Mental Illness Healthcare

[Dreamer]

What are your experiences with mental illness? What are your opinions on services?

My life has always been heavily impacted by mental illness... Addiction as well, which some consider the same thing. I see it more as a manifestation or catalyst, wherein some people advise drugs to handle mental illness and some people are triggered by drugs and alcohol themselves. My biological father was a pretty bad alcoholic, and the combo of alcohol and untreated mental illness really created a toxic environment.

But by far, the person who has impacted me the most with her mental illness is my niece.
My niece is ten years old and has been in and out of psychiatric treatment hospitals since she was six...  She was usually in acute stays, less than a month, but about two and a half years ago, she was in a residential facility for six months. She was greatly improved and we enjoyed two years of relative peace. And then half a year ago, she started getting much worse. She had some acute hospital stays. They recommended residential; they always do. She threw a hammer into a large television at home. At her last acute stay, she told how she would harm some classmate, kill them. She needed a residential hospital. But it's not so simple... She's so young, there aren't many places that will even take her. The hospital where she was at refused to admit her as residential because she'd already been there previously. So when the insurance cap hit, they sent my niece home. Things did not go well. She was not stable. She slept for 2-4 hours a night. She snuck out of the house and simply entered a stranger's home and asked to call her mom. When Stole her mother's knife from a locked car in the middle of that previous night and hid it under her mom's chair.  She needed to be in a more controlled and structured environment sooner than the waiting lists for residential could get her in.

In a nightmare day that would not end, she was turned away from the nearest hospital where she'd been a number of times (they recommended residential, and they refused to treat her in acute while residential placement continued to be worked on) and my sister and I ended up in a hospital practically begging for help... The whole experience was awful, but in the end she was admitted to an acute hospital, a long ways from home.  The place didn't give any family therapy during her month stay nor change medications. They didn't even keep her clean.

She had nowhere to go until my grandfather did something unexpected (and ultimately a blessing):
He called CPS.

They placed her in a sort of group home for troubled girls, usually foster children. They've been providing family therapy and evaluating medications, working on changes. It has been the best place for her. She is able to enjoy playing outside regularly ( she actually became deficient in vitamin D at her previous residential stay), she receives constant supervision as there are staff 24/7. And most recently CPS has been able to connect us with a program that will allow her to remain where she is and  help with her future transition home or continued services elsewhere. The CPS case file has closed, the wardship has closed, and the court case has been closed. It was all necessary to get her the help she needs. What a long journey, just to get her on the path to help..

So, your own stories?

[TomFoolery]

I have a step daughter with... well, the most recent diagnosis is autism, ADHD, and OCD. In the past it was PDD-NOS as well as ODD. I mention it because she also has a number of signs of fetal alcohol syndrome. She also has developmental delays, virtually no impulse control, and cognitive disabilities. She's 11 years old, but mentally closer to 5 or 6. Her mom is a drunk and bipolar and probably drank throughout her pregnancy though she won't admit it.

When she was 8, she had a psychotic episode at school that resulted in her being placed in an inpatient facility. She's been in inpatient facilities on three occasions since. She's been expelled from a total of five schools and six daycares, had the police called on her three times and I can't even count how many private babysitters have told us to lose their contact information.  Just last week she tried to rip out her bus driver's earrings and hit the kid next to her on the bus with a fire extinguisher. When asked why, she said it was because she didn't want to do her math homework when she got to daycare. She was asked if she knew she would get in trouble, and she said yes. Completely remorseless. And also kicked off the bus.

A lot of the stuff she pulled when she was younger was largely overlooked because of her youth and troubled upbringing with her mom. Her mom lost custody of her two years ago and now she lives with us, and as she's getting older physically, it's getting harder and harder to explain away her behaviors. People understand when you have a toddler freaking out and threatening to punch you, but are a lot less willing to tolerate a 5 foot tall, 100 pound almost teenager with the same behaviors.

