Mental Health Journey

With my blog being featured over at The Experience Project I think this is a good time to reintroduce myself. Many of the major areas of my life have been detailed to a certain degree throughout the brief history of this blog but I will use this post as a way to summarize my journey so far.

I have been dealing with depression for as long as I can remember. My family history has mental illness on both sides going back for generations. Chances are I was depressed the day I came out of the womb and have been unable to get rid of this silent monster since.

Self harm started when I was seven or eight with the intention of punishing myself so I would be a "good" child and maybe people in my life would finally leave me alone. Needless to say this did not work. When I was twelve or so I tried to end my life and somewhere in the process I realized that as the blood left my body a sort of cleansing occurred which seemed to make me feel better. What I did not realize is this new monster would stick around for the next two decades.

To be honest I have no idea why I am still alive and there are pieces of my past that are a complete blur. Sometime in my mid twenties I seemed to have found the ambition to get my life back on track. I enrolled in college in Social Service Worker program with the intent of not only figuring out my own mind but also to be in a position to help those in need. The material of the course came very easy to me and I seemed to be flying through the program. In the last semester of college my father passed away and I did what I have always done which is completely ignore the emotional turmoil by throwing myself into another aspect of my life.

I graduated from college in May near the top of the class, in June I started to work at a group home for troubled teens and in July I married my long term girlfriend. For a while I thought my life was finally on track and everything seemed to be perfect. About a year and a half after we were married we were blessed with a beautiful baby boy.

Then things started to go wrong. I was constantly sick and had a lot of problems getting to sleep at night then when I did get to sleep the nightmares made Freddy Kruger look like Big Bird. When my son was about a year and a half I booked an appointment with my family doctor for at this point I knew I was in trouble and was very quickly losing control over all aspects of my life. After a brief meeting with the doctor I admitted that on the way there I was tempted to pull in front of every eighteen wheeler that passed on the opposite side of the road and the suicidal ideations were becoming a normal part of my life. The doctor immediately pulled me off of work, prescribed an antidepressant and made a referral to a mental health doctor. I honestly thought at this point that the med would kick in and I would be back to work in a matter of months but that was not the case.

I met with the mental health doctor a couple of months later and was diagnosed with severe Major Depression Disorder with psychotic features. He switched my medication and so began the experimentation of mental drugs that I have been on over the last few years. A couple of months later Paxil was tried and it effected me in a negative and dangerous way. Within a week of being on this med my self harm behavior went through the roof and it was impossible to tell which mood state I would be in from one moment to the next. With my wife basically threatening to leave if I did not enter a hospital setting plus the push from the doctor I agreed to be admitted into the hospital.

For the next two months I went through talk therapy numerous times per week, a variety of medication was tried and I went through five sessions of ECT. ECT is Electro Convulsive Therapy or what use to be known as shock therapy. After the fifth session it was stopped as I was taking a very long time for me to regain consciousness plus there did not appear to be any real positive changes. At the end of the two months I convinced a floater doctor that I was perfectly healthy and he signed my release papers which pissed off both my doctor and my wife.

A few months after the hospitalization all of the negative behavior had reappeared and the medication that I left the hospital on was beginning to lose its effectiveness. My wife took our child and left as my behavior was to unpredictable. My now ex wife did not make this decision hastily and in a lot of ways I basically pushed her out the door (thats another post).

I went through a number of mental health "professionals" in this period with the first one being arranged by the therapist in the hospital. This is going to sound terrible but it is the way it was and is, I admitted in the third appointment that during a rough period I resorted to self harm to get through the situation. Once I told the therapist this she basically ended the session as she felt I was not stable enough to treat. The next few therapists would reach the same conclusion and stopped treating me.

Fast forward a couple of years and another bad self harm session that through the doctors eyes looked like I tried to take my life again. So back on the psych ward I went but this time it was located in the city's main hospital that did not have a full time therapist on duty because of budget cuts and it makes too much sense. Some time during this admission I decided to tell my mental health doctor absolutely everything that I have been though during the course of my life. The first version was basically just the facts with little to no detail and due to his positive reaction stating he learned more about me in those few pages then he had in the two and a half years prior. I wrote out the second edition which gave details to the facts but still not disclosing everything. Again the doctor encouraged me to keep writing so I started the final version. This last version was pretty intense to say the least and an example would be I talked about my grandfather which is one of the best relationships in my life and a couple of pages took hours to write for every single detail I tried to include in the section. Each day I would submit a new section to my doctor who would read it carefully then gave his take on it. When I finally finished this last book on my life he advised me to give it to every mental health professional that was trying to help me so they would be able to treat me more effectively.

So I figured that no one knew my brain like I do I decided to create a treatment plan that would lead to recovery. I wrote out all of my issues and what would be the best way of treating them. I handed the paper over to my doctor who completely agreed about my plan but then stated that this city's mental health system would be unable to provide the specialized help that I needed. Another part of the treatment plan was to list out the diagnosis that I felt fit me and to this day I wonder if this was a mistake for everything was about to change.

The diagnosis that I listed were Severe Major Depressive Disorder with Psychotic features which had already been diagnosed a couple of years earlier. Post Traumatic Stress Disorder which was rather obvious if you look at the amount of abuse I have been through plus the flashbacks and nightmares. Generalized Anxiety disorder which tends to go with PTSD. The last diagnosis I listed was Borderline Personality Disorder and the second my doctor saw it his face lit up like a light bulb and declared it a perfect fit.

Due to the hospital not being able to provide the type of treatment that I needed I decided I would be better off back at home and seeking more specialized help in the community which my doctor agreed to. After a month of trying to contact every therapist around plus using a variety of mental health agencies for assistance I returned to my doctors office very frustrated. I told him about my problems finding help and he replied "Your too Borderline for treatment to be effective". Over the next couple of months he would add "Your going to have good periods, then your going to have bad periods which will cause you to crash and a hospitalization will be needed to stabilize you and then the cycle will repeat". Basically the goal is not to "cure my problems" but to avoid the hospital as long as possible. In my doctors eyes I am untreatable.

Do I believe the "untreatable" label? It really depends on the day. Over the last six months I have worked through various aspects of my life and I do see a light at the end of the tunnel but at the same time there are times when all of the movement I make seems to be backwards.

