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Halloween: Damage Control October 28, 2013

Posted by Crazy Mermaid in Insanity, mental illness.
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Halloween’s coming around, and with it comes the worn-out old stories about the mentally ill.  The slasher movies and the guts and gore of the horror-filled inspirational costumes- all coming to a theater near you.

Norman Bates in Psycho, a 1960 horror movie, was inspired by Wisconsin serial killer Ed Gein.  The insane Leatherface from Texas Chainsaw Massacre, a 1974 horror movie, and Buffalo Bill in Silence of the Lambs were both inspired by the same serial killer, a man whose “guilty but insane” conviction landed him in a mental  hospital.  In The Shining, Jack Nicholson gave a good impersonation of a psychotic man.  Dr. Jekyl was clearly insane when he became Mr. Hyde in the 1931 classic Dr. Jekyl and Mr. Hyde.   Then there’s the classic: Halloween, about a young insane murderer who escapes from his Sanitarium (mental hospital) after being locked up for 15 years- ever since he was 6. Over and over the mentally ill are exploited for the benefit of the media.  In fact, out of the top 50 best horror movies of all time, over half involve mental illness. Mental illness is, after all, scary.

Unfortunately for those of us who are mentally ill, the media makes no distinction between delusional people in the middle of a psychotic episode,  insane murderers, schizophrenics, and what I like to call garden-variety mentally ill people (bipolar, depressed, OCD, etc). We’re all, in their collective minds, the same as Ed Gein, the Wisconsin serial killer who inspired both Psycho and Texas Chainsaw Massacre. There’s nothing scarier, after all, than a mentally ill person.  Especially a psychotic one.   It’s no wonder that nobody wants to be identified as mentally ill. Who, after all, wants to be Ed Gein?

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Halloween October 31, 2012

Posted by Crazy Mermaid in Delusions, Hallucinations, Insanity, Psychotic.
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Halloween’s here, and with it comes the worn-out old stories about the mentally ill.  The slasher movies and the guts and gore of the horror-filled inspirational costumes- all coming to a theater near you.

Norman Bates in Psycho, a 1960 horror movie, was inspired by Wisconsin serial killer Ed Gein.  The insane Leatherface from Texas Chainsaw Massacre, a 1974 horror movie, and Hannibal Lecter in Silence of the Lambs were both inspired by the same serial killer, a man whose “guilty but insane” conviction landed him in a mental  hospital.  In The Shining, Jack Nicholson gave a good impersonation of a psychotic man.  Dr. Jekyl was clearly insane when he became Mr. Hyde in the 1931 classic Dr. Jekyl and Mr. Hyde.   Then there’s the classic: Halloween, about a young insane murderer who escapes from his Sanitarium (mental hospital) after being locked up for 15 years- ever since he was 6. Over and over the mentally ill are exploited for the benefit of the media.  In fact, out of the top 50 best horror movies of all time, over half involve mental illness. Mental illness is, after all, scary.

It doesn’t help that the news is filled with extreme cases of mental illness. Teenage kids and adults taking axes to their mothers, beating up complete strangers, etc. are in most cases the result of untreated violently mentally ill people and are  fodder for interesting scary movies.

Unfortunately for those of us who are mentally ill, the media makes no distinction between delusional people in the middle of a psychotic episode,  insane murderers, and what I like to call garden-variety treatment compliant mentally ill people (bipolar, depressed, OCD, etc). We’re all, in their collective minds, the same as Ed Gein, the Wisconsin serial killer who inspired both Psycho and Texas Chainsaw Massacre. There’s nothing scarier, after all, than a mentally ill person.  Especially a psychotic one.   It’s no wonder that nobody wants to be identified as mentally ill. Who, after all, wants to be Ed Gein?

Anosognosia Rears Its Ugly Head (Again) October 17, 2012

Posted by Crazy Mermaid in Hearing Voices, Insanity, mental illness.
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Anosognosia is the term for the most dangerous symptom of mental illness. It’s the belief that you’re not mentally ill and don’t need your meds.  I have been suffering  from this symptom a lot lately.  I have almost convinced myself that my diagnosis is a big mistake and that I don’t need my meds.  If I go off them, my memory and reasoning ability will return, as will my ability to get up at a reasonable hour. I will be employable once again, and because I’m so good at my job, I will easily find a position as a project manager and be back to my beloved profession, building buildings.  All of this is not possible while I’m on my meds.

I know consciously that going off my meds would be a bad idea, but because of this symptom, the concept seems perfectly reasonable.

Unlike many others, I have the sense to discuss my plan with my loved ones.

My sister, when confronted via phone with my idea, told me to open my copy of An Unquiet Mind by Kay Redfield Jamison. It’s a book where Jamison details out what it’s like to have a mental illness. My sister pointed out that Jamison, like me, convinced herself  that she’s the exception to the rule of needing her meds. In her book, she goes off them and repeats her cycle of mental illness, finally coming to terms with it and returning to her meds.  Reading that passage gave me doubts about going off my meds. Maybe that wasn’t the answer, but maybe it was.

If I stop taking my meds, the voice will probably- but not necessarily-return. But I’ve been hearing that voice for years, so it’s not a big deal. In my mind, it doesn’t mean I’m psychotic. I can manage to keep living in the “real” world without my medication as long as I can put up with a voice. My backup plan would be a return to the mental hospital if my psychotic state returned.

Bouncing this idea off my husband brought up a little problem.  If I went off my meds, and a voice returned, wouldn’t this mean I was psychotic again? he asked.  I disagreed. One voice doesn’t make you psychotic. But  if the definition of psychotic excludes hearing one voice, then how do I know when I’ve crossed the threshold into my definition of psychotic again?  How many voices and delusions does it take to be psychotic?  And would I recognize it if it was happening? Therein lies the problem.

Between my sister and my husband, I gave in to their logic and stayed on my meds.  But the battle never ceases.

Sam the Psycho July 8, 2012

Posted by Crazy Mermaid in Delusions, Hallucinations, Hearing Voices, Insanity.
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Walking into the mental illness support group, I was surprised to see two teenage boys sitting side by side in our small circle of chairs. Very few young people come to support groups.

It was clear from Sam’s glassy and brilliant eyes that he was the one with the mental illness, and that his friend, Carl, had simply been the means of Sam’s transportation to the meeting. Later on, we learned that Sam’s mom had actually talked Carl into bringing Sam here. I surmise that Sam wouldn’t get in the car with his mom. Or vice-versa.

When Sam’s turn came to share, he said he was getting more violent against his mom, and that he was having trouble with his relationship with her. His principal complaint was that she didn’t agree with his religious views.

He claimed that he and God were buddies.  He also claimed to be possessed by the devil and demons. He said he was routinely roused from sleep by the demons’ violence against him.  They punched him and pushed him and yanked his hair while he tried to sleep. Oh yeah: and he said he wasn’t mentally ill. He was just possessed.

Initially, he and his friend sat quietly listening to the three of us share our stories. But as time progressed, Sam was increasingly claimed by his invisible friends.  Talking and laughing with them, he faded in and out of our reality.

Sam said he had been taking two anti-psychotics for 2 months. Based on his severe delusions and his statement that he wasn’t mentally ill, I seriously doubt that he was taking his meds at all. His friend said that Sam hadn’t been back to his psychiatrist since he had been given the anti-psychotics. I suspect that was by choice.

Leaving the meeting, I realized the danger Sam’s mother was in. I hoped she had a lock on her door. After all, her teenage son, known to be very angry with her, roamed around the house believing that he was alternately God’s best friend or possessed by the devil and demons. It isn’t a stretch to imagine him slipping into her room at night and slitting her throat or stabbing her as she lay sleeping, convinced that the devil and demons- and maybe God- had directed him to do it. She would be just another dead mother whose soon should have been committed to a mental hospital before he murdered her.

