Kiss5Tigers

The 5 Tigers represent the big things in life. This blog is about facing them.


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Is Mental Illness Real?

I was browsing a Facebook group where I’m a member and one of the other members stated that there is no such thing as mental illness.

Huh.

In a forum of people who have psychological distress, you have stated that mental illness isn’t real.

Not sure where I stand on that.

Well, no, I’m pretty sure where I stand on that: It’s a bit dismissive. It’s more than a bit dismissive. It’s downright belittling.

But also, I get it. I mean, we talk about mental illness as opposed to “being normal” only normal isn’t real. It’s a statistical construct based on the average way people act. It isn’t even based on feelings most of the time because we don’t know what people feel, we can observe how they act.

I suppose that’s why Abraham Low, who might be the first CBT practitioner back in the 40’s and 50’s, talked so much about seeking to be average. I feel like, it’s not about what you really experience, it’s about your ability to pass for typical.

The person’s perspective on the forum, if I understand correctly, is that extreme mental states are part of being human. They are normal and natural, and shouldn’t be pathologized.

Also, there is remarkably little data about brains with mental illness. Or the functionality of brains without mental illness, for that matter. We have some really good ideas about how the brain works, but when it comes to mental illness, it’s a black box. We don’t really know what goes wrong when people lose touch. We think it has to do with chemicals and neurons, and theories have led to some effective medications.

But medication is not 100%. Things like Cognitive Behavioral Therapy are reported to be as effective in shifting mood as many drugs. Does that mean drugs aren’t effective?

Not all drugs work for the same condition in different people. I mean, you can pretty sure that if you and I both have an infection, the same antibiotic will help. But with my bipolar? I take one cocktail of medications and my friend with the same diagnosis takes a different one. Does that mean we have different disorders?

And there is no biological test for mental illness. We can test for high blood pressure or diabetes. We can see a physical injury like a cut or a broken bone. We can detect appendicitis or cancer. But mental illness is invisible in this sense, there is no way to detect it in the body. It only appears in behavior and reported feelings.

So here I am, dealing with bipolar. And I know the big thing is not that there is something wrong with me, but that my moods and feelings stray outside the realm of average and interfere with my ability to manage life.

Does that make me sick? Or maladapted? Or sensitive to mood?

I take drugs that help me with my mood. Mood under control means life is manageable, which is good. Manageable means I pay bills on time, take a shower, sleep daily, have a job. Manageable means I pass for normal, even though my moods are often outside the bell curve. Manageable means you don’t point and stare at me. I can pass.

Who do I take the drugs for? Me or you? Because some days, most days, I feel pretty average and that was true before my diagnosis. Am I making my life more manageable for my own benefit, or because you (whoever you is) are uncomfortable with my difference?

I have been called eccentric for most of my adult life. Eccentric is okay, not as creepy as being weird, not as out of control as crazy. I’m a little odd. You think I’m normal until you find out I’m not. I make you slightly uncomfortable from time to time, but you can pass it off.

For example, I seem to observe people closely, maybe a little too closely. It makes my friend feel scrutinized. I am not aware of doing it. I watch motion. If you happen to be moving, I’m watching you. It’s a habit. I’m not consciously doing it. In fact, my attention may be turned inward and I’m not paying enough attention to actually see you at all. But I’m tracking what you’re doing. I try to be conscious of this because it makes folks uncomfortable and gets me labelled weird. It’s rude. Is it a sign of illness? Or a poorly managed evolutionary adaptation? After all, in the wild, there are advantages to being visually attentive.

But I digress.

Suppose I am not ill. Suppose I am just at one end of the bell curve of emotional sensitivity. Why do I medicate? Wouldn’t it make much more sense to change my behavior? I mean, there’s nothing wrong with being 6’5″ tall or 4’9″. They are just opposite ends of the bell curve. Maybe I am just more sensitive and somewhere there is someone who is less sensitive. Maybe I don’t need medication but understanding.

Yet medication works, so isn’t that an indication that I’m sick? Medicine changes things for me in a way that is an improvement. Doesn’t that mean I’m unwell in some way?

Is mental illness real? I certainly have real troubles and real mood extremes and real cognitive distortions. What I don’t have is a physical diagnostic that shows where bipolar exists in my brain. I can’t have my bipolar removed or point to the area where my bipolar is. I can’t even say for sure what happens when I have an episode. Why am I sometimes depressed and other times manic? It seems like there must be 2 different things going on here, to get two such different mental states.

Personal experience says mental illness is real. Just like chronic fatigue syndrome is real. That’s something that was believed to be made up until enough people reported it. Pain is real. Psychological pain is real.

