I don’t think this is you

“I don’t think this is you.  This is your pathology, not your personality.”

 

This was told to me by a psychiatrist when I was going through a particularly rough patch, and my behavior was less than stellar.  The thing with mental illness is that our symptoms are not just seen as something apart from us.  The way mental illness manifests, is that it affects the very way we think and feel, the way we perceive the world around us, and the actions we take.

Sometimes corrections a person who is mentally healthy can take are actually impossible for a person with mental illness.  Then there is the added stigma of that if we were just “better”  more compliant with our treatment, or choosing different treatment that our illness would be better mitigated.

 

Being mentally ill is not something we “do” to other people, but unlike many other illnesses, it can get a bit messy, and affect not only we who are suffering, but affect those around us as well.  I don’t know how to avoid this.  And the longer that we do manage to hold things together the more it seems like a betrayal when things finally go off the wheels.

 

Mental illness is damaging.   It destroys one’s careers, one’s relationships, one’s perceptions, thoughts, and emotions.  In my case, any mitigation is always ephemeral. Sooner or later, it will become evident that I am ill.  Things will be done that are out of character for me, but they will still be me doing it.  While I get dissociated and see my pathology take the driver’s seat while my personality is taken along like a passenger.

 

Mental Illness is a hell of a thing.

When my illness feels close to the surface

Most days, under treatment, the symptoms of my mental illness can be mitigated.  My symptoms are always there, but some days they are further from the surface than others.  Today is not one of those days.  I feel very aware today that I am mentally ill. It makes me feel fragile somewhat.

Treatment even at its very best is imperfect. And my current treatment regimen is far from ideal.

I always try to do the best with what I got, and not see myself in competition with those around me, but right now I can’t help but see how deficient I am compared to folk who do not suffer as I or others do.

Part of this itching feeling of my illness being so close to the surface has made me more aware and sensitive to stigmatization of mental illness.  Deficiencies in mental health seem to be constant fodder for jokes about how crazy or insane someone is, or off handed comments about someone being off their meds.  When I am feeling more well, I can more easily brush these things off, but on days like today, they hurt.  They seem to cut deeper than most days. Where someone can apply a label in jest, there is nowhere I can go where I am not mentally ill.

Mental Illness in the Magic Kingdom

009

They call it the Happiest Place on Earth for a reason.  Within the span of a week, I have found myself in a psychiatric hospital after a suicide attempt for five days, then a few days later five days at Disneyland, in Anaheim California.

This is not the first time this sequence of events has happened.  When I was a teenager in 1987 I went from a psychiatric hospital to Disneyland in a span of days.

During my medicine respite in 2014,  I self-medicated with pixie-dust. My fiancee and I made frequent trips to the theme park which we jokingly called Disney Therapy.

I have had my medicine adjusted recently during my hospital stay, and am no longer suicidal, however suicidal ideation (and attempts) are just one of many symptoms of my mental illness of bipolar disorder.   The fact of the matter is, I have had a malaise of depression during this visit which has put a bit of a grey haze over what should be one of the most enjoyable things I can do in public.

I’m not exactly sad, though it seems to present as sadness.  What I really feel is frustration. Frustration that I cannot seem to have a genuine emotional response to something, but rather have to filter things through the symptoms of my illness.  Now there have been times approaching joy here at Disneyland, but it seems in general happiness is being held in reserve for something.  I don’t know what that would be, and I am sure that this articulation of my emotional landscape falls short of the actual experience.

A trip to Disneyland should not be an exercise in perseverance, pushing myself forward, and working hard to not give in to depression and just retreat.  Now as far as environments go, it is one that is easier than most to persevere in the face of depression, but no amount of Pixie Dust actually negates a mood swing.   We have been leaving the park early — often before or during the fireworks display, and my partner has taken pride in how well we are pacing ourselves — not pushing ourselves too hard.  Thing is, most of the time, I am pushing through an undefined malaise and the desire to just retreat.

I don’t want to make it sound like a Disneyland vacation is a chore — it is certainly not, but neither is it really the escape that the planning video claims it will be.  There is nowhere I can go where I will  not be mentally ill.  There is no amount of fun that will mitigate my limiting neurochemistry.  Rather than escaping my mental illness for a few hours, this trip just puts it in sharp relief.

