Mental Health Advice
A couple of people have posted comments asking for advice on how to deal with a loved one’s schizoaffective disorder or other mental illness. Rather than post multiple comments in reply, it seems easier to simply write a post. First and foremost, it’s important for everyone to understand that I am not a mental health care expert; I’m just a patient. While I know a thing or two from personal experience, please don’t read this blog thinking I have expert healthcare information, because it just isn’t true.
The first piece of advice I would give anyone suffering from a debilitating mental illness is to get some help. People are leery of psychiatry and psychology. I read lots of reactions from folks who think the industry exists purely to push medication, which is indeed part of its function, but not the most important part. For a patient, the most important function served by the mental healthcare industry is providing someone to talk with who understands the disease. Whether the contact person is a therapist, a case manager or even a social worker, having someone to talk to who deals with mental illness regularly provides a lot of reassurance and validation one can’t get from friends or family who just don’t understand the problem.
I don’t go to group therapy, but for many people, just listening to others’ experiences can help cut down on the isolation one often feels. I’ve had some truly bizarre stuff go through my head, and thought I was the only person alive who had a particular notion, only to hear the same thoughts echoed from someone I’d never met before. Even if you know and accept you have a disease, having other people around you who live through it just like you do can be extremely comforting.
Aside from therapy and communication, the mental healthcare system can provide lots of support to someone in need. From housing, to disability paperwork, to medicine management, mental healthcare provides a much broader scope of support than just therapy.
Let’s get back to medicine for a moment. I’ve met a statistically significant number of people who really hate taking meds, and there’s some rationale behind the hesitation. Psychiatrists in particular seem to feel that everything should be treated with a pill, from the slightest bit of social anxiety to the most acute schizophrenia. That’s what psychiatrists do. They’re doctors looking to alleviate symptoms with chemicals. They’re not necessarily the best people to talk to, though some are fantastic. Psychiatrists do push pills. If you’re anxious about taking medication, you may want to start off with a therapist rather than a full-fledged shrink. However, if you do suffer from persistent problems that keep you from leading a “normal” life, medication is something you definitely want to think about.
I know I felt uneasy about popping pills, knowing full well no med cures what I’ve got. I also know my worst times hit me when I’m not taking medication. Hearing voices, seeing things out of the corners of my eyes, paranoid delusions, and especially racing thoughts: all of these symptoms are helped by my two pills a day. There may be a trend in American society to overmedication, but that doesn’t mean all medication is useless. Some people truly need it, and if you’re one of them, I strong suggest you work with your doctors to find a medication that works well for you.
Finding a good, working medication can be a long and tedious process. Everyone’s body is a bit different, and every chemical is a bit different. What works well for someone has an opposite affect on someone else. Also, medicine needs time to work. You can’t just pop a pill and be better. You need to allow time for the medicine to build up to therapeutic levels in your bloodstream. You need to allow a doctor to monitor the medication and its possible side-effects. All of this sounds like too much work to some, so they stay off the meds, or worse, stop taking them as soon as life gets better, thinking they’re no longer needed. If medicine works for you, don’t let anyone tell you to stop taking it, no matter what the stigma around psychiatric medication might be.
The last bit of advice I have for people is to simply be honest with the professionals you talk with. Remember, in the case of mental illness, you can’t take x-rays and it doesn’t show up on a blood test. What comes from you - your behavior and your words - is the only way doctors have to gauge what’s going on inside your head. Don’t downplay your symptoms because you’re embarrassed; anyone you talk to has heard it all before. And don’t play up symptoms thinking that psychiatrists will miss stuff if you’re not a drama queen about it all. If your doctor doesn’t listen to you, then it’s time to find a new one.
This is about the only advice I feel qualified to give when it comes to mental health and dealing with any sort of debilitating mental illness. There is help, it does get better, and it will take some time.
Suicide is NOT Painless
Sometime toward the end of February, I swallowed a fifth of gin and two boxes of sleeping pills. Some people would call this a cry for help, but it was more of an honest attempt to just not be here anymore.
I remember drinking the gin. I remember swallowing the pills. I remember writing a very brief suicide note to whoever found my body. The next thing I knew, I was strapped down to a stretcher in intensive care with about six IVs sticking out of my arms and two male nurses trying their best to catheterize me.
I had no idea how I’d gotten to the hospital. I was so out of my mind I thought people had come to take me to get shock treatment. A friend’s face peered at me over the rail of the stretcher, but I couldn’t quite make it out because I’d lost my glasses at some point.
I was in intensive care 24 hours before being moved to the psych ward. It took me about three days to be able to remember what hospital I was in, or even the psychiatrist’s face.
