No way to know and no way out

Oprah, Maury, the erstwhile Sally, never really discussed what you've needed to know as you enter your crisis.

Television, radio, newspapers, books just don't seem to cover what you need.

This is rather odd because 25% of all homes in the United States are touched by mental illness; by definition, a home with an untreated mentally ill person is dysfunctional--it's rather like having an elephant in your living room; yet, there is very little help and virtually no education about what can go wrong and how to cope with it when it does.

Worst of all, you are in pain, and no one is interested in helping you, even if they could.

Unlike more popular diseases, cancer, heart disease, diabetes, even aids and alcoholism, mental illness is in a special category of itself which, if it were known that you or a family member had it, your whole family would be a pariah; one of the reasons is that most people with mental disorders are rude and unsociable to begin with:  So, instead of making it known and hoping that someone might come to your aid, you must hide it--if you've even suspected it in the first place.

Many times, mental illness is chameleon-like and not recognized for what it is.

Make no mistake: It is a very dangerous disease, and, in fact, one of the criteria for an involuntary commit is that a person is a danger to himself or others--which often makes it more difficult when you are dealing with odd inconvenient behavior which is quite disruptive, but doesn't legally constitute a 'danger'.

So your choice is to ignore it and hope it goes away [it won't]; try to get the person treatment [which will be staunchly resisted, because they think they are fine]; or try some form of self-treatment [which will be entirely ineffectual].

There is hope and you are not alone

You are not alone.

There is hope.

One of the resources you should consider immediately is the National Association for the Mentally Ill (NAMI):  NAMI has a great body of knowledge for those who are mentally ill and for their families.

The department of health in some counties have a unit to help those with mental health issues.

Sometimes there are programs associated with medical insurance and some businesses render help for employees and their families.

There are many web sites for those who have specific needs depending on their particular mental disorder.

There are mental health professionals listed in a variety of directories, although those seeking aid should be selective about the level of professionalism and track record of those from whom they seek assistance.

The Truth

With few exceptions, the truth is very important to a person with mental illness.

The truth often becomes a quest which adds to the complexity of a mentally ill person at a time when they need simplicity and stability.

They grasp the truth--at least the truth as they see it--as an anchor to sanity; they also tend to simplify matters into absolute black and white.

No one should trivialize what such a person by discounting their propensity toward truth-seeking by minimizing their value of truth.

This becomes problematic because people with mental illness are easily overloaded--they have too much to process already and as their condition deteriorates you may find that their lack of ability to administrate what they experience leads to personal chaos and confusion: Their rooms are a mess, their thoughts are disordered, they have difficulty making choices, they are confused, they get to the place that they can't take care of the simple things like personal grooming and they often don't brush their teeth and comb their hair--indeed, they may shave it off [and if this happens, you might take immediate note that something may be wrong]; they just can't manage to cope with the world around them.

And the world doesn't help much.

They perceive the world to be filled with lies and this is overload to them:  They just can't take it all in and deal with it.

And, unfortunately, they are right, because the world itself is insane and being in it just doesn't make things any better for a mentally ill person.

They often become involved in global issues, focusing and obsessing on the news--most of it bad--and this doesn't help in bringing them back to the reality of their personal situation.

Some become involved with such causes as Green Peace and Amnesty International [which may be quite helpful, but these organizations may cast a blind eye to the fact that mentally ill contributors really are not helped by their acceptance of the charity]; others become involved in cults where they find "truth" to their own furthered destruction, manipulation and abuse.

These people are generally naive and susceptible to manipulation because they want to "fix" problems they perceive and it is easy to convince them that the world is a better place through whatever truth is being pedaled.

This is not to say they are devoid of intelligence.

My dad tells the story of a someone who was driving his Model T Ford past Medical Lake outside of Cheney, Washington; a mentally ill person was standing by the fence that separated him from the road when a wheel came off the car; the driver found the wheel but could not find the nuts that held the wheel on the car; the mentally ill man saw that there were five nuts holding the wheels on the car and told the driver that if he took one nut from the other wheels, he could hold the other wheel on the car until he could get to a service station; the driver, impressed by the solution, did so and was amazed that this 'crazy person' could come up with the solution, to which the man replied, "I might be crazy, but I'm not stupid".

Truth seeking often gets mentally ill persons into great trouble with society at large, primarily that society can't handle the truth, and it makes the mentally ill appear to be more rude and aggravating while creating an atmosphere where the supposedly sane would like to dispose of these trouble makers.

The mentally ill often have a sense of humor based on their perception and recognition of the truth that leans to the macabre black humor which may well be misunderstood.

Too often mental health professionals have no sense of humor and this compounds the problems.

Dr. Frederick Frese, a chief psychological administrator with schizophrenia who was once a patient at the facility at which he works, went back to visit the Veteran's Administration hospital where he was also once a patient.

Now there are four questions that psychiatrists ask a patient they suspect may have schizophrenia:

1. Who are you?

2. Where are you?

3. What year is this?

4. Who is the president?

Dr. Frese has an awesome sense of humor and it is quite entertaining to listen to him speak [while he is telling us the important truth about schizophrenia].

His answer to the first question of "Who are you?" didn't help his cause very much when he told them that he was the chief psychiatrist of another mental institution.

His answer to "Where are you?" as being at a mental institution where he was once a patient with schizophrenia wasn't very helpful either.

But when he told them that Hillary Clinton was President, he really had a problem, and they almost didn't let him leave.

It was a joke!

They didn't get it!

And that's why a lot of times that people with mental illness rightly conclude that you just don't get it.

And that's just one more reason they find themselves misunderstood and without support--people really don't get it.

That is why it is important to listen to them--sifting what they relate carefully--to understand the truth that is important to them.

Another factor in relating to such people is that they are dealing with a lot of personal internal truths that make them seem insensitive to the problems of other people:  They are overloaded.

It is important to realize that a mentally ill person is internally overloaded and it is important to prevent adding to this overload externally.

They will seem incapable of caring for the needs of others around them and you may perceive them as being insensitive; that is all part of the picture; as an aside, when mentally ill people begin to show genuine concern for others, it may be a good sign that they are recovering, or at least coping more effectively with their problems.

Mentally ill people perceive the world to be filled with lies.

This is something they will be compelled to try to fix.

'Knowing the truth' and perceiving that others do not 'see' it, is very aggravating and confusing to a mentally ill person:  "I see it, why can't they?"; this can lead to anger which degenerates into violence either psychological or physical or both; if the person cannot be validated and felt understood and the violence continues, the only appropriate option is to distance yourself from the violence--either by restraining them [possibly with an involuntary commit], a restraining order, and / or moving away from them.

Truth to a mentally ill person can be a source of great distress.

Unfortunately, they will know the truth, but it won't do much to set them free.

Don't lie to them.

They have enough to cope with.

Socialization

Highly objective people representing 75% of the population probably think that subjecting subjective people, representing 25% of the population, who happen also to have a mental disorder, to large groups is a great idea:  After all, they like people themselves, and like to be around people, and handle large groups of people well, and they think that the isolated and solitary person with mental illness will do so much better if they just get out and meet other people.

"It's the best thing for you," they say.

"Why don't you join a support group," they add, innocently.

"Let's go to Disney World," they propose, where there are over a million people a day being pushed through the gates like cattle.

In their minds, getting out there in the public and exposing yourself to all those people is such a good idea.

For a person, let's say who has schizophrenia, the overload that this may cause makes this a very bad idea.

People impress their values on others, often with the most disastrous results.

People coping with those with mental illnesses need to understand that the person they know needs a stable environment where adventure, particularly adventure in the form of things going amiss, is quite limited.

People with mental illnesses most often have a need of knowing what is coming so they can be prepared for it and stability with fixed routines in a set environment is the order of the day--each day.

Dr. Frederick Frese's wife was quite upset with him when he came home from work and while she was talking to him, he stared at the wall, at the ceiling, at the floor; he avoided looking at her face; she was so upset with him because he would not look at her, that she was practically in tears.

Then she found out why he didn't look at her.

He explained that her face was so distracting that he stared at the wall, the ceiling and the floor to avoid being distracted and concentrate on what she was saying.

People often find people with mental disorders unpleasant because they don't understand.

My son was taken to a Chinese restaurant by his friend who has bipolar disorder; she wanted a bill; they explained that they could give her the bill later; she thought that she had to have the bill, so she fussed and fumed and caused problems and was disagreeable until someone at the restaurant brought her a bill and then she was just fine and the meal progressed more or less normally.

People having challenges helping a person with mental illness need the self-restraint, kindness and patience to understand that such a person may have difficulty understanding new things and new environments or even what they perceive to be extreme changes, however moderate, to their existing environment.

Self-esteem can often be at issue as well.

A man who had schizophrenia was trying to find a job and wanted to work, but the prospective employer was skeptical; when the employer asked what the man could do, he was told that the person under treatment liked to walk a lot.

The prospective employer decided to give him a try by having him take flyers and put them on doorknobs in the neighborhood.

The effort was quite successful, brought in a lot of business, and the man was more effective in performing the job than anyone else had ever been.

