All in Your Head? [Depression]

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Depression is a Mental Disorder, not a Disease

There are plausible arguments for the non-existence of mental illness. But there are still people who declare themselves to have a mental illness. After all, being sick mentally has no physical symptoms; it’s not like a kidney stone or an inflamed appendix. One can only hope it was this simple.

Yet depression is a progressive and debilitating disorder. It is like having a ‘bruised brain’ that refuses to heal. There is an substantial list of psychological disorders. Technically depression is a mood disorder that has a series of symptoms. These symptoms are the evidence that something is definitely wrong.

  • Depressed mood (such as feelings of sadness or emptiness).
  • Reduced interest in activities that used to be enjoyed.
  • Change in appetite or weight increase/decrease.
  • Sleep disturbances (either not being able to sleep well or sleeping too much).
  • Feeling agitated or slowed down.
  • Fatigue or loss of energy.
  • Feeling worthless or excessive guilt.
  • Difficulty thinking, concentrating or troubles making decisions.
  • Suicidal thoughts or intentions.
http://www.nami.org/

The above list is a summary of something called the DSM-IV which doctors use to diagnose the mental disorder of depression. Having five or six of these may indicate a problem. Spinning off this, you will discover some other disorders, like:

  • Generalized anxiety disorder (GAD)
  • Panic disorder
  • Depersonalization/derealization
  • OCD (obsessive compulsive disorder)
  • Psychosis and paranoia
  • PTSD (post traumatic stress syndrome)
  • Specific Phobias (fears of something)
  • SAD (social anxiety disorder)
  • Schizophrenia
  • Eating disorders (bulimia, anorexia)

Even though mental illness is widespread in the population, the main burden of illness is concentrated in a much smaller proportion-about 6 percent, or 1 in 17 Americans-who live with a serious mental illness. The National Institute of Mental Health reports that one in four adults–approximately 57.7 million Americans–experience a mental health disorder in a given year.

Unfortunately, there is a great deal of misunderstanding and stigma for those who have these disorders. I suppose it is akin to having VD (venereal disease) or AIDS. It seems that our culture is pretty quick at labeling people as deviant or undesirable.

I hope this post helps. I can see a 100 holes in it, and alas, it is a meager attempt. But perhaps it will be of some value. Both NAMI.org, Psychcentral.com, and WebMD.com all have excellent info on Mental Illness. aabryscript

Bedlam: Prisons and the Mentally Ill

Taking a Stand for Our Brothers and Sisters

 By Mark Earley, Christian Post Guest Columnist, Wed, Aug. 08, 2007
The least of these is my brother
The least of these is my brother

In the 16th century, London’s mentally ill were often kept at Bethlem Royal Hospital. The conditions inside the hospital were notoriously poor. Patients were often chained to the floor and the noise was so great that Bethlem was more likely to drive a man crazy than to cure him. The conditions were so infamous that the nickname locals gave the hospital—Bedlam—has come to mean any scene of great confusion.

Unfortunately five hundred years later, we’re still treating the mentally ill more like prisoners than patients. Fifty years ago, more than 550 thousand people were institutionalized in public mental hospitals. Today, only between 60 and 70 thousand are, despite a two-thirds increase in the country’s population.

Since there’s no evidence that the incidence of mental illness has dropped precipitously, the mentally ill who previously had been institutionalized had to have gone somewhere. While some are being treated successfully in their communities, at homes and groups homes, but for many that “somewhere” is behind bars. This last part shouldn’t come as a surprise.

Five years ago, the Washington Post told the story of “Leon,” a one-time honor student, who had 17 years in and out of jail on various drug-related charges. It was only after several suicide attempts, including drinking a “bleach-and-Ajax cocktail,” that Leon was diagnosed with bipolar disorder. Leon’s story was a microcosm of a larger problem: “Prisons and jails are increasingly substituting as mental hospitals.”

As one advocate for the mentally ill told the Post, “a lot of people with mental illness are charged with minor crimes as a way to get them off the streets.” In effect, they are behind bars for “being sick.” Fast forward five years and little, if anything, has changed. A few weeks ago, another piece in the Post discussed the same problem.

