Did you know that Winston Churchill, Abraham Lincoln, Sir Issac Newton, Albert Einstein, Patty Duke, Bette Midler, Robin Williams, and even Sting were or are crazy? Well, no they are not crazy. That is just a term that society at large applies to people with mental illness.
According to the National Alliance on Mental Illness (NAMI) 57.7 million Americans experience a mental health disorder each year. One in 17 people have serious mental illness such as schizophrenia, major depression or bipolar disorder. Children do not escape. One in ten children have serious mental or emotional disorder. Mental illness is a neurological disorder that affects everyone. There are no boundaries as to race, social class, ethnic group, wealth, or any defining characteristic you care to name.
Essentially mental illness is simply an illness that affects the human mind and the emotional connections people make to that aspect of themselves. If the stigma attached to mental illness is going to disappear in the United States, we are going to have to put a heart attack and heart disease on par with major depressive disorders and even schizophrenia and bi-polar disorders. In these cases the mental illness often has a chemical basis that is quite physical in the brain of the sufferer.
So why do people make some sort of distinction between physical illness that is taken for granted to be acceptable and the sense that someone is crazy or looney for mental illness: the social stigma that goes with these diseases? That must change.
Should anyone reading this piece at any time be feeling a great burden and depression mentally, or if there is some intent to harm yourself in any way seek help.
That is the most important message that could be given: do not be afraid to get help or stop yourself from making an appointment with a therapist, or a psychiatrist or any mental health professional.
Even seeing the family doctor you trust implicitly and telling them about it is a good step. If there is any immediate threat to your personal safety please go to the Emergency Room of the nearest hospital and check in and tell them point blank how you are feeling and why you are there. They can asses what help you need. You will be safe. Isolating yourself and not seeking help is the most dangerous thing you can do.
In my case I was diagnosed with a major depressive disorder and my therapist gave me a choice between going right to the ER or into an outpatient program at the hospital that runs the full work day called the Partial Hospitalization Program. I chose the latter but found a personal situation at the conclusion of a very good second day of treatment put me in what they called a 23-hour bed in the Inpatient Unit. I was admitted via the ER and then released to the outpatient program when the immediate danger I was in passed. Other people might spend a full week or even two weeks in an in-patient care unit in a hospital and then be moved into some kind of outpatient intensive therapy.
In that outpatient program you will be assigned a case manager who will admit you, and after a long chat or assessment on their part put together a treatment program. You’ll get a three whole punch binder and some information to read and to sign and then you’ll be welcomed into a group of other patients.
The first day is bewildering and a little overwhelming as everything is new and you are just trying to take it all in. But people are compassionate and friendly and it is a safe environment and you do not go home from outpatient without checking in with your case manager first and both agreeing your good to go for the day.
Treatment includes many things such as daily group therapy sessions that last from over an hour to a little beyond that. Each morning you fill in an emotional survey as to where you are at that day first, and go through goal setting before the therapy happens just before lunch.
In what is called “group” about seven or eight patients, and sometimes a few more, share what they are dealing with and the group reacts to it and offers support and suggestions.
While in group or any programmed activity your doctor who works very closely with your case manager will pop in, gesture to you and you follow them out and meet with them one-on-one for fifteen minutes or so and then rejoin the group.
There is cognitive therapy and educational sessions that are very important to your recovery too. You’ll always have a fully programmed and busy day in the outpatient program.
In the afternoons there is art therapy, expressive therapy and mindfulness training and relaxation training and even music therapy. You would think just reading this that it sounds like a lot of touchy feely nonsense. It’s not. After the first day or so you realize that all these experiences are designed to help you identify and confront your inner demons whatever they may be. I drew a cute blue volcano in art therapy and later learned it provided me a key insight I needed later in my therapy. So it is not nonsense.
One of the most interesting observations any outpatient makes in a treatment program this intensive is that you go home at four PM or so and you are just so tired: emotionally as well as physically drained.
Cognitive therapy, group therapy and perhaps some music or art therapy and the day is over and you are whipped. Staff will tell you that you’ve been engaging in intensive self-examination and real mind work and emotional connecting all day and that is why you’re tired. Some people will still have trouble sleeping. It may be part of their mental illness. Others, like myself, find that if my mental wheels did not start turning at bed I was out like a light for the night just like that.
People in group therapy share a great deal that binds us together. It is private. So you will not hear anything or read anything about anyone here or anywhere else: nothing. Not even my wife is included. I do talk about me freely of course. It’s my decision and I am comfortable with it.
What gets hashed around in outpatient therapy? Relationships that are tearing people up: partners who won’t commit or are leaving, divorce, chemical dependencies of the patient or their most significant other, depression, anxiety, self harm, and even work environments that have somehow gone very toxic where professionals advise you to set a boundary between you and your job. You might be bi-polar or have an eating disorder. It runs the full gamut of mental illness.
In therapy we are pressed to identify emotional triggers that set off our depression, anxiety or other related portions of our conditions. In my case a job situation had gone completely toxic and I was not fully aware of how much that was making me ill. It was not doing what I love doing on the job or the people I served or my colleagues. But some portion of the work environment was my most direct trigger and my doctor made it and has made it clear that I need to stay out of that toxic place. Going on a term of disability is where I am at now, released from three weeks of full and intensive therapy that is a real success story.
The mental health survey which goes on a scale where the higher it is the more ill you are had me at 32 when I started, or was admitted, and just 5 now. But this balance restored in my life is very fragile. My doctor wants me home and in outside environments where I am not working and not at my traditional job site: my big trigger for many weeks yet. I am following that good advice. My treatment continues. I have appointments with both my therapist and doctor, and plans for joining a support group.
Perhaps over the summer I will be in a position to work full-time without restraint. I’m officially retiring from my long-held job, a job I love, in June. I expect my doctor to give me a health okay disability wise in early July if all goes well.
The real insight I gained from treatment was the restoration of my self- worth as a human being, and the ability to understand when I am slipping into depression and having a set of plans to counter that. If all else fails, my spouse, therapist, doctor and the ER of my local hospital will all see me. I have a mental illness. It will be there for perhaps the rest of my days. But I now have a way of dealing with it: I have the tools.
The strangest feeling now is that I am still healing from a serious illness but can walk, and talk, and be fully in touch with reality as I was throughout and I should not go crawl into bed, take some aspirin, and a lot of water and sleep, take my temperature and pull the covers over me and crawl into bed. It is a largely unseen illness in many ways. That is mental illness.
We who have been treated or are being treated as in patients or outpatients for mental illness find our employer, friends, family and others often misunderstand what it is we are going through. They struggle too. We understand and simply ask your patience and to feel comfortable interacting with us unless the sufferer has told you that their treatment requires a boundary to be set between you and the one suffering. In my case it is staying away from my traditional job.
To use common slang: that plain sucks. I like what I do and I like the people I serve and I do not like letting them down. But I have learned that I am ill and will and am getting so much better and I can see and feel it. But I must set that boundary between myself and the trigger of my illness.
When you encounter someone with mental illness respect the fact that they are ill just as anyone who is physically ill. I suggested to my fellow patients as I was just about to get out of the outpatient program that we all should receive fake casts for our arms or legs or perhaps a sling or something visible so people will accept that we are ill and getting better and treat what we are going through the same way as they do for any illness. May it be so.
Dr. Thomas Martin Sobottke
For Struggles For Justice