May Is Mental Health Awareness Month in the US

May is Mental Health Awareness month at least in the US. What would you most like to see addressed with respect to mental illness in the next 5 years? Here’s my list:

  1. Find a way to describe people who are dangerous with an underlying mental condition as different from the bulk of people with mental illness who are generally not dangerous or are dangerous to ourselves. In other words, find a way to differentiate mass shooters from people in mental anguish who often suffer at their own expense rather than at others’. Find new and working vocabulary words to mark this distinction.
  2. Address mental illness stigma to where viable support may be readily given in the workplace, the place of worship, the neighborhood or within other community settings.
  3. Develop meds that don’t cause weight gain or other side effects like Type II Diabetes.
  4. Oh I am adding one – be sure first responders are trained to deal with mental illness particularly campus police as college is a time when many mental illnesses present. What’s your list?

My First Job out of Graduate School – Compartmentalization

My first job out of graduate school was as a Business Analyst in the IT department of a local engineering and environmental management firm.  This position built upon my role in information management at the state cultural organization where I worked before graduate school.  Shortly after joining this firm as a Business Analyst I was promoted to a financial application services manager position and worked in that capacity for a couple of years.  The position used and developed project management skills but was more process oriented than project outcome focused. 

During this time I completely compartmentalized my bipolar illness.  I went to Psyche appointments on my lunch hour.  I went for lab work on Saturdays.  Basically, I provided no insight to my employer or my boss that I was managing bipolar symptoms.

Ironically, this seemed to work well for my career.  I was managing four programmer analysts and helping to manage and develop software systems.  It seemed to help that I was managing a team who had more technical know-how than myself.  So, I was just facilitating progress; I was not driving progress.  It also really helped that my boss trusted me implicitly to manage the software program assigned to me and was always available if I had an issue that needed to be escalated to her level or above.  It meant a lot to me and to my ability to function that this escalation window was always accessible to me. 

Within a relatively short period of time, I went from being at a reasonable paygrade to being at a somewhat high paygrade for the time.  There was definitely stress on the job but what seemed to make a big difference was that the team of four programmer analysts were first in line when there was a triage situation.  This occurred a lot since the application we were using was still in a beta test mode for all intents and purposes.  But when there was an emergency as there was about once a month or so, my programmer analyst team was first in line to answer the “distress page.”  (This was still the time of pagers and not smart phones.)  My role was more to manage the process when there was a software outage rather than come up with the solution myself.  I depended on the programmer analysts for that.

So my problem with having reduced sleep at night was not really a problem in this job due to the pager protocol and my team being first in line rather than me being first in line when there was an outage or some other problem with the software.  This idea of missing a night’s sleep to nurse the computer system back to health did not really start until I began work a few years later as a project manager for a large telecommunications agency. 

Looking back on it now, I did not necessarily have less stress at this financial software job, it was just that I did not have stress that was a trigger for the bipolar symptoms – mainly lack of sleep for one or more nights.  In addition, it meant a lot that I functioned more as a process manager than a formal project or program manager.  It was my job to ensure problems were resolved but not directly to resolve them.  As a certified project manager some years later, the job was to solve the problem directly with the team.  This may seem like there is not much difference between these two scenarios, but the bottom line is that it is different to be responsible for process rather than outcomes.  In the financial services job, I was focused on process.  Later in more formal project management jobs I was focused on outcomes or results.  Also, again, it really helped me to perform in this job knowing that there was a clear escalation process when issues arose that I was not qualified to address. 

In terms of mental health stigma at this job, there was really no disclosure of my bipolar illness so there was no “real stigma” to address unless of course you count the fact that I felt compelled not to share my diagnosis with anyone at work.  I had circumnavigated the stigma situation, but this was only for a few years of my career.  I often wonder if compartmentalizing my illness during this job should have served as an example to me in later project management jobs.  I believe I continued to try in later years in project management positions to continue with the compartmentalization, but as the stress of the work positions grew so did my inability to control my bipolar symptoms on the job and off.  The increase in stress of the job was coupled by the fact that the stress I was now experiencing was directly triggering my bipolar symptoms – largely the sleep deficit trigger. The compartmentalization was something like having a pressure cooker going all the time.  The pressure was there even if I was not acknowledging it.   At some point in each project management job I took, the top was bound to blow off.

Stigma Resistance and Existence in the Project Management Workplace:

I have found in my 35-year career mostly doing project management work that the company you work for is only as accepting as the people who make it up.  When I have experienced a supporting atmosphere for my bipolar illness (which is extremely rare), my mentor or my boss has come from a place where mental illness was in their family.  One a husband, one an aunt.  This was volunteered information to me from them.  I find the ability of the workplace to be supportive is in direct correlation to the boss or mentor having first-hand experience with mental illness.  For all intents and purposes, the individual and not the company is the determinant of a supportive environment for working with a mental health condition.

It should not be this way.  The company as a unit in and of itself should be able to show understanding and support for mental health challenges particularly with such advances as the Americans with Disabilities Act. 

In my experience, the company is more prone to act out of fear or out of ignorance and assume someone with a mental health condition is dangerous to themselves and to others around them.  There is a tendency to criminalize people with mental health diagnoses in the workplace when that mental health diagnosis is exposed. 

Not uncommon is the ushering out of the office by building security when the mental illness surfaces.  Is this ever done when you have diabetes?  Or a brain tumor?  Or cancer?  No, you are not humiliated and meant to feel you are criminal just for being ill.  These other illnesses are accepted as part of the risk profile for managing employees.  People are given support for their illness by co-workers and by management for these other non-mental illness profiles, while for mental illness profiles the employee is considered an immediate and unsurmountable threat and treated as a criminal.

Again, I would hope in the US the Americans with Disabilities Act would change this criminalization of people with mental health diagnoses in the workplace, but in my experience it has not.  That sounds out as a sad state of affairs for employment for people with mental health diagnoses.

Have you ever been treated poorly at the office because of a mental health diagnosis or break-through event? Have you ever been treated well for the same? What causes some employers to act in a way that is supportive and others not?

If I can do it, you can do it!

I recently have gotten back into a physical exercise regime, what I have not done for about 15 to 18 years. I have been keeping a log of my walks and my yoga. So far it has been five weeks since I started. I have kept the log each day and include any comments like what yoga positions were difficult (code for I could not complete….) or whether the walk was long or short. I also include a day of rest each week.

In my prior life, I was an exercise fanatic, sometimes going on runs twice a day. Later after running I was an aerobics enthusiast and actually taught classes in college and later after I graduated in clubs. Later in life but still before meeting my husband, I was a self-taught dancer. I always considered myself to be very fit, but after my lovely daughter was born, I slipped into a not-so-fit lifestyle. I gave up on exercise and succumbed to the idea that meds cause weight gain.

I also succumbed to stress eating and snacking particularly at night before bed. This is not good for weight control and not so good for being at risk for Type II diabetes either.

I share my recent success with getting into a yoga and walk routine because I am proud to say this is the longest duration in forever that I have kept up such an exercise regime. I also want you to know that if you are on the fence about exercising, motivation can happen for you! If it happened for me, it can surely happen for you, too!

I am also proud to report that I have lost ten pounds and have kept it off over the last two to three months. I still am having my evening treat which I hope soon to discontinue or to substitute with a price of fruit. While ten pounds off is a good initial accomplishment for me, I would like to update that goal with an additional ten pounds more to lose. We’ll see if that’s doable.

Although I have known about the connection between exercise and stress management all my life, I still have been somehow unwilling to get back into the routine of things. This last month has reminded me how crucial exercise is to helping with mental health — especially anxiety management which is one of my biggest challenges.

I keep a basic log in WORD and write down a daily account of my walks and my yoga. I write down what was particularly difficult in yoga and what I did as an alternative pose. There is no room for judgement or for feeling bad if I cannot do a certain pose. I simply do what I can and modify the pose if it is too difficult for me. Whether I complete the class doing all the work or some of the work, I still benefit from a good bit of stress and anxiety reduction.

Anyway, I wanted to share my start back to a successful exercise schedule. Hopefully this will help keep me motivated. Also, I hope if you too are experiencing trouble getting going in this area, you will use the idea of my simple log to help you start your version of the same sort of regimen.

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?

My Sojourn through Bipolar Illness – Coming up Last on the Funding List?

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.

  1. For one we would have adequate beds to treat people who need 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 or behavioral impacts that often can go untreated or undiagnosed.
  4. Fourthly, we would have enough resources to fund a Cohort Model of support for those in a crisis or post-crisis state. 
  5. Fifthly, with more co-mingling of people with and without a behavioral health or addiction 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 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.    