The Case for Insanity May 29, 2012

Posted by Crazy Mermaid in Insanity.
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The case for insanity is compelling

In early February 2008, at the beginning of my traipse into a world of make-believe, I had ESP.  How cool is that? I talked with people in my head.  Powerful people.   Bill and Melinda Gates. The Dalai Lama. Oprah Winfrey.  My (then) bosses. All of these people and more were at my beck and call.

Then there was my job situation.  In my fantasy world, my (real) boss, via ESP, directed me to quit my (real) job.  So I did. Then, via ESP, he begged for my return, promising me more money and better control over my job.  In the meantime, Bill and Melinda Gates offered me a job at The Bill and Melinda Gates Foundation.  For twice the money.

And yet money had no real value.  I had access to Bill and Melinda Gates’ money.  I had a friend who was a time traveler who could make it so that I had money whenever I wanted it.  Because money meant nothing, I wrote a (NSF) check for  a beautiful, gold, brand new Lexus Convertible car.  Bill and Melinda Gates were going to reimburse me for the purchase as part of my new employment package. I bought a new wardrobe for my new job.

I owned $2 million in jewelry, including a 3 carat yellow diamond in a platinum setting, and an abalone bracelet that had once been owned by my (Mermaid) grandmother.

I talked with trees, dogs, and cats.

Last but not least, I was a genuine Mermaid.  Fish talked to me (literally). I had fins for feet. I had a beautiful tail.

I was beautiful.  I was energetic.  I was wealthy.

Now tell me that mental illness is terrible.

A Journey Into Madness… February 1, 2012

Posted by Crazy Mermaid in Insanity, mental illness.
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A journey into madness begins with the first step. It isn’t a case where you wake up one morning and say to yourself  “Oh no! I’ve lost my mind!”  Rather, it’s more like someone who gains say 25 pounds over the course of one year.  It’s a very gradual thing.  One pound. Then a leveling off for a few weeks. Then another pound.  Then a pound two weeks after that. And so on.

The same with mental illness. One small step towards madness the first day. Maybe you think you can communicate with one person via ESP.  And then a leveling off for a little while, as that small step (communicating with one person via ESP) becomes the new “normal”.  Then a few days later, another person is added to the ESP repertoire. Day after day, another person or two is added to the number of people you communicate with via ESP. Then you start seeing green people. Then zombies. Day after day these small steps play out little by little.  Step upon step, all becoming the next “normal”.  It’s not like a heart attack where you wake up and your world changed overnight.  It’s more like Alzheimer’s or Parkinson’s or some other relatively slow-moving disease where your world changes slowly but surely.

But I won’t kid you here.  The progression of my illness wasn’t in years. It was in months.   I went from being a relatively sane 49 year old professional woman (with no history of mental illness or drug or alcohol use) the first week in February 2008 to involuntary committment to a mental hospital with a full-blown case of Bipolar I with psychotic tendencies at the very end of May 2008. Almost four months from start to finish.

That would seem relatively quickly to some, but again think of weight gain.  You don’t feel every single pound of weight gain on a day to day basis. You don’t feel every single daily aspect of the loss of memory that’s the hallmark of Alzheimer’s. One little change at a time, piled upon the other little changes. And so it goes for insanity.

Halloween and Mental Illness October 19, 2011

Posted by Crazy Mermaid in Insanity, mental illness, Psychotic.
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Halloween’s coming around, and with it comes the worn-out old stories about the mentally ill.  The slasher movies and the guts and gore of the horror-filled inspirational costumes- all coming to a theater near you.

Norman Bates in Psycho, a 1960 horror movie, was inspired by Wisconsin serial killer Ed Gein.  The insane Leatherface from Texas Chainsaw Massacre, a 1974 horror movie, and Buffalo Bill in Silence of the Lambs were both inspired by the same serial killer, a man whose “guilty but insane” conviction landed him in a mental  hospital.  In The Shining, Jack Nicholson gave a good impersonation of a psychotic man.  Dr. Jekyl was clearly insane when he became Mr. Hyde in the 1931 classic Dr. Jekyl and Mr. Hyde.   Then there’s the classic: Halloween, about a young insane murderer who escapes from his Sanitarium (mental hospital) after being locked up for 15 years- ever since he was 6. Over and over the mentally ill are exploited for the benefit of the media.  In fact, out of the top 50 best horror movies of all time, over half involve mental illness. Mental illness is, after all, scary.

