Nov 20

“That’s Mental”: Bipolar II in Humorous Essays

That’s Mental: Painfully Funny Things That Drive Me Crazy About Being Mentally Ill  by Amanda Rosenberg, is a series of brief essays divided into BC (Before Crazy) and AD (After Diagnosis).

PureWow tells us that Rosenberg finally received her correct diagnosis of Bipolar II following “a mental breakdown, suicide attempt, stay in a psych ward and misdiagnosis of borderline personality disorder.” Bipolar II is seen when an individual doesn’t have full-blown mania but does have both depressive and hypomanic episodes.

“Rosenberg describes her depressive episodes as feeling like her head is ‘clogged up with a toxic sludge,’ while manic episodes mean she’s ‘impulsive and obsessive,’ and finds it difficult to articulate how she’s feeling. ‘Everything [is] CAPS LOCK’.”

How was she not diagnosed earlier? Largely because, as a part British, part Chinese woman, she didn’t fit the archetypal ‘mentally ill‘ person (either a brooding, misunderstood straight white man or an off-the-handle straight white woman). The thing is, she reminds the reader, mental illness doesn’t discriminate. ‘It’s not just straight, white, ethereal-looking people who get depression. Asian people are depressed. Black people are depressed. Queer people are depressed. Trans people are depressed. People with disabilities are depressed.’

In a pertinent excerpt about mentally ill characters on TV (Salon) Rosenberg further notes: “I have nothing against white people playing characters struggling with their mental health. But when you’re a non-white kid and the only people you see on-screen are white, it seems like they’re the only ones who experience mental illness. Not just that—they’re the only ones allowed to have a mental disorder.”

Mental health stigma, grief and loss, trauma, unhelpful advice offered by others, and the difficulty of taking mental health days are just some of the topics covered in Rosenberg’s book. Also, of course: medication and therapy.

Among the favorable reviewers is comedian Sara Benincasa, author of Agorafabulous!: Dispatches From My Bedroom (see my previous post): “Amanda Rosenberg writes in a very funny, wonderfully accessible way about her experience with bipolar II. She uses her experience as a jumping off point for advice that feels like it comes from a candid friend. Then, just when she’s got you comfortable, she punches you in the gut with a small snapshot of agonizing grief or a particularly evocative, elegant turn of phrase. Truly, this is my absolute favorite way for a writer to approach a tough subject, and she does it gloriously. May this book serve to make you laugh and to increase your compassion for all who live with mental illness. Perhaps you’ll even be kinder to yourself.”

Apr 25

Mental Health Stigma Arises from Language

One of the clues to mental health stigma is in our language. Why do many, for example, talk in hushed tones about the “mentally ill” but are not so judgy or secretive when reporting about the “physically ill?”

More specifically, why do we say someone “is” his or her diagnosis, e.g., he or she IS schizophrenic, versus saying that person “HAS schizophrenia”? Do we ever say so and so “IS cancer”? Or “IS a broken leg”?

Mental health stigma is definitely at play. Another language example comes from researchers at Ohio State University. They reported (Science Daily) that when participants heard about “the mentally ill” they showed less tolerance than when they heard about “people with mental illness.”

What is “mental illness” anyway? A couple definitions:

  • American Psychiatric Association: “…health conditions involving changes in thinking, emotion or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities.”
  • National Alliance on Mental Illness: “…a condition that affects a person’s thinking, feeling or mood. Such conditions may affect someone’s ability to relate to others and function each day. Each person will have different experiences, even people with the same diagnosis.”

Psychiatrist Thomas Szasz (1920-2012), on the other hand, famously proclaimed “the myth of mental illness” in his “Manifesto” :

Mental illness is a metaphor (metaphorical disease). The word disease denotes a demonstrable biological process that affects the bodies of living organisms (plants, animals, and humans). The term mental illness refers to the undesirable thoughts, feelings, and behaviors of persons.

