Op-Ed: Reform of the U.S. Mental Health System

Op-Ed: Reform of the U.S. Mental Health System
By Michael Gottlieb, B. Sc.
How the Mentally Ill Have Been Abandoned by the Ills of a Society Gone Bad
Note: The opinions expressed in this article do not necessarily represent those of City Voices, its writers or its staff.
Reform of the mental health system in the U.S. was well underway when President John F. Kennedy endorsed this new era in mental health in a 1963 speech. He called for a “bold new approach” in which “reliance on the cold mercy of custodial isolation will be supplanted by the open warmth of community concern and capability.”
One of President Kennedy’s sisters suffered from severe mental illness and back in the 1930s and 1940s they used brain lobotomy. What was Kennedy’s interest or attitude toward the mentally ill and mental health?
Kennedy agreed that locking people away in mental hospitals was inhumane and indecent. He was open to the psychiatrists and activists who wanted local community mental health centers. But Kennedy could not persuade the U.S. Congress to fund that program. So when psychiatric hospitals were closed and the patients discharged, they had to fend for themselves.
Electric shock ‘therapy’ (aka electro convulsive ‘therapy’) was popular for a while. Psychoanalysis seems to have lost out to cognitive behavior therapy and behavior modification therapy. And of course, psychiatric chemical medications. No primal therapy or orthomolecular (nutritional psychiatry) therapy. Those would be the two primary healing tools for mental illness.
President John F. Kennedy tried to introduce compassion into society. However, society seems to operate according to two basic principles: Mindless hedonism (engaging in activities to satisfy personal pleasures and desires, regardless of how it affects or hurts other people, the environment, etc.) and “the ends justify the means.” Helping the severely mentally ill by creating local community support systems (housing, social support, financial support, etc.) did not jive with those values. Hedonism nullified any serious effort to help the weakest and most vulnerable members of society. They were abandoned and left to fend for themselves.
Fountain House is the rare example of a support system for people with severe mental illness. However, they do not focus on therapy or healing. Fountain House is predicated on the concept of having the mentally ill perform useful and meaningful work to give them a sense of dignity, self-worth and demonstrate that the mentally ill can be productive members of society. But they do not focus on healing the terrible wounds afflicting these folks.
These mental ‘wounds’ continue to fester unless they are accessed and healed through primal plus dream therapy, counseling, orthomolecular psychiatry, etc. The mental wounds fester and eventually manifest as serious and severe disease: Multiple sclerosis, arthritis, heart disease, cancers, etc. The premature death rate is directly related to the disunity of mind, heart and body, which eventually breaks down under the ‘weight’ and ‘pressure’ of repressed mental ‘wounds.’
Fountain House is performing a very rare (in our society) and vital service for the mentally ill by providing a support system and a place to work. Founded in 1944 by Michael Obolensky, a former patient, and Elizabeth Schermerhorn, a former volunteer. Fountain House earned the 2014 Conrad N. Hilton Humanitarian Prize, one of a number of awards it has earned since 1996.
Society is also using prisons, jails, the streets, nursing homes, etc. to place the mentally ill. It is a known fact that thousands of mentally ill people are incarcerated in prisons. New York City’s own Rikers Island prison has, over the past decade, housed approximately 4,000 mentally ill men and women at any given time. Harsh jail conditions with their violent culture often cause deterioration in these inmates, which jails are unequipped to handle.
The pharmaceutical companies are making huge profits from selling psychiatric medications. Orthomolecular psychiatry (nutritional psychiatry) is virtually unknown in America. They censored Drs. Hoffer and Osmond.
When President John Fitzgerald Kennedy tried to introduce compassion into our society the U.S. Congress blocked most, if not all, of his legislation. Was that because our federal elected ‘leaders’ (senators and representatives), to a very large degree, mirror and reflect the values and consciousness of the masses of Americans?
The hardened materialism and callous indifference to the pain and suffering of the weakest and most vulnerable members of our society by the masses of our fellow Americans was the primary driving force blocking President Kennedy’s legislative program.
Is making money the primary goal, primary motivating force in our society? 
Making money, greed and callous competitiveness, regardless of how it affects or hurts others, seems to be a major motive of society. But society seems to have descended into the animal world of Darwinian jungle mentality. The idea of bringing healing or providing housing, social support to the mentally ill, or any person for that matter, has been trampled by the mindless stampede of hedonism and selfishness. Society seems to radiate enormous amounts of brutality and cruelty on a daily basis. It is considered ‘normal’ to be uncaring, unfeeling and callous, ignoring those left behind, the mentally disabled, poor, and frail elderly.
What happened? 
Our fellow Americans, with very few exceptions, adopted and believe in the Darwinian jungle values—survival of the fittest. Disabled psychologically and/or physically, this “consciousness” gives way to terrorism, war, theft, crime, hurricanes, droughts, earthquakes, violence, guns, etc. 9/11 could have been a wake-up call. Instead, society ascribed it to “an act of Nature.” 
Any final words?
Keep your eye single on the “I Am” spirit within you. Be more caring, kind and compassionate toward one another, and yourselves. Create solutions that are win-win for all. A little healing goes a long way. “This too shall pass.” Planetary ‘cleansing’ and ‘scourging’ will provide humanity with a fresh start to use free will more wisely. If human nature does not transform to help one another instead of hurt one another, Nature will take its course.

Pullout: “Be more caring, kind and compassionate toward one another, and yourselves. Create solutions that are win-win for all. A little healing goes a long way.” 

Book Ends: "Written Off" by Philip T. Yanos

Book Ends: "Written Off" by Philip T. Yanos
A Column by Kurt Sass
Examining Stigma with a Critical Eye

Dr. Yanos, a Ph. D. and Professor of Psychology at John Jay College, has written a captivating and well-researched book on the history, foundation, and most importantly, the effects of stigma about mental illness. This stigma includes the stigma by others (media, government, community and society in general), but also the stigma mental health consumers place on themselves (Self-Stigma)

Dr. Yanos has certainly put a tremendous amount of time and effort into this book as there are almost 500 references cited. Many of these references point to a current theme: The stigma and misconception (by both society and consumers alike) that once a person has had a psychiatric episode they will never go back to having a normal life.

Dr. Yanos points out many true instances of how this stigma has affected people's lives. The Nazis, for example, started an extermination campaign of their own people who had mental illnesses in 1939 called the T-4 program. The rationale behind this (even advertised in propaganda films) was that these were "mercy" killings and acts of euthanasia, as people with mental illness were incurable.

Another example is the actress Margot Kidder, who was extremely popular from the Superman and other movies. In fact, by the 1980s, she was one of the most popular actresses in the world.  In the 1990s, however, she suffered a psychotic break, which was widely publicized. Although she has not had any episodes in many, many years, she feels that people still think of her only in terms of the breakdown, and that this has hurt her career tremendously.

Of course, it is not only celebrities who have to deal with stigma. Dr. Yanos relayed the story about a single parent in Kansas, who, shortly after giving birth in 2009, experienced a psychotic episode. Her daughter was taken into custody by child welfare authorities. The mother was treated and recovered. She petitioned to regain custody but was denied even though she never abused or neglected her daughter, even while she was symptomatic. The judge in the ruling stated that her condition "is permanent and there is no likelihood the condition can be reversed." She went on to give birth to another child in 2011 and has been allowed to keep custody of that child, but not her first born. As of 2014 things have remained the same.

The last story I would like to share from the book is how stigma from the community can cause mental health consumers to suffer from "Self-Stigma." While doing an ethnographic study in Los Angeles, a sociologist came across the case of an intelligent, outgoing man in his 30s, living in a community residence. Due to all the stereotypes he heard over the years that no one ever recovers from mental illness—although he was no longer suffering from any symptoms of his mental illness—he was desperately struggling and grappling with these negative stereotypes and stated that he had a "futureless future." He feared that he was becoming a "human rock," and that he had no hope. He eventually committed suicide.

