Being a “Woman Who Blogs”-“I’m just a person trapped in a woman’s body”.

This is my favourite post, so now it lives here.

I have a vagina.

What it feels like to be in my brain when I am depressed

So, here I am, not particularly striking, with my weird nose, rather tired.   I look normal enough.  Nothing much going on there.  Visualise tumbleweeds, flotsam, carrion shuddering on bone in an arid desert…

And here’s my brain- poetic license has been observed.

(Note: Not actual size.  It has been proven that manic depressives have brains that are the size of walnuts, rather like sauropods.  Both are regarded with more sentimentality than they maybe deserve).

Then you get a bit closer…

This is the Universal Depressive Translator. 

He takes seemingly friendly and innocuous salutations, actions, laughter, jokes and so on and then turns them into horrible things that make me wonder if everybody really hates my guts so that I spend my entire waking life locked in a jumpy, paranoid ballet, loathing myself for every thing I say, do and am because it all seems to illicit further (albeit veiled) disgust from the world at large.

It makes it very difficult for me to concentrate on anything because I have to disentangle my thoughts, and other people’s words, from the sound of his voice.

So I lie awake and his voice spins around in my head, over and over again.

He doesn’t hate me, not really.  It’s what he has to say, what he has to do.   And I don’t really hate him either.  I regard him almost affectionately, because I have known him for a really long time. Both of us are just going through the motions.

But I do everything to try and drown him out- I walk around singing, I vocalise my thoughts.  And it works, for a while.  But eventually, my voice is lost altogether.  What I want stops mattering, stops even being real. I want to live, I think.  I become a phantom.

I had this dream in which I was repeatedly slapping someone called Christina in the face- what does it all mean?

(Christina has responded- see comments for what she says)

I’m, ahem, mildly critical of New Age-y pseudoscience.  It depresses me that “experts” like Gillian McKeith find their way onto our TV screens and peddle their non-science to the masses.  And today something came to my attention that I found hilarious.  But first…

It might have slipped your attention but I write a blog about living with severe mental illness and as your humble narrator, I’ve received hundreds of well intentioned e-mails offering me “the cure” (and often, for a price).  They’ve ranged from the sensible but misguided like DIET and EXERCISE, the vaguely credible scientific sounding Neurolinguistic Programming and to the downright trying to stifle a guffaw bollocks, such as  exposing myself to “midday sun” (but not early morning sun, apparently, this is bad, though it was never explained why.  Maybe the planets would realign, or, just maybe I’d spontaneously combust.  And what do they mean by “exposing myself”?  Do they want me to get my arse out?  I know I’m pale, don’t rub it in.).  I’ve also been asked to try out various homeopathic remedies at a “reduced cost”.  Well, don’t I feel special.

New Age pseudoscience is basically nothing tied up in vaguely scientific terminology.  Homoepathic remedies, for example, are concerned with treating “like with like” and are sold in bottles that look like they came on prescription.

The remedies undergo “Serial dilution”:

Serial dilution is one of the core foundational practices of homeopathy, with “succussion“, or shaking, occurring between each dilution. In homeopathy, serial dilutions (called potentisation) are often taken so far that by the time the last dilution is completed, no molecules of the original substance are likely to remain.

…meaning that by the time they’re sold, they are water. But it retains the, er, “memory” of the original substance.

However, some alternative medicines (so called because they’re not proven, had they been, and if they become so, they’ll just be medicine) and New Age remedies are slightly more credible than others.  And there are some that make you want to punch the monitor.

Take “expert” Christina Sponias who thinks that we can CURE! mental illness by the “scientific method” of analysing our dreams.  She says she is continuing Carl Jung’s work (and indeed says she is better than him) but seems only to have condensed his extremely wide reaching and complex theories and philosphies into fodder.  She has a free e-book called: Battling Depression and Craziness.   All of which certainly make for interesting reading, and I truly mean that.

She’s a font of knowledge, I mean, here’s what she has to say about schizophrenia (which Mental Nurse has already touched on):

Schizophrenia is the total invasion of the content of the wild conscience of the human being, into the conscious field. This means that the person is dominated by another personality: their primitive self, which is violent, immoral and cruel like a wild animal.

The unconscious mind shows them in their dreams all their mistakes, and they understand that they are responsible for their misfortune. This comprehension eliminates their hate for their enemies.

A schizophrenic patient is totally insensitive, and this is why he is very cruel and violent, without feeling the pain he is provoking to the others. He is totally disconnected with the external reality.

This is the result of the domination of his wild personality and the only possible psychotherapy for him is the elimination of the anti-conscience that dominates this brain and psyche completely. It has to be transformed into human, so that the person may find peace and mental health.

