I Take Responsibility (a Repost)

Originally published Feb 2010, I hope the links still work. Something I found today and really needed to be reminded of.

Thanks Beth for pointing me to two GREAT articles recently, one of which I will just mention briefly. Debate Over Cognitive, Traditional Mental Health Therapy from the LA Times touches on whether or not therapists should be designing treatment plans within the context of the medical model. But it is the other article, or rather part of it, that is really the focus of this post. The Americanization of Mental Illness from the New York Times also focuses on the medical model, but more extensively.

I'm not going to sum up the entire article as it is super long (totally worth reading the whole thing though) but I am going to pull out two parts. The discussion on the stigma of viewing mental "illness" within the framework of the medical model ("brain-disease"), as "... an illness like any other" (quote from page 3), something purely with a biochemical origin, versus as something originating from situational triggers ("psycho-social") is primarily located on page four. I'm not going to comment on this section anymore except to say GO READ THIS NOW (I'll wait) because I feel like I'd be repeating myself ad nauseam -- especially lately -- as well as because the opinion is substantiated by scientific studies and isn't just my verbal diarrhea.

There is this one quote from page 3 though that really stuck with me and that I will comment on fully.

"Mental illnesses, it was suggested, should be treated like 'brain diseases' over which the patient has little choice or responsibility." emphasis mine

Little choice or responsibility. Wha? Huh? Seriously? I didn't have little choice over whether or not to be bipolar, I had NO choice. It's not like I woke up one day and said "Gee I think I want to have a major mood disorder." I didn't know until high school that my dad is bipolar and this runs rampant in that side of my family. I just drew the short genetic straw so to speak.

[image description: tiles made by elementary school students in CA (found by google images) surround and illustrate the word Responsibility]

However, I DO have full responsibility over what I do with this information.

I AM responsible for the choices I make, although I often do not practice what I preach.

I AM responsible for the decision to take my medication or not, to go to my support group / therapy / medication appointments or not, to go to the gym or not.

I am NOT responsible for the fact that I will have repeated bouts of depression for the rest of my life.

I am NOT responsible for my panic attacks, especially when I have the ones that start in my sleep.

But, I AM responsible for how I decide to handle this, how / when / if I get control over the episode or if I decide to relinquish my power to my states indefinitely.

Little responsibility? How is that little responsibility? That is BIG responsibility.

On Recovery

If you haven't noticed by now, I spend a lot of time thinking about words and what they mean and how they are used. On Our On operates Wellness & Recovery centers. I HATE those words, to me they bring forth an image of illness. But I've had nothing better for recovery. I make a point of saying I have "psyc issues," a "psychiatric disability," or a "psychiatric diagnosis," depending on the day and what I feel like, and stay far away from mental health/illness. I won't call CP a developmental disability (DD), not because I am offended by the term, but because I just feel it's too vague of a term to have any purposeful meaning. I like the label of consumer, although a lot of my friends despise it. I grapple with knowing when I am in a setting where I could get myself in trouble for not using people first language and when I can be comfortable and free to slip into "crip" and "spaz." I generally prefer shrink to therapist, although I am ok with psychiatrist--social worker sounds awkward and how many people know off hand what LCSW means?

The thing is, I like the concept of recovery, fully embrace the general meaning, and feel like I could be on the path to achieving it. It's just that I don't like being associated with the substance abuse world. I don't use DD because I feel the need to differentiate, same thing here. This lack of alternative terminology has left me feeling awkward.

BUT I'VE FINALLY GOT IT!

I've been spending a lot of time over the last 2 months or so thinking about my mom's cancer. She's approaching 10 years post-diagnosis, and well, had cancer for some time before diagnosis, so it's been 10+ years. She has had cancer every single day for 10+ years. Who has cancer for OVER A DECADE? People deal with cancer for long periods of time, but they go in and out of remission. Or they don't. They die. After a lot sooner then a decade. She's never had a remission.

Which brings me to the topic of remission vs recovery. People don't generally recover from or are cured of cancer. Doctors are very hesitant to use those words because of the high probability of a relapse or an occurrence of a secondary cancer stemming from the side effects of the chemo or what not that got you into remission from the primary cancer in the first place. They wait years and are very cautious.

So I've decided I'd like to say one day (whenever that is) that my bipolar is in remission*. It acknowledges the very real fact that my symptoms will come back, but that I am/have been symptom free for a significant period of time. Unlike cerebral palsy, I do believe that it is possible to manage bipolar to the point where my symptoms become dormant (I hope that when they do come back they don't reappear with the force of a volcano). It's something to strive for, to hope for, to confidently reach for. A challenging but attainable goal.

*I realize I'm contradicting myself when I say I'm trying to differentiate by not using DD or recovery, and then gravitate towards another word already associated with something else. But I still feel it's a clearer definition. Oh, and I'm still undecided on how I feel about the term "symptomatic."

I Take Responsibility

Thanks Beth for pointing me to two GREAT articles recently, one of which I will just mention briefly. Debate Over Cognitive, Traditional Mental Health Therapy from the LA Times touches on whether or not therapists should be designing treatment plans within the context of the medical model. But it is the other article, or rather part of it, that is really the focus of this post. The Americanization of Mental Illness from the New York Times also focuses on the medical model, but more extensively.