I sincerely believe that Disneyland really is the Happiest Place on Earth.  I am not at all unhappy, I am just ill.

The continuing saga of Mental Illness is a hell of a thing part 43

I have come to the recent realization that I treat my emotions with suspicion. The nature of my illness means that emotions arise for no discernable reason other than my brain not acting in the manner that a healthy brain acts.

Part of my coping mechanism has been to develop a sense of emotional awareness.  Through introspection and self-honesty, I tend to dig down and analyze not only the emotion I am feeling, but the why of it.  It is only when I can understand why I feel a certain way that I can feel the emotion is genuine and not part of my pathology.

Mental illness is a hell of a thing.  I have lived with a diagnosis for 28 years now, but honestly the illness has been a lifelong presence for the 43 years of my life.  I have gotten pretty good at navigating it for the most part, but I also know it is probably inevitable that my coping mechanisms, support, and medication will not be enough and things go tits up again. I have built these survival strategies over my life, and it is sobering to realize that there will be a day when they are insufficient and I will need to learn new ones.

But for now, I am doing the best I can with what I got, and strive to keep moving forward.

Fernando Therapy

In the 1980s Billy Crystal had a character on Saturday Night Live that insisted that it was better to look good than to feel good.  With a cyclic mood disorder, there will be days, many more than I would like, that I won’t feel good.  Even with medicine and therapy, I will find myself in a depressive mood swing, and there really is nothing for it.  No amount of positive thinking or will power will allow me to not be depressed.

But even in a depressive episode, if i is not severe, I still have some control in my life.  I express this control by making the choice to look good.

Today is one of those days.  I have had mild depression for a few days now, so I indulged in a little self care.  I showered (something I am prone to neglect when depressed), and spent a goodly amount of time on grooming.  I’ve recently started shaping my beard in such a way that I get to wear a full beard, but also get to engage in the ritual of shaving regularly which I enjoy.  I got dressed in a shirt and tie, with the addition of a small lightsaber pin as a tie-tack.   I finished the outfit with bright red shoes to contrast my black pants and shirt, and to coordinate with my black and red tie.

I am still in the grip of depression, but it is balanced somewhat with pride in my appearance. It is a small victory, but I will take it.  Mentally ill, but still MARVELOUS.

There is no escape in this life

I am feeling a general malaise today. I think I am having a slight mood swing to the depressive side of things.
 
I am generally pretty accepting of my disorder which causes moods to manifest for no environmental reason, but just the whims of my brain chemistry. I accept it, but today, I don’t like it.
 
I am bipolar and there is not much I can do to mitigate that. I have medication. I have my coping mechanisms honed over a lifetime of living with this illness.
 
I recently had a discussion with a friend if I ever wished I could have a brain that works in a healthy manner. I said that I did not, not really. Mostly because I do not want to wish for something that simply is not possible. I am resigned that my illness will be a lifelong condition, and there is no escape from it.
I cherish my periods of stability, but I know they will always be brief respites between the hills and valleys of my cyclical mood disorder.
If there was an escape where I could continue living I don’t know if I would take any cure.  I mean practically, I probably would, but I have to wonder, if I lose my illness, would I also lose my creative fire?   Because my illness is manifest in my very mind, any treatment, and if there is someday any cure, would alter who I am.   And I generally like the man I am.  I have done a lot of work on myself, and I continue to do so, to shape myself in the person I want to be.  Well, that is, the person I want to be within the confines of my illness.
There is nowhere I can go, nothing I can do that will stop me from being ill.  Part of my life philosophy is to not form attachment to the way I want things to be.  I learn to recognize what is within my power to change, and what is not.  There is not any benefit in giving time in my thoughts to ideas that begin with, “If only I were not mentally ill, I could…” so I do not give my own mental resources to such exercises.   Rather I subscribe to a philosophy featured in one of my favorite Disney films, So Dear to My Heart. Namely, “Doing the best with what you got.”
Being mentally ill does prevent me from living the kind of life that many enjoy.  But that being said, I strive to do the best I can, with what I got.  Many times I fall short of what many people feel is “acceptable” yet with a at time debilitating illness many of my life activities are disrupted to the point of disability.  That being said, when I do fall, I at times just let myself lie there for a while, but I always get up eventually.   I keep moving forward.  I strive for small forward progress. Because I know even the smallest of steps, over a long period of change can effect a profound change.

