Archive for the ‘psychiatrist’ Tag

Bipolar Support Groups: What are they Supporting?   Leave a comment

A few years ago I was a mess.  Diagnosed Bipolar II with hypomanic episodes and freshly divorced, I was living with my girlfriend, one dog, a cat and her two little girls all in my tiny studio apartment in San Francisco.  Plus, my girlfriend had an ex-husband that would practically scale the side of my apartment hi-rise like a little lobster to the seventh floor looking in on us for incriminating evidence he could use against her in divorce court.

I was already seeing a psychiatrist for my medications and a psychologist for talk therapy.  But the latter felt I was suicidal and needed more support.  It was either go to group therapy or resign me as a client.  I agreed because whenever I was a little late for an appointment she started calling hospitals to see if I was on a metal table a toe tag.  Personally I thought hearing about other people’s problems would depress the pants of me.  However she was adement, so I went out of respect for all the good she had done for me in the past.

I began my group odyssey on a Saturday afternoon in a session held in the basement of a local hospital.  Right away I was greeted by an older, portly, belly sticking out of sweater, thick plastic bespectacled gentleman who would later introduce himself to me at least five more times in the next hour and a half.  I got past him and sat on a chair arranged in a big circle.  I was one of the first people to arrive aside from the facilitator.

The facilitator was not a professional and had no therapy credentials.  He was just a guy in his mid 30’s with severe depression and an uncontrollable inclination to insult strangers he sees out on the street.  Bloated from medication, too much cake and a crew cut that should have come with a complimentary pair of Dennis the Menace pavement sliders, he would read the meeting ground rules as if every syllable bored him more than the last.  Then he’d make sure anyone who wanted to talk had their ten allocated minutes.  And if anyone ever got out of line, he’d ask them to leave. But you could tell cake was his main concern.  Coffee cake, pound cake, walnut cake, angel food cake… Ah, so many wonderful cakes!

Quickly the empty seats filled up with what I assumed were bipolar butts.  But to my surprise almost anyone could sit down and chime in.  And some of the regulars were schizophrenic or had other major psychological disorders.  And when they started talking delusionally, everyone would get mad at them for wasting time and tell them to shut up.   I thought it might be a good idea to get them information about the appropriate group therapy session for their mental disorder, but the moderator just sat there with his thumb up his ass dreaming about the way sponge cake feels when rubbed all over his body.

Here is a snapshot of the Bipolar Support Group’s composure:

We had a delightful gentleman in at the ripe age of 90 who came to talk about his older sister.  He was just lonely and frightened of what life held for him.  He could have been sitting in Knitters Anonymous and be just as content.  But he was too nice a person suggest attending a different meeting.

We had a young school teacher on medical leave, afraid to return to the classroom due to severe panic attacks. It was obvious she was bright and communicative.  I felt her anxiety could be overcome with some exposure and talk therapy.  However, practically everyone united to convince heron permanent disability was the way to go.  To about half the group of around twenty people, the question wasn’t if you could go back to work, it was whether you could qualify for permanent disability.  The consensus was she could make a good case for it.

One lady was never formally diagnosed with anything, but liked making the coffee shop arrangements for after the meeting.  She was a mental illness groupie.  She would latch on to a really sick person and become their sole support system.  And when no longer needed, or getting on that person’s nerves, she’d find a new lost soul in the group to mother.  I think she had a disease called munchausen-bipolar.  She found self worth making herself part of the drama centered around a bipolar person going through hardship.

Then there was a 350 pound woman who was sweet on the outside and a trouble maker on the inside thriving on confrontation.  Once she brought a very old little dog to the group that was literally on it’s last leg.  She was bald, blind, barely able to walk and fighting for breath from fluid filled lungs. This woman walked it around the circle basking in the “isn’t she adorables.”  But the dog was so close to death it was like bringing a dead bird to the meeting.  It was probably a blessing, but the little dog died that evening.

My favorite was a woman who complained of Personality Dissociative Disorder, so she sat with a mirror in front of her reminding herself she was still there.  She never talked.  All she did was stare into the mirror.  I wanted to say, “Put away the mirror.  I’ll let you know if you disappear.”

Finally was the lady with a greenish abscessed toe bursting out of her shoe who always wasted half the session talking about free theatre tickets she can get through an agency that donates them to non-profits.  But that infected toe was like a gargoyle that encouraged me to keep my distance from her.