This is a very arduous process after the destruction of the human side of the human conscience. This is why we must prevent craziness and never let any human being become schizophrenic.

Schizophrenia is the worse existent mental illness…

However, the scientific method of dream interpretation can help schizophrenic patients eliminate the monster that dominates them, and acquire a human personality, even though they cannot recuperate their destroyed human conscience.

EH WHAT.

I’m going to hand that out to my schizophrenic and schizoaffective WILD ANIMAL friends.

Firstly, she starts out on the basic, common ignorance that schizophrenia is a “split personality” (or, this could be metaphorical, but I very much doubt she has a basic grasp on it anyway).  Most people I’ve ever met have thought this, and here it is, being peddled by an “expert” who claims to be a psychotherapist!  Schizophrenia means “split mind”, but that’s not “split personality”.

Secondly, has this woman even met someone with schizophrenia?  How dare she make value judgments on their being such as: cruel, violent, insensitive.  These are judgments, they are not symptoms.

This crap just promotes the staggering ignorant assumption that people with schizophrenia are dangerous.  About 1% of all violent crime is committed by someone with schizophrenia- and that’s just incidental, like you’d say 40% of crimes were committed by people with a car.  Many people with schizophrenia, like other mental illnesses, are suicidal, not homicidal, and not violent.  And the “negative symptoms” of schizophrenia trouble people as much, or more than, the psychotic symptoms (of which are not confined to schizophrenia).

And schizophrenia isn’t the worst mental illness.  There is no worst mental illness.  All of them affect people differently.  I hate this cloak and dagger business of schizophrenia being the “cancer” of mental illness.  That it’s hopeless.  It’s not, it’s just a frigging mental illness like manic depression is. People with mental illness are just sodding PEOPLE. And mental illness is an illness like others, at least that’s my “from reading and goddamn a lot of experience” opinion.  And as for the use of craziness, that’s one for our personal relationships and us crazies to use, not for quacks to use in regards to people with mental illness.

If you were feeling left out, she has some theories on bipolar disorder, too:

If you suffer from bipolar disorder this means that you are frequently dominated by the wild side of your brain and psyche, which pretends to belong to your human conscience, but is in fact a violent animal, without human feelings, that tries to mislead you.

Really?  Which are you talking about, mania or depression?

What does it mean to be dominated by the wild side of your conscience? The anti-conscience (wild side of your conscience) is a true demon and it invades the human side of your conscience through absurd ideas, feelings and sensations. If you pay attention to them, the demon becomes stronger and you gradually start losing the notion of what you are doing. You forget your moral principles, nothing has any meaning for you, you accept immorality… you gradually forget who you are.

Ah, mania then. What exactly is immorality?  Are we making value judgements again, missus?

When you are bipolar this means that the anti-conscience frequently invades the human side of your conscience, constantly sending you absurd ideas, feelings and sensations, or even a strange intuition.

However, this domination doesn’t last too long, and when you recuperate your human conscience, you cannot understand how you could have behaved the way you did.

Right, stop nodding at the back like I know some of you are.  This is sub par metaphorical wanking, not scientific theory.

How do I fix myself?  Oh please dear god, tell me how!

You need the protection of the unconscious mind that sends you wise messages in dreams with guidance, which works like psychotherapy.

Eh? What?

Your bipolar disorder will disappear completely as you will learn how to develop your intelligence and personality, transforming the wild content into human.

Wild content?  Look, my dreams consist of zombies, and, for some reason recently, the new Elbow album which I haven’t even heard.  What does it all mean?

Anyway!  After her profound misunderstanding of mental illness and the brain in general, we get to her methods:

Accurate dream interpretation using the proven scientific method provides a cure for depression, craziness and suicidal tendencies. The successful interpretation of each dream begins with reading the dream and understanding something about the dreamer’s life.

Let’s look at that again.

proven scientific method

Where?  Show me the data!

We must pay attention to the dream messages and learn the scientific method of dream interpretation so that we can overcome the primitive behavior of the wild anti-conscience and continue to evolve as humans. If we give in to our primitive instincts, our behavior devolves until we behave like wild animals, with cold indifference to human suffering, and prone to depression, and despair. (edit from Seaneen: in my experience: and this is anecdotal, too, people with experience of mental illness are more compassionate than your average).

Dream interpretation using the scientific method is based on translating the meaning of your dreams and dream symbols into words over a period of time. Dreams follow a logical sequence and provide information and advice gradually, so it is necessary to follow the messages over a period of time if you want to learn all the lessons they contain.

WHAT.

