Our Culture and Mental Illness-A Vent

Is it just me, or does it seem like with all the talk around Donald Trump’s mental health status, there are people who think they’re trying to dispel myths and stigmas who are actually unintentionally perpetuating myths and stigmas about mental health? I see people throw the term “mental illness” around or repeat what they’ve heard or read from articles online, but they don’t seem to actually comprehend or understand the meaning behind what they’re saying. I think the one that bugs me the most are the people who, while trying to dispel stigma, actually perpetuate the stigma that someone like me who has my diagnoses are fragile creatures who should be pitied and there is nothing that I can do for myself. That somehow, I can’t handle hearing about someone else’s possible mental disorder or that I should be ashamed of possibly being associated with someone like Donald Trump because he might have a mental disorder. Some of these people have good intentions and just don’t realize the meaning behind what they are saying. Others throw around terms like “ableism” at people who they think are perpetuating stigmas.

I hate the term “ableism”. No, I loathe and despise that term.  The ignorance of the so-called “ableist” is much easier for me to deal with than someone who thinks that advocating for me is to view me and portray me as someone who is fragile, should be pitied, and is a victim.

I am by no means a victim. I resent being portrayed as a fragile victim deserving of pity because casting me in that light is a means to an end–attention and validation for yourself. It makes you feel good if people perceive you as being my advocate and my ally, but you’re neither to me.

Yeah. I said it.

If you were really my ally, you would not be speaking about me or people like me in terms of fragility or pity. You would acknowledge that I am a strong, capable person who can function in regular society. You would focus on empowering people like me by raising us up instead of holding us down. You would acknowledge that while I can personally thrive, I still do face some struggles, mainly that which involve people’s attitudes and lack of knowledge about mental health issues and our mental health care system.

We need so desperately to be talking about mental health issues, but at the same time, this conversation must be led by people who have some expertise or experience in this area–the therapists, the psychologists, the people who live with mental disorders, their loved ones, their caretakers, the nurses and the techs who all work in the system, the caseworkers. We all live this directly or indirectly every day. We’re the ones on the front lines. We’re the ones who actually knows what it feels like to experience the stigmas associated with mental health.

Someone from this group must hold the media accountable for their part in perpetuating stigma and stereotypes about mental illness, because they are the biggest culprits in perpetuating stigma.

We can’t even begin to discuss mental illness, mental health, and related topics until people begin to understand what they actually mean. Mental illness, for one, is a legal term, whose definition is set by the individual states. Mental illness and mental disorders are NOT synonymous at all.  A person with a diagnosis of Panic Disorder has a mental disorder, but they most likely do not meet the legal definition of having a mental illness. Mental illness, as a term, is used in criminal proceedings to describe a defendant’s mental state at the time of a crime. Or it is used in civil commitment cases where the family is petitioning the courts to have a relative involuntarily committed because they will not seek treatment for their mental disorder voluntarily AND this disorder affects that person’s ability to take care of themselves and/or that person may be a danger to themselves or to others.

Insanity is another legal term that people get wrong. Insanity isn’t even a clinical term. When people say “stop calling people with mental disorders ‘insane'”, it’s not because they’re being oversensitive or politically correct. It’s because you’re using the term wrong. 

 Another thing that’s bothering me lately is this confusion about narcissism and Narcissistic Personality Disorder. Narcissism itself is a personality trait. Narcissistic Personality Disorder is a Cluster B Personality Disorder where, in order to receive a diagnosis, a person must meet a minimum of 5 of 9 criteria. Trumps narcissism is pathological. I noticed this back during the primaries and mostly because I was taking Abnormal Psychology during the spring semester.

Which brings me to another thing that bugs me–how the public just accepts that because someone made a strong case in favor of Donald Trump having a personality disorder, it’s the same as an actual diagnosis by a psychiatrist. It is not.  I could make a very strong case that Donald Trump has NPD. But just because I can make a case by going through all nine criteria and citing examples of his behavior that support my argument, it doesn’t mean he actually has this. Personality disorders happen to be very tricky to diagnose properly because of the fact that they have very high rates of comorbidity with other personality disorders. I’m sure I could get out my Abnormal Psych book, which does list the DSM-V criteria for various mental disorders, and make a case that Donald Trump also has Anti-social personality disorder or Histrionic Personality Disorder, too. But just because I can make a case for it, doesn’t mean he has it.  I read an article today where the author was trying to make the case that Trump shows signs of mania. One of the signs the author listed was his random, stream-of consciousness, speech patterns. I could take that and make the case that Trump might have ADHD.

