Tuesday, August 12, 2014

Mental Illness Can Be Terminal

Like many I was stunned to hear about the unexpected death of Robin Williams. I grew up watching him and being entertained by his humor. I remember his first appearance on Happy Days and his roles in Good Morning Vietnam, Dead Poets Society, Mrs. Doubtfire, etc...

However, I didn't think about his career when I heard about his death. As soon as I heard the statement from his publicist about how Mr. Williams had been suffering with depression, all I could think of that we lost this great comedian because his mental illness was terminal.

I do not say that lightly. I say that as someone who has a mental illness. I say that as someone who has been deeply depressed and suicidal at least twice in my life. I might not even be here today except for a friend who drove two and half hours in the middle of the night to come stay with me to ensure I wasn't alone.

Odds are you know or are related to someone with a mental illness. Some may be open about their diagnosis. Some may not be. There is still so much stigma and misinformation about mental illness many do not share their diagnosis.

Many do not understand the struggles those of us with mental illness face because our illness is not as easy to understand like diabetes or cancer. It isn't visible unless it is in our behaviors and sometimes even those aren't obvious signs of a deeply painful inner struggle.

I am bipolar with an anxiety disorder. I have a full time job. I have a car and I own my home. I have friends and family.  I have a good life. Many would not even know I have a mental illness. Many who do know forget.

I have suffered manic episodes, depressive episodes and many, many, panic attacks. It took a doctor to give me my first diagnosis: generalized anxiety disorder. I had gotten to the point in my life that I was was breaking down into a panic state nearly every night. Daily my body was thrown into a 'fight or flight' reaction. The constant stress manifested in stomach issues, palpitations, breathing problems, etc.... Essentially, the stress was wearing my body down.

People looking on the outside just saw me as a "worry-wart." They thought I was overly dramatic. I was told constantly, "Don't worry about it" as if my worry and fears were something I could control. I tried so hard and it only seemed to make it worse when each time I failed and found once again I'd be curled up in a ball of panic.

Getting the diagnosis and getting medication for the anxiety disorder literally made me cry with relief. Finally something made sense. However,  I hated going on the medications because at first they made me sick. I was warned this would be the case but the warning didn't prepare me for the reality of two weeks of nausea.

I was lucky though. I had insurance. It not only helped cover the cost of the medication but it helped with the cost of the therapist who began to help me understand the mind and body connection with my anxiety. She helped educate me on brain chemistry and how cognitive behavior, along with my medication, could help me manage my anxiety.

Still, that didn't solve all my issues. It would be a few more years, and another therapist, before I got the diagnosis of bipolar.  Although I did not embrace that diagnosis as readily as I did the anxiety disorder it finally did help me put into perspective other aspects of my behavior. It helped explain my wild and wonderful bouts of creativity, enthusiasm followed by my bouts of depression.

It also helped me understand why I would go through periods of over spending, periods where I got very little sleep and periods where I did nothing but sleep. I understood how I engaged in  self-medicating behavior. Drugs and alcohol weren't really my choices but food was and is. I could have days and weeks of binge eating and then periods where I would just forget to eat. 

Again there were medications to take and this time I balked. I balked because the meds made my brain work differently. I felt like a runner who suddenly had weights permanently attached to their ankles. How can I even begin to describe what that's like to feel your ability to think, problem solve, and to engage in creative thinking to suddenly grind to what seems like a screeching halt? I felt like my imagination had gone from painting in bright vivid colors to sketching with heavy blocks of charcoal. 

Then there is what I call 'living in the middle.' Being bi-polar is often described like riding a roller coaster. There are these hills, valleys, twists and turns you find yourself careening through without any control. While it's dangerous, it's also exhilarating! The highs are unbelievable! It's like flying. Your brain is speeding along and nothing seems impossible. The lows, though are killer.

It's hard to hold on to relationships. In an upswing you can make plans and promises only to find that when the time comes you barely have the energy or focus to get out of bed let alone go out. Conversely you could have the energy and the gumption to go out but not the wisdom when to call it a night.

When you are med compliant, going to therapy, getting your sleep, getting exercise and doing all the self-care you are supposed to do, the roller coaster stops. While that's the goal it can be uncomfortable and disorientating. Where's the exhilaration? Where's the drama and adrenaline rush? How do you live without that cycle? It almost seems, boring. It's a struggle to stay on those meds, to live in the middle when you miss those highs and you've forgotten about the lows.

Again, having a therapist and support network is crucial. They help you keep focused on what is healthy. Remind you what it's like in those low points. Help give you a reality check. However, it's no guarantee because ultimately all of this lies in your head.

Your therapist, your friends and your family aren't there in your head. They aren't there when the brain chemistry is off and thoughts are pushing in and you can't see your way out. There aren't there to understand the terror rising up inside of you leaving you screaming aloud and crying just wanting it all to stop.

Don't get me wrong. I am hopeful. I believe one can manage one's mental illness but it takes it hard work. It's daily vigilance on your thoughts, your emotions and following your medication program and practicing your cognitive behavioral techniques.

I'm grateful everyday I have health insurance. I'm grateful I have friends and family I can reach out to for support. However, sometimes they aren't there and I'm grateful I have been taught the skills or have the medications to handle those times when they aren't.

However, when I heard about Robin Williams death and the was an apparent suicide my heart was sick that not only did we lose a phenomenal comedian, actor and from all accounts a kind human being but that it was case where mental illness was terminal because for whatever reason the tools, techniques, the meds, the support, etc...did not work. The illness overwhelmed him.

There's a strange kind of feeling where you understand because you know, "there but for the grace of God go I." You want to help because you have some sort of insight and you can't. 

If someone you know has a mental illness, be there for them. Understand that it is an illness. It can be managed. They can have a 'normal' life but like a diabetic they live with that illness everyday. They have to manage it everyday. Some days are better than others.

If you have a mental illness and this is one of those bad days, please, remember you are NOT alone. Please reach out for help.

http://www.suicidepreventionlifeline.org/




3 comments: