Mental Health Month “Unipolar v. Bipolar & the great error”

After a school shooting or shopping mall attack, we nod and say; “Oh the perp was Bipolar (or schizophrenic).”

For those who are Bipolar (or Schizophrenic, discussed in a later post) this is the worst kind of association and thus, stigma imaginable.

Ironically throughout my life, I have been friends with a great number of Bipolar people and can attest that assuming all Bipolar people are gun-toting and ready to blow you away is a little like thinking all feminists want to castrate men.

Sure, mental illness can exacerbate another condition such as anger, and be part of the impetus that leads to an unacceptable outcome. However, this alone doesn’t logically mean all people with certain mental illnesses ARE going to do that. Just as the vast majority of those who are Islam would NEVER be a terrorist, the same is true of those with Bipolar (or other mental disorders)

But try telling that to the media who irresponsibly fuel this stigma.

It’s like the whisper game, you whisper to a friend and by the time you’re at the end of 20 people meaning has changed.

Ask most people and they will say that they think the majority of shooters of that kind are mentally ill and typically Bipolar or Schizophrenic. How could that not impact how they see those people?

As discussed before, stigma is the worst element of any ‘label’ and is carried even when you dismiss it, as a permanent stain in our society so fond of judging others.

Bipolar, previously known as ‘Manic Depression/Manic Depressive’ is a disorder of two parts. Typically you are either Bipolar 1 or ll or mixed-effect meaning not clearly defined by either category. The problem with categorizing is obvious, the benefit is for those trying to establish treatment protocols but like anything else, mental disorders go in swings and roundabouts of popularity, and at times, it’s almost the illness-du-jour to label a higher number of people Bipolar.

I question diagnosis for the simple reason that having seen it implemented I have seen a great many mistakes in those diagnosis. At times it can seem comforting to be ‘told’ what you ‘are’ and ‘treated’ and has saved lives. I don’t dispute that. I do however, worry that the tools by which we diagnose are faulty.

A diagnosis of Bipolar is based upon several criteria, one being that you must have had a manic episode. Bipolar ll requires a manic episode of less severity. A manic episode can be characterized by many behaviors, typically including, insomnia/wakefulness for several days, excessive impulse behavior such as spending money, making rapid and interchangeable big life changes, impulsivity and promiscuity.

Of the MANY bipolar people I know intimately, and have met throughout the years, I have yet to meet two who are alike. What that tells me is labels are usually as counter-productive as over medicating can be and Bipolars are often over-medicated. However unlike Uni-Polar (Depression and/or Dysthymia) Bipolars really respond to medication and are perhaps most likely to benefit from medication of all mental illnesses. As one who doesn’t believe in the ‘magic pill’ I would stand by anyone who has Bipolar taking medication but caution against over-medication and/or not considering other options in tangent, such as diet-change and therapy.

Many people who become Bipolar do so during puberty/late teenage years. It comes on usually as an extreme manic or depressive episode that can lead to hospitalization, suicide attempts or dangerous behavior. In the past Bipolars were characterized from depressives as being ‘delusional’ and thus, ‘clinically insane’ during manic episodes, and thus, their diagnosis was higher up on the ‘illness’ scale of mental illnesses and it was easier to declare them legally unfit.

In this I would agree. Uni-polar depression is basically that, depression. Bi-polar is a mixed cycle (of varying length, degree and frequency) of mania versus depressive symptoms. As such during the manic-period of Bi-polar, individuals can be clinically delusional and suffer delusions of grandeur, extreme expansive thinking and other exaggerated and not literal feelings. One could argue when someone is depressed they are delusional also, but ask a depressed person they will tell you they know it’s depression. Ask someone in a manic episode, they don’t know it until they ‘come down’ and thus, it’s hard to reason with someone during a manic episode. Consequently they can unintentionally do a great deal of harm to others and themselves.

What it takes to push ANYONE to the edge where they choose to shoot people, is more than any mental illness alone. It takes a CHOICE. If you are delusional you don’t have the same kind of choice system as someone sane, so to some extent you can appreciate the diagnosis of clinical insanity when a very ill person shoots other people BUT despite this, Bipolar has more consciousness than say, a full on Schizophrenic delusional episode, and as such, I would argue, most people with Bipolar can choose (not to shoot people) and are more likely to hurt themselves than others (explaining the very high rate of suicide comparatively).

Does that mean they are not capable of making some VERY bad choices? Of course not, they often will, but it is often rooted in self-destruction than destroying others. Some exceptions exist but that is true of everyone. You cannot say someone with Bipolar is more likely to kill than anyone else, because statistically more murders are committed by people without Bipolar than with. As with anything, there is a tendency to push someone over the edge if they are ostracized, shamed, judged, stigmatized and bullied. At that juncture they may act out of their norm because that’s how far they have gone down the rabbit hole.

Bipolar is a very painful disease to live with because on the one hand it can produce the highest elation and feelings of wellness, ability, skill, intellect, foresight, emotion and productivity, followed by a massive crash and the exact reverse. It is the rollercoaster of emotions that cause the higher risk of suicide, imagine feeling on top of the world followed by feeling like you want to die? How is anyone supposed to live with that? This is why medication does work because it can suppress the extent of mania and the extent of depression and level off that individual to a safer plato. But of course ask any Bipolar they will tell you it also curbs the intensity and feels a lot like castration of the mind and emotional pallet which is why periodically Bipolars will ‘go off’ their medication in an attempt to ‘feel’ authentic.

In my own experience, the vast majority of people with Bipolar are considerably above-average in intelligence, and can produce in short periods of time literally incredible outcomes be it artistic or another form. They often have an addictive intensity and are highly likable in those moods, and then quite a different person when crashed. It can be challenging being friends because even when medicated there are up and downs and these medicated shifts, are often characterized by irritability, argumentive(ness) and ‘bitchiness’ which can be difficult.

But all in all Bipolars are given an unfair ‘rap’ by society and struggle every day to achieve an equilibrium that is false to their very natures. In some ways their lives are more interesting than a uni-polar depressive who fights to ever feel that euphoria or happiness, but on the other hand, the swing and mercurial dive into darkness can be more life-threatening. Stupidly I used to envy my more manic friends who seemed to have endless energy and enthusiasm, but there is definitely a high price for this.

Diagnosis is an imperfect science and it is worth noting that more and more people are being diagnosed as suffering from Bipolar 1 or ll and I find this highly suspect. If you are diagnosed you may want to double-check by getting a second-opinion. If you asked anyone if they had a manic episode, chances are they have, be it in a fever-dream or otherwise. People can be promiscuous or manic for other reasons than Bipolar and given that the medication is often strong and has serious side-effects it’s dangerous to accept a diagnosis without being absolutely sure.

