Mental Illness and Drug Abuse

Last week I made the cover of the local newspaper, thanks to last week’s post. (http://www.columbian.com/news/2011/jan/14/shootings-spur-local-woman-to-share-tale-late-ex-h/) I’m hoping no one notices that isn’t really about me, though I find myself in the awkward position of talking about my subject matter while trying to blend into the background.

That’s been my life so far – blend into the background, and no one will notice me. Know what I mean? Mostly it works. I have a hard time breaking into social and business circles. I stay in the background, but I have things to say. Follow me on Facebook at http://www.facebook.com/MoniqueCWriter and you can see how it goes.

One of the questions on last week’s newspaper article concerned drug usage among the mentally ill – specifically, with Stew. The commenter noticed it hadn’t been mentioned, and seemed to think it was some sort of oversight.

I never think to mention his drug and alcohol abuse because there wasn’t any. It is true that many mentally ill do self-medicate, often unsuccessfully, but that certainly isn’t always the case. In some cases people turn to drugs and alcohol because nothing else is working, and they’re desperate.

Sure, Stew used meds, many of them over the years. Anti-psychotics. Pills to help him sleep. Pills to help him wake up. Anti-depressants and anti-anxiety pills. Pills to make the mind calm down, so effective he needed another pill to wake the mind up. Usually there were 5 prescriptions at a time that he was taking daily. Stew would be the first to tell you that meds saved his life.

But illegal drugs? No, there were none. Drinking? Back before he became ill he’d occasionally have a beer, but it had to be a good beer. He’d never been drunk. Then again, he was a big guy, and it would take a lot to get him drunk, and he’d never attempted it. Once he started on the med merry-go-round alcohol was out. Pepsi was his drink of choice, and I don’t think there’s been any correlation between Pepsi consumption and mental illness. He didn’t smoke either. The no drinking, no smoking thing were two of the things I loved about him. My previous husband had been a prolific drinker and smoker and I was really tired of it.

We like to think that mentally ill people have caused their own problems. It would make it easier for us to dismiss them out of hand. “Deserved what he got, didn’t he? All that drug use fried his brain.”

Simplistic. Each person who has mental illness has their own story, and many of them do not involve self-destructive behavior. They do often involve trying to get past their illness before really knowing what’s wrong, which is like trying to treat cancer when you think it’s a minor infection.

When Stew moved back to California to live with his parents he went to the local mental health facility and they were confounded by him. He didn’t have problems with drugs and alcohol and he had all his teeth. He was an intelligent guy who had issues. But by then he had started stabilizing, fortunately. There are many like him, people who are just trying to make sense of what’s happening to them when the entire world seems to be askew.  

Then there’s the idea that if we just round up the mentally ill and treat them all their problems will be solved. I wish it were that easy. But what treatments work? Everyone is going to react differently to available psych meds, and some will benefit from a combination of meds and therapy, and some won’t. Then there’s finding the right therapy. Stew talks about that, in the book we’re writing (he’s done writing his portion, I’m still working on mine). How many different meds was he tried on? How many therapists? He’s lucky he did find a good therapist, and he’s lucky his med combination, despite serious side effects, eventually started to quiet the angry voices in his head.

Until you experience a demon in your head telling you to kill yourself I don’t think you can pass judgment on those who do. It’d be easier if we could though, wouldn’t it?

Next week: watch me be funny again. I can still do it, I swear.

Mental Illness Ain't No Picnic

This is not what I’d wanted to write on the occasion of Stew’s birthday, but circumstances seem to have a mind of their own. Today, January 10^th, Stew Young would have been 40 years old, if he hadn’t died of cancer 3 years ago. It’s hard to imagine Stew at 40. It was hard to imagine him at 37, since he’d gone backward in time a bit and was just getting ready to return to a semi-normal life and adulthood when the cancer struck.

Prior to the cancer thing, Stew was severely mentally ill. By that I mean he was more than depressed, more than anxious, he was occasionally a full blown psychotic. Not too often, fortunately. It’s not the sort of thing one wants to repeat if one doesn’t have to. Over the years he fought his illness he was diagnosed as paranoid schizophrenic, schizo-affective, borderline, bipolar, depressed (and who wouldn’t be, with all that going on?) and with major anxiety. Again, see the depression comment.

