Self Medicating

Let's talk about the very human tendency to avoid discomfort. I don't know anyone personally, although I'm sure that saints exist, who hasn't had a glass of wine or a cocktail medicinally. By medicinally, I mean for the primary purpose of the depressant effect of alcohol - in other words, to relax or calm down. Nicotine - the primary drug in cigarette smoke - can increase concentration, decrease tension, and actually causes an increase in the amount of dopamine in the brain, acting as an antidepressant. Marijuana and prescription pain medications induce relaxation and euphoria, a terrific sensation of well being. These outcomes are all very desirable.

Unfortunately, these temporary outcomes all come at a terrible long-term cost. Of the estimated 14 million plus adults that suffer from serious brain disorders in the US, at least 3 million have been treated for substance abuse. About 20% of Americans smoke, but it's believed that nearly 90% of people with schizophrenia are smokers. In a culture that encourages us to "take a pill" for nearly everything, we must consider that these substances affect our most vulnerable area - brain chemistry. Just as our prescription medication for depression, our antipsychotics and such, don't always work as well for us as they do the next guy- so drugs, cigarettes and alcohol can have unpredictable effects as well.

Substance abuse often masks the symptoms of mental illness, even as it erodes the physical health of the abuser. Many drugs used for brain disorders are toxic to the liver and can't be used after years of alcohol abuse. Studies have shown that marijuana use can dramatically increase the onset of psychosis. And don't even get me started on the cancer and other lovely perks of cigarettes. As if treatment for co-occurring disorders wasn't complicated enough, it often involves yet another territorial wing of the health care system. So it won't be funded through your provider, or your SA provider won't cooperate with your mental health provider, and the list goes on. Do we really need more complications in our lives?

I know, I know. One more thing that we - consumers (hate that word!) can't do. Everyone else can have that drink, or take a toke, or have a smoke with minimal damage - maybe. But we need to try to just say "no." More info on co-occurring disorders here.

How much is enough?

Caregiver or enabler? That is the question. And we ask it over and over again. How much is enough? You know that this person that you love is sick, but... how do we live with the behavior? She sleeps all day and doesn't even bother to shower. He stays up all night pacing, or playing that video game and has just run up another grand on the credit card you didn't know he applied for. And that's the easy stuff. What about the screaming in the driveway at 2 in the morning or the threat to kill himself? Or kill you? Where do you draw the line with someone you love?

Dr. Peter H. Gott defines the two terms as follows:

Caregiver - takes care of another person in need.

Enabler - someone who excuses, denies and accepts someone else's inappropriate behavior. This attitude prevents the person from facing up to his or her problems, dealing with it, getting help and making appropriate lifestyle changes.

Mental illness is not an excuse for violence. A loved one with a mental illness does not mean we must accept a life of chaos. When dealing with someone who can, by the nature of their illness, be irrational, get help. Make a plan that includes other family members, mental health professionals and if necessary, public authorities. There are usually warning signs of impending crisis. Don’t face it alone.

Taking action to protect OURSELVES is absolutely necessary. Just as we don’t want mental illness to rob our loved one of his or her life, we also can’t let their illness threaten our lives and well being. If your health deteriorates due to stress, lack of sleep or simply living in a war zone; if you collapse, who's going to take care of anyone? The person that you love is not served by your sacrifice. It will only cause them more pain. So do the right thing. Be a caregiver and start with yourself.

See more strategies for caregivers here.

Reversal

I'll confess that I've been in one of those black moods this week... you know the kind - absolute darkness that no amount of sunshine or chocolate or even good wine seems to budge. I'm not necessarily a sunny person on a good day, but this was bleak enough to make me wonder if I need some chemical help again. To top it off, or maybe because of this, I managed to break my little toe quite spectacularly. Pain and depression. Add the frustration of my summer schedule and you have a trifecta of misery.

While mulling all this over, I keep tripping over my negativity. How exactly are we supposed to be positive when the brain is busy following those well worn neural pathways of gloom - stewing in it's own soup of neurotransmitters, most of which are obviously out of whack this week? All these folks with their Secrets (you know that your thoughts are creating your life, so just change those silly thoughts!) are forgetting that many of us aren't on a level playing field when it comes to brain chemistry.

I want it to be that easy. I know my brain chemistry is part of the problem and I want someone to fix that. What I don't want is to take some pill that's going to do a lot of other things to me as well... things I don't need done.... like mess with my appetite or destroy my libido. I wish that I could go to my doctor and he could say something like "oh, your serotonin is off by 5% and dopamine needs a 10% boost... here take this." I wish they could fix my personal chemistry - make my own cocktail of chemical happiness boosters and chemical anti-cranky stuff until my brain was just a regular brain. You know what I mean. A cure.

Not yet. But I happened upon a post today - an amazing post. Seems some scientists reversed the symptoms of retardation and autism in mice. Didn't treat it. FIXED IT. They did it by inhibiting a certain enzyme, and they found that "not only were structural abnormalities in connections between brain cells righted, proper electrical communication was restored between the cells."

They cured them. Onward and upward, science, onward and upward!

Read about it here.

An Open Letter to John and Tom

Dear Guys,

I'm so disappointed. I really love your movies. You both seem like such regular fellows - talented and good looking, with nice families. But then you do these interviews and talk about things that you know nothing about. When you say these things - that psychiatry doesn't help anyone and that psychotropic drugs are responsible for school shootings - from what experience are you speaking?

You see I have experience with these things. I remember holding my beautiful new baby daughter and carefully planning my walk to the next room, where the gun was, and what I would do next. I was out of my mind, of course, struggling with a hormone imbalance of biblical proportions. Tom, how can you say this was not real? I'm here to tell you that vitamins would not have helped. I've watched my son struggle without Depakote and I've watched him on it, and let me tell you that he NEEDS that drug like he needs oxygen. So John, you want to blame school shootings on this kind of drug?

I think it's easy to say what other people should do hypothetically. I've heard you say that these are your opinions and that you are entitled to them. Maybe so. But when people of your position speak, other people listen. It's the responsibility of fame. So when some ill informed mother denies her 16 year old the antidepressant that his doctor recommends because she read your interview in W magazine, and that 16 year old takes his life, will you give her comfort?

It must be nice to be healthy. It must be nice to feel right. But you don't have a clue. And knowing that you are comfortable making judgments about things that you know nothing about, makes me very uncomfortable about you. I think I'll skip your next movie, boys.
Sincerely, Trish

Read about Travolta's opinions, as thousands of others have, here.

Father's Day

This is a hard to say. My sons father is a good man. Parenting has never been easy for him - but that doesn't make him a bad parent. He tries. He has always done the right thing - paid his child support, paid his share for the braces. He does not forget birthdays. He never missed important band concerts, or little league games, or graduations. But...

I think it is extraordinarily difficult for a man to admit that there may be something wrong with his child. Perhaps it is cultural. Perhaps a man thinks of his child as an extension of himself and any perceived flaw in the child is somehow transmuted into a greater flaw in the man. If the flaw is a birthmark, or bad teeth, or short stature, well, that's bad enough. But mental illness? How does that reflect on the father? In a culture that views brain disorder as a flaw of character or a lack of will or discipline, how unthinkable is that?

My sons father has chosen the option of denial. It is easier for him to see his son as lazy or irresponsible or even incompetent than it is for him to admit that he has a mental illness. It is preferable to think that he may "snap out of it" or "finally grow up" rather than admit that he will always live with a debilitating disease. Although I can understand this way of thinking, I also see the devastating effect that this has had on my son and their relationship. Neither will ever meet the others expectations. It is a tragedy twofold.

I hope that my sons father will eventually move on to acceptance. As an ex-wife and a mother there is little I can do to intervene. They sometimes find some peace together when they go camping, escaping the everyday traumas - as if a mutual love of the natural world can bind some of their wounds. My son loves his father and expects little of him. He loves his son and expects the unattainable. I bleed for them both.

Read Families on the Brink: The Impact of Ignoring Children with Serious Mental Illness here.

F 2 F

I have just returned from one of the most profound experiences of my life. I spent three incredible days at the Tierra Learning Center outside of Leavenworth, WA, attending a teacher training for the NAMI Family to Family program. I can't believe that it has been nearly two years since I attended F 2 F with my husband, still reeling from my son's suicide attempt. That twelve weeks was life altering, as we met other family members living with mental illness and began the healing process - learning about these devastating brain disorders, medications, social services, etc. but even more - learning to communicate and deal with the aftermath of crisis.

I spent the weekend with people who have been there, done that, and bought the t-shirt. Their stories of pain and unbearable struggle were stories of survivors and that is the point. Family to Family is taught by the people who do indeed know what it's like to love and live with a relative who is profoundly ill. Through shared experience we can connect with people and help them come to terms with their lives as caregivers and help them have a deeper understanding of the debilitating effects that these diseases have on their loved ones. If taking F 2 F is an act of healing, then teaching it is an act of love.

I am deeply humbled by the experience. I am also excited that soon I will share this process of transformation with families in my own classes. I am filled with gratitude for Ron and Bruce, Judie and Nancy for sharing their knowledge and their time. I also want to thank every single one of the amazing women that shared the class with me - for their empathy and courage.

Learn more about Family to Family here.

See the beautiful Tierra Learning Center here.

Graduation

I attended my daughter's graduation today from our local community college. Although she seems a little jaded that this isn't a real (as in 4 year) degree, it was hard not to see what a tremendous accomplishment that this was for many of the students. At the very least, even for my overachiever, this is one of those passages in life that marks an expected change. The next step, if you will.

There are many people who don't find life a simple progression from point A to point B. While most of their contemporaries seem to be on cruise control down a smooth thoroughfare, for these individuals life seems like a series of missteps, wrong turns and disappointments. My father was quite the artist, and in one of his sketches he portrays himself walking sadly down a rocky road, personal rain cloud over his head, black cat crossing his path. I'm sure it seemed to him that every choice was the wrong one - that he was cursed, or jinxed or just unlucky. I suppose it's easy for me to say that he was simply depressed, some chemicals out of whack in his brain, probably a genetic condition. I'm sure that this was so, but it didn't make it any easier on him. In the end, you could say, he gave up.

I've watched my son struggle with these same demons. Never feeling good enough. Or never catching a break. I've watched his mood swings and his pain and I've lived in fear that maybe he would never be happy or even safe. We both laugh a little nervously, and make light of it, but we both always assume it's going to be the hard way. Hard on the people that love him. Much harder on him. Knowing that it's genetic - a brain disorder - a condition beyond his control - may help it to make some sense, but it doesn't change the feelings. Driving for long stretches without a cruise control is exhausting. Sometimes easy would be nice. But from this, there is no simple progression, no obvious next step. So we hope.

See ideas for coping with depression here.