Remember what I said about New Age stuff?  That it’s nothing wrapped up in vaguely scientific terms?  Yeah.

This isn’t about the subsconsious or symbolism in dreams.  I think our dreams are very interesting.  What annoys me is that it’s all about a cure and the cure involves- well, nothing to do with the actual mechanics of the mind.  She also specifies that when you submit a dream:

1. Your biography is very important. Write down the most important things about you and your life.

So, say you leave the detail out of your biography that you have schizophrenia.  Do you think she’s going to give you “the cure”?  All the details you provide can easily be slotted around anything you say about your dream to seem meaningful, when really it isn’t.  It’s cold reading.  Or in this case, hot reading.

Her interpretations are irresponsible too.  She starts with:

When we interpret a dream we don’t have to explain to the dreamer why we took these conclusions.

So that basically means, like it or lump it, I am right because your dreams told me so.

I go from one point to the other but I forget my purse somewhere in the way and I cannot find it. While I was looking for my purse, I meet an old friend, who had also lost something, but I don’t remember what it was.
We go together to a place like a jungle, and many snakes appear from everywhere. I think we won’t be able to escape. At this point, I wake up.
Biography: I’m a girl 18 – 20 years old and I feel insecure many times. I have a boyfriend, but I’m not so happy. He is always with is friends or always busy doing something. I feel alone.

Dream Interpretation:

You are in danger because another guy may induce you to betray your boyfriend, and steal you from him. Another part of your personality is too inconsequent, besides your human conscience. This means that you don’t understand the danger you are in.
It is obvious that if you are not happy with your relationship, at certain point someone else will appear in your life, to fill the emptiness.
Be careful and define your position: if you are not happy, don’t insist on this relationship, otherwise you’ll have to face many other unexpected problems, that will cost you too much, even though in the end you’ll learn a lot with everything, becoming more mature.
Be intelligent and separate this guy who doesn’t really love you. Stay alone until you’ll find someone you’ll really love and who will really love you. There is no meaning on living with someone who doesn’t care for you and become a sinner because you’ll betray him in the end…

This is just Agony Aunting from the biography.  Nothing to do with dreams.  There is no “scientific method”.

But hey, it’s apparently really successful.

Everyone finds health, happiness and wisdom following this method, without exceptions.

Unless:

Only if you don’t care for your dreams will you not see any positive results.

Oh.

So if it doesn’t work, that’s your fault.

And what exactly is your “anti-conscience”?  It sounds like a euphemism for your evil twin.

Here’s me and my “human conscience” today, with Little Ted.  As you can see, we’re deeply in love.

..and then…

OH NO!  LOOK WHAT MY ANTI-CONSCIENCE MADE ME DO TO LITTLE TED!

Why do I care about this random guff on the internet and this random person who charges for her services?

Well, quite apart from her absolutely infuriating misunderstanding and phenomonal prejudice of and against mental illness, it’s that people like this are becoming the new “Experts”.  She’s an extreme case of groundless quackery but just check out the world around you in which science is losing its credibility and we have endless programmes such as shite like, “The Baby Mind Reader”, holistic non-doctor McKeith in her white coat, lifestyle programmes that tell us that for well being we should align our furniture in a certain way and reiki available on the NHS when there’s a year waiting list for therapy (and therapy should be bloody mandatory for anyone with a severe mental illness, or at least should always be offered).  Science is not perfect but it exists to disprove and prove.  And its reputation is receding.

In terms of mental wellness, i.e just keeping yourself ticking over happily, or mild forms of some disorders, I say, do what you like.  Things like good diet, being active, socialising, hobbies, meditation and so on are all good.

As complimentary therapy, I don’t care and think live and let live (and I know that in itself, the more personalised approach that non-medical treatment has is enormously helpful to some people) but never say that your methods will cure someone of something when you have no concept of how someone even experiences it.

Mental illness is one of the worst of things to be afflicted by. It is isolating.  It is misunderstood.  And instead of moving into the direction of, “Hey, well, that might suck”, New Age crap like this (and it is an extreme case of it) pushes the theory of, “It’s your fault.  It’s you as a person that is bad and that’s why you’re like this and we can cure you.  If you pay me”.  Proposing a cure for anything without scientific basis is irresponsible.

In terms of mental illness and medical treatment, well, there’s the battleground.  Some drugs are apparently no better than placebo (see reactive depression and antidepressants). Some drugs should not be prescribed at all. Some work. Psychotic illnesses react well to antipsychotics.  They “work” in the sense that they help kill psychosis- the sociological aspect of that is something I’m not getting into.

