Tuesday, March 2, 2010

Anger

Anger is a tricky emotion.  I used to have these little psychotic flashes on a frequent basis.  In my car while driving I'd see myself do something like deliberately running a red light to cause an accident.  Or I'd be in the kitchen with a knife and I'd see vision of myself stabbing my husband.  You get the idea.

They seemed really random to me.  At times they'd be more frequent than at others.  It took me a long time to figure out exactly why they were happening.

You see, I expect a lot from myself.  Inside my head there's this constant list of things I 'should' be doing.  I 'should' be the perfect wife who keeps the house in perfect order, has meals ready on the table on time, plans and runs the household like a pro.  I 'should' be the perfect office manager who is there from 8:00 to 5:00, no lunch allowed, working to serve the needs of the patients, my employees, my husband doctor - anybody but me.  I 'should' be working to get a writing career going for myself, be more active in my church, learn scrapbooking, volunteer at the schools, etc. etc. etc.

There is no possible way for me to live up to all the 'shoulds' that are constantly running around inside my head.  When I don't live up to that impossible standard I get frustrated.  I get angry.  Sometimes it's good to get angry.  Anger is a great motivator.  If I see myself slipping away from being the kind of person I want myself to be, the anger usually kicks in enough to get me back on track. 

But, like I said, the standards I set are unrealistic.  There's no way I'm going to live up to everything.  It makes me angry.  I interpret the anger to be a bad emotion, and do my best to supress it.  That is when those little psychotic flashes come into play.

My repressed anger emerges in the form of violent thoughts.  I don't want to just hurt myself, I want to hurt the rest of the world for holding me back, for making life so difficult.  Why can't my husband be more helpful?  Why should I have to shoulder so much at work?  I didn't want this job.  Why does the house need to be perfectly clean and why should I be the one who must keep it that way?  Anger, anger, anger.

Logically I know I can't do or be everything for everyone.  Emotionally accepting that is an entirely different matter.  The anger's got to come out somehow, so I get disturbing flashes.

The good news is, that if I'm doing a good job of managing my stress the flashes don't come.  They can be eliminated entirely if I plan wisely, accept myself along with all of my limitations and budget my time in a way that accommodates my special needs.  I eliminate the stress, which eliminates the anger, which in turn eliminates the flashes.

I didn't know all of this in the beginning.  The flashes started when I was a teenager.  They distressed me terribly.  I couldn't believe my own mind would conjur up ways for me to hurt my own family members - the people I loved the most.  Back then when the thoughts came I'd cut them off, denying their existence, vehemently shutting the whole thing down.  It was actually the best thing I could have done.  I taught myself how to control my own thoughts so they couldn't get out of control.

When I was older, however, and the postpartum depression set in, the visions became huge.  What I saw in my head was violent to the point of absolute gore.  The rage was insatiably blood thirsty.  My little 'cut the thoughts off' technique wasn't enough.

Those were the times when I was unquestionably the most suicidal.  Time and time again I would come to the conclusion that the only way I would be able to spare the lives of others was to kill myself before I acted upon any of my horrific visions.

It is a realistic concern.  We read about people who go on killing rampages in the news all the time.  You don't think those people could be you or your friend or your own family member, but you're wrong.  There's a very fine line between thinking about such things and acting upon them.

I got help.  Even when nobody else thought I could do those terrible things, I knew I could.  It was either kill myself before something bad happened, or do whatever I had to do to find help.

Not everyone's experience with anger is like mine.  Other people get angry when their concept of justice is not met, or things don't measure up to their expectations.  Either way, if you're experiencing a lot of anger and rage it isn't something you should ignore.  You need to figure out why it is there.  If needed, get help before you snap.

I use anger every day.  Sometimes it is why I get up in the morning, why I exercise or fix dinner, or resolve problems at work.  It isn't a bad emotion.  Sometimes you have to toss out your whole concept of 'good' and 'bad' before you can actually see things for what they are.

My daughter now says she has the same kind of flashes that I often used to have.  They've been distressing her greatly.  They don't fit into what she sees herself to be.  I told her to try re-thinking the matter, that maybe it was just her own reaction to stress.  For some reason, just knowing why the anger was there is empowering.  She can move forward now.  I hate to think how things might be if we did not have so much in common.   

Wednesday, February 24, 2010

Noticing symptoms - my personal story

Last night gave me a big scare. It is extremely easy to have someone going through terrible pain and suffering due to mental illness right in front of you, while you do not have a clue that something is wrong. I am a great example of that conundrum.

When I was growing up you could easily have called me an over achiever. On top of earning good grades and taking advanced placement courses, I was heavily involved in all kinds of activities. My acting career began when I was eight. I was cast in a leading role in a university production. Not long after that I was in a television show for PBS. At the age of sixteen I earned the lead role in a production which toured Europe and was televised there. That was all on top of what I did through my high school and community theater.

Of course, that wasn’t enough for me. I was also an active, successful participant on the Forensics team, in DECA club, and choir, winning state and national awards as well as serving in many leadership positions. Since the age of eight I played the piano. My first composition won an award. Later on, at the age of fourteen, another piece I composed won a very important national honor.

By the time I graduated from high school I had already earned enough university credits to be classified as a sophomore. I pushed myself hard and believed I was unstoppable.

The over achieving alone was a sign of things to come. It’s not normal for a kid to do so much. All the time there was this constant pressure inside me telling me I needed to be more, to do more, that I wasn’t good enough.

There were down times which were like being trapped in a black hole. I would isolate myself, completely convinced no one wanted to be my friend. For hours I’d lay on the bed in my room staring at the ceiling.

I’d come home from dates and various activities only to break down sobbing in hopelessness. My parents brushed it off as teenage angst, PMS, and exhaustion, all very reasonable explanations. No one could have known It was all bipolar behavior. Back then no one knew about bipolar disorder. Little was known about depression.

At one point, after my mother had my brother, her fourth child, she went into a very serious depression. My parents went to great lengths to shield we kids from what was going on, but things were bad enough that I remember my dad sitting us down, explaining how mommy needed some extra help. She spent a lot of time locked in her bedroom. I don’t think my parents ever considered getting her medical help beyond some basic advice. They knew it was postpartum depression and figured over time it would pass.

So how would a person know if someone like me needed help? The real indicators didn’t show up until after I got married at the very young age of eighteen. The stress I put on myself boiled over. My memory began to deteriorate. I began having panic attacks - although I didn’t know what panic attacks were at the time. My headaches increased. My emotions became extremely unstable to the point that my husband began to wonder what happened to the girl he thought he had married.

Since much of my problem is based in my hormones, taking birth control pills made everything worse. I gained ten pounds of water weight, which made me hate myself even more than I had.

Hate myself you wonder? Yes. I was in a constant race against myself trying to prove that I was a person of value and importance. When we were courting, it took my husband an entire day of constantly lingering at my side, demanding an answer, until I finally admitted I loved him. It was too terrifying to make myself so vulnerable. On the surface I tried so hard to put on the face of confidence and control while inwardly I could find one reason after another why people would have good reason to reject me.

Not even a full year into our marriage the indicators were clear that I was having some serious problems. My extreme mood swings, the memory loss, inability to concentrate, insecure need for constant reassurance from my husband that he loved me, that I was indeed lovable, were all clear signs.

The two of us decided I could no longer take birth control pills. That was a wise decision. Beyond that we didn’t think there was a problem. Soon after, I went back to my old habits of thinking I could do anything. I piled mountains of stress on myself - working part time, attending school with more than a full time credit load, performing in a professional traveling show for extra income, and so on.

After two years of marriage we decided one of us had to graduate. Financially speaking, one of us needed to be working full time. I was the one closest to being done. I was the idiot who believed I could do anything, so we decided I was the one who had to finish school. With special permission from the university (due to my good grades) I took on a class load which was twice as much as the number of credits considered to be full time.

One month in I found out I was pregnant. The first thing that came to my mind was the stories I’d heard of how Chinese women would be working in the fields, pop out a baby, and return to their task. I figured if so many other women could do so much while they were pregnant, I wasn’t going to let it slow me down in any way.

For obvious reasons, I did have to quit the traveling show I was in. Otherwise I continued working, getting in as many extra hours as I could. It was unquestionably insane.

