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.

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.)