But medical treatment for mental illness can be painful because of the hardcore aspect of the drugs.  In short: the side effects suck and something pissing about with your mind and motivation can be distressing as hell, take that from me. And mental illness is of the mind- no, the brain, which is an organ, too.  But unquantifiable.  So we can be sold anything and in desperation we can try anything, because there is no stick or thermometer to tell us if we’re better or not.  And we can be told that what is going on with us isn’t real in the first place (although to me, “real” just means “really affecting you, therefore if you want help with it, you should be offered it without judgment).

I think that this rise of Pseudoscience is dangerous and damaging.  It relies on anecdotal evidence and is a growing, prosperous industry and that in itself is giving it unwarranted credibility.  In some cases it exploits people’s desperation.  And I don’t think that psychiatry or even science has all the answers but it is an arena that questions rather than anecdotally accepts.  I’d rather push forward in that direction of research into things that are working or work better than most than go backwards into the direction of New Age pseudoscience that says it should work because… well, it should.  Stick it up your chakras.

(Incidentally, Christina responded with exactly what I would have expected: you cannot see the truth, so you are wrong and I am right.  Read more here.).

The Insane Guide to Living With Mental Illness: The Mixed Episode

Ah, here we are. It’s now time for me to introduce the special circle of hell reserved for the manic depressive: the Mixed Episode. These were meant to be funny, sarcastic guides (like the Depression one was) but somewhere, it’s become all serious!

A mixed episode (also known as dysphoric mania or, for depression with hypomania, agitated depression) bears a little explanation. It is literally a mix of manic and depressive symptoms at the same time. It’s generally considered as the most dangerous of mood states, being that if you want to kill yourself, you have all the energy and frantic invention necessary at your disposal with which realise that particular dream.

However, if you believe the DSM-IV, relatively few people with bipolar disorder experience these episodes. The reason? It is strictly defined as mania and depression for a week; leaving out hypomania, thus nobody with bipolar II or cyclothymia has ever had a mixed episode. From my forays into BipolarLand, reading and research, please take it from me (and the dissenting voices in the psychiatric community) that the DSM-IV needs updating. But lucky me, eh, bipolar I, so, by the DSM-IV rules, anything goes.

It lies close to my heart. Dysphoric mania is, by far, the most common episode that I experience. Those much romanticized euphoric manias has almost disappeared as I have grown older, and my manias are now increasingly black and almost always psychotic. It’s why I’ve escaped being diagnosed with depression. I’ve been suicidal and depressed many times in my life, but the manic edge which accompanies my depressions has exempted me from being considered clinically depressed. It is one of the reasons, I suspect, that even when I’ve been in front of a psychiatrist absolutely suicidal, the relentless diagnosis of bipolar I has always been returned.

It is difficult to describe how it feels; imagine the white noise of racing thoughts pitched at total destruction and despair, horrible images, frightening visions, flights of ideas punctured by the bleak feelings of failure, endless energy overriding utter, utter exhaustion, nameless guilt, manic lack of inhibition, rambling and ranting, restlessness, the damaging impulsivity and grandiosity of mania, terrible agitation, rage, anxiety, panic, psychosis, paranoia and fear. It can be constant, or can fling you from mania to depression and back again extremely quickly.

A mixed episode landed me in hospital, and mixed episodes are almost totally at odds with normal functioning; it is simply impossible to go about your normal life when in a mixed episode. Everything is frightening or an insummountable challenge.

Yes. They’re no fun. So, here’s the Insane Guide to the Mixed Episode. I found it difficult to be sarcastic about mania, it’s almost impossible to be lighthearted about the dysphoric kind. So this guide is kind of crap.  Apologies.  Read the previous ones instead by clicking on the category, The Insane Guide…

The Mixed Episode

Manic, depressed, who the hell cares, you can have it all! Welcome to the mixed episode. You may never leave. I really mean that.

1. Eating and self-care

2. Social etiquette

3. Hobbies

4. Sleep

5. How to deal with those around you, who may not be so excited about your insanity as you are! Includes lovers, friends and the medical profession.

6. The future

1. Eating and self-care

Have you eaten? You can’t remember the last time you ate. You probably should eat, but you can’t focus long enough on anything, let alone the thought that you need food. Everything feels like it’s been put there to test you, and you find yourself by the kettle in tears of frustration. You can’t even do that, a task that wouldn’t tax a five year old. You can’t do anything.

