Bipolar 2 From Inside and Out

Posts tagged ‘public perception’

Would You Try Electroshock?

Photo by Mike T

In the course of dealing with my bipolar disorder, I had a near brush with electroshock. I managed to avoid it, but I did give it serious thought.

Now 60 Minutes has come out with a piece called “Is Shock Therapy Making a Comeback?” You can see the segment here: 60 Minutes.

ECT(electroconvulsive therapy, the modern name for the procedure), which is often done on an outpatient basis, works by inducing a brief seizure in a patient. The seizure, which lasts about a minute, releases multiple neurotransmitters in the brain, all at once. The patient is required to have someone to transport them to and from the appointment. Treatments are typically applied one or two times per week for 6-8 weeks.

In a brief article excerpted from the news show segment, Dr. Charlie Welch, of McLean Psychiatric Hospital, explains how ECT differs from how it was performed in the past: “What’s different first of all is that it’s done under general anesthesia with a muscle relaxant. So when the treatment is done, the patient is sound asleep and completely relaxed.” Call it a kinder, gentler shock treatment.

That was the procedure that my psychiatrist offered me after he had spent a number of years trying me on various medications that either didn’t work, or helped only partially.

My immediate reaction was negative. I recall thinking, “Fuck, NO! Keep away from my brain, you Nazi sadist!” After I calmed down a bit, I did some research.

ECT, my sources said, was a long way from the cruel, stigmatizing procedure portrayed in One Flew Over the Cuckoo’s Nest. The Internet was little help, though. The opinions and experiences of people who had undergone electroshock ranged from “It was hideous” to “It was a miracle.”

Truthfully, I was appalled by the notion of electrical jolts surging through my brain. My precious brain, which had both sustained me and betrayed me throughout my life.

Then I thought some more. So ECT sometimes causes memory loss. I already had that, thanks to some of my meds. I would be altering my brain with electricity. But hadn’t I been altering it for years with chemicals – medications that no one seemed to know how they worked?

So I went back to my doctor and said I would at least talk to the doctor who would perform the procedure. And I lined up a journalist friend to write about my experiences if her editor approved. (Note: In the 60 Minutes piece, former Massachusetts First Lady Kitty Dukakis gave permission to have her treatment filmed and broadcast.)

My psychiatrist, however, had one more medication that he wanted me to try before we took that next step. And it worked. So much for electroshock.

Now as to that side effect of memory loss – Dr. Sarah Lisanby of the National Institute of Mental Health in Maryland has developed a new treatment that seems to avoid that particular consequence.

The procedure is called Magnetic Seizure Therapy (MST) and it uses magnets (duh!) to stimulate more precisely focused seizures than ECT does. These focused seizures seem to avoid the parts of the brain associated with memories. As Dr. Lisanby told the 60 Minutes reporters, “For some people, ECT may still be needed. But if Magnetic Seizure Therapy could be effective without the memory loss who wouldn’t want to try that first?”

Would I try MST if I relapsed into treatment-resistant depression? I would certainly consider it, if it were out of the testing stage by then. And I’d do that before I signed up for ECT. While I have memories I’d prefer to forget, with my luck, those would be the ones left unaffected.

The cynical side of me says that these seizure-causing therapies are becoming more popular because insurance companies like the notion of a short course of 6-8 weeks of treatment instead of years of talk-and-medication. (Although Kitty Dukakis said that she has done ECT for years now and expects to continue into the foreseeable future.)

But I could be wrong. It is possible that some kind of treatment could be short in length but longer-lasting in effectiveness. I’m not ruling it out. At this point I’m not ruling out anything that could aid in my progress and my healing.

 

Category:

mental health

Tagged with:

Mental Illness and Gun Violence

photo by Thomas Hawk

There’s been a lot of talk lately that not allowing the mentally ill to own guns would curb the trend of gun violence in the U.S. There are just a few things wrong with that theory.

Are background checks the answer? They aren’t. Such checks at certified gun dealers screen out only the very few who have been hospitalized for mental illness – involuntarily committed, that is, not just referred for a 72-hour hold for observation or self-referred. That’s only a very small portion of those with mental illnesses. Most people with mental disorders are never hospitalized and some never receive any diagnosis or treatment from a psychiatrist, psychologist, or another counselor, which means that background checks would never turn them up. And there are loopholes in many states’ versions of background checks that, for example, allow private sales of guns without them.