Psychiatrist Marcia Kraft Goin told readers something that should shock and outrage them: “The Los Angeles County Jail houses the largest psychiatric population in the country.” As with the earlier Post piece, the conclusion was inescapable: “People with [untreated] mental illnesses often end up with symptoms and behaviors that result in jail time.” You don’t have to be a “bleeding heart” to understand that this is an injustice—any kind of heart will do.

Not only are the mentally ill not getting the help they need, they are as lambs to the slaughter in our crowded and violent prisons. They are being victimized twice over. They’re not the only ones being victimized.

At a time when most state prisons are unlawfully overcrowded, there are better uses for prison beds than as makeshift mental hospitals. As Goin wrote, “treating” mental illness as a criminal justice problem costs “more than treating patients appropriately in their community.”

As part of its ministry to prisoners and their families, Prison Fellowship supports community-based alternatives to incarceration. Not only because it makes “financial sense” but because it’s what Christ would have done. In Matthew 25 he called the ill and the prisoner his “brothers” and he expects us to offer them something more than bedlam.

“There but for the Grace of God go I…” –Bryan

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From BreakPoint®, August 6, 2007, Copyright 2007, Prison Fellowship Ministries. Reprinted with the permission of Prison Fellowship Ministries. All rights reserved.  “BreakPoint®” and “Prison Fellowship Ministries®” are registered trademarks of Prison Fellowship.

Good Links:

http://en.wikipedia.org/wiki/Bethlem_Royal_Hospital

http://www.bethlemheritage.org.uk/

http://www.pbs.org/wgbh/pages/frontline/shows/asylums/etc/faqs.html

http://www.afscme.org/publications/6042.cfm

A Day in the Life of a Mental Hospital Patient

6:30 am. “Rise and shine,” but this is debatable– you simply just breathe and walk, in this kind of a desperate mental fog,  (Simply put, ‘there will be no sunshine for you today.’) But, this only just seems to really matter to us, who have no hope.  You exchange brief greetings with your roommate, which only just seems proper, even at this level.  We are given “ratty” old surgical scrubs to wear through out the day.

We head down ‘en mass’ to the cafeteria.  I see the servers on the line, I notice that they avert their eyes from us as we form a hungry queue.  Sometimes, they will give us choices: “bacon or sausage?”  To a mental patient, this can be a Gordian Knot of complexity.  So the line moves slowly, as we try to sort out this conundrum.

There is no coffee for us, as patients.  It has been two weeks for me, and I dream of a cup of hot coffee, with cream.  Some of the attendants drink Pepsi, although it is done hiddenly, but we all know it.  We resent their liberty, especially when we have none.  There is a question of equity, with us, which has been violated.

8:40 am.  We are all race to be the first in line for our morning meds.  It almost seems we are afraid they are suddenly going to run out.  I get my Seroquil, my lithium, my Zoloft.  Additionally, because I am ‘post-op’ brain tumor, I am given a mild stimulant called Provigil to help me think clearly.  I have no idea if it works, or not. (I rather have a cup of coffee.)

We then gather into a day room full of clunky and ugly furniture.  It is big, and the chairs encircle a grimy tile floor to make a large open space.  This is not an orderly place, as people are wandering about, some stare at the wall or at a fake plant in the corner.  It is noisy, some even shout.  Others just “rock” back and forth to a song that only they can hear.  A few of us lie in “fetal position” of hiddenness, just wanting to disappear.

The thought occurred to me one day, of a ‘giant aquarium.’  It was constantly moving, swirling about.  If you stopped moving, it meant that you were dead.  Everyone was moving, and oblivious to the others who were also moving.  This seems to explain much.  (You will need to accept the ‘aquarium’ idea if you really want to process the moment.)

On one of my stays, weeks went by before I realized that this particular meeting actually existed, but I was very confused and seriously beyond any correction.  I was really struggling with clinical depression, so meals and meds was all I could manage.  When I finally figured this out, I quickly joined the fish bowl.  It was both good and bad.  But mostly good. Finally as bleak as it was, I started accepting reality.

