Sometimes I have an appetite for fixing people. When I do, I make it a point to shut up and listen for a while. (Or if it is a know-it-all who devalues my experience, find something else to do for awhile.) Everyone’s experience is different; I do not have all the answers. You will not hear me tell people in group the “true” motive behind their suicide attempt, what their character flaws are or hint at them, or give advice about experiences that I have not had (vicariously through a book does not count). I can only share my own story and that might not have anything to do with a person’s struggles. Compassionate listening is the true mark of a sage, I feel; and I am still not very good at it.
It is best to keep one’s ego small in these matters. Mine needs to go on a diet sometimes.
Support groups such as the one I attend often encourage fellow sufferers by sharing lists of people with our disorders who were successful. They are the most common explications of the benefits of being mentally ill and I do believe that they are helpful in instilling hope in those who have received diagnoses of bipolar disorder or depression. Thinking of Vincent Van Gogh or Percy Bysshe Shelley may tilt some towards grandiosity and denial, but most people take it to mean that they, too, can be able. Some such as New Age guru Tom Wooten go so far as to claim a “bipolar advantage”.
There’s a problem with this, however, and it is the failure to recognize how much people like Van Gogh and Shelley suffered. Van Gogh committed suicide. Shelley went to his doctors begging them for help with his catastrophic mood swings. In the end, the poet cavalierly ignored warnings of a storm at sea and went sailing anyways: he was found dead on the shores of Italy a few days later, an apparent drowning.
All of us who fight mental illness yearn for acceptance of who we are. None of us seeks the isolation which stigma brings. Comparisons of recovery rates in the industrialized world and the Third World by the WHO show that, one in six in the one and one in three in the latter* recover well enough from their first schizophrenic episode to function. Scientists suggest that the reason for this is less stigma and better family support in the latter. More important, I think, is the level of stress that afflicts one. Western societies are more competitive, more prone to casting off people who are seen as drains on resources. One finds oneself quickly isolated in the West and unless one has strong family support — witness the recoveries of Elyn Saks and Kay Jamison to name two — one may find oneself a prisoner of one’s apartment, denied any job or company.
Just a note of peripheral interest here: This is National Minority Mental Health Month. (Does that mean white people here in California?) Seriously, access to mental health resources for minorities, particularly African Americans, is limited. Many end up getting their treatment in jails instead of hospitals and through private psychiatrists like white people do.
I have opposed a bill by Representative Tim Murphy because it starts us down the road to forced treatment, which eventually, I believe, will create privatized “public” mental hospitals. (Even F. Fuller Torrey opposes these, but I think he is dreaming when he calls for government run mental hospitals. The private prisons movement will not hesitate to seize the opportunity to grab this new sector of the incarceration system.) These, I think, will turn out to be another place to warehouse African Americans and other minorities while white people will be able to stay out thanks to their access to outpatient mental health care. Rest assured that privatized mental hospitals will keep patients on the sick rolls as long as they can, indefinitely if it is allowed.
African Americans and other unprivileged Americans deserve access to decent community health care centers, an idea which the likes of Torrey and his lap dog D.J. Jaffe have written off as a failure — even though these have never been properly funded since the 1963 Community Mental Health Services Act. Murphy’s Law does call for grants to start 10 pilot programs for community mental health, but there is no guarantee of follow-through after the period of experimentation is over. Murphy’s Law also puts the burden of care on overstressed families, meaning that those patients whose families don’t have the resources will continue to lack decent care. (Meaning African Americans versus European Americans.)
Any future mental health legislation needs to ensure that programs help everyone. Compelling states to fully fund community mental health clinics where the staff are not overburdened and patients can get the medication they need is essential. Then we can apply evidence-based practices.
Posted on in Dreams
The curious thing about this dream is that I am both the main participant and an onlooker. I ride a bicycle quickly through a strip mall, passing many stores — at least one of which is empty. I ride fast, dodging people as I come to them. A series of landscaped pits open up in front of me. Both ramps and stairs lead down onto concrete floors. The challenge is to find the ramps. I swerve about, looking for the ramps. At the last pit, the one ramp is very far away, so I have to ride half way around the pit to get to it. When I get to the top, a couple of guys sword-fighting at the bottom of the stairs block my path. I yell at them to get out of the way as I speed between them. One of the fellows gets on his bike and starts to follow me. A voice tells me that I have finally met my match. I lose him, but I come to a place where a pudgy cyclops blocks a ramp up. I steer around him. He starts to chase me, clenching his pale fists. I find myself on a city street, pedaling as fast as I can. A block away, the light is green. I find myself muttering “Stay green. Stay green” as I wake up.