The employer asked the center if they had any more people with schizophrenia he could employ.

Progress in the treatment of schizophrenia is non-linear and often takes a long time for any results to be noticeable.

One man was released with treatment and went home.

He went into his room and basically did everything in his room without coming out--including eating.

Eighteen months later, he came out of his room, showered, dressed up, went downtown, and got a job.

When he was asked why it took him so long, he answered, "I had a lot to think about".

Unfortunately, for every success story, there are probably at least one hundred others which end in unfortunate tragedies: We have a long way to go, so we should never stop at one or two successes.

One needs be concerned with the company they keep: While my son was in the ward at the County Hospital, one of the patients thought it would be fun and found a way to remove all the tiles in the ceiling of the common room; at the State Hospital, my son shared his room with a man who had shot and killed three policemen--so if you are pushing a patient into socializing, you should be aware that there could be a down side to associating with other patients.

People working to benefit others who happen to have mental disorders need to be sensitive to overload.

Sometimes people need and value isolation.

It is a bad idea to push such people into groups of people for whom they may not be prepared.

Support groups are a terrible idea.

Some environments are particularly terrible for people with mental disorders, particularly those who have schizophrenia, although having bipolar disease can also be a challenge.

Modern corporations, particularly the environment of a corporate headquarters, and even more particularly a misfortune 500 corporate headquarters where all the senior management are crazy and the environment is nuts, is an extremely damaging and abusive environment for anyone having a mental disorder, let alone so-called normal people.

I would know.

I worked as a manager at one.

I observed people all around me with their mental disorders of ADHD, bipolar disease, alcoholism, and even a high functioning autistic contractor, not to mention the crazy lying narcissists [a mental disorder] running the place.

Outside of the fact there were no on-staff psychiatrists on site, I declare that the company should have been declared a mental ward.

The lies of the narcissistic abusive director [who was finally fired] created havoc.

I watched as one man progressed through a psychotic break into full blown full-blown manic-depressive illness; it was interesting to watch his pupils dilate as he ranted and then contract to normal size as I talked him down and calmed him; it was amazing to observe his bizarre behavior as he tried to make sense out of conflicting directions with which his management was stressing him.

Most mentally ill people do try to do their best, they try to please their employers and family, and their friends.

Like birds nesting at the airport, they are at first disrupted by the mental 'noise' around them, and then try to adapt as well they can, even if it makes no sense and is destructive to them.

Large corporations are the pits when it comes to management because, for the mentally ill who really need patience, understanding and a stable environment, big business management represents a constant threat through the pressures of business competition, competition with their peers, conflicting signals from the management, threats of being laid off and fired, threats of having their ideas stolen at a time when they need the self-esteem recognition would bring, and most of all, the disruption in their lives from the environment of lies surrounding them.

The lies, as noted above, are probably the most destructive of all, because usually the mentally ill person isn't equipped to endure the abuse of being told lies and being told, "Perception is reality", which a lie loosely translated as: "We are screwing you, and you have to endure it, as painful as it is, and you have to pretend it is the truth," is outrageous.

This is unacceptable to a mentally ill person.

It is also immoral, unethical, probably illegal and compromises everyone's integrity.

There is also a matter of the socially acceptable practice of allowing other people to steal your ideas and the work you put into them with the tacit understanding that when it comes your turn, you will steal someone else's work and take credit for it, earning the momentary approbation of your management and your peers; this is thought to be 'maturity' in modern corporations and everyone is expected to manage this theft with graciousness and aplomb; except, for the mentally ill person, it's all about stealing their ideas, stealing their work, robbing them of self-esteem, trivializing them, and when the 'their turn' comes, it really doesn't and they never get one thing out of the experience.

This is also quite unacceptable to a mentally ill person and it adds to their frustration, not to mention that it creates more problems with overload.

A mentally ill person expects more or less black and white, right and wrong, processes to work, things to be a certain way, things to work a certain way--a certain objectivity in employee review where there is at least 80% measurable criteria upon which they are judged; what they find instead is that 98% of their review is subjective based on how other people feel about them, their image, and absolutely nothing evaluated on their objective contributions, no consideration for the substance of what they have done, and no recourse to protest the objectively unfair review, unless it is in a court of law in a usually unsuccessful suit against a cadre of highly paid corporate lawyers.

Demeaned, demoted, devastated, devalued, a mentally ill person goes quietly (or in some cases, noisily) mad.

And the corporate body blames it on the person they've pushed over the edge.

Isn't that just crazy?

Is it any wonder we end up with Enron, Arthur Andersen, and Global Crossing.