Alas, there is hope. Research from the book has shown at least three strategies that have proven to work. The first is Cognitive Behavioral Therapy. The second is a National Anti-Stigma Campaign. (Note: The United States has local campaigns, but not a national one.) The last one is peer support.
I have given just a few examples of the stories showing how stigma can impact people's lives and the names of the strategies most effective in fighting stigma. I highly recommend you read this book to both read more of the stories and to find out how the strategies mentioned above work.

My Mental Health Journey: Stand Up Against Stigma!

By Jacquese Armstrong
I Educate the Next Generation by Disclosing My “Mental Illness”

I’ve lived most of my life literally walking through the valley of the shadow of death. And yet, hope and resilience follow me as if I know the way out. But the one thing I have no hope of changing or getting over is being considered a throw-away person in this society.

These are the words I choose to start the introductory essay in a memoir of essays I call Informed Naivete. One could think that my assertion is a bit skewed or harsh, but these are my thoughts associated with the aftermath of the dreaded “s” word.

Often, I’ve thought that if everyone who has, or cared about someone with, a mental illness stood up against stigma, we would outnumber the rest. Where would the stigma be then? And stigma is real. It can not only make your social life uncomfortable, but it can greatly affect your ability to earn a decent living.

So, why do I choose to disclose my mental health challenges? Why would I publish articles under my birth name, publish a poetry chapbook on my mental health challenges and welcome the chance to speak on mental health challenges and stigma and why am I so adamant about it, knowing what I know?

Although I am a psychiatric survivor of 35 years, I have only disclosed since 2006 when I agreed to be interviewed for a documentary on mental illness and minorities. Now, I have many projects that would be all but impossible to do without disclosing. Of course, it was a journey.

Before 2006, my “mental illness” was my most well-guarded secret. I lost a lot of friends in those first couple of years in the 80s and there were whispers and stares, but then I moved more than once. Because I was still in and out of the hospital, I developed lies and kept them going. 

The lies were used to patch the holes in my resume, explain the eight years it took me to finish college, the many colleges I attended, the disappearances, and the work absences. The world definitely doesn’t make it easy for you to resume the race and the charade becomes a job within itself. It also led to undue stress and anxiety. It fueled my paranoid symptoms, which at the time, were not under control at all. I was always in a state of flux, wondering who knew.

I came to realize that I was stigmatizing myself by living in fear and shame, playing into the stigma game. I asked myself, “How can I call for an end to stigma and discrimination if I am ashamed myself.”

It’s almost like making the decision to go natural with your hair. When I did, it wasn’t popular and it’s still not aesthetically pleasing to some employers. I looked at myself in the mirror one day as I blow-dried my hair and curled it with a curling iron and asked, “What’s wrong with my hair?” This was the day of a huge self-embrace. The 2006 documentary I participated in was another. Looking back, that decision was the beginning of my making sense of this mess.

Self-disclosure provided me with the freedom to come out of the shadows into the sun and be the person my Maker intended me to be; who I am. It was a tremendous boost to my self-esteem.
Years ago, at the age of 34, my grandparents had a discussion with me about my illness. They said, “Jacquese, this is God’s Will for you…you have to accept it.” Then, I thought they were “crazier” than I was, but now I see the wisdom in what they told me.
First of all, you can’t heal from something you don’t accept and you must try to heal. You can fight against it, but in the end, you’re fighting against yourself.

Second, most people want to find purpose and meaning in life. Why am I here? Why am I suffering? For me, if I have to suffer (and I have), then let me help someone else to rejoin society without missing too many steps. Let me enable them to embrace the opportunities I lost because of my challenges.

I started Project Onset, still in its infancy, which is a part of the African-American Outreach program of NAMI-NJ (National Alliance on Mental Illness-New Jersey). Through testimonies from a person with mental illness whose onset happened in college (me), a parent of a college-age student and a mental health professional, young adults and their families receive an education on how mental illness can occur in those crucial years.

In the end, I just want to be able to make some sense of my pain and helping people is the best way I know to do that. So, I educate, motivate and inspire on a grassroots level because I know it’s needed. It is a purpose-filled life, driven by the desire to help eradicate stigma for the next generation of survivors. That is why I make the decision to disclose my psychiatric illness. It helps me to take control of my destiny. I know that only I can control whether I feel ashamed or not. Stigma feeds on shame.

So, imagine if everyone with, or who cared about someone with, a “mental illness” stood. Then, we could all just get back to the business of living. 

How a Car Accident Saved My Life

By LAF
Do You Have An X-Ray To Prove It?

I’m 47 years old, was diagnosed with bipolar around age 25 and ADHD at age 44. Last week I learned that I have the triad: bipolar, ADHD and OCD. For twenty-four years after college I held nine jobs before I became disabled at the age of 44. 

Receiving a diagnosis didn’t change who I was, but it explained a lot. I was overwhelmed yet empowered by the information. I was always told that my behavior, thoughts and words were wrong, and I agreed. I was taken to the doctor twice in my teens for being depressed. Both doctors just said to relax. Now I want to scream from the highest peak, “I have the answer! Maybe now I can change!” But, that’s not how everyone else saw it. Some of the first responses I got were, “Do you have an x-ray to prove it?” and, “The doctor is just trying to get money out of you. Stop taking the medication.”

One of the first aggressive episodes that I can remember was at age 13. I punched a boy and he fell to the floor. I remember an incredible feeling of uneasiness beginning that school year. 

Sophomore year in high school I punched the kid sitting in front of me. My moods were very erratic. I was a quiet student one moment, a raging tornado the next. Words were my most powerful weapons. I spoke before thoughts had a chance to be processed. My insides spun like a hamster wheel. If I wasn’t scared, I had the confidence of Super Girl.

In college I felt progressively worse as I matured and held more responsibilities. I didn’t understand my anger, confusion and almost constant anxiety. I had explosive arguments wherever I went. 

By the age of 20, I was a college graduate and in the workforce. I was very independent and successful at work, but my anxiety and confusion hit a new peak. Everything was thrilling and overbearing at the same time. The obsessiveness was in control. My stomach spun just as fast as the thoughts in my head. People were calling me crazy to my face and behind my back. I agreed with them. 

At the age of 23, I had a car accident that indirectly led me to mental health treatment. I never should have been behind the wheel of a car. I had no intention of being reckless, but I wasn’t being safe either. The car spun around a few times, flipped over and landed on its side. I simply crawled out of the car and waited for the police. 

The orthopedic doctor I saw asked why I was on valium, and handed me the business card of a psychiatrist.

I was originally treated for depression before the diagnosis of bipolar. Once the right combinations of meds were found, I felt for the first time like I had support. I’ve been in treatment with medications ever since. My illness is always with me, but I am better at maintaining my life. If not for that car accident I don’t know where I would be.  

There are people who don’t believe that I have a mental illness. A few weeks ago when I was confiding how I felt, someone said to me, “No. That didn’t happen, you never said that before, that’s not ADHD.” If I had thought to give a report of my daily life for all these years would they still question me?

If I was to “report” the events of an average day it might go like this: “I had an argument with you today in my office. Luckily I realized that you weren’t there before someone walked in and caught me. I think the fire alarm above my desk might be a camera. When I left, I thought the toaster might be on so I went back. After I was in my car I thought the light was on, so I went back. On the way home I ended up in New Bedford. I thought I didn’t lock the gate, so I went back. Home now. Did I spell-check the last document that I emailed? I have to go drive around the block because I may have I hit something.”

Even without complete acceptance (or an x-ray), I’m thankful for my doctor, medications, support group, volunteering, hobbies and the love of my family that allows me to maintain my life with mental illness.

