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.)

Wednesday, August 15, 2012

Strong Woman

One of my dearest friends and I were discussing strong women on a sultry summer night. She was talking about how strong she was, and I echoed her when I matter-of-factly stated that I, also, was a strong woman. She laughed and then she snorted (Yes, snorted) and I was immediately offended to learn she did not consider me to be a woman of strength. I asked her, “Have you ever had someone you love die in your arms?” Very flippantly, she said, “Yeah,” but I knew that wasn’t true…then she added, “I just mean…well…you’re sick.” Those words delivered a crushing blow. Yes, I have a mental illness…I am a rapid-cycling bipolar 1 and I have had to bear the loss, stigma and isolation of my disorder along the way to learning how to manage this unwelcome disruption to my life.. My brother and sisters, who once looked at me with respect, now treat me as though I am a feeble child. That hurts. I was also surprised as I watched close friendships dissolve as my illness exacerbated. I felt betrayed and bereft, but as I became better acquainted with the aspects of my illness, I understood their departure from my life. Unmanaged, bipolar can be a very ugly illness, and, quite frankly, during the early days following my diagnosis, I wasn’t much fun to be around, and as bounced in and out of hospitals, and went through a plethora of drugs that either didn’t work, dumbed me down, or damn-near killed me, my social circle all but disappeared. My successful career was also a casualty of my illness, and to this day I mourn the loss of that. I became highly sensitized to the propagation of misinformation and stereotyping about this disorder. I am so tired and somewhat angry that the media frequently blames bipolar for violence and crime…The only violent behavior or crimes I ever committed during a bipolar episode were directed at myself, and I am fortunate that I survived. One in eight, with this disorder, is successful at ending their life…and many kind, worthwhile, and creative individuals are lost to us. For years I tried desperately to disguise my disfigurement until one day when I realized maybe, just maybe, I might be able to help or educate one person with this disorder, and mustering all the courage in my being, I finally stepped out of the closet and became quite vocal about individuals living with mental illness and its ensuing stigma. I became hopeful that I still had something to offer this world. I educated myself on every facet of the disorder and its treatment. I set up a web page on living with bipolar and began to discuss it openly when initiated by comments or other appropriate impetus. I have tried to live by example to show others I am not to be feared or avoided. Occasionally, I succeed, and that makes all my past suffering slip away a bit… Oh I still remember it, but it serves me well at times…keeps the fire in my belly burning.

As for my strength…as for being a strong woman… I survived a tortuous childhood of physical and emotional abuse at the hands of a man who wanted to decimate my spirit…. The love of my life died in my arms two weeks before Christmas, still I found a way to celebrate the life he lived and was strong enough to stand before 400 people at his memorial and give a very uplifting eulogy. His friends and family laughed, as together, we remembered the very full and good life he lived. I was devastated by the loss of the only real father I had ever known…He was a friend and a mentor and I still miss our long discussions and his wise advice. I still have some manic-depressive episodes, but I now know what I need to do to get through them. In a commentary for NPR, I coined a motto that I frequently use to end my articles: “I have a disorder…It does not define me.” I AM a strong and giving woman and, of course, I can be the funniest person I know. I will not let this illness beat me.

Wednesday, February 29, 2012

Supporting a Friend Living with Bipolar Illness

This is an unfinished article that definitely needs some additional work, but I wanted to get the guts of it posted. Stay tuned for a revised version.

Bipolar disorder (manic-depression illness) is still not understood very well in the mainstream, and when it is cited in the media, I often cringe, because the reference is usually negative. I get tired of hearing bipolar used as an excuse for criminal behavior. This just further reinforces the stigma and discrimination that many individuals with mental illnesses face. I cannot help it that the chemicals in my brain do not function as they should. I cannot help it that I have a genetically transmitted brain illness that interferes with the way I process and react to certain experiences, either propelling me into a manic rage, or sentencing me to a dark, debilitating bout with depression…and please understand: I cannot just “snap out of it.” A bipolar diagnosis is most often accompanied by a range of other problems including anger, anxiety, paranoia, and agoraphobia. I heard it said recently, that bipolar disorder had become a “fashionable illness.” This enraged me. My illness cost me my career, most of my friendships, my respectability, and more than once, my life was at stake. Doesn’t sound very fashionable to me.

The people in my life who know about and accept my illness are still often left at a loss for words and struggle to know how they might help me when I disappear into a manic or depressive episode. Over the years I have learned how to do a pretty good job of concealing the extremes of my illness. I hate knowing, that at times, I am a burden to those who love me, and consequently, I do my best to put on the smiling face and keep my voice light. Unfortunately, most often I withdraw from the world, trying desperately to hide my disfigurement. Many times, all the courage in the world will not help me reach out when I need it most.

So my family and friends ask: What can I do? How can I help? What should I know? I don’t have all the answers, but a few suggestions come to mind:
First and foremost, learn as much as you can about the illness. A wealth of information is as close as your keyboard.

Learning about the illness will help you begin to recognize signs and symptoms of an impending episode and help you know what you may be able to do to help your friend or loved one. Are they taking their medications? Are they getting adequate sleep? Several of my doctors have advised that they should be contacted immediately when the individual with bipolar stops sleeping. There are a number of medication adjustments that can be made to head off a manic episode.

If you have signed on to support a friend or loved one as they learn to live with bipolar illness, I commend you…It’s not an easy endeavor. Right up front you need to have an honest conversation with the individual to establish boundaries and gain understanding about triggers and signs related to their manic-depressive episodes. It is also important to have a solid support system in place that includes the family, friends, and doctors of the individual you are trying to support. When a crisis is looming, staying in touch with members of the support group is important. All involved should clarify and agree on what steps may need to be taken when the beast rears its ugly head. Has your friend unexpectedly disappeared for several days and can’t be reached by phone or email? It’s not an overreaction to get in your car and go to their house. Find them and try to assess what state they are in. Are they suicidal? Are they incoherent? Are they buried in their bed in a dark room? Are they agitated? Have they been drinking heavily, using drugs, or engaging in other addictions such as shopping or gambling? Sit down beside them and talk to them…Ask them questions about how they are doing and what they are feeling. Reassure them that you are there to help them get through this and that it is not their fault. Remind them that this illness does not define them. Sometimes if the individual is severely agitated or disconnected from reality, it may be necessary to take them to the hospital. Self-harm can be a very real threat when one is in the extremes of this illness.

As I said before, it can be an immensely difficult responsibility to provide support to the bipolar individual when they are in the grips of this illness. There is no shame in admitting you are not up to the task. Still, sometimes it is the simplest things that can make a difference for your suffering friend…holding their hand, giving them a hug, comforting them with calm words, giving them the encouragement to face another day…just being there at a time when they feel most alone.

I am immensely grateful to those who have helped me through the past eight years since my illness exacerbated. I owe my life and my well-being to their support:
My mother, Betty Van Covern, my husband Darryl, my remarkable friend, Sally Ann Frank Phillips, Doug W., Tom K., Mike T., my dear and loving friend, Kolina who shared with me a secret of life and reintroduced me to the world, my funny and compassionate friend,
Keri, my doctor Lance Reger, and my therapist, Linda Smith. I also must mention the many Facebook friends who have showed me support during some dark days. Thank you all.

I'd love to hear other suggestions on how to help your friend or loved one living with bipolar. I learn more about living with this illness every day...AND, oh yes, this illness will not beat me.