To take this to the next level of absurdity, it would be a severe breach of confidentiality if therapists had to report every client to a database somewhere, just in case, and would lead to fewer people being treated for mental health issues, for fear of being put on a registry that might be used for any purpose eventually, even employment. Gun owners don’t want to be on a nebulous registry “somewhere,” and neither do the mentally ill.

Can psychiatrists and other counselors report to the authorities clients they fear may become violent? Again, laws differ from state to state. Usually, the question comes up only when a client makes specific threats against a specific person or a government official. The therapist must make a judgment about whether the client is a danger to self and others, which could result in a 72-hour hold, and may of course be correct or incorrect. A client with generalized anger issues is probably not mandated to be reported.

And to whom and for what purpose would the person be reported? To the police, when no crime has been committed? Is a therapist’s report of a client’s report of feeling angry enough to shoot “someone” sufficient to justify a search warrant of the person’s house for a legally owned firearm?

Are mentally ill people more likely to be violent than other people? No. In fact, mentally ill people are much more likely to be the victims of violence than they are to be perpetrators. But no matter how many times we say that, few listen or believe it. Some mentally ill people turn violence – and guns –against themselves. Some are killed by police officers with no training in handling confrontations with differently abled people, including the mentally disordered.

Not only are mentally ill people more likely to be accused of violence, violent people are more likely to be accused of being mentally ill. That’s practically the first thing anyone says after a mass shooting – “Oh, he must be crazy” (or on psychotropic medications). Of course, with one in four adults being likely to experience some form of mental distress in their lifetimes, it is possible that a shooter is one of those people.

But newscasters and politicians and people on the street are, by and large, not psychiatrists or psychologists. They are no more able to diagnose mental illness than burger-flippers, dairy farmers, lawyers, or business executives. Not that that stops them. Mental diagnoses are flung about indiscriminately nowadays, from people who call themselves OCD because they straighten pictures to psychiatrists who claim to diagnose public figures without having spoken to them once, much less having developed a therapeutic relationship with them.

But can’t potential violence be predicted? No. It can’t. The prison system can’t do it, or there wouldn’t be so many parolees and probationers and those who have served their time who go right back to crime and violence. Mandatory sentencing laws and the political climate have reduced the problem in some areas, but there are still plenty of cases in which the system fails. At trials and parole hearings and sentencing hearings, there is always someone – doctor or lawyer or family member – to say that the offender will not offend again.

But the only known predictor of violence is past violence. That’s why some people think it’s more sensible to restrict the gun ownership rights of domestic abusers rather than someone mentally ill who has no record of violence.

Can’t mentally ill people who’ve proven to be violent be required not to own guns? Theoretically yes, but we know how well it works to tell people on probation who have no record of mental illness that they can’t own guns, drink liquor, or associate with known criminals. The probation system is too understaffed to enforce these requirements already. Who would be willing – or should have the responsibility – to check up on everyone, even the small proportion of the mentally ill who have been involuntarily committed or convicted and then released, and make sure they don’t acquire any guns? If the parole and probation people can’t handle the caseload they already have, why would we think that mental health professionals have any more time, capacity, training, or know-how to do it?

Would banning guns prevent gun violence by the mentally ill? In a word, no. There are already too many guns in circulation in this country for that to be possible, and those guns are too easy to get. And again, there would still be the problems of determining who is mentally ill, by whose definition, and how such a gun ban could be enforced.

So, I hear you asking, you’ve told us all the things that won’t work. Is there anything that will?

Not if you think that the problem of gun violence and the problem of treating the mentally ill overlap. Gun violence is one topic and the mental health system is another. There is a lot that can be said about fixing one or the other, but nothing that would solve both at once.

Not that a lot is being done now, unless you count blaming, finger-pointing, and spreading stigma.

 

For more discussion on the topic, see http://www.amhca.org/blogs/joel-miller/2017/10/03/gun-violence-and-mental-illnessmyths-and-evidence-based-facts from the American Mental Health Counselors Association.

Category:

mental health

Tagged with:

On Pain and/or Suffering

Recently, when I was reading Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis by Lisa Sanders, I came across this:

Eric Cassell, a physician who writes frequently about the moral dimensions of medicine, argues, in a now classic paper, that pain and suffering are very different. Pain, according to Cassell, is an affliction of the body. Suffering is an affliction of the self. Suffering, writes Cassell, is a specific state of distress that occurs when the intactness or integrity of the person is threatened or disrupted.

