Am I My Brother’s Keeper?

Am I My Brother’s Keeper?
By Anonymous
“911, How can I help you?”
“I’m afraid my brother is going to kill himself. He’s a psych patient, not taking his meds. Says he wants to die. Please send someone before he does something.”
“Has he tried to hurt himself? Is he trying now?”
“No, but I’m afraid he will. He’s been talking about it.”
“OK, we’ll send someone right away.”
Ten minutes later three officers and two EMTs arrive. When I tell the cops what’s going on, my brother yells from the bedroom, “Why’d you do this? There’s nothing wrong with me.”
One of the cops pulls me aside. “Let us handle this.”
My sister and her husband are there too, witnesses to what we all agree is my brother’s dire condition: Depression so severe he’s stopped eating. Only gets out of bed to pee. Apartment filled with garbage. He rejects every choice we give him to change the mess he’s in.
Thus, it takes the crisis team half an hour to convince my brother to come with them to the hospital…or else.
Twelve years before, I faced the same dilemma; only I was the one carted off to a hospital. After a long depression, I had tried to kill myself and the authorities showed up when my wife and a friend called for help.
Here I am committing my brother to a psych ward just as I had been. How can one peer do this to another?
My brother’s OCD and depression have always been worse than my bipolar disorder. He spent years in mental hospitals compared to months for me. Our family alternated between blaming him for his condition and fixing him when he broke down.
As his big brother with a diagnosis, I understood him better but still towed the family line. When he didn’t feel dependent on me, he felt betrayed. This is the kind of double bind that ties families in knots.
His love-hate relationship with our mother consumed both their lives. Since she died three years ago, he’s deteriorated mentally and physically. In the past we’d fight but make up. Now there’s no pleasing each other. It seems too late to change a lifetime of anger and guilt. I’m 67; he’s 62.
I ask myself again: How can I, a peer, think about my brother this way? I’ve tried to treat him with the respect of a peer counselor. He’s smart. We can talk about anything except what he wants to do. Inevitably I lose patience.
How bad can this standoff get? I considered forcing ECT on him when he was in the hospital, a treatment I refused during my last hospitalization. But he gained a little weight and his doctor decided ECT wasn’t necessary…yet.
Now he’s back home and I’m taking care of him. He lies in bed doing nothing and I see myself during my worst depressions—helpless and hopeless.
Do I save him from himself or let him drag me down with him? Or do I leave his life up to him for better or worse? In other words, how do I reconcile being a peer and a brother?

Is the NYPD the Best Response to New Yorkers in Crisis?

By Carla Rabinowitz, Advocacy Coordinator, Community Access, Project Coordinator, Communities for Crisis Intervention Teams in NYC (CCINYC)

Coalition Says the City Needs More Options

Recent police shootings of people in emotional distress have catalyzed our coalition of mental health advocates and organizations to further reform efforts. We testified about needed efforts at a recent City Council hearing, focusing on the need for alternatives to police responding to New Yorkers in crisis. On the day we testified, another NYC resident, Miguel Richards, was shot and killed by the NYPD. He was only 31 years old. Video of his shooting was recently released.

To create change, we need the Mayor to revive the defunct Taskforce on Behavioral Health and Criminal Justice. We need to bring all stakeholders together to build efforts to solve issues of community policing. And, we need the coordination of the Mayor’s office to find non-police alternatives to 911 calls of people in emotional distress.

We are planning a press conference for Wednesday, October 18, at the steps of City Hall in Manhattan at Noon. Everyone is invited to join us as we bring these pressing needs to the media to better inform elected officials.

My Testimony at the City Council Hearing on the NYPD Response to Mental Health Crises
“Thank you to the members of the Council for hearing this testimony today. My name is Carla Rabinowitz. I am the Advocacy Coordinator at Community Access and the Project Coordinator of CCINYC, a coalition of 75 organizations and stakeholders whose mission is to improve relations between the NYPD and the mental health community by advocating for a fully responsive Crisis Intervention Team approach and diverting mental health recipients away from the criminal justice system.

“Community Access is a 44-year-old non-profit that helps people with mental health concerns through quality supportive housing and employment training.

“CCITNYC and Community Access request that you revive the Mayor’s Task Force on Behavioral Health and Criminal Justice. This Taskforce met twice in 2014 and has since been defunct.
“We ask that you recommend the Mayor assign this Taskforce to the oversight of a Deputy Mayor.

