Recognizing Mental Illness[Posted by Sarah Jane Rothenfluch] LISTEN TO "Recognizing Mental Illness" (24MB MP3) When we discuss mental illness we usually only talk about what experts call "tertiary prevention." That's the work done at hospitals and in prisons long after a person has been severely affected by a psychotic illness like bipolar disorder or schizophrenia. Tertiary prevention aims at to prevent patients from becoming completely overwrought, or even dying, of their mental illnesses. But now the state is paying more attention to secondary -- and possibly even primary -- prevention. Secondary prevention is practiced at EAST, the Early Assessment and Support Team in Salem. This program serves youth during the early onset of psychotic symptoms, which may include delusions, hearing voices, or simply not being able to sleep or concentrate. Legislators seem to like this model: in the last regular session they earmarked funds to expand this program across the state. EAST-like programs -- whose names are still to be determined -- will be coming to counties across state (including Multnomah, Washington, Deschutes, Clatsop, Columbia, Union, Hood River, Wasco, Sherman, Gilliam, Jefferson and Crook) very soon. Meanwhile, primary prevention is beginning to make its mark on Oregon as well. At OHSU, Dr. Norwood Knight-Richardson is exploring how genetics and family make-up can lead to everything from psychosis to much more prevalent disorders like depression, anxiety and alcoholism. As part of OPB's ongoing mental health series On Our Minds, we explore whether mental illness -- or perhaps its worst effects -- can be prevented with early intervention. Do any of your own experiences, or those of loved ones, shed light on these questions? Do you know how to recognize the early stages of psychosis or depression? GUESTS:
I do not think our state should be recruiting people into the mental health system. The system is destructive, destroys lives and kills people. I was inside the system for over 25 years, after seeking help in college, for depression/low self-esteem stemming from a childhood lived with an abusive father.
Instead of help, I was given a nearly instant diagnosis of schizophrenia and propelled into the county mental health system. My life as I knew it ended. Many more labels were added over the years. I was often on 8 or 9 different drugs, with contradicting effects and dangerous side effects. I saw a case manager once weekly and a county shrink every few months for a few minutes. Other than that, I lived in a low income hotel isolated, lonely, without purpose or reason to get up in the morning, like so many others I knew in the system. The drugs, sometimes forced on me, caused extreme symptoms and nearly killed me several times. The hopelessness of such a life bore down on me heavily. I was in and out of psyche hospitals, received electro shock and more abuse by staff at OSH, endured the suicide deaths of nine friends, all within the mental health system, most of whom left the earth because they could no longer endure such a meaningless existences. In 1998, a few days before Christmas, I was severely beaten on a psyche ward by staff in Portland, then discharged, without shoes or coat or transportation, out into a snow and ice storm. I didn't even know Portland. I wandered to Mall 205, freezing. A stranger talked to me a few moments ,then disappeared. when he returned, he brought two pair of socks he had just bought, and put one pair on my freezing feet himself. He told me "you're not the crazy one." I left the system. But the beating ruptured a neck disk into my spinal cord. I could not get surgery for that horrendous injury, because doctors stated my symptoms, which included severe pain, were the result of mental illness. I finally got surgery. I never got justice for being beaten. I left the mental health system after that. I knew by this time finally, there was nothing mentally or physically healthy about it. I thought people would want to know then, that I immediately improved, that they had been so wrong, knowing others too have gone through this, and about the abuses I had endured in a system that is supposed to help people. I was further ostracized when I attempted to speak up about the abuses and misdiagnoses that stole most of my life. This system must be fixed before young people are recruited into it. The labels and being committed have limited my chance at gainful employment, as has the spinal cord injury incurred in that beating. In addition to these other atrocious consequences of subjective diagnoses, I lived my life in utmost poverty, on SSI. Please understand the truth of this system, before advocating that children be thrown to the wolves, as I was.
I lived along the river, in Corvallis, with a colony of feral cats, that is how I got what I needed. They became my family, my support system, gave me love. And slowly, self-esteem. When the river project came along in Corvallis, about the same time I had been so badly beaten, I became involved in trying to stop that project, for the sole reason of saving my river cat family. It was great trauma, actually. Many died. But I became strong, with an ability to believe in myself and not believe the shrinks.
