Bipolar 2 From Inside and Out

Posts tagged ‘mental illness’

What Schools Are – and Aren’t – Doing About Mental Health

I believe that mental health education belongs in schools. I’ve written about that (https://wp.me/p4e9Hv-Jw). There’s good news about the subject and there’s less-good news. I’ll let you sort out which is which.

First, two U.S. states are now required by law to include mental health in their curriculum – New York and Virginia.

New York’s law mandates teaching the subject as part of the K-12 health curriculum, which has only two other specifically required topics: alcohol, drug and tobacco abuse and the prevention and detection of certain cancers. According to the law, the new education requirements seek to “open up dialogue about mental health and combat the stigma around the topic.” Free resources for New York schools, such as teacher training, are available online. These include lesson plans, though schools and teachers are free to design their own curricula.

In Virginia, mental health education is required only in grades 9-10. Huffington Post reports that the legislation came about “after state Sen. R. Creigh Deeds (D-Charlottesville) saw that three high school students had researched, developed and presented the proposed legislation, which struck close to home for the legislator, who had lost his son to suicide in 2013.”

Indeed, those laws are good things, though one could wish that the other 48 states would take note and do likewise. They are, of course, not forbidden to teach mental health education, and many do, especially around the topics of drug and alcohol prevention and suicide prevention. Some of them even require education on those two topics, along with bullying. Many of these efforts are sincere, significant, and even life-saving, but it is worth noting that bullying and student suicide are events for which schools are at risk of legal liability. One might wonder whether that has influenced the laws, rather than supporting more comprehensive mental health education.

Contrast the U.S. experience with England, where all secondary school teachers and other school staff are being given training that will help them identify mental health issues in children, including depression and anxiety, self-harm, and eating disorders. This is thanks in part to Prince Harry’s openness about needing counseling to help him deal with the death of his mother, Princess Diana, which happened when he was 12. The Prime Minister has said that the prince’s disclosures will help “smash the stigma” regarding mental illness and the need for getting help.

“The programme is delivered by social enterprise Mental Health First Aid (MHFA) England, backed by £200,000 in Government funding,” notes the Telegraph, “and will be extended to primary schools by 2022.”

The campaigns around the mental health mandate, especially those featuring Princes William and Harry, have focused on the need for Britons to abandon their “stiff upper lip” image and to accept that men can and do need to seek help for mental difficulties. While that is indeed a vital message, one hopes that girls and women do not get left behind in the efforts.

What about U.S. states where mental health education is not a fact of life?

For schools in the U.S. that have not mandated mental health education, the National Alliance for Mental Illness (NAMI) has developed resources that can help districts, schools, teachers, and families address the problem through the NAMI Parents & Teachers as Allies program of training.

They have also developed a presentation for students called NAMI Ending the Silence, “designed for middle and high school students that includes warning signs, facts and statistics and how to get help for themselves or a friend.” These programs are offered free to schools and communities. For more information, go to https://www.nami.org/Learn-More/Public-Policy/Mental-Health-in-Schools.

For a more DIY approach, youth.gov (https://youth.gov/youth-topics/youth-mental-health/school-based) recommends that schools “partner with community mental health organizations and agencies to develop an integrated, comprehensive program of support and services.” Among the actions they recommend are for schools and partnerships to:

  • develop evidence-based programs to provide positive school climate and promote student skills in dealing with bullying and conflicts, solving problems, developing healthy peer relationships, engaging in activities to prevent suicide and substance use, and so on.
  • develop early intervention services for students in need of additional supports such as skill groups to deal with grief, anger, anxiety, sadness, and so on.

In other words, for schools to spend the time and energy to do for themselves what the state and national governments are unwilling or unlikely to do.

To me, this is one of those times when a national curriculum makes sense, or at the very least a mandate in every state. Mental health education should be comprehensive, freely available, easy to access, and scientifically accurate for all schools and schoolchildren. The education this would provide and the statement it would make would be invaluable. Drug and alcohol, bullying, and suicide prevention are just a start, but a start that many states have not made.

 

 

Category:

mental health

Tagged with:

What Kids Should Learn About Mental Health

The stigma and the misinformation surrounding mental illness are staggering.