My last example of the misplaced mentally ill was my greeter.  He would sleep through most of the session and suddenly awaken with a random suggestion, like how to get free pencils from the city.  Apparently he noticed someone writing with one in a notebook and felt it would be helpful knowledge.  Then his head would drop and he’d be back to slumberland in no time.

Basically out of an average of twenty people, two of them talked about real bipolar issues the first time I attended.  The rest would just give advice on how to get permanent disability, free psychiatric care and medications.  Others were there for the coffee shop get-together after each session.  It was more a place to socialize for the generally mentally ill and senile.

Not all bipolar support groups are the same.  I am sure there are some with a better illness vetting process and accredited facilitators who actually lead the group instead of waiting for it to implode.  My suggestion is to learn more about all the Bipolar Support Groups in your area and sit in on several.   Note others in the group looking for a feeling of commonality of mental disorder, age and education.  In other words, find a support group in which you feel comfortable sharing.  With support groups it’s the people attending the group who are most important. They are the ones offering advice and comfort.  It’s crucial you find people you can relate to.

That teacher with the anxiety disorder did eventually go back to work full time and the last I heard is doing quite well.  When asking someone what gave her the confidence to go back to teaching, she told me it was leaving  the support group.   If support groups were on Yelp, what a story she’d have to tell.

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Ten Things You Can Do to Stop the Madness   3 comments

If you are bipolar and mania hits, your mind starts to react irrationally.  You begin to make feeble excuses for rash decisions that make sense only to you.  Your thinking becomes grandiose and your ability to complete major undertakings is greatly overestimated.  The chances of speaking your mind and telling others they are mistaken is greatly increased.  Shooting off that email for which you’ll later kick yourself is almost guaranteed.  And, you may not even be aware you are manic.  Many people in this condition think they are finally depression-free and in their true natural state.  It’s in this condition many stop even taking their medications.

I will shit you not; mania is awesome!  You practically need an intern to follow you around taking note of your brilliant ideas, homespun witticisms and words worthy of quotation.  You spend hours composing an admonishing email to a co-worker until it is a perfect piece of literary prose that would even impress The New York Times.  And when you aren’t enlightening the world and putting others in their place, you’re most likely buying an entirely black wardrobe to fit your new Johnny Cash “rebel” image.  Plus, the meds go out the window.

If you have been conscious of your bipolar symptoms for a long enough time, you usually know when you are manic.  You also probably don’t want it to end.  However, you also know the depression that ensues is that much worse.  So, here are some tips on curtailing your mania and avoiding a crash landing on the cold hard unforgiving floor of depression.

  1. Consciously identify you are going through a mind scrambling manic episode.  Then follow the next nine steps without variation.
  2. Stop talking and sit or lie down in a secluded comfortable place attempting to “slow down your mind.”
  3. Do not send any emails or leave any messages for anyone so you don’t say anything strange or offensive.
  4. Write out everything you want to do with your grandiose thinking and why it makes sense.  Then read it back to yourself.  See any flaws?
  5. Write out what you would like to say to the person you want to email, but don’t send it.  Read it back to yourself.  Still want to send it?
  6. Pretend you are now very depressed and had acted on your grandiose thinking and antagonizing email writing.  Will you be sorry?
  7. Do not browse the internet.  There are too many temptations that even those without Bipolar Illness get sucked into.
  8. Put your credit cards and cash in a safe place and institute a moratorium on expenditures until the mania has resolved itself.
  9. Take a vigorous walk or have a hard work out to “sweat the manic” out of you.  Make yourself too exhausted to run around making asinine proclamations of greatness and alienating yourself further from co-workers with non-sensical emails.
  10. Read a book, watch a movie, listen to your favorite music… Anything to take your mind off your mania and focus on something else.

I am not a doctor.  I am not a psychologist or psychiatrist.  I cannot change the oil in my car.  These are just some tips I use to curtail my behavior when I am in a manic cycle.  The steps are difficult to follow because you are in a superhero frame of mind and their focus is to slow things down until you can evaluate the situation with a clear head.

