Mental Illness: we have met the affected, and it is us. Part II

When I was in medical school, a psychiatrist once said it is impossible to help someone with any form of mental illness if they do not seriously want help. I knew that because I had delayed seeing a doctor in college when I was depressed and had then found it almost impossible to spit out that I felt sad and tired all the time. It sounded defeatist, if not pathetic.

If you find your mental state, be it mood, thought pattern, intellectual abilities, memory, or other function changed for any amount of time in a way that is distressing and/or  people ask you if you're all right, consider talking to someone. If you are depressed enough you think about dying, certainly if you think about killing yourself, please get help immediately. Often you can make an anonymous phone call for first assistance, and you are not alone. As I found when I checked statistics to write Part I, mental illness is VERY common in every country.

Professionals who might be appropriate first people to talk with are not only psychiatrists, other physicians, and psychologists, but also nurses, social workers, clergy, teachers, and counselors. People who are already involved with the criminal justice system can talk to probation officers of other officials. If you don't get a listening ear and kind heart with the first person, try another. If you are truly afraid for your safety or that of someone else, go to the nearest emergency medical facility. Please.

It can be just as hard to watch a loved one or friend who seems to need help (or clearly needs help) and figure out how to get them effective care. If the person is rational, gently asking how they feel, mentioning you have noticed a difference in them and are worried, or directly asking if they would see someone may be good approaches. Think how well you know the person, what your current relationship with them is like, what their attitude to healthcare is, and how accessible healthcare is for them.

Although major depression can be periodic, the other most common forms of mental illness, bipolar disorder, schizophrenia, obsessive-compulsive disorder, and their close relatives are usually lifelong conditions. This is why healing from within, recognizing and managing positive dreams and abilities as well as medical care and objective measures of health, is so important in my opinion, and one reason why I founded healingwoman.net

If you have any of these conditions, and my son has two in addition to autism and other medical challenges, you need to find a life that includes your condition but isn't defined by it. Good healthcare, support groups with an experienced mediator, and educated/supported family and friends can help. If you have a loved one with mental illness, consider what resources are available to you in terms of support groups, volunteer-run organizations, hospital-associated groups or organizations, or religious supports. Professional counseling can help. (Some mental health resources, as well as ways to find help, are on the healingwoman.net website at Food for the Mind and Resources. Just check.)

Remember, especially if your loved one is diagnosed at a young age, that their needs and yours may change over time. I needed and benefited from a support group for parents of children with mental illness when Joseph was five or six. His behaviors were unpredictable and combative, he was distressed most of the time, and we were already involved with intensive medical care and educational supports. I found it a relief to talk with other parents (mostly mothers), finding I wasn't alone in wanting to do more or feeling guilty I wasn't more effective, angry that we had so many problems in public places with people staring, saying cruel things, or suggesting I keep my son at home. After several years, my husband and I had settled into a steady period and the time involved to attend group was more a negative than the positive it had been. That's ok. Change happens.

What should stay the same is that you love yourself, you love those affected by illness, and you do not give up, even if sometimes you have to admit there is nothing you can do to control things, either the illness of an adult or their willingness or ability to get or continue treatment. What you can learn to control is your feelings about their illness, your ability to see the rest of their life in perspective, and the ability to make sure you live your life as fully as possible.... sometimes remembering that healthy family members need attention too.

Finally, remember some tips for talking about mental illness, whether you are the patient or it is a loved one (and if a loved one, whether they are with you when you are talking about them). The affected person is neither good nor bad because they have a medical condition. They have a medical condition. Separate talking about the person from talking about the symptoms of the disease or the problems caused by it. Understand your limitations if you are not the patient and the patient is a mentally competent adult. People who are having psychotic episodes due to schizophrenia or bipolar disorder are psychotic: They can't be rational. The ability just isn't there at the moment.

Similarly, people with personality disorders (many of whom were the difficult, eccentric relatives of generations past) often cannot see that they have a problem. They see other people and circumstances as the problems. You may never get them to really want help. If that's the case, you need to manage your life and do what you can to help optimize theirs.

Most of all, talk, even if it is whispering out loud. The same psychiatrist told me that silence can be a prison. When someone can talk about illness, whether theirs or someone else's, they can begin to heal.

Mental illness: We have met the affected, and it is us. Part I

When I was a child, I didn't understand why some illnesses were discussed in normal tones and others in whispers. I remember my mother asking disgustedly once, "How can someone still think cancer is contagious?" but I knew there were things my family didn't talk about. I had my first episode of depression in college and found I wasn't the only family member to have it. With gentle asking, I found many friends who were battling it or had in the past, as well as other families that had multiple members affected. Almost none of those families talked about it. The stigma was in the whispers and the silence. Depression was not a nice disease.

Depression is a huge problem. The World Health Organization concludes depression is either the second or third leading cause of disease burden in the world and is number one in high-income countries. Furthermore, depression, bipolar disorders, schizophrenia, and obsessive-compulsive disorder account for four of the world's top ten causes of disability.

It is time for embarrassment over mental illnesses to be eliminated forever. Mental illness, disease that affects mood, thought, or behavior because of chemical imbalances in the brain, is illness. It is not weakness, it is not evil, it is not poor parenting. It is disease.

I should have known this from my time in medicine, that patients are people first, but I didn't really understand either the impact of mental illness or society's typical response until my son was a toddler. Joseph's most apparent problem is autism. However, he also has an atypical form of bipolar disorder, anxiety, and obsessive-compulsive disorder. He set a dubious record by being one of the youngest children seen at one of the most respected child psychiatry clinics in the world.

I learned lessons in the waiting room, looking at anxious children, tired parents. I remember one child begging his mother to ask the doctor to call his school so he wouldn't be expelled, saying it was so much better than the last one he had been thrown out of and he would try harder to sit still in class and not to blurt out his thoughts. I watched him a little more and realized he had Tourette's syndrome, a neuropsychiatric condition typically marked by repetitive behaviors and repeated vocalizations, often socially inappropriate ones. But mostly, I saw a little boy in pain over things he could not control. I watched my four-year-old running around the waiting room with my husband tailing him, responding to his anxiety by turning his hands into elevator doors, opening and closing them and saying "ding" like a bell. When he panicked, he would bolt toward a real elevator (his obsession) and we would chase him, running past people who stared at us as if we were all contagious with something.

Joseph is now a teenager, and with medication and behavioral management, he handles his anxiety better and bolts less often. But I sometimes see signs of the elevator obsession. I still see stares and disgust, if not fear, in some peoples' eyes when he runs into a fast food restaurant, bumps people on his way to the counter, and delightedly asks "What is the toy today?" Usually, people then notice that he walks awkwardly, that he speaks with a slur, that he is smiling broadly, and they relax a little. But not always.

There is no neat division of WE, the normal, and THEY, the affected. We are the affected, and we need to learn more about mental illnesses (diseases of brain function) and how to respond positively to people who live with them. In my next blog entry, I'll talk about educational and research organizations, support groups, and other ways to either live better with mental illness or help a loved one live safely and fully.