Op-Ed: The Public’s Misunderstanding of Our Disorders

By John
Comparing the Perception of Mental Illness to Cancer

I wish I had cancer. That’s not what I mean exactly. I wouldn’t wish that horrible disease on anyone. What I wish, is that my disorder had the same respect as cancer. In 2010 I was diagnosed as being bipolar and introduced to the world of mental illness. I was also made painfully aware that I shouldn’t tell anyone and that what I had was to be kept in the shadows and not shouted from the rooftops. 

Quick—right now—what month is Breast Cancer Awareness Month? What color is the ribbon? I bet 9 out of 10 people know that it’s October and the color is pink. You know what? That is great. However, did you know May is Mental Health awareness? Only if you or someone you love has a mental illness. If there is a ribbon for mental health awareness, I have no idea what the color is. Just in case that didn’t sink in, it’s more acceptable for men to talk about women’s breast for a month than it is for anyone talk about mental illness. 

All of the hospitals I have visited have cancer “centers.” While the mental health or “Behavioral Services” area is just that, an area. These cancer centers are usually adorned with someone’s name proudly emblazoned across the building. They are proud to have donated money to such a worthy cause. You would probably have to go back 100 years to find a dead artist that would be willing to have their name associated with the mentally ill. The behavioral services are also sometimes lumped in with the same people that are detoxing. That’s right, if you are schizophrenic or bipolar you are housed with the same people that are addicted to drugs whether they have a mental illness or not. They need help too and I’m glad they are getting it, but when you go and get heart surgery are you sitting next to someone drying out? No, they would never dream of combining cardiology with the “crazy people”. 

When researching cancer, one of the big statistics that National Cancer Institute keeps track of is mortality and understandable so. Dying sucks. But, you know what else sucks? Suicide. That’s how we track the mortality rate of mental illnesses. By the way, suicide is the 3rd leading cause of the death in the US among people aged 10-24. If someone dies of cancer we mourn openly. If someone commits suicide we don’t talk about it. 

Have you ever noticed a sign in your neighborhood advertising a BBQ chicken sale to support Dave in his battle with (insert horrible disease here)? Communities rally together to support someone they might not even know. I think it’s wonderful and shows great compassion. However, I’ve never seen a banner in my neighborhood that said, “Hey, support Jeff. He suffers from severe depression and is unable to maintain a job.” “Stop being lazy and suck it up like everyone else,” would be most people’s response as they drove past my fictitious sign.

Lately, I’ve heard the mantra “Stop the Stigma,” which I fully support. However, it’s a gross misrepresentation of the problem. Pitbulls have a stigma. Used car salesmen have a stigma. What people with a mental illness have is a debilitating disease that is misunderstood to the rest of society in the same way that Greeks thought the Earth was the center of the universe. That’s not a stigma, that’s a fundamental misunderstanding of the basic facts. People, society, media and even my family don’t understand the basic facts. It’s like trying to explain what salt taste like without using the word “salty.”

Mental illness is a stigma, don’t get me wrong. I just wish there was a more accurate and severe phrase like, “Mark of shame that you can never speak of, but screams more about who you are than anything you will ever do.” You know something catchy like that. 
My point is that cancer is horrible, but it gets the attention and funding it deserves. Mental illness is also horrible, but it is hidden, misunderstood and left only the dregs of support and usually only after someone has killed himself or herself. I have been struggling for over seven years with my own disorder, often alone. Even my wife, who spends every day with me doesn’t comprehend my struggles. Mental illness is such a sad state that I fantasize about being absurdly successful just so I can talk and advocate about my illness. That’s the level of disdain mental illness carries. One has to have celebrity status to be able to withstand the social prejudice that these disorders have. Until then, I will continue to fake a smile and pray in silence for those worse off that even myself.

“Ten Days in a Mad-House” by Nellie Bly

“Ten Days in a Mad-House” by Nellie Bly
By Carl Blumenthal
How Much Have Things Really Changed Since 1887?
Note: The author's use of “insane, mad, and crazy” is not meant to offend, but rather in keeping with the terminology Bly and everyone else used in 1887. Back then such labels were powerful indictments which could lock people up for a lifetime.
Mt. Holyoke College psychology professor Gail Hornstein lists more than 1,000 mostly obscure authors in her bibliography of first-person narratives about madness. 
(See www.psychologytoday.com/blog/rethinking-mental-health/ for an April 16, 2016 interview with Hornstein by Dr. Eric Maisel.) 
In contrast, a handful of journalists have gained notoriety for going undercover in mental hospitals by faking illness. One such journalist investigated Brooklyn’s Kings County Hospital in 1961. The first and most celebrated journalist to do so was Nellie Bly, who spent 10 days at the Blackwell Island Insane Asylum in 1887 and reported on her incarceration for the New York World.
During a period when many immigrants must have “lost their way” in new surroundings, Bly, who spoke Spanish, claimed to be Cuban in support of her “case.” Given her Irish family came here in the 1790s and grew to financial prominence, this early feminist needed to disguise her nonetheless ladylike airs. Thus she checked into a boarding house for poor working women and acted out the “alienation” which passed for mental illness in those days.
Less remarkable than being declared mad was that once inside the hospital with 1,600 other women, Bly dropped the pretense of insanity, only to be considered crazier than the norm. Why? As we look back, what stands out was not so much the expected deplorable conditions there, but the resourcefulness she exhibited. 
Bly risked punishment advocating for others, yet managed to identify workers who treated patients humanely. Likewise she met women who were sane when they entered with her and a few others who kept their wits despite ill treatment. All the while she pitied the overwhelming majority of “lost souls.” 
She wrote, “Pronounced insane by four expert doctors and shut up behind the unmerciful bolts and bars of a madhouse! Not to be confined alone, but to be a companion, day and night, of senseless chattering lunatics; to sleep with them, to eat with them, to be considered one of them was an uncomfortable position.” 
Uncomfortable indeed. Statements like these allowed the World’s customers to experience the horror of mental illness from a comfortable enough distance so they would continue reading the many installments of Bly’s story.  
In spite of their madness, the inmates, not the staff, were expected to maintain the asylum. When Bly saw the motto on a wall, “While I live, I hope,” (like “work sets you free,” which later adorned the entrances to Nazi labor camps), she thought, “The absurdity of it struck me forcibly. I would have liked to put above the gates that open to the asylum, 'He who enters here leaveth hope behind.'” 
Dubbed “the crazy girl from Cuba” by reporters from whom she hid her identity as a colleague, Bly was clearly exceptional. Why else would she be singled out among the dozens of women sent to Blackwell each day? That her objective reporting was sympathetic to inmates without being sensational—she avoided the wards for “incorrigibles”—probably explains why a grand jury investigated the asylum and the city increased funding for care by $1 million annually.
How long this lasted and whether it made a difference in conditions remains unanswered without more research. Journalists rarely revisit the sufferings of their subjects.

Recollections of Recovery: An Alphabet of Emotions from Anger to Hope

Recollections of Recovery: An Alphabet of Emotions from Anger to Hope
By S.A. Green

Poetically Peeling the Mask of Stigma

Note: The following text is an abbreviated version of “Recollections of Recovery: An Alphabet of Emotions from Anger to Hope” published for the Center of Rehabilitation and Recovery, a project of the Coalition of Behavioral Health Agencies, Inc. in the years after Ms. Green's diagnosis of bipolar disorder.

Anger

When I went to the drugstore to pick up my medication, the pharmacist informed me she could not fill prescriptions for psychotropic drugs. I insisted she was supposed to do so according to Timothy’s Law, state legislation to ensure that insurance companies cover physical health and mental health medications alike.

Perhaps inadvertently, she said, “You’d be surprised at all the things we’re supposed to do that we don’t.”

Betrayal

I wanted a psychiatrist who was not influenced by drug companies. Instead of asking prospective providers where they went to school, or whether they were board certified in psychiatry and neurology, I asked about their relationships with the pharmaceutical industry.

