Sunday, May 4, 2008

Reasons Why Mental Illness is Hell - A Guide for the Layperson

So pay attention:

1. The physical symptoms of an anxiety disorder, coupled, of course, with the anxiety disorder itself, can make you fear that you have some Terrible Disease. As my general practitioner put it during my last visit, "Anxiety affects every organ in your body." One of the misconceptions of mental illness is that, because it is a disorder of the mind, people with these disorders only feel bad in their minds. In other words, this is a version of the oft-repeated it's-all-in-their-heads idea. No, actually, it is - literally - in my body as well. People with mental illness feel bad all over.

2. When you have an anxiety disorder, or any other mental illness, doctors are in fact less likely to actually screen you for other Terrible Diseases because once they hear that you have a history of anxiety, they chalk your symptoms up to that disorder. When you are in the throws of anxiety, this can actually be pretty damn frustrating, if not maddening. While, often, the person with the mental illness does in fact have a high level of insight and can understand the doctor's prejudice, I, at least, can attest to the fact that having anti-anxiety medicine (or other medication for the mentally ill) tossed at you like dolla' bills in a strip club does not make you feel any better - not when you feel as if the doctor isn't listening to you, not when you feel judged and dismissed.

3. Mental illnesses and disorders are hard to pin down. Do I have severe depression with anxiety, or am I bipolar? Was that a manic episode or p.m.s.? I'm tired and have pain, so my doctor thinks I may have fibromyalgia, but she's not sure. I go crazy every month, so my therapist thinks I have hormone issues, but she wants me to ask my doctor. This is a big deal because defining the illness is, of course, a large part of successfully treating the illness. If you go about treating the wrong thing, for example, treating manic depression as if it were regular ol' depression, you can actually do a lot more harm than good. Antidepressants can spawn manic episodes. Nice, eh?

4. Three words: "trial and error." My general practitioner - again, at my last visit - acknowledged that we were in the "trial and error" phase of treatment, noting that I needed to have patience. I concur. It is damn difficult, though. When you have depression, anxiety, a mixture of the two, or a diagnosis of some other mental illness entirely, you want relief now. All you want is to feel better. Believe it or not, most of the time you want it more than your friends or family want it for you. You want to feel better more than anyone can imagine. Mental illness is not a cold. This is some serious shit, and no one knows that more or better than the person who is suffering it, especially if they've been through it before.

5. Two more words: "side effects." Side effects put the "error" in "trial and error." They can be horrendous. They can make you feel that the treatment is worse than the illness. They can make you feel that nothing is ever going to make you feel better. It's like a great big 'ol cherry on top of the depression.

6. Opinions. There are a lot of opinions out there. They can be deafening. Do a search for "depression" or "anxiety" on Google. Go ahead. Humor me. You'll find that for every psychiatrist out there promoting medicine, for every mental health professional and, furthermore, mental health organization telling you that you need to seek help immediately in the form of a medication, there are an equal number of natural health nuts and vitamin pushers who are out there promoting the idea that these disorders not only can be treated without medication but that they must be treated without medication because these medicines are dangerous. Now that can drive you crazy. I'm not saying that there's not something to eating well and exercise, but when the medicine pushers and the vitamin pushers are both throwing their tablets at each other, well, it's the person with the mental illness in the middle who's getting pelted.

7. Pressure. As mentioned earlier, not only does the person who is mentally ill want to become healthy, but there are also some other people (and institutions) invested in the mentally ill's return to sanity as well. This is not the rosy picture of loved-ones-gathered-around-the-hospital-bed-amidst-balloons-and-flowers that it seems. No. Notice, please, that I used the word "invested." I always (try to) choose my words carefully. I chose the word "invested" because, as an unchosen consequence of mental illness, the mentally ill, through no fault of their own, may have become dependant on a number of persons and institutions, mainly their family and/or Government Resources such as food stamps, etc. So then, while the mentally ill person is trying to feel better, they also feel a great deal of pressure, also commonly known as stress, or a strong sense of needing to pop-up off the bed and feel better already. The depressed and/or anxious person may feel this stress and pressure even if it is not communicated to them in any direct way. The mentally ill person has not only a keen sense of their own misery, but also a pretty good idea of how miserable they are making everyone around them as well. They know that they are a burden. You can guess, I imagine, that this sort of stress and pressure has, in fact, the opposite effect of providing good health and well-being to the mentally ill person. Instead, it makes the mentally ill person feel worse, and guilty, because they do not feel. better. right. now.

