Question ~ Why Is It Okay To Be Physically Disabled But Not Mentally?

This has bothered me for a long time. Why is it “okay” to have a physical disability or illness, but if your disability or illness is mental, people react differently? In other words, why is there so much stigma attached to being mentally challenged due to organic illness? People do not have a problem if you have a heart condition, diabetes, asthma, even cancer. But, tell them you suffer from depression, bipolar disorder, schizophrenia, anxiety disorders, PTSD, and people look at you sideways. People who suffer from physical illnesses frequently suffer from depression as well, but that still isn’t looked at the same way as depression on its own.

Mental Illness ~ The Invisible Illness

People suffering from the more severe psychiatric disorders are looked at even more sideways then people with depression. Especially, the schizoid disorders. Is it because people are afraid that others with these more severe diagnoses are behaviorally unstable, and people are afraid of us and what we may do to them? In my experience, most of us just want to be left alone to live our lives as best we can. I mean, what is the difference between using an asthma inhaler to control asthma, and taking a mood stabilizer or other class of psychiatric drug in order to manage a mental issue? The fact is those of us suffering from mental disorder, for the most part, take those medications because we want to manage our illnesses and to increase the quality of our lives.

He, Boyd, was turning to leave.

Where I live, it seems the police have declared open season on the mentally ill. We have one incident recently that may have made the national news (I do not know), but it certainly burned up people’s ears here. The man in question was an unmedicated (as many are) homeless schizophrenic who decided to camp out for the night in the foothills of the mountains east of the city. I, as are many people who live here, am unclear on how the police entered the situation. There are a fair number of “high-end” neighborhoods in the foothills, so it could have been someone who lives up there who saw the man in his ragged clothing, and freaked out and called police. I do not know. What is known is extraordinarily sad. There was some type of confrontation (the police are claiming he had drawn a knife on them; they have Glocks and Sig Sauers, what is a knife going to do? You have to get really close to use a knife), but the lapel cameras show there is some type of interchange between the man and the 9 or 10 police including SWAT members. The next thing the lapel cameras show is the man turning around and starting to walk away. That is the moment the police opened fire. When he was leaving the situation. The autopsy came back that the man who had done nothing wrong but be schizophrenic and camping outside (as was probably usual) in the wrong place had been shot in the back and the back of both arms. He was killed instantly. The public outcry was deafening. And this is merely one example of our police department shooting and killing someone with a mental disturbance. And, from what I can tell, they fire when people are leaving the situation, or are trying to get away from them, or my personal favorite, talking on a cell phone which our esteemed police department took to be a weapon, and killed a kid talking to his mother on his cell phone. I do not remember what his diagnosis was, but his mother got to hear the police kill her son. These things do not happen to people who are physically ill or disabled. 

I have a friend who is currently medically disabled who made an interesting comment to me the other day. He said that it is easier to get state assistance if you have a mental diagnosis than a medical one. He suffers from chronic, and I do mean chronic, depression, but he is unwilling to be diagnosed in order to get benefits he has earned through working because of the recent attitude of not only our police department, but society in general’s outlook on the mentally ill. I have news for people. Most of the mass shootings were not committed by people with lifelong mental problems, but people who are suffering situational mental difficulty or have a very strong belief in an antisocial ideology. It isn’t the Bipolar’s in manic episodes, it isn’t the schizophrenics of the world, and it isn’t the chronic depressives that are doing these things. It is people who have recently experienced a stressor like job loss, divorce, separation, etc. who also tend to hold to an antisocial ideology. It is the stressor that is key. I mean, honestly, I was depressed in high school, and yes, I did have fantasies of blowing up my school, but I, like many people like I was, didn’t do it because it was the wrong thing to do. 