How many adults believe that depression is “just being sad”? That the weather can be “bipolar”? That you can call yourself OCD because you’re a little too organized? That suicide threats are never acted on? That mentally ill people are dangerous? That prayer, or sunshine, or positive thinking will cure all mental disorders?

We can’t do much about educating and informing the adult population that all those beliefs are false. But we can avoid raising another generation that buys in to these misconceptions – if we start now with mental health education in schools.

Whenever someone proposes this idea, there are common objections. You want kindergartners to learn about schizophrenia. You’ll have impressionable kids thinking they have every disorder you teach about. Discussing suicide will give teens ideas.

Again, those are misconceptions. Mental health education in schools could look like this:

In kindergarten and grades 1-2, part of the health curriculum should be a unit about understanding emotions and how to deal with them. This is already being done when teachers tell kids to “use your words” or “use your indoor voice.” But more could be done in the area of teaching children how they can keep from letting anger, sadness, frustration, and other emotions cause them difficulties. Yes, this may involve techniques that resemble meditation and yes, these may be controversial, but the outcomes will be beneficial.

I also think that young children ought to be taught about autism, though it’s not strictly speaking a mental illness. They will certainly meet autistic children in their classes at this age. Helping them understand the condition at their age level will, one can hope, lead to more inclusion and less bullying of kids who are “different.”

Older elementary children can learn about mental illness in their science or health classes. This should be a unit that covers the basic facts: that mental illness is like physical illness in some ways, that treatment is available, that mental or emotional disorders will affect one in four Americans in their lifetimes, and that mentally ill persons are not generally dangerous.

Middle schoolers can be taught some more specifics: the names and symptoms of some of the most common disorders, the kinds of treatments available, famous people who have succeeded in spite of mental disorders and ordinary people who live fulfilling lives despite them. Speakers from local mental health centers or the school guidance counselor would be helpful.

The topics of self-harm and suicide should be brought up at the middle school level. It is sad but true that children in the middle school age range are affected by both – if not directly, by knowing a classmate who is. And suicide is the third leading cause of death for children ages 10-14. Learning the facts may help students who need help find it before it is too late.

In high school, the focus can shift to human psychology; more detail about serious psychological conditions; and the possibility of careers in mental health treatment, nursing, or advocacy. Topics of self-harm and suicide should be covered in greater detail, with discussions of how suicide affects the families and loved ones of those who die by suicide, how to recognize possible signs that a person is thinking about suicide or self-harm, and what does and doesn’t work when a person shows those signs.

The details of mental health education in schools still need to be worked out. These suggestions come from my experience as a person with bipolar disorder, who began showing symptoms while I was a child. Organizations such as NAMI (National Alliance on Mental Illness) and NIMH (National Institute of Mental Health) provide resources that can help in understanding the need for mental health education among school-aged children.

Understanding mental health is as important for schoolchildren as understanding physical health. Why should one get all the attention and the other virtually none? Mental health education that begins early can help children and their families in ways that will resonate far into the future.

Most adults have little to no understanding of the realities of mental illness. It doesn’t have to be the same for the next generation.

Category:

mental health

Tagged with:

The Disability Tapdance

man in brown long sleeved button up shirt standing while using gray laptop computer on brown wooden table beside woman in gray long sleeved shirt sitting

Photo by rawpixel.com on Pexels.com

Once I applied for disability for my bipolar disorder and I was turned down Then I took the process as far as I could with a lawyer and he eventually advised me to give it up too. Here’s my story.

I had gotten to the end of my proverbial rope and we had gotten to the end of our money. For over a year I had been sidelined by unremitting depression. There was nothing I could do and nothing my psychiatrist prescribed or my therapist said had helped. We had been living on my husband’s salary and what was in my 401K from when I had last been able to work.

At last my husband pointed out that we couldn’t hold out much longer. He encouraged me to apply for disability. I knew that there would be lots of hoops to jump through and that there was no guarantee of succeeding. But Dan was willing to go with me to the Federal Building and help me get through it. I certainly wasn’t capable of managing it on my own.

Between the two of us, we had looked up what sorts of documents I would need and had acquired them. I was glad we were able to do this because going back again and again for missing documents would have been a horror. I had my appointment with the intake person and went back home to wait.

