What is mental illness?

I’ve often struggled with the biological illness analogy — that says mental illness is (only) a biological thing, something medically wrong with the brain.

There is so much more to mind, and soul, and heart, than just the physical brain material.

In my own experience with depression, anxiety, and PPD, I know for sure that there is personal history, personality issues, very much mixed in with my experience, whether or not there is or was also some biological, physiological, neurological, hormonal element.

I have tried to be respectful of the biological analogy — what do I know about brain biology? And I don’t want to accuse any mentally ill person of having personal issues instead of a mere biological sickness. Especially when for so many people, medication seems to work.

Medication has certainly helped me — or so it seems.

I don’t know that I ever saw a clear effect from the Zoloft, but that may be because it was introduced to my system so very very gradually. It’ll be interesting to see what happens when I start tapering it off this month.

The Risperdal, on the other hand, I felt pretty sure that it was working the day after I first took it, and that was only 0.25 mg.

That’s also the one that scared me, though. Something used for schizophrenia, an anti-psychotic — when all I was dealing with was enough anger and irritability and confusion to scare me, and it doesn’t take much to scare me at all.

And why, if I already felt it working, did my psychiatrist double my dose?

I am so glad I’m not taking it anymore, even though I never experienced any bad side effects.

In my blog-reading and surfing, I find a lot of people (here’s the one who sparked this post) who have a lot to say against the medical establishment, particularly in the mental health field. About forced drugging, about abuses in institutions, about widespread and superficial “diagnoses” of children. About how difficult it is to get REAL therapy — long term, not an insurance-defined “sufficiency” of a handful of appointments. About how many therapists are abusing their power. And on and on and on.

It’s very scary.

I feel fortunate, blessed, that my experience has largely been quite positive.

My first therapist was absolutely excellent, and after trying some other folks out after moving, I’ll never bother again as long as Joe is still available by phone.

My hospitalization was more positive than negative. The psychiatric evaluator was fine the first time I showed up in the ER, and not too bad when I returned a few hours later, but as it became clear that I was going to insist on getting help, she became very cold and unsympathetic, disapproving. And they discharged me too soon and too abruptly. During my stay, though, most of the staff and the other patients were just fine to me. I was somewhat of a special case, coming in with PPD rather than a “real” mental illness, and being voluntary, I suppose; I was encouraged to participate in things but not forced. I was allowed to get what I really needed — rest and space.

My DBT group was awesome. The material suited me — it was focused and practical, but holistic and not shallow. And my fellow group attendees were wonderful people.

My first psychiatrist was okay. She messed up really bad once, but without the most terrible consequences I feared.

(I got angry enough at Amy that I got scared of myself. I called my doula to talk it out. She apparently talked about me, but not by name, to other doulas or something. Word got around to my psychiatrist, who recognized me by the description. She called me to ask if Mark could come to our next appointment, the next day. I immediately had a sinking feeling and asked why she wanted him there. She just said to catch him up. But when we got there, she explained the grapevine revelation, and started recommending all these extra interventions. I was shocked by her betrayal, and terrified that I might be committed or have Amy taken away. I couldn’t believe she was so dishonest in not answering my question on the phone, so that I could have at least been prepared.)

My current psychiatrist seems okay, although I’ve only met with her once.

Think, folks; wholesale skepticism isn’t necessarily the answer, but wholesale trust in authority isn’t either.

Too many

I know too many people (in real life and online) who have been sexually and otherwise abused as children. I just met another (online).

How can it be that so many men (and women) have found it necessary to do such things, not just once, but methodically, opportunistically, all the while blaming the child or anything but themselves, hiding, denying, or delighting in it, and now, if they even recognize that it was wrong, they think the adult child should just get over it, should forgive and forget, and move on?

And how these women still battle the blame they internalized, still wonder where their boundaries should be, and some are shocked and dismayed to find themselves taking out anger and shame and blame on their own children, the very children they so much want to protect from the harm they themselves survived.

Gather your friends together in your imagination. Is it possible that none of them were abused? Maybe. Even so, who knows what other skeletons leap out of closets to haunt their dreams?

Maybe you are one of the survivors.
Maybe skeletons haunt your dreams.
You are not alone.

“Be kinder than necessary, for everyone you meet is fighting some kind of battle.”

Analysis and pain

This post comes from some comment discussion with ama about therapy and analytical thinking; she says “I don’t care about understanding without change and relief.”

I think it was Freud who said the goal of therapy is to exchange morbid something or other for ordinary human misery.

Someone else said that it’s not so much that prayer changes things as that prayer changes oneself.

Understanding cannot stop, end, or control pain. Pain exists in this dark, fallen world, just as joy exists in this world that still bears the stamp of its loving creator.

Understanding does not change the past — what happened that hurt you or me did happen, and no amount of analysis can make it unhappen.

Understanding can change the way we experience pain.

DBT and other things has helped me in the process of learning to experience pain or any other feeling as something that is part of life, comes and goes, does not rule me, hurts but doesn’t destroy.

Understanding mainly helps me stop — again and again — fighting against reality. When I understand the sources of pain, the reasons I react the way I do to certain things, the desires that drive my will, and so on, I can remind myself that pain isn’t a flaw in my thinking — that I can’t change reality by will alone.

DBT and other things help me know when and how I can change some things, and when and how I must accept what cannot be changed. The only way radical acceptance is possible is when you realize the difference between accepting reality and condoning it.

In the past, every time I got depressed I would put just about my entire life on hold and concentrate all my energy on analyzing the depression — its roots, its reasons, its insights, its imperatives, etc.

Gradually I realized a few things. First of all, the same themes, ideas, and phrases would come up in my analyses, often in the same order. I don’t have to do the whole analysis all over again each time. Secondly, the depression always lifted eventually, and there was seldom any connection between the lift and analytical insight. Moods change, and are not directly tied to thinking alone (take that, CBT). Third, the depression would always come back; there was no sense in stopping life to deal with it, because dealing with it didn’t really have any effect on it, and because it seemed to be an integral part of my life.

I have nothing against analytical thinking. Hey — I’m a blogger and a journaler and I’ve been in therapy. Perhaps the problem is that I might still associate analyzing with willfulness, resisting reality, and trying to change things by understanding alone. Instead, most of the work of therapy must be about actually experiencing emotions and not only analyzing them. There is more to the person than mind alone.

After midnight

A) Toaster oven #4 is sitting on the counter, while toaster oven #3 waits on the table to be taken to the dungeon basement or garage.

Our first toaster oven, a classic 4-slice Black & Decker, lasted the longest. I don’t remember the reason for its demise. #2 was a Toastmaster that lasted about a year. Its thermostat went wrong, and it overheated itself and started melting and almost started a fire. #3 is a 6-slice Black & Decker. On the plus side, it neatly fits a 9×9 pan of cornbread and bakes it without black stripes. On the other side, it’s bulky, and it no longer toasts. It’s a pain to have to broil your toast. You have to turn it, you have to watch it carefully, it takes forever… Besides, it’s a TOASTER oven.

#4 is a Dura-brand. Hey, you never know. It still fits a 9×9 pan, is less bulky than #3, and did our bagels just fine. So far.

B) One of my pet peeves is when anyone who loves me gets irritated with me for feeling a certain way. Yes, I know, I perpetuate this pattern on Amy (and everyone else), whose behavior about certain feelings can be very irritating. I don’t like that I do that, because I know how unfair and unpleasant it is. I am working very hard to learn how to have my feelings, let her have hers, and treat myself and her with compassion and respect. There’s got to be a way to be irritated (a feeling) and still gracious (an action). I think the irritation — mine or others’ — must have to do with boundaries — feeling attacked or blamed or thwarted by the irritating feelings / behavior. It is very difficult, but so very important, to extend grace, compassion, respect, despite one’s own and the other person’s feelings and behavior.

C) Tonight I made the dough for the Thanksgiving pumpkin pie crusts. I also managed to remember to put the pumpkin in the fridge to thaw. I should have done it earlier, since I need to make the pies rather early in the morning.

D) Today I made a Texas sheet cake for Amy’s birthday celebration. I haven’t made a cake from scratch in ages, and the last one wasn’t very good. This, however, was excellent. It’s an easy recipe, too; one I got from my mom. Maybe I’ll post it. The icing is even good, and I usually hate icing. This one is buttery fudgy.

E) Amy’s birthday celebration was fun, and even though I don’t have pictures yet I’m going to write about it anyway.

Yesterday afternoon, my friend Amy came over with a present for our Amy, who woke up from a nap in time to open it with her. It’s a little tea set, with pretty bright colors and simple raised flower designs — a teapot, sugar bowl, plates, saucers, utensils, cups. Amy has already poured “tea” in / on all sorts of things.

This morning, after my in-laws arrived, we helped Amy open her presents from family and from our good friends Jim and Jen. She participated a little bit, taking hold of a rip I’d start, and pulling it a little further open. She wanted to play with each thing (or a previous thing) instead of going on to the next. Just as we were deciding to stop half-way through she renewed interest in the still-wrapped gifts, so we continued through them all. (Thank you, everyone, for the lovely clothes and toys.)

Midday we ate tortellini and salad and cake and ice cream. We served everyone a piece of cake and ice cream, and brought Amy’s last, with the candle and the singing, so that she could dig in as soon as it arrived. I was afraid she’d try to touch the flame, so I blew out the candle for her. She patted the cake a few times but wasn’t sure what to do with it. She liked the taste of the ice cream but was puzzled by its coldness. Once we cut up the cake, she tackled it with great interest, even licking the little cutting board we’d served it on.

F) This week my “once a day” commitment is not doing so well. I am trying to keep my regular visiting to a minimum, but once in a while I need to get online again (like to find out how many cups of powdered sugar are in a box, since the recipe called for a box but I had a larger bag) and while I was on, I might as well take a peek at my email, and…

G) I should probably go to bed. It’s 1:00… and we have a busy day (again) tomorrow, with pie-baking and then a lunch in Culver on our way to Indy for the holiday.

H) G’night.

Pain and pathology

I have a new blog friend who has written lately about depathologizing pain.

I think I know what she means, and I appreciate it: that pain is not unique to certain individuals, that pain is not the same as crazy.

And yet I find myself doing the same thing in the opposite direction: pain is pathological because it is not what we were designed for. (I don’t mean ordinary healthy pain like being able to feel when you get a cut or something. (I don’t think my friend means that either.)) But it’s a pathology that all people share, not one that divides the sick from the healthy. We’re all sick.

Like her, I don’t have a Mental Illness, a diagnosis in capital letters with a standardized treatment plan. But like everyone in the universe, I have mental health concerns. If illness can mean un-ease, discomfort, colds as well as cancer, then I think we all have mental illness, at various times, to various degrees.

I don’t think the line between sick and healthy, sane and crazy, is anywhere near as black and white as we want to think it is.

I think that’s why every time I get gruff with Amy when I’m angry at her, I think about abuse. I am not an Abuser. But I think the line between well-adjusted and abusive is pretty thin, too. And so I will take it seriously when I deal poorly with my anger, because I don’t want to cross that line or get any closer to it than I can avoid.

———

Edited to add: No, I realize I don’t mean that pain is pathological — I mean that some of the things that cause pain are pathological. Maybe all things. Eden was perfect — I’m not sure if that means no one ever got a scrape or a cold, but there wasn’t any sin yet and therefore no pain caused by sinning and being sinned against.

Pain is not pathological, because it is healthy to respond to harmful things with pain — whether the harmful things are scrapes and colds or sins and sinning.

So much depends

No, I’m not quoting William Carlos Williams again.

I was just browsing the Tag Surfer. Among other things, I look to see who’s writing what about depression, anxiety, and therapy.

Sometimes people write positively about mental health professionals. Sometimes they write negatively.

It’s bewildering and frightening to think that the very thing that is supposed to be safest, most helpful, most compassionate, most respectful, and so on, can really hurt people instead.

That there are really bad therapists out there. Really bad psych wards. Bad psychiatrists. Sometimes incompetent, sometimes hateful, sometimes unmindful of any dignity in their patients.

It’s not just mental health, either. Think of the really bad teachers you’ve had or heard about. Babysitters, medical doctors, families, churches, friends — in any interactive setting people can be really awful.

Somehow you would think it would be different in interactions that are focused on something caring — like mental health, education, family, church, friendship, childcare… hmmm…

At least it should be different in interactions where people are trained in caring — like mental health, education, church, childcare…

I guess it’s just part of the reality of living after the Fall, that people’s sinfulness and separation are going to hurt in all areas of life.

Of course there are positives in all these things, too. It’s just that the negative caught my attention this evening — that there is nothing guaranteed safe, nothing immune to sin and separation.