This blog was created so I would have a place to empty out my brain instead of trying to swallow the emotions/turmoil, a place where I can write everything down so I could analyze and try to correct any faulty thinking patterns. This blog is my therapy and for whatever the reason a lot of people seem to relate to it so at the very least I know the last three years has not been a complete failure.

Sorry for all the jumping around and like I mentioned earlier most of the above has been broken down in other posts that I have written. Any comments or questions do not hesitate to ask and I wish you all the best in your own journey. Take care

An Uncomfortable Situation

My last hospital admission was in late September or early October. I had walked into my doctors office and just pulled up my sleeves showing cuts that were made with bad intentions. In the middle of a cutting session my brain decided to take a mental vacation and when I came back to reality I was in the bathroom trying to fix up the mess. Reality can show up at the worst of times hitting you with what feels like a twenty pound brick and I finally came to the realization that I had once again lost complete control over self harm. Anyway once the doctor saw the marks the appointment ended with him picking up the phone trying to find me a bed in one of the two hospitals in the city. Where I live there is one hospital devoted to mental health and a hospital that has a psych department. The first admission some two years prior I had ended up in the mental health hospital so I figured that is where I was going again. The doctor told me to wait but about five minutes later I decided that I was not ready for an immediate admission so I went home to get ready. I did all of the things that I could to get ready such as grab a bunch of clothes, picked up a carton of smokes, made sure the mp3 player was ready to go plus sent a note to my mom and ex wife that I was going back into the hospital. I then called the doctors office and the doctor told me to report immediately to the main hospital with the psych department.

Now the first hospital had a therapist that treated a number of people in the hospital a few times a week so I assumed that this new hospital ward would be the same but I was wrong. What this hospital had was a couple of women who saw all types of patients in this main city hospital and needless to say they were very busy. Now my doctor thought that a key to my treatment is to work through areas of my past so that I could move forward which is something that I completely agree with so the nursing staff set me up with one of the before mentioned very busy counselors.

I have been around enough therapists and counselors to be able to decide whether or not they are in any good and I was pleasantly surprised at the caliber of this new helper but then a problem arose. There was no set schedule when she would be able to see me as it depended on how busy the rest of the hospital was plus one of her main areas was to help patients and their families through the death and grieving process.

After our second meeting a wave of fear ran through my body as we were getting to the point where I was about to open those old closet doors in the back of my brain. Due to this woman schedule I never knew when she was coming back nor did I know how long the session was going to be so the worry was that I bring out a demon from the past and once the monster is free it tends to cause havoc in my life. If I knew the sessions were close enough together then the process of going to war with my past would not have been a big deal but I was not sure if I would be able to handle the onslaught for a longer time period. I actually approached a nurse that I trusted and asked for advice which is something I do not do normally and explained my concerns. Her response was that in the setting I was in under constant supervision they would be able to react quickly to any situation so now was the best time to do it. What she said did make a lot of sense and I decided to wait till the next time I saw the hospital counselor then tell her my concerns and then begin to open the doors to the past.

A couple of days later after this decision I hit the mental wall going full speed to the point where I had lost complete control over everything. I scratched out a note that basically said that I was falling fast and I needed help to get out of this hell. I dropped the note on the nurse's desk where more then one saw me do so then proceeded to my room to wait for the calvary. Then I waited and waited and waited. To make a long story short it ended with a very nasty self harm session and my trust level of the nursing staff being sent out the window. A couple of days later my doctor asked about the note then freaked on the nursing staff when I told him they did nothing about it.

The hospital counselor came down later on that week and I just talked about the same stuff we had discussed the week before knowing that there was no chance that I would open those old closet doors. Take care.

A Day On The Psych Ward

Right off the bat I should mention that every psych ward is going to have its similarities and their differences. The last time I was on a psych ward it was for the month of October during 2007. This ward was located at the city hospital and its main purpose was suppose to be to deal with people in acute situations or in other words short term stays but due to lack of beds in facilities for complex situations half the patients were there for a lot longer then what the ward was designed for.

7:00am - This is my normal wake up time. I quickly dressed and left the bedroom while my three other roommates continued to snore. Normally I would grab my jacket and head out to the back deck for a quick smoke. The smoking area was a balcony that was literally caged in to prevent people from taking a flying leap.

8:00 - Breakfast would arrive. The menu switched from day to day with your usual morning food items. Coffee is all I cared for but every once in a while I would try something then quickly understood why I avoided breakfast. Around this time is when the morning meds would circulate.

9:00 - The doctors would begin to circulate. The patients would normally be sitting around waiting for the whole five minutes spent with their doctors. The typical question were (1) has anything changed since yesterday (2) How would you rate your mood (3) Any immediate concerns. Tax money well spent.

10:00 - The group therapy would begin. It covered such topics as meditation, relationship building and decision making. Picture ten people sitting around a small room all with a variety of mental illnesses though the majority were there for a form of depression and very quickly the group would be off track. I avoid group therapies for a few reasons (1) I have enough problems talking with my doctor and staff about problems in my life so the thought of telling my stories to a bunch of strangers is not exactly appealing (2) The topics that were covered I use to teach when I was at work (3) My personality works two ways in groups which is I dominate the meeting or I do not participate what so ever. I went to one group meeting during my month stay and it was mandatory for those going out on a weekend pass, the topic was what you hoped to accomplish with your brief trip home - my priorities were pretty obvious: spend time with my son and enjoy the visit with my mom who traveled six hours to give me a break from the hospital.

11:00 - Nothing scheduled.

12:00pm - Lunch. The food was pretty good until I was put on a diet for MAOI (antidepressant) then it was basically the same damn thing everyday. The afternoon meds would begin to circulate.

2:00 - Some sort of group activity Mon - Fri. Bingo, arts and crafts and what have you. The majority of people did not participate including me.

5:00 - Supper. See lunch.

7:00 - Another group therapy sessions but tended to be under half an hour.

8:30 - Snack.

9:00 - The night time meds would begin to go around.

10:00 - Bedtime for me.

Free time - There is a lot of free time on the psych ward. Some people spent that time in front of the television, others sat in little groups basically complaining about their situations, a small percentage spent the majority of the day in bed. I decided to write a book so if I was not working on communication with my doctor through letters, essays then chances are I was writing my book. I think I averaged close to eight hours a day on my book (that I have barely touched since my release)

Smoking - A lot of people on the psych ward smoke. If I did not smoke then chances are I would have never gone outside. A pain in the ass is there was patients whose cigarettes were on a schedule so they would be constantly begging others for smokes which the nursing staff completely frowned upon but some days fellow patients would give in just to have a moment of peace.