Later, when I was reading M Is for Malice, by Sue Grafton, I read this: “Pain was better than anxiety any day of the week and sweat was better than depression.”

The universe seemed to be telling me to focus my attention on pain and/or suffering.

Cassell (as quoted by Sanders), could have been (but probably wasn’t) talking about bipolar disorder when he defined suffering as “a specific state of distress that occurs when the intactness or integrity of the person is threatened or disrupted.” I certainly don’t feel intact or integrated while in the midst of a bipolar episode – either hypomanic or depressive. I suffer. My personhood is certainly threatened and disrupted.

It’s common to hear bipolar described this way: “I suffer from bipolar disorder.” I prefer to say “I live with bipolar disorder,” which I feel is more accurate. It’s always there, but I’m not always suffering. I live with it and it lives with me.

I think Cassell was wrong, though, about pain being a purely bodily sensation. I addressed the concept back in the early days of this blog. with a post called “Depression Hurts” (https://wp.me/p4e9Hv-6Z). In it I claimed that bipolar (or depression specifically) caused physical pain as well as emotional pain. I still maintain that one is as valid as the other and that they are virtually inseparable. The mind and the body not being entirely separate, or separable, you see. You get both for the price of one.

Grafton, on the other hand, through her character Kinsey Millhone, was talking about the physical act of running. We all know by now (or should) that exercise is recommended for those who have bipolar disorder or other mental/emotional conditions. But again, there is this idea that physical discomforts (pain and sweat) are better than emotional distress (anxiety and depression). She seems to be saying that pain is the antidote for suffering.

This can be dangerous territory. As someone who used to self-harm, I can easily see how one might think that pain is preferable to anxiety, or numbness, or dissociation – to suffering, that is. But in such cases, pain is really just another aspect of suffering, expressed in bodily terms. Again, the two are inextricably intertwined.

Personally, I would be delighted to avoid all four sensations – pain, anxiety, sweat, and depression. But I don’t think that’s possible, even with avoiding both exercise and self-harm. Sweat is the easiest to dispense with, thanks to modern toiletries, but there have been plenty of times when my anxiety has caused me to sweat. Think about being summoned to a tax audit, for instance, and you’ll see what I mean. Pain is unavoidable; no one goes through life without stepping on a nail or some such. Anxiety and depression occur at least occasionally in the neurotypical as well as the mentally disordered.

The human condition itself involves feeling both pain and suffering. Bipolar disorder involves both pain and suffering. Well, what do you know? We’re only human, after all.

Category:

mental health

Tagged with:

Do I Disclose or Don’t I?

As I’ve mentioned before (even on my other blog https://wp.me/p4e9wS-zY), I’m running low on money and clients in my freelancing business. Therefore, I’ve taken up searching job ads online for part-time, work-from-home gigs. (So far, Indeed is the only service that has presented me with reasonable options. I sometimes apply for as many as three a day.)

It’s filling out the applications that has me stumped. Oh, I’ve got a fine resume – one on Indeed and another file I can send to jobs not listed with Indeed. I can write a decent cover letter. If there are editing or writing tests, I can handle them too. I have way more education and experience than I need, but I explain in the cover letter that part-time, contract, or freelance work is what I really want at this time in my life.

Then come the other questions that many ask.

Am I a veteran? No.

Am I a U.S. citizen or do I have the necessary documents to work in the U.S.? Yes.

Is English my first language? Yes.

Am I male or female? Yes.

What race do I identify with? Yes.

(Those aren’t really yes/no questions and are usually marked as optional, but I answer them anyway.)

Then comes the real stumper. Am I disabled? Well, that depends.

Most of the application forms state that they abide by EEOC regulations. Some of them even have a handy list of what are considered disabling conditions – and bipolar is one.

So. Do I take them at their word and believe that they do abide by EEOC regulations, in which case I can reveal my bipolar condition without penalty. In fact, if the company is trying to prove to someone that they are abiding by those regulations, the answer is probably yes, I should.

But we all know that such questions, while well-meaning on the surface, may actually be used to screen out disabled candidates. So perhaps I should answer no.

The deal with the regulations is that employers must offer “reasonable accommodations” to let disabled employees do their jobs, unless the accommodations for that condition are not feasible because of expense or other reasons.