I started to see a psychiatrist who told me he had cut his ties to drug companies. However, one day he suggested an exorbitant formulation of a particular medication.
I told him I was outraged that he wasn’t recommending the regular pill, or a cheap generic. He responded by prescribing an antipsychotic with sedating side effects.

Did he want to muzzle me chemically, like Russian dissidents who received a diagnosis of “sluggish schizophrenia”? I, too, showed symptoms of “perseverance” and “struggle for truth.”

Confusion

Confusion is having more pills to take than you could keep track of if you were normal—and then trying to keep track of them while you are on those pills, and psychotic.

Determination

I remember a morning during an episode of depression, when I couldn’t figure out how to get out of the bathtub. As I struggled, it struck me that it had been easier to write my doctoral dissertation. 

Somehow, eventually, I did it, making little waves. Maybe I did it the way flowers sprout from cracks in the asphalt—cracks I believe they make in their blind struggle to reach towards the sun.

Elation

Being manic had its good sides, especially when I was a square twenty-something who didn’t do drugs. It broadened my experience with the spectrum of elation.

During one episode, I roamed the streets in the wee hours of the morning with a stranger who was used to artificially induced highs. He said, “I don’t know what you’re on, but I wish I had some of it!”

My manic self would think, “But yes, I can bottle it! I can sell spirits of mania in blue glass bottles, each with a message, like the ones sailors toss from a sinking ship, hoping that the message would find a reader. And let me see… these glass bottles at the discount store on the corner are a bargain. Let me order a few dozen, so I can have prototypes on hand for the next convention of behavioral health providers...”

Whether you want to start a business, jump into an affair, plan your presidential campaign, or conduct an imaginary orchestra in your living room, the elation in mania gives you energy, self-confidence, and an infectious happiness that makes people say, “yes.”

Grateful

Although I do not lack self-esteem, sometimes I am surprised my husband married me. It must be difficult to deal with a woman who buys eight wedding gowns on eBay before you’ve even proposed.

I am also grateful because family and friends take me to hospitals in the middle of the night, visit me in psychiatric wards, and insist I see doctors when I think, with manic exuberance, I've never felt better in my life.

And they do one thing more. They prevent me from taking what cripples so many people with mental illness: the sick role.

Glibness

“When do you want to come back to see me?” asked my psychiatrist.

I liked him. He was smart, decent, and genuinely cared about me. Since we lived in a small community, we had “dual relationships,” if not "triple relationships." He didn’t want to complicate matters further, or risk exploiting me, so he never charged me for visits.

We had already established that I wasn’t quite myself, but he didn’t know I had no idea what day, month, and perhaps year it was. I said smoothly, “Oh, I don’t have my appointment book with me. Can I call you?”

Concealing impairment, adaptive at work and at school, but not everywhere, had become an inseparable part of me.

Hopeful

We have images of mass violence welded to mental illness, and disparities in health and mental health care. But we also have peer services, supportive housing, trauma-informed care, crisis respite centers, and more.

I do not foresee an end to stigma and discrimination in my lifetime, but I am hopeful for the next generation. 

Harsh Experiences in the Workplace

Harsh Experiences in the Workplace
By Anne Percy
The Challenge of Returning to Work After a Setback

I am bipolar. This seems to threaten some people. In reality I am one of the gentlest, kindest-hearted people you could ever meet, someone who has never harmed anyone. I have had a variety of diagnoses in the past, including OCD, severe depression and schizoaffective disorder, until I was diagnosed as bipolar I.

I have tried a litany of psychiatric medications to manage my symptoms, some with terrible side-effects and others which worsened my symptoms. Stable on my current meds the majority of the time, I realize they are not a cure, nor am I symptom-free. I attend weekly group therapy, which helps, but individual therapy would help more. Unfortunately, right now, it is beyond my financial means.

I am currently unemployed, due to the effects of bipolar. A vocational rehabilitation counselor has been assisting in my search for a suitable job since April 2013, when I lost a job as a health insurance claims processor, which I held for seven months. My firing was due to a lack of concentration and attention to detail, resulting in too many financial errors when paying claims. I believe more accommodation could have been made on my behalf, since I had just completed six months of training when I was let go.

Prior to that job, I had been unemployed for nearly two years following my resignation from a previous position I held for nearly 11 years. The reason? A hostile work environment created by malicious coworkers. They were aware that I had mental health issues, and, in an effort to get me fired, were trying to cause a mental breakdown. Even though I had done nothing, they became convinced that I was a danger to them because of my mental illness. Eventually, the environment became so toxic, with my employer unwilling to intervene, that I had no choice but to resign and remove myself.

What was said to me would have been considered slander and harassment, but because of my mental illness, it was tolerated and apparently acceptable. Ironically, my employer at the time was a health insurance company that boasted the best health interests of its clients and claimed to promote diversity in the workplace. Apparently, that didn’t apply to those of us who suffer from mental illness. It took months before I could put the experience behind me. It still makes me question what kind of environment I will find at a new workplace. I did what was best for me mentally and emotionally, but at the expense of my finances and employment. In terms of finding work with the financial and other benefits of the job I left, I have never recovered.

When I apply for jobs now, I have been advised not to reveal I have mental illness, which makes explaining what occurred at my last two jobs difficult. I would prefer to honestly admit to having a disease, so as to explain when symptoms inevitably appear and not be such a surprise to my employer and coworkers. It would also be easier to ask for accommodation, if and when I need it, if my condition is known.

It makes me sad to think that if it were a physical disease, there would be no problem admitting to it. Also, I am worried about going through the same things with coworkers at another job should I find one.

In desperation, having had no income or health insurance since April 2013, I applied for Social Security Disability. My attorney filed for a hearing in June 2014, but we have heard nothing since then. Applying for disability was a last resort. I would gladly work, but no one will hire me. Even while waiting for a hearing, I still apply for jobs, hoping that someone will be interested in me and my attributes.

I was not eligible for a subsidy to help pay for health insurance due to having no income, and the state that I reside in did not expand Medicaid, so I am uninsured and pay for medical costs out of pocket. This limits my options for care. Fortunately, the medications I currently take are not as expensive as some I have used previously, which helps.

I am not sure what the future holds. I cannot go on indefinitely without income. I am not looking for a financial windfall, only a means to reach financial stability. Also, there is no guarantee that I will remain mentally stable. I already know that I am unsuited for jobs that I have held in the past. What I am unsure of is exactly what I would be suited for, which even vocational rehabilitation has been challenged to help me discover. I am not opposed to further education, but I would need financial assistance to pay for it, and since I already have one college degree, this seems unlikely. Realistically, several doors are closed to me when it comes to employment.

I hope reading about my experience helps others suffering the same things to realize that they are not alone in this.

Even for Those Who Suffer From Schizophrenia, Life is Precious

Even for Those Who Suffer From Schizophrenia, Life is Precious

By Rebecca Chamaa

I recently read an article titled “Mental illness haunts countless Americans” from the July 14, 2015 Camas-Washougal Post-Record, a state of Washington periodical, where the author said that schizophrenia was “a fate often worse than death.” It turns out the author’s son has schizophrenia. I was so offended by that one statement that commenting on it seemed senseless, but if that author really believes that, and other people really believe that, then I need to step up and write my truth.

Schizophrenia is hard. I win some of my battles with it and I lose some of my battles with it, but I keep on fighting. I want to keep on fighting. I want to keep on challenging myself to do the best I can with a severe mental illness. I have attempted suicide twice and twice my life was saved by complete strangers. I have no words for what those strangers did. The words grateful and thankful will never be enough.

I am happy to be alive. Yes, paranoia, psychosis, social anxiety and panic attacks are difficult to live with, but have you ever seen a sunset over the Pacific, or fallen asleep on your loved one’s chest, or had your spouse kiss you goodbye in the morning as you can smell the coffee they made for you still brewing?