Security - There was a security guard on duty from Monday to Friday between 7am to 11pm. There was no security of weekends for I guess people do not go crazy on weekends.

Nurses - They ran the scale. They were some nurses who constantly went out of their way to help the patients and then they were nurses who you would see only at med dispensing times.

Therapy - The psych ward did not have a therapist. There was a grief counselor who came in once in a while. This lady was really good but she was stretched way to thin as she was responsible for pretty close to the entire hospital. I think I saw her three times in the month that I was there.

Incidents - People losing control of their emotions for whatever the reason was pretty common but the nurses quickly led them back to their rooms so as not to effect the other patients. There was one major incident that lasted close to three days off and on. The patient would go from somewhat calm to completely freaking where she would scream, band the walls, tried to destroy her room and what have you. This incident effected every other patient on the floor as no one knew what she was going to do. The protocol was to bring her to another hospital that was better equipped to handle someone of her need but there were no open beds to do so. Eventually they gave her enough drugs where she would be quiet for eight hours or so then the situation would repeat. I basically signed myself out, my doctor agreed with my logic, as the anxiety from this one person was not helpful to my mental condition plus it became rather apparent the hospital was not designed to deal with someone of my need.

Overall - The psych ward is a rather boring place to be and you spend a lot of time in your own head trying to figure things out on your own. The thing with psych wards is that people tend to feel safe there as the staff are always right around the corner so after a while the real world gets more and more intimidating which causes some patients to exaggerate their mental illness to ensure a longer stay. Unfortunately this psych ward was designed to just deal with the crisis and not the overall problem so people leaving then coming back within a six month period was pretty routine.

Solution - The obvious one is money for longer term beds, one on one therapy and to switch the thinking from medicate to therapeutic treatment as band aids do not last very long.

take care

Where My Distrust Of Doctors Comes From .... Maybe

A little over six year ago I went home for Christmas and my father was not feeling well but he said the doctors thought he just had a cold. Christmas eve my girlfriend at the time and I decided to go for a walk so we could grab a smoke. My father soon followed us out but I sent him back home as his cough was pretty loud and I did not want him to get even more sick. Anyway the walk did not last long as it was typical Northern Ontario weather for December so it was bloody cold. The Christmas vacation ended so my girlfriend and I returned back to our college town as school was starting back up again.

I talked to my father on the phone a number of times over the next three weeks and that damn cold of his was not going away but he said the doctors have ran the tests and the best they could figure was a slight case of pneumonia. A couple of days after I last talked to my father my mom called saying they had spent the previous night in a hospital hallway as there were no free beds. That morning they did a test on my father and discovered that he had cancer and it was terminal. I went to school that morning and talked to my teachers who understood that I needed to go home as my mom wanted me to be there when the doctor told him that he was dying. As by this point my father did not know and just believed he had pneumonia.

I drove straight to the hospital and entered my fathers room where he greeted me with a smile. He talked about how he could not believe he was back in the hospital and was not happy that his "cold" was still present. My dad said that my mom was not taking this new admission well and he wanted to make sure I knew it was my responsibility to look after my mother and sister when he was unable to do so. I just nodded my head as I couldn't speak for my heart was in my throat. The next day my mom went to the hospital early and with the doctor told my dad that he had an aggressive form of cancer. The doctor said he probably had about six months left to live. My father did not believe him and demanded an autopsy be performed which the doctor agreed to do on Monday as it was Friday when the news was given to him.

I went into the hospital later that afternoon and my Dad had his best fighting face on and was talking about proving the doctors wrong once again. Over the years my dad had "died" four times in the course of heart attacks and during an open heart operation so needless to say my father knew how to fight. Two years prior to this event he had beaten prostate cancer. We talked about everything and anything except for the situation that he was now in. That night I told my father that I loved him and he said it back then I headed back to my parents home. During the drive I though about when was the last time I told my father that I loved him or him saying to me and I could not remember. I was raised in a fashion where as a male you keep your emotions to yourself.

On Saturday my girlfriend (who I would marry six months later) and I found my dad walking around his room with the window wide open and a fan blowing as he said that he was boiling. This is the middle of January and it was cold both outside and inside of his room. He would talk for a few minutes straight about getting back home and beating this new problem then he would not say nothing for long stretches at a time. Later that night I told my father I loved him again and kissed him which is something I had not done since I was a little boy.

That night I was mentally preparing myself how I would handle the next six months trying to figure out how I was going to get up to see him as much as possible while still working as my last college placement was due to begin shortly. I also had a small talk with God that night where I basically said if my father wants to fight then let him fight but if it was his time to make it as painless and peaceful as possible.

The next day we all went in early to see my father as I needed to head back to school. I said goodbye to my dad, told him that I loved him and that I would be back as soon as I could figure out a way. My girlfriend and I drove back to our college town. Once we were back inside of our apartment the decision was made that a shower was needed then we would figure out what to do for dinner. My girlfriend and I were in the shower for a few minutes when I felt my heart literally break and I broke down in tears. I was talking about how I did not have a dad anymore and I did not know what I was going to do. My girlfriend tried to get me to focus on the positive and the hope that things would improve for my dad. I stepped out of the shower and the phone rang. I picked up the phone and it was my mom "Sweetheart" she said "Your dad is gone".

The doctor had told us he had six months to live and it ended up being four days. I thought of the cold he had at Christmas and wondered why the Cancer was not found then and maybe if it was recognized then they could have done something that prolonged his life. My family doctor at a later date would explain to me that the Cancer that killed my father was a type that is lying in wait then for whatever the reason it decides to attack then the game is over. The test my father had on Wednesday night/Thursday morning the cancer was in his lungs and by the time he died it was present in 90% of his organs. My fathers aunts call it "galloping cancer" as it was the same type to take my Grandmothers life at exactly the same age.

Now when a doctor tells me anything this story comes to mind and I know they were wrong before so why is this time any different. I know the reasons that conflict this theory but to be honest none of them really make a difference. Does this hamper my recovery process? It might to some degree I guess but at the same time I do not take anything my doctors tell me as gospel. Take care.