You brush your hair and teeth, on automatic, and neglect to put on underwear, simply forgetting. It doesn’t feel very important. You can’t really concentrate, your clothes are a jagged mish mash of colours and shapes, old blood stains seeping through the cheap fabric. You look in the mirror but you can barely focus on the image. There’s pictures in your head, horrible pictures, that seem to permeate everything you try to look at.
2. Social etiquette

You did go out for a drink but found yourself crying at a table alone. You’ve been trying to talk to your friends but you just can’t, you can’t communicate at all. The words, rapid and free flowing, are not making sense. People can’t keep up with you. They listen, for a second, but you’re going too fast, and they drift off, nod, and turn their attention from you. You don’t look right, your eyes are fire in pitch from lack of sleep.

Self pity kicks in, and you’re convinced that everybody hates you, more than hates you, wants you dead. You are ferociously, wildly, suicidal and you begin to feel angry at those around you- why can’t they see that, why can’t they help you? The strong desire for someone to reach out is not as strong as your desire to be alone, so you leave, and walk quickly into a cold night, frightened at every single sound that you hear.

3. Hobbies

Nothing from the outside makes a difference; you can’t concentrate on a film, the things that used to calm you down don’t and your panic is rising. How can you slow the thoughts in your mind? So you have new hobbies- running on the spot, talking to yourself, anything to calm down. You’re exhausted, your whole body is screaming out to stop, but you can’t. Relentless, frantic energy grips you and there’s nothing you can do to get rid of it. Absolute rage and frustration courses through you, and the room is wrecked. You get up and write disjointed prose, the words jumbling up, making no sense at all.
4. Sleep

You tried to sleep, you lay down, but your head felt like someone was chainsawing inside, so you got up again. You want to sleep, but you can’t, you’re restless and anxious and the dark shadowy shapes in the room seem to be moving.

5. How to deal with those around you, who may not be so excited about your insanity as you are! Includes lovers, friends and the medical profession.

You’re depressed, you know you’re depressed, despair, sorrow and complete hopelessness is flooring you, but the doctor doesn’t know what’s wrong- you’re not eating too much or sleeping too much, you’ve had more energy than you’d had for some time and although you sit and talk for half an hour, nothing makes a difference.

Your friends are long gone- something you did or said, you can’t remember. Loved ones keep their distance, unable to cope anymore with your shouting and seemingly untriggered crying fits. It just compounds your guilt- you’re a bad person, and you know it.

6. The Future

You can’t think straight- tomorrow seems like it’s a thousand years away. You have no idea what you’re doing or what you’re going to do. You’ve been awake for days and are starting to become very paranoid. You don’t know how to feel safe or how to stop, you just want the agitation to calm down, for one second.

Crap guide there. I find it hard to write about. It’s just a horrible way of being and all I want to write is, “I’M SORRY” to anyone who might be going through one. To be honest, I’ve been getting so panicked and bizarre lately that I think I’m not doing too well myself. Today has been a White Noise Day, that is, very rapid, quite scary sequences of thoughts and voices going over and over in my head that frightens me and makes it impossible to concentrate.

Sometimes, I’m tempted to write down everything my brain voices say so that I can understand it. But I can’t, because they move so damn fast that it seems like malevolent gibberish.

The Sane Guide to Living with Mental Illness

Wow, this blog has gone right off topic recently. Flippin‘ friends dying, they’re so inconvenient.

I am still nowhere near caught up on e-mails so please excuse me if you haven’t received a reply from me.

I am fairly sane at the moment.

This is somewhat of a revelation; I can’t remember a time in my life when I have been fairly sane. Oh, glimmers of sanity have squeaked through the black tarpaulin of madness but by and large, even my most coherent writings have come from a chaotic planet.

I am not incredibly depressed, nor am I manic. I’m not fantasizing about suicide- it’s been a few months since I’ve white-knuckled safety railings at the riverside.

Anxiety and paranoia, yes, excessive worrying- well, that’s just me- and my ongoing battle with weight and eating continues. A lot of sadness and sorrow and anger at recent events. But mood-wise? Steady, in a mildly depressed kind of way.

How do I judge my own sanity? By not comparing myself to other people. I’m never going to be Completely Sane. The lovely thing about the world is that you’d have to look a long way to find someone who is.

I’m never going to not have manic depression. Even now, with a somewhat clear head, there are “residual symptoms”.

Anxiety and paranoia. An ongoing battle with weight and eating habits (and not-eating habits). Still having trouble sleeping. The reckless nervous energy that is 50% me and 50% manic depression. A mild, niggling, irritating depression that blunts my experiences and emotions. Intrusive thoughts and panic. Narcissistically worrying about being narcissistic.

But this is good.

It was only a few months ago that I was ravingly psychotic, swallowing a huge dose of Lithium and on the verge of utter annihilation. Every little victory- the return from self-destruction- I cherish. To judge my sanity, I compare myself, to myself.