I could write for days about the things in my life which are worth seeing, hearing, tasting, smelling, touching or experiencing. The scent of jasmine can transport me back to Cairo, Egypt and the time I spent there in school before I knew anything about schizophrenia.

It is true that being psychotic is one of the scariest things that has ever happened to me. It can only be described as living your most terrifying nightmares, and it has happened to me repeatedly, and it may happen again at any time. Even knowing that, I wouldn’t give up a minute of the joy, love, discovery, creativity, and life that is possible to take part in when symptoms of paranoid schizophrenia take a rest.

I have symptoms of my illness everyday, and some days are more than a little difficult, but hearing people say that they think living with schizophrenia is worse than death means that they believe there is no value to my life.

Tell my husband there is no value to my life. Tell my family there is no value to my life. Tell my friends and nieces and nephews there is no value to my life.

Just because the author of that article doesn’t want to walk the road I walk, doesn’t mean I don’t want to walk it. I do want to walk it. I want to walk it with everything inside of me. I want to walk it into old age. I want to walk it holding the hand of the man I love. I want to walk it with a passion for all life has to offer.

I have paranoid schizophrenia and I want to be alive as long as possible and experience that first sip of coffee along with the rising sun as many mornings as I am able. If you can’t understand that, then you don’t understand people who have the courage to take the good with the bad and keep moving in the direction of life. Life is worth living even with a severe mental illness. Trust me, I have one.

Pullout: “...hearing people say that they think living with schizophrenia is worse than death means that they believe there is no value to my life.”

The Words That Hurt the Most

The Words That Hurt the Most

By K. Rodgers

We Need to Sensitize and Educate Society About Mental Illness

I know it is coming as it has before and it will again. Those words. It comes in many different forms—whether it is said in conversation or typed on a social media page. It doesn't make the sting of those words any less bearable by a true diagnosed sufferer; a diagnosed sufferer. The words are generally fashioned like so: “I know I have OCD (obsessive compulsive disorder) too! I have to go back and always check to make sure I turned the curling iron off in the mornings even though I know I checked it and I wash my hands so many times a day!” I sometimes think it takes every ounce of my being to not educate everyone and anyone about the real turmoil that my diagnosed illness causes.
It is 2015 and I see no difference in the harshness of these words uttered today than a gay person would have of the phrase “you're so gay” in the 90's when it was most commonly used. The gay community has come such a long way, why must those with mental illness be left in the dust? Are we not worthy of a little dignity and respect? I could easily argue with medical findings that I did not choose this way of life just as homosexuals have argued for years that they did not choose theirs.
Since my initial diagnoses in 2008, I have become very open with my mental illness in hopes that it may help others. I am a sufferer of OCD, which in turn causes anxiety and depression. Some people who often throw these statements around may in fact actually have a true mental illness themselves. For those people I am always hoping that if my story doesn't push them to seek help, something or someone will. For those of us who have pursued the help we need, participated in hours of therapy sessions, and who have gone through a multitude of psychiatrists trying to nail down a stable medication combination, I cringe at these statements.
The effort that goes into therapy, physician appointments, medication combinations and changes, on top of all these thoughts that consume your mind, that cause you to stop your daily life to carry out so-called rituals is enough to drive anyone into a suicidal state. Oftentimes, this is followed by more hospitalizations.

People who are not knowledgeable about the illness, which they claim to have, utter the words, “Suicide is a selfish act.” Clearly anyone who ends their own life is not in a sound state of mind. Those who do not suffer from a mental illness and have never dropped to these depths may not understand that suicidal individuals are not thinking of the act as selfishness but as selfless. Once the thought and plan of suicide enters into one's head, it is very difficult to ever forget that plan. The problem or situation that existed to push one to those thoughts and actions may become better over time, but the ideas or plans stick for a very long time. Perhaps their entire life.
I urge those who are true sufferers like me to try and rise above people and their ignorant words, for they do not know what they say. The uneducated and those who believe themselves mentally ill can only hold us back as a community if we allow them to. I want people to understand us. I wish the world would shine a spotlight on mental illness so that it can be accepted today as so many other things have become accepted in daily life. I believe that a huge movement by the mental health community would help foster acceptance of our conditions. However, I am also aware that there will always be people who are not willing to change their way of thinking and accept their loved ones or friends who are suffering daily.
In summary, I would like to quote a very famous person who is known for her courage and generosity and not by her sexual orientation, in hopes that one day there will be someone famous, generous, and courageous who is seen for their strengths rather than their mental illness. “Be Kind to one another,” Ellen DeGeneres.

Pullout: “I urge those who are true sufferers like me to try and rise above people and their ignorant words, for they do not know what they say.”

Honest, Open, Proud: On Coming Out of the Mental Illness Closet

Honest, Open, Proud: On Coming Out of the Mental Illness Closet

By Carl Blumenthal

Airing Hopes and Fears in an Atmosphere of Support

From the 18th floor of the glittering new Department of Health and Mental Hygiene (DOHMH) in Long Island City, New York’s burgeoning skyscrapers rise like so many peaks and domes of glass, steel and stone. Encased within this hermetically-sealed office tower, even if you were possessed by the proverbial “bats in your belfry,” no one outside would hear you screaming, either by day or night.

Such speculation is apropos, my being at DOHMH on Friday and Saturday, August 6 and 7, for a training on “Honest, Open, Proud” (formerly “Coming Out Proud”), a program of the National Consortium on Stigma and Empowerment, which is based at the Illinois Institute of Technology in Chicago. The six-hour course, facilitated by peers, enables other peers to decide if, when and how to disclose their mental illness to family, friends, employers, co-workers, etc.

Twenty-five of us have gathered in a room small enough to encourage an intimacy reinforced by the nature of our jobs—we are all peer counselors for whom being “honest, open and proud” is a requirement of our work. But that doesn’t mean we always live up to this demanding standard. Here’s a chance to become better at helping other peers decide whether and when they want to publicly “join the club” of those like us who live with mental illness.

Yumiko Ikuta, Director of Rehabilitation Programs in the Bureau of Mental Health, is our host. Jonathon Larson, a psychologist at the Institute of Technology, and Kyra Wilson, an advocate for NAMI of Greater Chicago, are our Honest, Open, Proud (HOP) facilitators. All three are peers, but we wouldn’t know it until they tell us bits and pieces of their illness and recovery stories. 

In the first class we weigh the pros and cons of disclosure, both short-term and long. The group setting allows for an airing of hopes and fears in an atmosphere of support. But the trick is to avoid pressuring the individual one way or another. The emphasis is on choice, whether now or in the future.

If the decision to disclose is a go, then the second class concentrates on the circumstances of that coming out: how, when, where and to whom. Although the curriculum offers a step-by-step approach, there’s plenty of room for improvisation. Jon and Kyra encourage us in both the first and second exercises to use examples from our experiences of being honest, open and proud.

Finally, in the third two-hour class, we design our disclosure statements, a summary of our illness and recovery, what used to be called an “elevator speech” (but in this building would take less than “a New York minute” because the elevators are so fast). The facilitators provide a template to ease our words onto the page and eventually into what we hope will be sympathetic ears.

However, Jon and Kyra don’t stop there. Like a wrestling tag team whose purpose is to engage the crowd as much as each other, they exhort us in the techniques of running good groups, demonstrate those practices, and lead us through a series of role plays. As one colleague tells me, “I’ve been a peer counselor for eight years but no one’s ever taught me how to do this!”

Postscript: While HOP, including all training materials, did not cost us anything—DOHMH graciously provided bagels and sandwiches both days—the benefits are immense. Not only did we learn how to facilitate the program for clients of our agencies, but the process also enabled a group of more or less strangers, albeit all peer counselors, to bond over our shared efforts to do the best for those clients and ourselves. Thank goodness Jon and Kyra blew in from the windy city and Yumiko was there to catch them on the 18th floor! 

