How to Stop Isolating

I used to have trouble leaving the house. I wasn't really agoraphobic, just had mental problems (and still do). I made as few appointments as possible and did not show up for family gatherings. The one appointment I had to attend was with my psychiatrist. I HAD to go there.

But there is a way out of this isolating behavior. First, I had to have my depression under control, and over the years the right medication combination was put into effect. Next, I had to stop drinking alcohol. Not only is alcohol a depressant, but I would not want to make appointments because I might be drunk or hung over. Not good.

For me, taking "baby steps" was the key. I would force myself to go out somewhere close and for a short time. After repeated successes, I would keep going out of the house for longer periods of time. The excuse of "there's nowhere to go" had to be smashed. I realized that there are always places to go, such as the library, the mall, an art gallery, the park, a swimming pool or perhaps a coffee shop. I just hadn't been interested in going to those places. Once I started doing it, I found that I had a pattern of interesting places I could go to fill my time.

Sitting in the easy chair and watching t.v. is always an option, but it is no longer my only choice. With depression under control, abstaining from alcohol and going out to one of my scheduled places works quite well.

Alcoholism and Mental Illness - Dual Diagnosis

Why is it that so many people with mental illness are also alcoholics or other substance abusers? Since "I R 1" myself, I noticed how prevalent this "dual diagnosis" situation is among other patients I associated with (in places that people needing treatment frequent). One-on-one, we'd compare notes and find out that we were both in AA and in treatment/counseling for mental problems, and the alcohol counselors confirmed that dual diagnosis occurs regularly in their practice.

"Dual diagnosis is defined by the presence of both mental health disorders and substance abuse disorders (alcohol and/or drug dependence or abuse). There are a variety of different mental health disorders that can be associated with substance use and labeled dual diagnosis. Some of these disorders include: schizophrenia, bipolar disorder, anti-social personality disorder, narcissistic personality, and depression." (www.dual-diagnosis.net)

Someone writing on www.mentalhealthamerica.net states, "More than half (52 percent) the people surveyed who had ever been diagnosed with alcohol abuse or dependence had also experienced a mental disorder at some time in their lives. An even larger proportion (59 percent) of people with a history of other drug abuse or dependence also had experienced a mental disorder".

Ok, but I still ask "WHY?" What makes us that way, to where we are so drawn to substance abuse if we have mental illnesses?

More from www.mentalhealthamerica.net.
"Mental health problems often predate substance abuse problems by 4-6 years; alcohol or other drugs may be used as a form of self-medication to alleviate the symptoms of the mental disorder. In some cases, substance abuse precedes the development of mental health problems. For instance, anxiety and depression may be brought on as a response to stressors from broken relationships, lost employment, and other situations directly related to a drug-using lifestyle."

Ok, so that says that mental health problems come first, and then later on the substance abuse starts, presumably because at that point the pain of the mental illness is so great that the sufferer wishes to escape the reality of it. Or, perhaps they are just too crazy (no offense) to control themselves. On the other hand, if someone's substance abuse is wrecking their lives, their brains might just go "boing! tilt!" and their mental illness starts (i.e., depression).

I guess I can understand that. In my case, I think that the bipolar disorder came first. My life was quite unmanageable, and so I sought to "escape" through numbing myself. After awhile, I regularly drank. I was still bipolar and had a difficult time of it, but the alcohol dependence doubled the chaos. Not a fun place to be in life!

30 years ago, doctors were just not that aware of bipolar disorder and so often prescribed valium or other benzodiazepines for relief. Finally for me, one day in 1988, I was crazy enough to check myself into a psych hospital which I thought at the time was a rehab for alcoholism. It was there that I was correctly diagnosed. Yeah, by the way, just getting a correct diagnosis can be a bitch!

Depersonalization Disorder and Me

If you read my blog, you know that I am Bipolar and in AA. I also have "depersonalization disorder", possibly connected with PTSD. Like you, I never knew what "depersonalization disorder" was.

It started when I was about 8. I remember being outside at a party with my family, and suddenly was seized with feelings that I was "not real". It scared me so much that I started shaking all over. I had to lie down in the back seat of our car until it was time for the family to go. When I was in 9th grade Spanish Class, I remember getting those same feelings of unreality and had to leave the class and go home. Recently I have gotten this feeling when reading aloud to others. Suddenly I feel as though I am a robot and am watching myself read. I have learned not to panic because I now know what is happening.

What is "depersonalization disorder"?

"Depersonalization is characterized by feelings that the objects of the external environment are changing shape and size, or that people are automated and inhuman, and features detachment as a major defense. This disorder frequently coexists with mood, anxiety, and psychotic disorders.

