News Day Tuesday: BLOOM by Anna Schuleit

Hey readers! This week, we’re doing something a little different for News Day Tuesday.

I stumbled across Anna Schuleit’s beautiful BLOOM project from 2003 (yes, I know I’m super late to the party). Today, I want to celebrate that project.

In 2003, artist Anna Schuleit installed 28,000 (28,000! Yow!) potted flowers throughout the psychiatric ward of the Massachusetts Mental Health Center (MMHC).

Anna Schuleit’s installation project was created within the entire building of MMHC, on all floors, inviting former patients and employees, staff, students, and the general public, to re-visit the historic site once more before its closing. There was also a symposium at a nearby venue, and an open forum on the front steps of MMHC, during which the patients were invited to tell their stories. The events were dedicated to the memory of the thousands of patients of MMHC, and included as many of them as we were able to contact, as well as the doctors, nurses, support staff, researchers, students, and the general public. The project was a non-profit effort run entirely by volunteers and all of the events were free and open to all.

Source

As people living with mental illness, some of us with more than one, we know the therapeutic power of telling our stories, of having a voice when we’re so often voiceless. Mindy Schwartz Brown wrote some beautiful poetry about her experiences at MMHC, which you can read here. One poem in particular, “Asylum,” touched me deeply.

ASYLUM
(for Anna)

How did this edifice become “home” to its inhabitants-
the renowned multiply degreed,
the haplessly homeless dually diagnosed,
the walking wounded,
the worried well,
the happy go lucky who cleaned floors,
cooked lunches,
took blood pressures.

How could it contain all of the
the egos,
the disintegrated, the inflated,
occupying one space in parallel play?
MD, SPMI
Ph.D, BPD
MSW, DBT
Tell me in this soup, where does one find one’s ME?

DSM IV, Anybody going for V?
What’s the code for those who close hospitals
then open prisons for the sick?

We all feel so much better now,
knowing our brains are
faulty and we are not.
Structural errors ,
neurotransmittor deficits,
viral origins,
genomic misconfigurations.

So now can we all be friends?
Can we do lunch?
Just as we would with a diabetic?

October 3, 2003

Mindy Schwartz-Brown © 2003

The pain of not being recognized is one we know all too well. The lines “We all feel so much better now, / knowing our brains are / faulty and we are not” struck a chord with me that resonated all the way through my body and down into what some people call the soul.

We are the ones who are forgotten. We are the ones who are hiding in plain sight, not out of our own desire to be invisible, but of the desire of others to make us invisible. We make others uncomfortable, particularly when we don’t outwardly fit the mold of the “mentally ill person.” Whenever I reveal that I have bipolar I and CPTSD to someone, I am typical met with one of two reactions. The person either recoils–the discomfort in their eyes is stark and harrowing–or they tell me how “brave” I am.

I am not brave. I simply live. What choice do I have? I do not want to die, though there are plenty of people who view living with a mental illness as a fate worse than death–and I find that more disturbing than anything going on in my attic. There have been countless times when the hauntings have gotten so noisy that I feel as though my mind may literally split in two. Still, I live. Our lives have worth. We have worth.

I’d like to end by including a few photos of Schuleit’s installation. I spent a great deal of time yesterday perusing the photos and reflecting–not on my own experiences, as I have never been inpatient, but on what others’ experiences might have been like as they lived out their day-to-day at MMHC.

All images above copyright Anna Schuleit.

Tell me your stories, readers. It’s important.

News Day Tuesday: Sick Days

Hey readers! I’ve gotten really bad about posting regularly and as we all know, structure is crucial when you’re living with a mental illness (particularly bipolar disorder). I made myself a super-nifty planner before I started school in January and am actually going to start using it to keep myself on track. What this means for you is that hopefully, I won’t disappear for weeks at a time!

Anyway, today’s article addresses the stigma against physicians taking sick days for mental health. While it focuses on doctors in Australia, the topic is extremely relevant to anyone who has ever taken or needed a “mental health” day. According to the article, doctors (unsurprisingly) feel uncomfortable taking sick days for self-care, even when they begin to feel burned out and can’t deliver their usual level of care to patients.

“I’m completely supportive, but I’ll admit I’ve never been brave enough to take a mental health day,” one doctor said, adding, “How can you dump your workload on a colleague who is going through much the same things as you are?”