Now I’m not saying that he has any of this. My point is that you can’t just randomly pick out criteria from the DSM-V and say someone may have Disorder X without having an understanding of what you’re talking about. We can’t be treating the DSM-V like it’s the Psychiatric version of WebMD and that is what I’m seeing people who have little or no background in psychology or mental health doing right now.

Which brings me to another stigmatizing thing: this petition Representative Karen Bass started that is calling for Donald Trump to be forced to undergo a psychiatric evaluation.

First of all, there are no legal grounds for this. There is nothing in the US Constitution that requires that anyone running for POTUS has to go a psychiatric evaluation.

Second of all, while I have the knowledge and self-awareness of my condition to know when I should seek help, I have to recognize that not everyone else does. I do struggle with this, mainly when I see things that others don’t and I am baffled as to why other people can’t see it.

Third, this sort of thing harkens back to the 19th century and the abuses that brought about laws regarding civil commitment and involuntary commitment. No one person should have the power to have another person committed to a psychiatric facility for no good, valid reason.  You must build a case and present it to a judge, who then decides if that person should get a psychiatric evaluation. Then the judge uses the results of the evaluation to determine if involuntary commitment is even warranted.

While NPD is one of the ten personality disorders recognized by the DSM-V, it is highly unlikely that a judge would find that Donald Trump would meet the legal criteria for involuntary commitment. Delusions of grandeur are not even in the same category as the delusions or hallucinations that someone with schizophrenia might experience.

And fourth, civil issues pertaining to mental illness, like voluntary commitment, are handled by the individual states. Each state defines the legal term “mental illness”. Each state defines the procedure that must be followed if a family member wishes to pursue having a loved one involuntarily committed.  The Presidential election is a Federal issue. Which state’s definition of mental illness would apply in this case?

One last thing that bugs me about the way people are talking about Donald Trump and the possibility of his having a mental disorder: NOBODY is bringing up that, if this is indeed a case of someone in the public eye having a mental disorder, the behaviors that we are seeing are the hallmarks of UNTREATED mental disorders.

Many people who have untreated mental illness don’t believe there is anything wrong with them. Or they suspect something is wrong, but they don’t know what or can’t put a name to it. Or they even know something isn’t right, but are unable to get help until they hit their breaking point, which often means they are in the stages of sucidial ideation (thinking about the idea of suicide), considering suicide, or actually attempting suicide.  Or they have a breakdown in public.

Because most people don’t realize that they are having an episode or in the throes of a mental disorder at the time they’re experiencing it, and this happens in public, we just dismiss the behavior as weird or eccentric instead of showing compassion and trying to see that they get the help they need. And then when this person goes public with their diagnosis, we’re quick to dismiss them as seeking attention or trying to avoid responsibility for their actions.

People who have been diagnosed and who live with this every day should be able to talk about it, especially if talking about it aids in their own recovery.

There is treatment available. Granted, much of the issues surrounding mental health is the access, affordability, and availability of treatment for people who wish to seek it. But it is out there. People need to understand that showing signs or getting an actual diagnosis is not the end, but the beginning. They need to understand this in order to help advocate that anyone who wants to seek treatment can get it and not have to wait until they are suicidal or can no longer care for themselves.

I did seek treatment for my smorgasbord of mood disorders. My treatment consists of medications and putting into practice the coping skills I learned through behavioral management, cognitive behavioral therapy, and dialectical behavioral therapy. I learned how to recognize what might trigger a panic attack. More importantly, I learned that avoiding those triggers just made things worse. I learned how to face them, but more importantly, I learned how to recognize when to push and when to back off with the intention of trying again later. Two years ago, I could not go into a grocery store on a Friday afternoon because of my anxiety. Today, I barely even think about the crowds and the sensory overload around me that fuels my anxiety.

Now if I had to pick one thing that I wish people would understand, it is understanding that I don’t view mental disorders as something I should be ashamed of–not having one (or three), nor being associated with someone who has one, nor the possibility of being associated with someone who shows the behavioral signs of having one but has not been diagnosed nor is being treated for it. I am not ashamed of the term “mental illness”, either.  I feel that people need to understand this so that they stop mistakenly using shame in trying to quell stigma. When I see people who think they’re helping me by telling someone else that they’re shaming me, all I see is that person projecting their own shame and embarrassment onto someone else.

