Perfect

Are you a perfectionist? Some folks will tell you that they are with a certain note of pride. Perfection is seen as desirable, the sign of a winner, or a goal to be attained. Our culture views the perfectionist as someone who has ample ability, who strives to be successful, who can get the job done. But there is a great difference between those who have high standards and a healthy desire to be successful and the perfectionist. Do you have drive or are you driven?

Perfectionists subscribe to "all or nothing" thinking - seeing every experience as good or bad depending solely on the outcome. This leads to lots of anxiety - you can imagine the pressure when every task is seen as a potential disaster. Perfectionists are motivated more by a fear of failure than a desire for success, and that fear of failure can be crippling; the attitude of 'flawless or not at all' leads to procrastination at best or complete abdication at worst. All of this self inflicted stress inevitably results in depression, performance anxiety, and low self esteem. It takes a terrible toll on a persons physical and mental health.

Perfectionists have unrealistic expectations, not only about their own capacities, but also about what is reasonable behavior in others. This puts tremendous strain on their relationships. Because of these expectations, perfectionists often contribute to the demise of relationships by unending criticism and blame. What spouse could live up to their standards? And the children of perfectionists are terribly vulnerable to these unrealistic expectations. Dr. Edmund J. Bourne, wrote about the childhood origins of anxiety disorders in his book, The Anxiety & Phobia Workbook. He felt that children who grow up with parents who are perfectionists are likely to experience self-doubt and low self-esteem. They are also likely to grow up to be perfectionists themselves.

Are you a perfectionist? Unfortunately, I am. Learn more about coping strategies here.

Sing - sing a Song

One of the major symptoms of panic is short, shallow breathing. As our fear ratchets up, labored breathing, a sense of being unable to catch one's breath, chest tightness or pain and tingling in the hands and feet are often the result of this hyperventilation. Dr. David Carbonell recommends singing aloud as a simple method of preventing and interrupting panic attacks.

Singing forces you to breathe more slowly and deeply, relaxing your chest muscles and maintaining the balance between the oxygen you inhale and the carbon dioxide you exhale. Although not a remedy for panic disorder, it can be an effective way to stave it off - while driving for example. Combined with other techniques, like diaphragmatic breathing, it's an additional coping technique to add to your arsenal.

As to what you should sing, Carbonell considers humor to be the best response - an amusing song will probably be more distracting than a serious one. (Try this to the tune of Camptown Races - "I'll go crazy, then I'll die.... doodah! doodah!") Any song that lifts your spirits - a hymn, children's song, the national anthem, even a jingle - will do the trick. (Two all beef patties, special sauce, lettuce, cheese, pickles, onions on a sesame seed bun....!) Try it!

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.