For more information about Honest, Open, Proud, see www.comingoutproudprogram.org. If you would like to start a program in your group, contact larsonjon@iit.edu, kyra@namigc.org, yikuta@health.nyc.gov or call Yumiko at (347) 396-7247.

Pullout:  “The group setting allows for an airing of hopes and fears in an atmosphere of support. But the trick is to avoid pressuring the individual one way or another. The emphasis is on choice, whether now or in the future.”

Professional Actors Train Clubhouse Members in Order to Fight Stigma

Professional Actors Train Clubhouse Members in Order to Fight Stigma

Based on fear, misunderstanding or a lack of information about mental illness, stigma may cause people to delay treatment or to experience discrimination in employment, housing and other areas of their lives.

Goodwill Industries of Greater New York and Northern New Jersey, Inc. and Village Playback Theatre have been awarded a National Endowment for the Arts (NEA) grant to support a series of interactive performances designed to decrease the stigma related to mental illness and educate the public in Queens, New York. The prestigious award is part of the NEA’s second major grant announcement for the 2015 fiscal year.

Under the guidance of Village Playback Theatre, selected members of Citiview Connections Clubhouse, a center for adults with psychiatric disabilities operated by Goodwill NY-NJ, will train and perform with the professional actors throughout this project. Performances will be provided to adults with mental illness in shelters, residences, and treatment programs culminating in shows for the general public in May, Mental Health Awareness month 2016.

Note: To learn more, you can contact Russell G. Roten, Director of Citiview Connection Clubhouse at (718) 361-7030 or via email: rroten@goodwillny.org

Recovery From An Illness Best Kept Secret For Now

Recovery From An Illness Best Kept Secret For Now

By Katalin

There Were Many Steps

I attribute my recovery from mental illness to sound psychiatric counsel, positive lifestyle changes and consistent medication management. I have been stabilized for the past ten years, but things were not always this good, particularly before my diagnosis. Although I am delighted with my stabilization, my triumph over mental illness is wrought with certain medical problems due to the side effects of the medication I am taking. However hard these impediments might be, they have not deterred me from leading a rich and full life as a means to combat the negative effects of a possible relapse of my mental illness.

The psychosis I endured snuck up on me quite stealthily. At first it was just some voices here and there, then images and later delusions. I grappled with these bizarre thoughts for about a year until I was admitted to the in-patient unit at Payne Whitney Clinic. It was during my three week stay that I was diagnosed for the first time with late onset paranoid schizophrenia at the age of 44. When I was psychotic, I was very frightened because I knew what hearing voices meant medically—a psychiatric problem. I was also in a state of denial as I had never experienced symptoms before. I was very afraid that if I were admitted to a hospital, I would end up like my father, who also has this disease and has been institutionalized for over 40 years.

Once I was discharged from the inpatient unit, I thought I was home free. My psychiatrist said “not so fast.” I attended PW’s Continued Day Treatment Program where I was immersed for nine months in numerous helpful workshops. I did make some lasting friendships there. Once I was finished with the program I was positive I would be allowed to stay home. Again, not so. My psychiatrist strongly urged me to attend group therapy. I joined a group organized for other schizophrenic patients and was in the group for a year and a half. I was stabilized and ready to move on to a full schedule of extra-curricular activities.

Despite all the hard work everybody does for psychiatric patients at Payne Whitney Clinic, I probably would never have recovered successfully were it not for the medication I take every single day. What has also really helped is that I also stopped drinking and smoking. When I learnt from my doctor that alcohol and nicotine have adverse effects on the chemical interaction of the psychotropic medications and the brain’s chemistry, I decided to quit. Stopping drinking was harder than smoking, but after several attempts, I was able to stop both. Today, I move freely among people who drink and smoke without difficulty. Where I have trouble is with the physical problems I am experiencing with the neuroleptics I am taking. I have gained weight and this has led to some other medical problems. I am watching and managing my medical problems, but compared to the active symptoms of paranoid schizophrenia, these side effects are a small price to pay for my newly discovered “normalcy.”

My psychiatrists who have been treating me in the past were concerned about my lack of structure in my life. What they meant was that they would like to see me busy during the weekday. They were concerned that given my schizophrenia, this would lead to isolation and possible relapse. I have been attending concerts and shows, volunteering in a civic organization, doing my chores and writing. I also work out at a gym 4 days a week.

There are two drawbacks as I see it. One has to do with being unemployed when I am with others who are employed and the other has to do with disclosure about my mental illness. I choose not to disclose my mental illness to most people because of the stigma that is still associated with schizophrenia.

Be that as it may, I have had ten years to master the delicate balance of living in the world of “normals’ and interacting with the mentally ill. Sometimes I feel like I am living the life of a charade, but regrettably I cannot disclose to the public about my mental illness at this time. The circles in which I move are not ready for such a declaration. What I am grateful for are the good people at PWC who show kindness and respect toward people like us. I have never heard anyone call me a wacko, schizo, psycho, crazy, or a lunatic behind my back. And I hope I never will. My experience has taught me that in my transformation from psychotic person to stabilized individual there was something in life that was lost forever, but also tangible things that were equally gained for an eternity.

Letters and Emails to City Voices' Editors

Letters and Emails to City Voices' Editors

There is No Stigma

Stigma is defined as a 'mark of shame' or 'token of disgrace.' Mental illness is not a mark of shame. It is not a token of disgrace. Mental illness is—like many other illnesses—a no-fault disorder. Yet many persons with mental illness believe there is stigma. Why is that? It is because many in the general public are prejudiced against, discriminate against and dislike persons with mental illness. Some with the illness, rather than recognizing the bigotry, prejudice and discrimination in others, believe them and as a result have come to believe there is stigma— that having a mental illness is in fact a 'mark of shame.' Unfortunately, their belief system is encouraged by mental health advocates and organizations that go around teaching there is stigma. This is wrong. People with cancer, gays, African Americans, lefties and others once believed there was stigma to their circumstances for the exact same reason: others discriminated against them. Over time, these groups moved from believing there is stigma to fighting the bigotry, prejudice and discrimination in others. Few believe there is stigma to having cancer, being gay, leftie or African American anymore. It’s time to move on. Mental health advocates should stop teaching people with mental illness that there is stigma. Start teaching there is none. And start fighting bigotry, prejudice, and discrimination in others.

DJ Jaffe

Executive Director, Mental Illness Policy Org.

Loved the Winter Edition

Just wanted to take a moment to compliment you on your latest issue (winter 2015 edition). I was especially impressed with the pieces written by David Scott, "Tooth Extraction Unlocks Bipolar Adventure," and A.J. Johnson, "I've Been Here Before." The two pieces were vivid and illuminating. A.J. Johnson, especially, hits the alienation of being mentally ill on the nail. I hope that these two writers continue to contribute to your publication. Furthermore, both of the aforementioned contributors have inspired me to continue writing my psychological memoir, parts of which I may submit to your publication. Please continue your excellent work!
Craig R. Bayer

Empty Spaces: Pushing Back the Boundaries by Virginia A. Tobin

Empty Spaces: Pushing Back the Boundaries

By Virginia A. Tobin

Reclaiming My Consciousness

Anything or anyone who demands your attention on a daily basis becomes personal to you. Before I became mentally ill, my personal identity was common place to myself and to the rest of society. Since then, my paranoid schizophrenia has demanded my attention generally speaking for approximately 19 years, and has demanded my attention at every level of my life for most of those years. My mental illness has occupied the empty spaces and has pushed back the boundaries so that the gaps of emptiness are much wider than that of a mentally healthy person. I have come to see that being passive about this invites the mental illness to become a parasite larger than the host. The time has come for me to push back the boundaries of emptiness and to allow little room for the uncommon demand.