It's really hard. The state of mental healthcare in our country is depressing. During her inpatient stays she was only allowed to stay long enough to tweak her meds to the point where they were convinced she wasn't a danger to herself or others and then sent home. Numerous times we've tried having her admitted but unless she's actually in the process of harming herself or someone else, we're told to suck it up and see her regular psychologist, who only can give her an appointment every three months. He's one of two psychologists in the area covered under our insurance, and I'm so thankful we even have insurance. Her ABA therapy hasn't done a whole lot to curb her behaviors, even after 10-12 hours per week for two years. Her therapy would run us about $3,500 a month out of pocket if insurance didn't cover it. She's on three separate meds that would average another $1200 a month if insurance didn't cover it.

People can't afford to have mental illness in America. I'm very afraid that as she grows up and is still completely incapable of understanding how her actions affect others and continues to be aggressive, she will one day end up in prison. She's in such a gray area with a bunch of borderline diagnoses and a borderline IQ that I see it being very likely that she assaults someone. She knows her behavior is bad, but only after the fact. When she's actually doing it, it's like she's possessed or something. Watching my step daughter when she's in her "mode" as we call it, it's not hard to see how people used to believe in demonic possession.

[Aletheia]

Treatment for mental illness in my area has improved quite a bit. Several years ago I was misdiagnosed as bipolar and prompted by my case worker's belief that I was truly bipolar. This resulted in being placed on powerful medications that brought my thoughts to a near halt, almost no alertness, and did little to help with the anxiety I had. The experience from the misdiagnosis had affected me strongly, and so I spent the next few years seeking out low-cost therapists aimed at schema therapy and CBT. This did equip me with the skills to understand what was going on and did provide some coping mechanisms. However, this was ultimately insufficient to keep the symptoms of my disorder from escalating. In January I had a near psychotic break featuring paranoia, aggression, intense anxiety, and great difficulty separating the present from the flash backs. Once it had reached that point, I did the only thing I could to prevent myself from becoming a threat to everyone around me (this happened at work, btw), I hid. This separated me from additional stressors and gave me enough time to calm down. Luckily, I'm at a place that is used to working with mentally ill employees. So, my boss called the local mental health facility and set up an evaluation that day. By then, I had calmed down enough to where I felt essentially numb.

My former diagnosis was overturned and I was given a new primary diagnosis of PTSD. The medications they placed me on had a positive effect within the first week and have had minor side effects. I see two therapists a week, and due to my low income, all of this is provided free of charge. My work takes a special interest in my well being, and will work around my disorder if necessary. They will and have dropped me off at my appointments (my car had broken down that day). So far, my experience as of late with the mental health services here has been mostly positive.

As for my boyfriend, it has been nerve-racking because the inpatient procedure and various other policies fail to take into consideration that not all mentally ill clients are punctual, willing to ask questions, or capable of maintaining complex tasks.   

[Dreamer]

TomFoolery, wow. My niece is so very similar.. with her increasing size, the tantrums are also more and more dangerous and difficult to control... she's had many diagnoses... autism, sensory integration, early onset bipolar, impulse control... There are more, but I cannot remember them all... Her brain function is rather fundamentally different: the brain waves which normally occur during sleep also happen when she's awake. She has imaginary friends with very real consequences... For example, Jake the dog is a harbinger of doom if she says he's there and we're unable to make him leave.

I understand the unforgiving attitudes toward a tantruming preteen. People expect certain behaviors from people of certain ages and sizes. If your stepdaughter appears normal, as my niece does, then it's even more difficult.

www.Facebook.com/pleasehelpskylar I started this when we were desperately trying to get her placement. We're still trying to figure out exactly how to use it, but my sister decided no more hiding and suffering in secret.

[Dreamer]

Aletheia,

I'm glad you're getting help and the right medications to assist you.

I returned to counseling after my niece's crazy night at the hospital... I'm a mother now, and the thought of a breakdown like when I was seventeen terrifies me. I'd not been in counseling for many years, nor on medication. So I told my therapist everything... My history, previous diagnoses, what I'd done to manage without professional help... The self harm, enlightenment concepts, publicly outting a sex offender in a public fb group, etc. She told me that what I'd done is naturally discover CBT techniques to change my thought patterns. Instead of feeling demoralized, I was empowered. So I continue with counseling once a month, no medications... medications scare me, and I find it brave that you share how they have helped you.

I'm glad you have an understanding workplace... The mental healthcare system does have a number of hoops that must be jumped through, that are extremely difficult for anyone in a crisis.

