Surfacing After Silence

Life. After.

13 Reasons Why

ThirteenReasonsWhy

Okay, so I will join the great online debate over the book Thirteen Reasons Why, which has led to a television show.  I have read the book, but I have not seen any television episodes.  Most of the online discussions have centered on why people shouldn’t watch the show, how horrible a person Hannah is, how it will only encourage teens to commit suicide, and how it’s just “another mental illness book” that doesn’t actually confront anything.

I read the book when it first came out.  Although the writing wasn’t the best and the plot was contrived, I was glad it was written.  A teenager voicing her feelings and thoughts regarding what led to her suicide.  No, I do not agree with leaving thirteen tapes behind that nit pick and blame other individuals.  Her suicide was her decision.  She had full agency.  No one made her kill herself.

But . . . what the book shows is that suicide is anything but a simple decision resulting from a single bad day.  No, her friends didn’t make her commit suicide, but their behaviors contributed to how she felt.  Imagine if she had been able to voice what she was feeling in an open and honest manner while she was alive.  That’s what we should be focusing on.  This book exposes the truth that people suffer in silence.

You may say that with all the options out there now, there was no reason she had to suffer in silence.  Have you ever been a teenager and known something wasn’t “right” but you had no idea where to go or who to ask or even how to put the idea that something isn’t right into actual words?

Yes, there are options.  More than before.  But they still aren’t easily accessible for youth.  There is still so much judgment concerning mental health and mental health treatment.  So maybe Hannah was cruel in leaving those tapes behind, but she was still suffering and she still felt completely alone.

As a suicide survivor, to pass judgment on Hannah’s character and actions would be hypocritical.  I’ve been her.  I didn’t leave people tapes and letters, even though I had something I wanted to say.  My attempt was my decision; no one else is to blame.

I am grateful I’m here to write this.  Most days.  The chilling nature of Bipolar Disorder is that I know it doesn’t leave.   We have found a treatment that has proven most beneficial, and I have learned a zillion more ways to cope, but I still go through dark spells and I still make mistakes.

As for this book making suicide look trendy–we’re blind if we say that society hasn’t experienced this before.  The Bell Jar;  Girl, Interrupted; and Prozac Nation are the first three books that pop into my mind.  The harsh truth is that teenage suicide existed before, it exists now, and it will continue–even if no one watches this show or reads this book.  Maybe instead of discussing Hannah’s character flaws and how it was unfair of her to do what she did, we should discuss what it is in our  society that creates real-life-Hannahs every single day.  And then maybe we should discuss how we could create a new environment, one with less judgments and less isolation and more forgiveness.

April 20, 2017 Posted by | addictions, bipolar disorder, Body Image, Communication, coping, death, depression, Eating Disorders, family, feelings, guilt, identity, Mental Health Parity, progress, publicity, recovery, relationships, shame, suicide, therapy, trauma, treatment | Leave a comment

Regardless of gender, color, size, age . . .

 

where-is-everyone-report-cover-l

Recently, Obama signed the 21st Century Cures Act into law which will, among other things, require insurance companies to stop refusing payments for residential care, thus finally giving eating disorder patients access to adequate treatment.  The Miami Herald ran an op-ed discussing this new law, which originated with the Anna Westin Act.  The senators also discuss what was left out of the law–measures that would affect how images are photoshopped.  Regarding how these images affect those with eating disorders, they state, “Dissatisfaction with their own bodies based on unrealistic and unattainable physical standards promoted by these significantly digitally-altered images can develop into dangerous medical conditions including depression, anxiety, and eating disorders, costing both families and taxpayers dearly.”

