This has nothing to do with mental health (other than the fact that it has been bugging the crap out of me). After the tragic I-35 bridge collapse the news reporters have all been talking about the "EE-mediate" order to review the structural integrity of bridges.
There is no such freakin' word as "EE-mediate"!!! There is a word pronounced "EM-mediate" (immediate). The origins of the word are as follows: the prefix "im" which descends from the Latin prefix "in" -- meaning "not"; and, the Latin word "medius" meaning "in the middle" from which we get such words as "mediate", "Mediterranean" (middle of the world), "median", etc. Thus, the word "immediate" means "not middling" or, to put it into the modern English vernacular, "faster than moderate/without delay".
"EM-mediate" means something. "EE-mediate" means nothing other than the fact that the reporter reading the teleprompted message cannot even pronounce the words written for them correctly.
I call for an ee-mediate change to this.
Thursday, August 9, 2007
One Flew Into the Coo-Coo's Nest
I had the distinct privilege of spending my 40th birthday in a mental ward -- to be more specific a "crisis intervention" center. The Sunday before my wife and I spoke in great detail. For the first time, both she and I came to a true realization of the magnitude of my problems. Suicidal thoughts, or simple thoughts of fleeing, were regular for me. For months I suffered from paralyzing inaction at work and allowed almost every client and matter to stymie. The real prospect of financial ruin, bankruptcy and perhaps even disbarment loomed before me. While my wife had guessed at some of this, the sheer magnitude of it all surprised her. For sometime our relationship had been rocky, even before this revelation. The remaining flex turned brittle and broke. Faced with the magnitude of my problems and likely the end of a thirteen year marriage, I broke as well.
Monday afternoon found me in the facility (at my wife's urging, I might add -- she is not a completely heartless person). Life in the facility is difficult to describe. You find yourself returned to childhood and beyond. Your belt , your watch, your keys, even your money are taken away from you to keep you from presenting a threat to yourself or others. Your clothes are washed for you by an attendant, not as a point of customer service, but again to keep you from harming yourself or others with the washing machine or dryer.
Breakfast, Lunch and Dinner are all at set times -- much earlier than you are used to (dinner was at about 4:20). Not only was the food the typical bland institutional fare but there was only one choice of food with scanty servings -- I lost about 10 pounds while in the facility. However, because the dining room was on a different wing of the unit, the walk to and from each meal constituted the only real excitement for the day. For the remainder of the day I was free to watch television, to read one of a couple dozen dog-eared and decades old books from genres that were wholly unappealing to me, or to sleep. As the adjustment to my medications made me very drowsy, sleeping during the day became a very viable option. There were also board and card games led by the assistants, but I could never bring myself to get involved in these. My only responsibility was to metabolize the medications I had been given. Otherwise, I was free to do nothing -- and as little presented itself to do, doing nothing became amazingly easy.
My fellow denizens were a mixed lot. Several were drug addicts sent to dry out by the various local townships before continuing with their judicial process. I carefully avoided any mention of my profession to avoid the incessant requests for free legal advice that necessarily follow. Others were individuals such as myself, professionals and working individuals who needed to have a 'time out' and a readjustment of medications including a self-employed plumber, a business man, and a carpenter. I tended to spend time with these folks. Then there were the truly ill -- those being held until a court order requiring them to submit to long term treatment at the state's mental health facility could be obtained.
The truly ill presented the most uncomfortable aspect of the stay for me. Not because I ever felt endangered by them, but because part of my work as an attorney had been to work the very docket that they would appear on. The town where I reside has the largest mental health facility in the state, and attorneys in this town on a fairly regular basis are called upon to represent the severely mentally ill as they went through the process. Now I found myself on the other side of that system. Thankfully, as I came into the facility voluntarily it did not become necessary for me to appear as an inmate of the asylum before the judge that I had argued many cases before, represented by an attorney who knew me.
As for the conduct of the truly ill, it was mostly benign. One lady kept trying to pull down her pants and would regularly walk around the unit doing the 'tomahawk chop'. One older gentleman seemed fairly lucid until he began to tell you about the scar between his shoulder blades where his ancient ancestors cut off his wings. Another younger gentleman walked around the ward, regularly stating in a loud voice the first three or four "steps" of the twelve step program of Alcoholics Anonymous. The drug addicts would often sit in corners, trading information on the best and most undetectable means of cooking meth or passing drug screens. Me and my cohorts generally spent the day watching daytime television and/or watching one of the five DVDs available to us (I saw entire showings and scenes of "Napoleon Dynamite" and "Gone in 60 Seconds" more times than any human being should be subjected to over the course of one week).
The treatment I received itself was, in fact, pretty good. An RN there was the first person ever to ask if in addition to suicidal thoughts if I had ever developed a plan -- to which I honestly had to answer "yes". Why had I not acted on it? Well the ultimate conclusion that I came to mirrored that of Hamlet in the famous "To be, or not to be" soliloquy -- "And thus does conscious make cowards of us all." Weeks before I had even begun memorizing it as a mantra to keep myself from "tak[ing] up arms against a sea of troubles, and by opposing them end[ing] them."
During my stay my condition was stabilized and my medications were adjusted. In addition I received a much needed "time out" from the 'slings and arrows of outrageous fortune' as good ol' Willie put it. I felt ready by Friday of my stay to return home. First I would need to pass the shrink test.
