My Sojourn through Bipolar Illness – What to give up to fight stigma?

Do you feel uncomfortable when there is a news announcement of a violent crime committed by some one who is mentally unstable or mentally ill?  How can we address this stigma such that those of us who live with a mental health diagnosis largely lawfully are not readily lumped together with those people who are committing heinous acts due to their instability?

What might the typical mental health or substance use patient have to give up if there were to develop a Paranoia Hotline, a Paranormal  Institute or a Cohort Model is some level of privacy? (Please see prior posts for a discussion of these concepts.)  It is a “no brainer” to me that weapons do not belong in the hands of the mentally ill even when they are in recovery. 

I also believe we as a society should allow therapists and doctors to report clients who may be showing signs of being a danger to others. This is very tricky territory, but it seems to me that the person providing mental health care should be able to report findings to some larger group whose mission is to follow-up and investigate and intervene if the concerns raised by the therapist show that a patient is a threat to others.     At a minimum in my opinion, such notice from a therapist should ensure the patient goes on a weapon do-not-sell list.

In the past ten plus years the number of school or mass shootings in the US has sky-rocketed with the age of impacted schoolchildren often getting younger and younger.  I feel it is the responsibility of people with mental health diagnoses who know how dangerous paranoia can be and how quickly it can develop into an unsafe situation to speak up in favor of controlling and denying access to guns and other weapons for the mentally ill.  I also think the dialogue about what a therapist can reveal about his or her patient warrants more attention.  If a patient is clearly a danger to others, this fact should be communicated to a third party in charge of reconciling the account.    As people who strive day in and day out to be safe when there is often unsafety lingering around in the shadows, people with mental health diagnoses need to speak out as a group to ensure that lawmakers make weapons inaccessible to the mentally ill and provide societal intervention and/or follow-up for people who seem to be a danger to others.

It is only when we start to differentiate people who are a threat to others from people experiencing mental health symptoms but are no danger to others are we able to begin to address the stigma associated with mental illness.  The public needs to know that it is a small percentage of people with mental illness who are actually a danger to others so that we who are living with the impacts of mental illness are not lumped into that category of “danger to others”  and receive all the stigma that goes with that. These people who are a danger to others need early intervention from healthcare providers and first responders so that they do not act on these impulses to extend dangers to others.

What does behavioral health mean, anyway?

My last blog post referenced those with mental illness and addiction issues under the same umbrella of “behavioral health.” A fellow blogger had the insight to question use of the term “behavioral health” which is used widely in the US but perhaps not elsewhere. She is at: https://mentalhealthathome.org.

The challenge for me is finding a term that includes mental illness and addiction in the same breath. At first glance “behavioral health” does that – include mental health and addiction diagnoses. But as my fellow blogger and friend pointed out “behavioral health” is a weird way of describing mental illness and addiction. The use of the term “behavioral health” seems to imply that all that us mental illness or substance abuse sufferers need to do is change our behavior and all will be well.

Further, the term “behavioral health” does not include the more common understanding that both mental illness and addiction are associated with or caused by a chemical imbalance in the brain. The chemical imbalance is clearly an illness.

While there is room for behavioral change in any illness diagnosis including cancer and heart disease, the idea that a diagnosis can be reversed through behavioral change is missing the point. If I have heart disease, I can change my diet and exercise regime. If I have cancer, I can also adopt a healthier diet and exercise. However, my diagnosis of heart disease or cancer is not defined by my behavior. It is defined by the diagnosis and prognosis of the illness itself. If you are dying of heart disease or cancer, no one says “change your behavior and all will be well.”

So why should we term mental illness and addiction as “behavioral” issues? The key to understanding mental illness and addiction is in understanding there is a chemical malfunction in the brain. Sure, you can mitigate this some with behavioral changes, but that does not mean that mental illness and addiction are explained best by our behaviors or changes to our behaviors.

What are your thoughts on using the term “behavioral health?” Is there another term you choose to use to describe mental illness and addiction?

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My Sojourn through Bipolar Illness – the Red-Headed Step-Child?

Has behavioral health always been the red-headed step-child in terms of research and funding levels? If these levels of research and funding followed the severity and reach of mental illness and addiction, might we see the following results? What if behavioral health funding were equal to say cancer funding or heart disease funding or diabetes funding?

  1. For one we would have adequate beds to treat people who needed inpatient care for behavioral health or addiction. 

2. For another, we would have adequate funding to develop psychotropic drugs and other interventions without such severe side effects as weight gain and Type II Diabetes onset and memory loss. 

3. Additionally, we would be treating war veterans for mental health and addiction impacts that can go untreated.

4. Fourthly, we would have enough resources to fund the Cohort Model discussed previously for people experiencing a significant event or setback. 

