September 10, 2016

Suicide Prevention - Part Two

Well, here I am again.  I've already written a post about suicide prevention. Are you getting tired of hearing about suicide?  Well, believe me, I am tired of thinking about it. It's exhausting. Too bad for both of us: I have some more thoughts that I want to share with you. If you are serious about "suicide prevention," try to tolerate my rant.

I see "suicide prevention" as something the "preventers" do for themselves. I've heard and read lots of stories about how losing someone to suicide affects other people. It's all about the "survivor." And, yes, I actually have lost someone to suicide. But now I want you to think about what the suicidal person is going through. They never seem to talk about that in those stories.

Imagine the intense emotional pain you feel when you lose a loved one, or when a relationship breaks up, or when you have lost your job and livelihood.  Imagine that pain.

Now, imagine you are having that pain FOR NO REASON. And imagine that the pain comes and goes, You never know when or for how long it will be with you. That's how some of us experience depression. That's how I experience depression. Your brain has gone off-kilter. You are unable to carry out the most basic tasks because they are just too much effort. You feel worthless and useless. People try to reassure you that you are a good person and you deserve to live; they tell you good things about yourself, but YOU JUST CAN'T BELIEVE THEM. Besides, you can't stand to live with the incredible pain any longer. The pain that has no reason.  Can you begin to imagine this?

Your loved ones do all they can to help. They take over the tasks you usually perform.  That is wonderful, because you don't feel as if you are falling further and further behind.  But it's also awful, because you know that you are a burden, adding work to their already busy lives. They say it's ok, but you know in your heart that they would be better off without you; they just don't realize it yet.

If you are very lucky, like  me, you have a couple of people in your life whom you trust, who have seen you pull through this before, and who express their confidence that you can pull through again. Nobody else has any credibility.

If you are very lucky, like me, your spouse takes their wedding vows, for better or for worse, seriously. If you're not so lucky, your spouse tell;s you to suck it up, stop being so lazy, you have nothing to be depressed about. Maybe they divorce you. They cause your pain to increase. Think about that.

Maybe you have friends who have learned about "suicide prevention."  They say and do all the right things. But as legal scholar Susan Stefan puts it, it's more like (paraphrasing here) pushing a person out of the path of an oncoming train, feeling relieved that you have done so, but not helping the person figure out how to stay off the train tracks.

Now this may be a shocker: When I hear of a person who has died by suicide, I am happy for them. Of course I am sad and broken-hearted to lose them, but I know they have finally found peace.

Until this country takes some concrete action, suicide prevention is just a pretty phrase.

Here are a few helpful actions we could take:

  • Listen to people who have mental illnesses to learn what will help them.
  • Invest some real money in mental health research.
  • Invest some real money in mental health treatment.
  • Pay our mental health caregivers salaries and benefits they can survive on, so more people will be able to do that work.
  • Hire enough mental health caregivers that they are not continually understaffed.
  • Pay children's services workers commensurate with the incredible stress they encounter in their jobs.
  • Hire more children's services workers so they can give adequate attention to each case they are assigned.
  • Offer free parenting classes so people can learn how to raise their children without causing mental/physical/sexual trauma.
  • Offer free education to family and friends of those who suffer from mental illness to help them cope, and stay, with their sick loved ones.
  • Ostracize politicians who mock disabled people. Yeah, that means Donald J. Trump. 

There are certainly other things we can do; these are just a few things that occur to me right off the top of my head.

Will this be expensive?  Of course it will.  Can our leaders find the courage to make this happen? I have my doubts. But isn't relieving emotional pain as important as relieving physical pain? As treating Type 2 Diabetes? As research on diseases that cause much less disability? As building a fancy sports arena? As space travel? As incarcerating people who smoke pot? You're damned right it is. And it just might prevent some of those suicides people claim to be so worried about.

August 28, 2016

Back from the Edge

UPMC Western Psychiatric Institute and Clinic
Two days ago, I returned home from UPMC Western Psychiatric Institute and Clinic (WPIC) in Pittsburgh, and I want to tell you a little bit about my three-week stay there.

I chose WPIC because the limited psychiatric facilities in Erie PA don’t offer the services I need to treat my Serious and Persistent Mental Illness (SPMI) of Major Depressive Disorder - Recurrent Type - Severe.

