GUEST OPINION: Quest for mental health: A story in first person
Published: Saturday, February 2, 2013 at 3:00 a.m.
Last Modified: Sunday, February 3, 2013 at 6:04 a.m.
A few years ago, while my children did homework at the dining table, I stood outside in the night, disabled by rage, hopelessness and self-hatred, brought low by another mental health breakdown. Between drags on a cigarette, I pressed the burning end to my arms, legs and chest.
It was not the first time I had hurt myself, but it was the most intentional and serious, and I did it for weeks. Some months later, following another stay in yet another mental health facility, and after much of a lifetime fighting baffling mental and emotional problems, I was diagnosed with bipolar disorder.
To write this is to say that I am among you; that those who deal with mental illness are in this life with you; that far more likely than not, we are empathetic, functioning, productive members of society. You should know us.
Nearly one in four Americans over age 18 has a mental disorder, according to the National Institute of Mental Health. Six percent of Americans, or one in 17 adults, have what is considered a serious one, such as schizophrenia, major depressive disorder or bipolar disorder.
Revealing myself like this is uncomfortable and not a little nerve-wracking. But my family and I feel it is worthwhile if it helps pull back the shadows that cloak the mentally ill and hinder us all from discussing mental illness openly and honestly. Because without proper treatment for the mentally ill, lives are at risk. Overwhelmingly, those are the lives of the afflicted themselves — more than 30,000 mentally ill people committed suicide in 2006, the latest year for which the National Institute of Mental Health provides such statistics. On far more rare occasions, other lives are in jeopardy, as with the 27 victims in Newtown, Conn., on Dec. 14.
Violence on anybody's part — whether self-inflicted or directed at others — is, among other things, an attempt to regain control. And for the under-treated or untreated mentally ill, loss of control, the loss of dominion over one's mind, is always a prospect. Therefore, for the seriously mentally ill, especially those with mood disorders, the potential for violence — again, nearly always self-directed — is also a real prospect. Adam Lanza and those around him appear not to have understood or contemplated that, with the most terrible of consequences.
Studies do suggest links between mental illness and violence, as the Institute of Medicine reported in 2006. But the report emphasized that “the contribution of people with mental illnesses to overall rates of violence is small.” Also, according to the American Psychiatric Association, “only 4 to 5 percent of violent crimes are committed by people with mental illness.” And thankfully, my own mental illness has not led to violence directed at others.
But since I was a teenager, my illness has shaped my life, interrupted it, fractured it, left it repeatedly in need of repair. When inadequately treated — or untreated — I veered from troughs of self-destructive depression to peaks of grandiosity and obsessive, often equally self-destructive behavior.
These days I take four expensive drugs, including anti-psychotics and anti-depressants. But it took me until my 40s to be accurately diagnosed and to find doctors who delivered an effective, long-term medication regimen, partly because I was slow to relinquish the notion that I could, on my own, solve what seemed like intractable character flaws. With medication, I have controlled my illness for three years now. But mental illness is for life, and I dread another journey into what, at its lowest depths and steepest cliff tops, is true madness, where all perspective fades, where the desire to escape mental and emotional pain leads to increasing irrationality.
And consider this: I have lived in a middle-class stream, usually with good health insurance, always with the support of loving friends and family members. Without those resources, that web of care, and continued access to treatment, it's possible I would not be alive to write this.
And yet my experience is that even with such advantages, the passage to diagnosis and treatment is tangled, and the mentally ill must often carve it themselves. No one wants to be mentally ill, no one wants their loved ones to be mentally ill, and society is largely uncomfortable with those who are. Perhaps for that reason, it is generally not the first thing that occurs to people trying to explain and address worrying and troublesome behavior, their own or others.
He's hot-tempered. He's merely immature. He's temporarily depressed. He's too excitable. He's different.
I was a lot of things other than mentally ill. I was often in therapy, which has enormous value but is not always, on its own, able to treat a mental illness. I was even, sporadically, given various medications, to be tossed like a dart at whatever my current state of mind.
My illness progressed essentially untreated. Even when the latest crisis developed and even with a history of being medicated and of hospitalizations, it took two years of increasingly erratic, dangerous behavior and a prescribed diet of support groups and different medications before I was involuntarily hospitalized.
But the hospital was just a dreary way station where sedated patients wearing paper slippers took shuffling walks around a dirt track. When I was deemed stable enough to have my shoelaces and belt returned — in other words, when I was no longer a danger to myself or others — I was discharged: demoralized, groggy from drugs and with no instructions about what to do next. It was my wife who had to call friends in the mental health field for recommendations for a psychiatrist. It was he who diagnosed me and started treatment specific to bipolar disorder.
Imagine not having the personal support I have: the rudimentary working knowledge of the health care system; the inclination or ability to negotiate that system; the employer willing and able to work with me while I struggled; the union contract that installed a net of protections I was able to rely on. All those things meshed to carry me through to a safe shore. I can't imagine how hard it is or would be for others not so blessed.
For living with an active, untreated mental illness is to live on the edge. It is to live with consistent, persistent, increasing pain. It is to live with the prospect of that pain leading to a gradual, or at times sudden, terrifying loss of self-control. That must be acknowledged.
But it is crucial to also understand what it is to live with an accurately diagnosed, well-treated mental illness. That can so often be a life of hope and satisfaction, of productivity and belly laughs. It is a life often heightened by the recognition that needless pains — perhaps even premature death — are being held at bay. It is to live a miracle.
Jeremy Hay has been a staff writer at The Press Democrat for 11 years. He lives in Santa Rosa. Email him at firstname.lastname@example.org.
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