[Solomon Zorn]

I live in Indiana. The mental health care system here has been a savior to me. If it weren't for the Swanson Center, I would have been dead long ago. They have, once, placed me in an acute facility for a 72 hour hold, that was completely uncalled for, but overall I rate it pretty highly.

[Aletheia]

Aletheia,

I'm glad you're getting help and the right medications to assist you.

I returned to counseling after my niece's crazy night at the hospital... I'm a mother now, and the thought of a breakdown like when I was seventeen terrifies me. I'd not been in counseling for many years, nor on medication. So I told my therapist everything... My history, previous diagnoses, what I'd done to manage without professional help... The self harm, enlightenment concepts, publicly outting a sex offender in a public fb group, etc. She told me that what I'd done is naturally discover CBT techniques to change my thought patterns. Instead of feeling demoralized, I was empowered. So I continue with counseling once a month, no medications... medications scare me, and I find it brave that you share how they have helped you.

I'm glad you have an understanding workplace... The mental healthcare system does have a number of hoops that must be jumped through, that are extremely difficult for anyone in a crisis.

I've learned that living in fear of a breakdown tends to put a damper on any progress you may make. I've been through a few mental breakdowns, and yes, they are scary, chaotic, and often have high consequences - but such incidences are no more alarming than a car wreck. Much like driving a car, you take necessary precautions to ensure a day goes without incident, but sometimes we fall short. Should a car wreck occur, you are surrounded by countless things intended to help you survive. The same is true for a mental breakdown - you acquire skills to help you better cope with the situation. Is this full-proof? No. It does, however, put the odds in your favour. After such incidents, you pick up the pieces, learn what you can from it, and then put your life back in order again.

Medications are required to help in cases where deficiencies occur. The human body is a complex thing with countless opportunities for error in development. For example, in the case of the diabetic, if the pancreas is not working properly to produce insulin, the body will not receive the varying allotments of insulin it needs throughout the day and night. No amount of therapy, "natural" dieting, or positive thinking will repair the pancreas. Outside assistance must be provided to compensate - in this case, it would be externally introduced insulin.

Much is the same for many cases of mental illness. A "healthy" brain operates within certain tolerances so that normal function is more or less stable. An average person may be stressed out, lonely, happy, sad, etc, but they do not remain too long in any given emotional state and usually maintain a sense that they are capable of improving or at least enduring their given predicament. As a general rule, they can take the good with the bad.

Many forms of mental illness affect the physical structure of the brain via genetic dispositions and/or environmental factors such as severe trauma (which an alter the wiring of the brain). If the structural differences do not deviate too much from a healthy brain, then CBT and similar forms of therapy can encourage the brain to create new pathways and prune others so the person can function normally.

Other forms of mental illness arise from physical changes in the brain that is too severe to be overcome by the minimal effects of therapy. In such cases, small portions of the brain may be missing, altered noticeably, or there may even be wounds incurred by a brain trying to hastily cope with stress. Brains like these do not function within normal tolerances and are prone to having the mind stuck in emotional states for too long or not long enough - or such states may be too high or too long. A person's thoughts may lack coherence or become so focused that normal daily function is negatively affected. In such situations, it's not possible for the brain function normally and as a result, daily life for the person is needlessly difficult or even impossible.

Just like with our diabetic, no therapy or well-wishing will overcome these physical deficiencies. Medications can help in a variety of ways. They can reduce activity in an overly active part of the brain, increase activity in neglected areas, influence hormone regulation, induce sleep, and do a multitude of other things. This does not "cure" the problem, but it does allow the person to function within or close enough to normal tolerances.

In my situation, the medications I take induce sleep - which resets my circadian rhythm so that my mind and body have a more predictable schedule. Another lowers blood pressure so that the part of my brain that is prone to "sounding the alarm" way too frequently does so less often. Tweak the dosage just right, and my tendency to be anxious becomes average instead of "danger! danger!" hundreds of times a day. The last medication I take increases the saturation of seratonin which wasn't high enough in my brain. My moods are balanced and stress is not only easier for me to manage but I feel a desire to want to manage my stress.

The therapy helps to slowly build new pathways in which to cope and the medications enable the brain to function close enough to normal tolerances. Together, a person's outlook on life improves.

The bitch of the whole ordeal though is trying to find the right medications and dosage. Patience is practically mandatory.