5. Fifthly, with more co-mingling of people with and without a behavioral health diagnosis we might be able to reduce stigma substantially.

6. Finally and most importantly, by being proactive in our behavioral health and addiction programs in the United States, we may be able to develop some early warning signs among people struggling with depression and/or paranoid thoughts and/or addiction so that we can care for those patients before their symptoms become dire.

What about weight gain? Anybody experiencing that?

Asking about memory issues is popular on my blog, so I thought I would start a similar discussion on weight gain.

Back in 1985 when I was diagnosed with bipolar disorder, I was prescribed a combination of lithium and tegretol. There was a five to ten pound weight gain associated with those meds. With a diligence for exercise I managed the weight implications associated with lithium without a problem. As long as I stayed on lithium off and on until about 2004 my weight seemed largely manageable.

Fast forward to 2004 after the birth of my daughter. I never got off my baby weight. Also due to the postpartum depression, I suffered additional weight gain in that I ceased to be motivated to run 4 to 5 times a week. In fact, I am doing well now to get a short walk in.

In 2008, I was prescribed clozapine / clozaril which largely became therapuetic for me but also was associated with a good bit of weight gain. To this day I am 20 to 30 pounds heavier than I want to be. I also want to be walking regularly. In addition to the meds’ impact on weight, I began to eat as a nervous eater and a stress eater. This did not help with the weight issues.

I am hopeful if I can jumpstart myself back into an exercise regime, I can begin to address the weight-gain and the stress eating. Because my daughter is pescatarian we largely eat healthily as a family but portions are too large and snacking is too much.

Anybody Experiencing Memory Loss (revisited)?

This original blog post on memory loss and mental illness posted almost 2 weeks ago has had the most traffic of any of my posts: https://wordpress.com/block-editor/post/mental-health-is-health.com/473

For that reason I am revisiting it. With this update, I am trying to understand when people experience memory loss, what kind of memory loss it is and how long it lasts.

  1. Are your memory issues associated with certain episodes of mental illness, meaning they just occur when you are in a depressive state or manic state or the equivalent for you?
  2. Do these memory issues linger after the episode is complete?
  3. In other words is your memory loss temporary during the episode or does the memory loss remain after the episode is complete?
  4. Are you more likely to experience short-term memory impacts or longer term memory impacts?
  5. What coping mechanisms like writing notes, leaving reminders on your phone have you adopted to help manage the memory loss?
  6. Do these mechanisms help you manage the memory loss?
  7. Would you say the memory loss is mild, moderate or significant?
  8. Have you talked this through with your care team / doctor / therapist?
  9. Do you believe the memory loss is a function of the mental illness or the medication or both?
  10. Do you feel covid-19 is a factor in your memory loss?

My memory loss issues are largely short-term — where did I put the car keys or the phone? I also might forget going to a certain restaurant a month or two ago. My memory issues tend to exist during and after episodes and are not episode-specific. The memory loss is there whether I am showing signs of bipolar break-through symptoms or not but are worse for example when my anxiety is high. So far, I have not taken this up with my therapist and my doctor since the problem has been on the mild side. But since the memory issues may be getting more prominent I will likely share with my therapist and my doctor at my next appointments. I am not sure whether the memory loss is medication-specific or illness-specific. I use notes and to-do lists all the time to help manage as well as a few reminders on my phone. I use a hand-written calendar to track appointments and dates. I also use my online calendar to manage appointments as well. I have a bulletin board set up in the kitchen as well to post things that need my attention in the short-term or mostly in the long term. I would say covid-19 is a huge impact since all the days do run together one to the next.

Thanks for sharing your insights on memory loss as you are able.

If you had a wish list for your mental health, what would it look like?

Here goes nothing….

  1. I wish for psyche meds to be 100% therapeutic 100% of the time.
  2. I wish for no side effects to meds like drowsiness or weight gain or Type II Diabetes.
  3. I wish to recover all those times when I was emotionally inaccessible to those closest to me due to my bipolar illness condition – this is mostly having to do with family and definitely has to do with my daughter.
  4. I wish for my bipolar condition not to be genetically an issue for my daughter.
  5. I wish to undo any harm / make amends for any harm I have brought to people because of or during my bipolar condition.
  6. I wish for the stigma associated with mental illness and addiction in society to magically disappear.
  7. I wish for the United States to have a healthcare plan that covers everybody at a reasonable cost including pre-existing conditions and including mental health and addiction benefits.
  8. I wish for the covid-19 virus to become a thing of the past as quickly as possible since it has so many emotional components that impact my mental health and the mental health of others.
  9. I wish for a covid-19 vaccine in the next 4 to 6 weeks or better yet now.
  10. I wish for a support team for anyone experiencing any sort of mental health or addiction diagnosis / symptoms and that that support team is always there for you.
  11. I wish for everyone with mental illness or addiction issues to never feel alone or never feel separate from the rest of the world.
  12. I wish the world to embrace and include all people no matter what their diagnosis, skin color, religion, etc.
  13. I wish I could return to the weight I was when I married or close to it…..

