Tuesday, November 20, 2007

When Friends Slide Over the Edge

Thanks to Sue from Kannsass for this topic. What can you do for friends who are clearly suffering from depression, mania, or whatever mental illness manifestation?

You want to help but how? Your friend has withdrawn to the point that it's interfering with their life or is so out of control whacked out that you can no longer ignore the behavior. Well, not being a mental health professional but someone who has dealt with a sibling who suffers from depression, here's how I handled it.

First of all, tell the person that you love them. That's it. Don't talk any further, just hold them, give them physical reassurance. That goes a long, long way, especially for depressed people. I know myself that when I have been depressed, having someone who just gave me a loving hug did enormous good.

This can loosen up the toughest cases, I think. Once you feel that the person is receptive--you've built trust with the physical contact--then tell them that you are concerned (not worried, don't use that word) about how they feel and that you will support them in any way possible. You want the person to feel positively about getting help. Don't condemn, don't shame, don't get frustrated with their lack of response, even though it's often hard to avoid these feelings when dealing with the mentally ill. Understanding is huge in getting people to face their illness.

However, if the person is completely over the edge and incapable of making a sane decision, it's time to intervene.

If the person is actively suicidal, do not pass Go, do not collect $200. Contact a family member, if you are a friend, and emphasize the seriousness of the situation. Often the family members are the last to know how ill your friend really is. It is a life and death matter, no drama intended. If your friend has no one, call 911 or the local crisis intervention center, and get them hospitalized. Immediately. Don't be afraid of overstepping the boundaries. This person is no longer responsible for their actions.

Suicidal people can hide their intentions quite well, especially if they are bound and determined to off themselves. I know, having worked in a psychiatric hospital, that oftentimes, there are signs so subtle that even professionals miss them. If this is the case, ultimately the person will be successful and kill themselves, with little warning to those close to them. And therein lies the hideous tragedy--those left behind berate and torture themselves for not having "saved" their loved one. Sometimes, you just can't save someone from themselves. They have to have a glimmer of insight in order to pull themselves up from their depths and get the help they need.

Mania is another kettle of fish entirely. People in a severe manic state can do really dangerous, off-the-wall stuff, especially when the condition is severe. Grandiosity is a key symptom, as is paranoia. If your friend is convinced that they need to go to a casino with their life savings because they know they'll win big, you may or may not be able to talk them out of it.

Manics don't listen well. So the best you can do is gently but firmly suggest to the manic friend that their behavior is inappropriate and could cause them a lot of trouble. Their behavior. Not them. Don't say "You are crazy and you'd better stop this right now!" A more effective way of addressing it would be, "You know, your behavior lately has been pretty reckless. I'm concerned that your actions might get you into big trouble. Is there anything that might help? Can I help?"

By and large, helping someone who is in the throes of mental illness can be at best tricky. You can do what you can, but in the long run, the person who is ill either will accept their illness on their own and get help, or they'll be committed to a hospital. Either way, as a friend, just love them, listen, and be there. If you do that, you're a true friend.

Finally, don't be afraid to ask a mental health professional for some guidance for you. In fact, I would do that without hesitation. Because living with and loving someone who suffers from a mental disorder can be a strain on those who are the support system.

Thursday, November 15, 2007

Please, Sir, I Want Some More...Seroquel. And No, I Don't Drink. Really.

I was gobsmacked at the response to the Blog Resurrection. Here I'm thinking that I'm being rather self-indulgent and possibly borderline whiney about doing Swing Time again.

Maybe not. Right now, I'm not the best judge of whether I'm "normal" (or Abby Normal, as we say in my family, with credit to Mel Brooks).

Thanks to Matthew for telling me about the new Crazy Meds link. As you can see, I've been redesigning the blog (easier to read, no?) and I'll be putting the old resource links back up. And Ann, you were so right to let Martin's family know what the deal was.

Guzzle. Ralph. Thump.
Well, one thing I've discovered in my psychiatric travels is that manic depressives are often alcoholics. Self-medicating, dontcha know. Recently, when seeing the crisis intervention pdoc, he gave me a sideways look when I told him that I don't drink. I don't. Here's why.

I had a short but seriously heavy guzzle season back in the mid '90s, when I was a hot-shit NYC editor with a big, fat ego, and I managed to drink my way through many Chelsea bars with my drinking pal, Steve, another editor.

And then after finding myself puking in the Hoboken train station at 1 a.m. one too many times, I stopped drinking altogether. Because yeah, it runs in the family, that alcoholism thing. I was one step away from it, no question.

Previously to that little incident, I was addicted to Oxycodone, due to a painful cervical disk condition. My Dr. Feelgood was an orthopedist who later lost his license to practice medicine because he loved to write prescriptions that were at best questionable. I remember that the first time he examined me, he asked me this: "What kind of drugs do you like?"

Well, what did I know? So he got me hooked on Oxy. Now, mind you, this was in the early '90s, when the Oxy problem was not publicized, and all of us addicts had little trouble getting snockered. Boy, I loved the high I got. It acted in lieu of the psychotropic medication I should have been taking.

So the neck gets better--but now I'm craving the Oxy, its splendiferous high that makes the psychic pain, anxiety, and mania calm down. So I keep telling him it hurts and he keeps giving me happiness and sunshine in pill form. And if I ran out and couldn't get to the office, he very kindly put the Rx in an envelope and taped it to the office door. Because you know, these drugs can't be called in to your local CVS.

I finally realized that I was addicted. And went cold turkey. A nightmare, about which I never spoke about. Not to friends, not to family. I did it alone.

And then it was the alcohol, which happened about four years later. You would think, having been on Oxy and then having to kick it, I would have avoided drinking. Who says addicts are smart people?

The final chapter--hospitalization in 1995, with a diagnosis of bipolar II. It's been changed to bipolar I but I'm not sure that means shit. Take your pick. And during that hospitalization, the pdocs put me into an AA meeting because they didn't believe me when I said I didn't drink. I stood up in the meeting and said, "My name is Marilyn and I'm bipolar. And I don't belong here because I'm not an alcoholic." Since then, I've met several recovering alcoholics who suggested that maybe I did belong there. Because having kicked one addiction made me ripe for another.

I suspect that having an addictive personality and being bipolar go hand in hand. Hey, it's cheap and easy to drink to medicate. These days, I've wised up. And get myself to a pdoc rather than immerse myself in something far more dangerous than taking Seroquel and Lamictal.

Saturday, November 10, 2007

A Year and a Few Tears Later

I stopped writing this blog because I felt that perhaps writing about one's illness might be counterproductive and overly self-involved.

But I was wrong. It is, in fact, productive, and while somewhat self-involved, can put out into the light something that can help other people who suffer from bipolar disorder.

So here we go again.

Rather than dump bipolar stuff on my knitting blog, this is a far better venue. I dislike mixing the two, actually. Manic depression and knitting don't necessarily go together, although I find my color choices often hooked into my mood. Not exactly a revolutionary theory but rather one of a series of epiphanies that I've had about being bipolar.

You know how it is. You read something, it doesn't connect with your state of mind, and then three months later, you go, "Oh, right. That's me."

Now coming out of a nasty bout of dysphoria, I started to think that perhaps keeping this blog alive would add to my need for advocacy.

Let's ride. Not over the edge but backing away from it.