Mental Illness To Do List

All of a sudden the winds of change come roaring in from the north and leaves you suffering from a mental illness. This may very well be the most difficult stage in your life but there are things that you can do to speed up the process and get you back into the ballgame called normality.

1. Hate to break it to you but your doctor, nurses, therapists and counselors are human beings who do make mistakes. If you do not agree with what your mental health professional is saying then question it immediately. Last time I was in the hospital a nurse came by to take my blood. I asked what the test was for and she gave me an odd look then checked the form. The test she said is to test my lithium level and I responded nicely I had stopped taking lithium a couple of weeks earlier. She checked and sure enough I was no longer on Lithium so no poking needles for me.

2. Write everything that you want accomplished in a doctor's appointment beforehand. The problem with some mental illness is difficulties with focus. The doctor says something that sends you in the wrong direction and before you know it all of your questions that you wanted answered never happened. Write your questions and concerns down and just hand the paper right to the professional at the start of the meeting.

3. Keep a daily journal where you include all emotions and behaviors through out the day. This serves two purposes (A) It provides the doctor with the information that will help them serve you better (B) It may show you and the professional the patterns that you seem to be following and the faster they are identified the easier they are to correct. This is a very helpful tool when figuring out meds, med dosages and self injury trends. When I started Seroquel everyday I would have problems in the earlier afternoon. The doctor took the action of adding an additional dose and the difficult period disappeared. A trend I have experienced is when you tell the doctor of a bad period they are slow to react but when they see it written down on paper the doctor quickly responds. Go figure.

4. Tell your doctor, therapist or whoever everything. Something that may seem small and insignificant to you may be a indicator of a major problem. Your mental health professional relies on you for the information to help solve the issue and if you do not tell them everything your basically shooting yourself in the foot

5. Medication. There is a very good reason why your doctor has you on medication and I know the side effects suck but it is important to stay on them and make sure you take the meds every single day. When you decide not to take your med one day and then starting again the day after your putting your brain almost into a shock like enviroment which causes more problems. For the majority of mental meds to be effective they need to hit a certain level and stay there. If the side effects are just to much to handle then call your doctor immediately but do not stop the meds on your own or you may be introduced to a new level of hell.

6. The stronger your support system is the better off you are. The best part of the internet age is that it is easy to find support. Find a forum that you like, join an online group, invite your friends and family to join the fight just do what you have to do to get as much support as possible. Unfortunately all of your "friends" may be on board at the beginning but a lot of them will disappear with time. Online forums and groups are full of people with the same condition, emotions and behaviors who can identify with your battles and are quick to offer a pep talk, advice or an ear to listen.

7. It is up to you. The best care in the world will mean absolutely nothing if your not willing to fight for yourself. Sitting around waiting for the sickness to disappear may work with the flu but it does not work with mental illness. If you do nothing then nothing will happen except for your condition getting a lot worse. Fight for your life and fight for your recovery.

8. Routine. It is important to establish a routine and follow through with it. With depression it is easy to let little things slide such as eating, hygiene and leaving the house. Every day I make sure I eat, shower and leave the house at least once and to be honest more then once I had to force myself to do so but I recognize how easy it is to fall into a trend that will just cause more difficulty.

9. Recognize when your in trouble and act. There may be times when your brain just decides to jump out of your head and go south. This is the time when you tell your doctor that it is time for a more intensive form of treatment. The saying I use that involves this area is "When I can not convince myself I am not a danger to myself or anyone else it is time to check myself in". The life you are saving may very well be your own.

10. Hope. Never give up on hope that things will get better. If you believe that you will never get better then that is exactly what will happen. Remember it does not matter how you fight just that you are fighting. Never give up on yourself.

Well there is my top ten to helping yourself on the way to recovery. Believe in yourself and the possibility of a better tomorrow then you are already on the path to wellness but whatever you do don't give up.

How I Diagnosed Myself

Back in October of last year I was sitting in a hospital bed trying to figure out a way to get back on the road to recovery and the decision I made was to put absolutely everything down in written form then hand it over to my doctor.

The first time I took on this process I just ran through my life without giving much detail more of a glimpse through the window into my soul. The doctor was overly excited about this written material and he claimed that he learned more by reading five pages of writing then he had in the previous two plus years. I took this as a positive sign so I set out to write version two of the same story but a lot more detailed but again not the complete story. Once again the doctor responded that I was making great strides by focusing so much on the areas in my head that I was moved to write what turned out to be my complete profile or as complete as I was willing to share for there are parts of my life that I am still unable to talk or write about.

This third book broke my complete life down into sections and how I dealt or didn't deal which each part. For an example of the intensity involved it took the section dealing with my fathers death was about a page in length but it took me three hours to write it. After I had completed this book, each day I would hand my doctor a couple of pages, my doctor said "every time you meet a new doctor or a new therapist give them this journal and the success of the relationship will be greatly improved". My doctor then replied in his history as a doctor he had never had a patient who was able to go into their brain and analyze the way that I am able to do. This was a huge ego boost but didn't last long for he then came back and said "this is your gift and this is your curse as your brain just can't leave anything alone so your constantly reliving events instead of putting them to rest". I thought about what he said then I decided to create my own treatment plan thinking no one knows my mind like I do so I am the best person to plan out the route to recovery.

I wrote out this treatment plan where I listed out all of my issues both present and historical then I wrote out a recovery solution but I made a critical mistake. At the top of my treatment plan I wrote out what I believed my diagnosis should be and what had already been confirmed. The two confirmed were severe major depressive disorder with psychotic features and post traumatic stress disorder. The two left were generalized anxiety disorder and borderline personality disorder both of which my doctor agreed on a little bit too quickly. Then for some reason things began to get weird as our discussions were no longer on recovery but of me remaining stable. A week or so later I wrote out a plan of what I needed to do to get better and the doctor fully agreed then said there was no chance the hospital would be able to provide it, I asked for an intensive therapy program, so I asked to be discharged to get the help in the community and again he agreed. I saw him a month later and told him how no therapist would even let me in the door and the doctor replied this is not a surprise as you are too borderline for therapy to be effective. Which means I am untreatable in english.

The part that still bothers me is I wonder what would have happened if I had never brought up the Borderline diagnosis would it have came to the surface. Was my doctors fast reaction due to him wanting to say it earlier but didn't for whatever the reason or did I answer a lingering question that was already on his mind. The other part is how on Thursday I am making great strides to recovery but when the Borderline diagnosis came up on Friday all of a sudden I was untreatable. Common sense just does not work when it comes to mental health apparently.