Also, if you are really worried about losing control, find a friend you can call when you are in the throes of mania who can babysit you, making sure you don’t do or say anything you’ll regret.  Being bipolar indicates an afflicted person’s mind suffers at two different poles; uncontrollable mania highs and deep depression lows.  If you allow your mania to ruin your life, your depression will be all the more worse.

Statistics: The Thing Standing Between Bipolar Treatment and The Truth   7 comments

People were so gullible back in the 1950’s and 1960’s.  “9 out of 10 doctors recommend Pall Mall Cigarettes because they are less harsh on your throat. ”  “In a side by side comparison, Lincoln is better than Cadillac.”  “More people trust Goodyear than any other tire.”  I’m paraphrasing, but you get the gist.  And people believed this stuff.  Nobody was calling out for Google Analytics, or even for Pall Mall to simply show how they conducted their survey.  All you had to do is make the claim and everyone assumed it was fact.

Before you start musing at people’s low level of bullshit detection back then, we are still eating up the same statistical nonsense in 2012.  It’s just packaged differently.  Take the Bipolar Disorder drug Lamictal.  According to Wikipedia, between 5% to 10% of patients taking Lamictal will develop a rash, but only 1 in 1,000 patients will develop a serious rash. Plus only 1 in 50,000 patients die from the rash.  This is an un-cited claim according to Wikipedia.  The information powerhouse aggregator went on to say that 9 out of 10 doctors smoke Marlboro Cigarettes because the brand gives them steadier hands in the operating room.  Personally, I’d like my doctor to smoke Marlboros while he’s actually operating on me to insure the very best outcome.

Most people reading this aren’t looking for citations.  Wikipedia has credibility because it says so.  And if 1 in 50,000 actually die from Stevens-Johnson Syndrome (the killer rash), those are pretty good odds.  They are willing to take the gamble if they are suffering from bipolar symptoms and Lamictal is their greatest hope.

Wikipedia downplays the killer-rash statistic, as does its manufacturer GlaxoSmithklein.  But just getting the rash must be scary.  The patient doesn’t know if it’s “the big one.”  And 5% to 10% of patients will get it.   That’s at best 1 in 20 people.  Maybe 1 in 10.  I see these very same statistics influencing people not to try Lamictal,  So you see, we really have not evolved from the 1950’s and 1960’s vulnerability to marketing mind melding.  Any statistics can be made to lean in any direction you favor.  It’s the interpretation you chose to believe that makes up your mind.  However,  I don’t think anyone can argue the Lincoln is a better car than the Cadillac.  Everyone says it has a better ride.  Everyone.

Personally, I chose to flirt with death and take Lamictal for my bipolar symptoms.  Fortunately, I did not get the rash.  I also didn’t know any of the rash statistics.  I just trusted my doctor when he said getting Stevens-Johnson Syndrome was very remote.  And the minute a rash developed he’d stop the medication.   Notice how I used the phrase “I trusted my doctor.”  I think when the drug manufacturers and web sites are whipping statistics at you for their own less than altruistic reasons, you need a doctor or knowledgable advisor you can trust.  Someone from the real world who can talk from experience, not an Excel Spreadsheet.

Years ago when I was just out of college and had started my first job, I had a crippling attack of depression hosted by my bipolar illness.  It was a Friday night and I was rolling around on the living room floor shaking, unable to keep still and telling my then girlfriend that I wanted to die.  I couldn’t get through to my usual psychiatrist and I needed something to help me sleep and keep me from killing myself over the weekend.  One of my Dad’s friends had a brother who was a psychiatrist who I called at home and he said he’d see me first thing Monday.  But to get through the weekend he wanted me to have a glass of wine and a couple of Benedryl whenever I needed it to calm down.  He hadn’t met me yet and did not want to start pumping drugs into me site unseen.  From 30 years of practicing, he knew this was unorthodox but safe and effective.

I didn’t do it.  I was so depressed I ended up overdosing on sleeping pills and was taken to the hospital.  But I admired the doctor’s practical grass roots approach to getting me through the weekend.   He had excellent credentials, 30 years experience and a solution, albiet a little off beat one.   I trusted him more than a statistic.  I’m sure there are many statistics telling you not to mix even Sweet Tarts with alcohol.  However, we all do it now and then usually to no ill effect.  The doctor knew this.  He was being practical and compassionate toward my deteriorating condition.  He also definitely agreed more people trust Goodyear than any other tire.