Every time I cast mind back to six months, a year, a year and six months, I’ve been ill. For most of my life, I’ve been ill. I’ve clung on to the merry-go-round of madness and am barely alive because of it.

So, while I’m feeling relatively together, here’s my sane guide to living with mental illness. Bear in mind it’s from the perspective of “been there” rather than “been told”. Feel free to ignore everything, though!

1. In times when you feel better, don’t expect the unexpected.

If you’re like me, this is much easier said than done. I’m a born worrier. I worry about everything. When I click “Publish”, I’ll worry about that, too. Talking about myself all the time? How self-obsessed. And in my self obsessed way? I’ll worry about that. I worry about everything I say, everything I don’t say, and everything I don’t do, and everything I do.

So I find it hard not to worry about the next episode of illness.

I know it’s probably coming, so I find it difficult to enjoy not being mad for a change. Experience has taught me that these lulls in time are the calm before the storm. I’m a rapid-cycler, and pockets of sanity are brief for me.

But, this time, I’m trying to think, “Maybe this will last longer than a few weeks”. You never know. So don’t try to will your next psychotic breakdown or manic episode. Relax, if you can. Take your medication, try to be okay.

2. Keep taking your medication, even if you feel better.

Ah, this old chestnut.

I’ve only been treated for manic depression for the past year and a bit. But every time I’ve felt “alright” and decided to ditch my medication and miss appointments, I’ve become ill again, very, very quickly. It has nearly always resulted in a messy hypomanic or manic episode and has meant that my antipsychotic gets upped to deal with the “crisis”. Or, there are times I’ve quietly skipped my medications and lied about it and become suicidal.

Something I believe, and have emphasized a lot here, is that mental illness is partly biological.

Sure, nature can embellish it, but I strongly agree with the idea that there is a biological basis for most mental illnesses- almost certainly some forms of depression, manic depression, anxiety, schizoaffective disorder, addiction, schizophrenia (their symptomatic similarities to biological illnesses such as epilepsy only strengthens my conviction) and possibly personality disorders, eating disorders and DID.

I don’t subscribe to the belief that mental illnesses are “labels”. Cancer, diabetes, asthma, etc, aren’t labels, they’re illnesses. And so it mental illness. Once I got past that, I found it easier to write with conviction, without worrying about “labelling” myself. I have got manic depression. Whoop.

I’m not on the gravy train of the “medication is evil”. It doesn’t mean I like to take them, though. I hate taking my medications, I always will. I hate the ritual, I hate the weight gain, I hate the exhaustion. I can see the argument- especially in countries where you pay for healthcare, such as the USA, and where medications are advertised like sweets. But if you take something and it makes you feel better, well, I think that’s okay.

And I don’t think people appreciate how difficult it is to continue taking medication for mental illness. On one hand, the side effects can be close to unbearable. I do entirely understand the stance that medication can numb you. But if I hadn’t been treated for manic depression- and medications are a huge part of that- I would most likely be dead.

So on the other hand, we come full circle to…

It’s not a cure. It’s to help you cope and live with your illness, to alleviate some of the more frightening and terrible symptoms that you are living with.

So when you feel better, don’t stop taking medication and don’t miss appointments, however tempting it might be. You might be feeling better due to sheer force of will, help from people, or maybe your illness just shifted somewhat, but, if you’ve been taking medications for a while, there is almost certainly something in them that is helping, too.

3. If it’s not working, say so.

Lithium made me physically sick and didn’t help at all with my illness. But because it was the “gold standard” for bipolar 1 disorder, I didn’t speak up, and quietly waited to feel better.

I never did and after the third or so bout of vomiting, shaking and passing out, I told the psychiatrist that I didn’t want to take it anymore.

Likewise, Seroquel helps me sleep, quells psychosis for the most part but it’s “antidepressant properties” are non-existent in my case and it turns me into a zombie. So I am being slowly switched to risperidone instead.

Of course, there may be times you can’t tell your medication or treatment in general isn’t working. So this one’s for those around you who know you- if you can, let someone know. I was manic for a while on Lithium and it was Rob who noticed I was, not me. Insight is an occasional companion sometimes.

4. Get support.

It can be isolating to live with mental illness. And not everything is as culture tells us it should be; lots of people don’t have close friends or family to rely on. And that isolates us further. Sometimes, family and friends don’t understand. Sometimes, you just don’t want to talk to them anyway.

There are support groups around the country that you can speak to and make friends at. The Manic Depressive Fellowship (now the much more PC Bipolar Organisation) holds regular local support groups, and The Support Line has some links and phone numbers for people with depression. Rethink also offer support groups for illnesses such as manic depression, depression, anxiety, schizophrenia and personality disorders, amongst others.Other “service user” groups include The Perceptions Forum, run by mad people for mad people, centering around the psychosis experienced by people with psychotic illnesses.