In case your wondering about the accuracy of the diagnosis I meet eight of the nine of the criteria so not only do I pass I pass with flying colors. See this past article for a breakdown of the criteria

When Money Comes First

Throughout this blog I seem to be going after specific worker areas in the mental health care system and I do this for a reason and that is I believe this is where the most changes can take place with the most ease. The much larger problem to the mental health system in this country, Canada, and other countries around the world is the infrastructure is controlled by people in the government who are barely qualified to be in office let alone making decisions that effect millions.

Budget cuts have put the mental health system in a noose and sooner or later something is going to happen that will knock the chair loose. When I was working I dealt with Children's Aid Society(CAS) workers on a very regular basis as they basically controlled a lot of factors of the boys that I would work with. This system has been in place for a very long time but over the years the case load of each worker continues to grow year after year. At one point the workers had somewhere around thirty cases each to look after but now the number is fast approaching a hundred. So what happens is the children who deserve extra attention by their workers and should be making the next step whether into foster care or back home are being put on the back burner by other boys who spend way too much time in court and in trouble. This is not a conscious choice by the workers but when a good percentage of your time is spent in mandatory meetings, court hearings and the occasional treatment plan development it just does not leave you with the time to get to your entire caseload. Most of my boys relationship with their workers was done by fax machine which is wrong on all sorts of level but that is the way the budget cuts has led it too. Take a wild guess on how high the burnout rate is in this specific area. The CAS workers all started with the best intentions and that is to help children in trouble the problem is reality and budget cutbacks make their job extremely difficult and unfortunately too many young people go from John Doe to case number 9494, the caregiver part of a CAS worker has slowly been ripped away.

The first time I was in the hospital back in 05 I saw a therapist three times a week and she is a big reason why I decided to join my own fight again. This amazing lady set me up with a PTSD specialist in the community as she could only sees clients who are currently in the hospital. Anyway I lasted three meetings with the new therapist when I made the mistake of telling her I had a really bad night so I took it out on my body, according to her I was not stable enough to be in therapy. So when it was time to reenter the hospital I was sent to a local psych ward where I was a little bit shocked to find out that they did not have a on staff therapist as the budget would not allow it, yes thats right a psych ward that could not afford a therapist. What the hospital did was send a grief counselor down to see me I think three times during the month that I was there and this lady was good at what she did but just did not have the time to be effective. I saw my doctor every weekday for about five minutes at a time but his specialty is medication and diagnosing and not talk therapy which he has stated repeatedly over the years. The psych ward did have groups which are good for some people for small areas but nowhere near the impact of a one on one session brings. To me the system of emergency psychiatric care is designed to bring the person out of a crisis, medicate heavily then send back out the door and basically wait for the person to come back some time in the future. Medication enhances therapy and makes it possible for the person to really get at their problems but if there is no therapist around to help do the work the job is left to nurses whose technique comes from experience and not actual education. Someone told me that to work on the psych floor they need to take a two week course about dealing with mental health clients and I use to wonder why so many of my fellow patients would bring their issues to me. Maybe this is why I was always kept longer then the others as I was free help .... not likely.

I watched a documentary awhile ago about the new asylums in the states that appeared after a high number of state hospitals were closed due to budget cuts, mind you the new asylum is actually an older prison. I wonder where the politicians though that these people that populated the old state hospitals would go when trouble appeared or did they think the problems would just disappear but more then likely they did not care and just wanted to put through a sensible budget and the hell will the human consequences.

The only thing that will fix this area is money and lots of it but I am not going to hold my breath waiting for that to happen.

Loss Of Contact With Reality

When people have a sudden loss of contact with reality it is deemed that they are psychotic or experiencing a psychotic episode. Most people will experience a psychosis at some part of their life but like everything else in mental health there is a scale that measures severity.

When the question appeared about psychotic behavior in the comment section of another post I really did not think that psychoses effected my life but after a quick trip to a bunch of sites I realized the impact was much larger then I thought. Psychosis is a symptom of a high number of mental disorders as well as some physical ailments.

Delusions - Paranoia is a big one here. Remember the story of me searching an empty house with a golf club in hand looking for something that was not there. The majority of this situation can be linked to Post Traumatic Stress Disorder and Anxiety at the base level but it was a mental delusion that somehow someone entered my home without my knowing that had me searching the house ready to brain the intruder which turned out to be a creaking floor board. Another blog that has dealt with a delusion on the high end is when I thought that I was already dead so I had to hide to make sure death could not find me. Two hours under blankets before my brain could sort that one out.

Hallucinations - This category can effect any one of our senses taste, smell, sight, sound and touch. One of my diagnosis is severe major depressive disorder with psychotic features which means I am depressed and use to hear a voice that was not my own. This lovely little voice never told me what to do rather it encouraged negative behavior. Small things such as "You seem to be awfully stressed so why don't you grab a razor and make yourself feel better" or "Wouldn't it be nice to just lie down and all of your problems go away for good. The pill bottle in front of you can accomplish that" or "Remember when you were seven and..." this one leads to flashbacks which also can be found in the psychotic handbook. As far as visual hallucinations there have been occasions when I think I see something that is not there for example a couple of times I have destroyed my forearm trying to get rid of the bugs under my skin.

Thoughts - This differs from delusions as the thoughts themselves can be fine but what differs is the speed. My most problematic area is that my brain races to a point where I am completely overwhelmed and I will go to extreme lengths to make it stop which is more then not self harm. When I am communicating with others in this state nothing makes sense as I can not focus on one train of thought as there are what seems like millions of disconnected thoughts rushing through my mind. Sometimes I am able to catch it in times but there have been points where my brain just blanks and I have no clue what happened. My last admission can be tied into a psychotic break for I was having a bad day as my brain was spiraling out of control so I grabbed my razor then next thing I knew it I was in the bathroom cleaning cuts that could have ended my life. The next day I walked into my doctors office then pulled up my sleeve and two hours later I was in a hospital bed.

Black Outs - They are unbelievably terrifying and trying to deal with the consequences of them afterwards is difficult. How do you explain to someone your behavior when you have no recollection of the event happening. Not a nice feeling when your brain clicks back on and you can not account for a missing time period. My brain is wired in such a way that the person I will thrust my anger on first is always me and I have a lot of scars to show for it.