I agree wholeheartedly with everything stated with this op-ed, and I realize digitally altered photos are the main point of discussion.   However, the editors of the newspaper unfortunately contributed to existing stereotypes with their choice of a cartoon illustration depicting a very thin female with a huge shadow.  But why would the editors have chosen anything different considering our leading eating disorder organizations and treatment centers–regardless of the age and sex of the patients they accept–offer the same images over and over in their publications:  a thin female staring forlornly into a mirror or out the window.  Of course, she is almost always a she.  And she’s usually a white, older teenager, often with long straight hair.  We don’t see a rebellious teenager with spiked, dyed hair, with piercings and tattoos, dressed in black, staring angrily into the camera.  This is not the image they want to people to associate with eating disorders.

As the stereotypical all-American overachieving white college female, it was terrifying to reach out for help because I was afraid I wasn’t “thin enough” for anyone to believe me.  So I didn’t reach out for several years.  Imagine how difficult it must be for a forty-year-old Asian male to ask for help.  Or a black woman approaching retirement?  Or anyone considered at all overweight?  Or anyone who isn’t skinny?

I was in treatment with men and women and adolescents and adults from all different cultures.  Yet the treatment brochures don’t reflect that diversity.  Educational materials stating that eating disorders affect everyone across the population still only portray a small segment of these individuals.

Eating disorders already result in isolation and fear.  In order to truly reach the different people affected with these illnesses, we need to expand the face of eating disorders.

 

December 29, 2016 Posted by | Body Image, Communication, diversity, Eating Disorders, feelings, health, identity, images, inclusiveness, Mental Health Parity, publicity, shame, teaching | 1 Comment

One Person

(Trigger warning:  documentary includes numbers and photos of individual at low weight.)

A couple of months ago, I had the honor of working with a talented group of high schoolers on a documentary they were filming for a contest.  There were all sorts of rules about content and how things had to be filmed and what could and couldn’t be done.  They made sure they followed the rules of the contest; I just answered their questions.  They chose the general topic of eating disorders, narrowing in on the concept of balance.

I do not agree with their decision to include certain pictures or numbers, but I more than agree with their decision to tackle a difficult, and often ignored, subject with honesty.  I imagine there must have been easier subjects to consider, less emotional or controversial subjects.  But this group of high school students stepped away from the easy and stepped up to the challenge by speaking out.

I did not have the opportunity to meet the other individual interviewed, but she deserves major kudos for speaking out so openly so early into her recovery.  I was relieved to hear she had the support of the student body rather than their scorn, as I know still happens entirely too often.  Adolescence can be difficult when everything goes smoothly.  Throw in some struggle in the tense environment of a high school (or junior high, or college, or work environment) and sometimes (often) individuals find that it is easier to be sick than to seek help.

We need to learn some lessons from these students.

Admitting an illness is not a weakness.  Seeking treatment is not something to hide.  Admitting an illness take a great deal of courage and strength, and the willingness to seek treatment and work toward recovery is something to be proud of.  Not many are able to step up to this terrifying challenge.

In order to step up to this terrifying challenge, support is essential.  Family and friends and coworkers: we should look up to individuals who are willing to take a step toward recovery, not laugh at them or see them as weak.  They are facing their demons.  Are you doing the same in your daily lives?

Those of us who have begun recovery or recovered or want to recover: we need to speak up when we are ready, and in our own individual ways, always aiming to take care of our own needs.  Not every individual needs to or should step in front of a camera and tell his or her story.  Stories contain memories that may be difficult to share.  Not everyone needs to or should write a blog about their recovery.  Speaking up does not necessarily mean publicity.  It may mean an anonymous post on a blog or board that encourages or affirms someone else.  It may mean choosing to post of picture featuring a genuine smile that couldn’t be seen while you were sick.  It may mean donating to a scholarship fund.  It may mean letting one other person know that recovery is possible and that he or she is worth it.  It may mean sharing links about eating disorder education or treatment.  It may mean refusing to laugh at fat jokes and fat shaming.  It may mean leaving a social group that does not allow you to seek out health.  It may mean quietly loving yourself and silently doing what you need to do for you. It may mean confronting someone who is also struggling, planting the seed of hope and change.

We are not all called to change the world and win Nobel Prizes.