Additionally, Bipolars are often diagnosed in their 60’s and beyond which I believe is a misnomer and incorrect. Bipolar disease is a manifestation of the young, and it can worsen as you age, but rarely if ever occurs in older age. If it does this could be the result of something else and that should be treated before the symptoms of Bipolar. Bipolar without a co-morbid primary causality does not just ‘suddenly’ strike a 60-year-old or I would argue, even a 40-year-old. Yes you can go many years ‘un-diagnosed’ but to suddenly start exhibiting symptoms? That’s something else and you should not accept a doctor fobbing you off.

Some Bipolars can function without medication and if you are in that category that may save you the long-term side-effects of medication and the tendency of over-medication by medical professionals, but there is no shame if you are not able to function without some medication and many Bipolars find it helps so much to get on a regiment of medication that works for them, like anything, Bipolar is a disease of extremes and can be ‘mild’ or ‘severe’ just like depression can.

I cannot tell you the number of people I have known who were let-go, fired or forced to leave their jobs when their diagnosis was found out. Equally there are examples that concern me, of Bipolar Psychotherapists hiding their diagnosis and treating patients. I have a lot of compassion for this but from my own experience I think it’s best not to hide a diagnosis even if it means not being able to be a therapist. The same is not true of other jobs, we cannot expect most bosses to understand and we’re only increasing the likelihood of stigmatization to reveal it to them. That said, in some instances with healthcare insurance tied to employment it’s impossible not to.

Contrary to Bipolar stereotypes most with Bipolar are functioning pretty well all things considered and can be supportive to others, and often leaders in innovative, creative expression. But for every success story there are many who suffer so extremely and do not respond to medication and those people are often left feeling they have ‘failed’ where others have succeeded which only makes them feel worse. This is not the case. There is no failure there are degrees of illness. For some, Bipolar can be managed, for others, it cannot just as with varying degrees of depression. If you are not able to function ‘normally’ (whatever that is!) that’s not a personal weakness or indictment of YOU.

Try convincing someone of that … not easy especially when they are bombarded with stories of over-coming Bipolar. Bipolar cannot be eliminated but it can be dealt with. The extent to how much it can be dealt with depends entirely upon the severity of Bipolar and NOT the personal weakness/strength of the individual. It’s imperative never to compare those suffering from Bipolar unfavorably and make someone feel they are failing or not trying.

Typically Bipolars are more at risk for co-morbid diseases such as Borderline Personality Disorder (BPD) Anxiety, Attention-Deficit-Hyperactivity-Disorder (ADHD), alcohol and substance abuse. Again, this is not because they are ‘choosing’ these co-morbidities but because of the interrelationship between some mental diseases. Consequently Bipolars also report higher rates of sexual assault, and injury.

Our understanding of the facets of any mental illness is our way of being an inclusive and supportive society for those among us who suffer. What does it take to read this and learn more about a disorder that affects so many people in our society today? What does it take to become more aware of the pitfalls in hope that you could help someone in crisis in the future?

Finally, it is worthwhile considering holding off on a diagnosis of Bipolar in children unless ABSOLUTELY certain because many manifestations that ‘look like’ Bipolar are in fact not, and medication has a deleterious effect on growing-brains that is little understood. Therapy and treatment for the effects is a less dangerous way of dealing with symptoms that resemble Bipolar in children. It is uncommon to manifest as Bipolar before puberty and I personally though not a Psychiatrist, caution against diagnosis until late teen age years (17+).

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Mental Health Month “the stigma-ism’s”

You can get rid of mental illness by …

believing in God more

working harder

socializing more

going to the gym regularly

quitting bad habits and making good ones

replacing negativity for positive thinking

sucking it up

reducing how often you ruminate

and so the list goes on

The problem with all of the above, whilst absolutely good habits for most of us (bar sucking it up) are, they imply therefore, the sufferer of mental illness is not doing enough to help themselves and ultimately they leave the after taste of judgement.

So how do you strike a balance between helping someone or seeking to help someone with a mental illness and coming across like ‘if only you did this, you would be well’ and thus, not understanding mental illness isn’t a lamp, it doesn’t get switched on and off easily, mental illness isn’t a fad (though it isn’t always life-long either) and (some) mental illness isn’t easy to dismiss with will power alone.

Why do we judge?

Why do we stigmatize?

Have you ever thought about that? What is within most of us that causes us to judge others?

If you really think you have NEVER judged someone unfairly or harshly award yourself the “unlikely” prize!

If you really think you have a right to judge someone else regularly, it’s probably best to stop reading now.

Judging has its place. If someone kills your entire family in front of you, chances are at some point you will judge them and find them guilty. Those who have lost family members to these examples of violence, typically say they have to forgive the perpetrator to some extent to prevent it consuming them, or they have to work through the hate and get to a better place. It is not ‘necessary’ to try to understand why someone would do something so evil, but usually in our effort to understand, our first port of call is judgement.

Why did you do this wrong thing? Why are you the way you are? What is wrong with you?

In the case of the murderer of an entire family I doubt many of us would have an issue with their being judged. That’s where judgement comes in handy. Law and order. Justice.

But what about every day life? Why do we go around judging things all the time thinking we are the judge and jury and even executioner (figuratively speaking) what is it about human beings that makes them relish judging or attracted to judging others?

Is it as simple as being insecure? Putting someone lower than ourselves helps us feel better in a twisted way?

Is it as simple as egocentricism? I know I’m right, therefore if you do the opposite of what I believe, you are wrong?

Is it blind faith? This is my faith and belief, anything you do to contradict it or throw it into doubt, means I will turn on you and condemn you.

Is it a knee-jerk reaction out of not understanding? Condemning what we do not understand?

Is it fear? Fearing we are more alike this person whom we judge than not, and thus, pushing them away by judging them, making it clear we are different so nobody will consider we are also guilty?

I don’t know the answers. What do you think?

What I do know is nobody likes being judged. Sometimes it’s useful or necessary in extreme cases like the one about the murderer, or in small incidences where we help someone learn or grow as a person – but this is more advice-giving than actual outright judgement. Outright judgement tends to have no benefit other than to shame that person. If they are guilty of rape, child abuse, murder, swindling, theft, I don’t have an issue with judging someone guilty and then giving them a consequence depending on the seriousness of the ‘crime’ that’s law and order, but in our society we judge continually in casual ways that we may believe have no lasting impact.

And yet … they often have a life long impact.

Cruelty goes hand in hand with judgement. Often the two are nearly indistinguishable. Mental health can be affected by bullying, judging, condemnation, shame, humiliation, etc. Ask yourself, do you feel judging will help anyone? Will it make anything better? Or is it just your desire?

Ever heard the phrase, you can think it but don’t say it? Sure you have. I’m one who is all for the truth, I would rather someone said something to my face than thought it and kept it quiet, but I’m in the minority, most people seem content to be ignorant of the truth of what someone thinks of them, preferring that they not share the negative assessments/judgements they may have.

