Stigma

I work in a place where we sometimes have people with "psych issues."  Many of my colleagues make jokes and give their own, extremely unprofessional, diagnoses.  The biggest one I hear when a person is hard to care for is, "he/she is just borderline" and most everyone else rolls their eyes and shakes their head.  Unfortunately, this sets the patient  up for unfair treatment.  The same goes for bipolar, and on down the line.  I remember having a patient once who was obviously (to me anyway because I have been there) having panic attacks.  I mentioned something to the docs, who brushed me off and sent the poor guy off to a critical care unit for cardiac observation.  After several days in critical care this guy came back to us.  Several days after coming back to us, they decided the guy had nothing wrong and it was "all in his head."  Well, yep, it was.  And aren't neurosurgeons head doctors?  Sad thing is, I see this kind of thing all the time.  The attitude is present with most of my colleagues.  Funny thing is, these "psych" patients are most often assigned to me.  They are assigned to me because I work with them well.  Gee... maybe it is because I treat these patients as I treat all my patients: with respect?  In the past year I have been telling my colleagues about my depression because I am tired of hiding from the stigma.  Forget bipolar of borderline, I have had a hard enough time with the depression part.  Maybe someday I will get there.  I have found that those who I respect have usually been alright with me (as if I would be any different than before I said anything), or as one said, "oh, I am so sorry."   Reactions like this are not the hard part though.  It is reactions from some of the other nurses I work with that have hurt.  Sadly, those reactions are the same I see about my patients with some kind of mental health disorder.  I work in a nuerosciences unit, aren't they all a brain disorder?  Aren't the doctor's I work with brain doctor's? When someone has a tumor removed, they have a follow up appointment with a neurosurgeon; if they have a thyroid disorder they have a follow up appointment with an endocrinologist;  for a kidney disorder they are followed by a nephrologist.  What the hell is so hard about a follow up with a psychiatrist.  I have advocated for patients so many times to only see them be discharged without any kind of mental health care follow up.  Well, I do have to stand up for the neurologists... they will order psychiatric evaluations a little quicker than the neurosurgeons, but they are still slow to do so.  This is so frustrating to see.  It is so hard to see people who are going through some of the same stuff as I do, and not have any help.  Or, as often is the case, stigmatized by the very people who should be doing whatever they can to get help someone, like me, needs.  It is very sad.

[paranoid_cataclysm]

Sounds like your place you work at is just as bad as the place I last worked at and after four or five years I couldn't take the drama and BS anymore and snapped.

[Bluetwo]

You got to be kidding me. You think doctors would be more educated on the subject.

[starbunny]

I can so relate to your post and it highlights what a poor service psychiatry has to offer as compared with other branches. I can especially relate to the poor follow up that patients have and the way professsionals 'give up' on those deemed to have personality disorders. I have been told such shocking stigmatising comments myself in the past that people would find it hard to believe why I went back. The truth is that there is no other option where resources are so unimaginably sparse.
After experiencing utter mental hell for many years and being left to cope with unsatisfactory services as an outpatient I sat and thought about those I knew who had actually made it to a psychiatric hospital and recieved treatment. Two had shot at random strangers in very public areas (and missed fortunately) the other committed serious arson and another killed a fellow in a fight. It seems that where I live you have to not only have a severe psychotic mental illness but have to kill / nearly kill someone before someone takes notice. It has to get that far. It simply isn't enough to take an overdose (or endanger yourself), plenty of people I know have done that and most have never recieved any kind of follow up.
Thing is if those people could have accessed services before crisis those situations may never have come - it is like the system waits for you to crack first.
I know I'm on a rant but it feels good to get this stuff out because the outcome of horrendous services around here plays on my mind a lot of the time :-(

[starbunny]

I guess I also have a personal grievance because two people whome I knew with schizophrenia / bipolar killed themselves last year in the most horrific ways I can think of because the services failed them in my opinion, and these are not isolated incidences either.

[paranoid_cataclysm]

Well you touched base on something I am extremely frustrated with so... RANT TIME LOLOLOLOL

I feel the same way that most people aren't going to take me seriously until I snap one day and do something drastic like almost kill or successfully kill another person like your friend just because I have a lot of charisma and people like me in general and think I can't possibly have mental illness just because I'm a likable person.  People with mental illness can be polite and nice as well, hate to break it to these people and destroy their stereotyping.  God, that's so horrible that I ruined their negative image of people with mental illness.  I should be shot to death for my heresy.  I feel like not even killing myself would make these people take me seriously who are not taking me seriously.  Or then there's people who I know talk about me behind my back saying I'm just crazy and then to my face they downplay everything I go through like it's a minor annoyance or they have it so much worse than I do because they didn't get the car they wanted or their boss gave them a task they are slightly annoyed with or something of that nature when my own brain doesn't work right and ruins my quality of life and I can't even trust myself.

[Xila31]

Yes, you would think the neurosurgeions would understand. I know that schizophrenia shows up in MRI scans, and I think bipolar does as well. I hate it when people say, "it's all in your head." The brain is not fully understood and biochemicals cause more damage than people realize. Like paranoid_cataclysm said, we are all left with these brains that don't work right and when we come up with our "brilliant ideas" there is no way to know if it is reality or not. It is not fun at all.