The (lack of) joys of rapid cycling.

One of the aspects of how I suffer from Bipolar Disorder, is that I occasionally rapid-cycle.

 

I am having one of those episodes right now.   I was fine an hour ago,  took the garbage cans from the curb and back up against my fence, I walked my dog, and I chucked a blu-ray from Netflix (that I got in October) in the mail.   Things were fine,  I felt fine, nothing seemed out of whack.

Then… there was a sudden transition.  I could feel an even mood nosedive into a heavy sadness or slight depression.   Quite literally I was fine one minute, and the next I just felt the weight of a mood swing come across my body, my shoulders hunch, my head goes down, and I just hold my head in my hand and sigh.    Writing these words now feels like Sisyphus and the boulder.   This is a slight depression, but it is still depression, and that means even simple things take more effort.

The transition from “normalcy” to depression happened as quickly as the transition of walking from the outside to indoors through a door.  It did not creep up on me or build overtime.  Quite literally I was fine one minute, and the next, struggling, the feeling of slowly drowning or being buried, with no vector for these feelings to be addressed.  I am pretty sure there is no environmental cause, but just what my brain does.  Have I mentioned my brain is an asshole and entirely unreliable?

I was having a very difficult time with recall yesterday, I was worried about my brain acting up (I have a not quite small amount of anxiety about the reliability of my brain), I wonder if it was a precursor to this sudden mood shift?  Any answer would be guesswork.

DBHC Journal: Intake

On August 26, 2014  I voluntarily went to Doctor’s Behavioral Health Center in Modesto, CA to seek treatment for my illness of Bipolar Disorder, which at the time was not being treated clinically.   It soon became clear to me that the treatment I was receiving and would receive would not be appropriate, or perhaps not be all together legal.   I asked for writing paper, and was given  blank printer paper and a soft “bendy” pencil that would write faintly.   Over my 2 and a half day stay at DBHC, I wrote about 42 pages of handwritten prose.   This is the first excerpt from this journal.


 

This is what it is like for a mentally ill person seeking to return to treatment.  The beginning of the intake process was me surrendering my personal property, leaving me with a percentage of the clothes on my back.  I had to remove my wristwatch, my shoes, my belt, and two pins.   I was then subjected to a pat-down that I never gave verbal consent for, where my wallet and cell-phone  were confiscated, then I was left for what seemed a long period in a bare room with no stimulus.

Between the brief visits from nurses, I am left to my own devices — which amounts to the clothing I was allowed to keep and the pieces of furniture, three of which make up a small couch.  I have rearranged the room twice so far.

I am told I will be taken to the ER for a health evaluation before a decision as to whether or not to admit me to is to be made.  I suspect a the decision has been made, and it will be after I am returned here from the ER that I will be told of it.

A nurse came back in with the questions to determine if I am alert and orientated.  Before this I was informed that they are placing me in a 5150 hold.  So I will get help.  The bad news is that it is after 6:00 PM at this point; the 72 hour observation period will end after court has gone home for the weekend.  So discharge will be Monday earliest.

There is no way to communicate this to my loved ones at home, or my best friend who brought me here.  I imagine they are more concerned than I am at this point.

The questions I have so far been asked have been for the purpose of filling out fixed forms, which contribute to a decision-making matrix taking into account essentially minimums of legal liability.  I have been here at least two hours (though I cannot be sure, as I have no access to anything to measure the passage of time) and have had no opportunity to disclose my long-established diagnosis of Bipolar I and the period I have been without treatment.

I have just been informed that I am not allowed to walk to the ambulance that will transport me to the ER, but that I have to “sit on the gurney.”  I bet dollars to donuts I am about to be restrained.

Currently waiting in a room manned by more uniformed law-enforcement types than medical personnel.  I was restrained — but more seatbelts than straps to keep me from being dangerous.  You win HALF a donut.  I got here at a shift-change  — that and Tenet’s [The corporation that owns the facility and contacts with the county to provide care] practice of understaffing,  to the point of illegality means I will be here a while.

