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.

The DBHC Journal: Excerpt.

While committed at Doctor’s Behavioral Health Center in Modesto, CA as a survival mechanism I kept a handwritten journal which during my 2 and half day stay there ended up being 42 handwritten pages.  I shared the excerpt below on my Facebook wall shortly after I got home, my plan was to transcribe it in its entirety.   I put that project on hold when I decided to use a public-facing blog (and here you are, reading it!)   Once I finish with the “archival material”  my plan is to start posting sections from this journal.

 

This was during intake, after my clothes had been returned to me after my medical clearance at the ER — I was feeling desperate for help at this point, and quite angry I has not getting any — this is several hours into my experience there:


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 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 stimulus.

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 the value “soon” is never a small amount of time, but rather, a value starting from 3 times longer than you expect, and as long as “never”.

 


 

As commentary on the above, the first “help” I got on the unit came 22 hours after I first arrived, with my first one on one meeting with my clinician.

Suicidal Does Not Mean Sad

A post from Facebook giving some context of what my mindset was during the August, 2014 Crisis

 

L. Christopher Bird
August 29

I want to address a topic that seems to keep coming up, when talking with my friends about the event of the past few days.

I was not suicidal because I was “sad” or even “depressed” it was an expression of an illness I suffer from, that had gone untreated for far too long (some of the responsibility for the lack of treatment falls squarely on my shoulders, SOME).

If anything, I was SUFFERING, and I sought and end to that suffering. One of the avenues that I could figure out while in the state I was in, was suicide, the other was gaining treatment.

Even though I was not quite rational, I WAS “working the problem” as is my practice. I did seriously and sincerely contemplate suicide, so much as researching a method, and taking steps to carry it out. Before doing so, I sought other alternatives — which including finding and calling a suicide/crisis hotline.

I knew even there, that gaining treatment was ONE path to mitigate my suffering, and suicide a way to end it — however it would also end many things I enjoy — but could not enjoy while my suffering persisted. One of the reasons I was placed in a 5150 hold, because when asked my intentions, I clearly stated that they were predicated on if I was able to receive treatment or not. If I could not receive help, then it was my sincere intention to come back home and continue with what I had researched.

I do not know if it had to come to such an extreme crisis for me to be able to receive care in a timely manner, but by my perception (which I admit may have been flawed) it seemed to be to me.

I am on the mend…

“I am ill, I am here for treatment.” “Great, hands on the wall, feet on the yellow line.”

imagesterryfrisk
This was the first account I wrote in detail of my experience at Doctor’s Behavioral Health Center in Modesto, CA.  From August 28th.   I will let it speak for itself. 

L. Christopher Bird
August 28

A more detailed update, taken from my handwritten journal will be forthcoming, but in the meantime, now that I am home for the night, and can type on a full-size keyboard instead of on my phone.In brief, the intake process was damaging to me, it has introduced trauma that will take time to recover from, on top of the issues presented by my illness. In short, the first part of seeking treatment for my illness, was an injury.

The first staff I interfaced with after the receptionist was a security guard. The first procedure I was subjected to, was a feet on the yellow line, hands on the wall pat-down, described by the guards as “for our safety”. At this pat down, my wallet and cell-phone were confiscated.

I was then, a mere hours after contemplating, researching, and taken initial steps towards suicide, deposited in a featureless room, with no stimulus. I spent hours in this room, unattended. A couple hours before being sent to the ER and many more hours, after being medically cleared, and driven back in an ambulance, with the my requests to do so in my own clothes. At the ER I was put in a gown to be examined, and my clothes were kept from me for and after my return despite assurances they would be given back to me.

Kept in a featureless room for hours, with uniformed security guards in the hall, nearly all my autonomy taken from me, I exercised what I could. I took off, and folded neatly, the hospital gown I was issued, and sat in that featureless room in my underwear and socks — the only clothing I walked in with that I still possessed. Once I had done so, my shirt and pants were produced and brought to me.

