Thank You, David Brooks

For looking beyond the political rhetoric and making this point about the tragic violence in Tucson:

If the evidence continues as it has, the obvious questions are these: How can we more aggressively treat mentally ill people who are becoming increasingly disruptive? How can we prevent them from getting guns? Do we need to make involuntary treatment easier for authorities to invoke?

Torrey’s book describes a nation that has been unable to come up with a humane mental health policy — one that protects the ill from their own demons and society from their rare but deadly outbursts.

Read his column in the New York Times.

Early Detection in Mental Illness — Thoughts about John Lennon’s Death 30 Years Later

Lately I’ve been thinking about early treatment and mental illness. When we talk about cancer, we say, “Early detection is the key.” What about early detection for the mentally ill? I recently heard a psychologist arguing on the radio that the field’s focus should include avoiding initial breakdowns, especially in teenagers. Just as early detection and treatment improves the possibility of survival and allows for less invasive treatment in cancer, so does early detection in mental illness avoid changes in brain chemistry and debilitating treatments. 

This requires that we teach people, particularly young people, how to recognize symptoms of mental illness in themselves. And our system needs to be prepared to help people before they’re in dire straits. People need to be able to say, “I haven’t had a breakdown, but I’m heading that way and I need help,” and then get the help they need.

Today this seems especially poignant. Thirty years ago Mark David Chapman had a psychotic break and murdered John Lennon. Chapman’s history of difficulty with conflict, expressing his feelings, and drug use as a teenager are basic indicators for someone who may struggle with mental illness, although drug use can be a sign of a teenager sensing his or her instability and attempting to self-medicate. If other people had been following him closer, or if Mark Chapman had been taught to monitor himself, to ask for help, would John Lennon be alive today?

Has access to care and self-awareness changed in 30 years? Will it change 30 years from now?

Hoarders, The Television Show. Helpful or Hurtful?

Okay, well, I’m not exactly up on the latest in popular culture. So while Hoarders is nothing new to many of you out there,  it was new to me. I caught a couple of episodes this week for the first time almost by accident while I was working on the computer with the TV on in the background.

The next thing I knew, nearly two hours had passed. Another Hoarders episode was coming on, and I WANTED TO WATCH. It took real strength to turn off the TV and go to bed, which is what I really needed to do.

My first instinct, honestly, was repulsion. Not at the people depicted on TV or their situation, but repulsion that someone out there thought this would be entertaining. And, to be truthful, repulsion at the level of my own interest in the show.

Full Disclosure: I’m not a reality TV watcher. I’ve always thought reality TV simply elevates the old circus freak show to a broader audience. I know people love it  — from Survivor to Jon & Kate to the Bachelor. Eh. Just not for me.

I know hoarders, and I had one in my family. I had a very difficult time letting go of my mother’s belongings after she died, and I can empathize with those people who react with anger and frustration when people start throwing their things out, no matter how much they resemble trash. I was frustrated and saddened that these people and their mental illnesses would be subjected to this level of public humiliation. I was annoyed that the deeper issues behind hoarding weren’t really explored, and I felt like the hard parts were being swept under the rug. Where was the slow, probably agonizing therapy that I knew must occur for these people to actually get help and get better?

And then, I found this lovely site called the Children of Hoarders. And I watched the video of that lovely man, Jason, telling his story about living with a mother who was a hoarder. And I wanted to cry and scream and hug him at the same time. And I realized that, while I still think the show is simplifying a very complicated problem, it is doing something that I admire. It’s bringing attention to mental illness. It’s giving people hope. It’s telling them they are not alone. It’s telling them they can find help. It is supporting the families of the mentally ill — people who need far more support than they typically receive.

So maybe, just maybe, a television show can help hoarders move past the stigma of their illnesses and take the steps to rebuild their lives. I still haven’t made up my mind about the show. Watch this space as I continue to struggle with the clash of mass media and the depiction of mental illness.