Yes, the hurdles in mental health care are difficult at times, but I've found that talking to my therapists about these hurdles makes it a lot easier. Both have helped tremendously by finding out the best route to navigate through what is essentially bureaucracy. As for my boyfriend, it is an added stress for me, but I am able to use what I've found out to help him navigate the system as well.

[TomFoolery]

Aletheia, thank you for sharing your story. I know it's hard for people to talk about mental illness. I've had a hard time opening up to anyone about my step daughter for a long time, so I can't imagine what it's like to actually be in the shoes of a person suffering from mental illness and discuss it. There's just so much stigma.

Before my step daughter came into my life full time, I had a lot of misconceptions about it too. You talk about living in fear of another breakdown. I do too. I often feel so hopeless trying to predict what will set her off and walk on eggshells around her. It's often hard to remind myself that she doesn't just decide to have a bad day or a complete meltdown, and I think hearing it from your perspective helps solidify that for me. I've often wondered if she worries about having a bad day, because it seems like she does.

Dreamer, she looks normal on the outside if you don't look too closely. She has a lot of physical problems that are concurrent with a number of conditions, including aforementioned fetal alcohol syndrome and Fragile X syndrome. Flat feet, crossed eyes (that she had fixed with surgery), scoliosis, heart murmur, poor muscle tone and coordination, etc. She's very awkward physically, and it's because of this that she hasn't seriously hurt someone yet. She lacks the strength and coordination: but that's not really the issue. The issue is that she wants to when she's in that mode, and physical and occupational therapy have been a mixed blessing because of it.

She doesn't have visual hallucinations, but before she was put on seroquel she had auditory hallucinations. She would say things like someone was knocking on the door, or people were arguing, or there was someone looking for her. The psychiatrists chalked it up to her seeking attention and put her on such a high dose of seroquel she couldn't stay awake. We've tried weaning it her off of it for years, but the last time we tried, she chased her teacher around the room with a pencil threatening to stab her, so needless to say, she's back on it. I agree that many mental illnesses require drugs to stabilize certain physical conditions, but the drugs my step daughter is on were never intended for use in children. I often wonder what they're doing to her developing brain, whether they're helping it, harming it, or something in between. I know that her not being on it isn't an option without something else in place, but I don't know that there is anything else.

[Sal1981]

What are your experiences with mental illness?

I am diagnosed Schizoaffective disorder (which I thought was *just* me being bipolar, but that's a long story).

What are your opinions on services?

Around these parts, when compared to the services in Denmark, I hear we're getting drugged into complacency and lethargy, but that's hearsay, so I don't know more than my own experience with what treatment I've gotten so far. I don't see anything bad about it, but I have it lighter than others, I guess.

[Hijiri Byakuren]

Autism, panic and anxiety disorders, early symptoms of BPD. Treatment has been grand. The real issue was getting myself to seek it in the first place.

[Aletheia]

I agree that many mental illnesses require drugs to stabilize certain physical conditions, but the drugs my step daughter is on were never intended for use in children. I often wonder what they're doing to her developing brain, whether they're helping it, harming it, or something in between. I know that her not being on it isn't an option without something else in place, but I don't know that there is anything else.

Alcohol can disrupt so many different parts of the brain's development. If she exhibits auditory hallucinations, then it's a sign that parts of the brain are missing, overly developed, underdeveloped, or improperly wired. The violent tendencies suggests insufficient impulse control, which isn't purely will power driven - there are physical parts of the brain needed to regulate such control. As for her lack of empathy, that could be from both trauma and development delay due to her disorder.

If the doctors have her on something intended to suppress so much, then it might be because they are unsure which medication or combination of medications would allow her a chance to understand the world from the perspective of another and to imagine how the other is feeling and caring about the pain another feels (empathy) while holding her violent impulses in check. Sadly, there may not be a medication or combinations of medications that can do that for her since her brain's development is unique and our understanding of the brain is limited.

For a person in your position, it helps to see what current research has to offer about understanding FASD with Impulse Control. This will provide you with more educated questions for the doctors and give you some much needed insight into the reasons for the limits of what the doctor's can do.

