Stigmatization of People with Mental Disorders

"Stigmatization of people with mental disorders is manifested by bias, distrust, stereotyping, fear, embarrassment, anger, and/or avoidance. Stigma leads the (public) to avoid people with mental disorders. It reduces access to resources and leads to low self-esteem, isolation, and hopelessness. It deters
the public from seeking, and wanting to pay for care. Stigma results in outright discrimination and abuse. More tragically, it deprives people of their dignity and interferes with their full participation in society."

--U.S. Surgeon General Dr. David Satcher (ret.)

Friday, May 27, 2011

Mania Comes to Call

The first phase of mania is intoxicating and euphoric. I was confident and super-humanly productive today…I felt joyous as an indefatigable energy pumped through my veins. At first I was infallible, but as the thoughts jetted faster and faster through my brain, I began to notice small errors and somewhat poor decisions. Now I am at mach one and am fighting the agitation that is interfering with my ability to focus. I know the course…agitation will exacerbate into rage and if I don’t find the brakes, the mania will threaten my well-being.

I know what to do. I should reach out for a calming hand, but I hide it from those who have signed on for this erratic journey. I should take the medications that will slow me (and dumb me) down. Sounds simple, but when you spend a large portion of your days incapacitated by black depression, it’s hard to let go of the rush. I lie to myself and say I’ll be OK, I’m just excited. Look at everything I accomplished today. Who can I call to talk to…or, more accurately, talk at, as the thoughts race through my brain? Let’s email. Let’s Facebook. Let’s write a significant essay. Let’s clean the bathroom and wash four loads of clothes. Let’s get dressed up and go out for a drink. STOP! “Danger, danger, Will Robinson.”

After years of suffering and repeated hospitalizations, I was finally correctly diagnosed as a rapid-cycling bipolar 1 at the age of 49. It has taken seven years for me to truly know the beast and to find a successful medical management plan. I lost a successful career, most of my friends, and almost lost my life on several occasions. I am my worst enemy and my best ally…It’s my choice to make.

So I’ve fought the urges and taken meds to stop the fast-moving train. I will get much-needed sleep tonight and wake up a little lower on the mood grid tomorrow. If not, I’ll call my doctor and alert those closest to me. I have a responsibility in managing this illness and the pleasure is not worth the pain…I will not let this illness beat me.

Friday, April 15, 2011

Disorders Do Not Define: Living With Bipolar Disorder By Sheree Ann Martines

I remember when mental illness was a social stigma… There was no applause… no public accolades for undergoing treatment. It was commitment, plain and simple. Mental illness was a character defect-- cause for social isolation, job discrimination, and shame. There were no posh clinics; only dark corridors locked away from the world. At 22, I was ushered through those padlocked gates. I met the faces of psychosis and schizophrenia; the lost souls haunted by delusions and dementia. Many, like me, were buried under despair so deep; we had pursued a death of our own design. You lowered your head as you walked those halls, fearful of seeing your pain in another’s eyes.

After six weeks of therapy, my cognitive exorcism was deemed successful. I rejoined the world, unaware that the true nature of my illness remained hidden, and a long hazardous highway stretched out ahead of me. Burning to prove myself, I learned the power of overcompensation, and rose like the young phoenix. For more than two decades I successfully climbed the ranks of non-profit management.

During those years, the Americans with Disabilities Act passed, opening doors for many individuals living with mental and physical challenges. Mental health hit the mainstream with vast economic impact. Corporate benefits expanded to include a mental health component…If you weren’t on Prozac, you knew someone who was… AND every new drug for anxiety or depression was backed by a seven-figure marketing campaign. NO potential employer could ever again ask about my mental health history.

Confident my demons were in the past, I hardly noticed as my equilibrium progressively intertwined with emotional extremes. I began fighting to function on a sustained basis, burning through sick leave like a spark on gasoline. Vicious rages contorted me like a willow in a Nor’easter. The tide surged in and the foundation of my life crumbled in its wake. Only then, did I learn my demon’s name…I was one of more than 5 million Americans living with bipolar disorder. Untreated, this genetic illness exacerbates, slowly decimating a person’s ability to live a “normal” life… tossing them between cycles of paralyzing depression and self-destructive mania. Fifty percent with the disorder attempt suicide at least once. Of those, one in eight succeeds in their efforts to end life. I am well-acquainted with that desire to die.

Ignorance about this illness persists, despite legislation and health benefits. Trust me: You cannot “just snap out of it.” You do not choose to lose your career, your friends or your life. You come to accept that your sanity, EVEN your survival, will forever depend on a daily regimen of ever-changing medications.

I have a role in controlling this illness.Every setback teaches me something…Behaviors, triggers, responses–how to reach out. I no longer fear the social stigma or silent prejudice harbored by some. I must forgive those who stepped away along the ugly course of my illness.It takes stamina and understanding to endure my erratic and irrational behavior... to seek me out when I withdraw from life…to listen as I speed through a digressive one-way discourse…to painfully watch my self-abuse. To be the last barricade between me and death...Those who love me enough to ride it out are my blessing and my strength. I HAVE a disorder…It does not define me. I remain the loving, intelligent, and compassionate woman I have always been. This illness will not beat me! I WILL find joy in the middle ground.

Wednesday, March 16, 2011

Mania-The Morning After

The first arrows of sunlight are cutting their way through the trees outside my window. I sit with my head in my hands on the morning after the culmination of a severe manic episode. Clips of my behavior wash over me in horrifying detail. I am ashamed and bereft.

How many friends did I alienate with my caustic tongue and my grandiose exhibition? How many witnessed or got caught in the path of my mercurial madness?

Apologies and self-flagellation bear no weight against the eviscerating depression that now has sovereignty over my life.

It matters not that my doctor emphatically assures me the extremes of this disorder are out of my control, but it’s still hard for me to understand the physiology of defective nerve cells and brain chemistry. I know I am to blame. I know the signs…I know what steps I can take to keep the manic monster at bay. Instead I recklessly did the opposite: days without sleep, haphazard adherence to my meds, and excessive use of alcohol.

Mania is one of the extremes in the bipolar spectrum. A manic episode is characterized by a distinct period where one’s mood is abnormally and persistently elevated. The initial stages of mania are somewhat deceptive and hard to resist, especially when escalating from a period of deep depression: euphoria, frenetic energy coursing through your veins…The world is full of magnificent possibilities and there is no time or need for sleep. Family and friends who comprise the support network for the bipolar patient should be alerted immediately if their loved one is not sleeping. It’s not too early to step in.

As the manic episode escalates, other symptoms include rapid speech, hyperactivity, and distractibility. Racing thoughts, the inability to focus, irritability, and anxiety are also signs of exacerbating mania.

In full-blown mania, an individual may exhibit rage, self-destructive or suicidal behavior, and a loss of contact with reality. All these symptoms are aggravated by the individual’s inability to see or acknowledge that they are sick.

Ideally, the bipolar patient will sense the first stages of mania and contact their doctor. Sometimes a minor change in medications can head off the deceptive pleasure of mania before behavior is out of control. Often the task of calling the doctor falls upon those closest to the individual. In some severe cases, hospitalization may be required.

In the wake of mania I feel sad, alone, and ashamed. I know I must look at this as a setback, and brand in my mind the lessons that should be known all too well by now…So I call my doctor, take my medications, get some rest, and make amends where amends can be made. I will always be bipolar and it is my responsibility to play my part in managing this disorder.

I will not be defeated by this illness.