– abc.net.au

I find this extremely relatable because I’ve always felt awkward calling into work or needing to leave early because my brain has decided that doing anything other than crying in bed is just not going to happen. It doesn’t happen often, but I’ve always felt the need to claim another reason–usually migraines, which I used to get several times a week–because we’re conditioned to believe that depression, anxiety, and other disorders of the mind are not a valid reason for absences. We’re taught to believe that we need to suck it up and get on with our lives, even if that means hiding in the bathroom to cry or have a panic attack.

Naturally, this poses a huge problem for anyone in the workforce, but it’s especially problematic for health care providers. It’s something I’ve often thought about as my clinical practicum draws closer. How can I best serve my clients if I’m experiencing the same symptoms as they are?

I also fear that even in a mental health facility, where one would expect supervisors to be a bit more sympathetic, I’ll come across as weak or unsuitable for the job because of what’s going on in my brain. There’s an indescribable level of self-loathing and shame that comes with mental illnesses, and I’m sure all of you can relate. It’s the feeling of being less-than, the feeling that you don’t deserve to have a job because some days, you just can’t handle the world. You begin to question everything about yourself–am I being weak or overly sensitive? Am I doing this whole “adult” thing wrong? The fear of losing your job is a constant presence, which only makes things worse.

So what can we do about it? Unfortunately, there’s no easy answer to that question. One would hope that with increased media exposure, employers will become more understanding, although every boss is different and there are zero guarantees.

When I was first diagnosed with bipolar disorder, I loved my job. I was working as an editor at a translation company, but my symptoms were so severe that I actually had what I called my “Oh shit, I cried at work!” kit, which I kept in my desk so I could patch myself up after crying jags. Some of the items included eye makeup, because it’s embarrassing to have streaked makeup after crying (even though I became very good at crying without messing up my face). Although my employer was aware of my struggles, I still lost that job due to absences, which sent me into a horrific downward spiral that took over a year to break.

Since then, I’ve become quite anxious about divulging any information related to my mental health to anyone at any job…and that’s problematic by itself. Why should we feel ashamed of something that’s beyond our control? The answer lies in the stigma.

It’s going to be a long, uphill battle, though the fact that today’s article even exists gives me hope. Exposure and time are the only things that are going to remedy this issue. It’s an unhappy thought, but I sometimes find myself wondering if mental health issues will ever be considered as legitimate as something as simple as food poisoning when it comes to work absences.

I’d like to end on an up note with another quote from the article: “If we can’t help ourselves, how can we help others?”

Self-care is so important, readers. The Compassion Project offers a list of self-care activities that you can check out to build a plan for yourself. Here are some of my favorites.

• Reading
• Baking (I’m a huge stress baker, though I haven’t done it in a while)
• Knitting or embroidery
• Crafting
• Cuddling with a pet
• Going for a walk (which you can even do at work–take a five-minute break to stretch your legs)
• Doing a crossword puzzle

What are some of your favorite self-care activities? Let me know–I’m always looking to add to my list!

As always, readers, stay safe and I’ll see you next week.

News Day Tuesday: Bipolar Awareness Day!

Happy Tuesday, readers! Today (October 4th) is Bipolar Awareness Day, so I wanted to share an article with you that outlines the basic symptoms (for the uninitiated, as I know there are some new readers here) as well as what’s on the horizon in terms of treatment.

First of all, let’s hear about what bipolar disorder actually is. I’m referencing bt.com for the purposes of this tidbit, as the article I found gives a really great Reader’s Digest condensed version of the illness.

National charity Bipolar UK characterise the condition as “a severe mental health illness characterised by significant mood swings, including manic highs and depressive lows”, and note that, “the majority of individuals with bipolar experience alternating episodes of mania and depression”.

According to this article, it takes 10.5 years on average (in the UK) for people with bipolar disorder to be properly diagnosed. The National Depressive and Manic Depressive Association (NDMD) paints a similarly grim picture: it can take ten years or more for a diagnosis to be reached, and 69% of cases are misdiagnosed.

What are the symptoms?

There are two sides to bipolar: mania and depression.

During a bout of depression, it is possible to feel: grumpy, without hope, guilty, self-doubting, suicidal, pessimistic, worthless, lacking curiosity and concentration.

And with mania: elation, full of energy, ideas and plans, easily distracted, feeling invincible, risky behaviour including spending huge amounts of money.

Both can feature: lack of appetite, insomnia and delusions.