“We need all stakeholders and all city and state agencies at the table to suggest alternatives to police responding to these EDP calls. Expanding co-response teams throughout the city, more mobile crisis teams, and pairing mental health peers with police to calm down these encounters are a few ideas to explore.

“Some of the contributions of the Taskforce have already been taken up by the city, including the implementation of CIT training for some members of the NYPD.

“The NYPD training is going well, though there is still a significant need for adequate training.

We ask that at least 15,000 officers be trained, especially since Rikers is closing and there will be more of these encounters. Countless people have been saved by CIT officers. CIT officers saved a child threatening his mom with a knife, and stopped many potential suicides.

“But CIT training alone is not going to prevent these recurring deaths.

“Since the NYPD started CIT training, at least 6 mental health recipients have died in police encounters:

“Mario Ocasio, age 51, in June 2015; Rashan Lloyd , age 25, in June 2016; Deborah Danner, age 66, in October 2016; Ariel Galarza, age 49, in November 2016; Dwayne Jeune, age 32, in July 2017; and Andy Sookdeo, age 29, in August 2017.

“We need to solve issues before mental health recipients get into crisis, and for that we need funding of community services.

“We need alternatives to hospitals, which recipients fear, like Respite care, where people in crisis can learn to recover and get connected to long-term support.

“We need to support the police by building diversion centers to provide a rapid handoff of New Yorkers in acute crisis from police custody to get immediate care and long-term connections to community resources.

“We need community forums with police and mental health recipients to reduce the fear in the mental health community when the police arrive.

“And most importantly, we need the Mayor to revive his 2014 Taskforce on Behavioral Health and Criminal Justice. And place this Taskforce under a Deputy Mayor, with the resources to get things done.

“We need all stakeholders and all city and state agencies at the table to suggest alternatives to police responding to these EDP calls. Expanding co-response teams throughout the city, more mobile crisis teams, and pairing mental health peers with police to calm down these encounters are a few ideas to explore.

“Therefore, we ask that you recommend the Mayor revive his 2014 Taskforce on Criminal Justice and Behavioral Health.”

Robin Williams' Death Shines a Light on Depression

Robin Williams' Death Shines a Light on Depression
By William Jiang, MLS
We Still Need a More Open Discourse on Mental Illness
I have been putting off writing about the death of Mr. Williams. Although I never met the man, I still smile when I think of his comedic antics. He made me laugh so so many times. It was shocking and sad to hear of his suicide. I remember I learned of his death on Facebook. It was a gray day.
I feel Robin William’s untimely death teaches us a lot about mental illness and specifically clinical depression in today's USA. In 2020 clinical depression will be the new number one cause of long term death and disability, worldwide, according to the World Health Organization, so a conversation about depression and suicide needs to happen. The stigma of depression and mental illnesses of all kinds must end because, in the end, the stigma of mental illness kills people just as surely as the illness itself. Not only must the person deal with low mood and feelings of hopelessness and isolation due to the mental illnesses themselves, but the shame and further isolation of the stigma associated with the illnesses is an additional stressor.
They say it is lonely at the top. Robin Williams said, “The worst thing in life is not to end up all alone. The worst thing in life is to end up with people who make you feel alone.” When one is a rich star who makes his money in mirth, the last thing he wants to project to the public is that he is not feeling like laughing all the time. What a personal hell that poor man was in, trying to live up to the public’s perception of him as a comic character. I have a feeling the pressure of being two people—the comic and the man—suffering with depression caused a cleft in his mind and life.
We should all be comfortable with the slings and arrows of outrageous fortune, in the sense that if we break a leg we are not a broken leg. We have a broken leg. If we become depressed, we are not a depressive. We are a person worthy of love and respect who is struggling with a dangerous beast that lives within called depression.
The US and the world society needs to come out of the dark ages and have an open and honest discussion about mental illnesses of all types. Why? We need our sparkling gems of people, all imperfect, like Mr. Robin Williams, to continue to sparkle- all of us. Matthew Fox said, “If you look closely at a tree you'll notice it's knots and dead branches, just like our bodies. What we learn is that beauty and imperfection go together wonderfully.” Every knot and age ring in a tree’s trunk tells a story of the personal history of the tree. The imperfections are what make each tree uniquely beautiful. Robin Williams wasn't crazy. He wasn't ever alone. He is now a fallen star. He was loved by many who never even met him. He will be missed.
Note: Will Jiang has authored 15 books, many about mental health, and his blog is located here: http://www.mentalhealthbooks.net