So, as a person with bipolar disorder, what actual accommodations would I need?

The main ones I would need are the ability to work remotely, from home, and to have flex time. Those cost an employer nothing, usually.

And those are precisely the kinds of jobs I am applying for – work-remotely jobs in which you can make your own hours, or at least partially.

So when it comes to “The Question,” I have been answering “yes.” For the purposes of work, I am at least partially disabled by my bipolar condition. I cannot work full time. I have trouble working in a bustling office with lots of people around. I need flex-time to work around my symptoms. (I can still meet deadlines, though.)

Funny, but the forms don’t have spaces or yes/no questions on those subjects.

I have considered the idea that I am doing this all wrong. That I should not disclose my bipolar disorder until I have the job (and for those who don’t ask the question, that’s what I’ll have to do). That after I have the job is when I should discuss accommodations.

But dammit, all evidence to the contrary, I am a cock-eyed optimist. Those EEOC rules are there for a reason and I am that reason. I know that when most employers think “disability,” they think “wheelchair” or “impaired hearing.” But there it is, listed right among the possible disabling conditions – bipolar.

So far I’ve gotten a few form rejection letters and mostly a resounding silence. And in the meantime I’ve been scrambling for other clients and other assignments.

But I hope the day will come when just one of my potential employers means what it says about disabilities.

Category:

mental health

Tagged with:

Why I Hate TV Drug Commercials

Just as a general rule, I dislike commercials for any drugs. They impede the doctor/patient relationship. (I’ve often considered saying to my doctor, “I’m supposed to ask you if Latuda, Humira, Prolia, Viberzi, Lunesta, Cialis, Trulia, Trintellix, Keytruda, and Boniva are right for me.”) TV – and to a lesser extent print – ads encourage people to act as unpaid drug reps. And they only advertise expensive drugs until they go generic, which is when they stop being expensive and the drug companies stop making so much money.

(If you want to read more on the issue, go to https://www.medicinenet.com/script/main/art.asp?articlekey=106198.)

But there are other things about TV drug ads that make me more than a little cranky. Like where are the ads for drugs to treat bipolar disorder?

Oh, there are ads for drugs to treat bipolar depression, as well as ones for treating non-bipolar depression. You’d think that with approximately 2.8 million people who have bipolar in the U.S. and Canada (http://www.pendulum.org/bpfacts.html), there would be a market for bipolar treatments.

Also, the ads for depression treatments don’t always get it right. A few of them say that depression is more than just sadness, or that it lasts for several weeks at least. One even says that depression is a “tangle” of symptoms, which is certainly true. (Although the tangle is shown graphically in primary red, yellow, and blue, which don’t really say “depression” to me.)

Most, however, treat depression simplistically, with hidden depression represented by a smiley face mask hiding a frowny face mask. (The colors in that ad are muted during the “before” scenes and more vibrant during the “after” scenes, which is an old advertising trick.)

The ads also make it look like the most important thing about depression is not spending time with your family or not enjoying it if you do. While that certainly is one symptom of depression, it is by-and-large irrelevant to people like me, who don’t have 2.1 school-age children to take on picnics. And it’s pretty much a guilt trip for people who do.

Then there’s how the people in the ads are represented. Oh, they almost always show one POC and one slightly older person (frolicking with the grandkids). But all of them are attractive. All of them are models. Are we supposed to identify with them? Or just expect to look like them when our depression lifts?

I wouldn’t be so annoyed by this issue if it weren’t that ads for other kinds of drugs – those for psoriasis and diabetes, for example – have actual people with the disorder in them. Testimonials from those who’ve been there, as it were. Even real-life cancer patients are now featured in ads for treatment centers.

What’s up with that, I wonder? Surely they don’t imagine that only pretty people get depression or bipolar. It can’t be that they can’t find any well-spoken, real-life people who can relate their own experiences. I for one would feel more reassured if I heard about a treatment from someone who’s lived with the disorder instead of from someone selected at a casting call. Are we all homely and illiterate? (I meet the qualification for literacy, at any rate.)

Instead of trying to convince us what medications our doctors might prescribe us, the airtime would be better spent on ads that educated the public on depression and bipolar disorder. But those would be PSAs, of course, appear only at 3:00 a.m., and not make anyone any money.