I get it. Mental health is an uncomfortable topic. I wasn’t always comfortable talking about it myself. But the rest of the world is just going to have to get over their discomfort because we really need to talk about this topic.

If I have nothing to be ashamed of, then neither do you.

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New Meds and other Sundries

I haven’t posted in awhile. Busy with school. I’ve discovered that I like chemistry after all. I remember not liking it and not wanting to take it in high school because in junior high, we had to do A/B work if we wanted an A or a B in the class. I was so against this on principle, I wouldn’t do it and so I got C’s. I was against it because I felt that I should be graded on the basic class work and that my grade shouldn’t be based upon doing all this extra work and extra credit. Extra credit should be a choice.

Plus there was algebra, which I hated then and was not good at and, deep down, was afraid of and had convinced myself that I was no good at it. This was all because the teacher I had then was an asshole.

I conquered my math demons last year. While I had to take remedial algebra (for no credits) and then College Algebra, and I only got a C in College Algebra, I’m happy with it. I won the math battle.

 

Anyway, now for the meds saga. For background, see this post.  Long story short, I kept taking the prozac. I saw my doctor this past Friday and told her what happened. I’m doing better  than I was a month ago, and I know that some of it is because I started school and have more structure in my day. I’ve got my attention/focus issues sorted out and I went back on Vyvanse, which I haven’t taken in over a year. I was on that first, then switched to Concerta, which didn’t really do much for me. I wanted to get the old meds out of my system and then see how well I could manage my ADHD without meds. This was so I could get a base point. I am doing better managing some aspects of my attention and sticking to task, but I still need the meds for the other part I can’t manage.

One of the good side effects of this medication is weight loss. I have a confession to make. When I went off the ADHD meds, I gained at least 50 pounds. I’m flirting with weighing 200 lbs and I’m not liking this. It’s harder to find clothes that look nice and fit. I don’t like being winded. On the flip side, I do like the fact that my boobs are HUGE now.  As much as I try and get up and move, I haven’t been able to lose the weight or maintain where I’m at. I know some of this is due to age.

I will probably lose a bunch of weight after I’m on the meds for a bit. I’m hoping that I don’t lose too much in the beginning because I bought a dress for my son’s wedding and it would suck if it were too big for me to wear. Best case scenario is that I won’t have to wear the spanx I bought to wear with it. I do have a back-up dress. I’m hoping I don’t need it. It’s a nice dress, but it’s black and I don’t want to wear a black dress to my son’s wedding. I genuinely like my future daughter-in-law and I do not want people to think I’m pulling some attention whoring stunt by wearing a black dress.  Even so, if it comes to it, I’ll let her know what’s going on and why.

Right now, I swear, I could go run laps around the apartment complex and still not calm down.

I haven’t done a song of the day in awhile, so I’ll do one.

Today is opening day for the NFL and the Packers-Bears game is being nationally televised.  The Packers are in Chicago, so when they score, we won’t be hearing any Bang on the Drum. Today’s song is Bang on the Drum. I plan on firing this up whenever Green Bay scores.

 

The Medication Saga Continues

I’ve blogged a bit about the hoops I’m having to jump through in order to get new anti-depressants that my doctor prescribed for me. There are even more hoops I have to jump through, which involve approval forms in order to have the meds covered at a tier where the copay is one I can actually afford to pay every month.

Apparently, my medical records aren’t enough; I have to have my doctor fill out a paper stating that I had previously been taking an approved generic medication for a minimum of 30 days before they will cover a brand-name at Tier 2.

I’ve been on my current medication for JUST OVER 2 YEARS!

This hoop jumping because of some bean counter with no medical background or expertise in mental illness is absolutely bullshit. It’s pure bullshit.

And no, this isn’t because of Obamacare. I’ve been going through this long before Obamacare became the law.  So don’t even bring that up.

It has everything to do with the state pharmacy board, insurance companies and how they develop their drug formulary.

What I am experiencing is one of the reasons why some people don’t seek help for their mental illnesses. How am I supposed to be well when I’m denied medication I need and then have to go through all of these hoops to get it approved? How am I supposed to function on medication that isn’t working when the meds I do need are denied to me?

What most people who don’t deal with a mental disorder don’t understand is that we who do have it, or those who care for someone who has it, have to be our own advocates. The stigma associated with mental illness is very, very real and this is one of those times when you run into it head on. Stigma is discouraging. When you’re not well, when depression and anxiety are threatening to pull you back under, you have to somehow muster the strength to fight and keep fighting for the proper care that was decided upon by both you and your psychiatrist.