Resilient Not Incompetent

Resilient Not Incompetent
By Pamela
Finally Knowing the Reason for My Distress
I think I always knew that I had a problem. When I was young I used to be afraid of everything. I stuck close to my parents and stayed home with my youngest brother Andrew who had cerebral palsy. While my other brother and sister went out and made friends, I was at home.
I hated school. I was bullied and didn't have friends until my senior year. I was a terrible student. I found things very confusing and took a long time to grasp concepts. I would stare off into space and zone out, missing entire portions of my class. I thought I had a learning disability or that something was wrong with my brain, but I just couldn't figure it out. I was afraid to talk on the telephone because of the people on the other end and what they thought about me. What they were saying about me were things that scared me.
It doesn't happen often, but sometimes while having a conversation with someone, I will be in mid-sentence and then I begin what I call “word salad” where I jumble up a bunch of nonsensical words that mean nothing. It’s embarrassing. I can hear myself saying it, but pretend I didn't do it.
I've attempted to go to school to change my career twelve different times, each time leaving for a different reason. My instructor was sabotaging me, I had chosen the wrong field to study, I wasn't smart enough, I didn't feel comfortable in my classes because the students were talking about me under their breath.
I've changed jobs about as many times as school. Left and came back four times at one job. At my last job prior to treatment, I worked with a small group of people who were as frightened of me as I was of them. I was manic and tried really hard to do a good job. I worked and spoke quickly, again speaking word salad, and could not understand why they weren't pleased with my hard work. One day I just fell apart, hallucinating and seeing blue dots all over the floor, ceiling and walls. I thought everyone at work was responsible. I left that job the same day and never returned. After talking to my priest, a criminal psychologist, about my experience, he gave me the name of a psychiatrist. This wasn't the first psychiatrist that I had been to, but the first to name my condition: schizoaffective disorder.
I began the challenge of finding the right medication to help my depression, mania, delusions, paranoia, hallucinations and anxiety. While waiting for relief, I became suicidal. I was at work and had the good sense to tell my supervisor, who took me to the emergency room where I was transferred to a hospital for behavioral health and substance abuse. I was there ten days while they played with my medication. For one week after being released, I had panic attacks every day, causing me to have fainting spells. I would pass out and end up in the emergency room. I thought I was going to get fired. I requested a change in shift from first to second shift, so I would not have to work with too many people.
After five years and two more psychiatrists, I finally have a mixture of medications that work for me. I read all the time about people wanting to get off their meds and take care of their mental illness without them, but for me medication is a necessity. I've needed medication for a long time, and without it I am not lucid.
Right now I'm taking my meds as I should. I know that down the line I'll probably have another break. I think it's inevitable. My symptoms seem to be cyclic and I don't know that I'm in trouble until I’m in the midst of it, when someone tells me something is wrong. I am grateful to be finally aware of my diagnosis. It is a relief to know that it was not my fault to have failed at the many things I've tried so hard to accomplish. For years I believed I was stupid and incompetent, when what I really am is resilient.

All in the Family

All in the Family

By Eleni F.

Acceptance: Step One to a Better Life

There is magic everywhere; on the floors, on the sheets, in the walls. She tries to cut it out but it never really goes away. Spells are put on her by the same people who are always stealing her clothes and dishes. It’s the women her husband is always cheating with. They are the ones putting the evil in her home. She knows he is cheating because he never takes her out and they don’t have sex regularly. I know this because she tells me, because she thinks I am her friend, but I am not. I am her daughter.

My mom has paranoid personality disorder. I finally got her to see a psychiatrist a few years ago but she only went three times. Aside from her mandated stay at the hospital resulting from her calling the cops on my dad for killing her brother who had just passed away in Italy, she has never seen anyone for treatment. As the officers escorted her to the ambulance, I could feel my mind fracture my heart. They kept her for two days, releasing her after discovering I was a mental health counselor. She still blames every pain she gets in her aging body on the drugs they gave her then.

My mom says she is fine. She doesn’t see her illness. That’s common for people with her disorder. Living life with mom has been both an adventure and a lesson in patience. She is one of eight children, most of whom had mental illness. Sadly, none of them actually sought help except for her brother, John, who was schizophrenic and briefly hospitalized when he became catatonic. My mom’s illness has progressively gotten worse. She has ripped the molding off most of the walls in her home. She burns incense every single day, twice a day, to the point where a neighbor once thought our house was on fire. She reads the bible daily, religion being a theme in her paranoia.