8. Stigma. We've all heard of the-stigma-associated-with-mental-illness, but what most people don't understand is that it is much more stealth than the old, rude idea that mentally ill people are dirty, disgusting, hopeless, the Other, etc. We've become much more advanced than our turn-of-the-century ideas about mental illness, but we're still snubby snobs about it. Even after news anchors and movie stars have "come out" about depression, or perhaps because of this, many still believe that a mentally ill person needs to just get over it, or is whining, or is complaining too much, or is making things worse for themselves, or doesn't want to get better, or they like being mentally ill, or that they aren't really mentally ill they just have a personality defect, or that depression is easy to treat, or that the only reason why people with mental illness don't get better is because they don't go to the doctor or take their medicine. These ideas are simply not true. Depression and anxiety are much more complex and much more difficult to treat than the average person could know. It takes a lot of patience, a lot of compassion and, usually, a lot of time in order to get better. Just because Gwyneth Paltrow seems to have lost the baby weight, in, like, totally just a few weeks, doesn't mean that that is necessarily so, or true, or even possible. Same thing with anxiety and/or depression.

9. Mental illness cannot be cured. It can be managed. Therefore, you could treat it and then think you have it beat, you could return to your job, return to your friends, return to your life, and here it comes creeping back again. At first you try to deal with it by fighting it off the best you can without medication. Maybe you don't have health care anymore, at least not yet, until the insurance from your new job kicks in. In any case, it creeps up on you and hits you from behind and then there you are again, real bad off. And no matter how realistically you were able to allow yourself to believe in the bliss of being free of it, you realize that this may quite possibly be something you have to deal with for the rest of your life, whatever it is, you're not even sure, it could be Fibropressionxiety. You will have to be vigilant. It's scary. It's worse than the monsters under the bed. On top of it, you're afraid that everyone around you will get sick and tired of you, maybe not this time, but if/when it, whatever it is, comes back next time, and then you'll have to deal with it all alone. And you don't know if you can do that.

10. Sometimes you have OCD (Obsessive-Compulsive Disorder for the layperson who isn't familiar with the common acronyms of mental illness) and you have to have a nice, even number like "10" to round out your list of Reasons Why Mental Illness is Hell.

So, you should be able to see that mental illness is a pretty ugly thing to deal with. (How's that for an oxymoron?) So fight mental illness; go out there and be nice to someone.

It could make their day, regardless of their current mental status.

1 comment:

Amanda said...

Well, you read about how the Wellbutrin affected me, but what I didn't write in my post about Damon was that in the fall of 2003, I agreed to start taking the stuff again because I was once again pregnant and severely depressed and I knew I needed to do something to cope. (btw, when you're bipolar, it's bad to have three kids in 3.5 years, your mental health doesn't thank you) So I got back on the wellbutrin, and this time it didn't cause hallucinations. This time it caused "morbid thoughts." I had no idea what that term meant before, and didn't realize it until several years after I was off the wellbutrin and went back to read my journal entries of the time. Yeah.

I have now been on Lamictal for 4 years. They had me on a dose that was 3 times as strong as most people with bipolar disorder have. I needed it at the time, after 4+ years of either pregnancy or postpartemness. Unfortunately, no one ever thought to reduce the amount I was on as I eased out of postpartem from my last kid, and slowly I got to where I was gaining weight, my stomach hurt all the time, and I had one continuous migraine that wouldn't go away for months on end. No one put it together that it was the Lamictal levels. Last fall I went through hormone therapy that nearly killed me before i figured it out. Now I'm down to the normal level (though I did the latest cut without permission from my doctor, we'll see how he reacts when I see him in June). I'm just so tired. I hate this. I want to feel normal.