What would your wish list look like?

Anybody Experiencing Memory Loss?

This is a question for folks who have a mood disorder including bipolar illness. For the last several years I have been experiencing mild to moderate memory issues. I have chalked it up to strong psyche meds and basically have not worried about it much. What is the most difficult is that sometimes I forget where I put things. It seems worse for short-term items than long-term items and so far is manageable. It seems worse in the age of covid-19 than before March 2020.

I am wondering if memory issues typically accompany mood disorders including bipolar illness? Not big things like forgetting family names and places but where I put the phone or the keys. So far, I have chalked this up to too much brain function due to the bipolar and too much time at home due to covid-19.

Has anyone with mood issues noticed short-term memory impacts? Thanks in advance for sharing.

Giving Thanks…

I am not yet in the habit of giving thanks every day for my blessings. So here goes a try…..

I have a beautiful (inside and out) daughter. She is healthy, funny, smart, caring and resilient. I have a loving husband and understanding in-laws. He is non-judgmental and generally puts up with my anxiety that surfaces almost every day on some level. My in-laws also are not judgmental. I have a very good relationship with my Mom who is 83 though this has not always been the case. Now, she and I can talk pretty openly about events of the day including things that are hard emotionally or difficult because of my diagnosis. I have a solid rapport with my older sister who lives up North but continues to be a support for me every time I ask which is fairly often. I have a therapist I can trust and a doctor/ psycho-pharmacologist who I can talk to about raising or lowering meds depending on what’s going on with me. I have seen my therapist and my meds doctor since 2008 — there is little they don’t know about me and that is a blessing. I take meds that are largely therapeutic for me. I recently had a scare (this summer) with breast cancer but thankfully the mammogram, ultrasound and MRI were all benign / negative. I have strong bonds with my best friend from 1985 forward. She and I can talk to each other about everything and anything pretty much.

In writing this, I am noting that most of the things I am thankful for are relationships and health. Does any one else see a pattern in what you are thankful for?

My Sojourn through Bipolar Illness – Cohort Model Proposed

Adequate resources for mental health in my book would include funding allocated to the development of a Cohort Model to assist those experiencing a debilitating health event to gradually reenter society.  In my opinion, it would be less expensive for the State (at the State and Federal levels) to offer a Graduated Reentry Program than it is to provide disability insurance payments for all those who are unable to work a full-time job due to some sort of behavioral health or developmental disability.  This might include a mood disorder and/or an addiction issue.  In my opinion, people with behavioral health diagnoses ought to be able to work a 10 to 20 to 25 to 30 hour week and bring home enough pay so as to be a valid contributor to a family’s income.    Today this is generally not the case.  There are few part-time jobs available in the market today and the ones that are available do not provide a living wage or health insurance or occur during times of the day that are generally associated with sleep or family time. Also, disability payments in the US are few and far between and very difficult to qualify for.

The idea of a “Graduated Reentry Program” is that behavioral health consumers would progress from a 10-hour work week to a 20-hour work week to a 30-hour work week to a 40-hour work week depending on their health.  Participants would still be eligible for health insurance during this time provided they were engaged in all prescribed wellness activities.  When the hourly work week is at a reduced level, participants are expected to attend any given number of behavioral support meetings with their doctors or their therapists or in their community in order to prevent a repeat occurrence.  The reduced work week would be coupled with a regime of self-stewardship that might include mood support and recovery meetings, meetings with a therapist and/or meetings with a psycho-pharmacologist.  This time might also be time spent developing an exercise regime to reduce stress and limit unwanted thoughts.

The idea of a “Graduated Reentry Program” assumes:  1) behavioral health patients have serious work to do that is not part of a paying job typically and 2) it should be cheaper in the long-run for the State to sponsor a partial work week for behavioral health patients until such a time that they are ready to work a 20, or 30 or 40 hour week.  3) This type of program would allow people who manage a serious behavioral health disability or addiction to still earn a “living wage” even if they were working 25 or 30 hours of work per week.  4) This ability to work at a reduced level in order to dedicate time to managing aspects of the prescribed illness through support groups and support group programs, exercise and diet regimes, talk therapy programs and med management programs is hugely different than how that juggling act occurs today. 

Many people with mental health conditions, including myself, may not be able to work a full-time work schedule.  These people should have the sponsorship in society of working a 10 or 20 or 30 hour a week job as they are able.  Many people with mental health conditions seek financial assistance through Social Security Disability Insurance payments.  While this is often considered a critical financial development for some people with a mental health diagnosis, consider if more emphasis was additionally provided on programming to reentry society and the economy. 