I often tell myself I should be glad the only thing I got hit with was depression. My mental health resume is as follows: When I was 14, I was afraid to brush my teeth at night with the door open fearing my father would stab me from behind. When I was 16, I sat on my bed holding his gun, with the bullets spread out like a path to peace before me. When I was 22, I tested my veins with the blade of a knife and washed out the thoughts with vodka. When I was 29, I celebrated with a bottle of pills and some liquor. I was persistent, if not successful. I was also very lucky because I never wanted to die. I was just tired, exhausted from how hard breathing had become. I was tired of being tired.

I have been battling depression most of my life, though I didn’t always know it. I never went to a therapist until I was 22. She was the first of many I would see through the years. She tried putting me on meds but I stopped taking them, deciding I could do better on my own. I never liked the idea of needing something. I had issues with commitment. I can’t remember the number of jobs I’ve held and quit, or the number of therapists I’ve seen. I soon discovered drinking would make me feel better in the moment. So partying became my new antidepressant and blackouts were just a side effect.

I met my husband when I was on this self-prescribed treatment plan. I hid my amount of binge drinking by pre-drinking. He was smart, hard-working, and despite having met at a club, not into partying as I was. He was handsome and he made me laugh. So nine months after meeting this man, who made me want to walk away from the ledge, I married him.

I wish I could say that was the end of my battle, some magical happily ever after cure all, but it wasn’t it. It took years of on and off again binge drinking and getting on and off meds before I managed to understand this was not something I could just get over, or cure. This was something I needed to make peace with and accept. I needed to accept that medication was going to be part of my routine, and that this did not mean I was weak or crazy, it meant I had an illness. It took me years to realize that just like my mother, I had been unraveling in my own way through my own denial. With the support of a man who refused to let me drag him into the depths of my despair and also refused to abandon me there, I started to climb out of the abyss and find myself again, maybe for the very first time.

Through the Fire

Through the Fire

By Angelica

The flaming started with my husband’s suicide. His father had been bipolar and we knew it was a possibility for John. But we never expected to be diagnosed simultaneously. We had the same doctors, but I was hospitalized for what was supposed to be one year.

I was drugged almost to death. I’m very sensitive to medication. My mother and husband waited two weeks for me to recognize and speak to them. My thoughts kept flying away, but I managed to say “Hi.” Mom got me out AMA (against medical advice).

At this point John wanted a divorce. I dove into fear mode. We had three kids to raise and I only had one semester of college. What kind of job could I get? At this point, I could barely go to the grocery store. By then, I was in and out of three hospitals. Medications ruled again.

John racked up $122,000 in debts in two months. The judge did not grant him custody of one of the boys. His lawyers were exasperated with him. He quit his job. He had essentially no friends. The kids and I got the house. Thus, the suicide. Ironically, he received a job offer that same afternoon.

I went to support groups and endeavored to stay out of hospitals. I never went to a grief support group, but we all should have. I was off medication and did alright for one year. I met Chris in that time frame through a computer dating service. I told him I was bipolar and had three children, none of which seemed to bother him. We married six weeks later.

Unbelievably, Chris was diagnosed with bipolar several years later. He forged through his job until he was 59, then went on disability. We graciously allowed for each other’s shortcomings. We didn’t worry so much about money as much as we demonstrated our love for each other. It wasn’t all roses, but the love grew and grew. We have been married for twenty-seven years.

I painted, wrote, crocheted and did needlepoint through the mood swings. I adore colors and am fascinated by words. When I painted, I focused on colors, shapes, shadows and light. Words were invisible to me. One night, I was painting a piano and flowers when a big storm stirred up. I paused. Then I decided if it were my time to go, I would go with a smile. I kept on painting with a quiet joy.

Whenever I was writing my book, all worries and concerns were gone. In a way it was traumatic, yet in another way it was cathartic and left me drained. I was still happy to finish it twenty years later.

Two years after meeting Chris, I found my guru. Jesus had been my first teacher, but I wanted a physically embodied teacher. Baba’s teachings were a lot like Jesus’ only phrased differently. Instead of the Golden Rule, Baba said, “Help ever, hurt never.” I was so happy that I trucked off to India to see him. I spent two months there. It was heaven. I saw Baba in darshan (the seeing of an avatar) over 100 times. He didn’t speak to me there, but he did later in Canada.