Unfortunately for those of us who are mentally ill, the media makes no distinction between delusional people in the middle of a psychotic episode,  insane murderers, schizophrenics, and what I like to call garden-variety mentally ill people (bipolar, depressed, OCD, etc). We’re all, in their collective minds, the same as Ed Gein, the Wisconsin serial killer who inspired both Psycho and Texas Chainsaw Massacre. There’s nothing scarier, after all, than a mentally ill person.  Especially a psychotic one.   It’s no wonder that nobody wants to be identified as mentally ill. Who, after all, wants to be Ed Gein?

Which Medical Condition Is the Worst? July 15, 2010

Posted by Crazy Mermaid in Hearing Voices, Insanity, mental illness, Psychotic, Schizophrenia.
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If you had to guess which medical condition was the worst, which one would you pick?

Most people’s thoughts would go immediately to the most widely publicized, the disease advertised as the most painful and deadliest of all diseases: cancer.  With pancreatic cancer, the victim suffers prolonged agony, relieved only by colossal injections of pain medication, until finally he expires, leaving his cancer-ridden body once and for all.  The worst possible disease, some would say.

Many would choose Alzheimer’s disease as the worst disease.  Your mind slowly loses memory, forgetting things and people and places. Eventually, your heart “forgets” to beat, and you pass on, leaving a wake of pain and suffering by your loved ones.  Because you generally become less aware of your surroundings as time goes by, and because the deterioration happens over years or even decades, the pain and suffering are felt more by your family and friends than you.

Some would say that Lou Gherig’s Disease, also known as ALS, is the worst. Like Alzheimer’s, your body slowly forgets to function, but unlike Alzheimer’s, your mind works perfectly.  The result is a little like waking up in the middle of a surgery, and being unable to communicate to the staff that you are awake. Your body is paralyzed, but your brain is wide awake. Thankfully (or not), death is generally relatively quickly.

Others would say that a stroke is the worst, for reasons similar to ALS. Your mind is generally awake, but your body is unable to communicate that awareness to the world at large. Thinking that your brain has turned to mush because you undergo the humility of wearing diapers and eating baby food,  your family may treat you like you’re a piece of furniture, or as if you’re an infant. Unable to communicate your complete awareness to them, you suffer for years or even decades in silence.

As the worst possible disease, mental illness isn’t even on most people’s radar. But consider, for a moment, the facts.

One of the problems is that unlike cancer, mental illness has a lousy public relations campaign. It doesn’t have a public personality attached to it- at least nobody positive. There’s no Lou Gherig or Lance Armstrong or Stephen Hawking to bring a sense of empathy to the masses. Unlike breast cancer, hundreds of millions of dollars aren’t spent on events to publicize mental illness- events like the Susan G. Komen Walk for the Cure – where the color pink has come to symbolize breast cancer in everything from headbands to hand mixers. Unlike Lance Armstrong’s Livestrong cancer campaign, where yellow bracelets signify triumph over cancer, there is no public campaign for the little plastic bracelet color for mental illness awareness (silver). In fact, because of its enormous stigma, you would be hard-pressed to find many victims and family members willing to take the spotlight for mental illness.

Everyone recognizes that the term “cancer” is a blanket term for a multitude of illnesses all sharing the same basic characteristic: improper cell division. Unlike cancer, the general public doesn’t perceive mental illness as a blanket name for illnesses caused by improper brain chemistry. Both are breakdowns of normal bodily functions, yet cancer doesn’t have the reputation of being a character flaw or a sign of moral bankruptcy that mental illness does.

Patients with cancer are not embarrassed to tell their friends and family their diagnosis. They aren’t afraid of being thought less of as a person for that diagnosis, that somehow they fell short. But with mental illness, the stigma is so great that the fear of rejection and isolation is a legitimate concern.  You just don’t tell anyone.