Timothy McVeigh was not mentally ill, but he did hold anti-government ideologies

I think, and this is just my opinion, that one of the main reasons that people do have a fear of the mentally disordered is because when one of these mass shootings, or other violent act (the blowing up of the Federal Building in Oklahoma City, for example),the media will instantly latch onto any, no matter how slight, inference of mental illness in the party committing the crime. Through this slight inference, many people come to believe that a person with say Bipolar disorder is a ticking time bomb and is likely to go off at the least provocation. Not true of most of us. We are just trying to get along as the homeless, the disenfranchised and the poor of our society. There are times when I wish that all I had to worry about was my blood pressure (not to make light; just to make a point). I would be less likely to be arrested or killed if I were medically ill.

I Seem To Be More Agitated Than I Thought (Damn Mixed Episode) ~ Warning: Profanity

So, I have been experiencing the dreaded “mixed” episode for about a month now. This one has been particularly bad. The last one I had that even comes close was 8 years ago. The main problem with the mixed episode is that you cannot medicate yourself out of it the same way that you can a psychotic or manic episode. Depressive episodes are a category all their own. I would gladly give a body part for this to go away. The main problem with the mixed episode is that you are stuck between mania and depression. Your sleep habits change, your eating habits change, your whole structured life is ruined; this helps the mania, but does little for the depression.

I am freaking annoyed and pissed off at people for no other reason than that they cannot seem to understand that I am trying as hard as I can just to survive this. Another one of my little tells that let me know where I am on the Richter scale: Am I listening to Alice in Chains? And…….wait for it……wait for it…….the answer is yes. My absolute all-time favorite I am pissed off at the world so I am going to listen to songs that are as angry as I am. Yes, I realize this is childish. But, so is contemplating the amount of medication I have at my disposal. No, I am not suicidal, so do not get your panties in a bunch. I am just exceedingly tired of feeling like this. I am tired of presenting the happy face to the world. I am tired of pretending that I am not really that sick so people will leave me alone, I am just tired. What a cliche ~ I am sick and tired. Except it is true. I am sick. I am tired. It takes a lot energy to appear as if you are in remission (because it never really goes away, now, does it?) or at least to appear to be functioning, and that you do not mind that everything about your life is fucked.

Yeah, I can pretty cheerfully say, “Oh, I really do not mind having no car in a city where public transportation is a joke” or “No, I don’t mind hauling 50 pounds of food on foot one mile to my apartment” and “No, I really don’t mind living on $6.00 an hour”. I can easily and believably say all this bullshit, because that is what it is. Bullshit comes easy to me. If I can make the head of Children’s Psychiatric services at the University Hospital here believe that I am okay and that I don’t need to see him anymore, and then turn around two weeks later and try to kill myself (I was 16, and it was my first serious attempt), then I can make anybody believe anything. This guy was supposed to be a professional. I also had convinced that I didn’t do drugs as I sat stoned in his office. Am I that good, or was he just that stupid?I think, personally, he was just that stupid, because I sure as hell am not that good. 

And, I am tired and absolutely sick of people telling me I need to get a car, and a job. Well, people, if I had a normal fucking brain like the rest of the sheep on this planet who want nothing more than a 9 to 5 job, a house, 2.5 kids, and a dog, then maybe I wouldn’t get fired from every job I have ever held. I have been fired from a Temp agency. How the fuck do you accomplish that? How many people do you know that have been fired not just from the temp assignment, but from the agency itself? I mean, that takes skill. Serious skill.

How many people can honestly believe that I do not want to work? I have taken to talking to myself just to keep myself from going absolutely insane as opposed to the semi-sane state that I am currently in. Why can’t people see that? What is it that makes the people in my life so fucking blind that they can’t see that I am pretending to be well? I am not well. I am manic, I am depressed. Come on people, I don’t sense things the same way you do. My perception of emotion is fucked up. I don’t just have a bad day, I have bad years. I don’t have good days. I rise to heights that would scare tightrope walkers and I spend weeks there. And, somebody wants to employ that combination? What the fuck planet are you from? I do not even want to live that combination, but here I am, living it as successfully as I know how. Fuck you all…….get back to me when I am well…..or maybe when you are not operating under some delusion that I am just like everyone else. Everyone else does not see the world through a chemical cocktail designed to keep you as level as possible. Everyone else does not have wild, unpredictable mood swings. Everyone else is not addicted to anti-anxiety drugs that you take just to get through the day without having some form of panic attack. Everyone else is not on anti-psychotics that are supposed to keep you grounded to this planet, and wreak havoc on your body.