When He saw my finished book, He said there were a lot of Vedic truths in that, and how could I sell the truth? So, I promised to only gift them in the future. It was a big test. I always wanted to be an author and sell my books to raise my level of living. I guess God decided differently. So, I accepted that with just a whimper.

Around the same time I met Baba, I also lucked out with a great psychiatrist. His vote was out on the God issue, but he was so caring, I knew God loved him. After several medication cocktails, he hit on the right one. He was surprised how the low dosages were so effective for me. Gratefully, the sparks went out and I stabilized. I haven’t been hospitalized in eight consecutive years. Thank God.

One morning, Dr. T leaned forward and said, “I learned something.” I was all ears. “I learned that you don’t need so much medicine.”

“I told you so…”

“No, I learned that all my patients can have less medication.”

Amen.

Now, one son has bipolarity, and the beat goes on.

Saved By a Cat by Shannon

Saved By a Cat

By Shannon

How My Pet Kept Me From Committing Suicide

In 1982, I was diagnosed as having a “problem.” I was twelve. At that time there were no real medications, or much therapy, for juveniles. I suffered with periodic depression until I reached college and was able to get some therapy at the campus’s mental health center. Right after college, I chose to get married—instead of attending Graduate School for a master’s degree in counseling—for the mere reason that someone asked me to. I had such low self esteem that I figured I might not get another chance. BIG mistake. Though the man was patient with my issues, he never fully understood and simply flew quietly under the radar when I was at my worst.

In my thirties I began to experience extreme mood swings. I would go from frustration to full outrage in twenty seconds. I would throw things, scream, and once I tried to stab my husband in the throat with a screwdriver during the process of hanging a ceiling fan.

When I visited a psychiatrist and described the instances, I was prescribed my first mood stabilizer. Later came an anti-depressant before an anti-anxiety drug was added to the cocktail. I began intensive therapy but was getting nowhere with my bouts of depression. I began to take the anger and sadness out on myself.

I would have irrational thoughts, such that if I cut myself I could bleed out the pain, as if I were accidentally injured. Though for most of my life I was unaware of the name for this illness, I had been suffering from Dermatillomania, a disorder where someone can't stop picking at their skin. I had always been a “picker,” as it was a self-soothing mechanism I had developed early in life. I hated the results, but was comfortable enough to do so. With all of these things combined, I was finally diagnosed with borderline personality disorder, which put everything else under that umbrella into perspective, and subsequently changed both my medication and therapy protocol.

When I next became ill I was prescribed high doses of Prednisone. BIG MISTAKE. It resulted in an obsession with death and eventually a suicide plan. I was miserable in my marriage, at work, and had recently lost a very special pet. I was simply in more pain than I could ever imagine. More than anything, I wanted to end the pain and kill the painful parts of my being. I had no clarity that efforts to cease that would end all my future. I just did not see that they were all intertwined. I had a complete nervous breakdown, went on a manic spree, and then planned my suicide.

The morning I was to complete my act, one of my cats intervened. As I began to take the pills I had been stockpiling after doctor hopping for weeks, she literally swatted at my hand. SMART CAT! It shook me into a reality that made me realize how many joys I would be missing. I called my therapist and my husband and was admitted to an acute mental health care facility. I was only released after plans had been made to transfer me to another facility in another state that provided DBT therapy, which was the protocol for BPD (borderline personality disorder) patients.

After four months at the facility, the staff and I felt I was ready to resume life. My husband and I decided to divorce in that time. I had met another wonderful man while in treatment. After several months I moved to the state where we had met and we began a new life together.

I was doing really well for one of the longest periods ever. Meds were right, therapy was fitting, and things were going smoothly. During a five-day vacation period from my job, I somehow developed agoraphobia. I literally feared going outside, avoided sunlight and kept my curtains closed. Thus began another hospitalization, this time for about two weeks. My meds were again readjusted, and I was released. Since then, that boyfriend and I eventually broke up, and I moved back to my hometown.

I’m currently suffering again from deep depression and anxiety. Yet, now I have no health insurance and have to rely on state funded care, which is minimal at best. I am able to hold a part time job and socialize with two of my lifelong friends. I have a new pet that brings a level of peace and responsibility to my life, which helps to keep me together. I only pray that simply surviving will continue.