Likewise, David Oaks, a “psychiatric survivor” and founder of MindFreedom International, has proposed that “‘mentally ill’ reflects a medical model that’s too narrow. If you’re okay jusing this model about yourself, that’s one thing, he adds, but it shouldn’t be the only way of looking at things. Thus he goes further:

…Let’s stop legitimating the use of words and phrases like ‘patient’ and ‘chemical imbalance’ and ‘biologically-based’ and ‘symptom’ and ‘brain disease’ and ‘relapse’ and all the rest of the medical terminology when we are speaking about those of us who have been labeled with a psychiatric disability.

What kind of language might serve us better?

Are we supposed to go the way of insurance company lingo, I wonder, and try to view issues as “behavioral health” versus “mental health”? Less about your brain or having an illness, more about what you do? Even though they simultaneously require billing codes that label people with mental disorders in order for them to qualify for coverage?

Anne Cooke, PhD, proposes the following to psychiatrist Allen Frances in a Psychology Today post on a related topic: .”..Why not just use people’s own language? That way we enable people to define their own experiences and avoid imposing our own ideas on them.” (This advice would be more applicable to everyday or clinical usage than helping clients use their insurance coverage, I need to add.)

But what about, asks Frances, the more severe issues that actually require proper diagnosis or labeling in order to have an understanding of how to resolve them? Back to an earlier analogy, a broken leg can’t be properly fixed if we don’t diagnose it correctly in the first place.

No easy answers, but a combination of knowledge and sensitivity will at least guide our communication toward some better places.

Oct 07

Patrick Kennedy Portrays “A Common Struggle” In Book

Former U.S. Congressman Patrick Kennedy (RI-DEM) is probably best known and appreciated professionally for what he’s done for mental health parity—as he says, making “the scope of mental health coverage the same as all the rest of physical health care coverage.”

And he hasn’t stopped there. Since leaving the House of Representatives in 2011, he founded the Kennedy Forum, an organization that supports various mental health initiatives, and co-founded One Mind for Research, which studies brain disorders. One common thread among his different pursuits is his desire to eliminate mental health stigma.

Patrick Kennedy is probably at least as well known both for being the son of Joan and Ted Kennedy and for having well-publicized though not necessarily publicly understood personal problems.

Believing in the 12-step program maxim “You’re only as sick as your secrets,” Kennedy has come out in recent years about the specific nature of his long-term battles with substance abuse and mental health issues. He has also finally, after repeated efforts throughout his lifetime, made his sobriety stick—four-plus years worth, he says.

In his new book A Common Struggle: A Personal Journey Through the Past and Future of Mental Illness and Addictionco-authored with journalist Stephen Fried, Patrick Kennedy expands not only on his own story but also on that of his famous family—thereby breaking what he calls “the Kennedy code of silence.”

This past Sunday, the evening before the book’s publication, Kennedy was interviewed by 60 Minutes anchor Lesley Stahl. He expressed his awareness that many of his family members will not be happy with his revelations and/or perspectives.

“It’s a conspiracy of silence,” he notes, “not only for the person who is suffering, but for everyone else who’s forced to interact with that person. That’s why they call this a family disease.”

Although he writes mainly about his own issues, Patrick Kennedy also addresses certain family secrets—examples include the extent of the alcohol problems of both parents, the probable PTSD of his father (related to the tragic assassinations of brothers JFK and RFK), and the effects of no one discussing or processing these incidents as well as others, e.g., Chappaquiddick.

Stahl: “You actually say that because nobody talked about these things in the family, you were all kind of like zombies…”

Kennedy: “Well, we were living in a limbo land where all of this chaos, this emotional turmoil, was happening. And we were expected just to live through it.”

Somehow he has lived through it, and now he’s also managed to turn himself around. Currently he does what he can to maintain his sobriety, which includes daily 12-step meetings, and to treat his bipolar disorder, which includes taking appropriate medication.

So far, notably, it seems that news about A Common Struggle has focused more on the family’s negative reactions to it and less on reporting or reviewing its actual contents. The Boston Globe, however, calls the book “strikingly raw and emotional,” while other readers have applauded this Kennedy’s courage and openness.

Mar 02

Jessie Close: Memoir About Bipolar Disorder

You would have thought that after Glenn starred in Fatal Attraction, our family would have had a serious discussion about mental illness. Even Glenn didn’t see the connection between the crazed Alex Forrester character she’d portrayed and me. Jessie Close, Resilience: Two Sisters and a Story of Mental Illness

Many familiar with actress Glenn Close may already know she’s had an active role in helping to eradicate mental health stigma and that both her younger sister Jessie Close and her nephew Calen, Jessie’s son, have spoken openly about their own mental health issues.