There were more forms to come. My psychiatrist had to fill out a long one, of course, or write a letter, I don’t remember which. I had to pay him for his time and trouble in doing that but at that point it was just another step that needed taking.

The big step was the psychological interview where I had to perform my little song and dance and convince someone that I was truly disabled. Fortunately, the appointment was not downtown in the Federal Building but in a relatively nearby office building that I knew how to find. Then the hoop-jumping and tap dancing really began.

They tested my memory. They told convoluted stories and asked me questions about them such as the order in which things happened and why the characters did what they did. They were confusing.

They tested my spatial perception. They had me put together those cubes with triangles on them to match patterns they showed me. I still don’t know what that had to do with bipolar disorder.

Then came factual knowledge. I was good at that one. I admit I guessed when they asked me how big around the equator was. I knew the easy stuff like who wrote Tom Sawyer and such.

By the time they got to the word association test, I was very tired. First they gave a pair of words and asked what they had in common, easy ones like truck and train. Later they gave difficult pairs of words that seemed to have nothing in common, like acceptance and denial, but I was supposed to come up with a commonality anyway.

Finally, an interview. I remember the woman asking me if I knew what the saying, “What goes around, comes around” meant. I replied, “As you sow, so shall you reap” and she looked at me funny.

A seemingly endless time later my claim was denied and I got a lawyer to pursue it. By that time so much time had passed that I was coming out of the depression and was able to work a few hours a week. How much did I get paid per hour? he asked. “Thirty dollars,” I said, explaining that I could only work a very limited number of hours. It didn’t matter. As soon as I said thirty dollars the judge’s head would explode, evidently. Lawyer Joe recommended I drop the claim and I did. At least I was getting some work and some income even without disability.

It seemed that for me to get disability I would have had to be together enough not to need it, but sufficiently disabled that I would. Catch-22, as Joseph Heller said.

 

 

Category:

mental health

Tagged with:

When Your Therapist Tells You What to Do

The classic examples of non-directive therapists are Sigmund Freud and his disciples, who legendarily sat at the head of their couches and made comments like, “Hmm,” “Tell me about your dreams,” and “How do you feel about your mother?”

Freudian psychiatry is, thankfully, now out of vogue. But there are still therapists who believe that their job is to listen, not to instruct.

On the other hand, there are more directive therapists who assign homework. This can be anything from “Listen to this podcast on mindfulness” to “Write a letter to your ex telling him/her what you truly feel.” They probably won’t tell you to kick the bum to the curb, but if you decide to do so they’ll help you prepare for it.

But, although I am far from a Freudian and shy away from those who are (not many these days), I prefer non-directive therapists. I am not averse to doing a little homework or having a therapist ask me in a session to vocalize what I would like to tell a person or even to write a list of the coping mechanisms I’ve developed. My preferred dynamic, however, is to give-and-take with the therapist and then go home to contemplate what was said and how I feel about it.

I have had therapists who have given me homework and I can’t say they were wrong to do so. Sometimes writing something down or throwing teacups against the basement wall (or whatever helps you get your anger out) is a good thing.

My most recent therapist was a combination of the two. She mostly listened while I rambled on about what was happening in my life or what had happened in my past. Then she suggested ways that I could think about the events or pointed out coping mechanisms that I had developed or suggested ways I could put those coping mechanisms to use.

All in all, I felt that our sessions were mostly non-directive. She did suggest that I listen to a podcast on mindfulness, but she never quizzed me on whether I did and only listened when I told her what I got from it. She never told me that I should delve deeper into mindfulness or listen to more podcasts. She left that up to me, if I thought it might be helpful.

I understand that some therapists, particularly those that work in community mental health facilities, are required to file treatment plans and I can see where giving homework can flesh one out more than “talk about feelings.”

Perhaps there is something I’m missing. Perhaps at different stages of therapy, directive psychological interaction is more beneficial. Perhaps my particular problems lend themselves more to non-directive therapy. Perhaps I just have an aversion to being told what to do, especially where it concerns my memories and my feelings.

Of course, everyone has the option not to do the homework. This can be seen as resisting treatment, or disagreeing with the treatment approach, or simply lacking the wherewithal to carry it out. Sometimes it may be more helpful when the therapist sacrifices part of the session to doing the assignment there instead of leaving it to be done at home. In this case, the therapist is being really directive, though of course the client always has the choice not to do the assignment. It’s much harder, though, when the therapist is sitting there waiting for you to make a list of your dreams, your feelings, or your interactions with your mother, or to bash an empty chair with a pool noodle.

What it comes down to, basically, is therapeutic philosophy and therapeutic style. And a client is not bound to pursue whatever style of therapy that is favored. Although it is sometimes difficult to realize, a client has the option to request or to seek a therapist whose therapeutic style matches what the client feels is most helpful.

Remember, your therapist works for you, not the other way around. If you need a more or less directive therapist, it is your right to seek one out. Therapy has been known to stall and a different approach or philosophy may be just what you need.

 

Category:

mental health

Tagged with:

Exhaustion as an Antidote for Panic

Wednesday afternoon my husband called his doctor complaining of chest pain and was instructed to go immediately to the ER. Actually, he had had the chest pain off and on for several days but he A) attributed it to Taco Bell, B) is good at denial, and C) is stubborn.

So off to the ER we went. We were tucked into Bay 22 and after a time, a nurse drew my husband’s blood. While we were waiting for results, we watched The Big Sleep on the room’s TV, possibly not the best choice at that particular time. We were there from 4:30 to 10:00, when they reported that Dan’s cardiac enzymes were a “little high.” I left shortly thereafter and Dan was admitted.

Although in the past ER visits with my parents caused massive anxiety which then caused a variety of physical symptoms, this time I did not panic. I was too exhausted. I even had a little trouble driving home. The streets in our plat seemed the wrong length or something and I wasn’t absolutely sure where to turn. When I got home I fed and watered the cats and then collapsed. Sleeping, not weeping.

The next morning I had to get up and finish a work project, then go to see Dan for a few hours, then back home to more work. Again, an early collapse. Still no panic.

Today (Friday) I am writing this post after finishing the work project and while waiting to hear that Dan’s angiogram is done so that I can go and see him. Again, I am not panicking. Numb, maybe, and tired, but not anxious.

I used to hate not knowing. Waiting for the proverbial other shoe to drop was torture. I am given to catastrophizing at the least provocation. But now, when there is an event that lends itself easily to catastrophizing I find I’m not. I have decided to postpone panicking until I truly have something to panic about.

At the moment Dan is fairly comfortable, in a very good hospital with attentive staff and even therapy dogs. There is nothing that I can do except visit him and call him.  I figure that when he calls with the results of the angio and info on whether they gave him a stent, I can panic then if required. Say, if he has to have bypass surgery.

But I’m disinclined to panic until or unless they tell me that’s the case.

And … I just got a phone call from his doctor. Dan had multiple artery blockages and required four stents, but no bypass surgery for now. I’m relieved, of course, but my main feeling is still one of exhaustion. Maybe I’ve been worrying in the back of my brain at a subconscious level and that has added to my exhaustion. Maybe when this is all over I’ll let loose and have a good cry, when he’s back home.

My friends have been sending me and him thoughts and prayers, hugs, light, and even good juju. They have also been reminding me to take care of myself, to remember to eat and sleep and I’ve been doing that at least on some kind of level. A bowl of cereal now, cheese sticks as a bedtime snack, a visit to the Waffle House when I’m too tired to make a meal. And eight hours of sleep a night. I can’t say the sleep has been dreamless or restful. I wake up still exhausted but at least my body is taken care of in a reasonable manner.

So there you have it. A potentially dire situation happened but I did not panic. Was it postponing the catastrophizing that helped? The exhaustion? I don’t know, but whatever coping mechanism it was, I’m glad it kicked in.

Dan has done so much for me through the years. I’m glad I will have an opportunity to pay him back even if only a fraction as much.

Category:

mental health

Tagged with:

Inspiration and Mental Illness

high angle view of pencils on table

Photo by Pixabay on Pexels.com

I was manicky this week and it affected my blog writing. I had a post all ready to go this morning, but last night I thought about it and realized it was crap. It meandered, without focus. The ideas were confused. It sucked. So I got up this morning to write something different instead.

Many of you may recognize this aspect of mania or hypomania. You do something that you think is fantastic  while in the grip of mania and when you come down, you can’t see what you ever saw in it. Or you begin an ambitious project that you work on and work on but never can complete.