I still live on disability income, may be kicked off. I am in my mid fifties and am not sure what I will do if I lose disability. Be kind of difficult to bear, after all I've been through, the lies, the abuses, within the system for so many decades. What do I do now? I help the cats, of course. The cats saved me. I trap feral cats for spay/neuter, in high volume. Unpaid. My real life began in the year 2001--the year I just said no to psyche drugs and shrinks. I can tell you stories, all right, of despair, abuse, how I tried to kill myself over and over, not because I was mentally ill, although that is what the shrinks called it, but because I lacked anything in that new horrible life, of being stuffed away, living totally isolated without anything to do, no purpose, patronized, made fun of, relegated to the status of societal slug, stomped on, and enduring the endless hate of society, for those on any sort of public assistance, which still causes me guilt and angst. And may be one reason I work my butt off, more than 40 hours a week, sometimes 60 or 80 hours, helping people solve feline overpopulation issues humanely. Secretly, of course, I'm really helping the cats, who saved me. REturning the favor. The mental health system recognizes only drugs as treatment. Lots of them. The system fails to understand basic principles of mental ill health and what people really need: people need community, love, acceptance, work, meaning, exercise, good food, human contact and fun--the ingredients to real mental health.
Thank you so much for sharing your profound and painful story. The type of criminal victimization requires justice and should never be allowed to occur. Have you told Oregon Advocacy Center and/or the state human rights people about the abuse?
Unfortunately through our skewed funding and our concerns about civil rights we have constructed a mental health system based on disability and/or coercion in response to imminent. It was my experience of that and seeing its life-robbing impact on my loved one that led me to search for other ways. I knew that neither he, nor I, could cope alone, and that we needed people who had integrity, who could see him for the unique and beautiful person he was, who were willing to be creative and resourceful, and who he could trust. We've come close to finding that a few times. I got involved with EAST because I had met the folks at Mid-Valley Behavioral Care Network and I believed in their vision and integrity. When I first met them the first words I heard them say were that we needed to re-conceptualize the whole mental health system with the understanding that the people it serves are the owners. So I view EAST as an "Owners-in-Training" program. But more importantly, if we are recruiting, we're recruiting people to stay in school, maintain employment, and stay involved with friends, family and community. You said it so well- people need community, love, acceptance, work, meaning, exercise, good food, human contact and fun. I am glad to say that those things are central to what we do in EAST. We don't assume anyone will continue with the public mental health system, although some do. We don't assume much, except that every person will has a tremendous amount to contribute and deserves our full belief and support. I would value further correspondence with you about your experiences. You are clearly a very articulate, intelligent and concerned person. And a cat lover like myself (I only have four, though).
This story is hard to believe. Discharged from an unnamed hospital into the ice storm without shoes, but with a major spinal injury? The time line is off too. He was living by the river trying to save his cat colony while at the same time sequestered at a psyche hospital?
However, if this person is not pulling our leg, I don't doubt that he/she is mentally ill. Living by the river with "my river cat family"? Schizophrenics often don't recognize their own illness...
Goytrain, make fun of me all you want. The story is true. The hospital is not unnamed. It's Portland Adventist. The year was 1998, just before Christmas. You didn't read it very carefully. I don't know who you are, but making fun of someone's story, that you don't even know, is really not very nice. The state investigated the abuse only after I ran into then state mental health director Barry Kast, who is still a friend of mine. He initiated an investigation. The only justice I got was that Portland Adventist had to go through isolation room and restraint training. No real justice. It's very typical that people diagnosed as mentally ill are not believed, which is why abuse of such people seems so popular.
It is interesting how pervasive the fear of being labeled with a mental illness is. I hadn't thought about how much my own fears play into it until I was waiting for the registration email for this "alterego" I created to post about this topic. When I was thinking about it, I had to admit that I am always worried that people will disregard my thoughts and opinions on other issues if I talk about my mental illness history, even 13 years later. For the record, what I am going to share happened 14 years ago, and I have been "in remission" for the last 13.
