Sunday, March 29, 2009

A General's Personal Battle by Yochi J Dreazen

Maj. Gen. Mark Graham is on the frontlines of the Army's struggle to stop its soldiers from killing themselves. Through a series of novel experiments, the 32-year military veteran has turned his sprawling base here into a suicide-prevention laboratory.

One reason: Fort Carson has seen nine suicides in the past 15 months. Another: Six years ago, a 21-year-old ROTC cadet at the University of Kentucky killed himself in the apartment he shared with his brother and sister. He was Kevin Graham, Gen. Graham's youngest son.

After Kevin's suicide in 2003, Gen. Graham says he showed few outward signs of mourning and refused all invitations to speak about the death. It was a familiar response within a military still uncomfortable discussing suicide and its repercussions. It wasn't until another tragedy struck the family that Gen. Graham decided to tackle the issue head on.

"I will blame myself for the rest of my life for not doing more to help my son," Gen. Graham says quietly, sitting in his living room at Fort Carson, an array of family photographs on a table in front of him. "It never goes away."

Suicide is emerging as the military's newest conflict. For 2008, the Pentagon has confirmed that 140 soldiers killed themselves, the highest number in decades.

At a Senate hearing last week, Gen. Peter Chiarelli, the Army's vice chief of staff, told lawmakers that 48 soldiers have already committed suicide in 2009. The figure puts the Army on pace for nearly double last year's figure. "I, and the other senior leaders of our Army, readily acknowledge that these current figures are unacceptable," Gen. Chiarelli said at the hearing.

Beyond Fort Carson, the Army has launched a broad push to reduce the incidence of suicide. Over the next four months, all soldiers in the Army will receive additional training on suicide prevention and broader mental health issues. The Marine Corps, which is also being hit hard by suicide, will give all Marines similar training this month. In February and March, the Army for the first time ever excused units from their normal duties so, one by one, they could learn new ways of trying to identify soldiers in need of help.

Read the rest of the article here.

Monday, March 23, 2009

Yesterday

Yesterday, I got some inspiration to purge... and pulled out some boxes from the garage with the intent of clearing them out and consolidating. Everybody has some stupid cardboard boxes full of stuff, you know. Old stuff that seemed too important to toss but not important enough to have sitting in the room with you. Usually the stuff remains in the cardboard box forever, being dutifully moved from home to home until you die and then your offspring become in charge of tossing it out unceremoniously whilst muttering under their collective breath. This is the way of stuff.

However, I seem to have some odd recessive gene that occasionally prompts me to rid myself of the weight of some of the stuff. Unfortunately, this gene is not of the sort of nature that might suggest that I just march into the garage, pick a couple of boxes at random and heave them into the dustbin without a peek. There must be peeking and consideration, lest I might divest myself of something of deep and irreplaceable value. This is a good thing, as in this last batch of peeking I finally located my long lost divorce decree - which does indeed have some value and although not irreplaceable, could lead to a good deal of unpleasantness if suddenly needed and not available.

Within this box of divorce decrees (keep,) notebooks of adolescent poetry (pitch!) the first board I broke with my fist in karate (PITCH,) tax records from 1998 (still have to keep?) and such, was a rather nondescript envelope. And within the envelope was a photocopy of a death certificate and another copy of a handwritten note. And then I was crying and the purging of stuff came to an untimely end. Like the life described therein.

I wonder if I will ever really heal from the loss of my father. It's funny that I didn't miss him until I was 32 years old. Until then, I had this sad dream of a daddy who died tragically just before my arrival on the scene - snatched from life by an untimely accident. I spotted him occasionally in the pain in my mother's eyes, but beyond that he was only this tragic and beautiful fellow in my dreams. Then, as an adult with children of my own, that death certificate came home to roost and answered my questions once and for all. My father wasn't snatched from life at 25. My father took his life.

So, who am I crying for? Not sure about that. Suffice it to say that I have come far enough to say that I can understand the wish to have it end. Not so much a wish for death... just a wish for an end to the pain of living. Buddhists suggest that we embrace the pain; accept that pain is the whole substance of living - I haven't figured out how to do that. Not by a long shot. There are days that I open my eyes and my first thought is one of dread. Joy feels alien. Sunlight makes me wince. I often wonder if the one cell that my father gave me held all his pain as well. I often wonder if I didn't pass it on to my son.

In another nondescript envelope are some photos of my dad as a kid. As I rifled and sniffled one photo jumped out at me - like I'd never seen it before. Suddenly on a mission, I found another photo from another box and laid the two side by side. My dad at 15. My son at 15. I never noticed how much they looked alike.

I'm crying again. I'm still not sure for whom.

Shame

I don't look at mirrors.
Okay, maybe sometimes. At my face.
I don't mind my face too much,
if I don't look too hard and skip the eyes.
I don't watch as the soap slips along
standing in the shower.
I close my eyes to wash
or watch the water.
Reflections in windows
can be handily avoided
by keeping a sharp eye on the movement of feet;
avoiding judging eyes a value added.
At worst a window glance is brief
and thankfully clothed.
Bathrooms are harder.

Monday, March 9, 2009

The Right Thing

The question, friends, that is always on the tongue of those who live with a loved one with mental illness, is startling in it's simplicity. Because after you have come to grips with a diagnosis, or at least wrapped your mind around the reality that your child, spouse, parent, or sibling is not okay in the traditional sense of the word - after you have educated yourself about that malady and done your homework by reading book after book or endlessly surfing the net - after you've sought out support groups and doctors and counselors and social workers - after all due diligence you find yourself still grappling with that one question.

What is the right thing to do?

I live in America. This is a the "land of the free, home of the brave." This is a culture that looks disapprovingly upon failure, weakness and lack of a stiff upper lip, whatever that is supposed to mean. Homeless? You've failed to 'pull yourself up by your bootstraps.' Jobless? You aren't taking advantage of your opportunities. Ill? Well, how long can it take to get better? Take your pills for heaven's sake and get on with it. Addicted? That's just pathetic; we'll let you hit bottom and then you'll see the error of your ways and become a responsible citizen.

This is how the New Collegiate Dictionary defines the term enabler: "one that enables another to achieve an end; especially: one who enables another to persist in self-destructive behavior (as substance abuse) by providing excuses or by making it possible to avoid the consequences of such behavior." This has become the dirty word to fling at the family of the afflicted - as if they have caught some vile social disease by association. Not enough to blame the victim... blame the victim's family as well. This is how compassionate our culture is to the most vulnerable.

The flipside, of course, is that often our loved ones become most ingenious at using our compassion for them to their own ends. That just because a person is ill, does not mean he or she is not capable of being devious and manipulative, or lazy and unwilling to compromise. A person with mental illness may very well have the ability to decide that sitting at home playing video games trumps working at a dull minimum wage job hands down, or that Mom will clean up the mess if I don't. A little show of temper or the silent treatment may get the family back to walking on eggshells - and off my back. Which brings us back to the question.

What is the right thing to do?

The line between "enabling someone to achieve an end (recovery)" and "enabling someone to continue self destructive behavior" is always in motion. The ability to discern when a behavior is a direct result of the disease or a reactive coping mechanism is an ongoing learning curve - and just when I think I've got it down, I catch myself and have to reevaluate. The line is dependent on so many factors - what illness, how severe, what stage of recovery are we in, what outside factors are contributing, are the meds working, are they being taken... and so on and so on and so on. Sometimes it's too much to grapple with and I abdicate - and my fall back position is usually to help in some way, even if that help is enabling. But I fear that if I am always there to clean up the mess, to provide comfort, or just plain to save his butt from consequences that a normal (as in not mentally ill) person would have to face - that I am somehow doing him a disservice. How will he mature and grow and learn to handle things himself if I never let him deal with his own mistakes?

What is the right thing to do?

Sunday, February 22, 2009

Coping with Hearing Voices by Rethink


Most people in modern-day western culture think of hearing voices as a clear sign of mental illness but it's as well to remember that not everyone shares this opinion. A report published by the British Psychological Society in (2000) claims that 10-15 % of the population hear voices or experience other hallucinations at some point in their life. However, only about 1 % of the population is given a diagnosis of schizophrenia and a similar number get a diagnosis of manic depression (often called 'bi-polar disorder'). In some other cultures hallucinations are thought of as spiritual gifts. So not everybody who hear voices is thought of as having a mental illness by themselves, their families or even the mental health services.

Hearing voices in itself may not necessarily be distressing. What really matters is the effect that hearing voices has upon the person's life. For some voice hearers the experience is highly distressing and disturbing and it has a negative impact upon their life. Voices can be critical, hostile and even result in suicide. For others the experience is not distressing; it can even be positive, comforting or inspiring. Sometimes, hearing voices becomes distressing in itself because of the way it is viewed by our culture and because of the way the media portray people who hear voices as dangerous to others, which is very rarely the case.

But many people who hear voices find themselves having to deal with a different world, which may at times be overwhelming and may shut out everything else. As a result reasoning may be almost taken away, making it difficult or even impossible to go about life without being affected by such penetrating and confusing experiences.

What are the voices?

Using brain imaging techniques (ie using a brain scanner), researchers can see which parts of the brain are active during different tasks. So, using these brain imaging techniques researchers can see which parts of the brain are active whilst you are experiencing psychotic symptoms, such as hearing voices. This shows that when you are hearing voices part of the brain, called Broca's area, is active. This is the same area that is active when a person without psychosis makes inner speech, such as when reciting a poem to themselves. This shows that the voices originate within the brain, in just the same way inner speech is generated. The difference is that with hallucinations (e.g. voices) the auditory cortex is also activated. The auditory cortex is normally active when we are listening to sounds, such as somebody talking. So, when you have hallucinations of hearing voices, Broca's area and the auditory cortex are both active, making it seem like the voices are coming from outside. Whereas, in inner speech (such as silently reciting a poem to oneself) only the Broca's area is active and we recognize it as our own silent speech.

See the rest of the article, including strategies for coping, here.

Monday, February 16, 2009

Vets and Depression



* An estimated 9.3 percent of veterans aged 21 to 39 (312,000 persons) experienced at least one major depressive episode (MDE) in the past year.

* Among veterans aged 21 to 39 with past year MDE, over half (51.7 percent) reported severe impairment in at least one of four role domains (i.e., home management, work, close relationships with others, and social life), and nearly one quarter (23.5 percent) reported very severe impairment in at least one of the domains.

* More than half (59.6 percent) of veterans aged 21 to 39 who experienced past year MDE received treatment for depression in the past year.


Recent research indicates that an estimated 25 to 30 percent of the veterans of the wars in Iraq and Afghanistan have reported symptoms of a mental disorder or cognitive condition. Untreated mental health problems can result in long-term negative consequences for the affected individuals, their families, their communities, and our Nation as a whole.

The National Survey on Drug Use and Health (NSDUH) includes questions about military veteran status, major depressive episode (MDE), and treatment for depression. This issue of The NSDUH Report examines data from veterans aged 21 to 39, an age group that includes veterans with relatively recent service.

Read the rest here.

Wednesday, February 11, 2009

The wolf you may know

"WHEN YOU SAY THE WORD "sociopath" most people think of serial killers. But although many serial killers are sociopaths, there are far more sociopaths leading ordinary lives. Chances are you know a sociopath. I say "ordinary lives," but what they do is far from ordinary. Sociopaths are people without a conscience. They don't have the normal empathy the rest of us take for granted. They don't feel affection. They don't care about others. But most of them are good observers, and they have learned how to mimic feelings of affection and empathy remarkably well.

Most people with a conscience find it very difficult to even imagine what it would be like to be without one. Combine this with a sociopath's efforts to blend in, and the result is that most sociopaths go undetected.

Because they go undetected, they wreak havoc on their family, on people they work with, and on anyone who tries to be their friend. A sociopath deceives, takes what he (or she) wants, and hurts people without any remorse. Sociopaths don't feel guilty. They don't feel sorry for what they've done. They go through life taking what they want and giving nothing back. They manipulate and deceive and convincingly lie without the slightest second thought. They leave a path of confusion and upset in their wake.

Who are these people? Why are they the way they are? Apparently it has little to do with upbringing. Many studies have been done trying to find out what kind of childhood leads to sociopathy. So far, nothing looks likely. They could be from any kind of family. It is partly genetic, and partly mystery." (read more of this article here.)

So here's a little test... actually a question devised by a psychologist to see who thinks like a sociopath. Read the question carefully and give it some thought.

A woman, while attending her own mother's funeral, meets a man. She has never set eyes on him before and yet she finds him to be delightful. She is sure he is 'the one.' But somehow he leaves the funeral before she can get his number, or even his last name. A few days later, she murders her sister. SOOOO, what was her motive for killing her sister.

You'll have to check the comment thread to get the answer... and if you get it right, please let me know (so I can block your email.....:)

Read The Sociopath Next Door last year.... chilling.....