My symptoms began in 1995, unbeknownst to me, creeping up on me with peculiar occurrences, all culminating in 2007 when I was hearing and seeing ghosts. The onset of my disability seemed to coincide with my one and only marriage to a man I had dated in high school. I only know this in retrospect because I had no clue I was mentally ill until being diagnosed in 2004. My suffering really commenced when my husband left me, without much explanation, after six months of living together as husband and wife. I had a profound feeling of not understanding, which stayed with me, growing for years to come. This feeling of not understanding eventually became about everything that I experienced on a daily basis and thus became MY personal definition of the self.

I would not say that I was lost. I wasn’t. It’s just that this feeling of not understanding became accompanied by beliefs that I adopted to explain the feeling itself. This is where I split from the common understanding of the truth. I began believing that everyone around me was talking indirectly about me or indirectly to me. Following this, I began believing that I knew things that the public did not know about local and world events. Everything I heard, and everything and everyone I met, soon seemed to be a part of a perfect world in which every last detail and generality was previously planned from the license plates of the cars around me to the changing names of countries on the world map. Putting it simply, I recognized everything in the world. It was like experiencing the awesome power of God from a demonic perspective.

One cannot imagine what this felt like, nor understand how demanding this was on my attention. I was in a continuous state of shock and not understanding. This is where my paranoia steps in. I believed that strangers around me knew who I was and that they were all in on some kind of great conspiracy concerning me. I believed that spies from all over the world were watching, listening and following me, that micro-cams were in my bathroom and a tracking device was inside my watch. I don’t know when I started to believe there was an implant in my thumb. This now all seems so gratuitous, of course, since whoever planned the world’s goings on was so advanced.

I was eventually caught be the authorities as only mentally ill people will truly understand. In desperation, I went to the police while I was delusional and traveling around the country thinking now that I was being chased and harassed by the mob. The police sent me to the public psychiatrist where I was officially diagnosed. I immediately noticed that I was now in a different class of people because I was institutionalized. I had just relinquished control of my entire life, as a prisoner would relinquish control to the authorities by being incarcerated. My instincts were correct. This was only to be the beginning of a long span of time spent in and out of the mental institution. It seemed that everyone viewed me as a mentally ill person whose sudden civic duty it was to control and detain. This is how my life crashed.

My paranoid schizophrenia voided my daily experience of true living and settled in with voices from the spirit world. My disability took on a new dimension as voices only came from people in the material world before this. These new voices took my time and my attention so that I was unable to measure my life and at some points unable to measure time. Life events were seemingly non-existent. The value and the meaning of life became shabby. Emptiness was my master and I was its slave.

During the time period directly following my life crashing, I began to finally gain a feeling of understanding through the spirit world voices. They explained a whole new domain of delusion to me which justified everything that I had previously believed. Finally, I began to relax because I no longer felt the desperation of not comprehending.

Currently, I have a more developed understanding and realistic relationship with my disability. The goal is to close the gap of emptiness with a hobby or interest that I can share with others and hopefully earn some money with. The concept that I am pursuing is to teach myself how to make wedding gowns and eventually to design originals. Of course, I will take this very personally as it will redefine who I am by what I think about and do routinely. My attention will be mine again.

The Day My Life Stood On End and Changed Forever by Stephen

The Day My Life Stood On End and Changed Forever

By Stephen

Accepting My Life With Mental Illness

One day, in the middle of drawing storyboards for an advertising job, I picked up the phone, my face drenched with tears, and told my agent that I was in danger of ruining all of our reputations, and to remove me from the agency roster.

Then I drove to a remote Orange County parking lot, locked my car door and marched into the desert.

At some point during this woozy wobbly haze, I was on my cell phone, telling some man that no, I could not make it until Wednesday at 3:00 p.m.

I was finally in a room with someone who seemed to hear me. The words out of his mouth seemed a true response to what I had just said or exhibited, not just like reading off of some cue cards.

Over the next few months it was no work and all therapy.

Although the details varied from doctor to doctor, (PTSD, schizoaffective lapses, clinical depression, etc.) the verdict was clearly unanimous and solidly official. I was broken.

Not a year later, increasing suicidal ideation and time spent glued to the bed turned into admission into a psychiatric emergency facility, followed by a month in, shall we say, a very quiet place with scheduled meds.

I attended groups, slowly trying to get used to the idea of being a member of a community. Surely, it was like being a member of a stranded castaways club, but it was a club.

Even if I didn't feel completely understood in these groups, the beauty of it was that nobody pretended to. Nobody acted like they knew more about my experience than I did, or that my experience was some kind of laziness or put-on.

I haven't experienced as much grief from the “stigma” of mental illness as I have the proselytizing from people who think they can relate to me because they were once really bummed out for having lost some really great job. They've never slept in a bed next to a guy who screamed all night because of the voices in his head. They've never had a med side-effect that made their body feel as though it was trying to shake its skeleton out of it.

I now seem to spend whatever lucid time I have strategizing how to make whatever I'm doing with my day reinforce my recovery, maximize my chances at functionality, at happiness. I seem to do best when working from a "to-do" list. It gives some shape to my day and a sense of measurable accomplishment.

One thing that is a marvel to me is this: before the freak-outs and the meltdowns, I saw gauging this sort of thing as one might with a thermometer. Just how mentally ill are you? What's its level? Is it high? Is it low?

By now, I have been through an astonishing variety of experiences, wildly differing levels and flavors of mental pain, motor functionality, fuzzy thinking, speed wobbles, a mind of firecrackers, foam, wheels locking up, feeling like a glop of tar...the list goes on.

I now live in a one-room cabin duplex in a flood zone in the Northern California Redwoods. I share a paper-thin wall with an angry and volatile neighbor. It is the only place I can afford. I rarely leave the house, and when I do, it is truly an ordeal. I hobble to the kitchen or bathroom with a cane. Bathing is a laborious and bizarre spectacle. Groceries and other goods are purchased online and delivered. Doctor visits are now only for the most urgent and dire instances. I haven't attended a group in nearly a year.

These days, I'm limited to mostly poetry writing. My head can't seem to handle the stress load or sustain the focus to do much in the way of drawing or writing of any real length. I can sometimes play my guitar or keyboard for 15-20 min. at a time. Any more and my brain just locks up.

I take whatever meds are my doctors' current best guess and struggle with my now considerable weight.

My thoughts are mostly dark and it takes effort to repeat more positive phrases during certain types of meditation, but I do it.

I don't sit, wishing and hoping for the restoration of a former quality of life. All I shoot for now is a good day. Sometimes, a good day is made up of a temporary reprieve from pain, a few good laughs from a TV show and getting the dishes done.

My Life As My Very Own “Truman Show”