Next time you find yourself tempted to say something judging, ask yourself, are you judging because you want to make something better and will that judgement achieve that goal? Or are you judging because YOU CAN AND YOU WANT TO.

Then put yourself in the shoes of the person you are judging.

Sometimes its soooo tempting to want to bring someone down a peg or two. You’ve all met one of those, the people with huge inflated egos who boast and seem unbreakable. Haven’t you been tempted to give them a piece of your mind? Or dent their parachute? At the same time do you really know the egocentrism they display is real? Could it be an elaborate construct and underneath an insecure person hides?

If you have to judge, consider judging those who judge others. If there is anyone ‘deserving’ of being judged it is someone who does it for a living. Next time you hear someone being torn apart, defend them, stand up for them, shame the judger. That’s the best way to use our proclivity for judging, for the benefit of the underdog and others who are picked apart.

Words stay forever. You only have to be told once that you are ugly, worthless, a failure, stupid, to believe it. If that seems weak, look at a childs face when they’re told that by a parent or someone who matters.

Mental Health Month “Just die already”

Another blogger is to thank for today’s subject because she wrote a superb piece about what it felt like to have someone wish you dead when you are depressed.

I’m going to carry the subject on and share my own story.

Many times we hear in teen movies when someone has threatened suicide, some awful person say something to the effect of; “Go on then! Just die already!”

But what if that actually happens?

In my story a friend of mine experienced this that. This is his story.

Steven was 15 years old, good-looking, dyslexic and with a disruptive home life he had begun to experience the first signs of clinical depression as he came into puberty and he was turning to marijuana to numb his feelings.

Boys of that age tend not to be very responsive to therapy and this was the case with Steven when his mom took him to talk to someone after he failed most of his exams and began to wear a lot of black. It turned out Steven wanted to be a Goth (Emo) for a while and that led to him being picked on by others, which only exacerbated his feelings.

One may ask; Why choose something that is going to set you further apart from others? But that is exactly what people often do, it’s as if they have to act out how they feel inside, and they often do it unconsciously.

Steven met a girl three years older than him, she was mentally ill (Bipolar) and really beautiful and he had a huge crush on her. They did some drugs together including LSD that he had never tried before. During his ‘trip’ the beautiful girl had sex with him. He wasn’t sure how to feel about this first time, he felt both violated and excited and flattered and then guilty for feeling such opposing feelings. He didn’t really understand what he felt and when he had feelings of upset about it, he would berate himself because he worried it meant there was something wrong with him for not enjoying the experience.

He ended up getting VD (sexually transmitted disease) from her and he had to go to the clinic, his mom found out, his sister found out, even someone at school whom he had confided in, told everyone else and soon he was taunted even more at school. He was treated for it and over it, but the legacy of this carried on, with taunts of “VD Steven” being hurled at him.

Soon afterward Steven tried killing himself, he slit his wrists. He cut them side-ways not downward not realizing this was the less effective method, he bled a lot and ended up in ER where he was stitched up. The nurse was rude to him and made him feel like he was in the wrong for what he did and wasting resources. His mom was hysterical and angry, his father said nothing, his sister told him that he was weak. Two weeks later he returned to school and because it was Summer wore shorter sleeves, others saw his wrists and soon it became known what he tried to do.

Soon the taunts turned to; “Why didn’t you succeed you fucking idiot”

Steven tried an overdose the next time.

Around this time I met him and supported him back to a better place, along with some of his other friends who were not part of the campaign against him. It was his friends who told his parents not to guilt-trip him and explained what had really been going on.

If Steven had not had those friends to this day I believe he would have succeeded in his suicide attempts.

This for me is another example of the clear-cut connection between how people respond to mental illness and / bad situations and how this can push someone already vulnerable to take their own life (or attempt it). Parents should be aware of this and educate other siblings in how to approach the subject where they are not inadvertently making things worse. The best intentions in the world can come out wrong.

It really can save lives and sharing real-stories of real life people who have literally been saved can demonstrate to all of us the importance of how we treat each other. There should never be anything okay about telling anyone, suicidal or not, that their life does not have worth, or that they should go ahead and kill themselves.

Mental Health Month “Rape”

Rape isn’t a subject people talk about very often. Sadly it’s a subject people joke about quite a bit.

The first time I heard a rape-joke I didn’t get it. It was too disgusting to ‘get’ and I am glad I didn’t. Everyone else did though and they all laughed. At the time I didn’t think how someone sitting there who had been raped would feel, but statistics tell us, that likelihood is quite high considering that 80 percent of rape goes unreported and even the reported numbers are staggering.

How a rape joke could hope to be funny, baffles me, but it maybe is more telling of our society as a whole, that we can laugh at true misfortune and tragedy. That’s not gallows humor, that’s just sick.

Rape is never funny. Rape is never something that doesn’t matter. Perhaps if we acted like it mattered more, those who were rape survivors would not be more subject to a plethora of mental illness.

That’s why rape is a subject this Mental Health Month. Because the link between rape and mental illness exists. Rape can among other things, be a cause or contributing cause or exacerbation of; PTSD, Anxiety, Eating Disorders, Depression, Phobias, Suicidality and Suicide, Cutting/Self-Harm and many other conditions.

We’ve talked in earlier posts about how that doesn’t diminish the very real and medical ‘illness’ of mental disorders, and just because an act pushes someone toward feeling a certain way, does not decrease the legitimacy of the illness part of any mental disease. Illness can and is caused by trauma, and there are few things more traumatic to a girl or woman (or boy or man) than rape.

Perhaps though there is one thing worse and that is not being believed, or the act of rape being diminished or ignored.

I hope most of you have watched The Hunting Ground, a documentary on Campus rapes here in America, but if you have not yet, and you have children, know college age kids, or people who work on campuses, it is compulsory viewing not to be missed.

Ultimately the numbers of rapes committed in any situation are underreported, under prosecuted, and not punished. Some judges do not believe a rapist should go to jail. It is often said ‘but he’s such a good boy and he has his entire life ahead of him’ and this stands as a perfectly reasonable explanation for not giving a rapist a harsher sentence.

The other big let-down as far as rape in the legal system goes, is that rape has a statute of limitations and thus, if five years pass and you do not report your rape you are not protected under the law anymore and cannot prosecute your rapist. This is not true for many other crimes including murder, and financial embezzlement. In other words, you can prosecute someone for stealing from you years later, but you cannot prosecute someone for raping you after a certain time period. Great message you’re giving the survivor!

In the interest of fairness, it should be pointed out this exists because the likelihood of having proof after five years is diminished and it is to protect those falsely accused many years later. But that relies upon a significant swath of false accusations and assumes that proof must exist to punish a rape rather than taking the word of the survivor. Therein lies the rub. It is a difficult subject to prosecute when it’s one person’s word against another and historically women have not been believed over men who were upstanding and respected in the community. So if you’re a prostitute and you are raped by a politician, don’t expect anyone to believe you.