Murder-Suicide: Rare, Sad and Difficult to Predict

My community recently experienced a murder-suicide where a father took the lives of his two young daughters. I did not know the family, although acquaintances of mine did. One of the girls is the same age as my son. This, unfortunately, enables my over-active imagination to picture his face as a victim of a similar crime. I feel deep empathy for the girls’  mother, whose life was immeasurably changed just a few days ago. It makes me feel like someone punched me in the stomach, and I can only imagine how she must feel.

I’ve also been trying to imagine what the father must have been feeling and thinking before he committed this act. This is far more difficult. According to sketchy media reports, he was despondent over a pending divorce and suffered from depression. But millions of people get divorced and millions of people are depressed. And yes, millions are suicidal. There must be something more — something that pushes someone over the edge to commit murder of the people they love before they take their own life.

I was reminded that as a teenager with a bipolar mother, a therapist once told me that someone who is suicidal can also be homicidal. I didn’t fully understand this information at the time, although now I realize that she was warning me that someone who was contemplating suicide may consider it an act of mercy to take family members with them to prevent their suffering. In other words, she was trying to tell me to be careful.

At the time, I thought the idea was ridiculous. But then, I also couldn’t have imagined back then that my mother would eventually succeed at taking her own life. The unthinkable does happen. I’ve always thought that one of my mother’s twisted thoughts prior to her suicide was that she felt we would be better off without her. She couldn’t have been more wrong. I can only guess that the perpetrator of a murder-suicide commits murder as a perverted sense of altruism.

I’ve looked up research on the Internet, but studies on murder-suicide are far and few between. Murder-suicides are rare, thankfully, and the circumstances do vary. The researchers agree on some basic points — the perpetrators are typically men and involve firearms. A history of mental illness, particularly depression is common, as is domestic violence and economic uncertainty.

But none of the studies I’ve seen have helped with understanding why it happens and how to help others who are in danger. Like other forms of mental illness, what causes someone to commit murder-suicide is mostly unknown and therefore difficult to predict.

I hope we can find a way to help. Because the unthinkable does happen.

Is Animal Hoarding a Mental Illness?

We’ve heard the news stories about animal hoarders — people who “collect” animals under the guise of rescuing them until the situation becomes uncontrollable. The photos and stories of starving animals living in their own waste are highlighted in the media across the nation.

The media stories tend to focus on the animals, which they should. These innocent creatures are clearly the victims here. But the news media rarely digs deeper to the real problem behind animal hoarding. And maybe we should be asking, What about the perpetrators?

An enlightening story from the ASPCA talks about the deeper issues involved in animal hoarding cases. It describes the root of the problem as “Animal hoarding is a complex and intricate social issue with far-reaching effects that encompass mental health, animal welfare and public safety concerns. Victims can include cats, dogs, reptiles, rodents, birds, exotics and even farm animals. While it’s not clear why people become animal hoarders, current research suggests the cause is often attachment disorder in conjunction with personality disorders, paranoia, dementia, depression and other mental illness. The hoarder does not intend to inflict harm on animals, and in most cases, the hoarder can no longer take care of himself, much less multiple animals.”

I found this article particularly interesting because I’ve had a lot of experience with animal rescue operations, and the deepest issues involved in the problem are seldom addressed. I do believe, as does the ASPCA that “the solution lies in supplying hoarders with the resources and tools they need to keep them from repeating their destructive patterns.”

To me, that means mental health resources, something that is in short supply already in this country.

If you know or suspect someone you love is an animal hoarder, please check out the ASPCA’s Animal Hoarding page.

Mental Illness and the Gulf Oil Spill

We live far from the Gulf of Mexico, yet we’ve visited and spent a great deal of time in that area. Watching the news makes the tragedy of the BP oil spill feel close to home. While we want to know, we need to know, what is happening and why, the constant news coverage also leaves us with a feeling of hopelessness — what can we do, being so far away? How can we help? How can we prevent such tragedies? What lessons should we as a nation learn? Important questions without easy answers. And they leave us with a general feeling of malaise that we have started calling the August Angst. (Although we suspect it is not limited to the month of August, and it may evolve into a September Snit.) 