...

Depersonalization is defined as persistent or recurrent experiences of feeling detached, as if one is an outside observer of one's mental processes or body." from Medscape.

I would put it this way. This disorder is characterized by a weird feeling of being outside myself, observing my behavior from a distance as though watching a movie. Time may seem to slow down, and the world may seem unreal.

I think this is why I have a bad short term memory. I constantly rent DVD's that I have already seen, but don't realize it until part-way into the movie. I have written things on the internet that I don't remember writing. Stuff like that.

In researching this disorder on the internet, I have found conflicting information (surprise!). Some sources say that memory loss is a symptom of depersonalization disorder and some say it's not. All I know is, I have Bipolar disorder, depersonalization disorder, memory loss and possibly a touch of PTSD (from emotional trauma). I also can't concentrate...concentrate...concentrate... (a little humor from "Airplane".)

Poverty

It's Blog Action Day with the subject being poverty, and I view this important topic with a passion. So, what is poverty? In earlier times, the majority of people lived in poverty while the few control all the money. (wait..isn't that how it is today?) Today a child may feel that they live in poverty if they don't own a computer or cell phone. The adults may feel they live in poverty if they own the least expensive home or car on the block. In other words, "poverty" is a subjective term.

Let's concentrate our definition of poverty within the United States. A little history...I have owned beautiful homes, new cars, traveled overseas, had a 401K and other investments, but now I own very little. For example, I lost my glasses and cannot afford new ones, and paying for dental work is difficult. If I have a tooth that needs dental work, I usually opt for the dentist to pull out the tooth because that procedure is less expensive. However, I "count my blessings" because I have a roof over my head and food in the refrigerator. I have a mode of transportation (scooter).

Further down the poverty scale are the homeless. What a "black eye" this gives our country! Are we totally dead and blind to the needs of the homeless? Do we think that the homeless choose to be homeless? How ironic that many seemingly well-to-do homeowners are now losing their homes due to the sub-prime lending scandal.

A huge number of the homeless have mental illnesses. When the psychiatric inpatient laws changed some years ago to "free" the mentally ill, (supposedly because locking up a person was deemed inhumane), the result was that we now have the mentally ill often being homeless. What a tragedy!

I believe a person lives in poverty if they cannot afford decent food, housing and medical care. In other words, if a person is eating practically nothing but rice and beans, lives in squalor and can't pay for doctors' care or medication, they are living in poverty.

What can be done? Of course we can't just hand out dollar bills to those in poverty. However, we can do this in the form of creating "the poor house"..(see the board game "LIFE"), raising the qualification income limits for food stamps and instigating Obama's plan to provide health care for all.

Social Isolation and Mental Illness

15th May 2006 by Elise Stobbe (pen name for Carley)

Think about what it would be like to spend most of your time alone because being around other people is just too difficult. You feel that others are judging you for your mental illness, and so you are scared to face the world. You withdraw to avoid this stigmatization. This social withdrawal is emotionally very costly. But this is a two-way street — the mentally ill withdraw from society–society withdraws from them.

An Austrailian survey reported that two-thirds of people affected by a mental illness feel lonely “often” or “all of the time”. The research says in contrast, just 10 per cent of the general population reported feelings of loneliness. (1)

Social relationships are important for anyone in maintaining health, but for the mentally ill it is especially important. People with mental illness value contact with family. But families may be unwilling to interact with their mentally ill family member. Social isolation is also sometimes due to the unwillingness of others to befriend the mentally ill. The public may avoid them altogether. The stigma associated with mental illness creates huge barriers to socialization.

People with severe mental illness are probably the most isolated social group of all. They are judged, disrepected and made into pariahs. They fear rejection from others, who may be afraid of the mentally ill, so the mentally ill person may feel overwhelmed by the thought of attempting to form new friendships. Just avoiding any contact is often the choice. Or, they may make a great effort to conceal their condition from others, which results in additional stress from worrying about their true condition being discovered.

It is sometimes the case that the severely mentally ill person becomes homeless. This in itself is isolating, and they then must suffer the double stigmatization of being homeless as well as mentally ill.

Another reason the person with mental illness may experience social isolation is the nature of their mental illness. Social phobias like agoraphobia, or severe anxiety or depression often cause the suffering person to be afraid to venture out into society.

When anyone, mentally ill or not, does not have enough social contact, it affects them mentally and even physically. Loneliness creates stress, taking a toll on health. Other things affected can be the ability to learn and memory function. High blood pressure is also seen. It can be the trigger of depression and alcoholism. (2) Imagine the consequences, then, if you are already depressed or have other mental illnesses? Loneliness can make you worse. Loneliness and loss of self-worth lead many mentally ill to believe that they are useless, and so they live with a sense of hopelessness and low self-esteem.