In addition, no psychiatrists in Erie are accepting new patients.  Dr. Gustin, the wonderful doctor who cared for me from 1985 until 2014, retired abruptly due to health problems, so I found myself an orphaned psychiatric patient.  I was fortunate to find a Certified Registered Nurse Practitioner (CRNP), Charlotte Riddle, who has experience with psychiatric nursing and was accepting new patients. Even though CRNPs can practice and prescribe on their own, Ms. Riddle has chosen to affiliate with an M.D. psychiatrist and another CRNP; she says she likes to have colleagues to consult with on occasion.

Char has guided me well so far. As I fell into another suicidal depression earlier this year, she asked if I had ever considered ElectroConvulsive Therapy (ECT), what they used to call “Shock Treatments.”  Ya know, like in those old movies The Snake Pit or One Flew Over the Cuckoo’s Nest. You may cringe, but I had actually given serious consideration to ECT long ago. Here's why:

My mother received ECT in the mid-twentieth century, back when it was far from the gentler procedure it is today.  And even though it was unpleasant, even brutal, for her, she preferred receiving “shock treatments” over playing the anxious game of waiting for medications to work.  Or not work.  Mom said that, unlike meds, the “shock treatments” helped her mood right away.

So off I went to Pittsburgh. What a great bunch of professionals they are at WPIC, providing care with respect from the moment I set foot in the facility.

After evaluation and assignment to the appropriate unit, I settled in. WPIC is everything I could hope for in a psychiatric facility. Clean facilities, decent food, caring professionals, structured group therapy conducted by people who "get it," and skilled medical treatment. And my fellow patients were generous with their moral support and friendship.

There's a mix of patients there, from old birds like me to college students, and from patients who are spending weeks there to those who are only there for a couple days. If you are up to joining in, there is also music therapy, art therapy, and pet therapy. I thought I had received every kind of therapy possible over my 50 years of recurring depression, but I learned that they are still developing new therapies and that even this old dog can learn new tricks.

I have so far received eight ECT treatments. It wasn't all smooth sailing, but around my fifth treatment I noticed definite improved mood. At no time did I observe smoke or sparks spewing out my ears from my fried brain. I will continue with several more weeks of outpatient ECT, then we'll reassess to determine if and/or what kind of further ECT to pursue.

Don't get me wrong; I am still struggling and have more to learn, but I am no longer actively suicidal, and I feel as if I may be able to continue to live with this chronic illness. My next tasks are to make some decisions about whether I am able to return to work and what kind of work I could do. But the biggest factor in my decisions will have to be in regard to how I stay well. I want to contribute to this world, but I'm guessing I won't do anybody any good once my ashes are spread across its surface. Well, except maybe compost.

I'm going to lie low for a while now to allow myself to rest and recuperate. I would be honored if you shared your thoughts or questions on this post and/or shared this post on your favorite social media platform. The way I see it, we can only encourage suffering people to get help if we talk about mental illness and help eliminate the stigma attached to it.

God bless you all and thank God for the professionals who do the very difficult work of caring for people who have mental illnesses.

July 30, 2016

Facebook asked me what's on my mind. Here's what I said:

What's on my mind, Facebook asked.  Plenty. Let me tell you about it.

I am sick and tired of people talking about depression when they haven't had it or haven't had repeated serious suicidal episodes. Or who think psych meds are bad. Or that the meds are just some kind of happy pills. Or who think depression can be "cured" with some herbal remedy.

I'm also sick of the little platitudes about how you just need to think positive. Positive thinking is nearly impossible when you are suicidal. All these little slogans just make a severely depressed person feel even worse because they can't just "think" themselves better.  That's like telling a person with diabetes to control their blood sugar by positive thinking. I'm sick of it.

And I'm sick of people explaining away gun violence by saying the perpetrator had "mental health problems." Hey, here's a novel idea:  maybe we should take more care in who can buy guns and how they store them.  But that won't happen because the NRA (read gun manufacturers) owns all our legislators.