Throughout the day I’ve seen comments on various websites regarding the Arizona shootings. I’ve seen people comment that the shooter should have been receiving help, that his parents should have done something, that perhaps something should be done about crazies before something else like this happens.

Really? This is an original thought?

As if we hadn’t considered that before.

Let me tell you what happened with us. I was married to Stew when he started becoming mentally ill. It was a slow descent, and we kept thinking that he was getting better, or would get better, and when necessary, when he was suicidal, which he was several times before the Great Psychotic Break that led to years of uncertainty and pain, he would even take himself to the hospital. He was good about that, about seeking help. At the time he had a job, and health insurance. He worked for a large health insurance company, so insurance was a given. But what could they do for him at the emergency room? Talk to him, make him promise not to hurt himself, and then send him home again, that’s what.

So we’d go home again and hope things would get better.

When the Great Psychotic Break came it brought with it blood, all his, and I took him to the ER. They signed him up for daily outpatient treatment, and he couldn’t return to work for weeks. When I went to tell his boss what was going on he stood there and listened, and then visibly stepped back from me, as if I were carrying the contamination of mental illness with me and might infect him. He then began walking away, backwards, waving feebly as if shooing me and mental illness away.

Despite having been a valued employee and a likeable guy, Stew’s co-workers ignored him during this time. Perhaps they thought it was one of those where the less said the better, but Stew would have greatly appreciated knowing anyone cared. After having contributed to cards when others were sick and helping others out when they needed it and being ignored during his crisis, he felt more isolated than ever.

This is how it starts, the isolation. Let’s ignore the mentally ill guy and no one will catch it.

He returned to work and everyone pretended nothing had happened. But it had. Anyway, he didn’t get better. He’d get far worse before he’d get better.

Stew lost his job because he couldn’t work. He had six months of disability, and during that time we had insurance through Cobra. He had a psychiatrist, a therapist, and many meds. Some made him sleepy, some made him angry, mostly they made him dull and foggy, and he became a ghost of himself. He saw things that weren’t there. He heard voices that weren’t there. He struggled with knowing what was real and what was not, and with his parents two states away and me the only family we attempted to make him better.

The diagnoses changed, he didn’t fit into a category. And then the disability and the health insurance ran out.

So then what? We struggled through. His meds cost several hundred dollars a month. His psychiatrist eventually fired him because we couldn’t afford her. His therapist hung in there and kept treating him even when we could only make token payments. I was working, but I spent at least several hours every day making sure he was safe and not suffering too much, so my income was spotty and I was always tired. His parents sent money. We went various places to see if he could get help. By then he was living in his own apartment. At one agency we were told there was nothing they could do because he still had a roof over his head. “Come back when you’re on the streets,” they told him, “And then we can get you on the list.”

Oh good. I left messages with no return calls. I insisted his psychiatrist, who had fired him, provide a scrip so he could keep getting his anti-psychotics. She provided it grudgingly. I monitored his medications. I kept track of him. And both of us lived in a state of isolation. He ran errands for me and when I became overwhelmed he’d talk me out of it, or try to. Sometimes we both collapsed under the weight of our isolation and desperation. I sold anything I had that had any value.

And one day he went to a political rally with a knife, not sure why, but knowing he was angry and that a candidate had to be stopped. Who knows why these things happen. His rages were legendary, though he never ever hurt anyone. The political rally was a bust because he couldn’t find a parking space. Sometimes no parking is a good thing, no? When he came back to my apartment and told me I was straight with him. “If you ever do anything like that again, or give any indication you might, I will have to call 911 on you.”

And I would have. There was also the incident with the car dealer when his rage almost got the better of him, but I dealt with it.

Our mental health system is in bad shape. It’s not always easy to get help. Easy? Sometimes it’s impossible. Sometimes family members can do everything they can and it’s still not enough. Sometimes the mentally ill try everything they can and still can’t get the help they need.

But on the occasion of Stew’s birthday, this is what I have to tell you, and this is what he wanted you to know. Dealing with mental illness is really hard. If you haven’t had voices in your head telling you to cut your own throat you may not understand how very difficult it is, how very isolating, how it can be so very hard to tell the difference between reality and what’s only in your own head.

When Stew was dying of cancer he was more at peace than I’d seen him for years. He wanted to live, and he’d begun recovering from his demons. But once he was told he was terminal he realized that this was one way to ensure he’d be free of the demons forever. Death could not compete with mental illness. For him, it was a release.

I am so sorry that people died and were injured in Arizona. I’m so sorry we pretend mental illness always happens to someone else and we shouldn’t be concerned. I’m sorry about so much. I’m sorry that today Stew isn’t here to celebrate his birthday with us, but we’ll celebrate anyway, because he would have wanted us to. And I will keep telling his story, like I promised I would.

Shrek for the Holidays

New Year’s Eve we watched Shrek again, with crab and steak for dinner and 2011 in front of us like a bright shining experience waiting to happen.

I was 12 when I first discovered Shrek. Suddenly the world had possibilities – even if I looked like an ogre I could be happy!

That was my first lie of 2011. I’m obviously much too old to have seen Shrek when I was 12. I like to get the obvious lies out of the way early in the year so I can sneak in the less obvious ones later.

My love for Shrek isn’t just because it’s Eddy Murphy’s best work EVER, though one can never have too much of an annoying talking donkey who goes by the name of Donkey.  No, it’s more than that. And it’s not just Shrek’s rejection of a world that rejected him first, just because he’s an ogre, though I do identify with it. Not that I’m an ogre or anything, but it is easy to write off a world filled with cruelty by retaliating and closing one’s self off.

Not that I would know, mind you, except for that short ten year period we’re not to speak of.

Mostly my love for Shrek is because the upkeep for being an ogre is so much easier than the upkeep for being, say, a princess. If one’s a princess, one must always look princess-like, which includes much grooming, hours and hours at the salon every week, utmost care not to chip one’s polish, a clear complexion, form fitting princess dresses which require a tight corset, and a perpetually cheerful disposition. One is not supposed to be both a bitch and a princess, unless one is playing the part of the antagonist, and there are few instances of evil princesses. Princesses are pure and sweet until they become queens, at which time they’re allowed to become a bitch. It’s a clear progression, and rules must be followed.

But being an ogre! Now there’s something I can get behind. Once an ogre, always an ogre, unlike princesses, who are supposed to upgrade to queens. Perpetual princesses are not highly regarded, are they? Ogres, on the other hand, aren’t supposed to be lithe, nor are they supposed to be well groomed. In fact, I’m pretty sure grooming is entirely optional. The preferred color is green, and the preferred disposition is ogre-like. Now there’s something I can get behind. After all, who has time to be a princess? It’s a lot of work, much more work than being an ogre.

And with Shrek, my suspicion that one can look like an ogre and STILL be happy is confirmed. It is especially helpful if one is to marry an ogre. Not that I married an ogre, heavens no. I lucked out. But as someone who once considered herself much like an ogre (e.g., unsociable, unattractive, lived in a swamp, yada yada yada), I feel validated!

Don’t we all want validation?

And better yet, validation without the upkeep! Ogres don’t even have to wear stilettos! No one expects much of ogres. Ogres just are. If I have a bad hair day, it’s completely okay. As an ogre, I’m lucky to have hair at all. But if I’m a princess and have a bad hair day, well, that could ruin the numerous photo ops I have throughout the day, couldn’t it?

Ogres don’t have photo ops, which is yet another thing to be thankful for, if one is an ogre.

On the Ogre – Princess range most of us fall somewhere in the middle. I’m okay with that. Green isn’t my best color, for one thing. I don’t particularly enjoy swamps.

But I can certainly get behind the concept.

Shrek makes me happy, even while it confirms my theory that if people would just talk about things with other people we could avoid a whole lot of misunderstandings. But without those sorts of misunderstandings, movies would be a lot shorter, so I suppose it serves a purpose. Besides, I do like a movie I can sing along with.