It is very difficult to admit to a mental health professional that you need help for depression, PTSD, anxiety or what have you but trying to find the courage to tell my doctor that I was hearing voices and blacking out took a long time because I figured that they would lock me up and throw away the key. Now I take Seroquel three times a day and it has helped in many areas as the inner voice is gone, flashbacks have been reduced and most importantly my brain is not spinning out of control. I have come to the realization that the med class of anti psychotics will always be a part of my life and right now I am fine with that as I can still remember what happens when psychosis runs the show.

How My Personal War Affects My Son

During my last hospitalization the ex wife and I came to the decision that my son would not come to visit me while I was on the psych ward. At the time he was three and we did not think that a visit on the psych ward was appropriate for him. Normally the ward is a rather calm and boring place to be but there is times when the floor goes off so we did not want to take the chance plus I was going through withdrawal off of Effexor, Wellbutrin, Remeron and Lithium which had my brain going every which way but the right way. Not exactly the image I wanted to be presented to my son.

Every couple of days I would call my son to to see how he was doing and what he was up too. These phone calls were essential for the father son relationship but at the same time they took their toll. Mentally I was in an awful place so I needed to psych myself up for the phone call so he wouldn't have any reason to be worried. My son was told the reason I was in the hospital was because my meds were not working right so the doctors were trying to find the right ones which is basically the reason I was there simplified.

During every phone call my three year old would ask when I was going to be coming home and if I was better which tore my heart out but I always managed to answer him that Daddy was working very hard and would be home soon. After the calls mentally I was a wreck as I felt I was a terrible parent causing stress on someone so young and a couple of times it put me right over the edge. Thankfully every time this happened a good nurse would be on and helped me to work through it.

When it came time for me to go home and my son started his routine visits again every time he saw me he would ask if I was okay which is a brutal question to answer for a parent as it makes you realize that your not the only one being effected by mental illness. Since my ex wife became pregnant I promised my child to be the best father possible and always be there for him and my personal demons are preventing this from happening to the full extent.

There have been occasions when I have compared whether or not my son would be better off if I was dead and there is a lot of reason on how it could be viewed as positive but I also know that the odds of a child committing suicide because his or her parent did is sky high. The part that always stops this train of thought is that even though at times I am not on top of my game at least I am still there trying and the hope that with time I can be the parent I want to be so I continue to fight.

My son is what stops me from ending this hell that I live in, my son is the reason I have been trying so damn hard to win this war and my sons laughter is what fuels me for the battles ahead. I don't really care what happens to me but I care what happens to him and that is all I need to keep going.

Uh Oh You Need A Straight Jacket

Today the topic of the day is risk factor. The two simple words that sum up whether or not your a risk to yourself, to someone else or have the potential to do something that is not so good. Right off the bat if you think that you may hurt yourself or someone else pick up the phone and dial 911 or get your butt to the hospital then come back to read this particular post.

"If you can NOT convince yourself that you are a risk to your self or society in general it is time for a visit to the psych ward". This is the standard I use for me and for the most part I know when I hit the danger zone it is time for me to do the right thing and check myself in. I made that sound like it is an automatic response to when I am in "mental danger" which is kind of full of it as the process normally requires me arguing with my brain for a long time and when an agreement usually hits the crisis has past.

I have been hospitalized twice in the last two and a half years or so. Both times I walked into my doctors office yanked up my sleeve and said "I am out of control and I need help" then the doc picks up the phone and shortly after I am sitting in a hospital bed answering a million annoying questions.

Over my illness the offer of hospitalization has been offered at least a dozen times and I have always said no and will continue to do so. A big part of this is my Borderline Personality Disorder that admitting that I need help just does not happen easily as it goes against the wonderful fake ideals that I have roaming through my head plus the hospitalizations I have gone through I view as an utter waste of time where nothing was really accomplished but that is me. Most doctors want their patients to volunteer for hospitalizations as it cuts down on the paper work and it clears them of legal responsibility.

This is how it works in Canada when a doctor admits a patient against his or her will to a hospital setting. Legally it is allowed to hold someone up to 72 hours where at the end the doctor needs to prove the person still poses a risk or the patient is released so when some one volunteers this is not a concern. Anyway this process of involuntary admission is called being formed so if you ever on a psych floor and you hear someone muttering "I can't believe the (blank) formed me" this is what they are referring to.

When a mental health "professional" is assessing your risk factor they are looking at a number of different factors that will answer the question is this person a risk to themselves or others. The big one is suicide factors such as does this person have intent, does he or she have a plan and does this person have a history of prior suicide attempts. The next factor we will call mental clarity and this includes everything from paranoia to delusions to hopelessness to a separation from their reality. Mental history also comes into play so they will look at your past diagnosis and most of them automatically put you at a higher risk especially when there are any psychotic behaviors present. Support is a big player in risk factors and a lot of the time it is the difference between someone being formed or not as if there is someone present in your life who is willing to keep a constant eye on you it brings down your score but if there is no one near by who is willing to do this well chances are your headed to the ward. On a personal note I have a ton of support the problem is that I don't really know who they are as they all go by different internet user handles and my closest family member is over six hours away so I tend to stare at the ceiling when they ask about support. It is not an easy decision for a doctor to say whether or not someone is a danger or a potential danger for the wrong decision may result in a person taking their own life and in extreme cases taking others with them to the journey to the next life. The Canadian law regarding forming came when a person who should have been admitted refused to do so and there was nothing that could be done about it so this person went back out into the community, grabbed a gun and murdered someone which led to the "forming" process being passed in legislation. Unfortunately what is happening here and more so in the USA is that there are no open beds to put people in so this factors into the decision making and people who need to be on a psych ward are ending up in a jail cell or released back into the community which is not good for anyone involved.

Risk factor determination is tricky for people who have been living with mental health difficulties for awhile as the normal rules really do not apply in some ways. We will take two people who have the exact same risk factors at play: they are both having suicidal ideation's, have a loose plan on how they will end their life, self injury behavior, a general sense of hopelessness and are fighting to control the thoughts running through their heads. Now if this is the first time for person one they would be admitted in a heartbeat but the second person has been dealing with this for a long time to the point it has become a normal part of their life so if the person does not agree to a volunteer hospitalization then chances are the person will sleep in their own bed that night. My risk factor is always high but it is normal for me so it does not raise much concern but if Joe Blow suddenly developed all of the garbage I deal with on a daily basis if it does not cause him to throw himself in front of a moving bus it will land him on the psych ward. See what is absolutely devastating to one person may be perfectly normal to the next.