My Life As My Very Own “Truman Show”
By Lauren
When You Feel Like Life is Being Orchestrated Beyond Your Control
I grew up a very happy, healthy child. I had a loving family and plenty of friends. I always excelled in school and sports and was accepted into college right after high school graduation.
I was a college graduate and gainfully employed by the time I was twenty-two. I had a fantastic love life, an enormous circle of friends, and was having a blast living in the big city of Chicago.
This was my life for the first five years after college, until everything started falling apart. It began at the office.
I started suspecting that my phone calls weren’t real. I thought that hired actors were on the other line and that none of my accounts were actually real. I started spending less and less time with friends and family and more and more time alone. I also started getting what I thought were secret messages in the mail. I wasn’t able to understand what was happening, but the stress became too much and I was unable to keep my job.
I felt completely overwhelmed. I had started to consider telling someone what was happening, but by that point I was hearing voices that told me to keep quiet, and that if I told anyone what was really going on I would be killed. I was certain I had been implanted with some kind of device and was being watched on a hidden closed-circuit television. I knew if I didn’t make a drastic change, something would happen to me.
I decided to sell my belongings and move. I packed my car and got rid of anything that wouldn’t fit, or that might be bugged, and drove to Minneapolis to stay with some close friends from college. They had no idea what was going on.
Things were fine in Minneapolis for a while. I got a new job and was doing my best to save money to get my own place again. It was about six months until I started getting the text messages again. I was also getting emails I couldn’t explain, and the voices came back. By that point I was living with a roommate, I had lost my job again, and was not eating. It got to a point where I was convinced that my roommate was plotting against me, and had plans to murder me in my sleep. I would stay up all night, locked in my room writing and waiting for my roommate to come in and kill me. I would sleep a few hours during the day while she was at work, and the rest of my time was spent walking. I walked nearly twelve miles a day, still refusing to eat almost anything. That was the first time I was taken to the hospital and put in a psych ward.
This went on for another year until the messages, voices, and then visual hallucinations filled my day. I couldn’t hold down a job and sometimes even had trouble speaking. I was back home living with my mom and spending time either sitting in my room in the dark or walking the neighborhood talking to myself.
Because I couldn’t tell anyone what was going on, my trips to doctors and psych wards proved to be mainly useless. It wasn’t until I fled my mom’s house to Los Angeles in the middle of the night in her other car, that I finally got the help I needed.
My oldest and best friend lived in Los Angeles and took me in when I arrived there. She also got me to admit myself into the hospital there, where doctors and psychiatrists were finally able to give me the diagnosis of schizophrenia and give me the medication that would finally help bring me back to reality.
Things are better now. I was on disability for a couple of years, but was recently hired by a great company to do the same kind of work I did before everything started going wrong in Chicago. I also live near my mom, so she helps me when I have bad days.
Deep down, I wish all of this never happened. I don’t feel like myself. I’m much more withdrawn, overweight, and exhausted much of the time. However, I suppose this is better than the alternative. I also feel embarrassed about my diagnosis, but am working on that, too.

A-Slam- The Quiet Room, A Powerful Hip-Hop Musical Interpretation of Lori Schiller's Book The Quiet Room

Don’t Tell Me That I Am Sick

By Jennifer Ray

Coming to terms with my mental illness

I glanced at the clock on the opposite wall, taking a break from staring at a worn patch in the carpet near my feet. It was nearly 5 p.m.; the last time I looked up was about 1 p.m. My only motivation was to determine where we were in the rhythm of the day, to see how much longer I had to bear before I could retreat to my room. There, my eyes heavy from sleeping pills and emotional exhaustion, I could succumb to the only thing that brought relief from my depression: sleep.  It had not taken me long to discover that the most time-consuming activity on psychiatric units was doing nothing other that waiting for something to happen. Waiting to see your psychiatrist, your social worker, your nurse or waiting for a therapy group, for art therapy. pet therapy (if you’re lucky), waiting for a shower, to brush your teeth, waiting for morning meds, afternoon meds, evening meds, night meds, breakfast, lunch, dinner. How did I get here?

My depression during my sophomore year in college was not my first episode. I had gone through periods of depression twice during high school, received antidepressant treatment and counseling, and recovered. I took having a depressive disorder seriously and was diligent about seeking and getting help. I did not share my condition with other people, but I did not feel stigmatized. In an age of depressed Zoloft balls bouncing on the TV screen, depression seemed common in society; a little like having mild asthma or high blood pressure. I never though of myself as someone who was truly “sick”—I saved that term for people with schizophrenia or bipolar disorder, people I assumed spent most of their lives in secluded state institutions, receiving antipsychotics and getting “shock therapy.” If someone suggested I would someday know what it’s like to be in a hospital, to take a plethora of drugs, and to be considered severely and chronically disordered, I would have found the notion bizarre and comical, if not impossible. That was not me.

Near the end of my sophomore year, I noticed some familiar feelings that, in the past, heralded depression. Over the course of a few weeks, I lost my appetite. Things I normally found engaging—reading, being with friends, participating in groups on campus—had no allure. I lacked the concentration to read more than a page or two or even follow a conversation. As my mood sank, family and friends became concerned. I became increasingly depressed and despondent over a matter of weeks, and even though I recognized the symptoms and was educated about treatments, I did not want to admit that I was experiencing a relapse of the disorder I though had ended with my adolescence.

Ultimately, a close friend realized what was happening. Fearing for my safety, he made an urgent appointment with a local psychiatrist; I did not have the energy to protest. The psychiatrist spoke with me about my history, my current symptoms and thoughts of suicide, and determined that I needed to be hospitalized. My recollections of this decision, my admission, and the first few days in the hospital are foggy. My primary emotional response was shock and bewilderment, tempered only by the deadening apathy that engulfed my mood. I couldn’t quite get my head around how things had gotten “this far.”

I was on a locked unit with severely disordered men and women, many acutely psychotic. I was watched constantly by an aide, denied access to my shoelaces, and allowed to make phone calls only from a pay phone in the Day Room. But despite the indignities and trauma of this experience, I can now say it saved my life. I was discharged after a few weeks, not completely over my depression but on the way to feeling well again. I had started treatment and began to feel optimistic about my future. Within a month of getting back to school, I truly felt all this sadness and strife was behind me, and I never imagined that things could become even more challenging and complicated.

Right before my junior year I experienced symptoms that, unlike those during my depressions, I did not find troubling. I was always someone who needed a good nine hours of sleep to feel well rested, but I started getting by on dramatically less. Some nights I would not touch the bed (if I was even home), other nights I would fall asleep for 2-3 hours and then jolt awake, energized and ready to go. My waking hours became filled with frenzied activity—I never felt smarter, more able, or more confident. My thinking was swift and sharp and seemed to reach near superhuman perfection. These feelings continued, but the ecstasy soon devolved into agitation. Every annoyance seemed like a concerted, even conspiratorial, effort to thwart my plans. When my psychiatrist saw me in his office, he knew immediately what was wrong. I was experiencing a manic episode. I was enraged but eventually acquiesced to treatment. New medications—antipsychotics and mood stabilizers—were used to control my mood. Most of my symptoms abated within a few weeks, but the medications left me sedated and feeling somewhat dull. New medications for a new diagnosis: Bipolar I Disorder.

I came away from this traumatic experience dismayed and disheartened, my self-image shattered. I had already come to terms with being a “psychiatric patient.” But during my first manic episode, I was publicly sick in a way I hadn’t been before. I was embarrassed and humiliated. Being told I had a disorder only other people had—“other people” being unfortunates who lived their lives in drug-induced stupors in institutions or group homes compounded my feelings of defeat.

As I recovered, I reevaluated some of those feelings and saw things more realistically. I also met other young adults, through a support group, who struggled with the same disorder. It was enlightening and heartening to hear many of their stories, and they provided invaluable advice and support. My ideas as to what it meant to have a mental disorder shifted largely as a result of these conversations, allowing me to approach my own situation with more hope and strength. I began to see medications and therapy as my toolbox for maintaining a stable life in which I could achieve my goals. This involved tinkering to find the best combination of medicines and trade-offs in terms of putting up with some side effects if my overall health was good.

Coming to terms with having bipolar disorder, and learning how to effectively take care of myself, has been a process of peaks and valleys. After three years of feeling well, I relapsed and experienced episodes of mania and depression. Both required hospitalization and medication changes. Experiencing relapse after a few years of feeling great was a wake-up call. I secretly felt I was somehow past that sort of thing. Since then, I’ve tried to be optimistic while still recognizing that I have a chronic disorder, and the chance of having more episodes in the future is very high for me despite taking medication faithfully. Thankfully, when am stable I have no lingering symptoms. My goal is no longer to avoid getting sick again, but to keep myself stable and healthy for as long a stretch as possible. Despite my disorder, I’ve graduated college and graduate school. I’ve had lasting and meaningful relationships. I live on my own and have travelled widely. My disorder hasn’t defined my life, and despite the inevitable challenges ahead, I don’t believe it ever will.