I wish I had a more abridged version, but hopefully this might help to understand the complexity of your daughter's situation:

A Review of Executive Function Deficits and Pharmacological Management in Children and Adolescents

Impulse Control Disorders: Updated Review of Clinical Characteristics and Pharmacological Management

[AllPurposeAtheist]

Step daughter developed schizophrenia in her late 20s. Her mother wouldn't do anything to get her to take the medication prescribed so they both split and left me to go back to Ohio where they live across the hall from each other and drink so much that I think they've forgotten completely who I am.  My other kids try to help,  but none of them are equipped to deal with her much less my ex. I fear my ex is going to drink herself to death and if and when she does my step daughter is going to be on her own.
I'm in regular contact with the other kids,  but not the ex or the schizophrenic one.  She's convinced herself that apparently I'm the devil.

[Dreamer]

I am diagnosed Schizoaffective disorder (which I thought was *just* me being bipolar, but that's a long story).
Around these parts, when compared to the services in Denmark, I hear we're getting drugged into complacency and lethargy, but that's hearsay, so I don't know more than my own experience with what treatment I've gotten so far. I don't see anything bad about it, but I have it lighter than others, I guess.

I'd like to hear your long story... I'm also schizoaffective, with ptsd.

[drunkenshoe]

May be it is not mental illness by definition, but I suffered from clinical depression and sometimes still do in short relapses. (Diagnosed in 2009) I have felt extremely unhappy, sad, finally suicidal. I isolated myself. I was one of those idealist people who thinks she can fight with everything and mostly win. May be, I even did that a little for some time and was happy with it. Or I thought I was, who knows. When I arrived around 3o, something happened to me. I can count countless reasons. I have used effexor for almost a year. Then I quit and started therapy. I was supposed to go every day for an intensive jump start, but I chose to stay at the place because first it was far away from home -2 hours trip- and then it felt like it would be better.

Anyway, it was actually good in the begining. There were other people staying there. From all over the country. It's a private place, so it was comfortable, cosy and good. They made me take those tests -you know, it takes hours to finish and goes on a few days, they try to get everything from your general capacity to any disorder you might have or anything of the sort. Well, something weird happened, because of something I did. Around a week after I took them, I went to the library. I wanted to check some cds and books and the girl at the desk went inside to get. There was a pile of files on the desk and the top one had a name of someone I met there. I couldn't contain myself and quickly started to look at the others. I have found mine. All the files had some diagnosis written on it, mine had a dash in the box under my name. I opened it and saw a paper between the file cover and the first page. A report. I have read it. It said stupid, trivial things like 'hyper rationalisation, hypersensitivity, questioning self worth, low self esteem... etc basically nothing worth to feel suicidal and finally 'no disorder found'. Yet, I have been suicidal, felt constantly terrible, constantly worried, sad, I couldn't continue my life.

I have felt so guilty. Because in a week I have met people there with so serious problems, traumas, it's hard to listen. Probably, I will always feel a bit guilty. I still can't express all of it. I have always been very bad at asking for help. And add that how I started to see myself after that, it went worse. Of course, I told my therapist what I did and he tried to explain that this is not a matter of comparison. I know it is not. But I have a problem of expressing how I feel and why, when I am feeling bad or sad. And I find my own feelings trivial when I feel bad because of this. Because I think it looks trivial to people -and yes it does- or that it is trivial compared to what most people are going through. When you look from outside -also face to face- I am outgoing and loud, but I'm actually very loudly very shy. 

It took years for me to get a bit normalised. I quit my 10 years of job. Left the city I have lived all my life. Started all over. I'mmuch better, but still don't feel completely out of it.           

About how is the  mental illness healthcare in the country, I don't know. But state pays most of the drugs that I know. I didn't pay myself either. 

[Aletheia]

May be it is not mental illness by definition, but I suffered from clinical depression and sometimes still do in short relapses. (Diagnosed in 2009) I have felt extremely unhappy, sad, finally suicidal. I isolated myself. I was one of those idealist people who thinks she can fight with everything and mostly win.

Clinical depression is definitely a mental illness and hardly trivial. It directly affects your world view, your self-image, your thoughts, reasoning, and emotional well-being. When  it reaches suicidal ideation, it can threaten your very life.