In this PSA for their organization Bring Change 2 Mind, Calen, who has schizophrenia, is front and center. Glenn and Calen’s mom are also featured:

Recently Jessie, assisted by both Pete Earley and Glenn, wrote a memoir, Resilience: Two Sisters and a Story of Mental Illness, which reveals that a diagnosis of bipolar disorder with psychotic features was a long time in coming for her. 50-ish when she began to learn about her condition, Jessie had already experienced five failed marriages and a history of drug/alcohol addictions. And her son had been diagnosed with schizophrenia.

From an excerpt Early provides on his website, we learn that Jessie had actually been haunted by voices since her teens. She refers to the voices as “the Creature”—and they often told her to kill herself.

Was there anything significant from Jessie’s childhood that may have affected her mental health? Possibly. Kirkus Reviews describes a history of parental abandonment and family cult involvement:

…(H)er story quickly escalates into a harrowing ride for readers unaccustomed to the ups and downs of someone living with a mental disorder. When her parents joined the Moral Re-Armament [a cult] in the 1950s, Close’s childhood became chaotic, with frequent moves, one of which led the family to Switzerland and another to the Belgian Congo, where her father was physician to President Mobutu. By 15, she’d moved back to America to live with her grandmother and instantly began experimenting with sex, drugs and alcohol, three things Close would continue to abuse for the next three decades.

Selected Book Reviews

Publishers Weekly: “Close’s story alternates with brief corroborative vignettes written by her sister in a belabored and grim memoir that will nonetheless reach its intended audience thanks to the author’s famous sister and their shared nonprofit group geared toward mental health, Bring Change 2 Mind.”

Keith Herrell, Bookpage: “With a title like Resilience, it’s a foregone conclusion that the book will end on a hopeful note—in Close’s words, ‘a new chapter in my life, one of sobriety, hope and purpose.’ With her sister’s encouragement, Close is telling her story to the world in hopes of removing the stigma from mental illness. It’s a story well worth reading.”

Sharon Peters, USA Today: “Keep plugging through it. She has lived a life that even at her worst was spellbinding, and it’s a definitely-worth-the-read memoir.”

Nov 22

People with Schizophrenia: Susan Weinreich, Elyn Saks

Please hear this: There are not ‘schizophrenics,’ there are people with schizophrenia. And each of these people may be a parent, may be your sibling, may be your neighbor, may be your colleague. Elyn Saks, author of The Center Cannot Hold: My Journey Through Madness

Among people with schizophrenia who are open about it and have been managing it is Susan Weinreich, an artist diagnosed with paranoid schizophrenia. From Andrew Solomon‘s Far from the Tree, meet Weinreich:

Another woman who has come out about her schizophrenia is Elyn Saks—attorney, professor, founder of the Saks Institute for Mental Health Law, Policy, and Ethics, author of The Center Cannot Hold (2007), and speaker of the above-cited quote.

Saks explains the three things that have helped her survive (from CNN): her treatment (including psychoanalytic psychotherapy and medication), a community of friends and family, and the support of her workplace, the USC Law School. “Even with all of that — excellent treatment, wonderful friends and family, enormously supportive work environment — I did not make my illness public until relatively late in my life. And that’s because the stigma against mental illness is so powerful that I didn’t feel safe with people knowing…”

Her story is also available as a TED talk of longer length:

Selected Quotes from The Center Cannot Hold:

My good fortune is not that I’ve recovered from mental illness. I have not, nor will I ever. My good fortune lies in having found my life.

No one would ever say that someone with a broken arm or a broken leg is less than a whole person, but people say that or imply that all the time about people with mental illness.

Dropping in and out of your own life (for psychotic breaks, or treatment in a hospital) isn’t like getting off a train at one stop and later getting back on at another. Even if you can get back on (and the odds are not in your favor), you’re lonely there. The people you boarded with originally are far, far ahead of you, and now you’re stuck playing catch-up.