Because their loved one’s illness isn’t associated with moral bankruptcy and character flaws, friends and relatives of cancer victims don’t have the same incentives to keep anyone from knowing their loved one has cancer. Protecting themselves from the unspoken charge of moral bankruptcy by association isn’t a top concern of the families of cancer patients.

Other diseases, like cancer or ALS or a stroke, don’t cause its victims to commit heinous crimes.  You don’t see a breast cancer victim as the lead-in story on the nightly news because she murdered a bunch of school children. You don’t hear about a stroke victim trying to assassinate the President. A lung cancer victim doesn’t jump off a bridge to get away from the voices in his head. And yet the connection between these types of actions and mental illness, if the news media even bothers to make one, is voyeuristic rather than sympathetic.

People with cancer or ALS or all of the other diseases are aware that they are ill and need treatment for that illness.  In many mental illness cases, this is not true. The mentally ill patient, in many cases, has no insight into the fact that he is mentally ill and need treatment.

No legitimate insurance company would dare decline to authorize or pay  for mainstream treatment of a cancer victim, but most insurance companies have little or no such coverage for mainstream treatment of mental illness, reasoning that it isn’t, after all, a real physical illness. If they do cover it, it’s under a separate policy from “physical” health, called “Behavioral Mental Health”, and the payment for treatment and disability from the disease is very limited.  We don’t see major insurance companies splitting off cancer from a list of diseases, calling it “Cell Divisional Health”, severely restricting its access, and farming out its administration to an entirely separate company.

When it comes time for hospitalization, there isn’t a question of whether a cancer victim or stroke victim even needs to go to a hospital. If they’re seriously ill, a cancer patient doesn’t have to be at death’s door before he’s admitted to the hospital. But a mentally ill victim has to either be about to hurt or kill himself or others (as determined by a third party) or needs to have tried (and failed) to kill himself before a mental hospital will consider admitting him.

If they’re hemorrhaging, but not near death, a cancer patient isn’t turned away for lack of space. Cancer patients don’t have to wait until there’s room for them at a hospital. Unlike hospital space for the mentally ill, hospital space for cancer victims hasn’t decreased over the past 20 years.

Alzheimer’s patients aren’t routinely discharged from hospitals onto the streets, left to fend for themselves. Cancer patients aren’t routinely discharged before they are stabilized. And yet the mentally ill are routinely discharged out onto the streets while they are still unwell all of the time. Who do you think the homeless people are?

The cancer patient doesn’t have to give up his civil rights in order to be treated. He can leave the hospital whenever he wants to. But in order for a mentally ill patient to be treated, he has to give up his civil rights. Mental patients are locked in, physically unable to leave the hospital until someone else- the attending psychiatrist- says they can go- however long that takes.

Once in a hospital, a cancer patient has the option to discontinue medication at any time. Again, a cancer patient doesn’t have to give up his civil rights in order to be treated.  Mentally ill patients, on the other hand, must leave their civil rights at the door when they enter a mental hospital. Whether they want to or not, they are forced to continue medication while they are hospitalized. That is the treatment.

Comparing the physical pain of the cancer or the effects of cancer treatment with the effects of mental illness is in some ways like comparing apples to oranges.  Whereas the cancer victim fights for her life, the severely depressed victim fights to kill herself.  Is the physical pain of cancer worse than the emotional pain of continually hearing voices in your head nonstop? Is radiation sickness worse than lithium side effects?  Is prostate cancer preferable to schizophrenia?

I’m not trying in any way to minimize the pain and suffering that these diseases engender. My point is that each of these diseases –all of them- including mental illness-engenders tremendous pain and suffering. None of them- including mental illness- is any less severe than any other.

For too long, mental illness has been a quiet disease. Quietly terrible, but still quiet.  This is a disease- or a family of diseases- on par with cancer and ALS and strokes, and yet there is a huge vacuum out there. Nobody even thinks about mental illness as a true physical disease. It’s not even on the radar. This needs to change. We need to raise people’s consciousness about mental illness, and give it the parity it deserves.  We’ll know we’ve done our job when “mental illness” takes its rightful place on the list of Terrible Diseases in the public consciousness.

