mental illness issues

It’s Scary to Show People Bipolar, and Not Just Tell Them

→ June 28, 2010 - 6 Comments

Show People Bipolar DisorderThere are two types of writing I do about bipolar. The first type talks about being bipolar, what it’s like, information around it and so on. It’s generally not overly emotional. The second type is written from the point of view of my bipolar, period. It’s not therapied or controlled or softened.

And that second type really bothers people.

Showing People Bipolar Disorder

It has happened many times over the years that people have come onto my blog and gotten upset at my very “real” writing. Often bipolars tell me it expresses exactly how they were feeling and they are grateful. Others though, complain that I’m illogical, need help, and am just generally crazy. They want to yell at me, for expressing the sickness. Yell at me for showing bipolar disorder as it is.

So today on HealthyPlace I write some more about showing someone the bipolar versus just telling them about it.

I Hate Everyone Who Isn’t Suicidal

→ June 21, 2010 - 5 Comments

Today I feel angry.

Really angry.

Today I feel that my mentally ill, depressed, bipolar life is inexorably unfair.

Today I hate everyone.

I Hate Everyone Who Isn’t Suicidal

Yes, I know, I’m supposed to be better than that. Yes, I know, I’m supposed to rise above that. Yes, I know that isn’t fair or particularly true. But I feel it anyway. You try being this depressed. You try being this suicidal. See how many people you hate.

You Want, You Desire, Something

What do you want? Chocolate cake? Sex? Sun? A promotion? A child? A new car? More friends? To lose weight? To not get a divorce? To nap? To write? To laugh? To watch the latest episode of Top Chef?

I hate you.

I Only Want to Die

I only want the one thing: to die. I only want the thing I can’t have. Or rather I can have it, any time, but others swear I shouldn’t have it, and if I have it, it’ll be the last thing I ever have.

I hate everyone else for getting to want something else. I hate everyone for not writing a suicide note. I hate everyone for not having to take 6 seemingly-ineffectual meds. I hate everyone who wants to live. You are all lucky. And blessed. And I hate you.

I’m Damaged. I’m Bipolar. Love Me. Save Me.

→ June 14, 2010 - Comments off

Last night I watched Crazy for Love a very bad movie wherein a man, Max, is put into a mental hospital for attempting suicide for the tenth time. When he’s there, he glimpses a very ill, schizophrenic, Grace, whereupon he instantaneously falls in love with her. She too is determined to kill herself. His life’s mission then is to “make her better”. To “make her happy”. Having found his new mission in life, he no longer wants to kill himself.

Well, pin a rose on his nose.

White Knight Syndrome and Bipolar Disorder

The white knight syndrome typically occurs in men and is characterized by being attracted to, and needing to save, someone in distress. This is not so bad if it leads to someone helping you pick up your groceries after the paper bag broke, but in mental illness circles, it’s very bad news indeed. More at the Breaking Bipolar blog.

Are bipolars crazy? I am. It’s OK to be Crazy.

→ June 10, 2010 - 4 Comments

CrazyI am crazy. I tell this to people in my personal life. It’s not a secret. I figure there’s no point in trying to cover it up; it’ll come out eventually. I’m crazy. The approximately 20 scars on my forearms rather give away that something is amiss.

But people really don’t like the word “crazy”. In fact, most often, what people say to me is, “no, you’re not!”. Well, actually, I am. I have a mental illness, I’m bipolar and I’m crazy.

more at Breaking Bipolar: Are bipolars crazy. I am.

Bipolar Natasha Tracy’s Interview with HealthyPlace

→ June 9, 2010 - Comments off

Breaking Bipolar at HealthyPlaceHere is today’s interview with me, Natasha Tracy, complete with call-in questions. I think it went well. We discussed some of the negative impact bipolar has had on my life.

I talked about bipolar disorder, depression, suicide, coping and how my writings at HealthyPlace have been controversial.