Update: I have finally seen an ad for a drug to treat bipolar 1 mania. Everything else I wrote here remains the same.

 

Category:

mental health

Tagged with:

“Lock Up the Crazies Before They Hurt Someone”

Mass shootings and the public reactions to them are pretty predictable among the mental illness community.

One thing you hear after every mass shooting – and after many smaller ones – is that the mentally ill should not have access to guns.

Fine. But I have bipolar disorder, as well as some guns that I inherited from my father. I occasionally go to a gun range and fire them, but not often since I’m not the gun aficionado my father was.

So what am I supposed to do? Sell the guns? Give them away? Turn them in to the police? My therapist? I was taught gun safety from a young age by two certified pistol and rifle instructors (my parents) long before I received my diagnosis.

The further you go into the debate about guns and the mentally ill, or about whether the mentally ill are a danger, the deeper you get into fundamental constitutional, legal, and medical issues, as well as considerations of simple practicality.

Some advocate locking up the mentally ill. This is irrational. What the proponents really mean is “Lock up the dangerous mentally ill before they become mass shooters.” And that is impossible.

First, there’s the matter of due process, which is as much a part of the Bill of Rights as the vaunted Second Amendment is. You can’t just lock people up without a trial or at least a hearing.

Second, there’s no way to determine whether a mentally ill person is likely to become a mass shooter or any other kind of danger. The only generally known predictor of violent behavior is past violent behavior. In fact, there’s no way to tell whether any given individual is going to become a mass shooter. That’s because it’s really hard to predict the future.

Third, there’s the consideration of medical decisions and the right to privacy. HIPPAA has gone a long way toward protecting the privacy of patients – including the mentally ill. At the moment, a mentally ill person can only be held for 72 hrs., and then only if the person goes to the hospital voluntarily or is determined to be a danger to self and others. That’s a high standard, and it should be.

Fourth, the mental health system is already understaffed, underfunded, and overwhelmed. There are long waiting lists for beds in hospitals and treatment facilities. Are we to build new asylums to accommodate all these supposedly dangerous persons? Train more counselors to treat them? Or just lock them up and get them out of sight, out of mind?

Fifth, the idea that mentally ill persons can be forced to accept treatment and take their medication as prescribed violates several basic rights. My mother, who was not mentally ill, hardly ever took her medications as prescribed. She would quit taking one after a few days “because it wasn’t helping” or “it caused sores in her mouth” – without telling her doctor. Should she have had a caregiver to monitor her compliance? Who would monitor all those potentially noncompliant mentally ill persons as they take their psychotropic drugs? I see, we’re back to putting them in asylums.

Besides, refusing treatment is a right that patients have – even mental patients. Physically ill patients, for example, can choose to forgo chemotherapy or dialysis or medications that cause side effects worse than the condition they’re prescribed for. And mental patients have the same right. They can stop taking a medication because they fear side effects like tardive dyskinesia or even weight gain, though we hope they consult their doctors first.

But forced treatment and forced medication, as some have suggested, brings us back to the question of who, how, and where. Asylums? Court-ordered treatment? Medications that must be taken in the presence of a doctor or a therapist (who is not qualified or licensed to dispense medication)?

Take all those arguments against forced treatment of the mentally ill and add the fact that the mentally ill are far more likely to be victims of violence than perpetrators of it, and where are we? Admittedly, the mental health “system” is broken, or at least badly fractured. But is the answer really to take away the civil rights of people who have broken no laws?

The press and the public are quick to focus on the mentally ill as the culprits in mass shootings. But even if they were correct, taking away fundamental rights would not only be no real solution, but would chip away at the rights of other disenfranchised or minority populations – the homeless, for example.

If there’s a solution to this problem, I don’t know it, but locking up the “crazies” isn’t it.

 

If you want to read more on both sides of the issue, see the L.A. Times article by Paloma Esquivel at http://www.latimes.com/local/la-me-adv-lauras-law-20140310-story.html.

Category:

mental health

Tagged with:

Gaslighting and Bipolar Disorder: A Follow-Up

Over a year ago, I wrote about gaslighting and bipolar disorder (https://wp.me/p4e9Hv-pm). In my post I said:

[W]hat does gaslighting have to do with bipolar disorder? Someone who is in the depressive phase of bipolar – especially one who is undiagnosed – is especially susceptible to gaslighting. The very nature of depression leaves a person wondering, “Am I insane?” To have another person reinforcing that only strengthens the idea.