For marginal people who are having difficulty coping as it is, experience in the mental institution [and I mean that in the most unpleasant sense possible] of modern business will push them right over the edge.

In the confusion, the corporation will fire the people they have just pushed into insanity.

Then they will proceed to mark the person so they can't gain employment anywhere else.

Illegal?

Yes!

Done all the time?

Yes!

This is the ultimate in abuse.

This is not to mention the products which ruin the health of Americans.

Do we really think it is sane to serve fast foods that have 500 times the allowed safe levels of Acrylamide?

How about cigarette companies who kill off their customers?

They can claim, "But we kept the law! And anyway, it was their choice!".

Corporations and big business, whether corporate, governmental, academic, or religious, conspire to make the already bad plight of the mentally ill much worse and then they turn right around and give to United Way to make it all better.

How about cleaning up the lies of Corporate America?

This is the part of socialization which is never discussed, but has a huge impact on the mental health of people.

Pressing mentally ill people into socialization, particularly in an environment which is recognized to be destructive to nominally well people, is a disservice we do to each other.

People with schizophrenia often become disassociative on the job--that is to say that they cannot manage to stay organized and piles of paper and other junk may lie everywhere because they just can't administrate their environment effectively and it becomes chaotic and confused--which is another reason to find a way to fire them in the minds of the Nazi Overlords of the Corporation.

Another part of socialization is popularity, that triumph of image over substance, or, in the case of Hollywood, the triumph of image over substance abuse.

Very often people with mental illnesses have a variety of other problems and challenges which make them less than desirable to others.

Medicines which treat mental illness often tend to make those treated fat.

The fact that the treatment itself accounts for a very low score on the Brad Pitt meter lowers self-esteem among many.

Self-image makes socialization more difficult and as socialization is more difficult, there begins a downward spiral which gets worse as a person becomes older.

A mentally ill person is just like the rest of us, except the plumbing in the brain isn't working right; they have some of the same hopes, dreams, desires.

As they see that these aspirations will never be achieved, they despair and sink into deep apathy.

And the people around them, seeing them wandering aimlessly, muttering to themselves, starting somewhere and then forgetting why they went there in the first place, don't make anything better by the winks, the nods, the body language and the snide comments which come through loud and clear.

No one wants the mentally ill because they are not sexy or attractive--except the ones who are, probably really are dangerous.

In terms of socialization, generally speaking, there are monsters among us, but they aren't the mentally ill.

If someone you know is mentally ill, or you have good reason to suspect that they are, and they seem stressed and overloaded, and they ask to have some space, consider the wisdom of their request and if it is appropriate, give them the solitude they desire.

Remember too, that a mentally ill person probably can't take care of themselves; there should be no expectation that they can take care of others.

Taking responsibility

For most of those mentally ill, it isn't their fault; the disease with which they cope was at least genetically predisposed and more often than not came to full force by an event which was not of their doing.

It's not your fault.

This is very odd, for, in my experience, the police called to cope with the person who is mentally ill and their family, blames the mentally ill and / or more particularly the family of the mentally ill; their comments, their looks and their body language say it all--it's all your fault [and for mentally ill children, they blame the parents for their bad child rearing practices as the cause of the 'crime']; people need to be aware of this and pay attention [and be very circumspect]--police pack guns and they have been known to be quite, umm..., forceful.

Sometimes, people with mental illness don't believe the guns can hurt them, but they are dead wrong.

The attitude of the police is an arcane one, and somebody needs to establish sensitivity training for them; unfortunately, in their world of black and white and their power structure, they are pretty much independent and most of them would retain all of their attitudes even after such training.

The police often face very dangerous situations with mentally ill people and not a few [as pointed out above] have been injured and killed.

This is not a situation which presuppose them to being filled with love and forgiveness for such people.

Nevertheless, if ever there were people who needed love, understanding, and forgiveness [forgiveness for what? they weren't responsible!], it is those who have mental illness.

Violence, abusiveness, and bizarre behavior can be elements of the mental illness wherein the person with the behavior either does not have self control sufficient to behave in a reasonable manner and / or isn't perceiving the situation correctly and in a psychotic state is managing the environment in ways reasonable personally but which are completely inappropriate in an objective sense.

This is not unlike alcoholism, where the alcoholic is unaware that they can't start drinking and begin a slide into sickness.

It isn't your fault.

I once worked for a manager who was an alcoholic, had bipolar disease, and probably also had schizophrenia.

We went to lunch one day and I rode with him in his Cadillac.

I rode back with someone else in a Datsun.

The reason was the four martinis he had for lunch.

