Frankly, I stumble over words when I attempt to describe my thoughts about mental illness. On one hand, I want to be P.C. by implying that there is nothing wrong with the “person” inside of the individual exhibiting symptoms of mental illness. But the problem is that the “strength of character” of the person is exactly what is being affected in many cases. But there are layers. I don’t want to pass judgment on someone based on something out of their control. But when my safety or my own emotions are in jeopardy, then some bias is necessary.

When I went through a period of depression and hypomania towards the end of college, what affected me the most was a division of my intellectual side versus my emotional side. I knew intellectually that I was depressed, and as such, my reaction to things was greater than “normal.” But my emotional side hurt. I felt overwhelmed, frustrated, and sad. It was the fear of the stigma of being “depressed,” and the inability for my intellectual side to convince my emotional side to stop hurting that caused the greatest frustration. I cared what people thought of me, and figured an “admission” of being depressed would be damning. But I feared for what would happen if I lost the perspective of my “intellectual” side.

That is why I care so much about how individuals with mental illness are treated. I don’t like the idea of someone “looking down” on a patient because their thoughts and actions may be “irrational” as defined by the DSM. I could launch into a whole tirade of “what is normal?” but for the purposes of this discussion, I define the need to obtain help as being because one’s thoughts, feelings, or actions are disruptive to themselves or to others.

I would tell my therapist, “It is so frustrating that someone who takes an antidepressant is labeled one way, whereas someone with diabetes taking an insulin shot is thought of as simply having a medical condition.” My therapist would look at me, nodding condescendingly. I didn’t like that my credibility was shot simply because my perspective on certain issues was skewed. That in itself was cause for irrationality and rumination, because I would wonder which of my thoughts were “normal” and which were “exaggerated.” And the more I wondered, the more frustrated I became. So the cycle would continue: “I am depressed because I am depressed…”

If I worked in a psychiatric hospital, I would probably be in favor of the armed security guards because I would be frightened for my safety. For the patients whose illness is severe, their reactions may be extreme. They don’t want help! They want to get out! But they are instead restrained. They may be a prisoner of their thoughts. Or they may be frightened. They lash out in fear, anger, and defiance. It is these types of patients from which the “stereotype” of mental illness is derived: irrational, inconsolable, “lock ‘em up now!”

But then these same patients would view the security guards as being “proof” that the staff is out to get them. Or in the case of someone completely lucid, the presence of guards would be thought demeaning.

The staff wants to nurture their patients in the most effective way, but they also have to watch their own backs.

One argument against posting the guards was that they would not have training in mental illness. This is a mistake. If anything, those who would be “guards” should be acutely aware of different types of mental illness and the symptoms that could affect the way to handle various patients. Ideally, such guards could be plain-clothed, roaming the halls instead of being at rigid posts, dressed in uniforms. The psychological impact between the two scenarios is vast. Unfortunately, the ideal training for such staff is hindered by budgetary restraints.

Until California provides adequate funding for mental health and drug-treatment services, many patients will remain mired in their illnesses. Psychiatric wards will continue to face an uphill battle to ensure safety - Jeffrey Smith, Hospital Executive Director, as quoted in the Contra Costa Times article

I dated a man with bipolar disorder. Was I sometimes nervous about his condition? Yes. I was. And that angered me. I wanted to treat him “fairly.” I wanted to respect him 100% of the time and not question his thoughts. But because of his diagnosis, I knew that he had the potential to not be thinking clearly. Most of the time, I didn’t think about the pills he kept in a square leather case in his pocket. But when he would great me extra-enthusiastically with some grand idea, I would be lying if I said it didn’t occur to me that maybe he was having some mania. As much as I didn’t want to be prejudiced, I know I was.

And that is why my own vulnerabilities frustrated me, because I didn’t like being the one in the psychiatrist’s office. I didn’t want to be the object of the same prejudice that I knew I had. I knew it wasn’t fair to say, “Well, I just have mild depression and hypomania, whereas he is full-blown bipolar!”

He was 99.9% fine on medication. It was rare that anything would happen that would be cause for concern.

Quite the opposite, I have a friend whose adult step-son has not found the right cocktail. His behavior hurts his family. He overspends. He cannot hold a job. He gets in the car and drives for days on end without telling anyone where he is going. He is sexually inappropriate. She is a kind soul who wants to help him, but doesn’t want to be an “enabler” by giving him money; neither does she want him living with her toddler daughter. For years, he was under her roof, but it caused the rest of the family great pain. I believe he has been in a mental hospital before, but I am not certain of the duration or the reason he left.

My Maid of Honor has had short stays in a psychiatric hospital for depression, primarily during college. Shortly after my wedding, she disappeared to me and our mutual friends. I wonder where she is and how she is doing, but my attempts to track her down have failed. I hope that wherever she is, she is happy and getting any treatment that she needs.

I haven’t had personal contact with someone who has schizophrenia or a similar more serious disorder. Within the categorization of “schizophrenia,” there are multiple levels of lucidity versus hallucination, such that many patients are aware of exactly how they are being treated and how their “rational” self and “irrational” self are battling. But there are also those who are locked within themselves.

When my grandfather started declining from Alzheimer’s Disease, he lived at my parents’ house. I still lived at home, as did my brother. One evening, he approached my brother and didn’t know who he was. My proud grandpa was scared of my computer and frequently didn’t recognize us. He wondered where his deceased spouse was, and why he shouldn’t wake up if it were dark outside. The witty man I had known was replaced by a frightened, angry man who would have been insulted and scared by a uniformed security guard.

I wonder how the patients would feel about uniformed guards: scared, punished, untrustworthy? Or would some feel more protected from their peers or from themselves and the actions that they feel are out of their control?

I think I would be insulted. I would feel marginalized and further depressed that I couldn’t be trusted. But if I were a nurse at a mental hospital, I would want “back up” for the times that a patient became violent.

My initial reaction to the article was one of concern that this would perpetuate the stereotype of people with mental illness as being completely out of control and/or violent. I have mentioned before in my discussions of the Cat’s ASD how I hate labels and assumptions. But at the same time, I can understand why in “extreme” cases, safety is an issue. I am a “flip-flopper” between wanting to say, “Hey, don’t treat people as though they have no control over their thoughts and actions!” and yet admitting that is exactly why the patients are in the hospital.

These are people that have very serious and limiting disabilities at times, but that recover to the point where they can have very functional lives, if we do our jobs - Miles Kramer, County Director of Psychiatry and Detention Health, as quoted in the article

Even the term “functional lives” hits me the wrong way; but maybe I am just oversensitive. ;-)

Several people who I care about tremendously happen to have one form of mental illness or another. I could probably go on and on rationalizing my thoughts about how each are valued while fearing that my comments about such issues could be taken as condescension. I have felt helpless, but my pride is such that while wanting help, I didn't want to be rescued. I imagine that my peers who have had more serious concerns than mine have at their core felt the same way. As a result, I am sensitive about anything in the media relating to mental illness, and pray for an understanding that benefits patients and staff alike.