Maybe we cannot do enough about this to change it entirely, but speeding up the rate of prosecution cases, ensuring all rape kits are tested (when so many lie untested due to lack of funding) ensuring the survivors are not ‘blamed’ during their legal ordeal, and educating everyone about the low figures of false reporting, may make some difference.

As with anything we can find examples of those who cried wolf, but that is literally true of anything human. It is singular to rape survivors that they are accused of ‘making it up’ as if everyone involved knows of 1000 x cases of liars who pretended they were raped for whatever gain. We should as we do with ‘innocent until proven guilty’ assume someone is likely to be telling the truth when they pluck up the courage and report being raped. If nothing else, something is wrong.

No more so than on campuses across America today, where so many young people are raped and do not report it knowing it will not go anywhere, or do report it and find those who raped them are not penalized sufficiently because they are a star football player. This inequality of punishment needs to be eliminated because what you are effectively saying is, you are not worth as much as the rapist or we do not believe your rape mattered enough to punish this person.

Sometimes I have heard people say ‘she’s too ugly to be raped she must be lying’ and awful things like that. I had one person told by a police officer that because she admitted she was gay, she had obviously chosen to ‘try the other side’ for the night when she was dragged along the street at night and raped by a stranger in an abandoned warehouse. Sure. She wanted it.

Seeing why people who survive rape, are at high risk for some kind of short-term mental illness or at high risk for exacerbating a pre-existing one, is obvious when you look at the details of what someone really goes through. The aftermath of rape is nearly always the worst part. We need to bring our ability to empathize and our compassion to the table and treat all rape cries seriously.

I have worked in two Rape Crisis Centers and the second one I worked in, only prosecuted a handful of cases via the authorities, due to the enormous back-log of DNA testing (rape kits) and the desire of the authorities to plea deal rather than prosecute. Let us not forget a plea deal is often a free pass for a rapist and his offense is often knocked down to a smaller crime that will not indicate to someone looking at his record, that he is a serial rapist. Typically those who rape do so again and again, so if we do not incarcerate them, reeducate them and rehabilitate them if possible they will go out and do it again.

Likewise those who are beyond our help are still let out onto the streets along with paedophiles whom they know will re-offend it’s just a matter of time. How does this happen? How can we justify this?

For those survivors who tell others that they were raped, it is on our shoulders to be as supportive and gentle as possible with someone who confides in us. So often rape is a subject of humor and fun making and there is literally, nothing funny about rape.SAAMP2017 (SM)7

https://merrildsmith.wordpress.com/

https://www.rainn.org/

National Sexual Abuse Hotline: 800-656-HOPE

How to respond to a survivor: https://www.rainn.org/articles/how-respond-survivor

 

Mental Health Month “Inferiority”

The next time you come across someone who has a mental illness, consider the following…

We poke fun at people calling them mentally ill (Trump) without really considering the effect such labeling may have on someone who IS mentally ill. In poking fun we are looking to someone we do not respect and saying ‘they’re mentally ill’ by implication, someone we do not respect is mentally ill – this is all bad.

Just like saying ‘he’s so gay’ or ‘that’s so gay’ you may mean nothing by it, (good grief who hasn’t said it at least once?) but it is implying a negative connotion.

White people cannot and rightfully so, use the N word, but black people can because they own the rights to that word over anyone else. Likewise if you are gay, you could say to another gay person ‘you are so gay’ and it wouldn’t be offensive because it’s about who is saying it to who. So the same applies to derogatory statements about mental health. If two people are sitting in a psych ward and say “Trump is mentally ill” that doesn’t have the same emotional fall out as if someone who is not mentally ill makes the claim.

That may be hard to undesrtand but it’s about sensisitivity and it’s just like any category of people. A Native American can make jokes about Native Americans but an Anglo person cannot. Is that Political Correctness run amock? Not really, when you consider the history behind this.

Much as I have heard some awful sexist jokes and the only person who could tell them should be a woman, and not even then. Bottom line; Don’t go there, it’s not worth it.

I would argue, black people are better off NOT using the N word, and the same applies to any group who may use derogatory jokes/statements about their group in jest, it’s probably not very funny. If that’s too PC then so be it, I don’t see it as a detriment to world humor if we reduce how many off-color jokes we tell.

Ultimately what we relate things to says a lot about what we think of them. If we compare mentally ill people to someone they know we despise, then it’s a criticism whether wrapped up in a joke or not. Next time you are tempted to joke about mental illness consider whether it’s really worth the punch line and the laughs, and whether it’s really funny or just a means of exploiting an already stigmatized group of people. If that seems too serious, so be it, mental illness IS serious just like racism is, sexism is, prejudice is.

What does the mentally ill person feel when they hear jokes and put downs related to mental illness? Inferior.

One may say, a person who suffers from a mental illness is already subject to feeling of inferiority and this is probably the case, therefore they are vulnerable to begin with, and every subsequent insult and attack adds to that feeling.

Again, I have heard people lament the ‘weakness’ and over-sensitivity, of mentally ill people. The typical taunt being; “Why do you have to be SO over-sensitive?”

I would argue, what does it take to be a little sensitive around someone you know is going through a hard time? What does it actually TAKE?

There are many people who identify or are HSP (Highly Sensitive People) and this is not always related to mental illness but the two have a relationship because of the difficulty  of being an HSP in a world of mostly harder-nosed types, proud of their ability to not be sensitive, who see any sensitivity as a weakness and are not afraid of saying so.

I’m not going to labor the point about the value of having sensitivity or the obvious detriment to compassion if we do not have any, because I know there are two sides to this, and with such extremes it is unlikely they will agree. I would only ask that less judgement and condemnation exist, permitting those who are sensitive to go about their lives unmolested.

If you are a HSP and have a mental illness, your struggle is often magnified by the accute awareness of your situation and others reactions and responses to you. If someone makes a joke at your expense that wounds you on a deeper level than those who are able to shrug it off. For some, sensitivity is perceived as a weakness of character and their attitude is one of a bully who takes pleasure in seeing the sensitive person react. If you know someone like that, maybe now is the time to call them on that.

The TV show Thirteen Reasons Why may not be a good example of mental illness, and is lacking in many ways, but one truism is the development of hurt in the main character by the insensitivity around her. This can be a determining factor that leads to the taking of your own life, as in her case. I would argue that she also hurt others, and this was not explored in the show sufficiently, nor was mental illness really examined which it should have been. But irrespective, it highlights the progression of hurt to someone with presumably a pre-existing mental condition, that acts as a trigger to take her own life.

We can be part of a reason why someone is crushed. We may not realize we have that power, and maybe knowing we do, will make us a worse tormenter, but if we want to avoid hurting others, which I hope most of you do, then considering what our words do to those who are more sensitive, doesn’t take very long, doesn’t cost anything and can literally make such a difference. It can stop someone who already is feeling inferior from feeling so inferior that they see no purpose in going on.

Everyone is equal. Nobody is inferior to someone else until they act badly and show their true colors.

 

Mental Health Month “Friends without benefits”

Friendship.

Watching TV shows, reading books, the influence of an ideal, ‘friends forever’ the friends who are there when you need them, friends for life, friends through thick and thin.

Probably should preface this with “unless you are mentally ill”

Why?

Mentally ill people struggle to maintain life-long friendships and connections. An unkind soul may say “can you blame anyone for not being able to put up with THAT?”

Yes.

One reason mentally ill people struggle is the sense of isolation, loss, abandonment, and judgement, all discussed before. Friendship and ties to the community is the basis for survival for most people. Isolation and rejection can lead to suicide and worsening illness. It is not the duty of anyone to befriend a mentally ill person but equally as a society if we put our rapid judgement aside and turned from only seeking ‘fun happy people’ to socialize with, and gave a little thought to those suffering, our empathy would go a long way.

We are selfish on the whole when it comes to friendships. We don’t want to ‘bother’ too much, we don’t want to make an effort. We want something easy and fun. If it’s not we’re likely to drop it.

But the effort we put into our children, our families, our marriages, should equally be considered when looking at friends in need. If we cannot be a good friend are we even a friend? Or are we just a fair-weather friend?

Many people I have spoken with have talked about how much it hurt to be ‘friend dumped’ and how often this occurs when they are going through a hard time. The worst being, it can compound the already existing feelings of worthlessness and self-blame.

It is not the responsibility of others to take care of mentally ill people but it begs the question … if you are only friends with someone when the going is good, are you really friends? If you only want to be friends with someone without any strings attached and no difficult times, how invested are you? In short, are you even a friend?

Friendship is perhaps an art that is lost on us these days, with our increasingly ‘busy’ lives and selfish preoccupations. But remember, society functions well when all of us care about those in our society. If we simply live for ourselves and give no regard to others and their well-being, are we really the good and giving people we envision ourselves to be?

If we are Christian is this the Christian way? If we are Buddhist is this the way of the Buddha? If we are aiming for empathy and treating others as we would hope we would be treated, are we acting accordingly? What would happen if we suffered from a mental illness? What would we expect?

It is worthwhile considering this. A close friend of mine became incredibly ill with a brain tumor and she observed that she lost many friends, including those who went to her church. It showed her the time observed adage that you know who your friends are in your moments of crisis and need. This is where physical and mental health share something in common, in both instances, people flee the individual like rats from a sinking ship.

Finally we can say this is something both mentally ill and physically ill people experience. But why?

People are afraid of illness. They see someone with a brain tumor and act like it’s contagious. They know it’s not logically but this is an instinctive fear. They want to avoid sadness at any cost, they want to avoid reality at any cost, nobody wants to dwell on the possibility of death. It takes a very strong soul to want to go there.

Consequently at your time of need, the very hour you really need people there, you are deserted. Before I began visiting the hospital regularly I was completely unaware of this, I had no idea how many hospital rooms were emptied of visitors and support systems, how many go without any friends to comfort them in their hour of need.

I recall as a kid going to see a friend who was diagnosed with schizophrenia in the state hospital and how he talked about losing all of his friends. It seems like not much has changed.

And ask yourself this … how much would it take to care?

Recently another acquaintance developed Terminal Stage 4 Ovarian Cancer, when asked, her colleagues, who had worked with her for TWENTY YEARS put off going to visit, until someone posted on Facebook ‘she’s going to die! Go see her before she does!’ and then, the herd mentality took over and everyone went to visit. It was ingenuous and false, and I came to see, these people who had worked with this woman for two decades, really didn’t care, they wanted it over with.

I understand the knee jerk response to death and all things unpleasant, but we’re all going to die, is this how we would wish others to react to us? Empathy means, consideration of how we treat others, as much as how others treat us, and the two are connected by an understanding that it cannot be a one way street. As painful as it may be, supporting those in their hour of need is what makes the world a better place. If we are too busy to attend to that, what does it say about our priorities?

The same applies to the mentally ill. This can literally be a life saver, a life line, a much-needed support network. Suicide often occurs because of isolation and a feeling that the world would be a better place if I were not in it. Surely losing friends and being ignored, adds to that feeling and thus, the reverse is true if loyalty and constancy exist.

Obviously some friendships have an expiry date and that’s okay, that’s the nature of the beast, but if you’ve stopped calling someone because you are fed-up with their mental illness and it’s not ‘fun anymore’ consider this, what would you want if you were going through the same thing? Should friendship simply be about benefits?

Mental Health Month “The Workplace”

Ask many people with mental illness, how’s the workplace? Many will describe the frustrations of trying to work alongside people who either do not know or do not understand the struggles they are going through, the high rates of unemployment, underemployment and patchy employment relating to mental health.

We hear how many working days are lost to mental health, we know this, but as a society we do nothing to improve the resources for those experiencing mental health challenges. Again, for those who have not experienced any mental health issues, they may wonder, what could be so bad as to take people out of the work place?

Where to start? Panic attacks can make going to work feel like a torture. Anxiety can cause reduced career opportunities because of fear, phobias including agrophobia may make it hard to actually venture beyond the house to a place of work, depression may keep a sufferer in bed on days when they are most needed at the office, bipolar can cause a worker to shift from highly productive to shut down over night. Without a full understanding of the complexities of mental disease, your boss is likely as not, ill equipped to handle these things and that is why so many people with mental illness struggle in the work place.

But what are we doing about it?

In recent years, bullying in the workplace has been a topic of discussion and highlights that we have not progressed as far from the playground as we may think. Typically people with mental illnesses are far more likely to be the object of bullying both in the school yard and work place. We hear about work place violence and assume some ‘crazy person’ came and gunned down some innocents, and whilst there is no justification for work place violence, is there any excuse for work place bullying?

It is worth considering this if you work with someone who is being bullied. Stand up for them, let someone know it’s happening, don’t let those tensions get out of hand, and then wonder what you could have done about it after it’s too late and that person commits suicide or brings a gun to work. Equally, if someone is mentally ill and they’re making it hard in the work place let your boss know, so that they (whose job it is) can do their best to resolve the issue.

Let’s look at an example;

One

Jemima is a closeted lesbian who suffers from anxiety. Her work colleague grows suspicious of her ‘life style’ and watches her type in her password, when Jemima is out at lunch, her work colleague ‘hacks’ her email account bringing up private emails of Jemima’s to her girlfriend. The work colleague prints them out and everyone in the office giggles over their content, unbeknown to Jemima. One person in the office feels this is wrong but doesn’t know what to do. What should they do?

This is a true story. The outcome was, nobody did anything, and Jemima ended up leaving her job, feeling that she had no choice after she found out what had happened and experienced severe anxiety and feelings of shame and bullying. Some would blame her for being in the closet, whilst others would understand, sometimes it has to be that way. But what could have changed to prevent this? If one person had stood up and told Jemima’s boss, then thanks to legal changes protecting people’s private-lives, her boss, whether approving of Jemima’s ‘life style’ or not, would be legally bound to act. If they did not act then this could be protested. Additionally, Jemima’s colleague who objected to this hacking, could have told Jemima and urged her to go to HR and report this as a violation. By doing nothing, nothing gets better.

Sometimes when you stand up. You make a difference. It really can take one person to do it, think of Rosa Parks.

Case Two

Jose is Bipolar but feels if he tells anyone at work he will be fired because that’s happened in two previous jobs so he says nothing. When he gets insurance through his job he does not go to see a psychiatrist because he fears his disease being part of his permanent record and worries this will stigmatize him in the future. Consequently he pays for private care and spends a lot of money on medication.

One week he does not have any medication left and doesn’t have the money to replace them. He begins to get the side-effects of not being on his medication including being unable to sleep at night, paranoid thoughts, inability to concentrate and feelings of mania. He is not able to tell anyone what is going on, tries to do his work at home but because of not being well doesn’t do a complete job.

When he returns to work after getting paid and getting more medication his boss tells him he has to let him go because of poor performance. Jose loses his job and now does not have the money for his medication or any health insurance.

What could have been different here?

The American laws concerning healthcare protect us somewhat from workplace discrimination. This is not inclusive and it’s fallible because people can and do make up other reasons for firing their employees. If in doubt speak to the workplace commission in your state about what your rights are, knowing your rights is half the battle. Likewise, Jose’s boss would be breaking the law if he chose to disclose Jose’s health status to anyone else at his work place, so in this sense, choosing to speak to his boss about what was going on, protects Jose more than staying quiet.

The reality is however, that until stigma around mental health is gone, there are always ways to subvert someone based upon prejudice. If your boss is predisposed to thinking ‘everyone with bipolar is a nut-job’ they may circumvent the law and find a way to get rid of you despite your best efforts. Having anyone else on your side improves your chances, as well as letting the proper legal channels know. Ultimately however, not enough is done to self-guard those with mental illness in the work place and this is one failing that needs serious remedy. After all, we need an income to afford health care one way or another, if we cannot get a job, how are we expected to get treated?

The reality of mental illness is many people are in the closet about it, for a plethora of reasons, and until we reduce the stigma and judgement as a society, they have no incentive to come out. Mental illness does not mean you cannot be an asset to any job, but a level playing field means a fair one, where there is no condemnation or presupposition based upon a mental illness diagnosis.

For a GREAT example of mental illness at work – watch the TV series HOMELAND with Claire Danes. It’s one of the most realistic (as far as anything on TV goes) portrayals of the struggle against the system by a young woman with Bipolar 1.

 

Mental Health Month “If you weren’t so lazy!”

We’ve all heard the mom of a teen accuse them of being lazy. If you just did more, you could accomplish xyz.

For a teen who prefers bed to getting up going to school it’s not a big deal. When it’s a depressed person or anxious person who is told this, it’s tantamount to character assassination but how can we tell the difference between laziness and the inertia that is one of the side-effects of prolonged depression?

Laziness is where you don’t want to do something enough to do it.

Inertia is where you may wish to do something but cannot summon what it takes to do it.

And if you are able to get up and do something, then does that mean you’re lazy when you cannot? If you have the strength to achieve one day but not the next, is that saying something about your will power?

With the best will in the world anyone who has had anxiety/depression or some other mental illnesses, will attest, they’d like nothing better than to wake up feeling like they want to go jogging with their friends along the river side, or take a boat ride out on the lake, or read a book they’ve been dying to read, or start fixing up that DIY home-project of replacing the windows.

A lazy person chooses not to do these things, they may not even want to and prefer to have someone else do them.

It isn’t a choice if you simply cannot do it despite every desire to.

But surely if you put more effort in?

The impact those kinds of statements can have is dangerous. What’s the implication? Someone who doesn’t (fill in the blank) is not pushing themselves, making enough effort. Bottom line – failure.

If you are feeling depressed or anxious, chances are you are quite aware already of how disappointing it is, not to be able to do what you want to do. Being reminded of it, doesn’t motivate a person. It is not the same as pulling the teen out of bed because they are sleeping in and wasting the day, and we do a disservice to those who are depressed by thinking they can snap out of it ‘if only they do this’

But like anything it’s a fine line, because on the other hand, allowing someone we care about to be depressed and ‘wallow’ is not the answer either. Numerous studies attest to the benefits of not locking yourself away from others, avoiding the world and stimulation, when depressed. It may feel bad to get out and do things but guaranteed, it is worse to stay home and dwell. The distinction is in how we use language, avoiding blame phrases to ensure we’re not condemning someone inadvertently.

Depression like any disease can lead people to feel ‘half-alive’ and the last thing you want to do when you are half alive is go swimming or BBQ or socialize. Sometimes if it’s really bad there is nothing for it but call in a mental health day and spend it doing something comforting, hoping the crisis will pass. But if you find yourself in a rut, the loathed things may be the very things you do need to try to do.

If someone in your life makes you feel badly for not ‘trying hard enough’ explain to them depression is a consistent effort, of trying to do things others don’t even have to try to do. Help them understand the analogy of trying to push a bolder up a hill single-handed each and every day. Then next time they imply you’re just too lazy, maybe they’ll catch themselves.

Equally, take responsibility, if history proves that getting out even if it seems impossible, may be beneficial in some ways if only to get your blood flowing, try your hardest to make it happen and if you cannot do it today, aim for tomorrow. Never give up.

If the people who are in the lives of those suffering from depression and anxiety stand in solidarity and do not give up on them, there will be less feelings of hopelessness and isolation. Patience really can be a virtue, as well as considering that how and when we say things impacts a vulnerable person far more than we might be aware of.

Lastly, if you’re not able to move from the sofa today, don’t berate yourself, you tried, you did your best for today and tomorrow you’ll try again. If you see life as a series of efforts, you will soon see that some of those efforts pay off and you do keep moving, maybe at your own pace but nonetheless a pace. Don’t try to be like others who are not going through what you are going through, it doesn’t mean you are less than it means you are listening to yourself and your needs and being realistic about things. Motivating yourself as much as you can does work, but holding yourself to impossible standards, usually sets up feelings of failure.

We live in a society that reveres being ‘too busy’ and condemns ‘not being busy enough’ but if we see this as shallow advice and find a balance that works for us, instead of guilting ourselves over not being enough we can stop and appreciate our own rhythm. We are after all supposed to be living, not just running through life. Finding our own pace and avoiding the stigma of being judged for being at a different pace, means less guilt all round.

Mental Health Month “Shame”

SHAME

“Shame on anyone who provokes unnecessary shame.”

For those who have never experienced mental health issues, it may be possible to consider a mentally ill person as wallowing lazily in their feelings of elected sadness. This may provoke a feeling of ‘isn’t it a shame?’ a sense that they are wasting their life choosing to act and behave this way.

Many times the mentally ill person will be quizzed;

Do you work out?

Do you eat right?

Do you sleep enough?

Sometimes those quizzes are not kind queries but have the double-headed effect of sounding like criticisms. The implication being; If you worked out (better or more often) if you ate better (your fault) if you slept well (rather than badly, by choice) you’d not be sick.

I go back to my earlier point, barring cigarette smokers, would we say this to someone who told us they suffered from cancer? (And is it even morally right to condemn a cigarette smoker for his/her part in their disease?).

Who the hell do we think we are?

Well … we think we are the well ones, the ones who have the answers to the malady of elected depression and/or mental-illness. We think this because we have no ability to empathize with a different way of feeling, because we have no experience of it ourselves or we do and we ‘got over it’ so we assume everyone else can.

It’s worth noting, there are differing types of mental illness (no shit Sherlock!) and of those, differing degrees and/or cause/effects. By this I mean the following;

If you are raped, you may suffer depression, anxiety, flash-backs and PTSD afterward. If you don’t that doesn’t make you stronger. If you do that doesn’t make you weaker. Those symptoms may go in a short time, they may persist, they may last ages. It will depend upon a myriad of factors, mainly, whether you had a pre-existing mental illness or not.

If you are already anxious and depressed and you are raped, then it stands to reason, it will exacerbate pre-existing symptoms. If you are not anxious and depressed and you are raped, you may have fewer symptoms because you are not adding to an existing list of symptoms. Again, taht doesn’t reflect how strong you are.

See it this way … if you have an auto immune disease like thyroid, you are at higher risk of getting another auto immune disease. That’s because whatever propensity predisposes you to the development of the auto immune disease, makes you vulnerable to others because they work similarly as they have ‘auto immune’ in common.

With mental illness, people with bipolar often experience Borderline Personality Disorder at the same time, and ADHD. People with Depression often experience Anxiety at the same time.

Sounds bad?

The propensity is by no means a death sentence, it’s just like saying if you have red hair you are more likely to get skin cancer than if you have dark skin, but dark skinned people CAN get skin cancer and not every red head does. Propensity is not a certainty as there are other (epigenetic) factors at play as well as our friend CHANCE.

And chance, almost rhymes with choice – bringing us back to the point. Shame is a choice. It’s a choice we as people who experience mental illness can make, to avoid as much as possible, and it’s a choice people who know mentally ill people can make when they deal with them.

You can choose to treat others as you would wish to be treated. The law of karma let’s call it.

Or you can choose to satisify some blood lust within you and make someone else feel very, very bad. Yeah you have that power, you are almost a super hero – not.

Shame is inextricorbly linked with sexual abuse in childhood, rape, molestation, illness, rejection, certain religions, gender, sexuality and other societal conventions that often it appears, seek to remind us we are not good.

As women we are told, we are dirty if we sleep around.

As children we are told, we are perverted if we masturbate.

As loners we are told, we’re weird because we prefer a book to company.

The list goes on. It’s safe to say, it appears a fond past-time of humanity to judge and to shame. And we don’t have to be in 1600’s Salem!

Just because it’s 2017 don’t think this practice has stopped. We can find it in bullying, which incidentally, is the number one cause of teen suicide. We can find it in work-place bullying which owes a distinction because it affects older people and is growing in prevelency world-wide. We can find it in older populations who are ignored, neglected, considered less important and ‘past it’ to be contributors. We can find it in minority groups and ethnic groups, same-sex relationships, gender roles and identity or lack of, and all the shades inbetween.

My grandmother used to say; People don’t like what they can’t understand and they don’t like difference.

So I guess, if you’re left-handed, queer, red-haired, freckled, hazel-eyed and autistic you might feel left out.

Okay so that’s an extreme but how many of us don’t entirely fit in some way?

You only need to be into one thing others aren’t, or not like wearing dresses, or burn instead of tan, or have darker pigment than your other family members, to experience the feeling of shame imposed upon you by a bizzare set of ideals and rules.

In other words it’s modern society or as I like to call it, torture.

Except this didn’t start just recently, it started when we began to communicate with each other (read Vanity Fair the novel if in doubt) we use shame and shaming as a coping mechanism (attack other before we are attacked) a weapon (divide and conquer) and a tool (defeat the others first, win). Society is a battle-field. For the mentally ill they are easy targets, who among us who struggles to get out of bed in the morning can handle much more?

Even when someone doesn’t know it, they can shame others. It is very common place to say things without meaning them in a bad way. Perfectly ‘good’ and kind people can inadvertantly say something that can be taken the wrong way ‘I wish you felt better!’ and pain ensues.

Obviously you don’t want to walk around on tiptoe when talking to someone who is suffering, but at the same time, just as we should be aware of the sensitivity of other subjects we should consider the sensitivity of how we address depression and other mental diseases.

Not everyone who is bipolar is a mass murderer or school shooter

Not everyone who is schizophrenic will kill their parents

Not everyone who is depressed will jump off Golden Gate Bridge

But some may and those tiny minorities are but the extremes. Beneath those few extremes lie shades of grey. The depressed person who cuts themselves, the anorexic who develops heart problems, the BPD who alienates people and ends up alone, the bipolar or cannot read a book, and so it goes on.

Everyone has something. If we remember that, then we can treat mental disease the way it should be treated, as a disease, an illness, but not the sum of a person, only an element of their whole. Something to be conscious of, aware of, sensitive to, without stereotyping the whole.

The best technique in the world? Listen to what a person has to say. You can learn a lot. And by doing this, you afford an opportunity for your friend to speak about things without a feeling of shame or judgement. In the long run this acts much like talk therapy and can be incredibly cathartic as well as a really good way of realizing, mental illness doesn’t define you.

Mental Health Month “the invisible mentally ill”

Most people when faced with the knowledge someone is mentally ill says

why don’t you just get some help?

therein lies the rub

this writer can attest, ‘getting help’ isn’t as easy as clicking your red shoes together

In the US today there are large portions of what I term ‘shut-in depressives’ those people who are under-or-un diagnosed as suffering from Major Depressive Disorder. They are typically under-employed/unemployed/self-employed or on a pension. They do not factor into many of our statistics in this country. If we added them, imagine how much the landscape of mental health in this country would change? IE; More sick people than we realized.

Why aren’t they counted?

Many times if you aren’t insured by your full-time job you don’t have access to mental health resources. Even with insurance you are severely restricted to how much you can obtain. Individuals with this coverage often fear being discovered and do not use it, or fear the stigma from doctors who if they see ‘anxiety’ on your medical chart, will literally see any illness you have as being psychosomatic (in your head) so … chest pain? Anxiety. Headaches? Anxiety.

My friend who had headaches and was mentally ill was told, it’s anxiety.

It was a brain tumor.

Secondly; Those who are not full-time employees of a company who still insures their workers (and this is growing daily) has to purchase their own insurance. If you consider the cost of say, one of the lowest plans, at $450 a month, a car payment, plus a $8k deductible that has to be paid out of your pocket before you can begin being covered, how many people working say, part-time or a low to medium wage job can afford that? May as well not have insurance!

Of course if you want to pay out $900 a month like a friend of mine, you get great insurance. $900 will also pay for a rented apartment per month.

Thirdly; Those who choose not to go with the self-pay medical insurance are not irresponsible they are normal working folk who cannot afford to pay that much per month. They rely upon pay-as-you-go services like walk-in-clinics. Such clinics cannot refer you up the chain, so they’re great for a sprain or ant bites, not so good if there’s something seriously wrong.

Forth; The ER. The USA has seen huge numbers of people coming into local ER’s with mental health problems, they are second to major car accidents seen at ER’s and typically include the homeless, the low-income, the undocumented, and students. This is a short-term solution. If you are having a manic episode they will pump you full of pills, give you a script, a few lists of people you can follow-up with and send you on your way after a 3 day hold. Given that most state-run hospitals for mental illness were closed in favor of ‘care in the community’ more mentally ill people can be found in jail and prison than anywhere else. Second to that, the streets.

But what we do not consider, are the numbers of invisible mentally ill who fall through the cracks and defy the stereotypes. I will call those people high-functioning mentally ill, by this I do not mean they are ‘better’ than the mentally ill man on the street, but they are able to cover their mental illness a little more, and ‘act’ more functioning. This is the same as a high-functioning alcoholic, and it does in no way suggest those who are not, are weaker.

The high-functioning depressive is typically older. We hear a lot about teen depression because of the higher rates of suicide upon early diagnosis among teens. There are more resources for teens and young people than middle-aged brackets because the two age groups highest for suicide are the very young and the very old.

Where does that leave the 30-year-old mother suffering from postpartum depression or the 35-year-old man who is living in the back of his parents garden in a trailer or the 45-year-old wife who drinks during the day to cope?

The invisible and the high-functioning (because both are not mutually exclusive) walk among us. Typically if you ask them how they are doing they will say ‘fine’ and you will know they do not mean it but you will not ask them more and they will know they do not mean it and will not offer more. Why? Because unlike at 16 when you trust the world to want to listen, a few years down the road you get it, nobody wants to know.

And it’s not just that nobody wants to know about depression it’s that nobody wants to know a depressive, or be friends with a depressive, or be married to a depressive, or date a depressive, or hang out with a depressive.

Does that sound harsh? Do you feel the need to defend?

It’s a harsh truth because if you asked anyone, yourself included, would you rather be friends with someone who is depressive or not, most people statistically check the ‘not’ box. Does that mean if you are dating someone who reveals they are depressed you will automatically dump them? No because you are invested and loyal. But if you went on a dating site, would you choose the profile of someone who says they are depressed most of the time? A few will say yes, and mean it, but the majority, will not.

And that’s the crux of it. It’s a circular self-fulfilling prophecy.

The depressed person – puts off the non-depressed – by their sense of isolation and loneliness – and becomes more lonely and isolated because their depression causes others to avoid them.

So feeling isolated breeds more isolation in effect.

And they still say … snap out of it (like anyone who feels this way, is choosing that for a fun buzz)

Now, to be fair, isn’t it understandable and isn’t it unfair to expect people who are not depressed to ‘friend a depressive’ and be responsible for cheering them up? Sure. But that’s not what a depressed person needs. They know their partner, sister, mom, aunt cannot ‘cheer them up’ because it doesn’t work like that, and neither do magic wands.

What a depressed person wants is the same as what everyone else wants. They want to be accepted for who they are, they want to be respected, they want to be liked, they want to be loved.

But on the other hand they are battling feelings of isolation, alienation, despair, panic, anxiety, fear, nightmares, terror, self-hate, phobias, sensitivity and paranoia.

You may say, well if someone is paranoid then how am I supposed to help them?

Again, it’s not your job to ‘help’ it’s your role if you choose, to be in their life, just like you would anyone else.

For most this is a difficult chore. They find it hard when the depressed person bails on them because they cannot get out of bed, when they have a melt down for no apparent reason, when they are quiet and not talkative, when nothing they do seems to make them happy.

Oh happiness, the illusive demon for the depressed, always out of reach.

Or in the case of the bipolar, there, gone, there, gone, there, gone.

No depressed person or mentally ill person chooses their burden, and yet, the world is intolerant of their disease in a way that is unique to mental illness.

The next question has to be … why? We’ll deal with that in a future post.

So the bottom line is – among us today are many who are invisible to mental health services (of which there are precious few). They are not poor enough for the very lowest income options, they are not well off enough to realistically afford their own insurance, coverage or get a job that will provide that, and as America was founded on the work ethic and our health care was tied to our ability to work this was a problem that bore the need for alternatives, which we now have, but they are so expensive it defeats the point.

Where does the stay at home mom or stay at home wife, or part-time-worker with depression go to get help and treatment that is reliable, cost-effect, consistent and long enough in duration to have any effect?

Having lived in several countries I am in a position to attest, it’s not that much better in other countries. There are more services literally speaking in countries with socialized healthcare but they are so full as to be practically redundant for the complex needs of their societies. I have yet to find a model I would use to base future health care ideals upon.

Then of course you have countries like India, China, Russia, that have a mixed-bag in terms of their approaches to the issue of mental health. For some, it’s almost akin to a crime, for others, admitting it will effectively condemn you to forced inadequate treatments and large-scale stigmatization (more on stigma and shame in future posts) and others socially encourage the condemnation of the mentally ill so that it’s not even discussed and acknowledged.

So as a whole, when we look at all the countries that make up our planet, we are failing to help those who have mental illness, really, really failing. And worst still, there are those among us, who we don’t even know are suffering, who have nowhere to turn, and effectively subsist rather than exist.

You can see them if you look close enough. But most of us don’t want to, or are too ‘busy’ to care. With everything in our ever-busy lives, when do we have time? The only ones who may really try to do something, are going to be our nearest and dearest and for many depressed people there are no nearest and dearest.

What if you are alone more or less and you are mentally ill and you don’t have money, where do you go?

Posing this question to a mentally ill person in the midst of a crisis they are likely as not to say, I’d just give up and take my own life.

Next time you judge someone for being suicidal, consider, have we left many other options for them?