 

Watch live streaming video from healthyplace at livestream.com

 

See more video and audio at Breaking Bipolar at HealthyPlace.com.

Self-Harm: Stabbing Yourself is Bad

→ May 28, 2010 - 13 Comments

Stabbing is bad. It just is. If you have to pick self-harm options between cutting, hitting, and stabbing, don’t pick stabbing.

Unless you’re trying to kill someone, in which case I think stabbing would be pretty good. And satisfying. I’m surprised more murderers don’t pick stabbing.

Anxiety, Impulse Control Self-Harm and Stabbing

I’m having anxiety issues. And impulse control issues. And stabbing issues. Well, that last one is really a function of the other two, but it’s an issue nonetheless.

I’ve always been attracted to stabbing. I think that’s because when you start wielding a blade with force, you can’t change your mind. And it’s so easy to did deep. And draw a lot of blood.

Stabbing and Scars

And as I considered stabbing, I also thought it had the advantage of leaving a minimal scar. You cut down, not across.

This turns out not to be the case. Stabbing doesn’t produce a large incision, but the one it does produce tends to gape and cause more scarring than you think. Just trust me. Don’t try it.

And so, as much as I like the force, and blood, and bruising associated with stabbing, I’ve really written it off as a self-harm method. Death method, probably decent, self-harm, not so much.

Anxiety and Self-Harm

Self-Harm, Stabbing is Bad

But as I’ve said, I’ve been having issues.

For whatever reason, for whatever cocktail, for whatever brain misfire, I seem to be turning in super-anxious-suicide-girl at night. Like, way more than usual. And on top of that there seems to be a real lack of impulse control on my part, last notably seen with the cutting of my wrist with broken glass.

Hitting is Bad Too

And so I had been hitting myself with a blunt object, went into the kitchen to cut up a yellow pepper, and then as I was removing the core I thought to myself, I wonder what it would be like if I hit myself with this knife. And then I just did. And then there was a lot of blood. I was standing next to the sink so I just tried to keep standing while the blood went down the drain.

It just kind of, happened. Like stubbing your toe. An accident.

And it’s fine. My arm is fine. There does seem to be some nerve damage going into my thumb, but it seems minor and may get better, I don’t know. This isn’t really my area of expertise.

Self-Harm Without Control is Really Bad

And I don’t know. It’s a scary thing. To do something, without intention. One of the problems is I really don’t care if I die. I mean, like, really don’t care. I’m so over it’s unbelievable. So when something pops into my head, whatever filter I did have doesn’t exist. So I just do it.

And then there’s the drinking. Crazy people shouldn’t drink. Crazy people on meds really shouldn’t drink. Crazy people on meds and tranquilizers really, really shouldn’t drink. But I feel so irreparably horrifically self-loathing and suicidal that I couldn’t care less that it’s a bad idea. I’ll take any idea at all that would mask the pain. Even a little.

Sigh. All roads lead to scar tissue.

Again, try not to worry, OK? You’re scared, I know. I am too. But there’s nothing you can do. There’s nothing I can do. I’m suppose to see my GP on Monday and maybe she’ll be able to get me in to see a psychiatrist. Of course the psychiatrist won’t have any answers so it’s a bit moot. More moot than usual. Ultra-moot. Now with more brightening power.

Depression: Silence of Being Ignored Feels Like Loss

→ May 14, 2010 - 6 Comments

This silence feels familiar. I despise the deafening, familiar sounds of silence. They terrify me. I suppose the silence strangles me. Strangled, alone, screaming.

I Hate Being Ignored

People who know me, know this about me. They know how much I hate being ignored. They know that when they don’t return my calls or my emails my mind riles in negative and catastrophic scenarios. People who actually like me don’t want to do that to me. It’s the depression. It turns the pain of being ignored up to unmanageable levels.

Of course, there aren’t many people left who actually like me. Or at the very least, they don’t treat me like they do. I don’t know what it takes to be treated with care and respect. Most people just don’t treat me that way. (And yes, there are exceptions.)

