Bipolar 2 From Inside and Out

Posts tagged ‘public perception’

Those Science Fiction Crazies

There has recently been a huge kerfuffle in the science fiction community regarding the Hugo Awards. You don’t really need to know much about it and probably don’t want to. Suffice it to say that two groups had it out over the past and future direction of science fiction and fantasy, and the meaning of the asterisk.

The awards have now been given, but still the blogosphere is full of recriminations, sour grapes, and schadenfreude.

What does this have to do with mental health? Aside from the fact that very smart people can behave like vicious toddlers, it’s interesting to note that the various sides in this dispute did not always, shall we say, acted rationally. You probably guessed that from the asterisks.

This phenomenon is not unique to the Hugo Awards. If you have never been to a science fiction convention, let me tell you about it.

Most of the people there will be very intelligent, obsessive about their particular fields of interest, lacking in social skills to various degrees, and will have a history of being outcast or bullied in their youth.

Does any of that sound familiar?

I’m not a psychologist (nor do I play one on TV), but I can’t help thinking that if you tested everyone at one of these events they would score higher than a random group of people on the autism spectrum. Simply put, the SF community appears to have more than its share of Aspies – and a fair sprinkling of bipolar, depressive, and OCD people.

When their oddities are carried to the extreme – and they often are – SF fandom can devolve into incivility that results in unconscionable threats and exceedingly ugly online behavior.

When you see these kinds of behavior, it is tempting to dismiss science fiction fans as being the caricatures that the media have instilled in us – clueless losers who live in their parents’ basements, show up at jury duty dressed in Star Trek uniforms, and insist that Harry should have ended up with Hermione.

Admittedly, to a certain extent that is true. If you look around at a convention you will almost certainly see a number of people who conform to that stereotype. I myself have a relative who could be Queen of the Get-a-Lifes.

What you may not see is that, despite the cluelessness, rudeness, sometimes elitist or misogynistic behavior, obsessiveness, and disregard for the feelings of others, the science fiction community is actually, at heart, a place where the non-typical person can find a group of like-minded individuals to talk with, obsess with, bond with, and occasionally practice social skills with. It fullfills a very real social and psychological need. Without the science fiction community, whether online or in “meatspace,” many of these people would have little or even no place to have much of a social life at all.

Certainly the stereotype is not true of all members of fandom. Most hold regular jobs in technical, creative, or other fields, have families and close relationships, and negotiate their way through modern society as well or poorly as anyone else. But there are consistencies in their background. Most are incessant readers and have been since childhood. Many have been the targets of cliques in school and the workplace. A number would be described by their neighbors as quiet loners (though this is not to imply that SF fandom harbors more spree killers  than any other group). They have odd senses of humor or in some cases none at all. In a very real sense, sf fandom is for them, as one song would have it, made up of “My Thousand Closest Friends.”

So if you happen to be in a hotel and find the meeting space is overflowing with people dressed as Klingons, robots, and giant furry animals, remember that they are mostly harmless and enjoying a moment of fitting in to a part of society that celebrates and honors their differences and shares their pride in their oddness. Where they can relax and be themselves, without worrying about seeming weird or threatening or being put down, avoided, or scorned. Think of it as a support group with parties, art shows, panel discussions, music, costumes, movies, and chocolate.

A lot of us with mental disorders are glad to know that such places exist. A lot of us wish we could find or make such places, too.

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mental health, Uncategorized

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A Tattoo Is for Life…

…this one, especially so.

As soon as I learned about the semicolon tattoo, I knew I had to get one – and not just because I’m a huge grammar nerd. Because I’m bipolar and want to spread the word about mental health issues.

In writing, the semicolon indicates a place where a writer could have finished a sentence, but instead chose to go on. This makes the semicolon an effective and beautiful symbol for suicide prevention efforts and those who struggle with mental disorders.

Every day we choose to get out of bed; choose to take our medications; choose to make and go to our therapist appointments; choose to live another day; and choose to go on with our story.

This is not something I invented. Here are the people behind it: http://www.projectsemicolon.com/. And here are some stories about the phenomenon that have been working their way through the media and around the internet.

http://www.upworthy.com/have-you-seen-anyone-with-a-semicolon-tattoo-heres-what-its-about?c=ufb1

9 beautiful semicolon tattoos our readers shared to destigmatize mental health challenges

Here is my story.

I am possibly the last person you would ever expect to get a tattoo. I am probably the last person I would ever expect to get a tattoo. I’m in my 50s, a former English teacher, married for over 30 years, fond of reading and word puzzles and cats.

Nevertheless, the professionals at Monkey Bones Tattoos in Beavercreek, OH, did not seem surprised when I showed up one day and presented my wrist.

The naked wrist.

The naked wrist.

When I explained what I wanted – to put down a deposit and book an appointment to get a semicolon tattoo – I learned that they had a cancellation and could ink me right away.

What the hell, I thought. Might as well. I had learned about the tattoos about a month before and had thought it over plenty. It was by no means a spur-of-the-moment (or drunken) impulse.

Mike Guidone showed me into his studio and explained the procedure.

The tattoo artists work station.

The tattoo artist’s work station.

He presented me with stencils of three different sizes of semicolons. I chose the in-between one. My wrist is fairly small, so the big one would have looked out of place, but the small one wasn’t noticeable enough. The idea is for people to see it and ask, so you can share the meaning and talk to them about mental health and combatting the stigma.

I sat in the dentist-type chair, listened to a brief explanation, got answers to some questions, and was ready to start.

In progress.

Did it hurt? Not particularly. It was a feeling between a scratch and a sting, and took only about ten minutes. Some aftercare instructions and I was done.

finished1

Success!

Then I paid ($80, the shop minimum), tipped Mike, and was on my way. Now I care for the tattoo while it heals, anointing it with unscented lotion several times a day, avoiding sunlight or soaking, and trying my very best not to scratch or pick at it.

The results.

The results.

Am I happy with it? You bet!

And, like I said, it’s for life! My story isn’t finished yet.

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mental health

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A Response to the Dalai Lama

This Friday, my Facebook newsfeed included a quotation from the Dalai Lama.

Depression seems to be related to fear, anger and frustration. When you’re in a bad mood, even if you meet with your friends, you don’t take pleasure in their company. But when you’re in a good mood, even if things go wrong, you can cope with them without difficulty. This is why putting yourself in a good mood, making a point of developing a sense of loving kindness gives you greater inner strength.

While I respect and admire the Dalai Lama, on this subject he is wrong.

I wrote a blog post to tell him and his followers so. I posted it on Blogher.com. (Blogher is a site for women bloggers that sometimes syndicates content. It is more general than what I usually post here, so I wrote something special for them.)

As I researched, trying to find when and where the Dalai Lama said this (I couldn’t), I discovered several articles about research into depression and Buddhist principles and techniques.

One was an article by Kathy Gilsinan at The Atlantic
(http://www.theatlantic.com/health/archive/2015/07/dalai-lama-neuroscience-compassion/397706/). It talked about “high-amplitude gamma-oscillations in the brain, which are indicative of plasticity.” What that is or has to do with depression, I don’t know. It sounds like “handwavium” to me.

One that made more sense was this, from Jeanie Lerche Davis at
WebMD: http://www.theatlantic.com/health/archive/2015/07/dalai-lama-neuroscience-compassion. (The feature was reviewed by Louise Chang, MD.)

While meditation can help many who are depressed, it’s not a sure-fire cure, [Charles W.] Raison [psychiatry professor and co-director of Emory’s Collaborative for Contemplative Studies] tells WebMD. “In fact, many people with mood disorders find they can’t do meditation when they’re depressed.” Their thoughts are too overwhelming. They are anxious, nervous, and can’t sit – and likely they need antidepressants, he says.

That’s more like it.

In my response to the Dalai Lama, I said,

Real, clinical depression is not about being in a “bad mood.” It’s true that a truly depressed person does not find pleasure even in ordinarily pleasurable things, such as meeting with friends. But we cannot simply put ourselves in a good mood.

That’s the hell of depression. We want to enjoy the good times. We want to put ourselves into a place of inner strength. But we can’t. Not without help.

In fact, your advice is hurtful to depressed people. Too many times we have been told, “Cheer up.” “Smile! You’ll feel better.” “Think about someone else for a change.” “What do you have to feel bad about?”

Don’t you think we would if we could?

Remarks like these remind us that we have an illness and we cannot cure ourselves by willpower alone – no more than a person with hepatitis or tuberculosis or even schizophrenia can. We need help, and most of us need medication.

You do a disservice to people with depression when you tell them to put themselves in a good mood. You, an enlightened spiritual leader, may be able to do it, but we can’t.

Certainly we can benefit from practicing loving kindness and developing inner strength.

But without treatment for depression, how many of us can do that?

It angers me when people say that depression – or any mental disorder – is something people can or should be able to cure with an attitude adjustment. I’ve heard it too many times from people in my life, and I’m sure you have too.

What’s really disappointing is that someone like the Dalai Lama, with his legion of followers and enormous credibility, is perpetuating this old way of thinking.

This lie.

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mental health

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New Hope for Mental Illness

Did you hear the news?

Bullying, inflammation, anger, low self-esteem, abuse, biochemicals, unsettled gender identity, cat parasites, and anything bad causes depression/bipolar disorder/PTSD. (Double-jointedness, too, except I don’t know if that’s bad or not.)

But don’t worry. Reading, happy memories, cat videos, a new vaccine, or Tylenol can help!

Science reporting these days is confusing, deceptive, and sometimes just plain wrong. Perhaps science reporters don’t mean to mislead, but that’s exactly what they do. Among the problems are publishing demands, lack of knowledge, logical fallacies, and the difference between correlation and causation.

Let me explain.

Publishers demand big, catchy headlines, and they prefer “New Hope for Bipolar on Your Grocer’s Shelf” to “Experiments on Genes and Diseases Continue.” Add to that the fact that editorial budgets have been slashed and personnel shuffled around so much that todays’s “science reporter” may have been last month’s “political correspondent” – and trained only in basic journalism, if that.

Science is complicated and difficult to understand, unless you’ve got special training. Even then, your expertise is likely to be only in one area – the microbiology of prostate cancer in mice, for example. And most people’s understanding of how scientific research works is, well, not understanding so much as knowing that DNA is somehow like a fingerprint.

Here’s a website with videos that tackle the subject quite nicely. My personal favorite is the one about animal trials in research, which explains (among other things) why my father, who had bone cancer, always said he was tired of being compared to a white rat.

http://www.vocativ.com/culture/junk-science/

Another problem is argument by analogy, which appears more in opinion pieces than in stories labeled as science. But here’s a sample, damning research on psychotropic drugs, written by Kelly Brogan, MD, ABIHM (American Board of Integrative Holistic Medicine).

The most applicable analogy is that of the woman with social phobia who finds that drinking two cocktails eases her symptoms. One could imagine how, in a 6 week randomized trial, this “treatment” could be found efficacious and recommended for daily use and even prevention of symptoms. How her withdrawal symptoms after 10 years of daily compliance could lead those around her to believe that she “needed” the alcohol to correct an imbalance. This analogy is all too close to the truth.

Well, no it’s not, for a number of reasons. Analogies always break down after a while, some sooner than others. For example, that hypothetical six-week trial would be longer than six weeks, come only after years of animal studies (including ones that focused on unwanted side effects like, I don’t know, hangovers or liver damage). The trial would have included control groups, placebos, and other research protocols. The ten-year “withdrawal” effect wouldn’t show up in six weeks; people who drink only two drinks per day are not generally considered alcoholics or go into withdrawal (indeed they may be drinking wine for heart health).

(See http://www.madinamerica.com/2014/12/depression-serotonin/)

And so forth. Having two drinks per day is not analogous to taking a medication for social anxiety disorder. It’s associating the disliked thing (psychotropic meds) with a thing known to be bad (alcoholism) and damning by association.

Here’s another flaw: the principle that “correlation does not equal causation.” The classic example comes from the 1950s, when it was claimed that rock and roll music would lead to teenage pregnancies. It’s true that some teenagers who listened to rock and roll became pregnant (correlation). But some didn’t. And some teenagers who listened to country or jazz became pregnant. And I think by now we know what really causes pregnancy (causation).

This problem is illustrated by an article, “Scientists: The ‘Tortured Artist’ Is a Real Thing.”
The first thing to notice is that the headline is misleading, or possibly completely untrue. The article explains a study that supposedly shows that “creative genius and mental disorders are connected at a genetic level,” then goes on to debunk it:

“Any particular set of genes is only going to explain a very small part of variation in any psychological trait,” says Scott Barry Kaufman, a psychologist at the University of Pennsylvania. Indeed, the variants in the new study have a tiny, miniscule impact on creativity – less than 1 percent.

The rest of the article waffles back and forth and concludes inconclusively. Are creativity and “madness” linked somehow? Possibly. Does one cause the other? We don’t know, but there are a lot of theories. There are lots of other possible factors. Without the headline, would anyone read that? How do you define “creativity,” anyway?

(See http://mentalfloss.com/article/64852/scientists-tortured-artist-real-thing).

Here’s a selection of recent articles that purport to have some relevance to mental illness or mental health.

Can Reading Make You Happier?
Answer: Bibliotherapy helps some people, possibly because of changes in the brain.
(http://www.newyorker.com/culture/cultural-comment/can-reading-make-you-happier?)

Artificial Recreation Of Happy Memories May Become The Next Big Weapon Against Depression
Thesis: “Urging a depressed person to stay positive by remembering the good things in life is unlikely to be helpful advice. That is because depression blocks access to happy memories. But what if we could somehow artificially recreate such memories to allow for some more positive thinking? A study suggests that this is indeed possible – at least in rats….However, more research will be necessary to obtain a clearer picture of how this might work in humans.”
(Again with the rats.)
(http://www.iflscience.com/health-and-medicine/artificial-recreation-happy-memories-may-become-next-big-weapon-against)

Science Shows that Watching Cat Videos is Good for You
The article, which says “research suggests that the pleasure you derive from watching cat videos can often outweigh the guilt of procrastination,” is largely tongue-in-cheek, but that headline is a grabber. Headlines that use “waffle words” like may, can, might, possibly, someday, appears to usually indicate a story that says nothing significant. They build up hope, but if a study comes along that disproves the theory, it will never be reported.
(http://www.iflscience.com/environment/science-shows-watching-cat-videos-good-you)

Researchers Are Developing A Vaccine For Post-Traumatic Stress Disorder
It begins: “New studies are suggesting a link between the immune system and the way the body reacts to stress. Research with rodents are raising hopes that one day, tweaking a person’s immune system could be a way to treat or even prevent conditions like PTSD, Nature reports.” How many warning signs can you spot there?
(http://www.iflscience.com/health-and-medicine/vaccine-help-ptsd)

Double-Jointedness Is Linked to Anxiety
One of my favorites. Correlation/causation much?
(http://mentalfloss.com/article/65333/double-jointedness-linked-anxiety)

Your pain reliever may also be diminishing your joy
Actually it says that acetaminophen blunts both positive and negative emotions. And, it adds, “this study offers support to a relatively new theory that says that common factors may influence how sensitive we are to both the bad as well as the good things in life.” Gee, who would have guessed?
(https://news.osu.edu/news/2015/04/13/emotion-reliever/)

Is Depression a Mental or Physical Illness? Unravelling the Inflammation Hypothesis
This is actually a good article. The headline question is a valid and interesting one, and the author states, “But while there may be a connection between inflammation and depression, one doesn’t necessarily lead to the other. So it’s too simplistic to say depression is a physical, rather than a psychiatric, illness.” Hooray for correlation/causation!
(http://www.iflscience.com/health-and-medicine/depression-mental-or-physical-illness-unravelling-inflammation-hypothesis)

What does all this reporting prove? Almost nothing. Except “let the reader beware.”

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mental health

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We’ve Got Demons in Our Heads

I posted this just after the Charleston shootings, but it needs saying again.

The media don’t say it in so many words, but that’s what they mean when they talk about “mental illness” after a tragedy, especially one that involves gun violence and mass murder.

Demons are responsible. And those demons are the mentally ill (and/or) their medications (or lack of medications). Any way you look at it, we are the demons.

Here’s one of my favorite examples lately:

“It seems to me, again without having all the details about this, that these individuals have been medicated and there may be a real issue in this country from the standpoint of these drugs and how they’re used.”

This was from Rick Perry, Daily Kos reminds us, “the fellow who destroyed his last presidential bid after a bizarre debate performance that he later blamed on prescription painkillers he had taken beforehand.”

(Don’t you love that part about speaking without having the details?)

And this, from Mike Adams, who calls himself “The Health Ranger” and Editor of NaturalNews.com:

The headline is “Every mass shooting over last 20 years has one thing in common… and it’s not guns.” The article is actually a reprint of “an important article written by Dan Roberts from AmmoLand.com.”

(NaturalNews sounds maybe okay, but when the source is AmmoLand, you’ve got to wonder about bias.)

Here goes:

“The overwhelming evidence points to the signal [sic] largest common factor in all of these incidents is the fact that all of the perpetrators were either actively taking powerful psychotropic drugs or had been at some point in the immediate past before they committed their crimes.”

Then follows a list of people, crimes, and drug names. The list was compiled and published to Facebook by “John Noveske, founder and owner of Noveske Rifleworks just days before he was mysteriously killed in a single car accident.”

(Again note the source and possible bias, plus the hint of conspiracy theory. Gotta love it.)

Want something more mainstream? How about Newsweek?

“Charleston Massacre: Mental Illness Common Thread for Mass Shootings,” by Matthew Lysiak:

“…. If history is any indication, the shooter most likely has a history of severe mental health issues that have either gone untreated or undiagnosed.”

He then provides a list of crimes and psychiatric diagnoses with a number of the same instances as the AmmoLand account, though not a listing of medications.

The author goes on to say that the “rise [in mass shootings] correlates directly with the closure of the mental health institutions in 1969, according to mental health experts.”

(Correlates with – not caused – please note. That’s important. I’ll have more to say about that, probably next week.)

Lysiak goes on to say that the requirements for civil commitment (read: involuntary) are too loose. He quotes Liza Gold, a forensic psychiatrist in Arlington, Virginia: “The commitment requirement needs to be less strict. Today it currently requires both mental illness and dangerousness to have someone committed. I think we need to focus more on the dangerousness and keep these people from getting guns.”

If that’s so, we should be worried more about “sane” people such as abusive partners with histories of violence and restraining orders than about the mentally disordered, shouldn’t we? Comments revealing that “most people who commit acts of violence don’t exhibit signs of mental illness, and most people who are mentally ill are not violent” are buried near the end of the article.