Human beings are amazing creatures that are able to adapt to the most extreme conditions and keep moving forward which has nothing to do with inner strength but just doing what it takes to survive. Someone asked the other day what I would do if I woke up tomorrow and all of my mental dealings had completely vanished and my answer is It would probably drive me insane as I would not know what to do or how to deal with it.

I have spent over three months in the hospital and years working in the field but have yet to see a single straight jacket. I guess those days are long gone which is probably a good thing as now they have meds that basically do the same trick .... maybe that is not a good thing.

If you think you or someone you know is at risk pick up the phone and call the police or get to a hospital and let the doctors determine what the risk factor is and hopefully act accordingly. My reaction to some one who is suicidal is its better to over act then to take a chance of being wrong.

Steps That I Have Taken To Beat The Monster

Part of this comes from a thread I started on Healthboards a few months ago to just show the steps I have taken to battle against my mental disorders. The odd thing about the thread is it turned into a good conversation that deals with the ins and outs of Borderline Personality Disorder, 291 posts and almost seven thousand views which is a pretty neat trick.

Anyway here are some of the steps I have taken and hopefully it will help someone else and answer the question of what I have been doing for the last three years.

1. Two voluntary hospitalizations lasting a total of over three months
2. Electro Convulsive Therapy - 5 sessions in 2005 and one sessions in 2007 (the whole forgetting how to breathe stopped this treatment pretty quick
3. Medicine -
(A) Antidepressants - Celexa, Paxil, Remeron, Effexor, Wellbutrin, Nardil, Trazodone
(B) Mood Stabilizers - Lithium
(C) Antipsychotics - Zyprexa, Seroquel, Clozapine
(D) Benzodiazepines - Ativan, Xanax, Valium, Klonopin, Temazepam
4. Diet - Due to the wonderful world of Zyprexa my weight shot up to 270 pounds so the last six months I have made it back to 200
5. Exercise - One day upper, second day lower, third day rest, repeat for the last two months. Missed three days due to Nardil withdrawal
6. Wrote out my entire life history and handed it over to my psych doc so that he would understand me better which made our relationship a lot more productive at least for a while.
7. I tracked every single behavior, emotion, when I took my meds, when I slept all to provide the doc with better information so he would know which dosage would work best plus it allowed me to identify any trends that I could work on or at least prepare for when it came to self injury.
8. Therapists - The best one was during my first hospital admission. The next one dealt with PTSD but once I made the mistake of telling her I cut one night she deemed me too unstable to treat. There were a couple of others who never made it past the third appointment again using self harm to stop my treatment. After the second hospitalization I sent a letter to the CHMA which is the Canadian Health Mental Association asking for their help to find a therapist in the area which they said they would look into, it has been three months now and nothing. Chances are for me to see a therapist I am going to have to accidentally forget my Borderline diagnosis to make it through the door.
9. Education - I spend a lot of time surfing the net studying different therapies, research and what have you then trying to apply it to my own situation.
10. Support - 96 percent of my support comes through online friends who over the years understand me to a higher level then anyone in the really real world as most of my friends have disappeared over the last few years
11. Came up with the perfect treatment plan for me which my doctor supported while I was in the hospital. Problem was the hospital was not equipped to handle some of my need so the decision was made to receive the help in the community. Once in the community I sent the letter to CHMA, applied for a bunch of support groups and nothing came of it. I brought up the situation to my doctor who then stated "I was too borderline for treatment" in other words I am untreatable.
12. Forums and this blog - It gives me a chance to focus on something else plus gain new perspectives on my own situation.

Nice eh. Any way this is some of the steps I have taken in the last three years or so to get to a more stable and better place. Depending on how much my depression is at play decides whether I believe any progress was made at all. I guess the real question is not what have I done to make myself better but what haven't I done.

Girl, Interrupted (1999) - A Review ... Sort Of

"I know what it's like to want to die. How it hurts to smile. How you try to fit in but you can't. How you hurt yourself on the outside to try to kill the thing on the inside"

This movie is based off the book of the same title written by Susanna Kaysen from her experiences of time spent in a mental health facility in the late 60's. The movie stars Winona Ryder and Angelina Jolie who won an Oscar for best supporting actress for the part. Susanna disillusioned with her life tries to commit suicide and is sent to a mental health facility in order to rest and get her life back on track.

This happens to be one of my favorite movies for a number of reasons and times watched are probably in the hundreds. The way the film portrays the hospital is very realistic at least in my experiences except for the bowling alley but the casual day to day living to the brief moments of excitement are typical in todays mental health wards. Most people are under the impression that the majority of your time is either spent in bed or dealing with some person of the therapeutic team but actually a very high percentage of your day is spent with fellow patients and over time relationships develop somewhat similar to the movie. There are patients who dominate the ward in terms of personality then those who just go along with what is happening then the rest who try to interact with the group as little as possible.

There are parts of the movie that don't make any sense to me such as Lisa being capable of leaving a high security floor and then able to get Susanna to leave with her, escapes are so rare off a high security floor that when they do happen they make the newspaper and the television but mind you things have changed in the last thirty years. Another part that I found odd is the number of patients who remained there during Susanna's two years there and no new patients coming off of the ward as in todays facilities the population is constantly changing and outside of a few exceptions long term stays especially in years are pretty rare, the hospital in North Bay Ontario still has a few patients who receive lobotomies back in the sixties but these people have no chance at recovery due to the mid evil treatment they received a long time ago. Long term patients can be looked at from two perspectives and they are A)The mental disorder is so extreme it is beyond medication and therapy so the person would be a threat in society B) The staff of the facility is so incompetent that they are unfamiliar with the concept of psychology to make a sick person well again - there are horror stories that come out of state hospitals in the USA that prove this theory by instead of promoting positive they would repeatedly try to beat the bad out of someone to make them well, most state hospitals have been closed over the last decade and a lot of potential patients are ending up in the prison system.