I have 50 years of battling severe depression. I think about suicide every day of my life. If you haven't experienced something like that, take care not to say shit that just makes the suicidal person feel worse. Like "You have so much to live for," or "practice an attitude of gratitude, or "just think about so-and-so and what they have overcome, " or say you know how we feel, or advise us to "give it to God. Or tell us to use our "coping skills." Believe me, we've heard it all and tried it all before.

And above all, don't call Crisis Services, because they'll either try to put you in the hospital or just humiliate you. Hospitalization, since the insurance companies now control it, is pretty much worthless. They'll just throw some different meds at you and send you home before they can see if the meds help. Because the insurance companies won't pay for a hospital stay beyond their criteria. And they don't give a rat's ass about your doctor's opinion. There's a perfect example of "death panels."

And that, I told Facebook, is what's on my mind.

June 07, 2015

Here's some REAL suicide prevention.

I previously wrote that suicide prevention isn't really for suicidal people.  I still believe that.

But I have still been looking around the net to see if there's any thing helpful out there.  For future reference.

And I found something!

It's called Alternatives to Suicide, and it's peer run.  There's info here, along with an informative video. I'll be adding this to my links list at right.

They also offer training for people to learn to facilitate an Alternatives to Suicide group.  This is going on my wish list.  They say that two co-facilitators are required, so I would need another person to take the training with me.  Then we would be ready to start a group in Erie.

I see a new agenda item for our next peer support meeting.

This is pretty exciting!

May 10, 2015

Misogyny misogyny everywhere, so what's a girl to think?

Misogyny is deeply rooted in our society.  This little thought exercise shows how amazingly widespread it is and how it affects girls.

Imagine you're a young girl.

Ever since you were old enough to understand, here's what you've learned:

  • Girls can't be athletic.  In fact, it's an insult to tell a boy that he "throws like a girl."
  • Girls cry, and that's a bad thing. Because if a boy cries, he's crying "like a little girl" and he'd better stop right now.
  • It's a bad thing to wear anything like girls' clothing.  If a male wears something that's the wrong color, or that has a flowery pattern, someone will tell him that his clothing is "girly."  And that's a bad thing.

As you enter high school, you learn more:

  • Just the possession of male genitalia makes someone stronger, so even grown women can be told to grow a pair or be taunted, "You don't have the balls."
  • It's even worse to have female genitalia.  There's not much worse than being called a cunt or a pussy.
  • You learn that you must be trim and beautiful.  But if you take pains to dress well, wear makeup, do your hair,maybe even wear high heels, you will be subject to catcalls and inappropriate remarks from strangers.  You may even be called a slut.

So what are you to think?  You think that you are not as good as a boy. 

No, you know you are not as good as a boy. 

Nobody has told you this. In fact, some may have explicitly told you that you are just as good as any boy.  But deep down, you have learned that boys are better.

You carry that knowledge into adulthood, where you encounter new insults:

  • You are not supposed to show your age.  You are  accosted by hundreds of commercials that promise you can stay young by using the advertised products. You are expected to be slim, in shape, and fashionable.  But men can be paunchy, wrinkled, balding, and baggy and nobody seems to care.
  • You learn that you will be judged as being bitchy or aggressive for the same behavior that is considered strong or assertive in a man. Senator Elizabeth Warren, a former professor of law at Harvard, is called "angry" and "violent" because of her straightforward comments.  Even Hillary Rodham Clinton, after serving as a US Senator and Secretary of State, is still called a bitch. You'd better be careful.
  • You understand that, no matter your professional bona fides, you must field questions about your clothing that would never be asked of a man. Even the Chancellor of Germany, Angela Merkel, is criticized because she looks frumpy.   
  • Even in a commercial  for a diabetes medicine, the guys are workers but the women are walking on the beach. Couldn't they think of a different setting to put the women in?  Oh, wait, they did.  They also showed women in the kitchen.

Now, do you feel good about being a woman?

No wonder so many women struggle with self-esteem issues. Nobody has to tell a girl or woman that being female is bad; she just absorbs that knowledge from birth, because misogyny is embedded in our culture.

October 11, 2014

Life Threatening Illnesses

For anyone who's been following along, New-Medicine-Number-3 worked beautifully.  After taking it just one week, I walked into my doctor's office and said, "I don't want to kill myself today."  What a breakthrough!

