Tuesday, October 23, 2012

This Was Not Part of the "Package"

Over the last few months, a few people have asked me some form of the following questions:
Did you have your bipolar diagnosis when you married your husband?
Did he know that was part of the "package" when marrying you?

My husband and I met when we were 15 and 16 years old. We knew I was sad a lot and that I had really bad anxiety but I did not see a therapist and psychiatrist until I was 19 years old and we were in college. At that time I was diagnosed with only depression and an anxiety disorder so that was all he knew when we got married at 21. At that point I was on an SSRI and doing a bit better but then we moved out of town and I got a lot worse. I went back and forth on medications being treated for depression, not knowing I had bipolar and the SSRI's were triggering mania.

High School Graduation, 1996

Many people assume my husband has always been understanding of mental illness and supportive of my treatment but really neither of us understood what was going on and in the early years he still thought mental illness was a choice. He is a left-brained computer programmer and logic makes the most sense to him so having a wife that does not have a hold on reality was hard for him. He did not really read much about mental illness and did not go to doctors appointments with me in the beginning. We fought a lot and were not sure if we would stay together or not. We had many dark times.

We struggled like this for five more years until after our son was born and I was finally diagnosed correctly with bipolar disorder. At that point, after so many years of us struggling, he did start to do more reading and went to a few doctors appointments with me. As we went back and forth with treatment, he got more and more involved in helping me. He has always wanted to understand what I was going through but it is really hard for people who have control over their mind to really get what is happening to their loved one.

Today we still we struggle with treating my illness. (Sometimes It's Hard to Stay Together) Some days one of us is not entirely sure we should still be together. My illness was clearly not part of the "package" Jeff married. And honestly, he is not the same "package" I married either. The whole marriage "package" idea actually really bothers me. No one stays the same forever so thinking that you married a "package" is unrealistic. Both of us understood from the beginning that marriage is not perfect and the one you love will change a lot over the course of your lifetime.

For me, seeing my father go through serious illness and the other challenges my parents had, I knew that people do not stay the same forever and that marriage is hard. Life will throw sickness and many other horrific things at you, but you promised on your wedding/commitment day to get through those things together, in sickness and in health. I think the biggest problem with mental illness is that either the person with the illness does not think they have an illness and/or their partner does not believe it is an illness either. If one or both of you can not accept that this is an illness, then you do not know the correct way to manage it. You blame each other and think that you have a "deal breaker" in your marriage.

Wedding, 2000
None of us really has any idea what we are getting into when we marry/commit to someone. I have no idea why Jeff and I have been able to stay together except that when each one of us thinks about life without the other, it makes us sad. That sounds very simplistic, but it is what keeps us going. And it is not like we have not had times that absolutly would qualify as a "deal breaker" (as Dr. Phil says.) Jeff did not sign on for a wife who is sick, and will be for her whole life, with behaviors that negatively affect him.

We both agree that if either one of us was to hurt the other emotionally or physically and we were not getting help or did not admit we had a problem, that it would be wrong to expect the other person to stay in the relationship. We do believe in each other though. We believe that if either one of us is going through something, that we will take responsibility and get the help we need. The problem with mental illness is that it is extremely hard to treat so you have setbacks and you will not always be well. People with mental illness have high rates of non-compliance, which is not stubbornness or laziness, it is a symptom of the disease so it is not an illness that you treat and never have to deal with again.

In order to handle all of this, I encourage couples to go to doctors appointments together. Make sure everyone in the family is physically and emotionally safe and if they are not you may need to be apart until things are more stable but if the person is in treatment that does not mean you need a divorce. You really have to work closely with your doctors to decide the best options are for your family.

Two books that have really helped us are The Five Love Languages by Gary Chapman for general relationship help (given to us at a Couples Retreat at John Carroll University) and Loving Someone With Bipolar Disorder by Julie Fast.

Our best recommendations to couples are:  You HAVE to talk to each other. You have to see your doctor, together. You can't see marriage as a "package" that you bought and which stays the same. Don't have a big ego and either of you blame everything on the other person because both of you will make mistakes over and over again. Marriage/partnership is not easy and couples need help in order to make things work. ALWAYS ask for the help you need, and actually take the help given to you.


Rev. Katie

Wednesday, October 10, 2012

When They Say Mental Illness Is Not Real

One of the main issues which comes up in my discussions with other people with mental illness that causes them the most pain and spiritual despair is when family and friends refuse to accept that mental illness is real.

It just seems ridiculous to me to say that an illness well known by the medical field and which we can see on a brain scan is not real. These people who say mental illness is not real always, without fail, say that instead people use mental illness as an excuse not to take care of their life, themselves, and take responsibility for their life. I am always amazed that anyone would think someone would chose to have the difficulties people with mental illness have. No one wants this.

As I talked about this with my husband, he made me realize something, he said "Saying mental illness is not real is just a cop-out." So true. It is just denial. Family and friends who claim their loved one does not have mental illness can not admit to themselves that there is a problem, someone is sick, and they need help. It is their inability to deal with reality that makes them use this cop-out. And frankly, most of these people in denial have their own issues they need to work on and seeing someone else working on their life and trying to get better, is a reminder to them that they can not face the reality of their own life. This fear of theirs takes away their ability to be compassionate towards someone else.

If you have someone in your life that believes your illness is not real, I hate to say that you probably will never change their mind. Even if you show them test results, brain scans, and have them talk to doctors. I actually had one person in my life say that I was having my psychiatrist lie for me and say I had mental illness so that I could get away with being irresponsible in my life. So, these people will most likely never understand and it is extremely hurtful to you to have to try and defend yourself all the time. To sit and be made fun of, ridiculed, and shamed because you have an illness. No one would ever do that with someone who had cancer or Multiple Sclerosis and no one should do it to you.

Photo by K. Norris. (Hapkido, but you get the idea)
If people are hurting you in this way, you might think that you should ask them, kindly, not to talk about your illness anymore since you can't agree. However, this approach will probably just enrage them further and cause more attacks on you. Try giving them a little bit of information such as "I am working with my therapist on calming my anxiety." Just think of some short answer that does not offend them, gives them little information, but helps redirect or stop the conversation. Think of it as verbal Tai Chi where instead of countering your opponent's force, you deflecting it. You can also only put yourself in safe situations such as seeing them at large events when other people are around or meet them for coffee in public rather than have them over to your house. It's all about not falling into their trap and perpetuating the unhealthy system they are creating.

These people in your life are not bad people, they are just doing something that is extremely unkind. It really does not have anything to do with you but with whatever issues they have in their own life. Send them thoughts of loving kindness and move on with your life. One day they may come around, but in the mean time you need to take care of yourself.

Stay strong friends!

Rev. Katie

Tuesday, October 9, 2012

Raising Awareness: Non-Pharmocological Treatment

October 7-13 is Mental Illness Awareness Week. What do you think is one thing people need to be more aware of concerning mental illness?

I have so many things I would want people to be aware of. Of course one of the main things I would like people to actually accept is that mental illness is real. But the other thing I think we do not speak about nearly enough are all the non-pharmacological treatments for mental illness. I am eternally frustrated when I see people (adults and children) heavily medicated, on medicines that risk their life due to serious side effects, and no one tells them the other things they could try to do for treatment. Many non-pharmacological things work in treatment to either decrease the amount of drugs you need to take or some people don't even need prescription medications anymore.

Why do we make people go through this? Why do we not inform people of all the options they have? Why don't we give them the best chance at a stable life?

There is too much stigma around non-prescription treatments- assuming that if you can treat an illness through anything other than a pill then the illness is not real. But that is just not true. Heart disease is real and it can be treated with diet and lifestyle changes. Some forms of diabetes can be treated with diet and people can decrease or stop needing insulin injections. Diet is used in the treatment of epilepsy when medications are not working. Celiac disease is treated with a gluten free diet as are all other food allergies. There is no reason to think that because mental illness can be treated with things like diet, exercise, sleep schedule, meditation, supplements, etc... that it is not a real illness.

From NAMI's Facebook Page
Mental illnesses are chemical imbalances or damage in the brain and things like diet and exercise can change the balance of those chemicals or help repair the brain. For instance serotonin is often one of the chemicals that is out of balance, too low in people with depression. Sugar increases serotonin, but then it also produces a crash and creates mood fluctuations and that can create the chemical imbalance of bipolar. Not eating sugar and other simple carbohydrates can help balance serotonin so it does not have extreme highs and lows. Exercise helps in the treatment of ADD, depression, bipolar and more because it effects neurotransmitters such as norepinephrine and dopamine. Exercise also helps regulate the amygdala which is one of the parts of our brain affected in PTSD. Also, as Sharon Begley describes in her book Train Your Mind, Change Your Brain, meditation helps change our brain due to neuroplasticity (the ability for our brains to change, rewire itself.) Meditation has been successful in treatment of mental illness as well because it changes the pathways in your brain, this is especially helpful in PTSD and brain injury.

Nothing showed me just how easy it is to change our brain with things like food than an experience with my son.

We noticed my son was having emotional breakdowns. Crying over small things that, while annoying, were not things you would just fall apart for hours over. He is normally a totally happy and smiling kid who listens and is really easy to take care of. We knew something was wrong and we had already been researching diet and it's affect on mental illness for me and my husband has a gluten intolerance. We noticed when we cut out gluten we all felt better, but my son still had these breakdowns so we we started paying more attention to exactly what he was eating. We noticed that when he ate corn, a few hours later, he was a wreck! So, we cut out corn (even corn syrup), and he rarely has these episodes except when we eat out or he is at a friends house. No matter how hard we try to avoid it, corn is snuck into everything especially in the form of corn syrup. Even pre-made hamburger patties have corn in them sometimes so you may think you are just eating meat but you are not. We even noticed during school testing week that on the days our son had a breakfast of protein and carbs he was able to sit and focus longer for the test. On the one day I just gave him fruit and gluten-free pancakes, he had a hard time concentrating and sitting during the test so much so that his teacher asked me if he was feeling ok. I know that if he goes to a party or spends the day at the amusement park and we did not pack food for him, he will be sad, cry easily, and even withdraw to his room for hours. All because of the food he ate.

I recommend that all of this be supervised by your doctor and if you do not have a doctor willing to look at things outside of the medicine cabinet, then find a new one. It can be hard. For at least ten years doctors have been telling me "the research shows these things work" but they don't have enough experience to use it in treatment, telling me to experiment on my own. Not helpful! I finally found doctors this year who have enough experience and education on these treatments that they do use them.

If we as patients insist that we want to know ALL of our treatment options, we can make a difference. So I want to raise awareness to my fellow friends with mental illness and let you know that you have many options in your treatment plan. You have the right to insist that you are informed about them and are treated with them. We can demand more testing so that more doctors recognize these treatments as successful. Our lives are worth this fight.


Rev. Katie