I was toying with the idea of “inspiration porn” – the sort of post or story or TV show that holds someone up as an ideal, usually because they’ve lost a bunch of weight and gotten themselves into shape, or have an illness or disability and managed to do – whatever – again. Think “The Biggest Loser.” Or amputees who’ve learned to eat with their feet. It’s put out there for entertainment and to make everyone feel good that whoever it is conquered whatever it was. It takes a regular person out of the context of their lives and reduces them to their condition. And the subtext is that if this brave person can become able to do or be whatever again, so can everyone else with the same problem.

It happened to a friend of mine who was at a gym on a treadmill. A woman came up to her and said how inspiring it was to see her working so hard to lose all that weight. “Excuse me?” was my friend’s reaction. She was doing it for herself, not for anyone else, and especially not to inspire some random stranger.

The thing is, there really isn’t any mental health inspiration porn. For one thing, it would make lousy TV. Oh, they’d get advertisers – all those purveyors of psychotropics that clog the airwaves. But who would watch a depressed person finally getting out of bed and taking a shower, unless she had a coach yelling at her?

Inspiration for those of us with mental health problems takes other forms. Celebrities who speak about their struggles with mental illness are one. They are inspiring because they break the taboo about talking about mental illness in public and because they have done so to help other people.

Then there are the superstars of mental health inspiration. Carrie Fisher, Glenn Close, and Jenny Lawson, to name a few. These are people who focus light on the difficulties and struggles of mental illness. Their communications don’t stop with the announcement that they have a condition and encouraging people to get treatment, though those are also good things. But the real inspirations are those who open their lives, take others with them through the journey of symptoms, treatments, relapses, small triumphs, and bigger successes. They speak and keep speaking and keep speaking their message. They don’t make the process sound easy, because it isn’t. And they speak with authenticity and authority because we know they’ve been there.

They do inspire us because they are honest and open, and they clearly care about helping others in the same proverbial boat.

We lost a true inspiration when we lost Mama Carrie. No one will ever really take her place. But you can tell that she was an inspiration by the many people whose life she touched and how they remember her. If someday they make a movie of her life, I hope it features not only her personal struggles, but all that she did for others. Her speaking and continuing to speak despite – or because – of her ongoing struggles.

We can carry on her work by doing the same, by shedding the stigma, by talking to others, even family and friends. Recently a friend “came out” to me that she takes an antidepressant and an anti-anxiety med (the same ones I take). I was proud of her, but I didn’t make a big deal of it. But I was impressed and pleased that she was able and willing to share even that much. She was saying that she was part of our tribe.

As Jenny Lawson reminds us, in this we are alone together. And that’s inspiring. 

Category:

mental health

Tagged with:

Back to Work – Full Time

business clean computer connection

Photo by Ken Tomita on Pexels.com

As is true with many of us who can manage to work only part-time while dealing with bipolar disorder, I was always one paycheck away from financial disaster.

Then the checks stopped coming.

When my main source of work dried up, that financial disaster loomed closer. I knew that it was time to try to go back to regular work. Full-time. Outside in the world, if need be, rather than in my home office, in my jammies.

Looking for work was a job in itself (https://wp.me/p4e9wS-zY). It turns out I’m overqualified for many things and underqualified for others, sometimes both at once.

And the specter of bipolar reared its fearsome head. Even if I found full-time work, could I do it? Especially out there where it’s all people-y? It’s been years since I’ve worked in such an environment and my last few years at it did not go well, as I was beginning to slide into a major, long-lasting bipolar depressive episode.

Looking for work at home was not much better. Even telephone jobs (customer service or order handling, please, not sales) required some experience and my Girl Scout cookie days were back when we still thought it was safe to go door-to-door. When I responded to work-from-home jobs, many of them turned out to be Uber or Lyft, which is hardly the same as work-at-home, if you ask me.

I found a couple of small gigs to tide me over. Then I found one that was really promising.

Proofreader.

They warned me during the phone interview that I was vastly overqualified. I told them that this kind of job was exactly what I needed at this point in my life and please to keep me in mind if any of the other candidates washed out.

The job was with a transcription service, proofing scripts of meetings and reports that other people had typed up from audio files. But there wasn’t much of it, and it didn’t pay very well.