Fortunately, not all the media are demonizing the mentally ill, though the dissent doesn’t seem to be coming from the major media. Slate and Salon have published articles that question the automatic connection.

The article on Slate, by Anne Skomorowsky, is long, and refers to the Germanwings airplane deaths, but it’s thoughtful reading and well worth the time.

“Because Germanwings pilot Andreas Lubitz killed himself when he purposefully drove a plane carrying 149 other people into a mountain in the Alps, there has been an assumption that he suffered from “depression” — an assumption strengthened by the discovery of antidepressants in his home and reports that he had been treated in psychiatry and neurology clinics.” She adds, “Lubitz did not die quietly at home. He maliciously engineered a spectacular plane crash and killed 150 people. Suicidal thoughts can be a hallmark of depression, but mass murder is another beast entirely.”

And the take-away: “Many patients and other interested parties are rightly concerned that Lubitz’s murderous behavior will further stigmatize the mentally ill.”

Salon’s Arthur Chu talked about the more recent Charleston, SC, shootings and other incidents in “It’s not about mental illness: The big lie that always follows mass shootings by white males.”

“I get really really tired of hearing the phrase ‘mental illness’ thrown around as a way to avoid saying other terms like ‘toxic masculinity,’ ‘white supremacy,’ ‘misogyny’ or ‘racism.’

“’The real issue is mental illness’ is a goddamn cop-out. I almost never hear it from actual mental health professionals, or advocates working in the mental health sphere….Seeking medical help for depression or anxiety is apparently stronger evidence of violent tendencies than going out and purchasing a weapon….Doing the former is something we’re OK with stigmatizing but not the latter.”

I’ll let that be the last word, fellow demons. Until the next time, that is. Until the next time.

Correction: The Skomorowsky article appeared on Slate, not Business Insider, as originally stated. I have fixed the text and regret the error.

Here are the references for the articles cited, in order:

http://www.dailykos.com/story/2015/06/19/1394713/-Rick-Perry-says-guns-aren-t-to-blame-for-Charleston-accident-it-was-prescription-drugs

http://www.naturalnews.com/039752_mass_shootings_psychiatric_drugs_antidepressants.html

http://www.newsweek.com/charleston-massacre-mental-illness-common-thread-mass-shootings-344789

http://www.slate.com/articles/health_and_science/medical_examiner/2015/03/germanwings_co_pilot_mental_illness_suicide_is_linked_to_depression_but.html

http://www.salon.com/2015/06/18/its_not_about_mental_illness_the_big_lie_that_always_follows_mass_shootings_by_white_males/

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mental health

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Diagnosis and Dickinson

The Brain — is wider than the Sky —
For — put them side by side —
The one the other will contain
With ease — and You — beside —

The Brain is deeper than the sea —
For — hold them — Blue to Blue —
The one the other will absorb —
As Sponges — Buckets — do —

The Brain is just the weight of God —
For — Heft them — Pound for Pound —
And they will differ — if they do —
As Syllable from Sound —
Emily Dickinson

I ran across this poem in a book called Shrinks: The Untold Story of Psychiatry (about which more some other time) and it made me think.

Dickinson was, by all accounts a recluse. She seldom went out and, when visitors came, she sometimes sat behind a screen while she talked to them. She never dared to submit her poems for publication. Less than a dozen were published in her lifetime, and those only because someone else submitted them without her knowledge. Her wealthy, loving family sheltered and nurtured her so that she never had to face the outside world.

Emily Dickinson had Social Anxiety Disorder.

And Abraham Lincoln suffered clinical depression. So did Charles Dickens.

Bipolar sufferers include Beethoven, Schumann, and Isaac Newton.

Charles Darwin, Michelangelo, and Nikola Tesla were all obsessive-compulsive.

Autism, dyslexia, and various learning disabilities affected Einstein, Galileo, Mozart, and even General Patton.

And Van Gogh! Let me tell you about Van Gogh. He had epilepsy. Or depression. Or psychotic attacks. Or bipolar disorder. Or possibly some combination thereof.

I call bullshit. I’m not saying none of those people had assorted mental disorders. My point is that we can’t tell from this distance in time.

In none of these cases, as far as I know, did any of the aforementioned people see a psychiatrist, psychoanalyst, psychotherapist, or even a phrenologist. None were diagnosed with any psychiatric condition, and no record of such a diagnosis has come down to us from any reliable source. Some even lived before psychiatry was invented.

People – mental health workers, but also art and literary critics, biographers, and the general public – have looked at these extraordinary people’s lives and work and decided that their behavior and their art look like those of a person who might be bipolar or obsessive-compulsive or psychotic. (They also like to retro-diagnose physical conditions there is no record of or only vague names for. King Tut, Henry VIII, and Napoleon are particularly good theoretical patients.)