For these reasons, I am not a big fan of the statistic, especially when it is not cited or the fine print is a disclaimer for it probably being inaccurate.  I also detest when people just make a claim citing everyone as their source.  My grandfather, a Philadelphia native and its biggest cheerleader, used to tell me things like “Philadelphia has become the restaurant capital of the world.”  I’d say “Pop, where the hell did you hear that?”  And he’d say, “Hear it?  Everyone knows it!”  He also smoked Lucky Strikes because LSMFT.  (Lucky Strikes Means Fine Tobacco).   How could you argue with that kind of logic?

So when negotiating the bipolar landscape of doctors, medications and therapy, do your research.  But don’t believe everything you read, even the statistics.  Find people you trust and talk with them.  Statistics are not real.  They are man made.  Experience is real.  And someone you trust to help you evaluate it is invaluable.  Just please always remember, Michelob is the right beer when you’re having more than one.  At least that’s what they say.

A Bipolar White House?   2 comments

Last night I was watching MSNBC with Lawrence O’Donnell and he was showing footage of a speech Mit Romney made yesterday more or less accepting the Presidential candidacy nomination for the Republican Party.  I say more or less because he won most of the states in the primary, so it was pretty much a given.  His self-congratulatory speech was like me buying a house and then making a bloated speech to my real estate agent accepting the property.

The thing that bothered me most is that for many of Romney’s statements, Lawrence O’Donnell juxtaposed footage of him blatantly contradicting himself.  At first I thought I was watching a skit from Saturday Night Live.  It would have been the first funny thing they did in ten years.  Worse yet, he began revising history of how President Obama was the one who created the deficit, that we are still in a downward recession and Obama wants to make the United States a secular nation.  If you think any of this is true, you need to get out of your trailer more and stop watching FOX News.

Most revolting, is Romney wants to double the tax rate on student loans.  Well, he claims he doesn’t, but video footage shows him saying on camera at a rally students shouldn’t be relying on loans and interest rate discounts.  They should pay their full ride with no assistance.  But now he’s for keeping the student loan interest rates from doubling.  If Mit Romney went to a psychiatrist, I guarantee you’d find some major issues.  A main psychopathic feature is the ability to lie with no remorse.

However, you can’t just blame Mit.  The entire GOP is constantly rewriting history in an overt effort to bring President Obama down.  I honestly believe it’s because they can’t stand having a young magnetic black man in the White House.  And if they have to go into liar’s-overdrive, then so be it.  Wasn’t there a movie in the early 1980’s with Clint Eastwood and a Chimpanzee side-kick called “Any Which Way You Can?”  Well right now Mit is the Republican Party’s Chimp doing it “Any Which Way He Can.”

Everybody tells lies to some extent.  When I was at my obsessive compulsive worst trading in my car every six months for a new one,  I told my critics I could sell each one for even money, so why shouldn’t I drive what I want when I want?  The truth be known, I was losing a fortune trading cars in so frequently, but I couldn’t stop my compulsion.  But I was embarrassed and trying to hide my bipolar disorder.  And the only person I was hurting was myself.

The thing is, in all my bipolar illness, I would never tell a lie that would effect someone else.   If I lied, it was to keep people from finding out about my OCD, depression, a suicide attempt, a hospitalization or the likes.  I never disparaged anyone or tried to harpoon their character for my benefit.  And although bipolar people are not less prone to lying, they are not more prone either.  And I don’t think the majority of people in the world are liars either.

Then we see these republicans telling lies the size of hot air ballons that do affect our country in a negative way.   There are also a lot of stupid people out there who believe this rhetoric and republicans seem to have no remorse feeding them this political fodder in the form of pert little sound bite suppositories.    Worst of all, they literally ignore the fact their lying can be documented.  This is psychopathic behavior.

I’m still waiting for a Republican to stand up in Washington and say “this is ridiculous!  The Republican Party has gone too far!  Republicans and Tea Partiers, line up for a psychiatric evaluation at the Lincoln Memorial!”  I think it would look just like a mostly white Million Man March.

I could never run for President.  After all, I’m Bipolar II.  I could get depressed, go to bed and sleep through the passage of an amendment to the constitution.  Or, I could get hypomanic and keep threatening to launch a missel at France if they don’t send me over a wheel of brie every Friday.  I might even have an OCD flair up and start trying to conquer nations that start with the letter “M.”  No, the United States could never have a bipolar man in the White House.

