No way to know and no way out
Oprah, Maury, the erstwhile Sally, never really discussed
what you've needed to know as you enter your crisis.
Television, radio, newspapers, books just don't seem to
cover what you need.
This is rather odd because 25% of all homes in the United
States are touched by mental illness; by definition, a home with an
untreated mentally ill person is dysfunctional--it's rather like having an
elephant in your living room; yet, there is very little help and virtually
no education about what can go wrong and how to cope with it when it does.
Worst of all, you are in pain, and no one is interested
in helping you, even if they could.
Unlike more popular diseases, cancer, heart disease,
diabetes, even aids and alcoholism, mental illness is in a special category
of itself which, if it were known that you or a family member had it, your
whole family would be a pariah; one of the reasons is that most people with
mental disorders are rude and unsociable to begin with: So, instead of
making it known and hoping that someone might come to your aid, you must
hide it--if you've even suspected it in the first place.
Many times, mental illness is chameleon-like and not
recognized for what it is.
Make no mistake: It is a very dangerous disease, and, in
fact, one of the criteria for an involuntary commit is that a person is a
danger to himself or others--which often makes it more difficult when you
are dealing with odd inconvenient behavior which is quite disruptive, but
doesn't legally constitute a 'danger'.
So your choice is to ignore it and hope it goes away [it
won't]; try to get the person treatment [which will be staunchly resisted,
because they think they are fine]; or try some form of self-treatment [which
will be entirely ineffectual].
There is hope and you are not alone
You are not alone.
There is hope.
One of the resources you should consider immediately is the
National Association for the Mentally Ill (NAMI):
NAMI has a great body of knowledge for
those who are mentally ill and for their families.
The department of health in some counties have a unit to
help those with mental health issues.
Sometimes there are programs associated with medical
insurance and some businesses render help for employees and their families.
There are many web sites for those who have specific needs
depending on their particular mental disorder.
There are mental health professionals listed in a variety
of directories, although those seeking aid should be selective about the level
of professionalism and track record of those from whom they seek assistance.
The Truth
With few exceptions, the truth is very important to a
person with mental illness.
The truth often becomes a quest which adds to the
complexity of a mentally ill person at a time when they need simplicity and
stability.
They grasp the truth--at least the truth as they see it--as
an anchor to sanity; they also tend to simplify matters into absolute black
and white.
No one should trivialize what such a person by discounting
their propensity toward truth-seeking by minimizing their value of truth.
This becomes problematic because people with mental illness
are easily overloaded--they have too much to process already and as their
condition deteriorates you may find that their lack of ability to administrate
what they experience leads to personal chaos and confusion: Their rooms are a
mess, their thoughts are disordered, they have difficulty making choices, they
are confused, they get to the place that they can't take care of the simple
things like personal grooming and they often don't brush their teeth and comb
their hair--indeed, they may shave it off [and if this happens, you might take
immediate note that something may be wrong]; they just can't manage to cope
with the world around them.
And the world doesn't help much.
They perceive the world to be filled with lies and this is
overload to them: They just can't take it all in and deal with it.
And, unfortunately, they are right, because the world
itself is insane and being in it just doesn't make things any better for a
mentally ill person.
They often become involved in global issues, focusing and
obsessing on the news--most of it bad--and this doesn't help in bringing them
back to the reality of their personal situation.
Some become involved with such causes as Green Peace and
Amnesty International [which may be quite helpful, but these organizations may
cast a blind eye to the fact that mentally ill contributors really are not
helped by their acceptance of the charity]; others become involved in cults
where they find "truth" to their own furthered destruction, manipulation and
abuse.
These people are generally naive and susceptible to
manipulation because they want to "fix" problems they perceive and it is easy
to convince them that the world is a better place through whatever truth is
being pedaled.
This is not to say they are devoid of intelligence.
My dad tells the story of a someone who was driving his
Model T Ford past Medical Lake outside of Cheney, Washington; a mentally ill
person was standing by the fence that separated him from the road when a wheel
came off the car; the driver found the wheel but could not find the nuts that
held the wheel on the car; the mentally ill man saw that there were five nuts
holding the wheels on the car and told the driver that if he took one nut from
the other wheels, he could hold the other wheel on the car until he could get
to a service station; the driver, impressed by the solution, did so and was
amazed that this 'crazy person' could come up with the solution, to which the
man replied, "I might be crazy, but I'm not stupid".
Truth seeking often gets mentally ill persons into great
trouble with society at large, primarily that society can't handle the truth,
and it makes the mentally ill appear to be more rude and aggravating while
creating an atmosphere where the supposedly sane would like to dispose of
these trouble makers.
The mentally ill often have a sense of humor based on their
perception and recognition of the truth that leans to the macabre black humor
which may well be misunderstood.
Too often mental health professionals have no sense of
humor and this compounds the problems.