Well, my insurance company better buckle up because I refuse to back down on this.


 

Today’s song is self-explanatory and also NSFW.

 

My Head is Swimming

Well, I can definitely tell that things are getting better as far as the sinus infection is concerned. I can get up and do things, but when my head starts to swim, I have to sit down. I’m hoping to make soup tonight.

Less than 7 days until school starts back up again. I’m looking forward to it. This morning, my chemistry class was posted on D2L, and I can tell it’s going to be a tough one. I’m up for the challenge.

I’m waiting on a couple of text books to come today. These are for my two psych classes.

Screenshot_2015-08-18-11-03-37
Two Days Ago, it was in the 90s and humid. What a difference two days and a cold front makes.

It’s gray and cool for August. Soup weather. In fact, if my head stops swimming, I’m going to make soup for supper.  This is one of those days that remind me of October and that when fall rolls around, I like to start baking and cooking again, especially comfort food.

There’s a glitch in my new meds. I can’t afford them. So now, between the doctor, the pharmacy and me, we have to figure out something that works and something I can afford. $75 a month is ridiculous.

This is one issue that many people who deal with a mental illness face: little access to affordable medications. The insurance companies don’t seem to understand that psych meds work differently on different people. What works for me may not work for someone else. Because two medications are similar doesn’t mean that they work the same on different people, either.

Sometimes, a medication works for awhile, but then it isn’t as effective after a period of time. This is what is happening to me at the moment. I need to try something else, but again, my insurance company is interfering with the decision that should be between and my doctor.  When the option we decide on for my disease management is either denied to me outright or it becomes difficult for me to have access to it, I am basically in the position where someone in an office, some number cruncher, is dictating my health care to me.

Ironically, this was something that people who opposed the Affordable Care Act cited: bureaucrats and strangers making medical decisions for you. This has been going on long before Obamacare became the law. This is also not the first time I’ve had this happen to me, either.

When people do not have access to medications, counseling, or whatever treatments they need to have, treatments that are decided upon by both patient and doctor, mental illness goes untreated.

Untreated mental illness does not get better on its own. 

People need treatment now, not later. Not when they become agoraphobic from an untreated anxiety disorder. Not when they start listening to the voices telling them to do things they know they shouldn’t do because they have undiagnosed or untreated schizophrenia.

They need it NOW. 

 


 

Today’s song is Here Comes That Rainy Day Feeling Again by the Fortunes. It’s a rather upbeat song about something sad. It’s a good metaphor for today. I’m feeling upbeat, but the day is gloomy.

 

The Anxiety Monster Strikes Again

One of the major anxiety and depression traps I have to try and avoid is worrying about things over which I cannot control.  I don’t want to say it’s always easy to do this, because it really depends upon the focus of my anxiety. It’s easier to make myself take a step backwards and get my bearings when the focus is on a thing or a situation. It’s not so easy when the focus is another person’s behavior.

Lately, I’ve fallen into this cycle of worry, depression and anxiety and I’ve felt this way since D came home from Gen Con.  While he was in Indy, I was holding down the fort in Sioux Falls. And then I noticed a few things that I couldn’t notice if he were there.

D is overweight and I worry about that. He’s addicted to Coca-Cola, and I’m worried about that. We live on a third floor apartment and whenever he comes in the door, he’s not only out of breath, he breathes through his mouth even when he isn’t out of breath.

He’s had to get a CPAP for sleep apnea, which I believe is both age and weight related.

I’ve noticed, while he was gone, that I avoid wanting to cook healthier like I used to because if I do, it goes to waste. While he was gone, I ate more veggies than I do when he’s around.

I get the soda addiction because I used to be addicted to Mountain Dew. I rarely drink soda anymore.

In the middle of all of what sounds like a lot of complaining on my part, is this worry that one morning, I’m going to go into the bedroom when it’s 45 minutes past when his alarm went off and find that he died in his sleep.  Or that he has a heart attack and he either dies from it. Or that he is diagnosed with diabetes and won’t do what the doctor tells him because he has to give up eating bread and other refined carbs and sugars.

What makes all of this worse is that I know that I’m catastrophizing things, but I can’t stop.

I love my husband. I wish he would take better care of himself. I have both unselfish and selfish reasons for wanting this.

I think my current meds have stopped working, too, but that’s easier to do than having a conversation I’ve had with him many times before.