Come on, you fucking normal people, try to get a clue about the different people in this world and your life. I am sick of fucking “normal” people telling me what to do. Just because I look “normal” with my painted nails, made-up face, straightened hair, and well thought out clothing choices does not mean that I am anywhere near freaking “normal”. I am just a well-groomed freak. I am a well-groomed waste of space. But, at least I am well-groomed. That’s not even funny. Talk to me about being “normal” when the voices in my head have stopped talking, and my moods are not on a see-saw. I do not even know where I am going to be on the scale from moment to moment, let alone for my whole life. Yeah, I am fucking employable. At least, I don’t have any more monkeys on my back. That may be the only healthy thing about me right now. Please get a clue, step outside for a minute and realize that I am pretending to be okay. I am most definitely not okay. Far from it.  But, I will be. I always am. Because I have to be. I apparently have no choice.

 

So I Am All Tranced Out On House Music And Thinking…..

This is a “thought bubble”. It is an illustration depicting thought. (Photo credit: Wikipedia)

 

I am thinking about the impossible to know with a reasonable level of certainty. What do two people have to do or not do to make a marriage work or die a flaming death much like mine? AC/DC’s song “Shot Down in Flames” comes to mind. While I admit that the world is probably a safer place for all involved if I live alone, I wonder what it was that I obviously did or did not do. I know what my problem with the whole grown-ups behaving badly thing is/was. No need to cover old ground, or extremely tainted water under a falling bridge.

 

I realize that having a diagnosis such as Bipolar tends to knock you a little sideways, and your perceptions of yourself in relation to the world changes a bit (maybe more than a bit). However, once you have recovered your senses, and you happen to be a highly functional mentally interesting person, shouldn’t things get easier not more tedious? Yes, I flew off the handle one too many times, but once again, I wasn’t the one who could not leave my computer sometimes for days on end. I tried to communicate, but how do you communicate with someone who does not know how to communicate with you? It’s like clapping with one hand (thanks to Anthrax for that analogy).

 

What are you supposed to do with someone who has no desire to really get to know who you are apart from your interestingness, and does not seem to have any desire to learn anything substantial about Bipolar? I, upon receiving said diagnosis, went out and read everything that seemed legitimate. How can you battle that which you do not understand fully? Answer: you cannot effectively deal with any illness unless you know what you are dealing with. 

 

This was supposed to be forever, but I guess that’s a big fairy tale society tells little girls: your knight in shining armor will come and all will be sparkly and shiny and smiley and happily ever after. They lied. I think I met my knight in shining armor, and ditched him to get married to a man who turned out to be a far cry from the “face” he put on during the courtship. I am sure he feels the same about me, but I really do not know how to be anything but myself. He knew my moods weren’t completely handled, but he said, no problem, he could handle it. Apparently not. 

 

So, now I am in my early 40’s looking at starting all over again. Dating in my 30’s was not a problem because of said knight in shining armor. I never had to worry about someone to go drink beer and listen to blues bands with. He was always there for me, in all ways. What the hell was I thinking? Now, I am left to pick up the wreckage that used to be a perfectly satisfying life. I did not have self-worth problems, I did not have problems with how I looked, I did not have a problem with how feminine I was or was not. I didn’t have a problem with a lot of things. As I imagine he didn’t either. But, I wasn’t shattering his masculinity every single day. 

 

i think that I took him very much by surprise when I actually did file for divorce. I had mentioned it several times over the past couple of years, but he never thought I would actually take any action. He said everything I said was just talk and more talk, no action. Well, I guess you shouldn’t threaten me physically. I don’t cotton to that very well. I just wish I could pinpoint where it all went wrong. When I became unhappy with him and he with me. I play it over in my mind, and nothing seems to just pop out at me. I think I became upset with myself when I stopped getting mad about his Internet activities. There was no point. i was just wasting breath. I do not know, but I do not think I will try it again anytime soon. Talk about a learning experience. Never again will I allow myself to be treated like that. I am surprised I didn’t see it until the very end. After all, I grew up in an emotionally abusive family. I should have seen it for what it was and left much sooner. Maybe then I wouldn’t feel so scarred. Again.

 

Death By Suicide: An Interpersonal-Psychological Theory Part Two (warning: potentially triggering)

English: In 2005 a fence was added to Tromsøbrua because it was one of the most used bridges by people who wanted to commit suicide at the time. ‪Norsk (bokmål)‬: I 2005 ble det montert et gjerde på Tromsøbrua fordi den var blant de mest utsatte for selvmord og selvmordsforsøk i hele Norge. (Photo credit: Wikipedia)

 

The Way Out, or Suicidal Ideation: George Grie, 2007. (Photo credit: Wikipedia)

 

This is part Two of the commentary on “The Interpersonal-Psychological Theory of Suicidal Behavior.” The following sections will elaborate on the three main components. One caveat: this theory is more geared to people with mood disorders, but not the more common personality disorders like Borderline Personality disorder.

 

The first question was “What is the desire for suicide, and what are its constituent parts?” Joiner states that two deeply held beliefs or perceptions must be held at the same time, and for a long period of time. The first is an unwavering state of “perceived burdensomeness”  which is defined by the view or perception that one’s life/existence burdens family members, friends and/or society, in general. Joiner states that this produces the idea that death would be preferable and of more value to family, friends, and society at large. This perception ~ it is important to note ~ represents a potentially fatal misperception. 

 

Past research, although not  direct empirical tests of the Theory of Interpersonal-Psychological, have found that “perceived burdensomeness” especially toward family is correlated with suicidal ideation among community participants and high-suicide-risk groups (DeCatanzaro 1995). Past research has also documented an association between “perceived burdensomeness” and suicidal ideation.

 

Direct tests of the theory have been supportive, as well. In two separate studies of suicide notes, the raters detected more expressions of being a burden in people who had died by suicide compared to those who had tried but had survived. It also occurred in people who had died by suicide using a violent means versus those who used less violent methods. People who committed suicide using a gun for example, showed a higher degree of burdensomeness than those who chose a less violent method.

 

In a study of psychotherapy outpatients showed a measure of “perceived burdensomeness” was a healthy predictor of suicide attempt status, and of current suicidal ideation even while controlling for powerful covariates such as hopelessness (Van Orden, Lynam, Hollar, & Joiner 2006.)

 

The second condition that must be present, and have been present for a period of time is the concept of “low belongingness or social alienation” ~ which is defined as a sense of being alienated from others, or not an integral part of a family, circle of friends, or other valued group. As with research on “perceived burdensomeness,” there is a great deal of evidence that this factor is implicated in suicidal behavior. Although, very little of this evidence derives from direct empirical tests of the Theory of Interpersonal-Psychological of Suicidal Behavior, a strong case can be made that that of all the risk factors for suicide, ranging from the molecular to cultural levels, the strongest and most predictive support has emerged for indices related to social alienation (Boardman, Grimboldeston, Handley, Jones & Willmott, 1999.)

 

The connection between belonging (or its absence) and suicidality has been established for a number populations including adolescents, college students, the elderly, and psychiatric inpatients. What I find interesting is that suicide rates go down during times of celebration (people are coming together to celebrate a common event); Joiner, Hollar & Van Orden, 2006. Suicide rates also go down during times of collective crisis such as the 9/11 bombings, and for about a week after the assassination of President Kennedy (people pull together to commiserate.)

 

Direct tests of The Interpersonal-Psychological Theory of Suicidal Behavior

 

Conner, Britton, Sworts & Joiner evaluated 131 methadone patients who displayed a high level of “low belongingness,” and found that it predicted a lifetime history of suicide attempts that were not accidental overdoses. The association was specific to actual attempts and not suicidal ideation. This association crossed demographics, correlates of suicidal behavior and other interpersonal variables.

 

The third component is the “acquired ability to enact lethal self-injury.” Feelings of “perceived burdensomeness” and “low sense of belonging” may instill a desire for suicide, but they are not sufficient on their own to produce an attempt. The third element of the ability to inflict lethal self-harm has to be in place. At this point, the theory assumes a fight with one’s innate self-preservation instincts. However, according to the theory, a person having fought this battle repeatedly and in different settings instills the ability to override the self preservation instinct ~ should such an individual want to do so. Experiences often include previous self-injury, but can also include repeated accidents numerous physical fights; and occupations like physician and front-line soldier in which repeated exposure either direct or vicariously to pain and self-injury produces the acquired ability to commit the act of suicide.

 

The basis of this proposition is primarily an “opponent-process” theory which suggests that repeated exposure to affective stimuli results in the stimuli being unable to exact the same response, and instead the opposite reaction is strengthened (Solomon, 1980). Based on this, it is hypothesized that the capability to commit suicide comes from repeated exposure to painful or fearsome experiences. This results in habituation and a lessening of the fear or pain response. Thus, the capability to end one’s own life is largely due to this habituation.

 

The basic implication of this habituation is that past suicidal behavior will cause individuals to become “immune” to the pain and fear of self-injury making future attempts more likely. A history of suicide attempts has been found to be a strong predictor of future attempts, suicidal behavior, and completed attempts (Joiner et. al., 2005). The highest levels of “acquired capability” were reported by people with multiple past attempts as the theory would predict.

 

Acquiring the capability to commit suicide is not limited to past behavior ~ it can be acquired by habituation to other fear or pain-inducing behaviors (e.g., non-suicidal behavior like cutting, self-starvation, physical abuse, etc.). For example, the behavior of cutting oneself has been shown to anticipate a higher likelihood for suicide attempts and those who have a longer history of self-injury, use of varied methods tend to report an absence of pain during self-injury ~ all indicative of habituation and tolerance (Nock, Joiner, Gordon, Richardson, & Prinstein, 2006). Aside from direct exposure, the theory also puts forth the idea that vicarious exposure to pain and injury may produce the capacity for suicide. Physicians fit in this group with high suicide rates despite many protective factors (hawton, Clements, Sakarowitch, Simkin, & decks, 2001).

 

The Interactive Nature of the Theory

 

The interactive nature of the theory suggests a three-way relationship between the main concepts. Particularly, the ideas of “perceived burdensomeness” must be present with “low sense of belonging” to produce the will to die. However, that will or desire will not be acted upon unless in the presence of the “acquired capacity” for lethal self-harm.

 

To date, four studies have looked at the interactive nature of the model. All have shown significant statistical interaction among the three major concepts even while controlling for covariates such as depression, gender and age.

 

The Interpersonal-Psychological Theory is promising with growing empirical data to support it. It suggests that clinicians be aware of their patients’ levels of belongingness, sense of burdensomeness, and acquired capability (especially previous attempts; my own therapist spent 10 minutes today assuring herself that I wasn’t writing an elaborate suicide note. Far from it, mostly these days I am irritable) as this awareness may aid in suicide risk assessment and therefore, being able to target therapies.

 

Full link to article here: http://www.apa.org/science/about/psa/2009/06/sci-brief.aspx

 

I Just Don't Understand……Maybe I Really Am As Dumb As I Feel Sometimes

You Don’t Understand Me (Photo credit: Wikipedia)

 

I do not get some people. It isn’t for lack of trying. Every person I have spoken to today has either been very snide or has outright yelled at me. Which tends to make me really irritable. I am already having a “manic episode” which means that I am not sleeping, eating, or anything else I supposed to do to keep myself healthy. What I do not get is why other people cannot seem to see when I am “sick” (I hate that term), and that is when they choose to get strange on me. 

 

I have no one to talk to about what is happening to me because nobody wants to hear it; they’ve got their own, much more important problems to deal with. I am being sued by my student loan provider, I am on the verge of being sued by my other student loan provider, if they win the payment amount per month that they want, I will be homeless because I simply can’t make nearly $300.00 in loan payments and pay rent. I figured it out. If I pay as the plans stand, I will have $662 (roughly) to pay rent, utilities, and try to feed myself. That’s impossible. I will be homeless. I will lose everything I have worked so hard to accomplish both socially and privately. Material possessions can be replaced eventually, but once you have been knocked down, it is really hard to stand back up.

 

I am going through a divorce and trying to live out the lease with my soon to be ex-husband. I can’t talk to him about how I feel about that. Most of the times, I feel okay about it. Neither of us were happy. But, then there are days like today where I really need someone to just listen to me. I feel very sad and lonely (as per the usual) today. I didn’t want to file for divorce, but it was the only thing that would resolve the entire situation between us. We fought all the time, made snide remarks about each other, he always defined me by my mental “interestingness”, but never by who I really am which is a normal person who feels life more intensely than most. I wrote him a note today trying to explain to him that I was not doing this out of malice, or that I can no longer tolerate him, but rather it was out of love for him and concern for his welfare that I was stepping out of the picture before I do any more damage, Apparently, it is very difficult to have a relationship with a bipolar person. I say it is very hard for a bipolar person to have a relationship with a chronically depressed person.

 

I basically have no friends anymore because he isolated me from them through very subtle emotional and verbal abuse. But, I am just as much to blame on that front. Sometimes, I think we fought about nothing just so we could hurt each other. It was really good for about the first year and a half, and then very slowly, it started to go downhill. Then it picked up momentum, and became it’s own living entity. But, how do you fight something you cannot see? How do you fix something when the other person is blaming you for nearly everything that has gone wrong, but they cannot see their own contribution to the demise of something that was once beautiful? 

 

I am feeling very uncomfortable today. I cannot seem to say anything right to anyone I have encountered today. I have been flat out yelled at by another mentally “interesting” friend who is really struggling right now. Nothing I said was right, she shot down everything I suggested as “impossible,” she put down any idea I had that might have helped. I even offered to help her clean and organize her apartment, But, that was met with more yelling. I tried to tell her that people are willing to help her, but that she pushes them away by repeatedly turning down their offers to help her. Eventually, people will get tired of getting shot down every time they try to help her, and they will stop offering. Why beat a dead horse?

 

I feel very alone in this. I know that I will be okay in the long run, but the short run is a bitch. I feel like the wicked witch of the west. I feel like he was right all along; that the destruction of this relationship was mostly me. I changed him, I damaged him, I hurt him, I didn’t show enough affection, I didn’t do this and I didn’t do that. He never stops to think that he did two very important things: he spent hours on the Internet watching and collecting amateur porn which I felt very disrespected by, and he didn’t open a single book written by the people who are the experts on mood disorders to find out how to support me, or even to just understand me. To me, that shows a lack of real caring. It tells me that his love was conditional on my not getting upset about his porn addiction, and just let him carry on his merry little way thinking that he understands the multitude of bipolar manifestations.

 

I cannot talk to anyone about this. Everyone I know is happily married. When you are getting divorced, the last thing you want to do is talk to someone with a functional marriage. It just makes everything that iota worse than it already is. I find myself questioning whether I have made the right decision, or if I really am as dumb as I feel.