More clothes have been taken from me, and a tie-in-the-back gown given in trade.  Of what I dressed in today, all that remains are my socks, boxer-briefs, eyeglasses, and a hair tie.  Who wants to wager that my hair tie will be the next thing  surrendered  on my return to the psychiatric hospital?

I had to give a urine sample. When directed to leave it on a counter by the sink, I say that there is a second sample there, and both are unlabeled. I am assured that they can tell them apart.  When someone else asked, “who’s urine?”  a voice called out that the light one is his, and the dark one is hers (the donor of the dark urine arrived in handcuffs escorted by a sheriff’s deputy).

A quick examination by a doctor, I tell him matter of factly of my long-standing diagnosis, my period without treatment, and that I am in crisis.

I have obtained a new piece of clothing — and ID band. On it are four copies of the same QR code.  When I get my phone back, I will see what Google Goggles has to make of them.

I am medically cleared to return to the mental hospital, but am not allowed to do so in my own clothes.  So, an ambulance has been called.

The donor of the dark urine has begun to yell; it is addressed by one person in scrubs and three in blue security uniforms, with a fourth standing back holding leather restraints.  I mean, I can’t blame them, but the entire experience has been demonstrating that the mentally ill are treated more like criminals than patients.  They drew a curtain, but it sounds like bodies piling on her and replacing her steel handcuffs with the burgundy leather straps.  I can see to my left a bin overflowing with the things and covering the surface of the cart on which the bin rests.

Before they exited  from behind the curtain, I heard not-quite suppressed chuckling, then first security guard walking by me with a smile.  The two uniformed security guards are still laughing about something, but their conversation is too hushed to know what.

My personal effects are here in a locked cabinet that I saw one of the pseudo-cops open.  I think it would probably be futile to ask for access to them.  It is locked by a push button combination lock; the combination starts at the top and works its way down the single row of five buttons.  I think I could probably open it in 3 tries or less.

I asked about access to my personal effects and, as expected, was denied.   I asked if it was because I am under a 5150 or if it is policy for all patients. I was told that it was I am ‘a 5150.’  I asked then if I could make a phone call, and was told by the security guard that it was up to the nurse, who as if on cue, stood up and walked out of the room.

Currently I am one of three patients in this room, and the only hospital staff is the smiling security guy, hand on mouse, staring intently into a monitor. He took a small break to take out his Maglite, examine it, and re-holster it. I spent a year in my youth as a Police Cadet, and know the many off-manual uses of a Maglite.  In a well-lit hospital with back-up generators, any uses Smiley has for that piece of gear does not require charged batteries (dead ones would be of use as added mass).

I can hear my phone, in my satchel, in the locked cupboard, occasionally alert me to a Facebook IM.  It was also logged into Second Life when it was confiscated, as I was letting people who I mainly have contact with through that virtual world know what was happening.  I can only wonder what they must be thinking as my avatar is standing alone and idle, doing and saying nothing.

It occurs to me that the release they had me sign that would allow my fiancee to  know I was admitted, my general state, and to visit me was presented to me with only her name filled out.  When I said that it was incomplete, the nurse insisted that it did not have to be filled out.  I filled out what I had memorized, and crossed out what I did not.  I signed the bottom and only then notice text that read something like “I have been offered a copy of this release” – it was taken from my hands before I could strike that out. Of course no offer was made.

It is getting later, I am getting hungrier, and still I wait in my argyle socks and tie-in-the-back hospital gown. My plan upon my return to the mental hospital, after I am given what effects I am allowed to have, is to get dressed in my own clothes, call my loved ones, and directly after that, my patient’s rights advocate.

A fourth patient has arrived, and the staff here acted amazed that he was not here under a hold.

I arrived at the mental hospital at 4:40 PM – I remember this because I had to put that on the first form I filled out.  That was three minutes shy of four hours ago according to the the clock on the wall.  A few hours before that, I had contemplated suicide by Googling the the overdose of Ambien (15 mg) and counting out eight 10 mg pills on the bathroom counter.  Before I went through with my plan, I Googled a suicide hotline (with the first resulting link being broken) and tearfully explained my state of mind, which lead to the series of events that lead me here – writing longhand twelve pages of my experiences so far with a bendy pencil  (bendy, I assume to prevent stabbing).   I have still not been offered any clinical help.

Due to the nature of my illness, I have been treated to a series of indignities as a prerequisite to receiving treatment.  I will be confined in a place that, if past experiences play out, will be like a combination of jail and kindergarten.

Upon return, I am deposited in the same featureless room with no stimulation.  The furniture is not as I left it.  I suspect it was searched while I was at the ER.  I was told by a security-type that some of my clothes will be brought to me.  I was not asked if I had any preference as to what the selection will be.

I packed my brown Jedi robe, both because I wear it when I feel too cold, like a hoodie, and it also comforts me emotionally, like a security blanket.  If they do not allow me to have or wear it, I will insist that it is a religious garment.

Over four and a half hours since I have arrived and have not been offered any psychiatric help of any kind.

I had a crying jag in the ambulance on the way here.  In a moment of brilliant insight, the woman in the back with me asked if I were an animal person. I am crying again about my dog, Sadie.  I rescued her recently, and tonight will be our first night apart in 26 days since I brought her home.

Those fucking pseudocops in the hall can see me weeping and I am left in this featureless room, alone, in crisis, with no means of contact with loved ones, not even the company of a stranger or the dignity of my own clothes, other than my nicest pair of socks and some clean boxer briefs.

Not only am I not being helped, much less cared for, I am being denied things that would be beneficial, like my robe, my family, or my dog.

I was wrong about being alone. There is a mosquito here and I sometimes have an allergic reaction to mosquito bites.

I have just come from the toilet.  I asked the the hallway guard if the lack of paper towels was an oversight, or intentional. It is intentional.  I dried my hands with toilet paper.

I have taken off, and folded as neatly as I can manage, the issued hospital gown. I will suffer the chill and immodesty of sitting here in drawers and socks for the sole reason that it is practically the only choice available to exercise what autonomy that currently remains with me.  I am entertaining the the thought of nudity as protest once I get on the ward.

When I was on this campus in 1987 [in 1987 it was the newly opened Modesto Psychiatric Center; by my stay in 2014 it had changed names and owners twice], it was some of the finest care I ever received.  I would say that so far, this is the worst care I have ever received, except that I have received  no care whatsoever.

It occurs to me that the first thing I wrote that was published in print was a letter written while I was here in 1987 to the letter column of the comic book Ultra Klutz, which in turn lead to my first short story being published in the letter column of a different issue.  I wonder what readership this journal will eventually find?

My clothes, the ones I walked in wearing about five hours ago, have been returned.  Well, shirt and slacks.  My tie, belt, shoes, watch, and pins, along with the rest of my property, are still confiscated and unavailable to me.

I decided to wander the halls to ask the first employees I could find to ask if mental health was exempt from the oath of Hippocrates.  The pseudocops who found me me had never  heard of the Hippocratic Oath, one claiming, “I just got here.”  I informed them that the first tenet is, “do no harm” and asked why for the first five hours I have been subjected to things detrimental to my mental health.  I asked to see a clinician, and was sent back to my featureless room with no stimulation.

Just-got-here popped his balding head in the doorway a few moments later to inform me that a nurse will be transferring me to a unit “soon” and I will be helped there.  Among my skills and past professions is computer programmer.  I know that the value of “soon” is never a small amount of time, but a value between three times longer than you expect and “never”.

I just finished editing the previous 20 hand-written pages (good writers are inspired, great writers edit) and I am still here, hungry, alone in this bare room.  “Soon” is not here yet, as its actually only been slightly over twice as long as expected.

I have started a new form of protest.  While trying to request food, phone, and new paper, I was ordered back in the room by another pseudocop.   I decided to stand in the room, but keep the door open.  Pseudocop ordered me to shut the door.  When I asked why, he insisted it was policy.  When I pressed for reasoning behind the policy, he refused (I suspect ignorance).  I then said I was choosing to break the rule. He then huffed off saying then he could not listen to my requests.  So I have again rearranged my furniture using a a section of that three-chair couch thing to prop open the door.


Coming next: On the unit.

Good writers are inspired, great writers edit, and excellent writers have their talented writer friend Amy Mayo help with the editing.

My upcoming day in court

Tomorrow, I have a court date.   I am not in trouble, but I am bringing a petition to have relief from a firearms prohibition.