Through out the cast or patients there are a wide variety of mental disorders present from being gay to a eating disorder to a chronological liar to mental retardation which would not land you in a mental facility at least not for long. Being gay might be a mental illness or it might not decides which side of the fence you are on but either way it will not land you in a facility in the hopes of "curing" someone. Eating disorders now have their own systems and only last a few days for the most part until a specialized bed opens up in a treating center which is not to say that there are not people with eating disorders in the hospital because they are but it is normally a symptom or reaction of another disorder that is being treated. Chronological liar to my knowledge is a personality disorder but I have never crossed a person with this disorder while in a facility as I don't think they pose much harm to the community and normally if their lies hit a grand scale they will end up in jail before a hospital. Mental retardation is evident to some degree in a hospital but again at least in Canada the majority of people with severe enough disabilities reside in group homes unless they enter a psychotic episode then they are brought to a hospital setting. Again these disorders and how they are treated are more a sign of the times then an error by the director.

Susanna's diagnose of Borderline Personality Disorder is rather weak in my opinion as for the most part I can not see it. It is clear that she has a form of Major Depressive Disorder, self harm issues and a lack of a vision for her self but that is not BPD in my opinion that is just different symptoms of a depressive disorder. Mind you that back in the sixties the definition for BPD is a lot different then it is today.

Lisa's diagnose of a sociopath has left me scratching my head as well as to me she is a true borderline struggling with an inner self image and living in the here and now with no worries of long term consequences. Sociopath or antisocial personality disorder has a lot of tendencies or characteristics that cross over into the borderline personality disorder realm so that is probably what is causing some confusion on my behalf the line I guess is BPD people are aware of the difference between right and wrong where your sociopath does not really bother with it.

I have ordered the book from Amazon and it is due to arrive sometime in February I believe so I am hoping that by the book I will be able to see more of the characteristics of the people on the ward to help join those missing pieces where the questions now lie.

This is a very good movie and if you have not seen it you really should as it shows a mental disorder from the human perspective and the hope and work required to get through a difficult situation.



Tony - "Do you see purple people? My friend, he saw purple people. And so the state came and took him away. He didn't like that. Some time went by and, and he told 'em he didn't see purple people no more.
Susanna - "He got better.
Tony - "Nah, he still sees 'em.

You Want To Put Electicity Into My Brain?

During my first admission the doctor told me that he believed that ECT might be good for my situation and he said I should go forward with it. I replied that is good what the heck are you talking about? ECT is Electro Convulsive Therapy or shock treatments and when he said this all I pictured was the scene from "One flew over the Cuckoo's nest" so I was not exactly thrilled with this suggestion but the mental place I was in at the time was eating me alive so I said what the heck thinking I would just pull out at a later date if things became to hairy.

First things first they need a second doctor to check you out to make sure that you are a good client for this treatment. The guy met me and a minute later he stamped his sign of approval. Then they get you to watch the movie on how the procedure works and what to expect, it is not a pretty picture but I was really glad to find out I would not be conscious for it. How it works is your brought down to the room where they give you a combination of meds, then you are told to bite down on this piece of rubber and then you breath the sleeping gas until you fall asleep a few moments later. There are two types of ECT one is bilateral which is they put two pads on each temple and the second is unilateral where both pads are on one side of your head. There are a number of people in the room and they each grab a limb then the doctor nods his head and a short blast of current is passed between the two pads putting your body into a convulsion. There are apparently good convulsions and bad convulsions determined by the time they last, the positive one I believe is somewhere over thirty seconds or so. The patient wakes up a while later and after the first one you swear that you had just been run over by a mack truck. Most people undergo a treatment every Monday, Wednesday and Friday for three to four weeks so between nine to twelve sessions is ideal but some people require less while others need a few more. It is a lot safer then it use to be and the injury rate is very small but of course you need to sign a waiver that basically says there is a chance bones or teeth may be broken, bruises may appear and of course there is a chance you may die. Oh by the way your memory around treatment days if not hazy have disappeared and don't come back but why would someone want to remember a day in a mental institution is beyond me.

The problem with ECT is that it does not work for everyone and the so called experts of the field are not really sure why it works at all. The best explanation I have ever heard is that it is like a TV that is on the fritz so you unplug it and then plug it back in hoping for what ever reason it has fixed itself. My ECT sessions were stopped after five or six as I was not showing any signs of improvement and for whatever the reason it was taking a long time for me to come back to consciousness, this is a genetic thing as a number of family members do the same thing even when electricity is not involved. I know people that ECT has worked for and basically changed their lives, I know people where the effects of the treatments only last a short time so they undergo maintenance treatments about once every couple of months to keep on the positive track and I know a lot of people that the treatment did nothing for at all. I was not happy that they stopped my sessions so soon as I thought I was feeling a bit better but the hospital did not want to take a risk when the benefits were not that clear so I lost that argument.

Two years later I am back in the hospital coming off of a number of drugs to start a new med class plus a few other reasons. I figured that since I was in the hospital anyway they might as well try ECT again. They ran every test in the book to make sure I would not have any problems with the meds and then they booked the operating room to ensure nothing went wrong. I remember waking up that morning then waking up in the recovery room with nothing in between. The first thing I did was asked the nurse if I came around fast enough to which she lied to me and nodded her head. I was informed the next day that the ECT sessions were now off limits as I posed to much of a health risk and for a while all my doctor would say is that it took you too long to wake up again. My brain does not let things go that easily so I pestered the heck out of him for the next few days until I got the real story. Everything went smoothly with me falling asleep, I had a great convulsion and then I stopped breathing for about a minute so they had to "bag" me for awhile until my brain remembered I was suppose to be breathing. I didn't ask any more questions about ECT after that.

ECT or Electro Convulsive Therapy is a last resort treatment as the odds are not great that it will work and there is a bit of danger that goes with it, my stopping breathing is not normal and they are unsure whether it was the meds they gave me or the meds that I was taking at the time that was responsible for this. ECT is meant for people whose depression has hit a point where quite honestly it can't get any worse so they will try anything to bring you back out of that hole of despair.

Long term effects I really do not have any except for a few hazy days and a couple of missing hours. After the first couple of treatments the mack truck is down graded to a golf cart that ran you over but within hours after the session you would never know I had it done. I started writing a book in the hospital as a way to basically kill time and I was always able to remember after a session what I had wrote the day before. Like I said if you feel that your on your last legs and will do what it takes to survive then look into ECT and try to picture this post and not "One flew over the Cuckoo's nest" as it is a hell of a lot safer then it use to be.