There are also tons of online forums that exist to support people with mental illness. A great one is The Mood Garden, which has forums for depression, self harm, anxiety and panic and substance abuse.

There are other good forums and support groups for problems such as anxiety and eating disorders.

5. It’s good to talk. Therapy is important too, but if you’re not going private, bring a book.

I was diagnosed with manic depression over a year ago and I’m still not in therapy. Medications can be good, but I think therapy is just as important. Having someone to talk to, learning ways to cope with an illness that you might have forever and taking the strain from ear-bashed loved ones is valuable.

I am finally speaking to a therapist soon- about friggin’ time an’ all. As biological as mental illness might be, sometimes, treatment is complicated. For example, I can’t take antidepressants. It’s been done a few times, and each time has been the same- hello mania. Treatment, then, is needed to help me cope with depression. I also have, as you know, Body Dysmorphic Disorder and problems with eating disorders, that pills don’t really help.

And even if you have a tidy mentally interesting diagnosis, life still happens, and it’s hard. Quite aside from regularly lapsing into depression because of my illness, there are life-things I struggle to cope with.

And again, it’s a little-thought line that dealing with the diagnosis itself it very difficult indeed. I still have trouble accepting my illness, however lucid and sage I seem here. Like any life-long illness, coming to terms can be hard.

The fall-out from episodes of illness can often be extremely hard to cope with. The strain it can put on your relationships, jobs, physical well-being, finances and other areas can sometimes be the beginning of a downward spiral. (After bad episodes of illness, I hate myself and feel so guilty and worthless I want to top myself. But there are always people I can’t look in the eye, and I find it very difficult to speak to friends and to manage the practical aspects). Psychotic episodes, in my experience, can be the worst as it’s a side of you people may have never seen before, and may find very hard to understand. It is really good to talk these things through.

So, if you’re being treated, push for therapy. You might have to wait a while, though. If you have specific issues (or your loved ones do), such as bereavement, substance abuse and “youth” related problems, there are many free counselling services around that you won’t have to wait so long for, such as Cruse and the Mind Guide to Counselling.

Also, never forget that if you feel you have no-one to turn to, there are confidential counsellors available by phone and e-mail such as the Samaritans. It’s their job to listen, and they can really help in a crisis.MIND also offer free counselling.

6. Mentalist- know thy services.

It’s not inevitable that you’ll need to go into hospital in an acute episode of illness. Whereas sometimes it may be the only option (such as needing to be sectioned for your own safety, and the safety of others), hospitals can be extremely traumatic. They are boring, above all else, and the surroundings can leave a lot to be desired.

If you, your “team” and those around you think you may need somewhere safe to be for a while, there may be other options. For example, there are crisis centres. I am lucky to have (and to be visiting next week with the CPN) a women’s only crisis centre.But look up mental health services in your council directory and ask questions. There may be a crisis centre near you.

You can also enlist the help of a crisis team if you want to avoid admission to hospital. Most councils have a community mental health crisis team who can give you ongoing support and evaluation at home.

7. If you can’t work, get benefits advice and help claiming them. And get someone to keep an eye on your finances.

I have been too disorganised and unwell to even begin to sort out my benefits. My CPN played a huge part in helping me, as did Islington People’s Rights. Now I’m finally on Income Support, Housing Benefit and DLA.

If you’re able, find out what to claim and how, and try to get independant help and advice from local people’s rights services or from the Citizen’s Advice Bureau. If you have family or friends, enlist their help in getting forms for you and helping you fill them out. There are also online services and resources such as the Advice Guide and Rethink.

When you have a mental illness such as manic depression, borderline personality disorder or schizophrenia, you might be, like I have been, impulsive and reckless with cash. When I’ve been working I’ve gone on many a manic spending spree and completely cocked up my finances. The “oh no” bank statement is not your friend, so, embarrassing as it might be, it can be a good idea to ask a friend or someone close to keep an eye on your spending for you.

8. If you’re reading this, you’re alive. Nice one.

Mental illness can equal terminal illness. It’s true that many people with mental illness will go on to commit suicide. Even with the best of care and support, it is not altogether unavoidable.

But being alive, day after day, is a victory. It’s not a failure, it’s not “being weak”. Whatever help you receive, it’s ultimately you who is responsible for yourself. So if you’re managing to continue living, no matter how horrible things get, even if in the past you’ve tried to commit suicide, you are alive and you should try to have some pride in your self.