I'm not going to sum up the entire article as it is super long (totally worth reading the whole thing though) but I am going to pull out two parts. The discussion on the stigma of viewing mental "illness" within the framework of the medical model ("brain-disease"), as "... an illness like any other" (quote from page 3), something purely with a biochemical origin, versus as something originating from situational triggers ("psycho-social") is primarily located on page four. I'm not going to comment on this section anymore except to say GO READ THIS NOW (I'll wait) because I feel like I'd be repeating myself ad nauseam -- especially lately -- as well as because the opinion is substantiated by scientific studies and isn't just my verbal diarrhea.

There is this one quote from page 3 though that really stuck with me and that I will comment on fully.

"Mental illnesses, it was suggested, should be treated like 'brain diseases' over which the patient has little choice or responsibility." emphasis mine

Little choice or responsibility. Wha? Huh? Seriously? I didn't have little choice over whether or not to be bipolar, I had NO choice. It's not like I woke up one day and said "Gee I think I want to have a major mood disorder." I didn't know until high school that my dad is bipolar and this runs rampant in that side of my family. I just drew the short genetic straw so to speak.

[image description: tiles made by elementary school students in CA (found by google images) surround and illustrate the word Responsibility]

However, I DO have full responsibility over what I do with this information.

I AM responsible for the choices I make, although I often do not practice what I preach.

I AM responsible for the decision to take my medication or not, to go to my support group / therapy / medication appointments or not, to go to the gym or not.

I am NOT responsible for the fact that I will have repeated bouts of depression for the rest of my life.

I am NOT responsible for my panic attacks, especially when I have the ones that start in my sleep.

But, I AM responsible for how I decide to handle this, how / when / if I get control over the episode or if I decide to relinquish my power to my states indefinitely.

Little responsibility? How is that little responsibility? That is BIG responsibility.

11 Sentences on Illness vs Disability

My uncle, a practicing psychologist, and I were emailing about mental health stigma a few weeks ago. The conversation has been interesting, to me at least. Here is part of our conversation, which is more of my same argument (at least along those same lines) although much less of a rant and more of a thoughtful reflection.

Most people I hang with like the term mental illness, but I HATE IT! To me, if you are sick you take medication and it not only gets better, it goes away entirely. I prefer to think of it as a chronic condition because it will always be there. I have psyc "issues" for lack of a better term, or a psychiatric disability. I even use the term dual diagnosis sometimes which really throws people off. No, I'm not an alcoholic, but I have 2 very different kinds of disabilities that both impact each other greatly. They don't exist independently, are not mutually exclusive.

I have found though that most people who have a psyc diagnosis are scared of being labeled as "disabled" because having a disability is something bad, something that makes you less than. An illness however is something that everyone has had, something everyone knows. It can be equated with the flu, and catching the flu doesn't make you less than someone else or a bad person. I think illness is a more comfortable term for people b/c it's familiar, and I guess disability is what has always been familiar to me.

With Your Illness...

I just had to bring this picture back. I met with someone at disability support today. I don't know why, what the point was, but my department head told me to go and you do what she says. So I went. I don't like going to disability support; I find the whole thing pointless. There is never anything they can help me with at all. I keep being sent there for psyc issues that really affect my school performance. So it seems logical that I go right? For a school performance issue. Except that these are issues better handled between me and my shrink. I see the person at disability support once, maybe twice a semester at most (last semester not at all because that's when I realized she's pointless). I've seen my shrink once a week or once every other week for over a year. I think she's got a better read on me. DUH!!!

[image description: a boy wrapped in a blanket with a thermometer in his mouth and an ice-pack on his head]

Not only that, but the person from disability support offends me. After I was diagnosed with BP II my file got switched over to the person that handles all the psyc students. She started here two years ago, is an LCSW (licensed clinical social worker), and her previous job right before this was as an elementary school guidance counselor. She's really nice and really tries to be helpful (even though she never is). It's her use of language that gets to me.

3 or 4 semesters ago right after I was diagnosed I went to her office thinking she could be a big help, and in the course of conversation she said "people like you..." meaning people with BP. I immediately got a pit in my stomach that I couldn't identify until later that day. When I was a baby I was diagnosed with CP and right afterwards in that same appointment the Dr started off on "people like her..." She was trying to convince my mother to institutionalize me. It wasn't 1920, it was 1985. But back to disability support. People like me? Has she had extensive experience with people who have a dual diagnosis of CP and BP? Does she know anyone else with both diagnoses? I'm willing to bet $50,000 that the answer is no. So we can't talk about "people like me," We can only talk about me. We have to work within the framework that sometimes the two diagnoses make life way more difficult then if I was just dealing with just one of them. Sometimes they clash or work in combination to exacerbate each other. She gave me advice that made no sense to me because we were never really talking about me.

That brings me to today. I only went at the request of my dept head, to satisfy her and to appear compliant with fixing the current problem. As I said, I didn't want to go. I don't like to go (I do however like my shrink and feel confidant that tomorrow or Monday when I see my psychiatrist things will get all worked out).

In the course of conversation the lady at disability support said "with your illness..." I don't remember why, I don't remember the context or the rest of the sentence and it was only 2.5hrs ago. I fixated on those three words. "with your illness..."

What illness? Where? Do I look pale? Do I have a fever? Diarrhea? Can someone please clue me in because I never got that memo. I'M NOT SICK NOR IS THERE ANYTHING WRONG WITH ME! I have a chronic condition g-d damn it, and there's a HUGE difference between the two (for almost the same rant, see my earlier post). I feel almost as if she pities me because I struggle so much. That's what those words mean to me. I don't know, maybe I'm reading her wrong... but I just cannot stand her and I needed to rant. So thanks readers.

*rant over now*