While in that room, on more than one occasion I was weeping openly, with body racking sobs at my situation. At one point, I saw a security guard peer in the window in the door, snarl, and look away, disgusted, while I continued to weep, cold, alone, and unattended for hours.

There is much more, 45 pages of handwritten notes detailing them, but it will have to wait. Of my experiences, this was the most traumatic, but not the last of the continued humiliations, degradations, and dehumanizing practices I was exposed to, because I was an ill person seeking treatment.

More to come, true believers, but I need some rest.

Facebook Posts leading to the August 2014 crisis

I am copying some Facebook posts which will put the posts following some context.   In the previous post, I wrote about my medicine respite, and like any untreated illness, the situation was untenable.   These posts were leading up to me being hospitalized under a 5150 stay at Doctor’s Behavioral Health Center in Modesto, CA.

 


 

L. Christopher Bird
August 26 near Modesto, CA

I need someone to come get me and take me somewhere — anywhere. I do not want to be here, and I have no means to leave.Things are becoming untenable in my current situation.


L. Christopher Bird
August 26 near Modesto, CA

I am seriously considering ending my relationship, but also among what I am considering is just ending …. everything.

L. Christopher Bird
August 26

The last two posts were a classic, but sincere cry for help. Though I was triggered into contemplating suicide, I still have not allowed myself to indulge in my emotions, but have been working the problem, and putting in place a possible solution.After googling fatal doses for medication I have on hand, and ascertaining I probably had enough, I contemplated a bit and decided to see what other options there were I could seek help, and what the process was.

Julian Girouard Jr. is on his way to get me and take me to where I was directed to go. I suspect that soon I will be out of contact until Friday at the earliest (remember that it is better to seek help for suicidal intentions before Wednesday rolls around. ).

I feel angry towards some people that I love, but it is all tangled up as to what is justified, and what is delusion and pathology. I literally have to get my head straight to even contemplate repairing my relationships.


Julian Girouard Jr. posted to  L. Christopher Bird
August 27
A brief update:Last night (Tuesday, August 27, 2014, for you conventional-time keeping folks), I drove Christopher, per his request, to check himself in for a psychological evaluation. I went to visit him tonight, and long story short (although still longer than visiting hours), in spite of the many outrageous things he is enduring to get it, he is receiving treatment. I would not do justice to his story by trying to recount it here myself, and expect that you will hear it in his own words soon.

Right now, he is essentially cut off from the world except for visiting hours and limited access to a Neanderthal-style telephone. He has no access to the internet, his personal phone or to any contact information for his friends and loved ones. If you would like me to pass along your phone number to him, please send me a private message. Please bear in mind that I cannot guarantee that I will be able to get it to him, or that he will be able to call you once he has it. I cannot see any therapeutic value in the isolation and loneliness that has been suddenly thrust upon my dearest friend.

-Julian

— with L. Christopher Bird.


L. Christopher Bird
August 28

I have been discharged, and have a treatment plan in place. The path to get here was horrific. Although that sounds like hyperbole, it is not. Details to come later from about 45 pages of handwritten journaling of my experience.

As a preview, the booking process for my overnight stay in jail in Casper, Wyoming for a failure to appear over the matter of a traffic ticket (the failure to appear was in part due to a depressive episode) was MUCH more pleasant and less traumatizing and less dehumanizing than the intake process at Doctors Behavioral Health Center in Modesto, California.

Up Next:  Accounts of my hospitalization

Medicine Respites, personal illness, and societal ills.

This was originally a Facebook note from August 11, 2014

 

My recent note touched upon how I have not had any pharmacological treatment of my Mental Illness for quite some time.   This has come up here and there, and quite some time ago, I promised a post about my “medicine respite”.  This is it.

Originally, I went off my meds for a variety of reasons, many of which were to be honest based upon being impoverished.  Yes, I had MediCare part D, which made my medicine available for a small co-pay, but that was not nearly the only factor or cost in obtaining my medicine.