Dr. Frederick Frese, a chief psychological administrator with
schizophrenia who was once a patient at the facility at which he works, went
back to visit the Veteran's Administration hospital where he was also once a
patient.
Now there are four questions that psychiatrists ask a
patient they suspect may have schizophrenia:
-
Who are you?
-
Where are you?
-
What year is this?
-
Who is the president?
Dr. Frese has an awesome sense of humor and it is quite
entertaining to listen to him speak [while he is telling us the important
truth about schizophrenia].
His answer to the first question of "Who are you?" didn't
help his cause very much when he told them that he was the chief psychiatrist
of another mental institution.
His answer to "Where are you?" as being at a mental
institution where he was once a patient with schizophrenia wasn't very helpful
either.
But when he told them that Hillary Clinton was President,
he really had a problem, and they almost didn't let him leave.
It was a joke!
They didn't get it!
And that's why a lot of times that people with mental
illness rightly conclude that you just don't get it.
And that's just one more reason they find themselves
misunderstood and without support--people really don't get it.
That is why it is important to listen to them--sifting what
they relate carefully--to understand the truth that is important to them.
Another factor in relating to such people is that they are
dealing with a lot of personal internal truths that make them seem insensitive
to the problems of other people: They are overloaded.
It is important to realize that a mentally ill person is
internally overloaded and it is important to prevent adding to this overload
externally.
They will seem incapable of caring for the needs of others
around them and you may perceive them as being insensitive; that is all part
of the picture; as an aside, when mentally ill people begin to show genuine
concern for others, it may be a good sign that they are recovering, or at
least coping more effectively with their problems.
Mentally ill people perceive the world to be filled with
lies.
This is something they will be compelled to try to fix.
'Knowing the truth' and perceiving that others do not 'see'
it, is very aggravating and confusing to a mentally ill person: "I see it,
why can't they?"; this can lead to anger which degenerates into violence
either psychological or physical or both; if the person cannot be validated
and felt understood and the violence continues, the only appropriate option is
to distance yourself from the violence--either by restraining them [possibly
with an involuntary commit], a restraining order, and / or moving away from
them.
Truth to a mentally ill person can be a source of great
distress.
Unfortunately, they will know the truth, but it won't do
much to set them free.
Don't lie to them.
They have enough to cope with.
Socialization
Highly objective people representing 75% of the population
probably think that subjecting subjective people, representing 25% of the
population, who happen also to have a mental disorder, to large groups is a
great idea: After all, they like people themselves, and like to be around
people, and handle large groups of people well, and they think that the
isolated and solitary person with mental illness will do so much better if
they just get out and meet other people.
"It's the best thing for you," they say.
"Why don't you join a support group," they add, innocently.
"Let's go to Disney World," they propose, where there are
over a million people a day being pushed through the gates like cattle.
In their minds, getting out there in the public and
exposing yourself to all those people is such a good idea.
For a person, let's say who has schizophrenia, the overload
that this may cause makes this a very bad idea.
People impress their values on others, often with the most
disastrous results.
People coping with those with mental illnesses need to
understand that the person they know needs a stable environment where
adventure, particularly adventure in the form of things going amiss, is quite
limited.
People with mental illnesses most often have a need of
knowing what is coming so they can be prepared for it and stability with fixed
routines in a set environment is the order of the day--each day.
Dr. Frederick Frese's wife was quite upset with him when he
came home from work and while she was talking to him, he stared at the wall,
at the ceiling, at the floor; he avoided looking at her face; she was so upset
with him because he would not look at her, that she was practically in tears.
Then she found out why he didn't look at her.
He explained that her face was so distracting that he
stared at the wall, the ceiling and the floor to avoid being distracted and
concentrate on what she was saying.
People often find people with mental disorders unpleasant
because they don't understand.
My son was taken to a Chinese restaurant by his friend who
has bipolar disorder; she wanted a bill; they explained that they could give
her the bill later; she thought that she had to have the bill, so she fussed
and fumed and caused problems and was disagreeable until someone at the
restaurant brought her a bill and then she was just fine and the meal
progressed more or less normally.
People having challenges helping a person with mental
illness need the self-restraint, kindness and patience to understand that such
a person may have difficulty understanding new things and new environments or
even what they perceive to be extreme changes, however moderate, to their
existing environment.
Self-esteem can often be at issue as well.
A man who had schizophrenia was trying to find a job and
wanted to work, but the prospective employer was skeptical; when the employer
asked what the man could do, he was told that the person under treatment liked
to walk a lot.
The prospective employer decided to give him a try by
having him take flyers and put them on doorknobs in the neighborhood.
The effort was quite successful, brought in a lot of
business, and the man was more effective in performing the job than anyone
else had ever been.
The employer asked the center if they had any more people
with schizophrenia he could employ.