Apparently, I’d written an email to a whole bunch of people in my address book, telling them of my charming plans to off myself. No one discovered the email until 7:00 the following morning, at which point several different people sped toward my building, fearing to find my dead body stretched out on the floor. Instead, they found me semi-conscious in the hallway, my shirt covered in vomit and completely delirious from the mixture of booze and narcotics. The medical report had words like “encephalopathy” and “cardioarrythmia”.
My friends called my landlord and 911. They met at my place, where the landlord opened the door and the paramedics got me into an ambulance.
Suicide attempts aren’t glamorous or poetic. They’re ugly and messy. They instill terror and sadness in loved ones. They cost thousands of dollars in medical expenses. Laying in a bed to which you’re strapped down and repeatedly urinating all over yourself isn’t exactly a great way to spend the weekend, either. For god’s sake, don’t ever do this to yourself. Get some help. In the US: National Suicide Prevention Lifeline - 1-800-273-TALK.
Back Home
Again.
Hopefully, a more stable version of me now haunts the net. I have lots to talk about, but not net access at home currently. I’ll be writing, then going to the library or a cafe to upload.
God, but it’s good to be back.
Things To Consider Before Checking Into A Psych Unit
If you’ve never been in a position to need emergency mental health care, but are afraid you someday might be, I think there are a couple of things you need to know first.
Primarily, psychiatric wards at hospitals are designed to stabilize a patient experiencing a disturbing mental imbalance at the moment. Whether a person is suffering from suicidal thoughts, a psychotic break, or undergoing shock treatment (ECT), the psych unit is designed to deal with the immediate situation, not long term problems.
Consider a patient taken to the emergency room as the result of an automobile accident. The patient is x-rayed and inspected, then moved to the appropriate unit. They patient is mended, if possible, and then released. The hospital treats the injuries, it does not make the patient a better driver. The same can be said for the psych ward; it helps stabilize a patient currently in crisis. The psych ward does not make the patient less likely to have future problems.
A psychiatric ward is composed of doctors and nurses, not therapists. Consequently, a patient can expect medication and examination, not counseling. Fix the immediate problem, not the underpinnings.
Another thing to keep in mind about psych units is that doctors are often wrong. The units I’ve been in seem to have about a one doctor to ten patients ratio. The psychiatrist meets briefly with each patient every single day. On top of this, there are lab tests and medications to coordinate, meetings with nursing staff, and tons of other obligations. My own meetings with ward psychiatrists typically lasted between five and fifteen minutes.
For patients who already have an established diagnosis and treatment plan, this can prove problematic, because doctors need to treat what they see at the time. Diagnosing a mental illness isn’t like diagnosing a physical injury. You can x-ray bones; you can’t always tell the difference between post traumatic stress disorder and borderline personality disorder.
It’s a sad fact that psychiatrists, perhaps more than any other type of doctor, need a patient’s input for correct diagnosis. It is a sad irony they are least likely to listen to a patient under their care in a psych ward because, hey, the patient’s not rational. Doctors go by the book, and it often comes down to little things. For me, a correct diagnosis hinged upon whether my psychosis caused anxiety and depression, or whether depression and anxiety caused my psychosis. These things can take time, and a psych ward stay often isn’t long enough. Don’t be afraid to tell the psychiatrists they are full of crap.
Life as a psych ward patient (at least in the US), is highly structured. Meals are served at specific times. There are group sessions largely of no value whatsoever. You will be poked and prodded; scrutinized. If you’re unlucky enough to be at a teaching hospital, you will meet with teams of people. And all while locked up with a group of folks who are as imbalanced as yourself. You will be given pills you might not like. If you’ve ever had a drop of alcohol in your life, you will be treated like a drug addict or alcoholic.
You will be lied to by social workers. This happens all the time; it’s called passing the buck. Especially for people being newly enrolled on disability in the US, it takes time before one can get treatment for mental health issues. Family doctor care? No problem. Social workers and discharge workers will look for reasons to put you in family care, then tell you to ask for a referral for mental health. They lie on your behalf, then ask you to perpetuate the lie. Remember, a psych ward is not about helping you solve your problems; it’s all about immediate crisis intervention. As far as they are concerned, if you leave stable, they couldn’t give a rats ass if you completely fall apart the day after.
Not all social workers or case managers will lie to you, but remember that some do. Don’t be overly trusting when someone promises you solutions that hadn’t been present before you checked in. A week in a hospital may stabilize you, but it doesn’t fix your life.
Finally, unless you’ve been brought in against your will, you always have the right to leave. In the US, mental health professionals can only keep you so long without your consent. If the ward you’re in is making you worse, not better, by all means, get the hell out of there!
Psych wards can be good places. If you’re seriously considering suicide, or hearing voices, or are suffering anxiety to the point of agoraphobia, some emergency care might be in order. Just remember what the ward offers, and what it doesn’t.