I started having seizures out of the blue. I was hospitalized and had a full neuro work-up. (Thank goodness we had good, employer-based insurance at the time.) When it was determined that my seizures were non-epileptic and some form of mental illness, the treatment that I received became less desireable. I was shunted from one doctor to another, almost every one changed the prescriptions I was on. No one seemed to specialize in treatment, jsut management of the symptoms. I did finally find a therapist who was on our insurance plan and had some experience dealing with somataform seizures. Through all of this I was in a wheelchair, wearing a helmet, have up to 20 grand mal seizures a day. I was literally locked into my room at night when my husband would go to work, because we never knew where the next seizure would come from, and if I was out of the room, which had padding on all the floors and walls, I might break another bone. I gradually started recovering the memories of being molested by my father. At first they were only the memories of the fear I felt while it was happening, and then the things my eyes had seen as I "floated" over my body. The memories are still not completely coherent, and it is only with ongoing therapy that I have been able to integrate them into my life, and help myself make sense of my childhood memories, or lack thereof. Even as I was having fewer seizures, because of the processing I was doing in therapy, the doctors kept increasing my medication dosages and "tweaking" with the cocktail of meds. Their theory was that they could get them to completely stop if they just found the right combination. I still regret that I didn't question it more, but mentally the meds made me so sluggish, I began to have a hard time even thinking in my therapy sessions. I quit going to therapy, because it seemed that it wasn't helping anymore. I have to say, the best thing that ever happened to me was having my gall bladder need to be removed. While I was in for the surgery, I had to come off all the medications I had been on. I didn't have a single seizure while I was off the meds in the hospital, and when my doctor wanted to put me back on them, I refused. I was labeled "noncompliant" and warned over and over that I would regret not following their advice. I have never regretted it. I switched doctors, went back to therapy, and while I had a few seizures after coming off the meds, three months later I was seizure free and haven't had one since. Too often I think that we have doctor's who do not understand the psych meds they are prescribing, or psychiatrists who don't see their patients long enough to really evaluate the effects of the medications and other factors in the lives of their patients. I think the entire system is focused on how to medicate a problem better, rather than figuring out how to create a life worth living for the person with mental illness. I still have nights where I hide in a corner when the memories overwhelm me, but they are fairly rare. I still go to therapy once a week, but those sessions tend to focus on coping skills, how to help my children deal with my divorce, or how I am going to solve a situation with my new husband. I am not "cured" but my mental illness is in remission, and I make sure I am getting the mental tune-ups I need. Thank God for my bad gall bladder.
Alterego,
Last week I gave a sermon at my church about mental illness. It was harder for me to tell them about my own experience with dysthymia than it was to talk about a lifetime of experience with my relatives' mental illness. But I do think it's important for us all to get used to talking in a matter-of-fact way about our experiences, because at some level they are so common, and if it's viewed as common, then the doubts start to fade. It sounds like you have a good life and I'm glad. Thanks for sharing!
I think awareness of mental illness is crucial. My younger brother suffered from a mental illness for 11 years before taking his own life. He was only 27.
It started when he was 16. Out of the blue, he had delusions, hallucinations, that were completely out of his character. Shortly after, my parents committed him. He was diagnosed as schizophrenic. Later, it was found he was bipolar. But, the medicines had horrible effects as well. He wanted to live a normal life, but that wasn't possible. When he died, he was working towards a Master in Cognitive Psychology to better understand his disease. I now have two small boys and receive mixed messages on if mental illness on that scale can be passed on. They're only 1 and 4 years old. Ari was bright, driven, a talented poet, and his life was horribley taken off track due to mental illness. I've attached one of his poems. Every year, I walk the National Alliance Mental Illness (NAMI) walk as a team with my family, Remember Ari. It's a great organization that supports and informs. ~ Chari
Your guest touched on one of the biggest challenges for the families of loved ones whom they suspect have a mental illness: not being ill enough to force them to get help. I am the sister of an individual who shows all the classic symptoms of bipolar disorder, including risky behavior, extreme highs that have gotten her into debt, and extreme lows that have worried us and ruined her personal relationships, yet she is not so ill that she can't hold a job or keep an apartment. As a result, it's very difficult to get her to understand our concerns. Additionally, there is a history of mental illness in our family, and the stigma is even more acute because of that. We are at a loss.