In December of that year our apartment building was sold to a new investor who decided to raise the rent considerably. It was far beyond our budget. In order to complete my required student teaching winter semester I had no choice but to quit my part time job. The loss of my income was too crushing. When we were unable to find another affordable place, we ended up moving in with my parents.

Although my parents were wonderful about the whole thing, our situation only became worse. My husband was mortified that we were living with his in-laws. The weight of his responsibility of being a provider was crushing him. We had a child on the way. My huge belly was a constant reminder of that impending lifelong commitment. He was scared.

I didn’t have time to get scared. Every day I had to be at the high school working the same hours as the drama teacher I was assigned as my mentor. In theater school doesn’t end when the bell rings. Always there are rehearsals lasting at least until 5:00. Saturdays were required. On top of that, I was still trying to take an evening course.

I was exhausted, overwhelmed. This strange, constant nagging pain was in the top of my head. My ability to focus was slipping.

By the time winter semester ended, even though we couldn’t afford it, I’d found us an apartment. It was clear my husband couldn’t deal with living with my parents any more and I needed to have my baby in my own home.

I went into a crazy cleaning frenzy just before we moved in. Any kind of dirt or mess within my home had become a point of extreme distress and aggravation. I’d start cleaning, but the more I cleaned, the more I realized there was no way I could get rid of all the dirt. It was probably the first time I ever noticed my own odd obsessive compulsive behavior.

We moved. The pain in my head continued to grow worse. Everything in general seemed worse. I couldn’t concentrate on any of my school work. When I could concentrate for a moment or two I’d end up falling asleep. With my student teaching completed I was able to return to my job. My credit load was higher than ever. Just to get everything in before August graduation I was working to test out of a number of classes. In the mean time I was scheduling interviews with local schools for teaching positions.

Midway through spring term on a Friday my son was born. I actually had to call a principal from the hospital to cancel an employment interview. Determined to not let anything keep me down, I was back in class by the following Tuesday.

Things start getting blurry after that. My husband and I were so thrilled with our new son. I wanted to be everything for him. Since I was breast feeding I was up all night, never able to get any kind of regular sleep. During the day I have little ‘black outs.’ I’d be doing one thing, like walking to class, then I’d find myself in a whole other place. The missing time was nominal. I don’t think I even noticed it was happening at first. Then, when it started as I was driving, it increasingly began to scare me.

All the same, I blamed it on exhaustion and did not allow myself to think it was anything serious. Somehow I survived spring term. Summer started. I was six weeks away from graduating. Everything was still on schedule.

I don’t know what I looked like to my husband. He was worn to the bone just like me, doing hard labor full time as a roofer over the summer. At night I’d been trying to let him sleep even though the baby kept me up. Outwardly I was going to great lengths trying to convince everyone including myself that I was fine.

I already wrote about the hallucinations that began (The Brain Tumor). They were what prompted me to go to my doctor. I was convinced the only reasonable explanation for me to be having such horrible hallucinations, black outs, memory loss, and constant headaches, had to be a brain tumor. That one misconceived notion probably saved my life.

There were signs and symptoms all over the place, but no one noticed, not even me until it was almost too late. That is one of the most fearsome things about mental illness. Someone can be falling apart right in front of your own face. If you don’t know what to look for, you could miss it entirely - an oftentimes very fatal mistake.

Tuesday, February 23, 2010

Know Your Limits

If you think life is hard as a young parent, even as the parent of a teenager, you are in for a rude awakening when you become the parent of an adult.  All of a sudden the controls you've been accustomed to having are gone.  You can't tell your kid what to do - well, you can, but it doesn't mean much.  There comes a time when you have to let go and accept the fact that your kid isn't a kid any more.  He or she needs to make their own decisions, their own mistakes, and live with them without you to cushion the fall.

You know that story about the little boy who's father is in a dark hole.  The father calls to him, telling him to jump into his arms, saying he'll be safe because his dad will catch him.  The boy jumps.  Dad catches him. Happy ending. It's supposed to be all about faith.

Well, with the adult child you have to say - hey kid, there's the hole; jump if you want; if you break your leg I'm sorry, it's your choice, but I'm not down there waiting to catch you.  The lesson is still about faith - having faith in your kid.  That doesn't make it any easier.  I remember back when I left home.  I made some stupid mistakes, paid the price for them, all while my poor parents had to watch. Like the wonderful parents they always were, they always supported me regardless of my own foolishness.