Being Ignored Feels Like Loss

To lose another person I love. To lose another person I thought loved me. Not only does it prove to me that no one really does love me, but it also proves that no one ever will. That I can never trust that anyone actually does. Even the people who say they do, can watch me slip, screaming into the worst deadly mire without even blinking.

And here’s the question I leave to you: how many emails from a suicidal girl would you ignore? Even if you didn’t like her. I mean, really.

(Upon pushing the publish button I actually did receive a 1-word email. Perhaps I’m not being ignored, I’m simply immensely unimportant. Sort of not news.)

Will ECT Work for Me? – Predictors of ECT Efficacy

→ May 12, 2010 - 2 Comments

It would be nice to know ahead of time if a treatment would work. Unfortunately, no one cal tell the future: not for cancer treatment and not for mental illness treatment like electroconvulsive therapy (ECT) either.

Will Electroconvulsive Therapy Work for Me?

But very smart people try to figure out what might predict the outcome of treatments. Especially treatments like ECT, a hotly debated, and much maligned treatment. That’s the good news. And the bad news.

In a retrospective chart review of depressive and bipolar patients in a Netherlands hospital, of those who received  ECT, 65.8% met the standards for remission. The only predictor of response found was duration of index series.

The good part here is that medication failure did not predict response; so theoretically, no matter how many medications you have failed you have an equal chance of response to ECT.

The bad part is that the more times you get ECT in your initial series, the more likely you are to respond. I say this is bad because the more times you do ECT the more chances are you’re going to suffer more and worsening cognitive side effects too.

It’s something to consider when thinking about starting or stopping ECT treatment.

Image by rolffimages / 123RF Stock Photo.

People Who Attempt Suicide Don’t Want To Die

→ May 7, 2010 - 276 Comments

There are frequent reports that of the people who survive suicide attempts, they realized sometime after the pills, or the gun, or the jump, they didn’t want to die. This is obvious. No one wants to die. People who attempt suicide don’t want to die.  They want to be out of pain.

Read more

How to Make the World Better for the Mentally Ill

→ May 2, 2010 - 3 Comments

It’s understandable that people who love those of us with a mental illness tend to feel powerless. But here are some ways you can help make the world better for the mentally ill.

Six Ways to Help People with Mental Illnesses

Bipolar is one of the most commonly diagnosed psychiatric conditions among teens and twenty-somethings, but there has been little written about it from a younger person’s perspective and few people know how to approach the topic. In her new book, Welcome to the Jungle: Everything You Ever Wanted to Know About Bipolar but Were Too Freaked Out to Ask (Conari Press, May 2010), Hilary Smith fills in the gap with an upfront and empowering approach to the challenges of being diagnosed with bipolar. Here she shares with us six tips for making the world a better place for people with mental illnesses.

  1. Meet a person with a mental illness. – The best way to learn about mental illness is from a person who lives with one. The National Alliance on Mental Illness (NAMI) has a new program called In Our Own Voices in which people living with serious mental illnesses give presentations in their communities. These free presentations are a great way to learn about what day-to-day life with a mental illness is like, and presenters (who live with conditions such as bipolar disorder and schizophrenia) are more than happy to answer questions from the audience.
  2. Believe passionately in recovery. – The next time you’re walking down the street and you see a homeless person with schizophrenia, try to picture what his life would be like if he was getting adequate care for his symptoms. With proper treatment, the same man might be at home throwing a baseball with his young son, or growing prize tomatoes at his apartment. Severe mental illness does not have to equal homelessness, but until we learn to see people with severe mental illnesses as capable of recovery, their plight will all too often be seen as inevitable.
  3. Talk openly about your own experience with mental illness. – Even if you’ve never struggled with a serious disorder like bipolar or schizophrenia, you’ve probably had a friend or relative who has.
  4. Support legislation that helps people with mental illnesses. – Campaign for health care reform banning health insurance companies from discriminating based on pre-existing conditions. Vote yes on bills for affordable housing and increased funding for mental health programs. Support campaigns to keep people with mental illnesses out of prisons and receiving the treatment they need.
  5. Teach your children about mental illness. – Children often absorb their parents’ attitudes towards people who are different. Explain to your children what it means when they see people with mental illnesses acting or speaking in unusual ways. Emphasize the need for compassion and tolerance, and always put the person first, not their disorder. Teach your children not to see a “crazy lady,” but a woman struggling with a disease.
  6. Support community organizations that help people with mental illnesses. – Give time or money to an organization in your community that provides outreach, shelter, job training, counseling, or health care services to people with mental illnesses. Mental illness affects millions of Americans every year. One day, the person most in need of these services might be a friend, relative, co-worker–or even you.

