Help for Healing

Bitter & Sweet, living daily with grief

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Mental Wellness vs. Mental Illness

I think mental health is on a continuum, and every one of us fits on it somewhere. This is one of those topics where we talk in divisions and categories, but in reality the lines are not that concrete. The lines are helpful to discuss issues with each other, but in real life? It can be very hard to distinguish between them.

I am in private practice. Most of the time, my clients consist of people like me. I am functioning, capable, and relatively healthy. I struggle with depression, but overall I manage well. I see a counselor and plan to for the remainder of my life. I don’t always NEED counseling, but I benefit from it. I like having someone to bounce things off of. My clients are generally in the same “category” – they don’t necessarily NEED counseling to function, but choose it because it is helpful.

Oddly enough, I had never thought of a simpler way to express that idea but recently I was meeting with a UB student. There are med students who have the option to choose an elective called “Spirituality and Health” or something like that. These students meet one on one with several key people in our community to get several different perspectives of how spirituality affects our health. I am one of the panelists the students see. Recently I was meeting with one rather delightful student who happened to want to go to into psychiatry. It was a double connection with me, being in the mental health field.

Anyhow, she said she had read about the term “mental wellness.” She’s a good student so she wanted me to be sure and say she didn’t get credit for coming up with the term herself. I loved it. That’s it. People like me are pursuing MENTAL WELLNESS. People like me are helping other people pursue mental wellness.

I got an extremely huge education this week about mental illness. I spoke with some higher-ups and got a big clarification about hospitals like ECMC and what their goals and purposes are. The statistics I got were staggering. The amount of people a facility evaluates and the amount of patients that are actually admitted presents an incredibly huge gap. The hospital is only equipped to see the very sickest of the sickest. They just can’t meet the needs that the larger majority of people in need represent. My question is, then where do we tell our clients to go?

There isn’t a good answer. I am currently looking into some partial programs to educate myself further. It’s a huge problem. It’s what I encountered last year with my daughter. It’s what I encountered last week with my client. It’s what virtually all of my colleagues struggle with. What is there for those people who don’t fit into the “mental wellness” category? They really aren’t functioning well. Counseling and outpatient psychiatry isn’t enough. But they aren’t completely mentally ill either. They aren’t talking about aliens in their stomachs or wielding dangerous weapons around and a serious threat 98% of the time. There just isn’t much in place for them. There just isn’t. And it’s heart-breaking. I feel like I’m watching a disaster in the making. Worst case scenario is people continue to worsen and end up being in the “sickest of the sickest” category. Perhaps it could be prevented if they would get the proper help. Best case scenario is they don’t worsen, but live a life with almost zero quality. That pretty much sucks too.

Not sure what the answer is. I do know I will keep looking and fighting and arguing and trying. It’s time-consuming and non-rewarding most of the time, but I know of no other way. So if you are one of those support people in my life, be patient when I need to talk and vent and talk and vent. You need someone to put a pillow on the wall sometimes when you are banging your head into it. But I would rather do that than give up or become so disenchanted or jaded that I just give up. My daughter deserves better than that. So does my client.

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Good and Bad Drunks

You know how people are nice and friendly drunks, or they are mean drunks? Personally, I am an uber-friendly person, and when I have too much drink I get even friendlier. I tell everyone how much I love them, hug them, kiss their cheeks, etc.. On rarer occasions, I’m a sad drunk. That was what happened last time I had too much to drink. I told everybody my sad story. But I’ve never, ever been a mean drunk that I know of. If you remember something I don’t, please send me a private email to remind me…lol 🙂

Anyhow, I’ve discovered lately that there is more than one way to express mania, too. When people are manic, they can go for days without sleep and go on shopping sprees. One person I know of tried to abduct a child in a store while in a manic episode. Obviously, that wasn’t so good. I have a friend who probably has bi-polar disorder. I didn’t put it together for a long time, but once I finally did (after he mentioned he might be actually) it was so obvious to me that I couldn’t believe I hadn’t figured it out.

I had lunch with him today. I told him I thought he was being manic and he nodded his head. But I told him he’s a fun manic. How do I know?  Because he wants to go out to eat. Then he orders enough food for four people. Then he eats only half a portion, or sometimes none at all. Then we take all the food home in a box and it ends up feeding my family.

He asked me if we were going dutch this time, and I told him no. I told him I’d give him ten bucks but I wasn’t splitting the bill. Because I know better now. When he got in the car, I showed him my coupon book. He said no way, he wanted to go to the Outback Steakhouse because they have lunch specials. We got there and he tells me he is going to order for both of us, so I just sit back and watch.

No lunch specials for us. First, he orders a crock of french onion soup for each of us. Then he tells the waitress to just bring the other food and a couple of plates. Of course, you have to order steak when you are at a steakhouse. I expected that. Then he ordered shrimp. Then he threw in a lobster tail. Mashed potatoes and macaroni and cheese for sides. Then he decides to add a quesadilla platter in for fun.

It was so much food it was ridiculous. We ate the lobster and shrimp and pretty much all of the rest of it came home with me and fed Colin for dinner. And it cost 70 bucks for lunch. Well, it cost him 60 with my 10 buck contribution. I suggested next time he pick out a coupon place.  We laughed about it. Being manic isn’t truly funny, but at least if you are going to be manic, he’s a nice one. And I’m stuffed.