Big sigh.

That's the way it is with anyone you love who's all grown up.  You can tell them what to do until you're blue in the face.  You can break your back trying to save them from themselves, but in the end, no matter how hard you try, the only person who can make change happen is the person.

It's a good plan.  God made it up.  I trust Him.  I wouldn't want anyone to take away my right to choose, so why should I ever think to take something so precious from anyone else?

All of this is from a very emotionally drained person, so if it sounds dreary, I'm sincerely sorry.  It's just a harsh lesson I'm learning - kind of like drinking through a fire hose right now.  I'm losing my kids to that dark hole they're jumping into.  I don't know the outcome.  It scares me.  I honestly believe in the end, things will work out great.  We all have our insecure moments.  This one is mine.

Monday, February 22, 2010

THIS IS SUPER IMPORTANT!!!

Please, if someone you know or love is showing signs of utter hopelessness, do something about it!  Right now I'm beating myself up inside.  I just got an email from someone I care about very much.  He's been struggling for a long time.  About a year ago he was in a hospital program for a number of weeks.  The only reason he was there was because I'd insisted he had to do something to help himself.  For a while he was doing better.  He went off to school, got a job, seemed to be doing okay.  He was certainly doing a good job of making things look like he was doing okay when he really wasn't.  Now things are extremely bad.  He has no hope at all for himself.  When I told him to go to the emergency room at the hospital, he said it was pointless, he was never going to get better.  The next step to that kind of attitude is suicide.  I'm sure the only thing that has kept him alive this long is his religious beliefs.

Now I feel sick inside because I didn't see things for what they are sooner.  I'm blaming myself for not catching on to how serious his problems really are.  Nobody wants to have mental illness.  Nobody wants someone they love to have mental illness.  It is so very easy to pass things off like they're a passing phase, or have the attitude that it will pass over time.  But to be honest, when you see signs of trouble, you've got to take them seriously.

I thought it was ridiculous the first time anyone told me to go to the emergency room due to my own mental health.  I didn't consider myself to be in the midst of that kind of serious crisis.  The truth of the matter is, a mental health crisis often ends in death.  Death is pretty serious. 

At least I know now that he's on his way to getting help.  He's alive.  I let him know something had to be done.  I've done what I can do.  I'll never give up.

Sunday, February 21, 2010

Finding a Good Counselor or Therapist

Finding the right person for you can be tough. First, if such services are covered by your health plan, you need to be sure to find someone within your health plan. I would suggest that instead of looking up the list of providers online or listed by your insurance, first ask friends, neighbors, and co-workers if they know of anyone good. Make calls to the offices people suggest, asking if they take your insurance plan. Usually they will. If not, move on to the next most popular referral until you do find someone who will work.

The same principle applies to people who may not have insurance coverage. You are going to want the most bang for your buck. Get the same referrals from your friends, then call and ask about cash pay discounts that may be available. It may take you some time making phone calls, but in the end you could save yourself a lot of money and heartache.

One thing to consider is the gender of the therapist. If you call in to a group of therapists that is the first question you’ll be asked. Do you want a man or a woman? You may be more comfortable with a woman than you are with a man or vice versa. For myself, I’ve come to find that men tend to be more logical and less emotional. Women are generally empathetic and understanding. The best therapists for me have always been men. They suit my personality, filling my need for logical efficiency. I even prefer therapeutic self help books written by men rather than women. Thus far, all of my kids have done better with men as well. You, however, will have your own set of needs, so this is something you need to seriously consider.

Once you’ve found someone do not think the matter is finished. Your first visit will be a big indicator as to whether you will get along with this person or not. Based on my own experience it takes at least three separate visits before you know for certain if a person is really a good match for you or not.

At one time I went to a great deal of trouble trying to find the best possible person for my daughter. I checked every possible resource. This lady was supposed to be a big specialist in dealing with teenagers with my daughter’s specific kind of problem. For the first appointment I went with her to see how well they did with each other. A couple of appointments later my daughter called me up, sobbing uncontrollably because of something the therapist had said. After a great deal of discussion I finally figured out that the therapist and my daughter did not understand each other when it came to religion. The therapist was telling her what she thought my daughter needed, when in fact, her comments were making her feel far worse. It was not the fault of the therapist, or my daughter, or either person’s religion for that matter. They just did not understand each other.

In truth, my daughter had to go to three different therapists before she was able to find someone who was right for her. Now that she has the right person, she’s finally seeing her problems for what they are and taking steps toward doing what she can to help herself get better.

Be patient. Be persistent. Eventually you’ll find the right person. Don’t give up.

A Word About Psychologists

I’ll tell you point blank, I don’t like psychologists. My overall experience has been that they tend to make more problems for you, not resolve the ones you already have. Just recently my daughter was hospitalized for a relatively minor problem. The hospital counselors were saying that she urgently needed to have ‘family counseling,’ that she had some seriously messed up issues with her two siblings.

Okay, I already knew she had some issues with her siblings. I also knew those sibling issues were getting blown way out of proportion because of her momentary mental state. What she really needed was to get the right combination of meds working for her. Once that was in place, anything with her brother and sister would fix itself as well as it could be fixed.

That’s been my experience almost every time someone has been hospitalized. Because there is mandatory counseling involved it’s like the counselors have to validate themselves by making problems for the patients. My other daughter was told she had huge problems with her father. All of a sudden, on top of all the distress she had in the first place, she was even more upset. Sure, she did have a little problem with her dad, but it was nothing like what they were making it out to be. Once again, as soon as she was mentally stable and had the right meds, there was no problem.

I’ve had the same thing happen to me. Blame has been placed on my parents, my husband, my religion, when in truth, all of those factors were by far more helpful and supportive than they could have ever been damaging. That kind of thing infuriates me. The terminology I use is that counseling is more retroactive than proactive.

Even in the case of people who do have legitimate, traumatic experiences which have left them emotionally crippled, they need positive things they can do to overcome those hard times. If the discussion isn’t bringing the individual closer to healing, what is the point? A counselor cannot become obtusely engrossed in the problem itself. I daresay all kinds of so called counselors have made all kinds of money off of simply listening to people go on and on about themselves and their problems. The patient leaves feeling better because there is a cathartic effect which comes from having someone simply listen. In the long run, however, they’re not any closer to an actual resolution.

In order to get better you need more than a listener. What you need is someone who can realistically help you to identify your problems, then provide you with the steps you need to take to overcome those problems. There are counselors out there who can be very helpful. The trick is in finding someone who will work well for you.

The Difference Between Psychologists and Psychiatrists

A lot of people seem to be confused regarding the difference between a psychologist and a psychiatrist. Psychiatrists are medical doctors. They have gone through the traditional training required for any M.D., then have had additional training to specialize in psychiatric medicine. The main thing you need to keep in mind is that Psychiatrists can prescribe medications. They are familiar with the physical as well as mental aspects of the conditions they treat.

Psychologists earn degrees much like educators. They can obtain a Bachelors degree only or advance further to earn a Masters. Their highest level of education is a Doctorate, but even though you can refer to a psychologist as a ‘doctor,’ they are not doctors in the medical sense, but rather doctors like a professor at a university. The degree designates the level of their education, not an education in medicine.

Obviously, it takes a lot more time, effort and education to become a psychiatrist. Their time is very valuable. Nowadays the primary function of a psychiatrist is to prescribe and manage medications. This means that the average psychiatric office visit is only be about fifteen minutes long.

On the other hand, the average psychologist or counseling visit, is about forty-five minutes. It’s kind of like you give your psychologist the full version of your personal novel while you give your psychiatrist the abbreviated version. In most instances, psychiatrists will tell their patients to get further support through a counselor. You sign a release which allows the two to share information so that your needs are more fully and efficiently met.

Not all mental patients need to see a psychiatrist in order to obtain treatment. If you need a mild to moderate degree of medication you can oftentimes work through your primary care doctor and/or their physician’s assistant, nurse practitioner, etc. Usually they will strongly urge you to meet with a counselor as well, which helps them monitor you more efficiently, just like a psychiatrist.

If you think you have a problem, I would recommend that you see your primary care doctor first, then go from there. You may or may not need medication. They could simply send you to counseling, but it is always wise to get a medical opinion.