Stigma delay or not?

What strikes me as poignant is that the stigma/judgment/prejudice associated with mental illness is less visible or more delayed while the stigma/judgment/prejudice associated with darker skin seems more immediate.  To the average Joe, I look like a white housewife with no major troubles.  It is not until my mental health behavior gets in the way that someone might recognize me as having a behavioral health disorder and therefore might judge me as less than.  Behavioral health stigma is not generally associated with the way a person looks right off the bat unless that person shares that information upfront.  Whereas, with black and brown skinned people, it seems to me (from the outside looking in) there may be no such “delay” or “invisibility.” Someone with brown or black skin appears to be judged even before any behavioral questions good or bad emerge just because of how he or she looks on the spectrum of dark skin to light skin.

I hope I have not offended anyone of color with this comparison or that you think I think I can comprehend what it is like to be black or brown and to be judged by your appearance alone. 

I do not make the comparison to mental health above because I know how it feels to be judged by the color of my skin.  I don’t.  I have not experienced that.  But I would like someone of color to know that I do understand very well what it is like to be judged for something I was just born with. Perhaps I am not at liberty to make that comparison because I am not dark-skinned.  But I do think part of the solution in the Black Lives Matter movement is that we become unafraid to talk about our perceptions of race and racial stigma.

From here the conversation atrophies into the question: why make a comparison between skin color and a disability?  It is not a good comparison to make.  Yes, I agree a disability is not the same as skin color.  The whole “Black is Beautiful” movement underscores that. 

Then the conversation atrophies again, as a person with a disability, I am supposed to think of myself as a person WITH bipolar illness not that I AM bipolar.  I am not my illness.  I am supposed to not let that “label” define me.  Should we in turn say someone of African American heritage is a person with black skin rather that black?  Probably not.  For the behavioral health person, we typically don’t want labels to define us.  But for those with black and brown skin, the difference may be in embracing that difference and celebrating it along the lines of “Black (or Brown) is Beautiful” from the 1960s or 1970s.

Somewhere also in the midst of this conversation is the reality that up until the 1950s people with behavioral health problems were locked up in institutions largely for life.  Families sent them away to institutions where they were often forgotten and buried as a number in a mass cemetery for the mentally ill rather than by name.

So all in all, the parallel between having a disability and having darker skin has limits.  Perhaps this is just an ice breaker into a conversation of what can be and what we want to be different for those experiencing racial pain and stigma and those experiencing mental pain and stigma.

My three most popular posts

My three most popular posts so far since March 2020 have less to do with mental health and mental health symptoms than they do with talking about the general well-being of, well, everybody. Folks have liked a list of suggested things to do on a rainy day. Folks have liked the observation that amidst all this staying at home, the air and water quality may ironically be getting better. This is a small silver lining to the tremendous pain and suffering of covid-19. Folks have liked the idea that those of us with clinical depression or clinical anxiety may be able to help those experiencing these same issues situationally specific to covid-19 by simply telling our stories.

So what are we saying in all this? Is there a pattern? Do we want our sympathy and our empathy to extend to all folks who struggle not just those folks who have clinical diagnoses? Do we want posts that take us away from our own mental health predicaments and lead us to think about the greater good? Do we want posts that encourage us to do things that make us and those around us feel good simultaneously?

To me, what all this is saying (in my opinion) is that as people with mental health challenges (and diagnoses) we want to reach out to others and to our better selves more than we want to isolate. And for many of us, including me, that is simply a big deal – a very big deal.

Do you have posts with a lot more traffic than others? Do you see any patterns in what people “like” or like to “view”?

This has come up today

This has come up today in reviewing and updating comments from an earlier post of mine. It has been suggested that people who are accustomed to mental health and behavioral health issues may be able to empathize not just sympathize with people who are experiencing depression and anxiety for the first time due to covid-19.

Therefore mental health “veterans” like us may be able to help others in some small way. I am very curious to hear what those of us who are familiar with depression or anxiety might say to those who are first encountering symptoms due to covid-19 – likely situational depression and anxiety and uncertainty. These folks may not have clinical depression or clinical anxiety but that does not diminish the impact of what they are experiencing.

What might that look like if we were to reach out to those who are not familiar with or are new to depression or anxiety or uncertainty of all kinds?