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?
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?
- 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.
Here goes nothing….
- I wish for psyche meds to be 100% therapeutic 100% of the time.
- I wish for no side effects to meds like drowsiness or weight gain or Type II Diabetes.
- 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.
- I wish for my bipolar condition not to be genetically an issue for my daughter.
- I wish to undo any harm / make amends for any harm I have brought to people because of or during my bipolar condition.
- I wish for the stigma associated with mental illness and addiction in society to magically disappear.
- 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.
- 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.
- I wish for a covid-19 vaccine in the next 4 to 6 weeks or better yet now.
- 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.
- I wish for everyone with mental illness or addiction issues to never feel alone or never feel separate from the rest of the world.
- I wish the world to embrace and include all people no matter what their diagnosis, skin color, religion, etc.
- I wish I could return to the weight I was when I married or close to it…..
What would your wish list look like?
Has behavioral health always been the red-headed step-child in terms of funding levels for medical research and treatment?
If the statistics on mental health and addiction were more widely publicized, would we begin to see more clearly the widening funding gap between dollars to treat and cure mental illness versus research and treatment dollars dedicated toward heart disease, diabetes or cancer? Currently, while mental health and behavioral health including the opioid epidemic and addiction pose tremendous challenges, the funds and expertise to tackle behavioral health and addiction just aren’t forthcoming at the same rate say for cancer research or funding. What would happen if we as a society could place as much money and effort into mental health and addiction research and treatment as we do into cancer? The projected impacts would likely be enormous.
- For one we would have adequate beds to treat people who need inpatient care for behavioral health or addiction.
- 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.
- Additionally, we would be treating war veterans for mental health or behavioral impacts that often can go untreated or undiagnosed.
- Fourthly, we would have enough resources to fund a Cohort Model of support for those in a crisis or post-crisis state.
- Fifthly, with more co-mingling of people with and without a behavioral health or addiction diagnosis we might be able to reduce stigma substantially.
- Finally and most importantly, by being proactive in our behavioral health and addiction programs in the United States, we may be able to develop awareness of early warning signs among people struggling with mental health and addiction before their symptoms become dire.
It only follows that research for and treatment of mental illness and addiction is proportional to the level of medical challenge that is presented with these diagnoses.
That I have felt loved by my family of origin as well as my family by marriage including my in-laws who put up with a lot of crazy behavior from me in the postpartum period has made a huge difference in my ability to move forward in my prognosis. Although it felt at times I was going it alone, in reality I have had and continue to have huge support from my family – as much as they were capable of providing given knowledge of the illness at the time.
Throughout my twenties and thirties, I seemed to pivot back and forth between the two models of successful marriages that I knew. At times I would fall for a guy who had no delight in earthly things (more like my Dad). At other times I would fall for a guy who was very established in his career and financially secure (more like my stepfather). This back and forth continued through the time that I met my first fiancé and ended when I met my current husband. My husband James was a perfect blend for the most part of the values of my Dad’s remarriage and the values of my Mom’s remarriage.
When I met James, he was very informed for a lay person about bipolar illness. He was successful in his own recovery from addiction and had heard many stories of bipolar illness in that context before hearing mine. Most of my prior boy friends had little if any experience with bipolar illness. In addition to his familiarity with my illness struggles, another aspect of our relationship was that we tended to fight well. Regardless of the topic, our fights were usually brief and seldom fell into the same old rut that marriage disagreements often follow. We continue to fight well today although we do have our marriage ruts to get through. The third aspect of our relationship which seems to help a great deal is that we share a faith journey. This faith journey has shifted in the past year due to a situation at our church which caused a massive leadership change. James and I still stay vested in helping to develop a faith journey for our daughter even though we as a family are not in a church right now.
James’ and my shared goal right now is for me to be volunteering or working a stable but not particularly demanding job preferably part-time. We are in agreement about what this goal is and what the desired future looks like. We continue to fight about money from time to time but in general our goals are on the same page.
This is a reworking of a comment I left on a prior blogpost I read and commented on….
I did not meet my husband (one and only) until I was 38 years old. Before then I had been in a series of relationships, some lasting a while (almost three years) and some not lasting long at all. I seemed for years to go back and forth between men who were like my father and men who were like my step-father. This yoyoing back in forth consumed all of my twenties and some of my early thirties. I was engaged to be married to someone before my current husband arrived on the scene.
I learned from that failed engagement that a couple does well to share a belief in God and to argue well. My fiance had clinical depression so on that level we understood each other’s behavioral health challenges. I have bipolar illness. But our relationship was toxic. We always had the same argument over and over. Why aren’t you opening up? Why aren’t you letting me in? Eventually he would call off the engagement, but it was a friendly parting. Years later he wrote and seemed to wonder about our getting back together. I had already moved on.
After the engagement broke off, I began a period of celibacy. This lasted for almost 7 years. During that time I stopped with the yoyo dating and focused inward on myself and my job. It was very important for me to validate myself during those years with something other than a relationship (short-term or otherwise) with a man. I did not even kiss a man for this 7 year period before I met my soon-to-be husband.
I met my current husband (one and only) at an online data service in 2001- this was very early in the web dating sphere. That is a story in and of itself. The first thing I noticed was that our mutual faith in God seemed to make things easier. I also noticed a couple of other characteristics of our relationship as it started to grow and mature. These are my insights into what has made my marriage a successful endeavor for someone with bipolar illness and someone with addiction issues.
For me there are three keys that help my marriage work – though I cannot guarantee these will work for everyone. Hold some sort of faith belief in common. It helps me through the darkest hour if that is not a topic that I argue about with my spouse but one that grounds me in that relationship. Second, be able to argue well. I try not to always go back to the I told you so’s. I try to make each argument have a beginning, middle and end. I try to learn from it once it’s over instead of drudging it up over and over. Finally, a sense of humor goes a very long way. I find it important to be able to laugh at myself and with my partner. It is amazing how a good laugh clears the air.
In addition to these three items, I am adding the ability to be thankful to God for people who are helpful in my life’s journey. I am still working on being thankful every day instead of always asking God for something. There is so much to be thankful for. So here is my two moments of marriage wisdom. Took me until I was 38 to figure it out – still figuring it out at 56. Oh well, later is better than never. 🙂
I do not know if this is the experience of other people with bipolar disorder or clinical depression or other behavioral health diagnoses including addiction, but when I am in the midst of a high or a low, it feels like that state will never end. The mania is all consuming. The depression seems never ending. Yet invariably the high or the low does dissipate. Perhaps this is because I have found medication that is useful or perhaps I or my therapist have talked myself out of anxiety about this or that potential event occurring. In the past when I have had a low or a high that was not receptive to medications, I have felt like that high or that low would last forever. The mania is all consuming so that I am unable to think of anything else. The depression feels like it will go on interminably. The only silver lining in these episodes is the idea that “this too shall pass.” Invariably after medication (including trial and error with multiple meds) and/or therapy do take hold, I can see clearly that the mania was temporary as was the depression. So is it possible that those of us who are first-hand familiar with anxiety and/or depression are perhaps more familiar with the anxiety that surrounds us today perhaps because of our own mental health conditions? Do we go through each day with the knowledge and perhaps the mantra that “this too shall pass?” Can we be a reminder to each other through our words and our actions that whatever negative thoughts or feelings we are having, in time things will be looking up or at least be more manageable? Can we be a reminder to those unfamiliar with anxiety or depression that again “this too will pass?” Can we through it all be the face of resilience?