Monthly Archives: July 2013

A new (old) way to treat mental illness and ‘cognitive remediation’

I came across the following article on the internet entitled:

A new (old) way to treat mental illness. I had to find it and read it.

At a chance meeting at Boston’s airport, Cheryl Gagne met a former psychiatrist of hers who was en route to deliver a keynote speech on mental illness recovery. The psychiatrist stared at Cheryl, confounded, recalling her formr patient’s years of being psychologically crippled by alternate diagnoses of borderline personality disorder , bipolar disorder and a succession of hospitalizations … read on by clicking the link.

http://edition.cnn.com/2013/06/14/health/cognitive-remediation/index.html?iref=allsearch

Do you help old ladies cross the street?

2 ol lady crossingIf you are the kind of person who helps old ladies cross the street, use some of that attitude in rethinking your treatment and interaction with a person who has schizophrenia and lives nearby. This doesn’t mean that you need to be overly friendly, but please don’t ignore them as this is the worst thing you can do. You can engage them in conversation without being intrusive. People with schizophrenia, like a physically frail person, cannot defend himself/herself the same way as someone in full possession of their physical powers. They are often on heavy doses of medication which may slur their speech or make them react slowly. Please take into account that sometimes that person might be anxious and may withdraw. That’s okay, but leave the door open. Maybe ask him/her to visit you when he/she feels able to do so. Offer a cake or a plant or … any other friendly gesture. Send them an e-mail with a brief, friendly message every now and then. They will be ever so grateful.

The best way to avoid relapses

I have to admit that at the time, I did not understand how to carry out the following advice given to us by various professionals:

  • It’s advisable to provide a structured, supportive, tolerant and low stress environment. But, when neither my husband nor I knew what had hit us and when the whole family was in total chaos, this was difficult.
  • We were advised to keep our home atmosphere as calm as possible.
  • We were advised not to get overinvolved with our ill son. He was on medication due to his paranoid schizophrenia so – what is involved and, what is overinvolved?  We had to give him psychological as well as physical space, keep criticism and over- enthusiastic praise to a minimum.
  • We tried not to get irritated when he paced a lot because my son’s pacing reminded me of a lion in a cage and was unsettling.
  • We were told to put limits on bizarre or hostile behavior. We  even heard that delusional verbalizations would decrease if we told him in a bland way that it was inappropriate. Like hell it decreased!
  • Our son had paranoid ideas and we did learn not to argue as it was useless. All we could do was empathize with him.
  • We were told to take care of ourselves. I didn’t even know that I existed. I did what I had to do at home, went to work, tried to give our daughters as much attention as I possibly could as my husband was giving all his attention to our son, being sure that the weakest needed the most attention; tried to spend some time with my husband, so … where did taking care of  myself come in?
  • A smart social worker told me; ‘The future is unpredictable so stay with the present.’ Sounds easy, doesn’t it? Neither of us succeeded. Over a period of time we reduced our expectations for a rapid recovery, a slow recovery, and then … no recovery.

So, we did not manage to follow the advice: Modify overall expectations and strike a reasonable balance between realism and hope.

 

DON’T SHOUT! The other voices are interfering.

holding his head

When dealing with a person with a mental illness, it’s so important to avoid patronizing statements.

It’s advisable not to use threats.

Try not to shout as other voices are probably interfering. The other voices they may hear in their heads.

Criticizing will only make matters worse.

Don’t argue with the other members of your family over the best strategies. A calm atmosphere is very important.

Don’t allocate blame. Nobody is to blame.

It’s inadvisable to bait the patient into acting out wild threats, as the consequences can be tragic.

If the ill person is sitting; it’s a good idea to sit too. Hovering is threatening to him/her.

Avoid continuous eye contact and when the person is agitated and  try not to touch him/her.

If possible, try to comply with his/her requests provided they are not beyond reason.

 None of this is easy to do as we seldom had time to think things through, but it is worthwhile bearing in mind for future use.

Anticipatory Grief

ANTICIPATORY GRIEF

Anticipatory grief is what I experienced when my husband had Alzheimer’s disease. I’d been told that there was no cure and had to live with the fact that he would die from Alzheimer’s if nothing else claimed him first. It was a burden that weighed on me heavily. A friend denied the existence of anticipatory grief and I had to work hard to assure her that it was very real.

We went through the same heart-rending process when our son was ill with schizophrenia as a psychiatrist had warned us that many people in his condition end their lives. Can you imagine living with something like this hanging over your heads? In the end, the doctor proved correct. Anticipatory grief? Yes. When our son changed from being the friendly, happy, tall lad we had known, slowly but surely we started mourning for the son we’d known and 16 years later, he ended his life.  Real grief, not anticipatory ?

 I think that the difference between healthy bereavement and unhealthy grief is whether someone actually progresses through the grief cycle or whether they get stuck in it. Our son’s death was a terrible shock. But, we all decided to move on and do our best not to slip into a depression. When my husband passed away, we did the same thing. Of course it took its toll, but getting stuck in the cycle of grief is not healthy. Slowly we all learned to live, to love and to smile once more.

What we learned along the way

We learned that one cannot cure a mental disorder for a family member and despite our efforts, the symptoms became worse. Of course, they can go the other way. A social worker told me that if I felt resentment, I was giving too much and I think this applies to any caregiving position.

It was not easy to continue loving my son while hating his disorder so I had to learn to separate the two. When there were side effects from the medication, I had to separate those side effects from my son too.

I never did learn that I had needs too, so I neglected myself. I pulled on jeans, seldom worried about my clothes and did not take care of my hair or skin.