So naturally we found it interesting, but not surprising, that the mental health of people living in communities along the coast is affected. This story by Medical News Today outlines some of the findings of a study by Columbia University’s National Center for Disaster Preparedness. Among not-so-surprising results: Over one-third of parents report that their children have experienced either physical symptoms or mental health distress as a consequence of the oil spill.

If we, who live at least a thousand miles away, are feeling mental health distress, it only makes sense that those who are so close (and whose livelihood may depend on the Gulf) are affected. We’re glad someone is studying this issue, and we’d like to send good thoughts out to you Gulf Coastal residents. Let us know how we can help.

U.S. Army Responds to Suicide Risks

I was fascinated to read this AP story about the U.S. Army’s attempts to address suicide among their ranks. What a brave man Army Spc. Joseph Sanders is for stepping forward and becoming the face of this campaign. I found his story to be inspiring, and at the same time, I suspect it is more prevelant than he knew at the time.

I’ve never served in the military, but I grew up next door to a military base. My husband’s family has a long history of military service, and I have some idea of the type of environment and culture that comes with the military life. I can’t imagine a more difficult combination of elements that could spark mental illness while at the same time limiting a person’s ability to seek help. I found it heartening that the U.S. Army is at least giving it a try.

The pressure in the military to “be strong” is part of the very culture of the institution. It is not limited to any one branch of service, one country or even one era of human history. For the U.S. Army to change the message and try to address the problem is quite the “about face.” (Pun intended. Sometimes I can’t help myself.)

This story hits home for me in a very personal way, because I know a military vet who is currently suffering from depression. He lives the “be strong” motto through and through. In his case, just like many others, it is preventing him from seeking treatment for his illness. For him, I want this campaign to be just the tip of the iceberg. I want him to feel like it’s okay to ask for help. I want him to know that asking for help doesn’t make him weak. In fact, it’s the opposite — it requires great strength and courage to seek it.

I’m pleased the Army is making an effort to provide more mental health services, and I hope they dedicate the resources necessary to make it work. Keep up the good work, soldiers. And to Army Spc. Joseph Sanders, I salute you.

Help for Teenagers Affected by Suicide: Break Through the Static

My local paper ran a story about a new nonprofit organization dedicated to helping teenagers who are affected by suicide. This organization, called Break through the Static, defines its mission as creating “a caring community aimed at helping teenagers survive, heal and grow after losing a loved one to suicide. At Break Through the Static, teenagers will experience a safe and encouraging environment designed to strengthen their emotional and physical health through positive peer and adult relationships, and by joining with other teens to share and cultivate their unique talents and interests.”

Wow, I wish this group was around 20 years ago.

In fact, I find it a little disturbing that it took this long to develop such a group. It shows, yet again, the large hole in support services for people who are directly affected by mental illness.

If you are a teenager who is affected by suicide, or you know one, please check out Break through the Static. What an amazing resource for an under-served group of people. We are not alone.

The Many Faces of Mental Illness: Get Well Soon, Kahlil Greene

Back when I lived in San Diego I was a big Padres fan. I’ve since moved away and the team I loved has been dismantled, as often happens in sports. But I was surprised when I recently searched for Kahlil Greene, of my favorite players, and discovered he’s essentially been forced to retire due to social anxiety disorder (SAD). In the 2009 season, SAD put him on the disabled list twice and he missed 46 games. Kahlil signed with the Texas Rangers for 2010, but his contract was voided because he wasn’t well enough to attend spring training. I don’t know what his current status is or whether he’s being treated.

I don’t much about SAD, just that it’s a type of anxiety. However, I found the Hacksaw article the most interesting because it shows how descriptions of his personality changed over the years. Back in his Padres days, he was quiet and shy, but in rehab he was “reclusive and a danger to himself.” Were the signs of his disorder always there, but waved away because he was such a talented shortstop? Or had things escalated, perhaps because of the demands of a career as a professional athlete? Whatever it was, I hope he gets the help he needs and goes back to being an amazing human vacuum in the infield.