Mental Illness and The Law: How We Got Where We Are June 29, 2010

Posted by Crazy Mermaid in History, Insanity, Involuntary Committment, Mental Hospital, mental illness, Mental Illness and Medication, Psychotic.
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If you want to change things, first you need to understand how they got the way they are.  In the case of mental illness law, politicians and lawyers had the best of intentions, but as with other ventures, the devil was in the details.  The unintended consequences of their actions continue to remain the source of frustration and even danger.

In his 1946 article “Bedlam 1946: Most Mental Hospitals Are A Shame and A Disgrace” http://www.mnddc.org/parallels2/prologue/6a-bedlam/bedlam-life1946.pdf in Life Magazine, Albert Maisel made the case that mental hospitals were terrible institutions.  The final paragraph of his article summarized his point succinctly: “Given the facts…the people of any state will rally… to put an end to concentration camps that masquerade as ( mental) hospitals and to make cure rather than incarceration the goal of their mental institutions.”

While the sentiment is perfectly understandable given the horrific conditions he found when he investigated the state of mental hospitals throughout the United States shortly after the close of World War Two, he threw out the baby with the bath water when he declared, in effect, that nobody should have to be institutionalized.  The wildly popular Life Magazine gave Maisel a platform from which to launch his idea of closing all mental hospitals, also called deinstitutionalizing the mentally ill.

Helping this idea along was the development of the first generation of antipsychotic drugs in the 1950’s. Used to treat schizophrenia and other psychoses as well as acute mania, agitation and other conditions, their discovery allowed many mentally ill people once hospitalized to return to their families, hopefully with their illness under control and able to function as productive members of society in many cases.  In many cases this was true, but not in all.

The advent of these new antipsychotics lent fuel to the fire of the deinstitutionalization movement, and, combined with the publicity of the atrocities perpetuated in the mental hospitals, served to throw the doors to the mental institutions wide open in the mid-1950’s.

From the mid-1950’s to the mid-1960’s, a small percentage of the eventually deinstitutionalized were released. But from that point forward, the trickle became a flood, culminating in the release of the majority of the mentally ill by the mid-1980’s. And as the mentally ill were released from the hospitals, rather than wait to see whether whether the experiment was going to work, those hospitals were closed down forever, shrinking from a high of around 550,000 beds in the mid-1950’s to around 40,000 today. As this experiment failed,the homeless and prison populations of every major city and State ballooned.

In the meantime, California was the first state to pass the Lanterman-Petris-Short Act in 1967, giving the mentally ill the legal right to avoid treatment for their mental illness, regardless of how damaging that mental illness became. Unless the person was in imminent (immediate) danger of severely harming or killing themselves or someone else, they had the right to be left alone, free to wander the streets, homeless and victimized, eating out of dumpsters, lost in their own world. Other States followed their example, with the former Governor of California, Ronald Reagan, leading the charge on a national level as he ascended the highest office in the land, the Presidency.

The mistakes the do-gooders made in this two-pronged approach of first deinstitutionalizing and then arming the mentally ill with the right to refuse treatment were twofold.  Their first mistake was  in perceiving all hospitalization to be bad hospitalization. Secondly they assumed that anyone who has a mental illness has the presence of mind to know when to seek treatment for that illness.

Treating mental illness like any other illness, disregarding the fact that one of the symptoms of the illness can be a failure to realize they are ill, and denigrating all mental hospitals as evil are poor choices for which we have all paid dearly, in the form of the fallout from our endless supply of suicides, the incarcerated mentally ill population, the homeless population, and mentally ill people who attack and assault others.

Until we realize that mental hospitals can also be used for good, and that mentally ill people can’t always help themselves, nothing will change.

(Note:  Part of my research for this article was done with the help of Dr. E. Fuller Torrey’s book The Insanity Offense. (2008).