To get a prescription, I had to see a Psychiatrist.  These visits cost out of pocket $50 a piece.   Because I had no car, I had to take a bus.  To take the bus, I had to have a pass.

Also riding the Bus took an investment of a minimum of two hours of time, and usually up to three or three and a half hours.  The time was spent getting to the stops, waiting, the actual ride, and the same process on the way back.  More than once, I got stranded because when I got out of my appointment, the routes I needed either initially or during a transfer had stopped for the day before I was able to  avail myself of it.

Then there was the matter of actually picking up the medicine at the pharmacy.  While at times, I was able to get a ride, mostly I had to ride a bicycle for about 30-40 minutes through a high-crime neighborhood to get to the pharmacy, and then the same amount of time (actually a bit longer, as I would be more tired coming back) to get back to the squalid little room I was living in at the time.

So the process of getting a prescription took 7 hours minimum over two days at about a cost of about $65 or so.

Because of my Psychiatrist’s penchant for micro-managing my life, and my occasional non-compliance with my medication, she would have me come see her as often as once a week — writing me a one week prescription at a time (no refills).   So with an income of around $730 a month  about $260 was devoted to getting medicine.  Rent for my squalid little room was $400 a month.   And the time spent obtaining medicine, added up to over a week out of the entire month pretty much devoted to just obtaining my medicine.

It should be clear why this situation was untenable.  But this is only ONE of the points in the matrix that lead to the decision.

While there are others (such as what medicine was covered by my insurance, the efficacy of such, and the bureaucracy of obtaining it), the one worth mentioning is the actual intended effect of psychiatric medicine (side-effects aside).

There is no other way to put it, Mental Illness is a hell of a thing.  While the politically correct thing is to not identify a person AS their illness, the fact of the matter is, with (at least MY) mental illness, the symptoms are expressed as, well WHO I AM.  So any pharmacological treatment,  in essences, changes my mind.  It modifies my very personhood and identity.

While during the worst of my mood swings, this IS, believe it or not, actually the preferred path to take.  But it is a hell of a choice, and it is a hell of a COST.

I know many of you reading this care and love me.  But something to understand, Christopher ON psychiatric medication is for all intents and purposes a DIFFERENT PERSON than I am right now, off of them.  While this medicine, in part, is to help prevent suicide (and other dangerous behaviors) being on it, IS a kind of suicide.  The worst part of this, is that Meds-Christopher is AWARE of the change, and knows that the change is imposed on him.   I gotta tell you, when I am on meds, I do feel like, an emotionally stable (if the medicine is having the desired effect) COPY of the “real” (unstable) Christopher.  Many (but not all) times I feel like an inferior or “less than” copy.

So, let’s talk about imposition on the mentally ill.  Medication imposes a different mind upon my brain, that is one level.  Another level is that society imposes the medication on the mentally ill.

The usual reaction when someone (both friends and strangers) discovers I am mentally ill and not taking medication is “you NEED to be on your meds!”   It seems to be an acceptable reaction from when someone has a psychotic break in public,  to when someone even may just be casually annoying  to state that “wow they must be off their meds”.    I have even seen friends share posts from a Facebook post called “Mom is off her meds again” or similar.  To me, I find this societal attitude very, very hurtful.  The reason such attitudes hurt, is that such expressions imply that treatment in general, and psychiatric medicine in particular, is not to treat or address the suffering of the mentally ill, but as a mechanism of control so that the mentally ill do not inconvenience others.  In short, that if one is mentally ill, then their health decisions are not theirs to make autonomously, but something to be imposed upon them.

It should not matter in my opinion,  what other people think one should do about an illness, mental or otherwise. It is, like all medical decisions, that of the individual and their physician(s).