Anyway, I recently saw a friend who had fought cancer.  She had lost her hair, and had on a cool head scarf.  She talked with a balding male friend who asked her how she was.  She said she was fine, and joked that she didn't have any more hair than he did.

I thought, wow, what a great attitude.  What a strong woman. She cheated death and can laugh about it.

It took me a few days, but I realized that I, too, had cheated death!  And that I can have a relapse at any time, just like a cancer survivor can.    It's just that my disease isn't really considered a disease by most people. It's looked at as more of a character defect.

And I am so dismayed with myself, because I didn't realize right away that I had given cancer survival more significance than surviving Major Depression.  If I gave cancer more significance, even though I have been an outspoken advocate for the mentally ill and against stigma, then how can I expect other people to take mental illnesses seriously?

The truth is that Major Depression, for me, is a life-threatening illness. In fact, I have been fighting this disease for 48 years. That's a long time to fight; I really need to give myself credit for being a strong woman, too. I came very close to killing myself several times during my last episode.  Yes, I promised someone that I wouldn't do that, but I almost gave in anyway, just to stop the pain.

I survived six months of absolute misery.  I wish everyone could have that feeling just once, so they could understand what it's like and be less judgmental..

I cheated death, alright, but I can't quite laugh about it. Not until other people stop laughing at it.

February 26, 2014

I'm Tired of This Game

Well, here I am.  I'm sorry in advance if I sound whiney.  Sympathetic comments are not necessary.  I just have to write this down.  I feel a need to let people know about the experience of mental illness.

New-Medicine-Number-2 gave me a nice boost to a normal mood.  Unfortunately it also gave me akathesia.  Did I describe that in a previous post?  I don't know, and I don't have the energy to check.  Let's just say it was a horrible sensation and my doctor advised me to stop taking New-Medicine-Number-2 ASAP.

The mood improvement stuck around for a while.  Then it was just the dread of going out of the house that was keeping me from returning to work.  But things were looking pretty good.

Well, the mood boost is gone now. I saw a couple warning signs of deepening depression, then BOOM! my mood dropped very quickly. So here I am severely depressed again.  This is like being in hell.

I saw my psychiatrist a few days ago and we discussed my options.

He said any other meds he could add to my Current-Medicine risk the same side effects as New-Medicine-Number-2.  And since there's a chance those side effects won't go away even after you stop taking the medicine, I'm afraid to try them.

Then we discussed my going off of Current-Medicine and going on a Different-Anti-Depressant that works in a similar way.  That would entail tapering off of Current-Medicine for a week or two, then starting the Different-Anti-Depressant and giving it a few weeks to see if it helped.  Good God, that would be another six weeks of this.  With no guarantee that Different-Anti-Depressant would work.

I practically begged to know if there was anything else I could add that worked via a different mechanism, then he suggested New-Medicine-Number-3.  It works on a different neurotransmitter than Current-Medicine.  So I have started New-Medicine-Number-3.  Now I wait.  But at least, if it works, it will be a shorter wait than it would be for Different-Anti-Depressant.

I have been practicing gratitude.  I am so thankful for my supportive husband and daughter, for the roof over my head, for my husband's hard-work ethic, for our cuddly dogs, for the kind people where I work, for kind friends who send me notes, for this computer, for internet access, for my comfortable bed, for hot and cold running water, for the privileged position I was born in relative to most of the rest of the world's inhabitants, for my job, for my physical health . . . there is just so much good in my life.  I have been practicing gratitude for years.  I understand how lucky I am.

But lately, as I practice this gratitude, it just makes me feel unworthy.  How do I dare be this depressed when all is well in my life?  I feel horribly guilty.  How can a person this fortunate feel like they don't want to live anymore?  I should just go trade places with a homeless person who could appreciate this good fortune.   But I'm also fortunate (or unfortunate, as the case may be) that there are a couple of situations that make me unwilling to take my life.

I was doing so well during the past few years that I thought I had all the tools I needed to stay well.  Apparently I was wrong.  I am hoping I will feel well again.  I am doing psychological work along with taking my meds as prescribed.  I am staying away from politics and other things that piss me off.

But here's the thing. So I get well again.  So what.  I'm just fated to go through this hell again.  It might be months, or it might be years, but it will be back.

I don't want to play this game anymore.