For those of you familiar with "Under the Influence" by Dr. James Milam, it would be clear that he had traversed the first two stages of alcoholism and was firmly entrenched in the third and final stage that comes just prior to death.

He came to work at 10:00 AM or thereafter, staggering drunk.

The Director gave him an ultimatum: Come to work drunk one more time, and you're fired.

He came to work one more time and resigned.

It didn't stop there.

He made threatening phone calls to the Director and others.

He was sent to jail.

He had a restraining order.

He persisted.

He was involuntarily committed for 90 days to The State Hospital.

After he got out, there were still some problems, but mostly, for years, it was the voice mail left at 2:00 AM from someone in a drunken stupor who finally realizes he doesn't work there any more and hangs up--and doesn't remember the call the next morning.

Here is a man who was a monster and difficult as a manager--who was always a little 'off'--who probably didn't know about his conditions early on.

But by the time he got out of the Hospital, we all have to believe that he knew what was wrong with him, and he knew what to do.

It's one thing to have mental illness and not know what to do and how to cope with things, but it's quite another to know what is wrong with you, and have solutions, only to defiantly decide that you are NOT going to stay on the program!

It was shear defiance.

He had decided that he wasn't going to take the medications, but he was going to continue drinking--and by the way, they don't allow you to take alcohol in the mental ward--trust me; so 90 days should have been enough to get free from practicing the alcoholism.

No one was going to tell him what to do.

For awhile, he wandered from place to place, changing his unlisted phone number every three months, being enabled by his apologist friend now retired who used to work for him.

He was a monster.

Ironically, he called a married woman he knew from work at her home at night because he perceived her to be sympathetic; her husband is a deputy sheriff.

There comes a point in every one's life where they know and understand, and have a chance to take responsibility.

This was a story of someone who decided not to.

In the end, he died alone, December 31, 2002, in his apartment.

His is not the only story we could tell. A young man living with his parents had been stable, but decided to stop taking his anti-psychotics. He stayed up day and night. He charged his credit cards to the max. He went unstable and told his helpless parents, "I can do anything I want". He had to be involuntarily committed. Previously, he had been able to recover from periods of instability, but as time has gone on, he isn't really recovering. He made a choice while he was stable not to take responsibility to keep himself stable and has now paid the price. The situation is sad, but the parents have reluctantly concluded that they cannot take care of him any longer with no accountability and without his taking responsibility.

Now sometimes it takes a lot of convincing for someone to come to the conclusion that they are mentally ill, and it takes a lot more to convince them they need treatment, but for most, that day comes, and they cooperate with the program and make progress toward recovery, such as it is and what there is of it: Of such people are the Dr. John Nashes and the Dr. Freses of the world who struggle to be well; and our hats are off to those people who truly make the effort and try to live a life with concern for the rights and feelings of other people.

This, in itself, brings new challenges for those around those with mental illnesses.

What do you do when the person you have known with mental illness is effectively treated so they function more or less normally?

This can be a problem.

Many family members, coworkers and others may view the person under treatment and appropriately coping with mental disorders as being the same sick person with which they had to cope, perhaps with which they had to cope for years.

The worst thing to do is be trapped in the rut of viewing them the same as they were and treating them the same way.

They are now changed.

The rest of us must make the same progress in change as the person who is effectively treated and making progress coping with their mental illness: Not to do so creates a vacuum into which dysfunctionality rushes.

Do you really want to be the dysfunctional person when the mentally ill person is recovering and coping?

A change in attitude is appropriate when a person with a mental illness begins recovery.

The elephant is out of the living room.

It's time to stop acting as though it were still there.

For those who refuse to take responsibility, the choice is clear: Reject them--you won't be doing them a favor or yourself a favor by being an enabler and apologist; you need to take care of yourself and get on with your life--without the person with mental illness who has made the choice deliberately and stubbornly that they want to remain just the way they are.

For the rest, we all need to take responsibility and be supporting one another.

That's what hope and recovery is all about.

Glia Cells

Neurons in the brain get all the attentions, but glia cells are far more numerous and they have the function of supply the neurons with nutrients and oxygen and all the other good things the neurons need to live.

In people with bipolar disease, particularly if it is not treated, the glia cells die off more quickly than they would in a person without bipolar disease, and this leads to the deterioration of the brain in a person with bipolar disorder.

This means that as a person ages, their mental health deteriorates more rapidly than normal and contributes to the degeneration of the brain.

The brain consists of 90% glia cells which are necessary for the correct 'wiring' of the brain.

By themselves, the nerve cells in the brain connected together poorly, but the combination of the two cell types of both nerve cells and glia resulted in strong connections between nerve cells.

