Managing Mental Illness

Posted by fxckfeelings on July 1, 2009

Human nature tells us that the best way to solve a problem is to get to the root of the issue, but some problems, like mental illness, have no simple cause and no solution to speak of. In today’s cases, two people need to rethink their approach to mental illness; when you stop looking for someone to blame or a silver bullet cure, you can get to the real business of learning to cope with the reality of the present.
–Dr. Lastname

I think one of my sister’s kids might be mentally ill—he’s 9 and very intense and unhappy—but my sister doesn’t see it, and I don’t know how/if to get her to pick up on it. It should be fairly obvious to her since we saw the same symptoms in our mother, who wasn’t diagnosed as bipolar until we were kids and she had a chance to put on quite a show. I guess my sister doesn’t really understand that our mother wasn’t just a mean drama-queen but actually sick, maybe because she was younger when Mom went to the hospital and doesn’t really remember, or maybe because she’s in denial, or maybe both of those things combined with the fact she and her husband are space cadets that are such hands-off parents they don’t even notice that one of their own children is clearly suicidal. My goal is to get my sister out of the clouds and get my nephew some help, because if something happens to that kid, I don’t blame genetics, I blame her.

As any teacher well tell you, the danger of bestowing your idea of help on another parent’s child is that you have very little control over how parents react, because no parent wants to hear that something is wrong with their child. And their default response lies somewhere between defensive anger and general freaking out.

The freaking out also comes from the fact that it’s hard to keep the urgency and alarm out of your voice, no matter how diplomatic you think you are, and feelings trigger feelings. Suddenly you’re in a perfect storm of hysteria, but hey, no good deed goes unpunished.

If your real goal is to help your nephew (and it should be, since your sister’s probably been in the clouds her whole life and isn’t due to return to earth any time soon), you’re more likely to help the child if you limit your goal to providing your sister and her husband with helpful information while assuring them of their ability to use that information to make good decisions about their child.

In other words, if you accept your own inability to be directly helpful, and keep your own feelings well stifled, you may be able to help your sister become a better manager of her son’s problem. If you don’t show how much you care and how urgent the need is, the more likely you are to actually help.

Given your family history, you’re entitled to share your discovery that it’s easy for a parent to screen her child for depression and its higher-risk symptoms before deciding whether to get a professional opinion. You don’t have to have mystical “shrinking” powers (or even a couple Harvard degrees, but it helps).

No one is better able than a parent to observe whether a kid looks unhappy all the time or irritable or tearful or loses the ability to concentrate, socialize, or eat or sleep normally. Parents will usually get a direct answer if they ask a child whether he feels bad all the time or wishes he wasn’t alive. (Kids often clam up, much like adults, if you ask them “why do you feel that way” or “what’s bothering you,” or give you explanations you can’t use to help them, so you can leave those questions for last or let the experts ask them.)

Also, parents are best qualified to decide whether the risk of allowing a kid’s behavior to continue unchecked is more or less dangerous than the risk of treatment, particularly medications.

Once you’ve finished teaching, and demystifying, the facts about childhood mental illness, as well as separating it from failures in parenting, you’re less likely to threaten your sister by wondering whether your nephew has symptoms and asking her what she thinks and whether she’s concerned about his attitude or social or school behavior.

Because really, your goal is not to get help for your nephew. It’s to see whether you can give your sister some tools for doing her own depression screen and some confidence in her ability to decide what to do next.

STATEMENT:
Compose a statement to keep yourself from pushing or alarming your sister. “My sister and brother-in-law are caring, concerned parents and I know that their parenting style, though different from mine, is not likely to cause a child to get depressed. But my nephew appears depressed and I’m not sure that my sister is aware of the problem or knows what to do. Fortunately, I can tell her how to screen him and make treatment decisions without being critical or requiring her to see things my way. Even if she avoids the issue of his depression, I’ll have framed it in a way that will allow me to disagree without implying that she’s a bad parent or that our disagreement is anything more personal than a difference in point of view.

I suffer from both depression and bulimia. It started when I was in college, and five years, several residential treatments, and many different counselors later, I still haven’t found a way to recovery. Until now, my illnesses didn’t have too much effect on my everyday life, at least professionally, and I really do love my job (I teach nursery school). In the last few months, things changed, because for no reason I can figure out, I’ve been more depressed lately and vomiting constantly and I’m too spaced out to do my job properly. It’s harder to get out of bed, I have much less energy, and it’s easy to make mistakes. I almost got written up last week. If things get worse, it’s not going to be my job much longer. My goal is to get control of this condition before it gets me fired.

After all those years in treatment, you should know that making it your goal to get control of your disease is both useless and counterproductive. It’s an understandable wish, but at this point, it’s clear that your condition isn’t something you can control—as of this morning’s paper, there’s no cure—and putting that responsibility on your shoulders will only make things worse.

Really, if you want to figure out depression and bulimia, become a researcher and go win a Nobel Prize. But if you try to find the answer while throwing up, fighting a fog of fatigue, and holding down a challenging job, you’ll get more distracted and helpless and throw up some more. Your goal isn’t to control it. It’s to accept that you never completely control it, so that you can be positive with yourself during relapses.

I bet you haven’t told your boss that you’re not feeling well, and, while I’m not suggesting you have to tell him/her exactly what’s wrong (unless you think it’s OK), why not say that you’ have a serious condition that flares up from time to time, and that you get regular treatment for it. And that it’s been worse lately.

If you haven’t told your boss, you’re letting shame dictate your actions. Sure, there’s stigma, and sure, you, like most everyone, want to be normal. But those are feelings, and feelings won’t pay the bills once you get fired for being too proud to admit to your boss that you’re ill.

If you’re going to manage a life-threatening condition, don’t be influenced by shame. You’re not normal, but you don’t need to be “normal” to be a good teacher or a good person.

In spite of your illness, you’ve found good friends, completed a challenging education, held down a good job and helped people. You have more to be proud of than the normal guy who’s done the same thing more easily and with better grades. Your goal isn’t to control your illness, but stop letting it control you.

STATEMENT:
Prepare a statement to protect yourself from shame and the search for the Holy Grail of Complete Control. “I may have no more control over bulimia today than when I was a kid, but I haven’t let it stop me. I can be proud. Relapses happen. So does shit. I will take care of myself and my job commitment in the same way I would if I had any other illness. And, however long it takes for this relapse to pass, I will do everything I can to fight it and continue my normal life.”