We are all called to change our own world for the better, however we can.

One person telling another person.  Who will then tell someone else.

Just imagine what one word of support could do. How much could change. How many possibilities become more than just possibilities.

April 25, 2015 Posted by | bipolar disorder, Body Image, Communication, depression, Eating Disorders, Mental Health Parity, recovery, relationships, shame | , , , , , , , , , , , , , , , , , , , | Leave a comment

pituitary, prolactin, procedures, and . . . possibility?

Early this morning I had my first CT scan with iodine contrast.  I don’t like the iodine bit, but lying motionless for several minutes with noises around my head–I’ve got that one down.  Three or four weeks after I moved back home, I started experiencing a cluster of symptoms that I have always associated with iron deficient anemia–and I’ve always been really good at knowing when I’ve been anemic.  Well, Doctor #1 told me that all the symptoms were from depression.  Doctor #2 believed me when I said this was different from depression.  Psychiatrist Doctor agreed with me.  So they took several vials of blood, and anything pointing to anemia was good. 

My prolactin level was off, however.  By itself, not really that big a deal.  Elevated prolactin levels could be caused by two of my medications.  But my psychiatrist is doubtful since I’ve been on those medications at those doses for a rather significant amount of time and all my levels have been fine in the past.  So we went ahead with further testing.  The CT scan was looking for a pituitary adenoma, which would explain every symptom I’ve been complaining about.  Almost all adenomas are benign and can be treated with medications. 

I’m not worried about having an adenoma.  I’m worried about not having one. 

During the CT scan, I kept repeating, “Please find something please find something please find something.”  I’ll be relieved if the scan comes back positive.  I want something to be wrong with me.  Something I can point to on a picture and say, “Right there.  That is what’s causing everything.  And this is how we’re going to fix it.”  Sometimes I am so tired of having Bipolar Disorder.  I want something concrete to point to and blame for all the ups and downs.  I want to be able to say, with some assurance, that this is what we’re doing to treat it–and it’s working. 

I know that mental illnesses are “real” and that they are just as “physical” as my heart disease.  I advocate for mental health parity and try to encourage individuals to seek treatment and be open about their struggles.  But sometimes to not have to explain everything, to say “I’m Bipolar” and have the other person nod in understanding would be nice.  It would be nice to have everyone believe me when I say that I can’t just will myself out of it, that I can’t just smile and pretend everything’s fine, that some medications work and some medications don’t and it depends on the particular doses and the combination and they can just stop working at anytime. 

Sometimes this whole journey is so exhausting and my motivation starts leaking out of me.  Maybe some day, they’ll be able to diagnose and cure Bipolar Disorder with a CT scan and a given medication that has proven reliable and effective.  And maybe someday insurance companies will agree that mental illnesses are actual illnesses and will agree to cover them equally. 

Until then, I’ll probably just keep hoping for positive tests results.

August 22, 2014 Posted by | bipolar disorder, Communication, coping, depression, faith, health, heart, identity, Mental Health Parity, progress, recovery, responses | Leave a comment

suicide

This post is partly stole from Facebook.  These are two of my comments in reply to a friend’s discussion about suicide:

 