In the brain, such connections allow nerve cells to pass along messages about our every sensation, thought and movement; weakening of these connections could be responsible for memory loss and other symptoms of strokes and Alzheimer's disease.

On their own, the nerve cells appear to do the right thing -- forming the connections, called synapses, and even using them to pass along electrical messages -- but the transfer of messages is inefficient and often fails; with glia around, the connections rarely fail, and the nerve cells pass on more and stronger signals.

Some glia wrap around nerve cells and insulate them with a protein called myelin: Glia at synapses act both as a physical barrier that prevents crossed wires and as a disposal unit that mops up extra messenger molecules released by nerve cells.

In the presence of glia or the glial factor, nerve cells make more connections among themselves, but this effect alone does not fully account for the increased transfer of messages; the more significant change occurs inside each nerve cell transmitting the message to its neighbors--for some reason, the glial factor makes the transmitting nerve cell release its chemical messengers more readily in response to an electrical signal.

It appears that a healthy physical brain can contribute significantly to better mental health.

To your better mental health

The best way I know of to better health is exercise.

Other factors are important: Diet, enough sleep, balance of focused work and recreation, proper supplements when needed, appropriate social activity.

But exercise can do a lot of good in a short period of time.

The supply of oxygen to the brain, the toning of muscle, and the general well-being that exercise brings can be quite useful to those suffering with mental illness--and exercise may well mask the symptoms of mental illness [that's a joke! see above!].

It should be noted that taking so-called 'recreational drugs' [most of them off the street, where you don't know where they've been, and definitely illegal] are usually highly damaging for a mentally ill person, as is alcohol, but, unfortunately, these are the self-treatment of choice among the mentally ill.

Hey, guys, if you're trying for sanity, you've missed the boat.

There are many supplements which may help stimulate the brain to keep in functioning order, such as Phosphatidylserine.

Often overlooked is the role that building vocabulary has in building a healthy mind:  As a person builds a vocabulary of words derived from Latin and Greek origins which renders precise meaning, the synapses of the brain are developed and the cortex of the brain becomes stimulated to make the person much 'brighter' and making it more easily possible to reroute some of the functions of the cerebellum [see "Shadow Syndromes"].

With the proper programs in place, it may well permit a person with mental challenges to reach their 'tipping point':  The brain is extremely complex, not unlike the weather, and, when conditions are right, a 'good' event may trigger a cascade of positive change throughout the brain.

From "Shadow Syndromes":

On the balance, the research shows that the majority of positive neurological alterations to the brain occur as the result of long-term, regular exercise. Nevertheless, some changes do occur from the first day a program is begun: neural levels of dopamine, serotonin, and norepinephrine rise after a single workout. Mind depression and anxiety in particular can be very responsive to the effects of exercise. Exercise increases alpha-wave emissions in the right 9or "depressive") hemisphere; this is beneficial because and increase in alpha waves appears to correlate with an overall decrease in activity in that area (since alpha waves are slower than the beta waves produced when we concentrate). In short, exercise appears to slow the right side of the brain to some degree, and to stimulate the left side. That is a good thing, because the left-dominant brain is generally a tougher, more adaptable, more stress-tolerant brain. Which is what most of us desire.

Externally, the best stimulus we could have to stimulate the brain in a positive direction is music:  Studies have shown that music by Mozart actually helps raise the IQ and has been found to be positive in children's development [forget the fact that cows give more milk]; however, some kinds of music [so-called] has been found to have quite a deleterious effect on mental health [and guess which kind of loud music a young modern mentally ill male will choose, huh?].

So music of the right kind can be be beneficial [and we saw this quite dramatically in our son--he was much better when he listened to classical music].

And, finally, don't forget to keep your sense of humor: Humor is one of the best ways to keep your sanity--just keep it to yourself [and laughing at things you find hilarious that you don't explain to others, isn't going to help your cause much either!].

Schizoaffective

Schizophrenia is very rare and affects about 1% of the population; bipolar disorder and the attendant mood swings may impact any where from 2% up to--according to some estimates, as much as 10% of the population or more; the intersection of the two diseases as defined by schizoaffective is obviously much more rare and very difficult to diagnose, particularly if the mental health professional focuses on manic-depressive illness as being much more common, and has little or no experience with schizophrenia.

What is schizophrenia?

That's a good question, one which did not have a very good answer until the early part of the 1990s; and while it was known that there is a genetic component, that inherited factor does not follow the Mendelian Inheritance patterns; that is to say, that the inheritance of the disorder does not follow a linear inheritance and there are other factors, such as early development, which are involved; Gregory Mendel's premise that if you have such and such in the parental genetics, you will get such and such results in the offspring--which always worked out for him and his bean sprouts, but there's more to it than that in some cases, obviously.