-bt.com

My experience began very early. I remember fits of agitation and depression as early as eight years old, which at the time was chalked up to the incredibly rough hand I was dealt–a broken home, a mother who struggled with bipolar disorder herself as well as alcoholism, extreme bullying, and persistent nightmares (which were later diagnosed as a feature of PTSD). NAMI states that rapid-cycling bipolar disorder, the most severe form of the illness, seems to be more common in individuals who begin exhibiting symptoms early in life.

From NAMI.org:

Early Warning Signs of Bipolar Disorder In Children and Teens

Children may experience severe temper tantrums when told “no.” Tantrums can last for hours while the child continues to become more violent. They may also show odd displays of happy or silly moods and behaviors. A new diagnosis, Disruptive Mood Dysregulation Disorder (DMDD), was added to the DSM-5 in 2014.

– See more at: http://www.nami.org/Learn-More/Mental-Health-Conditions/Bipolar-Disorder/Overview#sthash.l0XKtkSy.dpuf

When I was eighteen, I decided to see a therapist and psychiatrist for the intense mood swings that had plagued me for most of my life. I was initially told that my deep depressions were the result of PTSD. I was prescribed fluoxetine (brand name Prozac), which only made the agitation worse. And I was still depressed.

At 22, I relocated to Wisconsin and began the search for something, anything, that would finally help me feel “normal.” The misdiagnoses continued: major depressive disorder, for which I was prescribed Abilify and trazodone. I felt amazing on Abilify for about two weeks, and then I crashed. Trazodone made me a zombie. (Note: It is not atypical for antipsychotics to be prescribed to treat both MDD and bipolar disorder.)

Bipolar disorder is most often misdiagnosed in its early stages, which is frequently during the teenage years. When it is diagnosed as something else, symptoms of bipolar disorder can get worse. This usually occurs because the wrong treatment is provided. Other factors of a misdiagnosis are inconsistency in the timeline of episodes and behavior.

-healthline.com

When I was 24 and in my first “adult job” with health insurance, I found a wonderful psychiatrist who, over the course of several sessions, examined my family history and asked very specific questions to find the root of my illness. At first, I didn’t even think to mention my “up” periods, because even with the agitation and sleeplessness, I actually felt good–and no one goes to the doctor when they’re feeling well. But upon deeper probing, he came to a conclusion: first bipolar II, then, after further investigation and a few weeks of mood tracking in a journal, rapid-cycling bipolar I.

That first year was rough. I cycled so frequently that the days were exhausting. One day, I bounced between depression and mixed episodes several times in a single 24-hour period. Slowly but surely, the medications my doctor had prescribed (venlafaxine/Effexor, lamotrigine, and lithium) began to take effect. I began to stabilize. There were no more florid creative periods, but I was also able to sleep for more than an hour a night for the first time in weeks. My misery began to ebb, and though it didn’t disappear completely (a dysfunctional marriage contributed, among other things), I began to feel like a person again instead of a defective thing that needed to be turned off and fixed.

Aside from pharmaceuticals, NAMI’s website mentions cognitive-behavioral therapy, psychotherapy that focuses on self-care and stress management, and, in rare cases, electro-convulsive therapy (ECT). Learning to recognize the triggers for each type of episode is key; one suggestion offered by the numerous therapists I’ve seen over the years is mood tracking/journaling.

However, I had to stop at one point because, in the heyday of my illness, I began to obsess over the cycles, sometimes tracking up to ten or eleven times a day. Instead of the journaling soothing my mind, I began to worry that I was untreatable. I found my mood journal during a recent move and it was difficult reading, to say the least. But it was also a reminder of how far I’ve come and how much my quality of life has improved since receiving a proper diagnosis.

These days, I’m doing much better. My medications have been adjusted slightly to accommodate the deep depressive episodes I’m prone to during the fall and winter months, but I am proud of myself for being able to recognize that the winter storm was a-comin’. Three years ago, I would not have been able to see the symptoms for what they are: a warning sign and a signal that I need to not only keep up with my medications, but to practice good self-care. In the past, I saw fall and winter as something awful that I had to endure. Now, I realize that I can still enjoy life even when the days begin to get longer and darker. The seasons are no longer a metaphor for the overall “climate” in my head.

How long did it take for you to receive a proper diagnosis, readers? Are you taking care of yourselves as winter approaches? I hope you’re all doing well and staying healthy and safe. And spread the word–this illness is massively misunderstood, even by mental health professionals, so it’s our job to reach out and counter-strike against the misinformation and discrimination.

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My very first column – “Depression: Cancer of the Mind,” published October 15, 2008.

This marks the beginning of a new mini-feature on the blog: Throwback Thursdays. See below for more!