11:00 am.  One thing you do notice is a lot of disjointed conversations.  You would speak to someone and 10 minutes later they would answer.  And for the most part, conversations would be muted, whispered to people.  As if there was a conspiracy involved, and a certain appropriateness must be taken. We were a paranoid bunch.

Sometimes an attendant would turn on the TV.  I can remember watching cartoons and just maybe I would think that they were communicating to me in code.  We did have a VCR for movies, but because one guy urinated into the machine, it shorted it out.  So, alas, no more movies.

During one stay (and there were several) I was suicidal.  The staff watched me like a hawk, sitting at my door out in the hallway. But I was desperate to cut my wrists, so I stood up in a chair.  I took down a clock and wrapped it in a blanket, to muffle the sound of breaking glass.  I managed to slash my wrists deeply and often, before the nurse came in my room.  For a moment, I brought an excitement to the staff.  And perhaps a certain meaning to me.

When you’re in a psych ward your days are beyond tedious.  One day is like the next.  The psychiatrist comes to see you for 10 minutes, and it is a high point of your day.  You discover that any new explanations, or treatment plans are done solely by the doctor.  That is one of the first cardinal rules on the ward.  Ask a nurse or an aide, and they invariably dodge.  But the psychiatrist “rules the roost.” Everyone follows his decision. This is useful to know.

1:00 pm.   Suddenly a young teen girl with schizophrenia, screaming and pounding her head against the wall has now becomes the focus.  Every couple of days this happens, and in a twisted way punctuates the drabness of the day.  She is artfully restrained by the staff and taken to “the padded cell.”  We are all told it is for her own protection,  but we as patients, we all rally behind her fight.  When she makes a break from the nurses we all cheer her effort and want her to escape.

The second cardinal rule of the floor is that you don’t “stick out” in any way. Creating an issue is never tolerated, whatsoever.  Demanding more TV time, or coffee, or a newspaper will hardly ever go over well.  Just before Thanksgiving, 2003, I timed my meeting with the pdoc to raise an issue of a fresh cup of coffee.  There was a nurse present at our meeting, and she had to respond to the doctor’s order that I was to be given coffee on Thanksgiving morning.  The next morning the coffee was delivered, but the nurse insisted that she would set in a chair next to me until I finished.  Nevertheless, it was a glorious moment.

3:00 pm.  I soon developed auditory hallucinations.  First, I kept hearing a CB radio, squawking constantly.  A few days later, I started to hear a telegraph, “dit-dot-dash.”  They both were very loud and insisting that I pay attention.  Also, I would have 3 or 4 moments of seeing black and hairy spiders climbing at me.  They were so real, and even volitionally know they were not real, I still panicked.

4:30 pm.  They’re other issues as well.  I basically hated phone calls from family.  When they did come they always seemed intrusive and seemed to work against the thinking on the ward.  When a few friends did visit, I would be abrasive and rude.  Wishing they hadn’t made the effort.  I imagined their hearts processing me and my need to be there, and it disturbed me.  Since I lived about 300 miles from the hospital, it took effort on their part to try to see me.  Looking back though, I wish I had been nicer.

8:48  pm.  Getting ready for bed.  It seems that is what I have waited for this all day.  These are moments I have started to live for.  Sleep = oblivion.  I fade to black, and life is paused.  There isn’t any issues for me to figure out.  For eight hours, I find peace,  Sleep is a deep mercy, a gift given to us from the Father.  Those of us, who struggle hard against the dark, understand the “gift” of grace in the form of sleep.  Depressives very often crave sleep. We often want to hide into it, as if doing so would solve our problems and issues. For me, sleep was the only time I was free from the ward.

I want to sleep, to close my eyes and to be gone.  I suppose that is true, for all of us who want to “commit suicide by sleep.”  We seek oblivion, and long for the moment when we can “check out.”  We want to be forgotten and overlooked. We deeply want to be erased, and move directly into forgottenness.

When we have been committed to the ward as patients, we will probably be shaken to our core.  Our insertion into a diverse floor of mental illness, will always introduce us to deep desperation. We are jolted that there is a darkness that is pursing us far beyond what seems is right.  We must call out to Him who can save us.

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kyrie elesion, Bryan

 

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