Dimensional Diagnosis of Mental Illness

→ April 23, 2010 - 9 Comments

There is a recognition among many of us crazies, as well as the professionals that treat us, that most of us do not simple fall into one camp – we’re bipolar with a hint of ADD; we have a borderline personality disorder with depressive and psychotic features; we suffer from schizoaffective disorder with post-traumatic stress disorder (PTSD) and addiction mixed in. Humans are complex, and their brains even more so.

My Depression Isn’t Your Depression

And what’s more, my depression isn’t like your depression. In fact, so much so, that using the same word is almost nonsensical. I sleep 15 hours a day, but you only sleep 3. I have a successful job, but no family or friends. You have neither but participate in online support groups 10 hours a day. I think about killing myself every day but you actually plan for it once a week. You never cry but I cry all the time. Are we the same? Am I more depressed than you, or less?

And things get more complicated when you compare personality disorders and bipolar and ADD and PTSD combined with comorbid conditions like addiction. And yet somehow we’re supposed to suss this all out, find a label, and a treatment that goes with it. That’s pretty tough.

Mental Illness Doesn’t Fit in a Box

The medical community recognizes that mental illnesses frequently occur together and that each person has unique symptoms. More at Bipolar Burble blog.So some doctors would like not to put people in boxes, but to place them on continuums. You would become a multi-dimensional person, probably with severity ratings attached. So, I might be 80% bipolar, with a severity of 7/10, 10% anxiety, severity 3/10, and 10% PTSD, severity 2/10. (The scales used here are coming out of my head, not from any published source.)

And if you know mentally ill people, and you’re educated about disorders, you can see that continuums really do fit more people than boxes do. Boxes are, naturally, self-limiting.

But there are some problems here. Well, too many to count, really. First off, how would you measure how depressed a person is? Or how schizophrenic? Or how bipolar? There are many scales that have been developed for this but there is no standard as none have been proven to be wholly accurate. The scales we do have are more effective at measuring change over time, to tell if you’re getting better or worse, than objectively coming up with a score indicating how much you are of something.

Mental Illness Severity

And severity. Severity is a personal thing. If I can’t work because of a disorder, then naturally that is severe, but it can be just as severe to have nothing in your life but work. Doctors feel that planning your suicide is worse than thinking about suicide but if all you do is think about your death all day long, is that not severe? What if you cut yourself but never really suffer any grave injury, is that severe or not?

It’s personal. Severe to me probably isn’t the same as it is to you. And it probably isn’t the same from doctor to doctor either, so coming up with a measurement is rather difficult.

Mental Illness Definition

But even if we could measure how much of an illness you had, and how severe it was, and we could assign you a magic number that represented all of that, what good would it do? It doesn’t change the treatments we have available. It still doesn’t change the drugs, or the therapies, or the electroconvulsive therapy (ECT), or the vagus nerve stimulator (VNS). All that remains. And as it stands now a doctor might prescribe any medication for any disorder anyway so what’s the point in being so numerically specific? Whether you’re 100% bipolar or 75% with some PTSD doctors are going to try lithium, mood-stabilizers and antipsychotics anyway. It really doesn’t matter.