Progress in the treatment of schizophrenia is non-linear
and often takes a long time for any results to be noticeable.
One man was released with treatment and went home.
He went into his room and basically did everything in his
room without coming out--including eating.
Eighteen months later, he came out of his room, showered,
dressed up, went downtown, and got a job.
When he was asked why it took him so long, he answered, "I
had a lot to think about".
Unfortunately, for every success story, there are probably
at least one hundred others which end in unfortunate tragedies: We have a long
way to go, so we should never stop at one or two successes.
One needs be concerned with the company they keep: While my
son was in the ward at Puget Sound Hospital, one of the patients thought it
would be fun and found a way to remove all the tiles in the ceiling of the
common room; at Western State Hospital, my son shared his room with a man who
had shot and killed three policemen--so if you are pushing a patient into
socializing, you should be aware that there could be a down side to
associating with other patients.
People working to benefit others who happen to have mental
disorders need to be sensitive to overload.
Sometimes people need and value isolation.
It is a bad idea to push such people into groups of people
for whom they may not be prepared.
Support groups are a terrible idea.
Some environments are particularly terrible for people with
mental disorders, particularly those who have schizophrenia, although having
bipolar disease can also be a challenge.
Modern corporations, particularly the environment of a
corporate headquarters, and even more particularly a misfortune 500 corporate
headquarters where all the senior management are crazy and the environment is
nuts, is an extremely damaging and abusive environment for anyone having a
mental disorder, let alone so-called normal people.
I would know.
I worked as a manager at one.
I observed people all around me with their mental disorders
of ADHD, bipolar disease, alcoholism, and even a high functioning autistic
contractor, not to mention the crazy lying narcissists [a mental disorder]
running the place.
Outside of the fact there were no on-staff psychiatrists on
site, I declare that the company should have been declared a mental ward.
The lies of the narcissistic abusive director [who was
finally fired] created havoc.
I watched as one man progressed through a psychotic break
into full blown full-blown manic-depressive illness; it was interesting to
watch his pupils dilate as he ranted and then contract to normal size as I
talked him down and calmed him; it was amazing to observe his bizarre behavior
as he tried to make sense out of conflicting directions with which his
management was stressing him.
Most mentally ill people do try to do their best, they try
to please their employers and family, and their friends.
Like birds nesting at the airport, they are at first
disrupted by the mental 'noise' around them, and then try to adapt as well
they can, even if it makes no sense and is destructive to them.
Large corporations are the pits when it comes to management
because, for the mentally ill who really need patience, understanding and a
stable environment, big business management represents a constant threat
through the pressures of business competition, competition with their peers,
conflicting signals from the management, threats of being laid off and fired,
threats of having their ideas stolen at a time when they need the self-esteem
recognition would bring, and most of all, the disruption in their lives from
the environment of lies surrounding them.
The lies, as noted above, are probably the most destructive
of all, because usually the mentally ill person isn't equipped to endure the
abuse of being told lies and being told, "Perception is reality", which a lie
loosely translated as: "We are screwing you, and you have to endure it, as
painful as it is, and you have to pretend it is the truth," is outrageous.
This is unacceptable to a mentally ill person.
It is also immoral, unethical, probably illegal and
compromises everyone's integrity.
There is also a matter of the socially acceptable practice
of allowing other people to steal your ideas and the work you put into them
with the tacit understanding that when it comes your turn, you will steal
someone else's work and take credit for it, earning the momentary approbation
of your management and your peers; this is thought to be 'maturity' in modern
corporations and everyone is expected to manage this theft with graciousness
and aplomb; except, for the mentally ill person, it's all about stealing their
ideas, stealing their work, robbing them of self-esteem, trivializing them,
and when the 'their turn' comes, it really doesn't and they never get one
thing out of the experience.
This is also quite unacceptable to a mentally ill person
and it adds to their frustration, not to mention that it creates more problems
with overload.
A mentally ill person expects more or less black and white,
right and wrong, processes to work, things to be a certain way, things to work
a certain way--a certain objectivity in employee review where there is at
least 80% measurable criteria upon which they are judged; what they find
instead is that 98% of their review is subjective based on how other people
feel about them, their image, and absolutely nothing evaluated on their
objective contributions, no consideration for the substance of what they have
done, and no recourse to protest the objectively unfair review, unless it is
in a court of law in a usually unsuccessful suit against a cadre of highly
paid corporate lawyers.
Demeaned, demoted, devastated, devalued, a mentally ill
person goes quietly (or in some cases, noisily) mad.
And the corporate body blames it on the person they've
pushed over the edge.
Isn't that just crazy?
Is it any wonder we end up with Enron, Arthur Andersen, and
Global Crossing.
For marginal people who are having difficulty coping as it
is, experience in the mental institution [and I mean that in the most
unpleasant sense possible] of modern business will push them right over the
edge.
In the confusion, the corporation will fire the people they
have just pushed into insanity.
Then they will proceed to mark the person so they can't
gain employment anywhere else.
Illegal?
Yes!
Done all the time?
Yes!
This is the ultimate in abuse.
This is not to mention the products which ruin the health
of Americans.
Do we really think it is sane to serve fast foods that have
500 times the allowed safe levels of Acrylamide?
How about cigarette companies who kill off their customers?
They can claim, "But we kept the law! And anyway, it was
their choice!".
Corporations and big business, whether corporate,
governmental, academic, or religious, conspire to make the already bad plight
of the mentally ill much worse and then they turn right around and give to
United Way to make it all better.
How about cleaning up the lies of Corporate America?
This is the part of socialization which is never discussed,
but has a huge impact on the mental health of people.
Pressing mentally ill people into socialization,
particularly in an environment which is recognized to be destructive to
nominally well people, is a disservice we do to each other.
People with schizophrenia often become disassociative on
the job--that is to say that they cannot manage to stay organized and piles of
paper and other junk may lie everywhere because they just can't administrate
their environment effectively and it becomes chaotic and confused--which is
another reason to find a way to fire them in the minds of the Nazi Overlords
of the Corporation.
Another part of socialization is popularity, that triumph
of image over substance, or, in the case of Hollywood, the triumph of image
over substance abuse.
Very often people with mental illnesses have a variety of
other problems and challenges which make them less than desirable to others.
Medicines which treat mental illness often tend to make
those treated fat.
The fact that the treatment itself accounts for a very low
score on the Brad Pitt meter lowers self-esteem among many.
Self-image makes socialization more difficult and as
socialization is more difficult, there begins a downward spiral which gets
worse as a person becomes older.
A mentally ill person is just like the rest of us, except
the plumbing in the brain isn't working right; they have some of the same
hopes, dreams, desires.
As they see that these aspirations will never be achieved,
they despair and sink into deep apathy.
And the people around them, seeing them wandering
aimlessly, muttering to themselves, starting somewhere and then forgetting why
they went there in the first place, don't make anything better by the winks,
the nods, the body language and the snide comments which come through loud and
clear.
No one wants the mentally ill because they are not sexy or
attractive--except the ones who are, probably really are dangerous.
In terms of socialization, generally speaking, there are
monsters among us, but they aren't the mentally ill.
If someone you know is mentally ill, or you have good
reason to suspect that they are, and they seem stressed and overloaded, and
they ask to have some space, consider the wisdom of their request and if it is
appropriate, give them the solitude they desire.
Remember too, that a mentally ill person probably can't
take care of themselves; there should be no expectation that they can take
care of others.
Taking responsibility
For most of those mentally ill, it isn't their fault; the
disease with which they cope was at least genetically predisposed and more
often than not came to full force by an event which was not of their doing.
It's not your fault.
This is very odd, for, in my experience, the police called
to cope with the person who is mentally ill and their family, blames the
mentally ill and / or more particularly the family of the mentally ill; their
comments, their looks and their body language say it all--it's all your fault
[and for mentally ill children, they blame the parents for their bad child
rearing practices as the cause of the 'crime']; people need to be aware of
this and pay attention [and be very circumspect]--police pack guns and they
have been known to be quite, umm..., forceful.
Sometimes, people with mental illness don't believe the
guns can hurt them, but they are dead wrong.
The attitude of the police is an arcane one, and somebody
needs to establish sensitivity training for them; unfortunately, in their
world of black and white and their power structure, they are pretty much
independent and most of them would retain all of their attitudes even after
such training.
The police often face very dangerous situations with
mentally ill people and not a few [as pointed out above] have been injured and
killed.
This is not a situation which presuppose them to being
filled with love and forgiveness for such people.
Nevertheless, if ever there were people who needed love,
understanding, and forgiveness [forgiveness for what? they weren't
responsible!], it is those who have mental illness.
Violence, abusiveness, and bizarre behavior can be
elements of the mental illness wherein the person with the behavior either
does not have self control sufficient to behave in a reasonable manner and /
or isn't perceiving the situation correctly and in a psychotic state is
managing the environment in ways reasonable personally but which are
completely inappropriate in an objective sense.
This is not unlike alcoholism, where the alcoholic is
unaware that they can't start drinking and begin a slide into sickness.
It isn't your fault.
I once worked for a manager who was an alcoholic, had
bipolar disease, and probably also had schizophrenia.
We went to lunch one day and I rode with him in his
Cadillac.
I rode back with someone else in a Datsun.
The reason was the four martinis he had for lunch.
For those of you familiar with "Under the Influence" by Dr.
James Milam, it would be clear that he had traversed the first two stages of
alcoholism and was firmly entrenched in the third and final stage that comes
just prior to death.
He came to work at 10:00 AM or thereafter, staggering
drunk.
The Director gave him an ultimatum: Come to work drunk one
more time, and you're fired.
He came to work one more time and resigned.
It didn't stop there.
He made threatening phone calls to the Director and others.
He was sent to jail.
He had a restraining order.
He persisted.
He was involuntarily committed for 90 days to Western State
Hospital.
After he got out, there were still some problems, but
mostly, to this day, it is the voice mail left at 2:00 AM from someone in a
drunken stupor who finally realizes he doesn't work there any more and hangs
up--and doesn't remember the call the next morning.
Here is a man who was a monster and difficult as a
manager--who was always a little 'off'--who probably didn't know about his
conditions early on.
But by the time he got out of Western State Hospital, we
all have to believe that he knew what was wrong with him, and he knew what to
do.
It's one thing to have mental illness and not know what to
do and how to cope with things, but it's quite another to know what is wrong
with you, and have solutions, only to defiantly decide that you are NOT going
to stay on the program!
It was shear defiance.
He had decided that he wasn't going to take the
medications, but he was going to continue drinking--and by the way, they don't
allow you to take alcohol in the mental ward--trust me; so 90 days should have
been enough to get free from practicing the alcoholism.
No one was going to tell him what to do.
And so today, he wanders from place to place, changing his
unlisted phone number every three months, being enabled by his apologist
friend now retired who used to work for him.
Now he's a monster.
Ironically, he still calls a married woman he knows from
work at her home at night because he perceives her to be sympathetic; her
husband is a deputy sheriff; he's not just a monster, he's a mentally ill
defiant stupid atheist monster.
There comes a point in every one's life where they know and
understand, and have a chance to take responsibility.
This was a story of someone who decided not to.
Now sometimes it takes a lot of convincing for someone to
come to the conclusion that they are mentally ill, and it takes a lot more to
convince them they need treatment, but for most, that day comes, and they
cooperate with the program and make progress toward recovery, such as it is
and what there is of it: Of such people are the Dr. John Nashes and the Dr.
Freses of the world who struggle to be well; and our hats are off to those
people who truly make the effort and try to live a life with concern for the
rights and feelings of other people.
This, in itself, brings new challenges for those around
those with mental illnesses.
What do you do when the person you have known with mental
illness is effectively treated so they function more or less normally?
This can be a problem.
Many family members, coworkers and others may view the
person under treatment and appropriately coping with mental disorders as being
the same sick person with which they had to cope, perhaps with which they had
to cope for years.
The worst thing to do is be trapped in the rut of viewing
them the same as they were and treating them the same way.
They are now changed.
The rest of us must make the same progress in change as the
person who is effectively treated and making progress coping with their mental
illness: Not to do so creates a vacuum into which dysfunctionality rushes.
Do you really want to be the dysfunctional person when the
mentally ill person is recovering and coping?
A change in attitude is appropriate when a person with a
mental illness begins recovery.
The elephant is out of the living room.
It's time to stop acting as though it were still there.
For those who refuse to take responsibility, the choice is
clear: Reject them--you won't be doing them a favor or yourself a favor by
being an enabler and apologist; you need to take care of yourself and get on
with your life--without the person with mental illness who has made the choice
deliberately and stubbornly that they want to remain just the way they are.
For the rest, we all need to take responsibility and be
supporting one another.
That's what hope and recovery is all about.
Glia Cells
Neurons in the brain get all the attentions, but glia cells
are far more numerous and they have the function of supply the neurons with
nutrients and oxygen and all the other good things the neurons need to live.
In people with bipolar disease, particularly if it is not
treated, the glia cells die off more quickly than they would in a person
without bipolar disease, and this leads to the deterioration of the brain in a
person with bipolar disorder.
This means that as a person ages, their mental health
deteriorates more rapidly than normal and contributes to the degeneration of
the brain.
The brain consists of 90% glia cells which are necessary
for the correct 'wiring' of the brain.
By themselves, the nerve cells in the brain connected
together poorly, but the combination of the two cell types of both nerve cells
and glia resulted in strong connections between nerve cells.
In the brain, such connections allow nerve cells to pass
along messages about our every sensation, thought and movement; weakening of
these connections could be responsible for memory loss and other symptoms of
strokes and Alzheimer's disease.
On their own, the nerve cells appear to do the right thing
-- forming the connections, called synapses, and even using them to pass along
electrical messages -- but the transfer of messages is inefficient and often
fails; with glia around, the connections rarely fail, and the nerve cells pass
on more and stronger signals.
Some glia wrap around nerve cells and insulate them with a
protein called myelin: Glia at synapses act both as a physical barrier that
prevents crossed wires and as a disposal unit that mops up extra messenger
molecules released by nerve cells.
In the presence of glia or the glial factor, nerve cells
make more connections among themselves, but this effect alone does not fully
account for the increased transfer of messages; the more significant change
occurs inside each nerve cell transmitting the message to its neighbors--for
some reason, the glial factor makes the transmitting nerve cell release its
chemical messengers more readily in response to an electrical signal.
It appears that a healthy physical brain can contribute
significantly to better mental health.
To your better mental health
The best way I know of to better health is exercise.
Other factors are important: Diet, enough sleep, balance of
focused work and recreation, proper supplements when needed, appropriate
social activity.
But exercise can do a lot of good in a short period of
time.
The supply of oxygen to the brain, the toning of muscle,
and the general well-being that exercise brings can be quite useful to those
suffering with mental illness--and exercise may well mask the symptoms of
mental illness [that's a joke! see above!].
It should be noted that taking so-called 'recreational
drugs' [most of them off the street, where you don't know where they've been,
and definitely illegal] are usually highly damaging for a mentally ill person,
as is alcohol, but, unfortunately, these are the self-treatment of choice
among the mentally ill.
Hey, guys, if you're trying for sanity, you've missed the
boat.
There are many supplements which may help stimulate the
brain to keep in functioning order, such as
Phosphatidylserine.
Often overlooked is the role that building vocabulary has
in building a healthy mind: As a person builds a vocabulary of words derived
from Latin and Greek origins which renders precise meaning, the synapses of
the brain are developed and the cortex of the brain becomes stimulated to make
the person much 'brighter' and making it more easily possible to reroute some
of the functions of the cerebellum.
With the proper programs in place, it may well permit a
person with mental challenges to reach their 'tipping point': The brain is
extremely complex, not unlike the weather, and, when conditions are right, a
'good' event may trigger a cascade of positive change throughout the brain.
From "Shadow Syndromes":
On the balance, the research shows that the majority of
positive neurological alterations to the brain occur as the result of
long-term, regular exercise. Nevertheless, some changes do occur from the
first day a program is begun: neural levels of dopamine, serotonin, and
norepinephrine rise after a single workout. Mind depression and anxiety in
particular can be very responsive to the effects of exercise. Exercise
increases alpha-wave emissions in the right 9or "depressive") hemisphere;
this is beneficial because and increase in alpha waves appears to
correlate with an overall decrease in activity in that area (since
alpha waves are slower than the beta waves produced when we concentrate). In
short, exercise appears to slow the right side of the brain to some degree,
and to stimulate the left side. That is a good thing, because the
left-dominant brain is generally a tougher, more adaptable, more
stress-tolerant brain. Which is what most of us desire.
Externally, the best stimulus we could have to stimulate
the brain in a positive direction is music: Studies have shown that music by
Mozart actually helps raise the IQ and has been found to be positive in
children's development [forget the fact that cows give more milk]; however,
some kinds of music [so-called] has been found to have quite a deleterious
effect on mental health [and guess which kind of loud music a young modern
mentally ill male will choose, huh?].
So music of the right kind can be be beneficial [and we saw
this quite dramatically in our son--he was much better when he listened to
classical music].
And, finally, don't forget to keep your sense of humor:
Humor is one of the best ways to keep your sanity--just keep it to yourself
[and laughing at things you find hilarious that you don't explain to others,
isn't going to help your cause much either!].
Schizoaffective
The happy ending: Our son is doing very well, and may just
be the most sane member of our family and is still living with us.
He is on Social Security as being permanently disabled
which means that he examined by a psychiatrist every three years to see if he
is still disabled with schizoaffective illness--the combination of the most
extreme form of schizophrenia and bipolar disorder.
Schizophrenia is very rare and affects about 1% of the
population; bipolar disorder and the attendant mood swings may impact any
where from 2% up to--according to some estimates, as much as 10% of the
population or more; the intersection of the two diseases as defined by
schizoaffective is obviously much more rare and very difficult to diagnose,
particularly if the mental health professional focuses on manic-depressive
illness as being much more common, and has little or no experience with
schizophrenia.
What is schizophrenia?
That's a good question, one which did not have a very good
answer until the early part of the 1990s; and while it was known that there is
a genetic component, that inherited factor does not follow the Mendelian
Inheritance patterns [for those interested in more detail about Mendelian
Genetics, may want to review the MIT research at
http://esg-www.mit.edu:8001/esgbio/mg/mgdir.html but be aware that it can
get kind of complicated]; that is to say, that the inheritance of the disorder
does not follow a linear inheritance and there are other factors, such as
early development, which are involved; Gregory Mendel's premise that if you
have such and such in the parental genetics, you will get such and such
results in the offspring--which always worked out for him and his bean
sprouts, but there's more to it than that in some cases, obviously.
What has developed about schizophrenia is the research
which has developed a model wherein it is now understood that it is a result
of clumping of brain cells inappropriately during the first few years of
development: There are too few brain cells in one area of the brain, and too
many--particularly in the functional parts of the brain involved with
perception--in another.
This leads to a remarkable ability for those with
schizophrenia to almost instantly recognize patterns which would be lost on
other people.
A simple example of this was given at the "Hope and
Recovery Conference" where a slide of seemingly random dots were shown on a
screen; the audience was supposed to figure out what it was from the patters;
a second slide was shown with more dots; and so on and so forth until the
fifth slide had enough dots to show that it was a five dollar bill.
And one person in the audience got it from the first slide.
People with schizophrenia are often quite brilliant, as,
for example, Dr. John Nash who shared his Nobel Prize for Economics in 1994,
after years of struggles with schizophrenia.
The problem begins when inappropriate associations are made
in patterns, such as Dr. Nash trying to see the patterns in newspapers and
magazines for extraterrestrial alien messages [forget what the movie said];
the problem ends with an overload of signals in the brain that cannot be
processed--probably because there aren't enough neurons in the areas of the
brain needed to process the input; this is one of the reasons that people with
schizophrenia hear voices: Their brains are trying to make sense of stimuli
which are accumulating at too great a rate.
We all try to make sense of what we experience--please hold
that thought.
People with schizophrenia suffer from overload.
This is an important consideration when people,
particularly family members, are striving to communicate with them.
How well I remember Friday, December 3, 1993.
My son was between his mother and his sister, who both had
taken up a three hour shouting match for reasons long forgotten; he stood
there, unable to processes their arguing; I warned them to stop, that they
were doing great damage, and they would not listen--locked in an incredible
struggle--while my son sank; I had considered putting him up in a motel, but
was too enervated to finish the thought; finally, the arguing ended and
everyone went their way and I thought there was peace.
The next night we returned from a talent contest where our
daughter sang, "Windmills of My Mind" and was upset because she did not win
anything; our son had loud rock music coming from his room; when I went in to
ask him to turn it down [it was 11:00 PM], he pulled a small serrated hunting
knife; I moved toward him and pushed him slightly and he fell down; we called
911; the Kirkland Police came--it took four of them to get him down in his
room; he was taken to Group Health Emergency where the consulting psychiatric
nurse told us that "he is very disturbed"; they then sent him on the the
University of Washington Hospital for evaluation; we went home, and got a call
about 4 AM because he was released on his own recognizance and had no way to
get home and they weren't about to provide him one.
Sunday, was miserable, but he took off with his friends and
came back some time Monday--he had not slept; some how we got him to the Group
Health Psychiatrist who told him that he was sick and needed help, but, since
he was of age and had a choice, he refused to take any medications.
He kept up with the loud rock music, playing his stereo at
top volume at one end of the house and the TV on MTV at top volume at the
other end of the house; if we approached him, he would hold a broom stick he
had sharpened at one end as a weapon to ward us off; he was in pretty much
complete control and we could do nothing.
He told us that he had destroyed and recreated the entire
Universe and that the house had to be purged to hold off the evil; to do this
he used the tail of our most unfortunate cat sitting on the chair, and pulled
down his tail, rather firmly, to "ground" the house.
In order to make sure that the house was "grounded" from
evil forces, he turned off all the power to all the appliances in the house
and threw the main circuit breaker; we had cold showers.
We called the Crisis Clinic; they did nothing.
We called the Crisis Clinic; they did nothing.
We called the Crisis Clinic, and they contacted the King
County Health Department.
Two nice lady social workers came out from the Health
Department for an evaluation; our son was uncooperative; he told me to handle
them and make them go away; they requested that he turn down the stereo at
both ends of the house; he refused; the social workers came away with a
determination for an involuntary commit and began to work with us, the mental
health community, and the police to take him away the next day--on Thursday.
Fortunately, his mother had stowed away some sleeping pills
slipped to her by Group Health and convinced him that they would help him
(since had not slept since Friday Night), and he finally slept for the first
time in days, and so did we.
On Thursday, I took off work and took him to the airport,
then to the movies to watch "Jurassic Park", where he thought Jeff Goldblume
was the Devil because he wore black; in the evening, the forces were
assembled, and off he went to Harborview for a six week stay.
It was a sad day for all of us.
By the end of term at Harborview Fifth Floor Psychiatric
Ward, he was convinced enough to take his medicines and make frequent trips to
the Group Health Psychiatrist and / or consulting nurse.
Our son is brilliant and he was pulling down straight A's
from the University of Washington.
We thought things were going OK, and he moved out.
We moved 35 miles south to get closer to work.
Things weren't going well.
His meds weren't working, even if he were taking them; he
played his rock music at top level in his roommate's apartment, stayed up to
all hours, did nothing; finally, his roommate couldn't stand it any more, and
had him involuntarily committed.
This lasted three weeks, and then he came to live with us
in an apartment.
More trouble, and we called the police and they took him to
Western State Hospital and we moved again--due to, ironically, three men
upstairs from us playing their rock music loudly at all hours.
He returned and lived with us and it was OK for a year or
so.
All this time, he was diagnosed as having bipolar disorder.
There was no hint that he had schizophrenia.
Then, a year later, he began to have bizarre
behavior--partly because the County Social Worker advised him that it might be
OK to experiment with his medications and maybe not even take them.
Bad plan.
His bizarre behavior included, but was not restricted to
damaging our property, and going outside and sucking on a stick he found as
part of a religious experience he had chosen.
He wasn't sleeping and neither could we.
We called the mental health professionals.
They came and evaluated him, but by that time, he had a
small amount of sleep and was almost OK, except that he had convulsions and
the paramedics had to come [apparently, there were some withdrawal symptoms].
They went away and said they could do nothing, because he
was not a danger or threat to himself or others.
More bizarre behavior--and this time he started to make
threats to kill us, and discussed how he might kill each of us.
And this time I got it on tape.
It was 5AM, but a social worker came out and listened to
the tape, talked to him, and determined that he was indeed a threat and
danger; it took some time, but by 10:30 AM, the police came and hauled him off
to Western State Hospital for a 90 day stay; he was angry because I had
committed him; the police glared at me as being the one who caused all his
problems, while the neighbors observed from their windows hidden behind their
curtains [as if some of them didn't have the police come for them later].
It was a full three months in Western State Hospital before
someone there woke up to the fact that he might also have schizophrenia as
well as bipolar disease; as a result, they changed the medicines and it made
all the difference in the world.
And, as they say, the rest is history.
We all barely survived.
It took over seven years.
Nothing's perfect
Our son is doing quite well today, at least as far as his
mental condition is concerned, but does have a number of health problems.
He's brilliant; he's funny; he's sane.
I got my wish: I told him at one point, I want my son back;
and we got him back.
This doesn't mean that he's filled with joy and full of
life.
These experiences have robbed us all of self-esteem and
depleted us physically, mentally, and financially.
People with bipolar disease are given to spending money in
their manic mode because they lose all perspective of accountability; they are
having a glorious time and in their expansive grandiosity, have no concept of
future results of their deeds; therefore, they can pile up impressive credit
card debts; in fact, in evaluating whether a person has bipolar disorder, many
doctors used to ask if you had significant debt because that is often an
effective guide in determining if a person has been going manic.
One of the things that must be watched closely is the sleep
cycle; mania produces endorphins that create a better high than most street
drugs and people with bipolar disease quickly find that if they don't sleep,
they can achieve the manic state; it feels SO GOOD!
And people with a manic episode certainly prefer this state
to the terrible gray depression that deprives them of any hope or joy: They
would commit suicide because it feels so bad, but they can't because they are
so incapacitated that they can't even get off their bed.
Between 20% and 25% of all people with untreated bipolar
disease commit suicide, and 50% of all suicides are the result of clinical
depression.
But we have medications that treat these diseases, and they
work most of the time for the majority of people, but they have side effects.
The medications can be downright unpleasant.
It isn't so much the dry mouth; it's other things, like not
being able to get sleep, liver damage, kidney damage, extreme weight gain,
constant shaking like palsy; and, oh, by the way, you will never drink alcohol
again if you want to remain stabilized.
Oh, my!
Communications
Keeping an effective dialog open between those with mental
illness and family and friends is as useful as it is difficult.
People with mental illnesses most often feel that people
don't understand them and don't understand what they are going through.
They may be right.
Unfortunately, the mentally ill person probably doesn't
know what other people around them are going through and probably don't care,
because it's their pain, and darn it, they need help.
Actually, we all need help.
A significant part of that help is knowledge, understanding
of the knowledge, and the wisdom to use the knowledge and understanding; and
wisdom is related to love.
All parties must make an effort to keep effective
communications, but unfortunately, the brunt of the responsibility must lie
with the family members who may be as victimized or more victimized by the
insanities of the mentally ill family member.
There is a tight rope to walk here: It is important to
listen, and in this, "Seven Habits of Highly Effective People" by Steven Covey
might be useful here, particularly in the area of what he calls empathetic
listening.
On the other hand, family members must recognize reality
from fantasy and be on guard against the fantasies of the patient: A mentally
ill person can be quite convincing in his illusions and can really suck you in
if you begin to follow their line of reasoning.
It is important to remain objective--and, yes, I know--that
may be asking a lot, particularly when you are confused yourself, deprived of
sleep, not thinking clearly and without sufficient information to make an
informed decision on where to go next.
So life isn't perfect.
But Still
Doing nothing is not really an option.
If you can find the right resources and make the right
decisions, there is hope.
There is no quick fix.
But if we continue on the path of a journey to better
mental health, things can improve.
We're in this for the long term.
Never give up; never surrender.
You are not alone.