 What do we say when people die of cancer? “At least he’s not in pain anymore.” That doesn’t mean we condone cancer. Depression, like X has said, is an illness. A physical illness caused by chemicals that can be genetic. And yes, because depression originates in the brain, being severely depressed affects the brain. This is why “children at risk” are often failing in school–not because they’re dumb or stupid or lazy, but because the signs of childhood and adolescent depression are different and people are ignoring the problem, and then the student can’t focus in class, or doesn’t have the motivation to read “Great Expectations.” And depression is known to affect memory, so tell a student with depression to memorize Spanish conjugations and see how effective that is. And yes, severe depression–in all ages–affects the ability to reason and think through situations. And I’ve been there multiple times, where suicide seems like THE LOGICAL choice, and the only reason I’m here is because my treatment team stepped in and took me to the hospital, and as the depression was treated, I began to think “THAT was a logical option?” I like to explain it to people this way: 99% of my brain absolutely knows for sure that I never want to commit suicide. But severe depression sneaks in and convinces that other 1% that it’s the best option. So now I’m not only fighting depression, but I’m fighting suicidal thoughts as well. And as time goes on, I get more and more tired, more and more confused, and less and less attached to reality–and I do mean that literally. I CANNOT process what is real and what is not. I cannot understand the ramifications of suicide at that point; all I know is that I am in such intense pain that I crave release and freedom. No, I don’t endorse suicide. But like, X, I empathize with the sufferers. And I don’t judge them. I judge the society that thinks depression can just be controlled by the mind. I judge the society that makes finding treatment so difficult. I judge the society who calls suicide selfish–which only makes the people suffering from mental illness feel shame and guilt and results in them keeping their shame secret until they can’t hold onto it anymore. We NEED to talk about this. We NEED to listen to what the victims are telling us. We NEED to find a way to be courageous enough to step up and help them.

  (In response to a comment that implied I had called someone judgmental.) I didn’t mean to imply that you in particular were judging people. But I do know that society as a whole judges people with mental illness, especially those who commit suicide. I’m not advocating for suicide; I’m advocating for reliable, adequate, and available treatment for those with a mental illness so that they stand a chance of fighting hell. Because I do think that suicide is unavoidable for some, because they do not receive support, care, treatment, or other options. But telling people suicide is selfish or implying that people who attempt suicide are weak hurts the general population because it only incites the current stigma attached with mental health. perhaps if Mental Health Parity actually existed, we wouldn’t be having these discussions. But until Parity is an actuality, we need to discuss this in an open manner.

(now non-facebook rambling)

When I say that “I do think that suicide is unavoidable for some” I am not encouraging suicide.  But imagine being diagnoses with rare genetic heart disease (oh.  wait.  that’s right–I have been diagnosed with just that very thing) and then being told, “I’m sorry, there’s nothing we can do to help you, either in this very moment or in the future.  Please figure this out on your own.”  I have had friends with heart disease that could not be treated and death was just a matter of time.  But doctors jumped in anyway and monitored progress, trying to make life as pain-free as possible, trying to give the patient as much life as possible. 

But here’s the scary thing:  I have walked out of a doctor’s office after telling him I was thinking of suicide, listening to his words over and over: “It can’t be that bad.”  Nothing to help me deal with the immediate stress.  Nothing to help treat the underlying problem that could possibly prevent future moments of such stress. 

This happens more than one would think. My immediate thought was: what can I do to show the doctor I mean it?  How could I prove that it really was “that bad.”  My thoughts generally ran along these lines:  I could cut myself and then go to the ER for stitches.  I could take some extra meds that will make me sleepy but not kill me but go to the ER and say I overdosed.  I could lose more weight.  If I do kill myself, at least he’ll believe me.

Judgment and stigma do exist.  (I have been told many times that it doesn’t exist, I’m just over-sensitive.)  Here are comments I’ve had thrown at me:

  • Can’t you just smile for awhile?
  • Is it really all that bad?
  • You’ve got to choose happiness over sadness.
  • You’re doing this for attention.
  • You know you’re going to hell for attempting suicide.  (said by a nurse on the night of my suicide attempt as I was throwing up charcoal.)
  • Well, I don’t know what to tell you.  Seems like an easy decision to me.
  • Buck up!

There are more.  And I’m sure others have heard similar comments, either by the general public or from professionals. 

Someone should not have to prove he’s in pain.  And yet the majority of society expects just that. 

I read one article that said we should glorify Robin Williams’ life and not discuss his suicide on social media in case it encourages copy-cat suicides.  I agree.  We need to glorify Robin Williams’ life.  But I do not agree that we should be silent about the suicide.  We need to be careful about how it is presented, but if we don’t talk about it at all, we don’t start talking about solutions.  And shove mental illness into the dark, bringing up shame in those suffering from it. 