Again, it is my belief that such a Graduated Reentry Program would pay for itself by increasing the productivity of workers who may move from a disability status to a 10 or 20 or 30 or 40 hour a week job status.  If it does not pay for itself, I believe the cost savings from the Paranoia Hotline / Paranormal Institute would pay for this Graduated Reentry Program. (See prior post regarding Paranoia Hotline).

Through the on-going development of this text, I am becoming more and more clear to myself and in myself as to my current emotional challenges.  While I am clear that a high paying job in project management is not a fit, I am not completely clear what type of job might be a fit for me.   While just a few years ago I was a keen advocate for a Graduated Reentry into society of working first 10 hours, then 20 hours then 30 hours a week, I currently am of the mindset that applying for Disability Insurance may be an important option for many people particularly in the absence of the Cohort Model in today’s America. If I am to continue to place a premium on our daughter’s development and on my own health, this may mean not working a job in the traditional sense.  This leaves the door wide open as to the possibility of making writing like the writing of this text to become “my work.”

My Sojourn through Bipolar Illness – Paranoia Hotline?

Is There an Impetus for Founding a Paranoia Hotline and/or Paranormal Institute?

*** Discussion includes talk of paranoia***

Another idea I have had along the lines of paranoia is in consideration of whether or not any aspects of paranoia are based on “the truth.”  What if my six-year-old child within has access to paranormal thoughts or heightened intuition like a blind person may have exceptional musical abilities?   What if other people with mood disorders or developmental disabilities have access to paranormal thoughts or heightened intuition?  What if there exist bits of truth, albeit highly fractured, that are hidden in paranoia?  Even if there is no paranormal thought pattern for behavioral health or developmental disabilities patients, what if we were able to develop a “Paranoia Hotline”?  People who have paranoid or paranormal (if they exist) thoughts would have a place to discharge and release or let go of these thoughts.

As an example, consider if 25 people call in with the same fear (this is a fictive example) that the water supply in Augusta is not safe.  The sheer number of people with the same paranoid thoughts may be enough to signal authorities that there is in fact some tangible threat to Augusta’s water that needs to be addressed. 

In this example, consider a man living in Minneapolis-Saint Paul who is telling his therapist that he envisions a strange color in the water in some US city.  Consider that three people in Boston call in with the fear that there is a strange odor coming from the Augusta water supply.  Consider two people in Newark call in reporting that Augusta is unsafe from terrorists.   Consider that one person has indicated a criminal who lives on East Woodland Road and is targeting the Augusta water supply.  Alone any one of these thoughts could be considered paranoia.  But putting these stories together possibly, possibly may mean there is an underlying element of “truth” to the paranoid perceptions.  Perhaps the threat to the Augusta water supply is clear in the aggregate of these reported thoughts in a way that would not be the case for any individual report of paranoia. If these paranoid perceptions have at their root a real concern or a real threat, perhaps that threat can be identified before harm sets in.  If this were to be the case that aggregate accounts of paranoia or paranormal thought allow crime prevention, a Paranormal Institute would more than pay for itself.    

This should be a “win-win” for everybody.  The behaviorally or developmentally ill have a place or a person specifically designed to listen to the dynamics of paranoid thoughts, review them or at a minimum unload them.  This creates a great sense of relief for the patient just in the downloading of the paranoid thought.  First Responders could create a database of all the reported paranoid thoughts and track their various data attributes.  If there were data trends in the data attributes, it may be that the information reported could prove helpful in preventing some sort of security threat or breach to society.   First Responders ideally might get more accurate and earlier aggregate data on various threats. 

Such a Paranormal Institute if found to be warranted may more than pay for itself in a matter of months or years.  The extra funding that may develop as part of this Institute could be designated to making the Cohort Model and Graduated Reentry Model discussed in an upcoming post a reality.  

Even if the data shows that there are no “paranormal” aspects to paranoia, such an institute may still be of use. The discharge and letting go of paranoid thoughts to a concerned party at a Paranoia Hotline may allow the patient relief from a life-threatening episode.  Even if my hopes of uncovering paranormal data trends from paranoia do not bear out, there still may be great value in a Paranoia Hotline. The Paranoia Hotline would ease the minds of the person reporting his or her paranoia.  Meanwhile First Responders may be provided extra time to assess and address what could be the precursor to a society-threatening event.   

All in all, I am not in a position to know if paranormal thoughts are a portion of what makes up paranoia.  I alone am not capable of making that assessment.  But, First Responders with a database of reported paranoia could readily research the data and make that determination.  Whether the data bears out for a Paranormal Institute or a Paranoia Hotline, either way the patient and society win.