Again, this is an “easier said than done” rule but I think it’s worth pointing out.That’s all from me for tonight- jesus, it’s a Saturday night. I’m going whip out the media player and turn on the lights so I can pretend I’m at a club or something.

I’ll be writing more trying-to-be-helpful things about living with mental illness in the future. Please feel free to suggest stuff.

Mental Illness and Mortality

Last night when my brain was car-crashing, I was reading about 10 articles per five minutes. One them was this about serious mental illness and mortality.

That was the article that triggered my panic attack. Here’s another:

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Clinical & Research News

Death Data Have Researchers Searching for Answers Eve Bender

People with serious mental illness are dying at higher rates and at earlier ages than people in the general population who don’t have mental illness.

Metabolic dysfunction caused by some medications may play a role. People with serious mental illness in one sample of psychiatric inpatients had more than three times the rate of death of those in the general population without mental illness and died an average of 32 years earlier.

The leading causes of death among people in the sample, most of whom were diagnosed with a psychotic disorder, were heart disease, suicide, accidents, and cancer.

The findings call for increased screening and monitoring of patients with serious mental illness for medical comorbidities, according to the authors of the study, published in the October Psychiatric Services.

Researchers collected medical information on 20,018 patients hospitalized on at least one occasion at one of nine hospital sites associated with five behavioral health care organizations in Ohio’s public mental health system between 1998 and 2002.

They matched patients’ hospital records with death records from the Ohio Department of Health and identified 608 patients who died during the four-year period (hospital deaths were included in the sample).

The patients who died had been diagnosed with a number of mental disorders, including schizophrenia (134), schizoaffective disorder (128), alcohol abuse (101), bipolar disorder (87), alcohol dependence (85), major depressive disorder (80), cannibis abuse (59), other mixed or unspecified drug abuse (56), and cocaine abuse (35). The majority of patients in the sample died from heart disease (126), suicides (108), accidents (83), or cancer (44).

Researchers also measured years per life lost for those who died, which is a measure of premature death based on the current mean survival age for a cohort matched by age and gender in the general population. Patients with serious mental illness died an average of 32 years earlier than patients in the general population, according to the findings.

The average age of death for the people in the sample was 47.7 years. When researchers calculated the standard mortality ratio for patients in the sample who died, they found 3.2 times the rate of death as that of the general U.S. population.

The most prevalent comorbid medical conditions for patients in the sample who died included obesity (144), hypertension (136), diabetes (70), chronic obstructive pulmonary disease (62), and injuries (39). Among the 126 patients who died of heart disease, leading comorbidities included hypertension, obesity, diabetes, chronic obstructive pulmonary disease, and disorders of lipid metabolism.

Previous research has yielded similar results. For example, a report released by the federal Centers for Disease Control and Prevention in April said that patients with schizophrenia or bipolar disorder lose as much as 20 years off their average life expectancy compared withsimilar individuals in the general population without seriousmental illness and had elevated rates of heart disease (Psychiatric News, July 7).

At a 2004 meeting convened by the American Diabetes Association and attended by several APA members, the organization issued a consensus statement confirming the risk of metabolic changes associated with second-generation anti-psychotics and calling for careful monitoring of patients on these medications.

In the study of hospitalized patients with serious mental illness in Ohio, researchers could not draw conclusions about cause of death. They speculated, however, that underlying factors may have included medication-induced weight gain, poor personal hygiene, reduced physical activity, increased prevalence of smoking and substance use, and inadequate social support, according to C. Bayard Paschall III, Ph.D., chief of the Ohio Department of Mental Health’s Office of Performance Improvement.

“The question is how we tease some of these characteristics away” from others to be able to associate them with cause of death for patients with serious mental illness, Paschall told Psychiatric News.

Study findings indicate a need for closer collaboration between psychiatry and primary care, according to lead author Brian Miller, M.D., M.P.H., a PGY-2 psychiatry resident at the Medical College of Georgia. In ideal circumstances, patients with serious mental illness could walk from their psychiatrist’s office to an office across the hall to see a primary care physician “who might screen them for some of the comorbid medical conditions we observed in our study,” he said.

In addition, he suggested that psychiatrists and other physicians treating patients who take second-generation antipsychotics carefully monitor these patients for side effects associated with metabolic dysfunction and also write orders for tests of fasting blood glucose, lipid profiles, and liver and thyroid function. Miller and Paschall are conducting further research on some of the factors that may be contributing to excess death rates among people with serious mental illness.

 

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I’m not sure what to draw from that as they don’t mention if the alcohol/drug abuse is co-morbid with mental illnesses. Still, it is sobering and frightening. Especially given just how low on the agenda mental illness is in Britain.

My dad died right on the money- aged 47.11 years.