Then they asked me if I would move up to typing. And whether I would do it full-time.

Those were separate questions. I’m not a fast or good typist. I never took typing in high school (though I discovered that I needed it once I got into college). All these years I’ve been faking it, looking at the keyboard and using at most six or seven fingers to type with. But I said I’d try and I did. I’ve been sweating over these typing jobs and they take me lots longer than they do for other, ten-fingered, trained typists, but I’ve been hitting my deadlines.

Full-time was another issue. I said I’d try, with the understanding that I’d go back to part-time if I couldn’t handle it. It’s certainly been a challenge, forcing myself to spend six or more hours at the keyboard five days a week (and then using my days off to write blogs and work on my novel). It’s exhausting. But at least I’m still in my jammies and ready to go to bed afterward.

And I’ve learned a few things. One is “Never volunteer.” Often the company has extra work with even tighter deadlines that pay more per minute and are up for grabs. I made the mistake of grabbing a couple. It nearly did me in, combined with my regular work. (I did get an Amazon gift card for working on the Fourth of July.) Full-time work is hard enough. Full-time plus is a meat-grinder, or I should say a me-grinder.

So now for the big question – did I disclose my bipolar disorder?

I did not. As long as could do the work, it didn’t seem relevant. Work-at-home is not the sort of gig where they make accommodations or modifications for those with disabilities. And if I can keep up my stability and relative mental health, and get time off for doctor’s appointments, my mental status shouldn’t be relevant.

But I’m thinking I may have to cut back to four days a week. Five days is running me ragged. And then in December, when I retire, I can give it up altogether or work only a couple of days a week.

I will have a fixed income, which has both good and bad points, but at least it will lift from me the crushing anxiety of “Will we make the mortgage this month?” (I never was able to get disability.)

So, for now at least, and for the next few months, I will be working full- or almost full-time, if only my bipolar disorder will let me.

Wish me luck.

(Full disclosure: That photo is not an actual representation of my writing space. Mine is littered with legal pads, stuffed animals, Kleenex, and water bottles.)

Category:

mental health

Tagged with:

Forgiving and Forgetting

man standing on riverbank

Photo by Pixabay on Pexels.com

Forgive and forget. That’s the saying.

To err is human; to forgive, divine. That’s another saying.

But what about when you can’t forget and can’t forgive? When you’re human, not divine?

Forgiveness is a tough subject for me, because there are things I can’t forget, despite the fact that either my bipolar disorder or my meds have made my memory spotty at best. But there are things I remember too well. And some of those I can’t forgive.

I can’t forgive the person who called my mother a murderer because she had her sick, ancient little dog euthanized. And then kept rubbing her face in it by saying she did not support my mother’s actions. This person caused my mother unnecessary pain when what she needed were understanding and comfort. By those criteria, I am a murderer too. A person that toxic is someone I don’t need in my life.

And maybe that’s wrong of me, but it was my decision.

Another person I can’t forget or forgive is my gaslighter, Rex, about whom I’ve written before (see https://wp.me/p4e9Hv-pm, https://wp.me/p4e9Hv-dR, https://wp.me/p4e9Hv-4t). In one of those posts I said, of forgiving and forgetting:

I can’t do either. The memories have faded over time and seldom give me flashbacks anymore. (The dreams still come.) As for forgiving? He’s never asked for it and never would. I’m sure he doesn’t think he did anything that needed forgiving….

That emotional abuse happened, and I can’t forget it. It was my first serious relationship and I left chunks of my soul and most of my barely existent self-esteem in that house on the hilltop. I had failed – at the relationship, at meeting my parents’ expectations, at so many things. I felt I was the one who needed forgiveness and spent much of the following years repeating incessantly, “I’m sorry.”

I once encountered a Christian who said that the essence of forgiveness was to “fore-give,” to give someone something before they ask for it, as in Jesus, fore-giving his life for His followers. Or giving a homeless person your coat before they ask for it.

I’ve since been told that that’s an inaccurate reading of the word “forgive.” But at the time it stuck with me and influenced my thinking. If that was forgiveness, I didn’t understand it and couldn’t accomplish it. Something to do with that “to forgive, divine” thing.

I couldn’t fore-give my mother’s pain. I surely wouldn’t have given it to her myself and I couldn’t fore-give that other person the right or the opportunity to do so.