Being mentally ill, should not mean that one’s health decisions are up for public review, approval, or disapproval.  Unfortunately in the society in which I live, it in fact IS.  Not just by entitled individuals, but by the power of LAW. Let’s put it this way, the worst day to feel suicidal is a Wednesday.  In California a statute enshrined in the title of a Van Halen album, 5150,  REQUIRES that if an individual is “a danger to themselves or others” that they be hospitalized for a “72 hour observation”.   This happened to me on occasion, but one that stands out was in the mid 1990s.  Why?  It happened on a Wednesday, and that evening I was committed to a County Mental Health hospital. When one is committed under a 5150,  you actually have to sit before a Judge to be released.  In this case, I did not have to go to a courthouse,  the court came to me.  Court was held in a small room at the hospital.  “Court” here, not being a euphemism, but an actual legal hearing with a Judge in the room hearing it.  But here is the thing, I should have gotten my hearing after 72 hours — which put that mark, late Saturday evening.   They do not have Court on the weekends.

 

If you are suicidal on a Wednesday, you have AT MINIMUM a 5 day stay at a mental hospital ahead of you.  If your doctors or the Judge are not convinced you are well enough, your stay can be much longer.  But the point is, the choice is not that of the individual, at all.Now, I am not saying that involuntary treatment is never necessary.  While at times, it is the correct thing to do, it should be motivated by compassion for the individual, not by the fear from others.  I would like it to be understood, that it can really suck for the individual involuntary treatment is being imposed upon,  and if it IS indeed necessary, a RATIONAL reaction should not be expected (like at all) due to the nature of the illness, the reason for commitment.  When the inevitable irrational response is received, the individual (who figuratively and literally is not in control of the situation) should not be responded to with criticism, shame, or punishment.  Compassion tempered by empathy and understanding, in my opinion should be the guiding principle for these interactions.

L. Christopher Bird

The Craic House

Modesto, CA

August 11, 2014

An Important Note for those I love. (Facebook Note Aug. 10, 2014)

This is a Facebook Note from August 10, 2014

 

I hate to break it to you,  but I am living with a serious, debilitating, and possibly fatal illness.  While there are treatments, with different levels of efficacy, there is no cure, nor is there likely to be one for Bipolar Disorder within our lifetime.

You are probably aware that I have not been using an pharmacological treatment for this illness for about 10 months or so .Some of you have mentioned, how well I have been doing, and my skills at mitigating some of the effects of my illness.   What I would like  you to know, is that my illness has not been mitigated these long months at all.  I still suffer from the effects of Bipolar Disorder, not daily, but moment to moment.  When I seem “well”  that is not because I am not experiencing symptoms of this mental illness.

What appears as “stability” is nothing of the sort.  I am not stable, and have not been for months.   These moments of calmness and lucidity come with great effort on my part.  It is not an affectation, but it is not  a state that happens organically.  Any calmness, lucidity, clarity of thought, etc, comes as a result of work i have been doing that you have not, and cannot see, for it is internal.

I need you to know, that these periods also have to be maintained by a great deal of effort.  Sometimes, I am simply not strong enough to sustain it, and I will have periods of moodiness, or as has been often lately, quick, explosive irritibility.  For that unpleasantness I apologize.  I do not want to hurt any of you, but be assured I am doing my best, even when my best is pretty goddamned awful and pathetic. Your happiness is very important to me, and I would lovingly do anything within my power to increase it.  However that being said, your happiness is NOT my RESPONSIBILITY.   Nor is mine yours.   There will be times that I will fail to be able to do things that may lead to your happiness, and I regret that, but please understand, that I do not have the intention to willfully do things that decrease it.   If that does occur, I ask you to please let me know kindly and compassionately, so that I may correct such things.  While it is my responsibilty to make those corrections, help doing so would be appreciated.

I would like you all to know, that I love you, however, I ask for your understanding about the seriousness of my mental illness, and be mindful of the effort and work I am doing to live with it at this point in time.

August 10, 02014 The Craic House Modesto, CA (The people tagged in this note, are those that I feel are most impacted by my illness, but this note is for everyone in my life, from partners, lovers, to the most casual acquaintance, new friends, and even potential friends whom I have not yet met.)