Why the tendency to ascribe mental disorders to famous people? I can see two reasons, beyond the thrill of solving a mystery and feeling clever.

The first is the old saying about there being a thin line between madness and genius. These historical figures were geniuses, so they must have been mad. Or as we say now, suffering from mental disorders.

The other is the need for role models and inspiration. If Van Gogh could become one of the most famous artists ever (though not successful in his own lifetime), you too may rise above – even use – your disorder to accomplish greatness.

It’s possible, I guess, but it’s not likely. Certainly those with mental disorders can aspire to and achieve rich, full lives, satisfying relationships and jobs and artistic pursuits. These are the ordinary accomplishments of ordinary people, both with and without mental illness, and it’s a small miracle that people can achieve any one or more of these. Not everyone does – again with or without mental troubles or psychiatric diagnoses.

And for me, at least, it’s enough.

Can the spark of imaginative genius strike a person with a mental disorder? Of course. Can that person succeed and achieve lasting fame? Maybe, though the odds aren’t good. Is a person saying, “Look, I can be Van Gogh!” likely to fall short? Almost certainly. Can that failure to achieve greatness make a person feel worse about himself or herself instead of better? You tell me.

There’s nothing wrong with aiming high, and nothing that says a person with a psychiatric diagnosis can’t do just that. It’s a good idea for anyone. (As one of Lois McMaster Bujold’s characters says, “Aim high. You may still miss the target but at least you won’t shoot your foot off.”)

But pinning your hopes on a similarity with a non-psychiatric, perhaps non-existent, diagnosis of a genius may not be the best way to get there.

Better to look in these geniuses’ work for insights that can help you understand your own condition or pull you through tough times. Here’s another of Emily Dickinson’s poems that has always spoken to me about the experience of a depressive crisis and its aftermath.

After great pain, a formal feeling comes —
The Nerves sit ceremonious, like Tombs —
The stiff Heart questions ‘was it He, that bore,’
And ‘Yesterday, or Centuries before’?

The Feet, mechanical, go round —
A Wooden way
Of Ground, or Air, or Ought —
Regardless grown,
A Quartz contentment, like a stone —

This is the Hour of Lead —
Remembered, if outlived,
As Freezing persons, recollect the Snow —
First — Chill — then Stupor — then the letting go —

Was Emily herself depressed? We’ll never really know. And as long as we have her poems, I don’t really care.

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mental health

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Why Do They Do This? (And Why Do We Allow It?)

The big story last week for those of us with mental disorders was this one:

http://www.rawstory.com/rs/2015/02/truly-barbaric-florida-deputy-drags-mentally-ill-woman-through-courthouse-by-shackled-feet/#.VOyTNKh2Gbc.facebook

For those of you who haven’t read it or seen the video, here’s the gist. A woman, Ms. Rios, was declared mentally incompetent at a hearing for a minor offense and not allowed to say goodbye to her mother. She wanted to sit on a bench and cry for a bit. When she did not go promptly with the officer, he dragged her through the courthouse by her shackled feet. A video was taken on a cellphone camera by a lawyer who happened to be present, but had nothing to do with Ms. Rios’s case. If you watch the video clip you can see and hear her distress.

As the headline says, this was barbaric.

But there’s lots neither the headline nor the story says. I have questions.

What is the woman’s mental illness? Or why is she mentally incompetent? The stories vary, usually calling her “mentally ill,” which is shorter for the headline writers, but so far I have seen nothing more specific. One could get the impression that in the mind of the media – and therefore their readers – that the two terms mean the same thing. Was she medicated or unmedicated or off her prescribed meds? Does she have a developmental disability? An autism spectrum disorder? An emotional or behavioral disorder? We don’t know. But does the label make her automatically suspected of potential violence? The woman did not behave like an animal even when she was treated like one.

I think we all know people who have mental disorders but are still mentally competent to conduct their own affairs, up to and including court proceedings. In fact, I know you know one – me. But who among us, or among the sanest and most stable of the general public, wouldn’t have needed to sit on a bench and cry before going to wherever the officer thought we should go? Who wouldn’t yell and protest and try to hold on to a table if we were dragged anywhere by our shackled feet?

Why is the officer’s action called “barbaric”? I’m not saying it wasn’t barbaric. But how was it more barbaric than other things routinely done to the incarcerated mentally ill (or incompetent)? Could it be because the officer’s actions were caught on tape? How many everyday barbaric actions aren’t? And putting aside simple human compassion (which he did), didn’t the officer’s actions create a larger, potentially more dangerous disturbance?

Why did the other officers present do nothing? You can see them on the video. They are spectators. No one says, “Hey, do you have to do that?” or “Give her a minute to calm down” or “Here, let me take care of this” or “You know, there are other ways to handle this” or even “Are you sure you want to do that with the camera rolling?” Nothing. Nada. Zippety. Doo-dah.

