My Family History of Mental Illness

I remember my grandmother in her baggy dresses that covered every inch of her body like the shrouds that covered the furniture when the summer folk had left for the season. My cousin Heidi was surprised when I told her that my grandmother — her aunt — had spent many hours of each day lying in bed.

“But she was always so jolly, so friendly.”

“Yes,” I said. “She could be like that. Like so many of us she knew how to fake happiness.” I do not mean that as a slander. I admire how she could pull herself together despite her suffering and be there.

I know my grandmother loved me. When I was young, she used to get in big fights with my mother for the way she mistreated me. The rows were long and loud — I would go to the very back of the yard so that I could not hear them.

My mother had her own problems: there was a deep-seated meanness in her. She disparaged my grandmother when we were alone together, complaining about what she thought as Stella’s laziness. When I was depressed, she was panicked at the thought that would do the same, so she hectored me about getting a job — any job — no matter how inappropriate or soul-killing it was. Once, when she was in the hospital with roof-busting high blood pressure, I told the doctor about our family secret. A psychiatrist prescribed Prozac. For three months, she was a nice person.

What Makes for a Good Caregiver?

When one takes aim at a system of privilege, some jump to the conclusion that you hate the people who stand to gain from that system and have no compassion for their struggles. Caregivers can make it hard on themselves and on the patient. They give twenty four hours a day seven days a week looking after people in severe episode. They neglect their own health. They grow weary and cross from all their over-involvement.

Our DBSA chapter feels that caregivers need their own place where they can talk about their issues and we have provided one. We do not tell them what they can and can’t talk about. We do not ask them to support certain laws or advocate for changes that they do not want. We don’t have a patient monitor the group to be sure that they act according to some unbearable standard of political correctness — people need to vent. We shelter them from people who may have an ax to grind (I have heard about other groups where caregivers were roasted over hot coals by angry patients) and who don’t appreciate how hard it is. We encourage them to talk to peers who know what it is like. We always ask them how they are feeling when they come to our patient-family support groups, reminding them that they, too, are important. We feel that their mental and physical health is as important as the patient’s and we tell them so.

I’ve been hit with some innuendo from some online caregivers who imply that I don’t care about the mentally ill. What I believe they are really saying is that I don’t care about caregivers. I do. It aches when I see a caregiver overburdened and I do my best to relieve that. Many have been the times when I have had a couple in a group and told the patient that she or he needs to realize that her or his manic state of mind is creating an extremely stressful environment for her or his spouse. How does this make me a foe of caregivers? I think much of the misapprehension stems from my opposition to Murphy’s Law, which I have explained at length elsewhere. It scares caregivers to hear me talk about sane privilege– just like it scares white people when we are talking about black people — where we who live with mental illness are left out of decisions about our treatment.

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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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Random story time!

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One day an incident between my mom and I sparked something like mania in me.

I was offended that she still felt she had control over me, so I was determined to move out. And not just move out, but completely erase any trace of me in the house. I wanted my bedroom to become a guest room, so that there was no returning.

In that time I spent hours cleaning my room, throwing anything and everything out that wasn’t necessary. I got rid of a lot of junk, which was good in the long run. But I also knew I’d have to get a job to support myself since I knew my parents wouldn’t pay for an apartment- and I didn’t want them to either.

I went out shopping for clothes to wear to interviews. I did end up buying a very nice outfit- which was another good thing because I did end up wearing it to an interview that got me a job (months later).

Another weird thing I did was completely shut everybody out of my life. I told my then-boyfriend that I couldn’t talk to him at all. I didn’t contact anybody, I barely spoke to my parents. I was in auto pilot.

I tore down half my posters, only half because I was manic. I was in this… trance. Where everything I did was to move out and distance myself from my parents.

This phase lasted about a week before I suddenly became very tired and realized I wasn’t capable of supporting myself and going through college at the same time.

It was an interesting week, I’ve never had a similar phase. It did end up with good things- cleaner room, clothes for a job interview.

But it also left things half done- like the posters that took me months before I put new ones up. This phase was about a year and a half ago, at least (I don’t remember exactly when, it must have been when my school suspended me because I didn’t have any school obligations keeping me from my task). And it is only now that I threw out one of the posters I torn down.

I just remember the productivity was through the roof and then it collapsed all at once.

I guess I’m remembering this because I’ve been cleaning my room. And also because I kind of want to move out again… but I know there’s no way that’ll happen anytime soon. It won’t happen for years. And plus, when I did live alone, it was a bad time for me. I would talk to myself, which is understandable but it disturbed me a little. It was just weird and I realize that it’s good I’m not alone. I need people around to keep me in check. If my boyfriend and I broke up, I’d be able to go back to cutting. If I lived alone, it might turn into a very very severe problem again. I know I’d be drinking a lot, maybe abusing my prescriptions more than usual.

I’m in a good situation right now and I need to stick with it. I just wish that my life was different in some ways.