Since then, gaslighting has become a hot topic, appearing all over the Web, so I thought I’d write about it again.

The essence of gaslighting is that someone denies your reality and substitutes his own. (Gaslighters are mostly – though not exclusively – men.)

What I believe is driving the interest in gaslighting is the “#MeToo” movement. Women everywhere are speaking up about incidents of sexual harassment, sexual abuse, sexual assault, and even rape that they had not spoken of before. Or that they had spoken of but not been believed.

In many of these cases, gaslighting was involved. The women say, “This happened.” The men say, “It was a joke/flirting/a compliment/not that big a deal/consensual.” Until now men have denied the women’s perception of abusive reality and substituted their own innocent explanation. And, for the most part, the men’s reality has been accepted. Again and again.

Some of the high and mighty have recently been brought low by revelations of misconduct. The more we hear, the more it seems that men who achieve prominence in any field see women and especially their bodies as just another perk – like a company car or a key to the executive washroom. An audience for a dick pic. A pussy to grab.

Those are the cases that make the news. But the problem goes all the way down to the least prestigious situations. Any male in a position of power over a woman has the opportunity to exploit that relationship. Many are decent men and don’t. But many – from your local McDonald’s manager to the city bus driver to the head janitor – do. That’s millions of men and millions of women, the gaslighters and the gaslit.

Again, why discuss this in a bipolar blog? Because the very nature of our disorder makes us a little unsure of reality anyway. Perhaps this is mania and my boss is complimenting me because I really am sexually appealing. Perhaps this is depression and I deserve the degrading thing that just happened to me. Perhaps this is somewhere in between and I can’t guess what’s what.

A person unsure of her emotions is more likely to take the “bait” that the gaslighter dangles. A person unsure of her reality is more likely to accept someone else’s definition of it.

The #MeToo movement is empowering. It allows women to bring into the light the shameful things that have been hidden away. And it gives the bipolar person a more objective standard against which to measure reality. “That happened to me too! I was right that it was inappropriate!” “I saw that happen to my friend. Next time I’ll be strong enough to speak up!” “I see what’s happening. I’ll teach my daughter not to put up with that behavior. And my son not to do it.”

And it says to the bipolar person, “You have an objective reality outside your moods. You can trust your perceptions on these matters. You too have a right to live without these insults, these aggressions, this gaslighting. You can trust your feelings when you perceive that someone has stepped over that line.”

We have bipolar disorder. We are not the disorder. And it does not rule every aspect of our lives. When we perceive a situation as unprofessional, harmful, insulting, degrading, we can say so – and deserve to be believed. Just because we have a mental disorder does not make us any less worthy of decent, respectful treatment by the men in our lives, whether they be boyfriends, husbands, fathers, employers, or supervisors.

We have enough problems in our lives. We shouldn’t have to deal with gaslighting too.

 

 

Category:

mental health

Tagged with:

Does It Help When Celebrities Talk About Mental Illness?

It usually doesn’t hurt.

But how much does it help?

That depends on who is talking about mental illness and what they say.

Celebrity Activists

We need more mental health advocates like actors Carrie Fisher and Glenn Close. Both of them have spent years talking about their own and their loved ones’ experiences with bipolar disorder and schizophrenia. Neither one is a one-benefit-and-they’re-gone supporter. They repeat their vital messages again and again, in different ways, in different venues, in different words. Carrie Fisher, in particular, used her mega-star power and witty personality to keep the discussion alive and spread it to millions of people.

Active Celebrities

While not devoting as much time and attention to mental health activism as Fisher and Close, other well-known entertainers including Demi Lovato and Lady Gaga have made contributions to the public discussion on various mental illnesses. Because of their large number of fans, these messages reach millions of people. And their music reaches people at an emotional level that PSAs just can’t. If even a small percentage of their audiences pays attention to the messages, that’s a lot.

And we can’t forget Prince Harry. Positive messages about mental health coming from royalty are ones that people will listen to. (You know how we Americans love royals.)

Celebrities

Other celebrities mention their mental health diagnoses in public, but do little more to campaign for mental health causes. Catherine Zeta-Jones spoke of her bipolar II diagnosis when she was hospitalized for five days, saying that it was brought on by stress. And renowned glass artist Dale Chihuly admitted his bipolar disorder when he was more or less forced to by a lawsuit.