Suicide needs to be discussed.  Not by judging or shaming those who have attempted or committed suicide.  Suicide needs to be discussed because people need to be aware that our schools–K through 12–are filled with students who have already considered suicide as an option, but don’t dare talk about their pain. 

It is not going to go away if we sit here in silence.  No one will get better.  No lives will be saved. 

 

August 13, 2014 Posted by | addictions, bipolar disorder, Communication, coping, death, depression, Eating Disorders, guilt, heart, identity, Mental Health Parity, progress, recovery, responses, Robin Williams, self harm, shame, suicide, therapy | 1 Comment

grief and . . . anger

Warning: another controversial post ahead!

Robin Williams has always been one of my favorite actors, and his comedic roles always manage to make me laugh, something that recently only The Big Bang Theory has been able to do.  It saddens me that he had to endure such pain on a daily basis and fight so many demons.  I feel sorry that he had reached a point where the demons won and he no longer saw a strong enough reason to continue fighting that pain.  I do not judge him, for I have been there.  I wish no one ever has to experience such pain.

 

But I am also feeling angry right now.  Not towards him.  But towards the media.  Robin Williams will be The Thing on news channels and talk shows for a bit.  A psychologist will say how someone in his position was still vulnerable to depression and addiction and they will praise Williams for openly speaking about these things. 

But what about all the “normal” non-famous people who experience this same pain and fight these same demons on a daily basis?  What about the individuals who fight so long that they cannot endure anymore and commit suicide?  Why is there no media attention there?  Why doesn’t a talk show bring a psychologist on to discuss how depression affects children, teenagers, adults, and geriatric patients in all walks of life and in all careers?  Why does no one talk about how sad it is that someone feels that suicide is the only option every single day? 

Maybe I’m being too harsh, given as how it is just “the next day.”  But I’ve watched a lot of news channels and read the newspapers.  No one is mentioning that this is a world wide epidemic that is killing people every day.  No one is discussing how extremely difficult it is for us non-famous, non-rich people to find treatment.  Mental Health Parity hasn’t been discussed.  Neither has the fact that some of these deaths could be prevented if the individual had appropriate treatment?  (I realize there is no 100% cure rate for mental illnesses.)  When I moved to New York, it took over six weeks to find a therapist who was taking new patients and was willing to deal with my insurance.  And these six weeks in New York had followed two months in Missouri of searching online and getting referrals and making phonecalls and not ending up with a single lead.  I’d find therapists who would treat me if I paid $180 dollars per session, but that is just not an options for me.  “Funny”–I get a bad sore throat and I go to the doctor and my insurance covers most of the bill and most of the necessary prescriptions.  But when I start feeling suicidal, if I don’t already have a team in place, I can either go to the ER and be admitted for the mandatory 72 hour observation period or I can stay in bed and cry.  I can’t just “go to a doctor” unless I have around 300 dollars for a psychiatric consultation, and it’s rather iffy if my insurance will cover the psychiatric medication I’m prescribed. 

I hope that after this initial period of grief, someone is going to stand up and say, “Hey we can treat these illnesses and we can prevent suicide . . . but we need money to do so.”  I hope someone calls their congressional representative and pushes for Mental Health Parity.  I hope someone organizes a walk (there’s a heart walk every weekend) to raise awareness and raise money.  I hope that something good can come of this tragedy.  But I’m not all that hopeful, because we’ve all read about the stars going to rehab and needing to take psychiatric medication–and while it’s news for a week, nothing happens.  Nothing changes. 

Yes, his death was a tragedy, but now we need to talk about all the other people who are also in that same position and don’t have access to care. 

August 12, 2014 Posted by | addictions, bipolar disorder, Communication, death, depression, feelings, health, Mental Health Parity, progress, recovery, relationships, Robin Williams, self harm, suicide, therapy | 1 Comment