A zoo that I volunteer at has a huge salt water pond. Huge. They’ve decided to remodel it, so they removed all the rocks that allowed visitors to hop about and look into the deeper parts of the poll that you can’t see from the edges. I notice that the larger fish in the pool have died from the heat and are lying on the bottom. Several of us point this out to the zookeeper who seems unconcerned. He thinks he has a bigger problem — there are new houses going up on the hills looking down into the zoo and he wants to plant trees so they can’t see the animals. I go around the pool and find an area where there are lots of fish. Singing “Good Vibrations” I go back to find the zookeeper to tell him about it, showing him with my hands the size of the fish that I saw. He fishes out a sand dab — which he calls a rough carp — and shows it to everyone.
I just learned about the Nirvana Fallacy. It’s a logical prestidigitation where you compare a situation or proposal with an unrealistic and/or idealized alternative. A cousin of my wife’s likes to use it when attacking health care. He points to the woefully underfunded VA and declares that because this government-run system is so ineffective, we must resort to unregulated private industry (which was so good at providing health care before. Right.) Wikipedia describes it in more detail:
The nirvana fallacy is a name given to the informal fallacy of comparing actual things with unrealistic, idealized alternatives. It can also refer to the tendency to assume that there is a perfect solution to a particular problem. A closely related concept is the perfect solution fallacy.
By creating a false dichotomy that presents one option which is obviously advantageous—while at the same time being completely implausible—a person using the nirvana fallacy can attack any opposing idea because it is imperfect. Under this fallacy, the choice is not between real world solutions; it is, rather, a choice between one realistic achievable possibility and another unrealistic solution that could in some way be “better”.
I have been mostly stable since 2008. There have been a few interludes where I slipped either into mania or depression, but I managed these so that they did not spiral out of control. So I have nothing to worry about, do I?
There’s plenty to dread. Last week, as regular readers of this blog know, I had what is known as a breakthrough episode. In this case, it was a mild case of mania that I rode out with the help of sedatives and extra sleep, literally dreaming myself into a depression. I am not like many people with bipolar in that I do not fear depression. When I am depressed, I don’t have the energy to arrange a suicide. So it is not like a mixed state where I can pull the implements together and actually begin the death-by-my-own-hand. Still it debilitates me: I remain silent for long periods of time, talking to no one, writing nothing. Even now, I struggle to find the words for what I want to say. This is the nature of The Beast and there is nothing flamboyant about it now, just a gray, blubbery monster which lies on top of me and smothers me.
Mania scored my consciousness in steep peaks and troughs that never descended into depression the last two weeks. I got into arguments and I loved them too well. It was easy to laugh and the laughter fed itself. I quoted scripture at my opponents, both religious and secular. The color red seemed especially intense. Once I thought I saw someone run across the hall when I was alone in the house.
I thought I had an easy answer that I also feared: my Vyvanse had pushed me up beyond my normal humor. But when I went to take the little yellow capsules out of my lineup for the week, I discovered that I had not been taking them! So the psycho-stimulant was not guilty.
What was causing me to erupt? I didn’t know for sure, but I knew what I had to do. I took an extra Xanax to force myself into several extra hours of sleep, avoided sites that pricked my optical nerves with shimmering and pulsing light, and meditated.
There’s a mystery in the genetics report that I received from 23 and me and ran though the Promethease analysis engine: I have multiple genes that predispose me to lupus. I don’t have lupus but an uncle of mine did. It also says that I could develop multiple sclerosis and that I am at risk for childhood leukemia (I dodged that bullet.) My risk for bipolar disorder is only average. It also says that I am tall (true — I am 6′ 6 1/2″), probably have brown eyes, that risperidone works well for me, and have a tendency towards diabetes and obesity — right on all counts, though I am working to reduce my weight. All these things are in my genes. How is it that I show some of the predicted traits and not others?
Some might jump to the conclusion that genetics just gets these things wrong. No, the genes are there for certain. I am prone to lupus and MS. I could have had childhood leukemia. So why didn’t I if genes are the code that determines what I am? Why do I have bipolar disorder?