Why weren’t the officers and other courthouse personnel trained to handle situations like that? They obviously happen occasionally. Officers are (supposedly) trained to handle situations involving violent felons (which Ms. Rios wasn’t), domestic violence, and how to restrain suspects properly. Some even get sensitivity training on race, sexual orientation, and ethnicity. Where’s the training for interacting with the mentally ill (or mentally incompetent)? For de-escalating a situation instead of throwing gas on the fire? How about anger management before incidents like this one instead of after? Shouldn’t every law enforcement official be able to control or channel his or her anger and not take it out on the public?

Why the hell aren’t police officers required to wear body cameras – and have someone whose job it is to, oh, I don’t know, review them occasionally? Certainly when there’s been a complaint, but spot checks might also do some good. Why are civilians subject to increasing surveillance, while law enforcement personnel – who are also civilians, by the way – perform their jobs with minimal oversight.

And why is the Golden Rule suspended when the “others” have a mental disturbance? I’d really like to know.

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I am cross-posting a slightly altered version of this essay to Et Cetera, etc., my general purpose blog (janetcobur.wordpress.com).

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Yes, I Am Crazy. Thanks for Asking.

I’ve been called a lot of things in my time, from schoolyard taunts (loony tunes, weirdo) to psychiatric labels (clinically depressed, bipolar 2). This used to bother me, but anymore, I don’t mind.

It’s not because of the old saying, “Sticks and sones can break my bones, but words will never hurt me. We all know that’s a damn filthy lie. I think it’s because I’ve developed a sense of humor about the “crazy” thing. If Al Yankovic can embrace “Weird,” I can embrace “squirrel-bait” or “wacko.” Even “bat-shit” or “bug-fuck” crazy don’t get me riled, though many find them offensive – and I can’t fault them for that. Everyone has a different level of tolerance and sense of what’s funny.

Take, for example, the time when my sister Kathy gave me a t-shirt that said, “Leave Me Alone. I’m Having a Crisis.” Her husband was dubious about the gift, thinking that I would be offended. I wasn’t. Kathy thought it was a hoot and so did I. (I just bought a t-short that says, “You Won’t Believe the Crazy Shit That Happens Next…” I’m going to wear it to my next psychotherapist appointment.)

I admit to being disconcerted when publicly confronted by a person who asks “Are you the one there’s something wrong with?” or “Do you have mental problems?” (In the first case, the elderly gentleman was thinking of my sister-in-law, who had MS, and in the second, the person recognized me from the psychiatrist’s waiting room.) But I’m not offended. Mostly I regret that I didn’t have snappy come-backs. (I thought of some great ones later.)

There are still some assumptions that do offend or at least irritate me. Here’s a link to an article that enumerates a few of the touchy subjects and unwelcome phrases.

10 Harmful Myths About People with Bipolar Disorder

That sums it up pretty well. I’m not going to walk into a fast food outlet and start shooting up the place. Mania is not fun. I’ve decided not to reproduce, but nobody can tell me that I shouldn’t.

Oh, and there’s one other thing. In the past, when I’ve mentioned my mood disorder to acquaintances or co-workers, they feel obliged to take my emotional temperature five times a day. “Are you okay? How are you feeling?” So I would add to the list: Not all people with bipolar disorder are rapid cycling.

So, am I crazy? Yes. But I don’t think that’s necessarily a bad thing. Most people use the word “crazy” to describe how they feel when they’re in love. And I’m good with that.

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Why I’m Not Like Sheldon Cooper

Obviously, I’m not a man or a theoretical physicist or a character on The Big Bang Theory. But also, I can’t say, as he often does, “I’m not crazy. My mother had me tested.” I’d like to have that t-shirt, but it would be false advertising.

I am crazy and my childhood was entirely free of psychological testing.

It probably shouldn’t have been, because the crazy had taken full hold during my tender years. Crippling depression. Massive anxiety. But both my parents were ordinary folk from Kentucky transplanted to a bland Ohio suburb. They stayed true to their roots and never considered testing or counseling for me or my sister. According to their upbringing, having crazy relatives might be upsetting or embarrassing, but that’s just the way it was. You tried to shelter them from the outside world – and vice-versa – but you didn’t involve agencies or doctors or hospitals.

My crazy got too obvious to ignore when I was in junior high school. I developed a nervous tic – my head would jerk up and to the left uncontrollably. This was very distracting, not only to me, but to whoever was sitting behind me in class. It got me noticed.

It did not, however, get me to a psychologist or other mental health professional. I didn’t want to see one anyway, because I had the irrational notion that being “shrunk” would go on my permanent record and I would never get into a good college.