Staying quiet certainly is their right. Mental illness is a deeply personal and to many, a private thing. And celebrities as much as any of us must struggle with when and how and to whom to reveal their struggles. Perhaps in the future they may become more comfortable talking about their problems and contributing to mental health causes and organizations.

Suicides

Unfortunately, suicides speak loudly. Robin Williams’s death by suicide made a big impression. It got people talking – if only to ask “why?” Though a lot of the conversation revolved around “Even funny people can have suicidal depression,” that’s a start on the message that you can’t tell who’s suffering inside just by looking at them. It’s just too bad that the death of a beloved entertainer is needed to start that discussion.

Media

Are the media “celebrities”? A few individuals truly are, But as a group, the media have the largest platform of all. And what do they say about mental health? I think you know the answer. Mental health gets discussed in the news media in cases of terror and tragedy, and when no other explanation comes readily to mind.

The media bear a huge responsibility when it comes to stigmatizing mental illness. Theirs are the only messages that many people hear – and believe. The news media have (or at least used to have) a reputation for spreading the truth. Nowadays we can’t even count on that. The splintering of the news media into “sides” to promote opposing ideologies – combined with shrinking budgets that have nearly eliminated informed science reporting – make it difficult for the average news consumer to know who and what to believe.

Who does that leave to spread the message? Us. Those of us who live with mental illness or have loved ones who do. And sometimes I worry that we are talking mostly to ourselves – to each other. Don’t get me wrong. Those conversations are vital in helping one another deal with our difficulties and sharing messages of support and understanding.

But maybe we can do more – even if it’s educating a family member about depression or wearing a semicolon tattoo to promote suicide prevention or posting/commenting on social media when a news outlet has gotten its coverage of mental illness all wrong.

Among my fondest hopes is that one or more of my blog posts will be passed along to someone who needs to hear the word. “Here – read this,” is a message I would be proud to spread, even though I’m no Carrie Fisher.

Category:

mental health

Tagged with:

The Latest Headlines on Mental Illness

There’s a wonderful article, originally in The Telegraph, with the title “Can Depression Be Treated With Anti-Inflammatory Drugs?” Snopes.com, the preeminent debunker of all things dubious, proceeded to do what they do best – debunk. In their analysis, they find several factors common to many widely reported studies that illustrate why we shouldn’t take these announcements of causes or cures at face value or at least without a grain of salt.

They break down their reasons for not jumping on the study’s bandwagon into three major categories.

No Credible Scientists Have Argued that All Depression is Caused by Inflammation. The article in The Telegraph was talking about patients with Major Depressive Disorder (MDD) who were not responding to current medication, or who also had other inflammatory-related conditions such as rheumatoid arthritis (RA). And the information came from just one talk by just one scientist,

Association is Not Evidence of Causation. I’ve written on the subject before (http://wp.me/p4e9Hv-7Z, http://wp.me/p4e9Hv-9L), and included a link to a short video that explains the scientific process, from original study up to the time when a new drug or treatment hits the market (http://www.vocativ.com/culture/junk-science/). Briefly, it means that just because two things are correlated (or happened one after the other) does not prove that one caused the other. Inflammation may have caused depression, or depression may have caused inflammation, or other factors may have influenced one or the other, or both, or neither.

The Anti-Inflammatories Discussed Are Specific, Powerful Drugs with Side Effects. You can’t just go down to the corner drugstore and pick up a bottle of ibuprofen and think you’ve solved your depression problem. And it turns out that the anti-inflammatories they’re talking about increase the risk of infections and cancers, and are wildly expensive.

Snopes concludes:

While the science discussed by the Telegraph in this article is real, it omits seriously important context and misrepresents decades-old research as a breaking development in a way that could provide false hope to those suffering from depression. The interplay between the immune system and the mind is increasingly well established, but that doesn’t mean that science has established anything close to a new treatment for depression as a result of this understanding.

“False hope.” That’s what a lot of these headlines regarding causes and treatments for depression offer. Shall we look at another recent example?

This one, I’m sorry to say, comes from bp magazine (bphope.com). The headline is “Underlying Molecular Mechanism of Bipolar Disorder Revealed.” The tagline reads, “Findings inform development of potential diagnostic test and improved therapies.”