Other “manics” aren’t always so nice. I’ve recently spent time with someone who, when manic, gets messages from God that she is asked to deliver to those around her. Might be cool except they are usually about why she thinks you are broken and screwed up. She rips you to shreds and then tells you it’s just tough love and she wouldn’t be hurting you if it weren’t for your own good and that she loves you immensely.

That isn’t so nice. And it requires a lot of mental gymnastics. You intellectually understand that a mental illness is at work so you should try not to take it personally. But the “messages” couldn’t be any more personal and go straight for your jugular. Makes it VERY hard to stick around.

So I’m getting an education about lots of things, through more than one venue in my life. I try not to have too much to drink, but if I do, I’m still going to try to be the friendly and nice type. And if I ever come down with a mental illness, I will also try my hardest to not hurt those around me. Not sure how much control you actually have, but I can hope.

Now I’m going to take a nap because I’m stuffed from lunch!


Calls That Change Your Life

Sometimes in life, a phone call will alter the course of your future in a profound way. “Your husband has stage four cancer” is one example. Last weekend, I had a series of phone calls that changed my life. That is why this week’s blog is so late. I have a feeling I will be writing several blogs about the last seven days of events.

On Saturday, I got a phone call from my daughter Emily’s friend in Georgia. It seemed that Emily had drunk a bottle of cough syrup and was acting very strangely. I assumed she had attempted to commit suicide, but I couldn’t get Emily to really answer what her intentions were. Along the suicide train of thought, she was also talking about her will and reminding me that I was supposed to take care of her children if anything happened to her.

There was little sleep for me, and none for Emily or her friend Melinda. By 5 AM, I realized that Emily no longer was making much rational sense at all. The scales had been tipping more and more away from reality and now I was convinced she wasn’t okay.

What to do? I started with what I knew here in New York. I called Crisis Services and asked them for their equivalent in Georgia. Of course I had to call a couple of disconnected phone numbers before I found the right place. But once I reached them, they were amazing. I gave them the scenario, and they assured me they would send a mobile unit as quickly as possible to evaluate Emily. Being in the Georgia mountains, it was at least an hour drive. I was impressed with them from the first call, and they didn’t disappoint me. I got follow-up phone calls when they were en route, calls while evaluating her, and calls afterward.

By this time, Emily was going in and out of coherence. Sometimes she knew her father was dead, other times she didn’t. And the scary part was that when she acknowledged he was dead, she was also saying she was going to be with him. And scarier yet, she started saying that she was bringing her eight year old son with her. He needed to be with his grandpa. Mike was my contact at the mobile unit and he let me know that Emily definitely needed to be hospitalized. The only question was whether she would voluntarily go, or if they would 10-13 her, meaning involuntarily admit her. Voluntarily is always preferable, except that if you voluntarily check in, you can also check out whenever you want to. That was a big drawback. He made another call to me and asked me if I could get to Georgia as quickly as possible. Emily made it clear that she could trust me. He knew I was a licensed mental health counselor, and he felt strongly that she needed a family member other than her husband to advocate for her.

Of course, Sunday was my annual block party. Held at my house, of course. We started it the year Tim got sick and have had it ever since. It’s one of my favorite days and everyone else seems to look forward to it, too. I announced to the party that I had a family emergency but I would feel terrible if they didn’t stay and enjoy themselves. One of my favorite smart alecks assured me they planned to party without me, and would probably trash the place with their wild, inappropriate behavior. I felt much better!

Now I had to book a flight. I found one on Southwest for Monday morning. I forget how much it was, but I was surprised and grateful it wasn’t like a thousand dollars with the late notice. By then, Summer and Karen had come over and were in full swing being the great friends they have always been. I looked at Summer and asked if I should break some professional boundaries. I had a client who is a pilot who might be able to get me to Atlanta sooner. Without hesitating, she said “Get to your daughter as quickly as you can, by whatever means you have.”

I contacted the family and sure enough, within a few brief moments, they told me about a 7:00 pm flight that was highly likely I could get on. You have to fly stand-by so there are no guarantees, but it looked promising. The girls sprung into action. They helped me pack by bags, and make the 14 or 15 calls of cancellations I needed to make for the next week at all my various jobs. The next thing I knew, I was arriving in Atlanta.

Spencer (Emily’s husband) picked me up and we went straight to the hospital. By then it was 1:00 am. This was not a psychiatric hospital, nor did it have a psychiatric unit. The plan was to take her to a hospital that was a mental health treatment facility. We went back to see Emily, and her door was guarded by a police officer. I had to be wanded before I could enter the room. I asked Emily if she knew who I was and she did. She knew my name. But that was pretty much the only thing that was in tact. She knew everyone’s name from her entire life time. The details about their lives though were completely off base.

More in the next blog. Emily has given me permission to tell her story. I have learned an immense amount about mental illness and learned even more about advocating in a very, very poor health system. We both think it could be helpful to educate everyone else in case you ever find yourself in a similar situation. But you will have to wait for the story to unfold. I am exhausted beyond belief, and also behind in trying to resume my responsibilities here at home. For now, let me just say that Emily had what is called a psychotic episode. That means she was no longer in touch with reality. There were delusions and hallucinations. Stay tuned for the next several blogs and I will continue to explain how things unfolded…