often practiced by teens and is more common in women than in men, but make no mistake about it, many adults self-harm and men do as well. It is a behavior to be taken seriously. Here are some techniques to stop self-harm urges.
Dialectical Behavior Therapy (DBT) and Self-Harm
A lot of DBT techniques are built on scientific principles. The idea is to work to change your own neurochemistry or autonomic nervous system in a crisis. This sounds complicated, but really it isn’t; the techniques are quite simple.
Dialectical behavior therapy uses many acronyms to help people remember techniques and this one is T.I.P. – Temperature, Intense exercise, Progressive relaxation.
Self-Harm Avoidance Techniques
T – Change your body temperature to change your autonomic nervous system (the part of your body that handles unconscious functions like breathing and heart rate)
- Take advantage of your dive reflex, seen when you dive into cold water. Hold your breath and submerge your face into ice water or hold cold packs up to your face. It’s important that you get the eye socket area and under the eye cold.
- Warm your body to relax. Soak in a warm bath or put your feet in hot water.
I – Intensely exercise to calm down a body revved up by stress and emotions.
- Engage in intense exercise even if only for a short time
- Expend your body’s pent up energy and strength by running, walking fast, walking up stairs, playing basketball, weightlifting, etc.
P – Progressively relax your muscles. (There are many relaxation and meditation techniques that work to do this.)
- Starting with your hands and moving to your forearms, upper arms, shoulders, neck, forehead, eyes, cheeks and lips, tongue and teeth, chest, upper back, stomach, buttocks, thighs, calves, ankles and feet – tense for 10 seconds the relax each muscle and move onto the next.
Putting Self-Harm Avoidance Techniques into Practice
Only you can stop your own self-harm. You have to trust that some of these techniques are going to work for you but you have to actually do them for them to work. You have to want to stop your self-harm. You have to reach out to others. You have to get help. You can stop self-harming, but you have to do the work to make it happen.
Note: TIP self-harm avoidance techniques provided by local DBT practitioners.
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