My husband always kept his sense of humor but I seldom found anything to smile about.

I did revise my expectations while acknowledging the remarkable courage my son showed while dealing with his paranoid schizophrenia. Using a survival-oriented response by shutting down my emotional life, was not a good idea but I could not help myself. My inability to talk about my feelings then left me stuck and frozen.

Our family relationships were in disarray in the confusion around our son’s brain disorder. Our daughters became emotionally enmeshed, while distant family became estranged.

We were all grieving for the brother and son we’d lost to schizophrenia. We went through stages of denial and anger but eventually managed to accept what had occurred. When we reached the stage of understanding what this cruel illness had done to him, compassion crept in. We realized that like other diseases, mental illness is a part of the varied fabric of life. The problem was that other people simply seemed unable to grasp that mental illness is a biological brain disease; an illness in the brain instead of in the body.

Every family member has the right to assure his/her personal safety and it was not necessary for us to shoulder the whole responsibility for our son. That was for professionals to handle. We tried to work with them where possible. What I needed to learn was to forgive myself and others for mistakes made and to learn that our son’s needs did not necessarily come first, but that took time. What is extremely important is to set boundaries and clear limits.
Mental illness is nothing to be ashamed of. Reality was that we did encounter discrimination from an apprehensive public who received far too much incorrect information from the press and television announcers.

The most important thing I have to say is that no one is to blame:-

NO ONE IS TO BLAME.  NOBODY CAN CAUSE SCHIZOPHRENIA.

No, nobody can cause s c h i z o p h r e n i a – no matter how hard they might try.

More stigma

This came to me via Linkedin and is entitled PSA (MHA)  youtube.com. It was posted by Thomas Grinley.

Click on the link below.

http://www.linkedin.com/groups/PSA-MHA-Shortened-3775182.S.255462820?view=&srchtype=discussedNews&gid=3775182&item=255462820&type=member&trk=eml-anet_dig-b_pd-ttl-hdp&fromEmail=&ut=1zwBwdqljkllQ1

If you require more information on mental health, visit www.mentalhealthamerica.net

When he came out of his depression, we all felt better

“It’s so hard to accept that I am different,” says a young woman sitting in her parents’ living room. “My mother helps me deal with the fact that I have to accept my illness. She understands me and knows how hard it is.”

“My daughter is far too disruptive to live at home,” another mother told me. “She won’t share accommodation with others in the group home, maybe because she is lower functioning than they are. When my beautiful, sweet daughter landed up in a psychiatric hospital, my husband and I blamed ourselves,” she told me tearfully. “We turned into a pair of automatons but at the back of our  minds, we both realized that mental illness was bigger than we were – far bigger than we could handle on our own. I’ve been through tough times thinking that I was a bad parent. I cared for my daughter and loved her and it’s hard to grasp that in spite of all that, she became so very ill. Because of the terrible stigma, I find it hard to share all this with simply anybody. But, when I met another family that is was going through something similar, those meetings saved me. I feel less isolated now. I thought that I was the only one going through this. At our support group, everybody shares their stories and ours doesn’t seem so unusual over there. People speak of feelings of helplessness, anxiety, frustration and confusion, and while listening to them all, I know it could be me talking about our daughter. Telling a friend or a neighbor that your daughter is mentally ill, is not like telling her that she has diabetes, you know. Why there should be a feeling of embarrassment, I don’t know, but there is.”

“Try and explain to me why you feel embarrassed when telling people your story,” I said.

“Because I wonder whether they will grasp it. After all, not everybody has mental illness in their families. Then I wonder whether they will accept me after hearing my story and that stops me even  more from sharing it with people not in our support group. Sharing with other families in the same position is one of the best things we can do, especially when we are facing the toughest of times. When we had to tell our daughter that she could no longer live with us, it broke our hearts. But, we did so on the advice of her psychiatrist. Do you know what I think? I think we all suffer from compassion fatigue syndrome, if there is such a thing. I have seen health workers in a psychiatric hospital who are exposed to lots of trauma and I see the same signs of fatigue in them. To me they all seem to be at the point of exhaustion.”

Then she thought for a moment and added; “The stress wrecks marriages as well as health,” she told me.

“There was a woman in our support group whose husband suffered from severe depression and the stress of living with that almost wiped her out. She told the group; “My husband slipped into a depression aftr we’d been married for three years. As a result, he lost his job and most of his friends. On one occasion I went with him for a job interview and as we got there, he turned to me and said; “I’m sorry but I can’t do this. It seemed as if he’d decided to give up on life altogether.”

“How did you cope then?” I wanted to know. “I didn’t really. When he was in the depths of his depression, he paced, cried and was unable to sleep much. All ideas of going back to work were banished and he spoke of taking his life and leaving me to get on with mine.”  I hugged her as I didn’t know what to say.

“It took a few years, but when my husband did manage to come out of his depression, the whole family felt better.”

 

 

People who bring you down

A smart social worker once told me that relationships should help and not hinder. She suggested that we all spend time only with people who are likeminded and who do not upset us. When my husband was ill, I remembered her words.

Some friends told me that they hated their place of work. I am sure that if they liked their co-workers, their attitudes to life would  have changed.

I learned not to be afraid of change as life consists of so many changes. Every day is different; a new beginning and a new ending. I made the effort to embrace life and make the best of it.

I learned that good looks attract my eyes but personality attracts my heart.

What I am still trying to learn is that a tired mind is a less productive one.

Because life is unpredictable, I have learned to be prepared. There is a big difference between being scared and being prepared. After all, I will only live once.