For me, I just keep on doing what works. Medication helps. Support groups help. Making art helps. Seeking wellness helps. Working helps. Learning about my disorder helps. Because at the end of the day, it doesn’t matter if I need medication to cope or if I can learn resiliency skills. What matters is that I figure out what I need to thrive.


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12 Every Day

I saw a statistic the other day that 12 men commit suicide every day.

I know one of the 12.

That is, I knew him. Past tense. Past tense in a couple of ways.

He was my ex-husband and the father of my daughter. I was his first wife of 3. We weren’t close, but since his choices affect our daughter, I kept tabs on him, at least a little.

Jim memorial

I spoke to him about a week before it happened. Our daughter was worried about him so I checked in. He said he didn’t want to talk, then he talked for a few minutes. Not much, but clearly he was struggling with his life. He wasn’t doing well at work; wife 4#2 was hitting him up for over $2000 a month in child support, alimony and other incidentals; he had just totaled his car in a drunk driving situation that was likely to result in having his license suspended; he’d been checked into mental health facilities at least twice and released with Xanax even though he’d had a recent suicide attempt; he wasn’t going to make bankruptcy payments for the second month in a row; and wife #3 had just told him she was filing for divorce and moved out. It’s a lot. It’s a lot for anyone to deal with when they are doing well and frankly, he wasn’t strong. He didn’t seem to possess much fortitude. Then he said again that he didn’t want to talk about it and hung up.

My daughter called me the next Sunday to let me know he’d been found dead in a hotel room.

It wasn’t exactly a surprise. He was bipolar. He’d tried to kill himself in the past. He was overwhelmed. Although he’d obviously had relationship problems before, usually there had been financial security and success at work to balance out the difficulties. The totaled car was a Porsche. He wouldn’t sign custody of our daughter over to me unless I signed a document that I wouldn’t seek child support, but somehow he had $800 a month for a car. But that had been important to him, having an impressive car, and now he didn’t have that either. He must have felt like he was failing and he’d lost everything, but I’ll never know.

Our daughter told me later that she would climb into bed with him because he was crying and so lonely. No child, even an adult child, should have to watch a parent go through that. But she was glad to be there for him, and I know he appreciated it even though he probably never told her so. He would have been too limited by his own emotional state to think of it.

I talked to wife #3 a few times. Once she told me how he was generous and happy and how she loved that about him. I was happy for him that he’d found someone who saw the good in him even though he had struggles. Then I figured out that she didn’t really understand his situation. Another time she told me that they were in therapy because he had become a husk of the man that he was and all she wanted was her husband back.

Only, it’s all him. When you marry someone who’s bipolar, you get the depressed part as well as the manic part. Happy and generous husband is the same person as crying and doesn’t-get-out-of-bed husband. It isn’t simply a tough time, it is the cycle he continues to experience. It’s hard. It wore me out until I couldn’t do it any more, and he divorced me because he thought I was dragging him down. I needed a more stable situation, but I eventually lacked the ability to create that for myself or think about how to leave. I was what he made me, then he didn’t want it. Funny, ironic funny.

The day he took his life, he’d gone to weekly therapy with wife #3. About noon time they parted ways. She didn’t think anything was wrong, or at least, no more wrong than it had been lately. He didn’t go home. She tried to call him several times with no answer. I also tried to call him, but it didn’t surprise me that he didn’t pick up. I mean, who wants to talk to their ex when they feel crappy? She eventually called the police and had them make a welfare check. They’d been out to the house so many times in the last month that they knew where the key to the back door was. The house was empty. Nobody knew where he was.

The next morning, he still hadn’t shown up. Wife #3 called his mother, who had also called the police. Then she suggested to the police that he might have gone to a casino about an hour away. The bank account had been emptied and she thought he might be going to blow some money and try to feel better. The police widened their search and eventually found him.

Apparently when he left therapy, he headed in the direction of the casino but he didn’t get that far. He checked into a hotel room about 1:30 in the afternoon. He left his phone in the car. I know because I went with my daughter to pick up the car and we found the phone. That wasn’t like him. He was usually attached to his technology. There was an empty Xanax bottle in the hotel room. It had originally been filled for 90 tablets within the past week. A half-drunk bottle of everclear was also there. He’d finally found the combination that did the job.

I don’t know what he was thinking. I’m mad at him for doing this to our daughter and to his son with wife #2. And yet, I have an unexpected tenderness for him about this. He was difficult. He made my life difficult. I often wished he would just fall off the face of the earth, but mostly I just avoided contact with him because he didn’t seem to understand how his choices hurt our daughter.

Maybe he was tired of it all. Maybe it seemed like the only way out with so much going wrong. Maybe he thought he was doing everyone a favor. We’ll never really know, he took that answer with him when he went.

I wish the depression hadn’t won this time. I hope he finally found peace, wherever he is.