I couldn’t fore-give Rex my pain. I gave him enough of my life – over a year – as well as some of my hopes and dreams and aspirations. And yes, at the time, my love.

I’ve thought about writing him a letter, the kind that therapists often suggest you write as an exercise in exploring your feelings, explaining what went on from my point of view. But I haven’t – not even the kind that you don’t mail.

It would be futile. I’ve written about the person and the pain here in these posts and it hasn’t done a thing toward making me forget or forgive. Far from forgetting, I sometimes need to remind myself of the pain – to affirm to myself that yes, it really was that awful and to warn myself never to get caught in a situation like that again.

I don’t go through my life holding grudges against everyone who has ever wronged me (or my mother). Everyday hurts – unless they come every day – are possible to let go of. I’ve mostly forgotten the kids who bullied me in school. And I’ve forgiven them. They were kids and didn’t know any better. I’ve forgiven friends who have cut me out of their lives because they couldn’t handle my bipolar symptoms. Sometimes I can’t handle the symptoms either. If I get fed up with my disorder, it’s easy to see how someone else could too.

I’m not going to give you any advice on forgiveness and whether you should forgive or not. The topic is too complex and I don’t know how or why you’ve been wronged.

All I’m going to say is to be a little easy on yourself if you find you can’t forgive what you can’t forget. Those sayings about forgiveness are guidelines, not laws, and your situation may not fit into those guidelines. Just know that I do understand.

Category:

mental health

Tagged with:

Realistic Self-Care

woman in white long sleeved shirt holding white ceramic mug

I hate articles about self-care for mental illness such as the one I saw recently that said:

…[W]ays I practice self-care include swimming and Pilates, getting regular massages, spending time with friends and family, since staying connected is an essential part of emotional health at every age, watching TV, and seeing movies. I also love going for walks, especially near Santa Monica beach, and reading or listening to books.

If I could do all those things, I wouldn’t need self-care! When I’m depressed or anxious, I cannot make myself swim or exercise, or even get out of bed and shower at times, which lets out going to the movies and spending time with friends, too. I can maybe read a book or listen to a podcast if I’m not too twitchy and if my attention span and concentration will cooperate. And I can sit on the sofa and watch TV, but that feels like uselessness, not self-care.

Plus, guess what? A lot of those activities cost money.  Massages, movies, exercise classes (for which you need exercise clothes), and swimming (for which you need a swimsuit) would all require “shopping therapy,” which I loathe IRL and can’t afford online.

I personally would love a massage, but that’s not self-care for everyone. As Emily Roberts points out in “Self-Care for Mental Health: Find Ways That Work for You”:

The myth of a massage as an essential self-care activity – or anything that makes you more anxious – isn’t helpful for your mental health. I didn’t listen to my body the first time I booked a massage and guess what? It was so triggering to my body I couldn’t even finish it….I started to cry and couldn’t compose myself 10 minutes into the appointment. I was embarrassed and confused. I thought, “This stuff works for all the people in the magazines. What is wrong with me?”

I decided that booking an extra appointment with my therapist and having a date with my best friend was more helpful as self-care for my mental health than pushing myself to practice self-care in the way the media was telling me to.

One person’s mani-pedi can be another’s nightmare. I much prefer small ideas for self-care rather than big expeditions or splurges. For me, comfort food is one form of self-care. It has to be something I can make easily, though, like frozen mashed potatoes, mac-n-cheese, or French bread pizzas. (The microwave is my friend.)

Of course, these comforts require a little planning when I’m not overwhelmed to the point that I need self-care to restore me. I must think ahead, during those times when I’m able to go to the store, to bring home the foods that are easy to make yet soothing.

Another self-care technique I came across is definitely more my speed. Caiti Gearsbeck, in “Make Your Own Mental Health Self Care Kit” offers a simple, DIY alternative. She recommends filling a shoebox or other box with soothing things that appeal to all five senses, plus a few activities. Here are a few of her examples:

Sight: photos, cards, and letters

Smell: essential oils or candles

Taste: chocolate or tea

Sound: meditation CD or an mp3 player with a playlist

Touch: soft cloth or stuffed animal, stress ball or fidget cube

Activities: coloring books and pencils, a journal, a favorite movie

She adds: Whatever works for you!