I applaud a system working to recognize that we’re all different and that through standard diagnoses we almost always get it a little bit wrong, but at this point I just don’t see a way around it. Mental illness isn’t like a burn where you can measure the percentage of skin affected and burn depth. It just isn’t that simple. And maybe one day we’ll know more and we’ll be able to attach numbers to the illness of a brain but unfortunately we’re just not there yet. I suspect until we really have a biological way of identifying issues: 25% excess serotonin, not enough dopamine and so on, we’ll be stuck with the muddy mess of trying to categorize seemingly infinite variations on the human brain. Broad strokes are really the best we can do until not just something better, but something more useful, comes along.

Psychiatric Disorders in Children – Diagnosed and Medicated

→ April 20, 2010 - 13 Comments

I have bipolar-disorder-type-II-ultradian-cycling. I diagnosed myself when I was 20 years old, and once I finally agreed to see a doctor, he agreed sometime thereafter. My diagnosis was fairly easy for me. I’m very self-aware and I could pick out discrete moods and swings. But as a 20-year-old, in university, using research, and having a fairly high IQ, this is not terribly surprising. If I were five-years-old, the picture would have been a little different.

Epidemic of Children Diagnosed with Mental Illness

There is an epidemic of children, as young as two, being diagnosed with psychiatric disorders in North American right now. It’s made the cover of Time magazine and countless articles have been written on the phenomenon.

So, Antipsychotics are Now Approved for Children

It was once thought that disorders like bipolar did not occur before adulthood, but thoughts on this seem to be changing as diagnoses go up and more drugs are approved for treatment of children.

Antipsychotics FDA-approved for use in children (under 18) is:

And so on. And of course, doctors are free to prescribe any medication off label to children just like adults.

Antipsychotics Can Fuck You Up

I have been on all three of those antipsychotics and all three have fucked me up. Specifically seen has been weight gain, blood pressure changes, twitching, extreme fatigue, incurable hunger, and in the case of Geodon, psychosis. Among other things.

What Do Antipsychotics Do?

Antipsychotics turn down the dopamine in your brain. That’s what’s the do. They also turn down serotonin. These are two of the “feel good” chemicals in your brain, and you are turning these down. This seems to help with certain disorders like schizophrenia, but dopamine in integral for motivation, reinforcement, learning, and memory. If, for example, your five-year-old eats his peas, and you praise him, he feels good because a shot of dopamine is released. This then reinforces the pea-eating behavior, so that next time, he will again eat his peas. If you take away dopamine, he may not be able to make this link. And if you take away dopamine from a child’s (naturally developing) brain for a long period of time, no one has any idea what would happen.

I cannot, in any world, imagine giving these drugs to a child.

We Don’t Know How to Diagnose Bipolar In a Child

The truth is, no one knows what bipolar looks like in a child, or if it even exists. There is no diagnostic criteria in the DSM. Psychiatrists are using relaxed versions of symptoms seen in adults for diagnoses. This is patently ridiculous.

Children are Naturally Crazy

Kids blur the line between fantasy and reality. Kids act out. Kids throw tantrums. Kids ignore you. Kids break rules. Kids often don’t show a great regard for their safety or the safety of others. Kids throw broccoli across the kitchen table. Kids do, the darndest things. They’re kids. It’s what they do. None of this makes them crazy.

Recently a friend of mine was talking about a girl who hallucinated a dead robot baby. Moreover, this same girl spent her recent birthday having an elaborate funeral for a bird found dead in her back yard. Sound crazy? Not for a seven-year-old. It might be a bit unusual, but to me this speaks of intelligence creativity and compassion, not a mental disorder.