You might get some ideas from Xavier Amador's book "I'm Not Ill, I Don't Need Help". Sometimes the NAMI Family-to-Family Support groups can also be helpful. It's probably more important to listen for her concerns and respond to those than to focus on her understanding yours. That's what will motivate her to act, along with the accompaniment of someone who cares. Keeping a regular relationship no matter what where she knows you really care will go a long way.
There was no help. My son had his first breakdown as a High School Junior in 1997....but, now he tells me he heard voices at a very early age.
He has paranoid schizophrenia..... In Benton County....there was not much help at all. The main psych. doctor was the only one who took the time and effort to really look for a diagnosis. Then Benton County cut services....so, we moved my child over to Bend to live with his mom....he had continuing breakdowns and there were only 14 beds in all of Deschutes Country....for mentally ill folks. We have been, with my son, to Eastern Oregon Psych Hospital, the Oregon State Hospital in Salem, the Heeran Center in Eugene and another center down in Klamath Falls.....THERE IS NO COORDINATION between agencies! NOTHING! The Klamath County Mental Health and Judge wanted to release my son.....they had no records, they were not forwarded...he made his own diagnosis in ten minutes.....and this is the problem....there IS NO COORDINATION! I have had to fight, tooth and nail, with every part of this system since day one....including Social Security and every single health care provider....the outcomes of schizophrenia? No socialization, isolation, continual committment, huge weight swings due to medications, NO LONG TERM PLAN WHATSOEVER FOR ANYTHING OTHER THAN MEDS....IT's all MEDS, MEDS and more MEDS. Educate the community? In Corvallis? You would think a higher educated community would have a better social net for this kind of thing...no way....it was a revolving door to the hospital, and case workers who really ought to retire.....back and forth....no plan, no system, no caring.....KAIROS was a great idea.....and lost the funding.... What positive, long term view of the future, can a schizophrenic have? How are the days spent in the hospital? MEDS, MEDS and more MEDS. There is no hope.....have you been to the Heeran center in Eugene? There is no hope until there is a cure. Get real.
Jamison, if your son was diagnosed with diabetes, I doubt you would question the need for insulin. Why do you find drug treatment for schizophrenia any less responsible?
I find such naivety about treating mental health one of the main detriments to our societies backward response to the problem.
And I find your condescending attitude towards people who question the appropriateness of meds tiresome. Besides the ever-cited chemical imbalance, there are so many factors that can contribute to, exacerbate, or flatout cause mental illness. Here are a few of them: physical or emotional trauma, chronic pain, constant loud noise, loneliness. Likewise, there are many ways to build mental health that can help limit, or eliminate altogether the need for drugs. Here are a few of those: hiking in quiet and beautiful areas, getting involved and connected in your community, choosing a quieter place to reside, getting regular exercise, eating healthier.
The evidence/studies, at least regarding depression, seem to show that with each subsequent episode of depression it becomes easier to relapse. So curbing it at its roots would be a great way to go.
It seems hard to pinpoint, from anecdotal evidence, such as your earlier caller stating that he was given medications at a young age. Perhaps these medications did there job and allowed him to recover, so by the time he stopped, he was indeed cured. There is no easy way to know this.
I wasn't diagnosed with ADHD until I was 28 and it changed my life (I'm in my 30's now). Looking back at my childhood and young adult life I can see how an earlier diagnosis would have made a huge difference in my school and social early development success. Yet, even with all my obvious symptoms, no one recognized the issue. Sadly, my school and community did not afford resources to mental illness. Yet, an investment in children's mental health will reimburse the community ten-fold. Bravo for having this program.
Once more, OPB is running a show without a guest officially representing organizations of mental health consumers and psychiatric survivors.
There are certainly more than a dozen groups that could be asked. For instance, there is a new network called Oregon Consumer/Survivor Coalition that unites 14 groups. There's also our group, MindFreedom Oregon, based on Oregon that works on mental health. I am guessing the show feels that "experts" ought to be put on -- but in this case actually being on the receiving end of mental health care does not make our constituency "experts." Can you imagine a show on disability... immigrant rights... people of color.... gay/lesbian/bisexual/transgender... with no guests representing groups of such constituencies?????? I myself experienced bipolar label as a teen. I've been a human rights activist in this field for 32 years. We shall see if I ever get on the show... I was the first one to call in and I've been waiting... and waiting.... We hear on today's show how supposedly the program EAST is a new paradigm with a "shared explanatory model." Meanwhile, on the EAST web site it clearly says under "cause of psychosis" that: "Psychosis is basically an imbalance in the brain’s neurochemistry." This is the same dominant paradigm that has been large and in charge for decades, and is hardly a "shared explanation." I encourage people to check out our website http://www.mindfreedom.org. In the 'internal search engine' in upper right hand corner, put in OCSC to find information about the state-wide coalition. But clearly a bigger issue is mainstream media bias. For my more than three decades of this work, I've seen mainstream media constantly promote the current, dominant, corporate paradigm of the mental health system... and the result is massive drugging, even of two year olds. Please understand that I and our nonprofit MindFreedom are pro-choice about personal health care decisions, including people's decision to take psychiatric drugs. But Oregonians in the mental health system, and taxpayers who are fronting the bill for the massively expensive psychiatric drugs (especially 'atypical neuroleptics') are at risk from providing more, more, more of the same. It is outrageous that young people are increasingly being put at risk of more and more and more powerful psychiatric drugs. Well, I've been on hold for 37 minutes....
I am not debating the validity of your comment but your comparison of: gay..., immigrant rights and others, to a discussion on mental health is absurd. Last time I checked being gay was not an illness so there would be no reason to have on air a medical expert discussing it. I think if we discuss heart surgery, we listen to doctors and researchers, not people with heart disease. Don't ruin perhaps other valid points you might have with apples and oranges.
Actually homosexuality was classed a mental illness and included in the psychiatric diagnostic manuel until a group of psychiatrists led a drive to vote it out of the manuel's classification of mental illnesses.
And Scott, the horrendous abuses and destruction I experienced in the mental health system are valid experiences that shed light onto what really goes on inside this system, besides the tragic consequences they had on my own life. They're not apples and oranges. When diagnoses with heart disease, your rights are not removed. There are medical tests that prove or disprove whether or not you have heart disease. Mental illness diagnostics are subjective. The variables involved are innummerable. A quick example: I watched a CNN news story about a woman who had escaped the abuses going on at the Fundamentalist Mormon commmunity of Colorado City. Talking back to her husband led at least twice to her being carted off by a Colorado City Mormon police officer and committed to a Utah state mental hospital. The CNN story did not react to this with an investigation as to why a woman would be admitted to a state hospital for talking back to her husband. This small little story tells mountains about the mental health system and how it is used.
Davidwoaks,
Your personal unfortunate misdiagnoses is unfortunate, but can and does happen for all types of illnesses. Yet, it would be idiocracy to advocate against treatment because physicians can make mistakes. Would you encourage the disuse of antibiotics, knowing it to save lives? Why then do you think it's appropriate to dismiss the lifesaving abilities of drugs that treat any other illness, including brain chemistry? Such ignorance isn't bliss, it's deadly.
My child became withdrawn, suspicious, very unhappy, and started believing almost everyone was out to hurt him. Also, messages were coming to him from outside sources. EAST saved his life and our family. They allowed us very slowly to accept that he had psychosis, which we thought was a fate worse than death, and after more than a year we slowly started low dose medicines. Imperceptibly he improved and continues to improve in every way. He has friends again, continues in sports, and is excelling in college. The whole process continues, and has gone on for aver five years.
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