A psychopathic liar out to destroy the President because his vindictive political party can’t stand to have a successful democrat, little yet an African American in the White House?  Now that’s OK with a lot of Americans.  But not a bipolar.  That’s way too dangerous.

Suffering in a Six by Nine Cell   2 comments

He left the classroom, which was nothing more than a converted trailer, and walked out onto the San Quentin prison yard.  He sat down on the deserted baseball infield legs crossed in his prison blues.  Nobody noticed him at first until he started ripping up handulls of grass and shoving them in his mouth.  Finally a guard took note and walked over to the fence surrounding the baseball field.  He wanted to know what the prisoner was doing and ordered him to stop.  No response.  It was obvious the man was having some kind of  mental breakdown.

Guards at San Quentin, as they are in other jails and prisons, are taught not to enter a potentially dangerous situation with a prisoner without at least eight other guards.  This is to completely imobilize the inmate and not risk their own personal safety.  This particular one was sitting quietly on the ground shoving gobs of turf in his own face. He was obviously a threat and needed to be beaten down before things got out of hand.

So, when the proper amount of guards amassed, they proceeded to approach the man and do just that.  In fact, they protected the prison so well  the man was actually removed from the institution…  By ambulance.   Once again things were safe again inside San Quentin from grass-eaters experiencing psychological breakdowns..

And the volunteer teacher showing great concern who ran outside to see what was happening to her student?  She was also removed from the prison.  Told she needed to concentrate on teaching, and not the delicate prison security maneuvers she knew nothing about.  “Next time stay in the trailer,” were the gruff instructions meted out to her.

If you are not shocked by this, you should be.  But go inside a prison like San Quentin for any length of time and you’ll start to see such abuses of the mentally ill.  Sans the beating,  many are not getting the proper treatment or follow up they would get on the street.  Most of these men, and women in crisis, don’t end up in the hospital.  They are thrown back in their six by nine cells to silently suffer by  themselves.

However, if inmates are hearing voices or anything that pronounced, they could be fortunate enough to end up in the prison hospital where they have a better chance of being treated for their mental illness.  But if you are severely depressed from bipolar illness, that’s ok. “You’re in prison.  You’re not supposed to be happy.” is what you might get back from a guard.

Can you imagine hitting bipolar rock bottom, locked in a jail cell and not getting the right medication, if any at all?  Writhing in deep depression, unable to sleep, not knowing if anybody will come help or if anyone is even thinking about you?  Or to be mistakenly denied your medication and going through serious withdraw symptoms?  And in the middle of your dry heaving, severe muscle pain and uncontrollable tears, you’re told the prison psychologist already went home for the weekend and will see you on Monday morning?  But you are expected to sit in your hot little decrepit yellowed paint peeling cell and wait while he plays a little golf, barbecues a few steaks, gets his Lexus detailed, screws his wife, takes an aspirin for a headache and indulges in all the other pleasantries of being free and mentally stable?

It pains me to my core to know things like this are going on everyday in the California correctional system.  And, I’m sure we aren’t the only state without basic compassion for human beings in mental crisis.  I don’t want to hear, “well, they did commit a crime.” I drove in the car pool lane two months ago by myself intentionally.  It was faster and I was late.  Spotted by the California Highway Patrol, I got a $350 ticket. Does this mean I should be denied on the scene care from an EMT if I ever get into a serious car accident?  Because I once drove in the carpool lane without another passenger on purpose?  Of course not.  So why is it if you commit a crime are you denied psychiatric care, or competent psychiatric care, for that matter?  Why don’t we just stone mentally ill prisoners while we’re at it?

Nobody knew or ever reported on the San Quentin incident.  How many more went un-noticed?   Think how you would feel being incarcerated and bipolar.  Would you feel confident you were getting the right care?  How would your anxiety level be locked in a six by nine cell with another grown man you don’t like?   Everyone is complaining around you.  Can you even make your voice heard?

Being locked up and denied your freedom is the punishment for committing certain crimes.   Mental suffering while locked up is not something the judge orders.  Yet, our prison systems in the United States continue to serve it up.  We have to learn to slip the cuffs of silence on the subject.