Why do I have this prohibition? because I sought treatment for an illness.   The events that lead me to seek treatment at Doctor’s Behavioral Health  Center in Modesto, CA resulted in putting me under a 5150 hold — in short  someone determined that I was a danger to myself or others.

 

Under the Welfare and Institutions Code section 8103, after being placed in such a hold, I cannot so much as hold a firearm for five years.  However I do have the right under the same Code to petition to have relief from this prohibition.   While I can understand some cases where such a prohibition may be desired, it rankles when it is applied to me.    While I do not own any firearms, it is not within the realm of possibility that I may want to use one before the year 2020.   I passed the Wyoming Hunter’s Safety Course, being the only person in the class who scored 100% on the written test. I think Elk is one of the most delicious animals, and I cannot purchase elk steak at the S-Mart.  Deer Jerky is also very yummy.

 

When I was being discharged from DBHC, it was a flurry of forms, and a peevish nurse that was upset that I was taking the time to read what was put in front of me before signing — and refusing to sign if there was false statement on the form.   One of these forms was informing me of the prohibition I was now under, and having to surrender immediately any firearms I owned and had two boxes to check to either request a hearing for relief, or to waive my right to a hearing.

 

The box to waive my right to a hearing was helpfully pre-checked for me.

 

I modified the form,  but fearing that my modifications would be unclear — I copied the near-illegible url at the top of the form — it turns out incorrectly, but google is pretty smart and I found the form to petition to print out at home and mail to the Superior Court.   A copy of the original form somehow did not make it into the pile of papers and forms I was given at the end of my discharge.   So I printed out a new form, and wrote the following cover letter:

 

To whom it may concern:

Please find enclosed a request for hearing for relief from firearms prohibition. I was presented a form to sign during my August 28, 2014 discharge from Doctor’s Behavioral Health Center, 1501 Claus Road, Modesto, CA, that was filled out when presented stating I did not wish a hearing. I modified the form to request a hearing.

In my copies of discharge documents, a copy of this form was absent. Therefore, I am sending this form in the belief that the form I was presented during my discharge may be difficult to interpret, or not submitted at all. I apologize if this results in any duplicate paperwork or scheduling for the same case.

Sincerely,

L. Christopher Bird

 

That was sent September 1, 2014, and tomorrow, October 10th, I have my day in court.   But I would be lying if I said that it grates at me, that what is considered an fundamental right in the United States is contingent upon the health care options available to me for the treatment of mental illness.

 

My treatment at DBHC from the outset was more appropriate to a prisoner than a patient, and this is just a continuation of that.  Understand, I committed no crime , but because I was exhibiting the symptoms of an illness, I was subjected to a pat-down, the confiscation of my property, and   the removal of constitutionally guaranteed rights.

 

The good news, is that I think the law is on my side.  To wit:

 

 (6) The people shall bear the burden of showing by a preponderance
of the evidence that the person would not be likely to use firearms
in a safe and lawful manner.
   (7) If the court finds at the hearing set forth in paragraph (5)
that the people have not met their burden as set forth in paragraph
(6), the court shall order that the person shall not be subject to
the five-year prohibition in this section on the ownership, control,
receipt, possession, or purchase of firearms, and that person shall
comply with the procedure described in Chapter 2 (commencing with
Section 33850) of Division 11 of Title 4 of Part 6 of the Penal Code
for the return of any firearms. A copy of the order shall be
submitted to the Department of Justice. Upon receipt of the order,
the Department of Justice shall delete any reference to the
prohibition against firearms from the person's state mental health
firearms prohibition system information.
   (8) Where the district attorney declines or fails to go forward in
the hearing, the court shall order that the person shall not be
subject to the five-year prohibition required by this subdivision on
the ownership, control, receipt, possession, or purchase of firearms.
A copy of the order shall be submitted to the Department of Justice.
Upon receipt of the order, the Department of Justice shall, within
15 days, delete any reference to the prohibition against firearms
from the person's state mental health firearms prohibition system
information, and that person shall comply with the procedure
described in Chapter 2 (commencing with Section 33850) of Division 11
of Title 4 of Part 6 of the Penal Code for the return of any
firearms.

TL;DR: The State has to make the case for the prohibition, and if the D.A. does not show up, I win by default.

Even so, I am nervous as all get out.