Diagnosis: Denial

Posted by fxckfeelings on February 23, 2012

Mental illness, much like the devil, performs its greatest trick when it convinces the sufferer it doesn’t exist. That’s why some sick people don’t believe they’re sick, because they’re too sick to know, while others fall into denial rather than admit they don’t have control and can’t get it. If that includes you, don’t worry; you can force yourself to become objective as long as you’re willing to accept whatever unpleasant evidence you uncover. If it’s a matter of a deluded brain, however, you can’t recover without relying on the kindness and common sense of family and strangers to deliver you from evil.
–Dr. Lastname

I believe what started out as typical empty nest syndrome has turned into complete paralysis. I’m literally stuck in my own nest! I know it’s strictly up to me to get myself launched, but I’ve lost all confidence in my ability to go/do/be well, anything. I think it’s more than simply “get a hobby.” I’ve come to the sad reality that my “friends” were really more like “bleacher/booster buddies” from all of my kid’s activities over the years, and now I find myself without any close friends, and no real interests. I was a stay at home mom (by choice) and had always planned to get back into the workforce once my kids got older, but MS sidelined those plans, and keeps me pretty challenged nowadays. I know I need to get myself back in the game, but my list of excuses as to why this is impossible only grows over time. I’m not always mobile, I’m not confident about how I look, and I just feel like I’m boring and have nothing to offer anyone. Since I’m already assuming nobody’s going to like me, maybe I should just go eat some worms…but of course that would require a trip out my nest, and…well, I guess you get the whole “woe is me” picture. I cannot figure out where to begin to ever break this cycle of negativity. Can you help me hatch a better plan than the useless one I’m currently sitting on?

Anyone can get into a rut, but multiple sclerosis makes it much, much harder to get yourself out. You might not realize this, but your empty nest is actually more of a sick bed.

MS not only makes you doubt your stamina and physical balance, it also frequently makes your emotions more intense, particularly the negative ones that tell you you’re useless and lacking in courage.

So, when your mind tells you that you have no friends and nothing to offer, that’s the MS and depression talking. Of course, it would be easier to tune it out if there were other voices to help you do so, but the negative thoughts keep you from seeking out new company, and so the rut deepens.

Admitting you’re stuck is a good place to begin, as long as you don’t engage in negative self-analysis. Hopefully, like many people, you have someone in your life who likes and encourages you, even if you’re too self-critical to listen. If there’s isn’t someone like that, worry not, because you can hire one.

As you begin your search for a motivator/coach, your goal isn’t to air your fears and self-criticism, but to find someone who will help you respect your strengths (you’ve got your kids launched—no mean feat—and are obviously very articulate) and structure your efforts to be useful. You can get that help from a good MS support group, a rehab counselor (whose services may be free if you’ve got a documented disability), and/or a therapist.

Don’t assume that you’ll be able to do everything you’re motivated to do, or that you used to do; your equipment may be dysfunctional in more ways than you think, so get yourself checked out for depression and problems with executive function and get a better idea of what you’re working with.

You seem to have the negative thinking, low energy, and continual unhappiness, so it’s worth asking yourself whether you also have trouble with concentration, focus and irritability. If you have trouble organizing daily tasks, you may have a neurologic problem in addition to low motivation. Whatever the cause—MS, life circumstances, or being in a rut—once your brain gets pushed into the neurology of depression, it’s hard to get out. Neurology has a life of its own, the effect on your life be damned.

Once you stop taking responsibility for being stuck and appreciate how much of the problem is beyond your control, there’s no justification for self-blame. Your sole responsibility is to do what you can with this mess, and there are good things that can be done. It’s not your fault, just your disease, and your illness shouldn’t hold you hostage in your own nest.

STATEMENT:
“I feel like a lonely loser who can’t get herself going, but I’m the same person who raised kids despite a scary, unpredictable, incurable illness that has a reputation for creating negative feelings and thoughts. I will not let those become negative beliefs. I’ll follow the usual drill for treating depression (if it makes sense) and getting others to help me get going.”

My wife is acting really crazy and scary and desperately needs medical help, but I can’t get her to agree to see a psychiatrist. If she did see a doctor, she’d say I abused her and she’d sound so reasonable and sincere that the shrink would probably believe her. Meanwhile, she’s paranoid about everyone in her family, does weird things she doesn’t remember later, and can’t be trusted with the kids. This has been going on for over a year and I read online that the longer it lasts, the harder it is to stop. My goal is to get back the woman I married and end the chaos in my family.

Finding yourself with kids and a mentally ill wife is one of the toughest situations I can imagine. It’s horrible to live with someone who’s a ghost of the person you loved, not knowing whether she’ll ever come back or what she’ll do around or to your children in the meantime. This is truly the kind of situation where it takes a village to raise a kid and yet more villagers to keep an eye on their mother.

Getting her committed is, as you’ve surmised, not easy; in the simplest terms, the laws that protect people from being locked up for being different also prevent us from treating people with sick brains. At the time those laws were written, our society wasn’t so sure brains could get sick in the first place. Now we (who aren’t Tom Cruise) know they can, but the laws haven’t changed. Lawyers will defend the law in the name of your civil rights, but, since their focus is on the law and not medicine, they’re not so clear about your right to have your brain treated before it’s too late.

That said, sometimes people with paranoid delusions do get better and stay better after they’re given an antipsychotic, but you can’t force her into treatment until she does something dangerous and thus makes herself eligible for involuntary treatment. That means, regardless of your instincts for keeping her out of trouble, you need to allow a dangerous situation to develop for long enough to give you the evidence you need and then call the cops.

Don’t be too sentimental about keeping things normal at all costs, or try too hard to shield the kids from her craziness (aside from ensuring their safety). If you try to pretend things are normal and they’re half-way bright, they’ll pick up on the discrepancy and worry more. Regardless of how you really feel, tell them calmly and confidently that she’s a wonderful person but she’s not well and that you’re taking care of things. Calm yourself by doing a good risk assessment, consulting a shrink to develop plans for managing whatever worst-case scenario you can think of.

Respect yourself for managing one of the toughest burdens that can be thrown at a guy and doing it with patience and devotion. Then brace yourself for the opportunity to get her the help she needs, whether or not she’s ready to accept it.

STATEMENT:
“I feel totally helpless about my inability to help my wife or protect her or our family from her behavior, but I must be doing something right because we’re still together and nothing terrible has happened . . yet. Now I have to assume that things won’t get better unless we get lucky, so I’ll educate myself on how to manage the risks we live with and prepare for that rare opportunity that might allow me to help her.“