Social isolation is both a cause and an effect of mental distress. When the person isolates more, they face more mental distress. With more mental distress, they want to isolate. This vicious cycle relegates many people with severe mental illness to a life of social segregation and isolation.

Many people with severe psychiatric disabilities say that the stigma associated with their illness is as distressing as the symptoms themselves. This stigmatisation not only prevents them from interacting with others, but may prevent them from seeking treatment, which in turn exposes them to a greater risk of suicide.

Too often the public does not understand the challenges of the mentally ill and doesn’t want to try. It is therefore necessary to confront biased social attitudes in order to reduce the discrimination and stigma of people who are living with mental illness.

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References
(1) Mentally Ill ‘neglected by communities’. (05/08/2002). Yahoo. AU.
(2) Psychology Today. The Dangers of Loneliness. Morano, Hara Estroff. (Aug. 21, 2033).
First published at www.brainblogger.com

Myths and Minds

It has only been within the past decade or two that we have begun to better understand the biochemical causes of mental illness. Although there is still much to be discovered, it is now known that mental illnesses are similar to physical illnesses, since they often have biochemical causes and medical treatments.Most cultures view or have viewed severely mentally ill persons as crazy, lacking will-power, possessed, frightening or violent. One universal element of this stigmatism and discrimination against the mentally ill is the traditional belief that severe mental illness is caused by something supernatural or paranormal, such as possession by spirits, curses or sorcery attacks, influence by the moon (”lunacy”), divine punishment, karma, or is the result of a moral transgression. This myth about the cause of mental illness keeps the stigmatization of the mentally ill strong around the world. (There are exceptions, such as Native Americans, who historically have shown tolerance, compassion and respect for mentally ill people).

In the past, these supernatural explanations were widely accepted. In less advanced societies today, many of these myths still exist. “Treatment” can sometimes take the form of exorcism, torture or bartering with evil spirits. This is not to say that some traditional supernatural treatments were/are of no value, however. Again using the example of Native Americans, Native American shamans summoned supernatural powers to treat the mentally ill, incorporating rituals of atonement and purification. (1) A case could be made that this treatment can be compared to modern psychotherapy as far as outcome.

Today, even in the most advanced societies around the world, there is a certain supernatural-based prejudice against severely mentally ill people stemming from dogma about literal possession by evil spirits in the form of demonic manifestations, combined with the belief that sometimes the behaviors of a severely mentally ill person demonstrate spirit possession and do not stem from a biochemical cause. This is not to debate whether or not spirit possession or other supernatural explanations exist, but rather to demonstrate that severe mental illness is a separate entity from the supernatural and can be explained through science. Still, science doesn’t claim to have all the answers and things we call supernatural today might be explained by science tomorrow. The point is, labeling a mentally ill person as possessed by evil spirits and abandoning them to only religious solutions denies them a chance for symptom relief through psychiatric care or alternative medicine.

People with mental illness sometimes castigate themselves. “Individuals suffering from depression and feelings of hopelessness and helplessness because of their illness, may focus on religious themes of judgment. Some people believe that God must be punishing them or why would God have them in this situation. There is a strong feeling that the person is the guilty one, who has failed others and him/herself. The person believes that punishment from God is deserved.” (2) Again, this is not to debate God issues, but to point out that now it is widely accepted and understood that mental illness is a malfunction of the neurotransmitters of the brain. It is a biochemical imbalance, not moral weakness, divine judgment or other supernatural cause. So the same logic used by an individual to castigate him for a mental illness must be applied to any physical illness.

Ignorance continues to fuel prejudice and reinforces stigma. We need to accept that a mental illness is an illness. We have become aware that an imbalance in our bodies can increase the likelihood that we will have a disease like diabetes. It is time that we understand the same is true for mental illnesses. (3)

Society needs to view mental illness in a less judgmental, more scientific way. In the best of cases, we hope that individuals with mental illness are treated with respect and compassion. Mental illness should be treated with research, medicine and legislation rather than moralizing. (4)

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References

(1) Mental Wellness.com. “History of Mental Illness“.
(2) Pathways to Promise. “Working with People with Mental Illness - Themes“.
(3) Stephens, The Reverend Charles J. “Attacking the Stigma of Mental Illness“. (2002).
(4) Palmer, Ann. “20th Century History of the Treatment of Mental Illness: A Review“.

first published at www.brainblogger.com