What's worse is that insurance doesn't always cover for psych. I don't know why they don't refer to a psychiatrist at least. When I was in the hospital after my second son, I saw a psychiatrist one time. She gave me Abilify, didn't tell me not to breast feed on it, then it was going to take 3 months to see another psychiatrist. In the mean time I ended up having a sever reaction to my medicine and not even my OB could get me any help.

The system fails every day. If you don't believe it, go walk in any urban city and look at the homeless people. The majority of them have mental health issues just like us, and all of us are at risk of ending up there if we don't have a support system. It is terrifying. :(

[yarrow]

The system does often fail (maybe even usually), from health care coverage for the mentally ill, to practical care in the office, to hospitalization.  Part of it is indeed due to malfunctioning professionals, as you say.

Our son, now 37 (diagnosed 12 years ago, but in my estimation a genuine case of childhood bipolar disease) has manic periods every four to six years. As time has gone by, he has developed a very focused anger towards us, his parents, and family therapy sessions have been largely devoted to hours of listening to him rage about insults and injuries that are imaginary but perfectly real to him.  In fact, they become more real to him the more he talks!

He is very bright, good looking, and charismatic, and his counselor (a guy) who seems to have rather fallen in love with him,spends these sessions nodding in approval and admiration.  No help there.  The counselor has actually--in my presence--told our son that he thinks the shrink's diagnosis was wrong.

After some experience years ago with Lithium and Depakote, our son now refuses all meds except  Lorazepam, and the result, I think, is that his condition has worsened, to the point that his accusations toward us now include abuse (not just during his childhood, but ongoing, even though we do not even see him for months at a stretch).  This idea has inflamed him to the point that five months ago, he physically attacked his father, but fled before the police arrived.

Our son is a grown man, partially unhinged and potentially dangerous.  We know that his counselor is ineffective, but that he will see no other one (small wonder with the feedback he gets there).  We also know that the psychiatrist has strongly recommended psych meds to our son, and that they have been loudly rejected.

The fact is that this patient is an adult, and even professionals who would like to help him are powerless unless he commits a violent act in public and is caught.

[Xila31]

I'm sorry to hear of your problems with your son. It comes down to the fact that he doesn't want to have an illness, and he has a "professional" telling him that he was mis-diagnosed. This is a dangerous combination. Denial is a powerful thing, especially when it is reinforced by someone who you see as powerful. :(

There is a big movement that people with mental illnesses do not need medications necessarily if they have the right treatment, but I am not in agreement due to my own situation. I look back at the things I have lost that stand out very clearly to me due to untreated bipolar. My memory is slipping, my concentration falls to pieces, I can't read the way I love to, my writing talents slip away. I feel like a ghost of the person I was only 5 years ago. Anyone who says our illness is fake is an idiot. I wanted to be a writer. I could write for 8 hours a day. Now I feel fortunate if I get out one page in a week. :(

I hope your son finds a reason to get himself treated properly.

[yarrow]

Your observations about what you perceive you have lost ring true.  Our son is an extremely gifted writer and artist, and we have seen his abilities diminish dramatically as his illness has raged on untreated for so many years.  His ability to think and write clearly is definitely impaired, and of course, he cannot concentrate for any length of time.

Our own counselor (who has seen us all in session) has told us that we must simply have the best life we can without a son, because ours will probably not seek help until he hits bottom, and perhaps several times at that.  Kind of bleak, eh?

But you seem to have thought about your condition a lot and have gotten a grip on it.  Congratulations to you for that.  As for the regrets, yes, you have undoubtedly lost time and perhaps certain kinds of ability, but you know, even for those of us without bipolar disorder, we lose things.  We lose them irretrievably sometimes, but like you, we forge onward as best we can, because that is our human destiny.

[Xila31]

Although my treatment isn't going well, I accept that I have an illness and that it causes me a lot of trouble. I do this because I have my boys and my husband and I don't want to leave them through something horrible, like a suicide. I know that demon lives in me, so it is my job to fight that demon even when I have no weapons like medicine. I also know that just because I have this it doesn't mean I should just lie on the floor and wait until it ***** the life out of me. My mom died of breast cancer when I was a girl, but I watched her fight until there was nothing left, so if she can fight that I can fight this.

Plus I don't want my boys and my husband to have to look back and I'm just a ghost the way my mom is now a ghost. I can prevent this from killing me, so I will. My mom didn't really have a choice at the end, but I do.

[paranoid_cataclysm]

lol I'm particularly at risk of being homeless since I have no job right now but I just laugh at it instead of freaking out.  I think maybe I have one last support beam however in this area in case this does rear it's ugly head that can prevent it from happening so we'll see.  It's not so much I had a lack of support system that got me into this however, it's just a lack of planning and insight that got me into the situation as I was told and I agree with.  I just worry I will lose a lot of my support system I have now which I highly believe prevents me from being hospitalized if I have to go to the last resort to prevent becoming homeless.

[Xila31]

Well, hopefully you can find a new job somehow and that won't happen. Like you say, you do have a support system so hopefully it won't give out on you. I think that's the most important thing in the end that keeps people from being homeless; family and friends who understand who are there when things like job loss happen. Either that, or not accepting the illness and staying in treatment. I think those are the two main causes of so many people with mental illness on the streets.