There was a pile of files on the desk and the top one had a name of someone I met there.... I have found mine. All the files had some diagnosis written on it, mine had a dash in the box under my name. I opened it and saw a paper between the file cover and the first page. A report. I have read it. It said stupid, trivial things like 'hyper rationalisation, hypersensitivity, questioning self worth, low self esteem... etc basically nothing worth to feel suicidal and finally 'no disorder found'. Yet, I have been suicidal, felt constantly terrible, constantly worried, sad, I couldn't continue my life.

These qualities mentioned both contribute the to development of depression and interfere with treatment. Yes, they can cause suicidal ideation and greatly diminish the quality of life.

* Hyper rationalization
Rationalization is a defense mechanism that involves explaining an unacceptable behavior or feeling in a rational or logical manner, avoiding the true reasons for the behavior. Hyper rationalization takes this even further, therefore never really addressing the underlying issues.

* Hyper Sensitivity
Hypersensitive individuals are easily over-stimulated by seemingly subtle aspects of life. The core of any anxiety disorder can be derived from hyper sensitivity. This can lead to the person feeling overwhelmed and at times, helpless.

* Questioning Self Worth
When you question your self worth then your self image is in a state of flux. Confidence is derived from valuing your self and being comfortable in your own skin. People often make the mistake of looking outside of themselves in order to ascertain their own value. However, this causes constant uncertainty as everyone's assessment of you will be different. Self worth is not judged by other people, it is judged by yourself. When you're honest, then you are able to accept your good qualities as well as your bad qualities.

* Low Self-Esteem
Self-esteem describes a person's overall sense of self-worth or personal values. This is considered a personality trait since it tends to be stable and enduring. The variety of beliefs about ones self pertaining to one's appearance, beliefs, emotions, behaviours...etc all fall into the realm of self-esteem.
When you have low self-esteem then your self worth is diminished. This can affect your confidence in yourself and even how you like yourself. Much like self-worth, the appraisal of your personal values are not judged by outside influences - they are judged by you. If you are accepting of your qualities then you tend to like yourself more. This in turn affects your confidence in approaching new things in life.

These traits affect the way a person views themselves and are fundamental to how a person assesses their life as worth living. To call these things trivial is to call the foundation of a house trivial because it's just a slab of concrete - never mind the fact that all the other things that make a house what it is rests on this foundation.

When they put "no disorder found," it can often mean that other disorders were not found or that your current problem shows promise of being resolved more easily.

I have felt so guilty. Because in a week I have met people there with so serious problems, traumas, it's hard to listen. Probably, I will always feel a bit guilty. I still can't express all of it. I have always been very bad at asking for help. And add that how I started to see myself after that, it went worse. Of course, I told my therapist what I did and he tried to explain that this is not a matter of comparison. I know it is not. But I have a problem of expressing how I feel and why, when I am feeling bad or sad. And I find my own feelings trivial when I feel bad because of this. Because I think it looks trivial to people -and yes it does- or that it is trivial compared to what most people are going through. When you look from outside -also face to face- I am outgoing and loud, but I'm actually very loudly very shy.

No need to feel guilty for anything. When you have a difficult time functioning normally in daily life or consider non-existence a reasonable option, then it is readily apparent that you have an issue that is top priority to resolve. As they say, you had a legitimate right to be there.

Your thoughts and feelings are not trivial - they are among the most important aspects of your self and affect every facet of your life. No parent, sibling, child, or lover will ever be as close to you as your thoughts and feelings. Recognize them as valuable, because they are. Will other people agree? Yes and no, but the value of our thoughts and feelings are not assigned by them... so their opinions really don't matter.

It's a common defence to compensate for insecurities. It takes time to shrink  insecurities down to their proper size and realize they are merely big shadows belonging to very tiny imperfections.

It took years for me to get a bit normalised. I quit my 10 years of job. Left the city I have lived all my life. Started all over. I'mmuch better, but still don't feel completely out of it.           

About how is the  mental illness healthcare in the country, I don't know. But state pays most of the drugs that I know. I didn't pay myself either. 

Feeling like you're stuck in a rut (dull routine that doesn't seem to be going anywhere) and then changing things up can re-energize a person and make them feel like anything is possible again.

I hope you come to accept that your issues are legitimate, your thoughts and feelings matter greatly, your insecurities are not nearly as big as they seem, and that life is worth living - especially as the individual you are.