What has developed about schizophrenia is the research which has developed a model wherein it is now understood that it is a result of clumping of brain cells inappropriately during the first few years of development:  There are too few brain cells in one area of the brain, and too many--particularly in the functional parts of the brain involved with perception--in another.

This leads to a remarkable ability for those with schizophrenia to almost instantly recognize patterns which would be lost on other people.

A simple example of this was given at the "Hope and Recovery Conference" where a slide of seemingly random dots were shown on a screen; the audience was supposed to figure out what it was from the patters; a second slide was shown with more dots; and so on and so forth until the fifth slide had enough dots to show that it was a five dollar bill.

And one person in the audience got it from the first slide.

People with schizophrenia are often quite brilliant, as, for example, Dr. John Nash who shared his Nobel Prize for Economics in 1994, after years of struggles with schizophrenia.

The problem begins when inappropriate associations are made in patterns, such as Dr. Nash trying to see the patterns in newspapers and magazines for extraterrestrial alien messages [forget what the movie said]; the problem ends with an overload of signals in the brain that cannot be processed--probably because there aren't enough neurons in the areas of the brain needed to process the input; this is one of the reasons that people with schizophrenia hear voices:  Their brains are trying to make sense of stimuli which are accumulating at too great a rate.

We all try to make sense of what we experience--please hold that thought.

People with schizophrenia suffer from overload.

This is an important consideration when people, particularly family members, are striving to communicate with them.

How well I remember Friday, December 3, 1993.

My son was subjected to extreme stress.

We left for an even and when we returned our son had loud rock music coming from his room; when I went in to ask him to turn it down [it was 11:00 PM], he pulled a small serrated hunting knife; I moved toward him and pushed him slightly and he fell down; we called 911; the Kirkland Police came--it took four of them to get him down in his room; he was taken to our HMO Emergency where the consulting psychiatric nurse told us that "he is very disturbed"; they then sent him on the the University Hospital for evaluation; we went home, and got a call about 4 AM because he was released on his own recognizance and had no way to get home and they weren't about to provide him one.

Sunday, was miserable, but he took off with his friends and came back some time Monday--he had not slept; some how we got him to the HMO Psychiatrist who told him that he was sick and needed help, but, since he was of age and had a choice, he refused to take any medications.

He kept up with the loud rock music, playing his stereo at top volume at one end of the house and the TV on MTV at top volume at the other end of the house; if we approached him, he would hold a broom stick he had sharpened at one end as a weapon to ward us off; he was in pretty much complete control and we could do nothing.

He told us that he had destroyed and recreated the entire Universe and that the house had to be purged to hold off the evil; to do this he used the tail of our most unfortunate cat sitting on the chair, and pulled down his tail, rather firmly, to "ground" the house.

In order to make sure that the house was "grounded" from evil forces, he turned off all the power to all the appliances in the house and threw the main circuit breaker; we had cold showers.

We called the Crisis Clinic; they did nothing.

We called the Crisis Clinic; they did nothing.

We called the Crisis Clinic, and they contacted the County Health Department.

Two nice lady social workers came out from the Health Department for an evaluation; our son was uncooperative; he told me to handle them and make them go away; they requested that he turn down the stereo at both ends of the house; he refused; the social workers came away with a determination for an involuntary commit and began to work with us, the mental health community, and the police to take him away the next day--on Thursday.

Fortunately, his mother had stowed away some sleeping pills slipped to her by HMO and convinced him that they would help him (since had not slept since Friday Night), and he finally slept for the first time in days, and so did we.

On Thursday, I took off work and took him to the airport, then to the movies to watch "Jurassic Park", where he thought Jeff Goldblume was the Devil because he wore black; in the evening, the forces were assembled, and off he went to Harborview for a six week stay.

It was a sad day for all of us.

By the end of term at the Fifth Floor Psychiatric Ward, he was convinced enough to take his medicines and make frequent trips to the HMO Psychiatrist and / or consulting nurse.

Our son is brilliant and he was pulling down straight A's from the University.

We thought things were going OK, and he moved out.

We moved 35 miles south to get closer to work.

Things weren't going well.

His meds weren't working, even if he were taking them; he played his rock music at top level in his roommate's apartment, stayed up to all hours, did nothing; finally, his roommate couldn't stand it any more, and had him involuntarily committed.

This lasted three weeks, and then he came to live with us in an apartment.

More trouble, and we called the police and they took him to the State Hospital and we moved again--due to, ironically, three men upstairs from us playing their rock music loudly at all hours.