For me, that box would contain photos, Irish Spring soap, oolong tea, an mp3 player, a stuffed animal (I have lots to choose from), and a CD of The Mikado. I’d need a cat in the box, too. But given the nature of cats, there would probably be one in there anyway, whether I wanted it or not. All of that is stuff I have around the house, unless I’m out of Irish Spring or oolong. Add a quiet room like the bedroom or my study and I’m all set. At least until I can afford a massage.

References

https://blogs.psychcentral.com/millennial/2017/10/make-your-own-mental-health-self-care-kit/

https://www.jwi.org/articles/mental-health-and-self-care

https://www.healthyplace.com/blogs/buildingselfesteem/2018/5/self-care-for-mental-health-find-ways-that-work-for-you

Category:

mental health

Tagged with:

The Compliant Patient

My mother was not a compliant patient. She would have side effects from medication and just stop taking them: The meds gave her sores in her mouth or nauseated her.  And that’s valid. We’ve all had medications that we couldn’t tolerate because of the side effects. But Mom stopped taking them without telling her doctor. Once she went to the emergency room, where they had a list of the meds she was supposedly still on and I had to tell intake, “No, she stopped taking that one. And that one too, I think.” (She was not mentally ill, but that’s where I’m going with this.)

There is only one psychotropic medication I know of (though there may be others by now that I haven’t heard about), where the potential side effects are so horrible – potentially lethal – that patients are advised to stop taking them immediately and get medical help right away.  The side effect is called Stevens-Johnson Syndrome and it is a potentially fatal rash.  I wrote about it a few years ago, (https://wp.me/p4e9Hv-1g)

Other than that one instance, psychotropic medications should never be discontinued unless you have consulted your physician. You never know what withdrawal symptoms lie in wait for you, but they’re bound to be unpleasant, even if they don’t cause you to relapse, which could easily happen. Withdrawal from any drug is not fun; it’s to be avoided.

Nonetheless, I read posts in support groups all the time which say that people have decided by themselves to stop taking a medication, or even all their medications on their own. I have friends who have taken their treatment into their own hands this way.

There are several reasons they sometimes give for giving up medications. One is that the meds aren’t working. What they really mean is that the meds aren’t working yet. Many psychotropics don’t show positive effects until they have built up in your bloodstream, which can easily take four to six weeks. Expecting results in a day or two is unreasonable.

Others stop taking their meds because they “feel better” and think they no longer need the pills. This is just ridiculous. The meds are the reason that you feel better. Your psychiatric condition does not just go away, like the flu, when you feel better. Your disorder may soon come roaring back (or creeping back). And the thing is, when you restart a medication, it sometimes no longer works as effectively. Then you have to start all over with a new prescription and have another four to six weeks of symptoms while you wait to find out if it works or doesn’t.

Still other people simply don’t like taking medications.  This I don’t understand.  People take meds for flu and infections and such conditions and never seem to resent them. Maybe it’s the idea that you could well be – will likely be – on psychotropics for the rest of your life. But lots of people have meds they need for life – insulin, cholesterol meds, anti-inflammatories, asthma meds, thyroid meds, and others. People don’t quit taking those just because they don’t like to take pills or injections.

I think the real reason people don’t like to take their psychiatric meds is that they’re psychiatric meds. There is still massive stigma around the subject of mental illness. Taking medication for a mental illness means admitting you have one, which some people are reluctant to do.

Or they may be giving in to “pill-shaming.” There are plenty of people, perhaps in your own family – and certainly across the Internet – who will tell you that all you need is self-love or affirmations or sunshine or exercise or vitamins or meditation or willpower to banish your mental illness. Funny how they never tell people that sunshine will cure their broken leg or that exercise will cure their breast cancer.

I hesitate to say that I love my psychotropics, but in a way I do. They have brought me out of states of mind that were harmful to me. They have made it possible for me to function and create and communicate. They probably have saved my life.

Occasionally I let my psychiatrist know that I may need a change in dosage or that one of meds is no longer working. I’ve even reviewed with him whether there are any meds I could quit taking (there aren’t at the moment). But I keep taking them faithfully, every day, morning and night.

I need the psychotropics. So I am a compliant patient.

Category:

mental health

Tagged with: