Marya Hornbacher Again

A few weeks ago, I took a survey by Marya Hornbacher, author of Madness: A Bipolar Life, which probed my feelings about mental illness. She has written back with more questions. Here they are with my answers:

Do you consider mental illness a chronic physical disease? Please explain your response.

There’s no other explanation for it. I have tried willing myself into better moods or trying to stop my impulsiveness, but they were just too massive a problem for mere force of mind. It was like trying to prevent my cold from generating mucous or insisting that my pancreas produce more insulin. I tried, believe me, I tried to stop the tidal wave of emotions that consumed me but they kept rolling over me and I drowned. When I stopped seeing it as a character flaw and began treating it as a disease of my brain, I got on medications. While my nasty habits didn’t vanish overnight, the moods that drove them achieved a halcyon state in which I was not thwarted in my efforts to change. Just as my heart medications lowered my blood pressure, so, too, my mood stabilizers calmed me.

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Book Review:

Stop Pretending, what happened when my big sister went crazy by Sonya Sones  

 

This is a great book for siblings, who sometimes get lost in the shuffle. I know when my brother was very symptomatic all the attention was on him and I felt neglected.

This is a book of free verse. If you don’t like poetry, give it a chance. It is a quick read. The writing draws you in and you want to follow the story.

A Response to Marya Hornbacher’s Research Project

Kitt O’Malley put me onto a research project by Marya Hornbacher who is writing a book that “will profile the lives of people who have a mental illness or who work in the field, and she’s trying to develop a deeper understanding of how the public views mental illness.” I couldn’t resist throwing in my own two cents. Because I have a long track record of never being included in such studies, I thought I would share my answers to her questionnaire here for your consideration and discussion:

Has mental illness affected you personally? If so, how?

Yes, I live with bipolar disorder, PTSD, and ADD. I lived in quiet torment for many years, occasionally bubbling over in rages that left my wife emotionally overwhelmed. This left me with feelings of deep guilt, but I didn’t do anything at first because I had been told that suffering was part of life and I should just buck up and endure it. When I finally did seek help, I was diagnosed with major depression and put on Prozac. Because I was “cured” the next day, I sought no further insights into my diagnosis until I came to the brink of committing suicide at age 47.
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11 Commandments for People Living with Bipolar Disorder

Recovery from bipolar disorder is almost like a religion or an ethical system. Certain devotions must be part of our lives if we are to recover our balance.

  1. I shall hold myself accountable for all works of my body and my mind including those which I wreak when I am in episode.
    It is important, I feel, not to separate the illness from ourselves. We did the things that happened while we were in episode. There was no second soul seizing control of our bodies. Our mind is a stream that flows continuously, sometimes over rough ground, sometimes in placid stretches, and sometimes over cliffs. We own all these states of our being.
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How Far Would You Go?

We are quick to judge someone who abuses drugs. But shouldn’t we evaluate what led them to use such methods in the first place?

The first time I smoked weed was because I felt depressed and wanted to feel anything else. I didn’t know I was in a depressive episode at that time.

I no longer use it, I actually rather despise the substance.

But it is not the only drug.

I want to feel guilty about abusing my psychiatrist’s trust but I am not the type to feel much remorse.

The powder can work better than the whole. Your nose may ache and the initial rush is so heavy you feel like your heart will explode out of your chest. But I found if you balance the drug with another… then you can excel.

In a way, it is typical cliche college student. They say a ridiculous amount of college students abuse stimulants but I’m not sure of how accurate that is. I have yet to meet any who do but then again- I don’t have many friends and I’m sure it is not something most will announce to the world.

It is not something I do that often, at least not anymore. It is something I do when I’m desperate. I felt so stressed out that I couldn’t function- I couldn’t focus, I couldn’t get started- and the seconds were ticking away.

The pressure to never fail. Not a single class. You want to go to grad school, don’t you? You want to be a success, you want this career because for some reason you have equated it to happiness.

You’d do an awful lot to get this, wouldn’t you?

There are some who would go further than I am. Sabotage their peers even. I am not so devious.

Shouldn’t I feel bad that I have to use these methods at times? I should but I don’t. Like I said earlier, I’m not the type to feel guilt. Would I feel more accomplished if I did it the “right” way? Eh. Maybe. But I’d probably see no real difference. Either way I got the work done- that’s what matters, right?

I’m driven to these methods by expectations. Expectations that were put on me by family and by myself. Ever since I was little it was like my whole life revolved around my future career. Was it my fault? I don’t know. My siblings are all older than me by quite a bit. When I was old enough to start having a good concept of the future, my siblings were all determining what they wanted to do in this world. It made me ask myself the same question. And for as long as I can remember I have had a career goal. I revolve my life around it. But I don’t want to. I want to be happy and have fun.

So I come to be between a rock and a hard place. I can either spread out the time spent studying by not going out drinking or I can get it done in one night by working excessively (and perhaps with a little help) and go drinking.

I’ve done this to myself. I feel trapped in a world where career is everything. But to get to career, I have to get through college. And let me be honest- I hate college. Or at least, I hate the pressure. The deadlines, the high marks, everything. I wish I could learn in an enjoyable way. But let’s face it, I hate my major. I love my minor. Both are useless unless I can get into grad school. I’ve given up on med school, which is what I have completely devoted my college classes towards and it is too late to go back. I am shifting my goal but it doesn’t exactly align with what I’ve done.

What a mess.

Stability… does that word even truly apply to me, ever? You would think so. But I don’t think so. I am always a little up or down. Always have some unhealthy addiction. Am always a little self destructive.

Tonight I used unethical means to get some school work done.

But will you judge me before you even consider what made me want to?

Don’t call me lazy. But if you want… you can call me desperate.

-Quinn

Another Hockey Mask: Andreas Lubitz

*TRIGGER WARNING*

square855I must tell the truth here: I do not understand what Andreas Lubitz did. In my suicidal fugues, I thought of many ways that I might kill myself that involved others such as throwing myself in front of a truck or crashing my car into a tree or driving it off a cliff, but the idea of taking others with me — that wasn’t the self-annihilation that I planned. When I came close,I found a secluded place where someone would eventually find me. That was the maximum involvement of another that I planned. Though I thought capital punishment might work for me — and send a message to those who loved me — I did not want to assassinate others.

>Rumor has it that Lubitz was going through some catastrophic issues with his girlfriend. He knew that he was ill and he was seeking treatment for it. The day of the crash, his psychiatrist issued a sick leave note. Andreas did not use it, however, and his doctor could not call the airline to tell them that he was at risk. But Lubitz did not stop at ending his own life:

Andreas Lubitz was breathing, steady and calm, in the final moments of Germanwings Flight 9525. It was the only sound from within the cockpit that the voice recorder detected as Mr. Lubitz, the co-pilot, sent the plane into its descent.

The sounds coming from outside the cockpit door on Tuesday were something else altogether: knocking and pleading from the commanding pilot that he be let in, then violent pounding on the door and finally passengers’ screams moments before the plane, carrying 150 people, slammed into a mountainside in the French Alps.

In a different article, The New York Times reported that Lubitz concealed his illness from those closest to him:

Peter Rücker, a member of the flight club where Mr. Lubitz learned to fly, told Reuters television on Thursday that he knew the young man as a cheerful, careful pilot, and that he could not imagine him committing such an act.

Online, Mr. Lubitz appeared to be a keen runner, including at Lufthansa’s Frankfurt sports club, and had completed several half-marathons and other medium-distance races, including an annual New Year’s run in Montabaur in 2014.

A Facebook page with a few tidbits of his possible “likes” was visible Wednesday but had been removed by late morning on Thursday. It showed a photograph of a young man near the Golden Gate Bridge in San Francisco, though there were no clues to when the image was taken or any other details….

Data from the plane’s transponder also suggested that the person at the controls had manually reset the autopilot to take the plane from 38,000 feet to 96 feet, the lowest possible setting, according to Flightradar24, a flight tracking service. The aircraft struck a mountainside at 6,000 feet.

Before Mr. Lubitz, 27, a German citizen, set the plane on its 10-minute descent about half an hour into the flight from Barcelona, Spain, to Düsseldorf, Germany, the cockpit voice recorder picked up only the usual pilot banter, “courteous” and “cheerful” exchanges, the prosecutor said.

Then the commanding pilot asked Mr. Lubitz to take over. A seat can be heard being pulled back and a door closing as the captain exits the cockpit.

Lufthansa, the parent company of Germanwings, takes the position that nothing could be done, that even the best system in the world cannot protect the public 100% from such disasters. And they are confident that they have a good one.

I am not a big fan of willy nilly violations of confidentiality. It seems to me, however, that there should have been a way for the doctor to tell the airline that Lubitz was a danger to self and others and see that he was grounded. There should be ways for the pilot to open the door from the outside of the cockpit or to place a toilet inside the cockpit so he doesn’t have to enter the passenger section of the plane. So many things can have been done differently, but I am afraid that this is not where the media, public opinion, and politics will take us. The Times’ restraint will almost certainly be accompanied by more shrill attacks on the mentally ill among us. Lubitz, I dread will become another hockey mask, another poster child who will be held up as a clarion call for denying the mentally ill their confidentiality. Laws stand before Congress that call for allowing “caregivers” to be informed of what goes on between psychiatrists and the most severe mentally ill. Will Andreas Lubitz’s crash take us another step? Who else will psychiatrists be forced to inform? How will confidentiality be broken after this incident? Who else will be able to enter the circle that HIPAA laws now defend? I shudder at the possibilities.

We must look, I think, at another major factor in this crash: stigma. Some out there think that stigma like racism no longer exists or impacts on lives. Believe me, it is alive and well. I know people who have lost jobs because their employers found out about their illness. We are told that we are ax murderers even though we have no history of violence or making threats. Friends decide that they want nothing more to do with us. Spouses panic and file papers for divorce. Now they will say that we harbor these impulses in secret, that we are all ticking time bombs.

Andreas Lubitz kept his illness a secret, I suspect, because of what would have happened to him. He would have lost a lucrative job. He might have found himself unemployed for months or even years. Friends would shun him. He would find himself very alone. In the final analysis, because he could not reveal his ache — because he could not talk about it without bringing an end to the life he had worked so hard to create for himself — the pressure built on him. When he found himself alone at the controls of the jet, he forgot the passengers. Only his pain was real to him and he ended it in the most powerful way he could.

Self Destructive Habits

People see the scars on my arms and legs and they tell me to stop in various ways.

But what people don’t see is all the other ways I harm myself. I get myself into bad self-destructive situations. I smoke, I drink, I take a little too much Xanax, I get into pointless arguments.

Self-harming isn’t just cutting yourself or even burning, hitting, etc.

The actions you take can be self harm too.

It may not be the definition. Maybe it doesn’t count. But to me, these are ways I hurt myself.

I’m putting myself in a situation that will lead to bad consequences. But I can’t help myself. I don’t know how to stop.

I don’t want to talk about the situation… I told myself I’d turned over a new leaf. Yet here I am following this path of self destruction once again. And I don’t know how to make it stop.

People like me get one hell of a bad reputation. But… maybe if they were in my situation, they’d realize how hard it is. Maybe they wouldn’t think so badly of me. Well, I think badly of myself. But it feels out of control, I feel myself going through the actions, getting myself into this situation, and feeling helpless.

I just gotta hold on till I see my therapist. I need real advice, I have a real problem here.

I don’t want to be this person anymore.

Tough Love Isn’t For Mood Disorders

Every now and then, someone comes into one of the support groups I attend or encounters me online and talks about how their family has decided to apply tough love. They are not alcoholics nor do they use illicit drugs. The parents or spouse are reacting to symptoms — usually the lack of motivation to exercise, take care of themselves, etc. The helplessness of the patient does not matter to them. They may not understand that it takes time to recover from a mood disorder or they may deny its existence. If you’re now taking medication, you should be better now, right? Or maybe they think it is time that you “got out into the real world”, suffered what “everyone” else suffers.

So they apply a philosophy that they heard about — maybe from friends, maybe from a therapist, maybe from Bill Milliken’s 1968 book or one of the many self-help guides that have replicated the idea which is called Tough Love. At its best, it is merely setting good boundaries — “sorry, but if you are going to use the money I give you for food to buy street drugs, I am not going to subsidize you”. But in American culture, it too often means employing cruelty to be “kind” whenever the patient doesn’t act in a way that the caregiver doesn’t like. And many caregivers make the mistake of thinking that the symptoms of the disease are something that the patient can control. You are depressed, they might reason, because you don’t exercise You are sleeping all day because you are a lazy good for nothing.

When they apply tough love in this situation, they are abdicating their responsibilities as a parent or a spouse. First of these is to understand the illness. Psychiatrists, for example, see the lack of motivation to exercise less as a cause than as a symptom. Studies show that exercise doesn’t do a lot to pull people out of depressions. A systematic review of the literature on exercise’s effect on depression found:

Exercise is moderately more effective than no therapy for reducing symptoms of depression.
Exercise is no more effective than antidepressants for reducing symptoms of depression, although this conclusion is based on a small number of studies.
Exercise is no more effective than psychological therapies for reducing symptoms of depression, although this conclusion is based on small number of studies.
The reviewers also note that when only high-quality studies were included, the difference between exercise and no therapy is less conclusive.
Attendance rates for exercise treatments ranged from 50% to 100%.
The evidence about whether exercise for depression improves quality of life is inconclusive.

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Not sure which is worse?

I think we’ve all done it. The smiling through our tears. Putting on a facade that we are happy even though we are miserable inside. I do that a lot. I don’t want people to worry. Sometimes, I can’t help it. It would frighten my children when I would cry for no reason so I got better at hiding my feelings.

But, other times, I tell people how I am feeling. But, I still have the smile. I can laugh at a joke after I told them I was contemplating suicide. They don’t take me seriously because my words don’t match my affect.

So, sometimes I am hiding and sometimes I am not believed because I am scared to show outside how I feel inside. It seems better to cry inside than to shed actual tears.

The Dangers of Online Mental Health Quizzes

Alright so this is a big topic for me. A fellow author posted a link to a ridiculous quiz on Facebook that I feel the need to (and was asked to) write about.

I am going to take this quiz, step by step, and report exactly what I think about it. And after I will tell you why these quizzes aren’t just silly or stupid, but dangerous (with my anecdote evidence- reliable I know).

Alright, so when you click on the quiz, it starts off by saying, “Are you prone to dramatic and unpredictable mood-swings? What about anxiety and frustration? What’s your level of uniqueness? Find that all out right here.” Right off the bat I am annoyed. This perpetuates the stereotype that bipolar is sudden changes in mood. Going from happy to sad and back in a second. Unless you have extremely rapid-cycling bipolar, this is very unlikely. Bipolar is experienced in episodes. Generally meaning they have to last at least a few days. Although I do have little spikes of bipolar feelings, they aren’t full episodes and are mostly just annoying.

And for anxiety and frustration, yeah those can happen. I have anxiety that is sometimes correlated with my bipolar. But bipolar itself doesn’t specify that you need to have anxiety. Additionally, “frustration?” Really? Who doesn’t experience that? And lastly- “What’s your level of uniqueness?” That makes me want to hit my face on my keyboard. Being bipolar is unique in a sense, because a small amount of the population experiences it. But in this context it is taken in a positive way. In the United States we have a culture where individualism and self-expression is very important. If you’re unique, then it’s usually considered a good thing. But as far as I’m concerned, bipolar is not a good thing.

And then, of course, it adds that this should be used as a diagnostic test. And I’ll explain later why that really doesn’t matter.
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