When I was nineteen (and probably manic), I submitted a column proposal to my hometown’s newspaper. Shockingly, they decided to pick it up. It wasn’t a huge reader base—my hometown’s population is somewhre in the 60,000 range—but I was surprised and elated to have the opportunity to share my experiences and put a face to mental illness, which was a big deal in a small city in Iowa.

I had to abandon the project seven months later, when taking a full course load and working two part-time jobs plus an internship became too much; however, I was approached the following summer by two women in my hometown to write a series of articles regarding the transition from high school or college to the “real world.” The series caught the attention of Mental Health America (the Iowa branch) and I was honored with an award and some cash (which, as a poor twenty-year-old college student, was greatly appreciated). 

I’ve kept all of the articles and letters in a box for years. I still pull them out sometimes when I start to feel like a hack or minimize the impact of the things I’ve done. Ultimately, it’s not about recognition or awards (although I must admit that my writerly ego really enjoys being stroked from time to time). It’s about having tangible proof that I was here, that I was able to accomplish something despite having been dealt what most would agree is a fairly difficult hand in life. 

As an existential nihilist, it’s difficult for me to see any inherent meaning in the universe, which I view as absurd and often confusing. But it’s actually a very hopeful philosophy/worldview to have, because it means that each of us has the opportunity to create meaning for ourselves and share it with others. I am slowly beginning to learn that “hope” is a four-letter word, but it’s not necessarily a bad one.

Over the next few weeks, I’d like to share my articles, some memorable stories about my time as a columnist, and perhaps a few of the more poignant letters and emails I received in response to my columns. I’m somewhat mortified by how young my voice is, but I’m reminding myself that it’s an interesting and valuable snapshot of who I was at 19: a girl who wasn’t afraid to put herself out there, who believed she could make a difference in her own small way and was maybe a bit idealistic.

In some ways, I think I am still that girl.

“Depression, cancer of the mind” was originally published on October 15, 2008. My editor had titled the first article, which I’m assuming was because I was too disorganized/cycling too hard to do it myself. I can’t remember who came up with the titles after that; it was probably a mixture. The column appeared every other Wednesday.

Note 1: The features editor decided to give my series a title—Depression: Cancer of the Mind—and a little banner at the bottom, which I thought was the coolest thing ever.

Note 2: At this point in time, I was still diagnosed with and being treated for mild-to-moderate PTSD and general depression. It wasn’t until September 2012 that I was re-evaluated and diagnosed with major depressive disorder, and it was an even longer wait (July 2013) until my correct diagnosis—rapid-cycling bipolar disorder, type I, and C-PTSD with dissociative features—was confirmed and I was able to begin treatment.

Depression, cancer of the mind   Published October 15, 2008

Sometimes people ask me, “How did you do it? How did you make it through 11 years of severe depression without ever once asking for help?”

I guess I can understand their disbelief: I have been through the mental equivalent of hell and come out the other side. I have climbed over Satan’s frozen back, much like Dante traveling through Hell in The Inferno. The only difference is that in this case, “Satan” is the despair trapped inside my mind, causing it to decay slowly from the inside out.

Some say that schizophrenia is the cancer of mental illness, but to an extent, I disagree. It’s true that schizophrenia does kill the mind and allow the sufferer to descend into madness. But just as there are many types of cancer, there are infinite varieties of mental illness that could be considered cancerous.

Depression is one of them.

When you are depressed, most people assume that you will “snap out of it,” even though the stereotypical person living with depression does not leave his or her bed for days, sometimes weeks, at a time. It is every bit as destructive as cancer or diabetes, though even now few people realize it.

I suppose this is because people traditionally fear the unknown, and mental illness, aside from death, is one of the biggest unknowns of all. It can strike anyone at any time. Even those of us living with depression who have found ways to cope and make it through the ending and exhausting days look just like everyone else. Unless you are having a particularly bad bout of depression and feel the urge to run from the room crying (which society views as unacceptable), depression usually goes unnoticed.

It is my hope that by sharing my struggles against the silent suffering associated with depression, others will know that they will be OK, that mental illness is nothing to be ashamed of, and will share this knowledge with others. The more that people know about mental illness, the better; educating the public is the first and most effective step in fighting to tear down the stereotypes.

Something that I would like anyone who has lost hope to know is that you are not crazy, only extremely sensitive to the world around you. You are very brave, but you do not need to suffer alone. There is always help available, and accepting it is not admitting defeat.