Instead, I was taken to our family doctor. He prescribed Valium, which did stop the twitching but did absolutely no good for my depression.

Later, during my college years – at a good school, I might add – I had another run-in with Valium. This time my symptom was pain like a railroad spike being driven into the side of my head. Naturally, I thought it was a brain tumor.

I went to the doctor, who said, “I can do any test you want, but I can tell just by looking at you what your problem is. Your jaw is crooked.” He diagnosed me with temporomandibular joint (TMJ) disorder, explained that tension made my muscles contract unevenly and cause excruciating pain in my temples. He sent me away with a prescription for Valium. Which helped with the stabbing pain, but again not with the depression. (Also, I was self-medicating with wine, which just made the crazy train run faster.)

It was not until years later, after college, that I got half a diagnosis – depression – and a non-Valium prescription – Prozac. And many years after that until I got the more accurate diagnosis (bipolar 2) and an appropriate regimen of drugs, which does include Ativan, but not prescribed alone or with wine.

And that’s another thing I don’t have in common with Sheldon Cooper. He’s not taken any psychotropics (or wine) and is happily stuck in his supposed non-craziness. I’ve accepted my craziness, gotten help for it, and am slowly rising, if not above it, at least to where I can peek over the top of it.

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All in Our Heads

Well, mental disorders probably are mostly in our heads, or at least our brains (and genes), but I keep seeing news features that “offer hope” for new diagnostic tools and treatments that “may someday” alleviate the suffering.

Here’s an example from the University of Pennsylvania:

Many factors, both genetic and environmental, have been blamed for increasing the risk of a diagnosis of schizophrenia. Some, such as a family history of schizophrenia, are widely accepted. Others, such as infection with Toxoplasma gondii, a parasite transmitted by soil, undercooked meat and cat feces, are still viewed with skepticism. A new study used epidemiological modeling methods to determine the proportion of schizophrenia cases that may be attributable to T. gondii infection. The work suggests that about one-fifth of cases may involve the parasite.

Great. I am sure that schizophrenics will be comforted by the thought that their problems are caused by brain parasites and cat poop.

I noticed that the study showed that only 20 percent of schizophrenia “may” involve the parasite. What about the other 80 percent? Are those cases caused by some other parasite? And how will the parasites be detected? Blood test? Brain biopsy? Could be a world of horrors there for the already mentally unstable. And, perhaps most important, will real-world results back up the computer simulations?

Schizophrenia is far from the only illness being studied. Bipolar disorder and our old pal depression come in for their share of lab work too. USA Today recently reported on a procedure that might help with depression:

The treatment — transcranial magnetic stimulation — was approved by the Food and Drug Administration in 2008 for the treatment of patients with medication-resistant depression.

Magnets generate a directed, pulsed magnetic field — similar to an MRI in strength — to the prefrontal cortex, the front part of the brain behind the forehead. The magnetic fields induce small electrical currents, which encourage a mood-lifting chemical reaction in the brain.

The treatment is daily, for four to six weeks. If the patient improves enough, the treatment is then provided as a periodic booster.

Never mind that it’s entirely subjective when a patient has improved “enough” or even shows anything other than a placebo effect. And never mind the effects of having 42 MRI-strength treatments in a row.

Apparently scientists and insurance companies are battling it out on the money front (there’s a surprise).

Plus, as always, there are nay-sayers:

The National Institute of Mental Health describes the treatment as effective for some patients, but notes that studies of its efficacy have been “mixed.” The American Psychiatric Association’s guidelines for depression treatment states the procedure conveys “relatively small to moderate benefits.”

To the desperate, any potential “cure” or even palliative treatment eventually seems worth a try. I should know. I came that close (imagine several millimeters here) to having a go at electro-convulsive therapy (ECT). Formerly know as shock treatment.

The thing is, you only hear about theories that “might” be correct and treatments that “may” help. Studies are hardly ever published that say, “You know that treatment we said was going to relieve the suffering of millions? Turns out, not so much.” If the general public even gets to see the negative results, they may still cling to the hope offered by the earlier reports.

Just look at the anti-vaxxers. It has been repeatedly proved that childhood vaccines do not cause autism. The experiment that reported that finding was a fraud and the author (Andrew Wakefield) has been discredited – investigated and found guilty of “four counts of dishonesty and 12 involving the abuse of developmentally challenged children.” Basically, he’s been kicked out of medicine altogether and given the Lifetime Achievement in Quackery award by the Good Thinking Society. (I’m not making that up.)

And yet epidemics of measles and other deadly diseases continue to rise as parents yield to fear and refuse to have their children vaccinated.

I’m not trying to say that a parasite doesn’t cause some cases of schizophrenia or that magnetic therapy will never relieve anyone’s depression.

I’m just saying that if those theories are proved false, we’ll likely never hear about it from the popular press.

 

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