He returned and lived with us and it was OK for a year or so.

All this time, he was diagnosed as having bipolar disorder.

There was no hint that he had schizophrenia.

Then, a year later, he began to have bizarre behavior--partly because the County Social Worker advised him that it might be OK to experiment with his medications and maybe not even take them.

Bad plan.

His bizarre behavior included, but was not restricted to damaging our property, and going outside and sucking on a stick he found as part of a religious experience he had chosen.

He wasn't sleeping and neither could we.

We called the mental health professionals.

They came and evaluated him, but by that time, he had a small amount of sleep and was almost OK, except that he had convulsions and the paramedics had to come [apparently, there were some withdrawal symptoms].

They went away and said they could do nothing, because he was not a danger or threat to himself or others.

More bizarre behavior--and this time he started to make threats to kill us, and discussed how he might kill each of us.

And this time I got it on tape.

It was 5AM, but a social worker came out and listened to the tape, talked to him, and determined that he was indeed a threat and danger; it took some time, but by 10:30 AM, the police came and hauled him off to the State Hospital for a 90 day stay; he was angry because I had committed him; the police glared at me as being the one who caused all his problems, while the neighbors observed from their windows hidden behind their curtains [as if some of them didn't have the police come for them later].

It was a full three months in the State Hospital before someone there woke up to the fact that he might also have schizophrenia as well as bipolar disease; as a result, they changed the medicines and it made all the difference in the world.

And, as they say, the rest is history.

We all barely survived.

It took over seven years.

Nothing's perfect

Our son is doing quite well today, at least as far as his mental condition is concerned, but does have a number of health problems.

He's brilliant; he's funny; he's sane.

I got my wish: I told him at one point, I want my son back; and we got him back.

This doesn't mean that he's filled with joy and full of life.

These experiences have robbed us all of self-esteem and depleted us physically, mentally, and financially.

People with bipolar disease are given to spending money in their manic mode because they lose all perspective of accountability; they are having a glorious time and in their expansive grandiosity, have no concept of future results of their deeds; therefore, they can pile up impressive credit card debts; in fact, in evaluating whether a person has bipolar disorder, many doctors used to ask if you had significant debt because that is often an effective guide in determining if a person has been going manic.

One of the things that must be watched closely is the sleep cycle; mania produces endorphins that create a better high than most street drugs and people with bipolar disease quickly find that if they don't sleep, they can achieve the manic state; it feels SO GOOD!

And people with a manic episode certainly prefer this state to the terrible gray depression that deprives them of any hope or joy:  They would commit suicide because it feels so bad, but they can't because they are so incapacitated that they can't even get off their bed.

Between 20% and 25% of all people with untreated bipolar disease commit suicide, and 50% of all suicides are the result of clinical depression.

But we have medications that treat these diseases, and they work most of the time for the majority of people, but they have side effects.

The medications can be downright unpleasant.

It isn't so much the dry mouth; it's other things, like not being able to get sleep, liver damage, kidney damage, extreme weight gain, constant shaking like palsy; and, oh, by the way, you will never drink alcohol again if you want to remain stabilized.

Communications

Keeping an effective dialog open between those with mental illness and family and friends is as useful as it is difficult.

People with mental illnesses most often feel that people don't understand them and don't understand what they are going through.

They may be right.

Unfortunately, the mentally ill person probably doesn't know what other people around them are going through and probably don't care, because it's their pain, and darn it, they need help.

Actually, we all need help.

A significant part of that help is knowledge, understanding of the knowledge, and the wisdom to use the knowledge and understanding; and wisdom is related to love.

All parties must make an effort to keep effective communications, but unfortunately, the brunt of the responsibility must lie with the family members who may be as victimized or more victimized by the insanities of the mentally ill family member.

There is a tight rope to walk here:  It is important to listen, and in this, "Seven Habits of Highly Effective People" by Steven Covey might be useful here, particularly in the area of what he calls empathetic listening.

On the other hand, family members must recognize reality from fantasy and be on guard against the fantasies of the patient: A mentally ill person can be quite convincing in his illusions and can really suck you in if you begin to follow their line of reasoning.

It is important to remain objective--and, yes, I know--that may be asking a lot, particularly when you are confused yourself, deprived of sleep, not thinking clearly and without sufficient information to make an informed decision on where to go next.

So life isn't perfect.

But Still

Doing nothing is not really an option.

If you can find the right resources and make the right decisions, there is hope.

There is no quick fix.

But if we continue on the path of a journey to better mental health, things can improve.

We're in this for the long term.

Never give up; never surrender.

You are not alone.