But that’s not exactly true. The first paragraph says nothing about the underlying mechanism of bipolar disorder. Instead, it talks about the mechanism “behind lithium’s effectiveness in treating bipolar disorder patients,” something very different. But that doesn’t make as snazzy a headline. The article also says the results “may support the development of a diagnostic test” and “may also provide the basis to discover new drugs that are safer and more effective than lithium.” May. Might. Or might not. Too soon to get your hopes up.

The conclusion? [T]he study demonstrated that bipolar disorder can be rooted in physiological—not necessarily genetic—mechanisms.” Well, I’m a word nerd, not a science geek, but “can be” is a far cry from “is.”

Now for my favorite, reported by the BBC: “Magic mushrooms can ‘reset’ depressed brain.” Again, the tagline says “raising hopes of a future treatment,” which is a pretty far stretch. The study was performed on 19 subjects, each given one dose of psilocybin. The article reports that “Half of patients ceased to be depressed and experienced changes in their brain activity that lasted about five weeks.”

So. Tiny sample. No control group. And flip a coin on the results. Personally, I don’t see that raising much hope.

Bottom line for this one: junk science. Eye-catching headline. They won’t be handing out magic mushrooms at the local mental health clinic anytime soon. (The article does warn not to self-medicate.)

We’ve been hearing for years about tests to diagnose depression and bipolar, and stunning new treatments. Well, the studies take years to do properly; the tests need to be proved accurate and better than current psychological testing; and the treatments must go through years and years of studies, animal testing, and human testing, complete with control groups and sufficient numbers of subjects to make them scientifically significant.

I just wish these people would quit reporting “results” until they have some to show.

 

Resources

http://www.snopes.com/2017/09/19/can-depression-treated-anti-inflammatory-drugs/

https://www.bphope.com/underlying-molecular-mechanism-of-bipolar-disorder-revealed/

http://www.bbc.com/news/health-41608984?utm_source=dlvr.it&utm_medium=facebook

Category:

mental health

Tagged with:

Andrew Tate Doesn’t Get to Define Depression

“Depression isn’t real. You feel sad, you move on. You will always be depressed if your life is depressing. Change it.”

Now, before you jump all over me, let me say that I never said that. It’s a tweet from Andrew Tate, kickboxing champion and former star of “Big Brother UK.” It caused quite a stir in the Twitterverse and was immediately challenged by, among others, J.K. Rowling and Patton Oswalt.

Obviously, there are a few things wrong with Tate’s opinions. First, the notion that depression isn’t real. To quote Hemingway, “Isn’t it pretty to think so?”

The millions of us with major depressive disorder and bipolar depression would love it if our disorder weren’t real; if we could just move on. If we could only change our lives. Kick depression out of our heads, as we should be able to, according to the kickboxer.

And Tate threw more fuel on the fire. He tweeted “MY DEPRESSION INBOX. Is hilarious. Full of crybabys. . . .”

Admittedly, many depressed people cry. But that doesn’t make us crybabies. Babies stop crying when their needs are met. People in the throes of depression don’t really know if their need for it to stop – their need for, if not happiness, at least not-despair – ever will.

When I first became clinically depressed I was a child and knew nothing about clinical depression. But I knew I was profoundly depressed. And I knew that if I waited long enough, that depression would lift. Being undiagnosed and unmedicated, I had no idea when I would come out of depression. All I could do was wait for it to happen.

Now older and wiser (and diagnosed and medicated), I know some things I can do to shorten that time until the depression lifts. I can practice self-care. I can call my therapist. I can turn to my husband. Now I know – really know and understand – that my depression isn’t forever, even if my disorder is.

And I know that, if I have to, I can push through depression instead of waiting for it to ease up on its own. Meeting my self-imposed blogging deadlines is one way I do that. Paying the mortgage and power bill is another. In some way those are both life-affirming activities, or at least statements that I am still connected to the world – however fragilely – and that I want and need to come out of the depression and get on with my real life.

It’s ridiculous to say “move on” or “change it.” Depression comes and goes when it wills. All we can do is endure it and keep pushing back until it gives the tiniest toehold. Then take that tiny purchase and push some more. It’s the hardest thing in the world when depression has sapped your energy, but believe me, there is more inside you somewhere. It may just take a long while to find it and to recognize it. We can no more change our depression than we can our souls. We can push back against it.

So screw you, Andrew Tate.

And screw you, depression.

 

 

Category:

mental health

Tagged with: