Right Mindedness and Mental FlossingPosted: December 3, 2011
Since my sister came back into my life, I’ve had to do some serious mental flossing to remove build-up about mental illness. You see, mental illness doesn’t happen in my family. Nope, it just doesn’t happen to us. We might do some crazy-ass things but we take ownership of them—we are in control. To say that one of us is mentally ill would be to say that person has lost control. And that just doesn’t happen. Nothing happens to us that is not a direct result of choices we make. What others might question as mental illness, we know is simply willfull snubbing of societal norms. No, we don’t have mental illness in my family, by God—we have bad choices and misbehavior!
When I first suggested to Mom there might be more going on with Jerri than your garden variety addiction, she snapped. “Your sister is a drug addict, plain and simple. She could stop using if she really wanted to. She chooses the life she has. Besides, even if there was something else wrong with her, she brought it on herself. You can’t pump that many chemicals into your system without messing up your mind.”
Never mind that there were all kinds of signals long before Jerri ever popped the first pill. For as long as I can remember, she was terrified of the dark, a fear that did not subside with time. She saw people the rest of us didn’t– a woman in a billowy white gown would enter her bedroom at night and sit on her dresser. Jerri slept in a sleeping bag beside my parent’s bed up until she moved out of the house at 16. If they locked their door, she would lie outside pounding on it and crying hysterically. When she was 19, pregnant with her first child, and temporarily staying with my parents, she again pulled out the sleeping bag. This is so obviously not normal and yet, we all turned our heads and went about our daily business as if nothing out of the ordinary was happening.
What exactly is mental illness? The answer is a source of great controversy. Whole books have been written on it. According to the Collins American Dictionary, Mental Illness is “any of various disorders in which a person’s thoughts, emotions, or behavior are so abnormal as to cause suffering to himself, herself, or other people.” I don’t find this definition especially helpful. “Abnormal”, as I’ve already pointed out, is open to interpretation.
The jury is also still out on what causes mental illness. One current thought is there is both a genetic predisposition and an environmental trigger. You may have certain genetic markers common to people who develop a given illness but unless you are exposed to an environmental trigger which could be tragedy, trauma, or just about anything that causes major stress, you may never actually get sick. I don’t know about the predisposition part, but I suspect that everyone, given the right set of circumstances, has the capacity for mental illness.
There also appears to be a link between abnormal levels of some chemicals (serotonin, norepinephrine) in the brain and mental illness. Many psych meds focus on restoring balance to brain chemicals. I’ve yet to find a detailed explanation for how these chemicals become unbalanced to begin with. Again, traumatic events and other stressors are thought to trigger the process.
Certain medical conditions are also linked to specific mental disorders, hypothyroidism, for example, can cause depression and unclear thinking. One of the first things I did after moving Jerri to Durham was to make her an appointment with an internist. Her lab results showed her thyroid wasn’t making enough of the hormones it’s responsible for. When she takes her thyroid medication, there is a noticeable improvement in her mood and her ability to cope with day-to-day life. There are times when I wonder if the thyroid medicine might be the only one she needs. At some point, we will likely test that theory.
Over the years, Jerri has been diagnosed with bipolar disorder, borderline personality disorder, and substance abuse. She believes she really only has depression and that what has appeared to be manic episodes in the past were actually reactions to various medications. Bryce, her psychiatrist, is not big on assigning diagnoses. He says it’s more important to treat the symptoms than it is to give it a name. What I like about Bryce is he tries to keep the number of meds to a minimum and he is not quick to change them. He also won’t prescribe a med just because she wants him too. Before Jerri moved, her psychiatrist changed her meds every single month and basically prescribed whatever Jerri wanted. Not sure what she was thinking given Jerri’s history with substance abuse and the street value of the schedule 5 meds requested. But that’s a topic for another day.
When Jerri talks about her mental illness, she refers to “not being in her right mind”. After the fact, she knows when she has been there but sometimes, during the episode, she will try to convince me otherwise. I’m getting a feel for it now and can recognize the symptoms of not-right-mindedness. One being she will toss objects to see if I catch them to make sure I’m not a hallucination. Others include paranoia, constantly losing things, psycho-dialing me sometimes 12 times in a matter of hours, staying in bed all the time, not answering the phone, lack of interest in appearance, talking to herself.
One of my first breakthroughs in mental flossing came after watching an early episode of Fringe. Peter Bishop makes a powerful observation about his father, Walter, and mental illness. He says (in essence), “I always thought mental illness was something he was doing to us, to Mom and me. But all along it was something being done to him.” Despite what I was taught to believe, Jerri can’t help what is happening to her. She did not choose it. It chose her.
Another mental floss breakthrough came when I attended NAMI‘s (National Association for Mental Illness) Family-to-Family class. This is a 12 week course designed for people with family members recovering from mental illness. This class kept me sane during the months immediately following Jerri’s move to Durham. NAMI defines mental illness as “biological brain disorders that interfere with normal brain chemistry. Genetic factors may create a predisposition in some people, and life stresses may trigger the onset of symptoms.” Given what I’ve learned about the impact of the thyroid and how psych medicines work, there is no question it is biological or that it involves brain chemicals.
Identifying my sister’s illness as a brain disorder helps me approach it differently, more constructively and with less fear.
What I find more helpful than defining mental illness is defining mental health. WHO (the World Health Organization) defines mental health as “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”. WHO does state that it is more than just the absence of mental disorder, however, based on this definition, I think its entirely possible for a person with a brain disorder to achieve mental health. And this gives me hope.
In order to really be there for someone diagnosed with mental illness, you have to get in your own right mind about it. You have to first examine what you yourself believe. You have to bring your beliefs into alignment with what is currently understood about brain disorders and recognize the person is not at fault. It’s like a swing bridge that was open so the tall ships could sail through and is now swinging back into alignment with the road. Sometimes my bridge swings back open and I have to again realign. But for the most part, I’m happy to say my family-ingrained perspectives have sailed.