And let’s face it, some kids are very challenging to handle. Some are overly aggressive, or sad, or obstinate. They hit their sister, break a vase, or refuse to stay in their room for a time-out. This still doesn’t make them crazy, this just makes them challenging. Parents don’t get a pass just because their job is harder than they thought it was going to be.

Kids Can Be Crazy and Still Perfectly Normal

Basically, kids can have almost any pattern of behavior and still be pretty darn normal. And that doesn’t take into account all of the environment factors that are effecting kid’s behaviors. I’ve never seen great parents with a kid with huge behavioral problems. Yes, I’m sure it happens, but generally, kids are a reflection of their home lives. And kids with bad home lives don’t need or deserve drugs. They deserve better home lives.

And on top of all of this, if a child really is having behavioral problems there are specialists who can help with that, they’re called child psychologists. They help children and parents all day long. And they don’t cause weight gain and high blood pressure.

And don’t get me started on how idiotic it is to diagnose a two-year-old with a mental disorder. Two? Really? It can take an adult two years for an adult to get a diagnosis of bipolar. That sounds like a parent disorder if ever I heard of it.

Children on Antipsychotics and Other Psych Medication Seem Like Lab Rats

It feels to me like these children are being treated as lab subjects, and not real people. I am highly suspicious of any doctor that would medicate a child. Could it possibly be a reasonable thing to do? Well, maybe. But you’d be hard pressed to convince me.

Mental Illness as Self-Fullfillment

And in addition to whatever drugs are being fed to these children, they are also being saddled with a diagnosis – for the rest of their lives. As an adult it can be extremely detrimental to be labeled “crazy”, but as a child I can only imagine it would be infinitely worse. These children don’t even have a chance to find an identity before they’re told they’re crazy. How can that label not result in self-fulfillment?

Victims of Fad Diagnoses

When the movie Cybil based on a woman with “multiple personality disorder,” came out, the diagnosis of this disorder exploded across the US. A disorder that had virtually never been seen was suddenly everywhere. But over the decades that followed, medical professionals were able to determine that these were not genuine cases. In fact, some doctors feel that there has never been a documented case of “multiple personality disorder” as featured in the film. There are other disorders with similar features, but the giant outbreak seen after the film, just didn’t exist.

Is Childhood Bipolar a Fad Diagnosis?

And one has to wonder if we’re seeing something similar here. If more adults are being diagnosed as bipolar, then naturally, we are looking for markers of it at younger ages, and in their genes. We want this information to help people, to help treat the disease, but it can just as easily be used to further label people before we even know how to do it properly. Multiple personality disorder looked like a correct diagnosis until we figured out it wasn’t.

And if someone as young as a toddler gets diagnosed with some behavioral disorder, don’t these children deserve time to correct this issue via safer methods than drugs? It seems that out of an eight year life, it’s impossible that enough other treatments have been tried to warrant drugs.

Now, it’s true, I’m not a doctor, or a parent. And I do have a strongly held belief that doctors and their patients should be able to choose treatments without judgment from the outside world. But I also think any doctor worth seeing is going to try the least harmful treatment first, especially in a population that has been radically understudied. True, behavioral therapy might not work, but it’s unlikely to cause debilitating side-effects. And what about waiting for a child to grow out of behavioral issues? I hear that was a thing that used to happen. Before we got all diagnos-y.

I’m not suggesting that no one under 18 is sick, or that no one under 18 should be treated with medication. What I am suggesting is that diagnosis and treatment of children needs to be handled with extreme care and caution. I’m an adult and I give informed consent to fuck with my brain; children do not have that ability, and yet, they will be the ones that have to live with the results. They deserve every possible solution that avoids nasty, unknown side effects. Parents need to be held to a higher standard of decision-making and not pick what is easiest for them, but what is best for their child. Doctors need to be held to a higher standard to care with children, ideally with third party monitoring of underage drug-treatment. This is not something to be taken lightly on any front.

Someone needs to sanity-check the parents. Kids need to be able to act crazy, without getting labeled crazy.

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