So some real talk about Mental Health and Bipolar Disorder

CW: Suicide attempts and ideation

So some real talk about Mental Health and Bipolar Disorder:

I get more suicidal ideation while manic or in mixed states than when I am depressed. Don’t get me wrong suicidal ideation visits me while depressed but I am more likely to act on it while in a manic rage.

My last suicide attempt happened thus. I was in a mixed state, but the main emotion I was feeling when I got in the car in a closed garage and turned on the ignition was anger.

I have been suffering my most severe manic swing in years for the past couple weeks, and I went there again today. I was enraged and making a plan. It involved either stopping taking my medication which is keeping my immune system from up and killing me, or taking all my medication at once (It probably counts in the hundreds of pills and probably would have taken an hour to ingest them all).

Moved by the Force or His Gods a dear friend checked in on me right after my plan gelled in my head. I did not tell him I was suicidal when he contacted me, but his love for me walked me back from the edge. At the end of the conversation, I did tell him and told him he probably saved my life.

Living with chronic illness has me despondent quite often, there is a very good chance that it will kill me sooner than later, but it won’t kill me today. And neither will my mental illness. Not today. Here that, God of Death? Not today.

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

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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.

The importance of feeling sad

I think that the attitude of sadness being a thing to be avoided is misguided.

Gandalf’s last words on middle earth included, “Not all tears are an evil”. Gandalf understood the important, and transformative power of sorrow.

Sorrow does not have to be avoided at all costs.  The push in the society I live in to see any kind of sadness as unwanted (in ourselves or in others), has lead to a lack of emotional maturity and awareness.   To see being sad as a kind of failing that needs to be corrected, is a terrible attitude to have, in my humble opinion.

Emotional turmoil can be awful to feel sometimes, but when I cry, I feel alive.  I feel human.

I think that emotions are physiological communication to our bodies and minds.  In the Tolkien Mythology, Gandalf was the student of a powerful Vala by the name of Nienna, who’s power is described as that,”she brings strength to the spirit and turns sorrow to wisdom.”

We should no sooner stop a person from exercising to gain strength of muscle, because it is difficult, that it may have pain.  Likewise, sorrow can be an emotional effort, which when we process it can leave us stronger, and wiser.

 


 

 

This ties into the stigma of the mentally ill, because those of us that have mood disorders, do feel sad,  and do so quite often.  What’s worse, is that outside observers can see no reason for us to feel so.   When one thinks that feeling sad is some kind of failing,  well feeling sad “for no good reason”  makes it absolutely unacceptable.

What we have here is in my opinion a societal ill, that affects the mentally ill more than most.

There is a lot of attention for those with cyclic mood disorders, such as my diagnosis of Bipolar I, on the highest highs, and lowest lows.  While those are the most dangerous moods, and when I am at those points in my cycle, I definitely need help and support (at times clinical)  the peak of mania, and the valley of depression, are just two stops on the cycle of my mood.   They don’t even make up the majority of my moods, they are however what gets the most attention.

The microprocessor was invented the year I was born.  My entire lifetime has seen us transition from the analog to the digital, and I see a lot of binary type thinking around me.  Even newscasters wanting to sum up a story as “is this good or bad?”   Thing is the world is not digital (as far as we know) and our brains certainly aren’t.  Things just are not always easily defined by two little boxes and “yes and no” questions.

I think we need to come back to embrace the noisy analog signal.  Am I happy or sad?  is it good or bad?  Well, its a mixture of both, and where one ends and the other begins ain’t exactly clear, and that’s fine by me.

 

 

An unsuccessful approach to ableism

While internet interactions may seem the most benign, they can also be the most public.  When  an online community has a policy against discrimination, yet gives ableism a pass, I think that policy is either flawed, or the moderation is.   Especially when the person stating that they are the object of discrimination is the one that is disciplined for “persistence”.   That is, the continued defense against fallacious, discriminatory assertions of instead of accepting the futility of changing a bigot’s mind.

The group in question is called Jedi church (the original)  the thread in question has already been altered, though by the participants or the moderators I do not know.

In my introduction in this blog  I relate the story of two decades past about an individual who said that they wish they were bipolar so that they “would not have to work.”  An interaction in this group was eerily similar.   A man by the name of Dave Jenson said the following:

As long as people can have an excuse for their behavior, as long as people can make a living by simply being mentally ill, as long as a living can be made helping the mentally ill. And as I had noticed that when mental illness drop in numbers, new illnesses are invented and old illnesses take longer than before to gain a handle on. As long as this persists their will always be mental illness, real or imagined.

 

Thinking that I might be perhaps misreading the situation, I asked that if the three points I was inferring from this statement was true, the three points being:

 

  • People wrongly use mental illness as an excuse for what Dave Jenson considers bad behavior.
  • People use claims of mental illness in order to receive income.
  • The Mental Health Profession is takes advantage of the first two points to justify a wage for those that work in the profession.

Instead of clarifying or correcting, Dave Jenson used further fallacious arguments and untrue statements of fact to support these initial claims, about how much money that Disability insurance is paid fraudulently so that fakers can “earn a living” and I used congressional testimony that his claimed number was over 51% or DI payments, which in turn makes it seem to me that Dave Jenson was inferring that if someone receives DI one is more likely than not to be a fraud.

Other assertions in this thread alone were:

From Talon Trevor MacDonald:

Emotion is natural, and necessary for most. Some get lost in Emotion, and cannot contain or control it. This is generally due to Mental Illness, but also in a few cases, It is on purpose.

This infers to me an assertion that lack of emotional control is generally only represented by 4.1 percent of the population in the United States (the percentage of Adults in the USA with Serious Mental Illness according to NIMH)

and Bae Ryder, a moderator had this gem:

There are only two reasons why a professional will use the DSM: 1- insurance purposes and 2: for personal information. The DSM is defective in more ways than one. I would not use that creditable source because no professional would. Just a suggestion.

You know, instead of using a diagnostic manual to CORRECTLY DIAGNOSE AN ILLNESS.

What makes it rich was from a post immediately following the above again from Bae Ryder:

With a topic like Mental Health, unless you are a professional sitting inside your office, don’t try to give someone advice on Facebook about it. It is dangerous and unethical not to mention, it can kill. Do everyone a favor and just don’t go there. The government is not a good source of information and neither is someone that does not have at least a masters in mental health or websites that have agendas.

This seems to imply that a person LIVING with mental illness is unqualified to speak on the matter due to a lack of formal schooling.  Which is rich coming from a person that just said that the DSM which is written by such is not fit to be used by the same professionals  to diagnose.

 


 

The silencing of those that advocate against the stigmatization of the mentally ill,  including those that self-advocate like myself, is itself a further stigmatization.   In the above groups  it was explained to me by two moderators (one of which I consider a friend) (again after I made no move to or expressed an interest in rejoining) in extended conversations about my banning, that the owner of the group “Paladin Carl” values harmony, and it was me voicing my objection to discrimination in a manner he finds unbecoming more onerous than the discrimination itself.  My friend Alethea Jolene Thompson, also a moderator  there, explained to me that it was my tenacity of trying to “win” that was unwelcome.

Rather than explain in detail my objections to these views, I recommend the following reading http://www.derailingfordummies.com/

 

Those named in this post are more than welcome to make their case in the comments, I give you my word, that I will not censor or silence, as I have been in the named facebook post.

For further reading on my thoughts of applied Jedi Philosophy see:  http://jedipath.org or my associated facebook page https://www.facebook.com/JediPath

 

 

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.

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