Mental Illness

Mental illness is a sickness, like any other you may experience. Rather than being visible and understandable for most people, they wonder why you just can’t snap out of it and try to be positive. They say to eat well and exercise, which is a completely tone-deaf bit of advice.

Challenges of Getting Help:  By far the worst part of suffering from mental illness is the challenge of getting help. Often, you are completely mired in your disorder by the time getting help dawns on you, and the act of doing so is complicated to the point of giving up rather quickly. In addition, mental health care services are typically behind a wall blocking access. I remember that the first time I asked for real help, my general physician gave me a list of phone numbers and told me to “be aggressive.” Aggression is not something readily executed by a profoundly depressed person.

Further complicating things is the masking of mental health services and appointments, even via my medical insurance log-in. Apparently this is “for my privacy,” even though they don’t seem to have a problem sending a post card reminder to my house for anyone to see. I actually have an appointment tomorrow that I had forgotten about.

The simple act of asking for help is so adversarial and challenging for even a mentally healthy person that its a wonder anyone gets access in the first place. In the event that you are able to run the gauntlet and succeed, medication can take months to even find out whether they work. That is, if your medications are even covered by your insurance. Imagine breaking your leg and being told your painkillers will kick in, maybe next week, and if they don’t then we can try something else.

Shows like “Intervention” make getting help look so easy. The sufferer spins out of control, the people around them decide they’re had enough, and they are whisked off immediately to treatment where they are bright and shining 90 days later. In reality there is a phenomenal about of lead time, paperwork, and astronomical costs involved – in fact getting help can be so financially devastating (at least in the US) that the sufferer’s “rock bottom” only happens after they graduate from treatment. While it’s true that many of the homeless in the US suffer from mental health and substance abuse issues, it can easily be the high cost and general ineffectiveness of treatment that can lead to homelessness.

Well, since you’ve asked (or didn’t!), here is the lovely catalog of my experiences with this particular disorder It’s quite a ride…

Bipolar Disorder Type II: Many misunderstand that Bipolar Disorder has to do mainly with emotions, but this isn’t true. Bipolar is a cyclical flow of multiple personality factors that are not readily controllable by the sufferer. My experience with bipolar falls into fairly distinct phases  – Mania causes me to greatly overestimate my abilities and extend myself in a way that most would actually consider admirable. These phases can last weeks or months, and depending on the length can be disastrous to my health and living situation though impulsive actions. Once I run out of energy I experience long bouts of depression.

One summer I took 21 college units and got all As. I woke up one morning and ran a marathon without any sort of training, severely injuring myself. I joined three different gyms just to have a wide variety of choice in what fitness classes to take. I spent every dollar I had on clothes from thrift stores, filling my closet to bursting. By the time I was coming out of this phase I weighed less than 100 lbs (I’m 5 foot 7).

In another episode I chose to leave my live-in significant other (a good decision as he was abusive) by buying a one-way plane ticket with no concrete plans for what I was going to do when I landed. I had no job or living arrangements. I had less than $5 in my pocket and felt for some reason that I would be able to bring a large quantity of water bottles through security.

Still again I entered into a period of promiscuity that I still refer to as my “one-woman tour of the local Air Force base.” Looking back on it it was a really good time – lots of precursory (and unnecessary) dinners and drinks before a lengthy romp in the sack. I am very fortunate to have emerged from that period of my life without any STDs. I do look back on this period fondly, and really the only reason it ended was because I ultimately rounded the corner within a social circle, generating a feeling of jealousy among the group.

There are many more examples of this sort of impulsive behavior. Some have been fun, others not so fun. The real challenge with manic episodes is that it’s difficult to determine when you are in the midst of one. You don’t try to get treatment and usually stop taking your prescribed medication, which plummets you into the deep pit of depression only made worse by the damage I’ve done to my life.

Obsessive-Compulsive Disorder: This takes many forms, from washing your hands, to obsessively cleaning your home, or being terrified of any sort of “contamination.” My OCD takes the form of constant, recurring, unwelcome thoughts. Very few people are willing to talk about these thoughts since they are usually socially unacceptable to discuss. Discussing them would possibly change the way I am viewed by the people around me.

EDNOS: This is an acronym for Eating Disorder Not Otherwise Specified. You are given this diagnosis when you meet all the criteria for an eating disorder (Anorexia, Bulimia etc) but not quite all of them. For me, I meet all the diagnostic criteria for Anorexia Nervosa however do not have a body weight low enough. So I’m a fat anorexic! I also seem to dabble in BDD (body dismorphic disorder) but don’t quite qualify since it’s not bad enough to influence my behavior.

Anxiety: Imagine for a moment that feeling you get when you lean back in your chair a little too far and feel like you are tipping back before gaining your balance. That momentary feeling is experienced on a nearly constant for sufferers of anxiety. It’s impossible to sleep or concentrate on any task. If you are trying to focus on a task requiring a high attention to detail (for example a spreadsheet) you will make multiple errors that will only increase your anxiety when they are brought to your attention.

Depression: This is more than just being sad or in a sour mood. Depression (or at least the way I experience it) is like having a full tank of gas and the car won’t start. It’s a heaviness of everything around you.

Substance Abuse Issues: Substance abuse tends to go hand in hand with mental health issues. Substance abuse can often mimic mental illness, so when a sufferer seems to have both, the first step is to cease use of the intoxicant. For me, stopping consumption of my beloved wine for a period of time was necessary to tease out what the true problem was. While I don’t strictly have these challenges, alcohol consumption does greatly affect my mental health when I consume it over a long period of time. Its easy to fall into a habit that leads to depression, but I am still capable of sticking to the amount previously decided upon when going out for the evening. I was easily able to stop for nearly two years when I was taking a medication that couldn’t be taken with alcohol. Up until that point no one had told me that I couldn’t. I did not fake my way though the faith-based AA program. I just stopped, and it was fine.

Suicidal Ideation: This is a strange one. Occasionally I will think about hanging myself. I am not suicidal, nor do I wish to die. If I did happen to want to take that step in the future, I wouldn’t subject anyone else to the horror of finding me hanging from the rafters of my garage. I also happen to live in a home with several unsecured guns – but same story there -I wouldn’t want anyone to find me. That said, my life will in all likelihood end by my own hand should I become terminally ill or subject to another form of intense physical suffering. It’s a very strange comfort to have that strategy in my back pocket.

When Disorders Collide: Many times these disorders bleed into one another. Currently I am having challenges with an obsession to only eat “clean” food as my OCD blends with my eating disorder. I am sticking to a very strict regimen of eating a mostly unprocessed vegan diet, no pasta or bread.

Constant suicidal ideation blends with OCD as I have recurring thoughts of ending my life. Its important to realize that this is not the same thing as being suicidal. I have no desire to die and am not at risk for harming myself. It’s very hard to explain, even to medical professionals, so I keep it to myself so that I am not involuntarily held.

Bipolar disorder blends with anxiety and OCD when I find myself needing to buy a “complete set” of whatever it is that I find myself needing to acquire. For example recently I needed a set  of watercolor paints for a class I am taking.  A reasonably skilled artist will be able to create any color they wish with a modest set of 10-15 colors, and a very skilled artist will need even fewer. Of course, if a certain brand of paints offers more than 200 hues, then I will be buying all 200 hues.

Anxiety and Substance Abuse issues come together when you are trying to relieve anxiety at any cost. Of course the guilt normally felt upon waking the next day begins the cycle completely anew.