Forever I have used humor, especially self-deprecating humor, in everyday conversation. It is part of my nature. So, when the shrink asked about what I thought of my stay I told him that, having turned 40 in a mental ward, that I'd been cheated out of my rightful mid-life crisis -- I should be chasing blondes with big boobs and driving gaudy sports cars. The shrink, of course, felt that I might be getting a little bit manic and ordered that I stay the weekend for further observation. (Note: I really did say that to the shrink and he really did make me stay an extra 2.5 days as a result. Shrinks have NO sense of humor.)
I do not think that it will be necessary for me to ever return to such a facility, but it holds less fear for me now than it did before. I would just be sure to bring several books with me that I would like to read.
Oh, and I wouldn't crack any jokes around the shrink, either.
Monday afternoon found me in the facility (at my wife's urging, I might add -- she is not a completely heartless person). Life in the facility is difficult to describe. You find yourself returned to childhood and beyond. Your belt , your watch, your keys, even your money are taken away from you to keep you from presenting a threat to yourself or others. Your clothes are washed for you by an attendant, not as a point of customer service, but again to keep you from harming yourself or others with the washing machine or dryer.
Breakfast, Lunch and Dinner are all at set times -- much earlier than you are used to (dinner was at about 4:20). Not only was the food the typical bland institutional fare but there was only one choice of food with scanty servings -- I lost about 10 pounds while in the facility. However, because the dining room was on a different wing of the unit, the walk to and from each meal constituted the only real excitement for the day. For the remainder of the day I was free to watch television, to read one of a couple dozen dog-eared and decades old books from genres that were wholly unappealing to me, or to sleep. As the adjustment to my medications made me very drowsy, sleeping during the day became a very viable option. There were also board and card games led by the assistants, but I could never bring myself to get involved in these. My only responsibility was to metabolize the medications I had been given. Otherwise, I was free to do nothing -- and as little presented itself to do, doing nothing became amazingly easy.
My fellow denizens were a mixed lot. Several were drug addicts sent to dry out by the various local townships before continuing with their judicial process. I carefully avoided any mention of my profession to avoid the incessant requests for free legal advice that necessarily follow. Others were individuals such as myself, professionals and working individuals who needed to have a 'time out' and a readjustment of medications including a self-employed plumber, a business man, and a carpenter. I tended to spend time with these folks. Then there were the truly ill -- those being held until a court order requiring them to submit to long term treatment at the state's mental health facility could be obtained.
The truly ill presented the most uncomfortable aspect of the stay for me. Not because I ever felt endangered by them, but because part of my work as an attorney had been to work the very docket that they would appear on. The town where I reside has the largest mental health facility in the state, and attorneys in this town on a fairly regular basis are called upon to represent the severely mentally ill as they went through the process. Now I found myself on the other side of that system. Thankfully, as I came into the facility voluntarily it did not become necessary for me to appear as an inmate of the asylum before the judge that I had argued many cases before, represented by an attorney who knew me.
As for the conduct of the truly ill, it was mostly benign. One lady kept trying to pull down her pants and would regularly walk around the unit doing the 'tomahawk chop'. One older gentleman seemed fairly lucid until he began to tell you about the scar between his shoulder blades where his ancient ancestors cut off his wings. Another younger gentleman walked around the ward, regularly stating in a loud voice the first three or four "steps" of the twelve step program of Alcoholics Anonymous. The drug addicts would often sit in corners, trading information on the best and most undetectable means of cooking meth or passing drug screens. Me and my cohorts generally spent the day watching daytime television and/or watching one of the five DVDs available to us (I saw entire showings and scenes of "Napoleon Dynamite" and "Gone in 60 Seconds" more times than any human being should be subjected to over the course of one week).
The treatment I received itself was, in fact, pretty good. An RN there was the first person ever to ask if in addition to suicidal thoughts if I had ever developed a plan -- to which I honestly had to answer "yes". Why had I not acted on it? Well the ultimate conclusion that I came to mirrored that of Hamlet in the famous "To be, or not to be" soliloquy -- "And thus does conscious make cowards of us all." Weeks before I had even begun memorizing it as a mantra to keep myself from "tak[ing] up arms against a sea of troubles, and by opposing them end[ing] them."
During my stay my condition was stabilized and my medications were adjusted. In addition I received a much needed "time out" from the 'slings and arrows of outrageous fortune' as good ol' Willie put it. I felt ready by Friday of my stay to return home. First I would need to pass the shrink test.
Forever I have used humor, especially self-deprecating humor, in everyday conversation. It is part of my nature. So, when the shrink asked about what I thought of my stay I told him that, having turned 40 in a mental ward, that I'd been cheated out of my rightful mid-life crisis -- I should be chasing blondes with big boobs and driving gaudy sports cars. The shrink, of course, felt that I might be getting a little bit manic and ordered that I stay the weekend for further observation. (Note: I really did say that to the shrink and he really did make me stay an extra 2.5 days as a result. Shrinks have NO sense of humor.)
I do not think that it will be necessary for me to ever return to such a facility, but it holds less fear for me now than it did before. I would just be sure to bring several books with me that I would like to read.
Oh, and I wouldn't crack any jokes around the shrink, either.
Tuesday, August 7, 2007
To Boldly Split Infinitives and Self-Observe Like I've Never Done Before
The distinction between mental illness and mental health is not a bright-line distinction. On one end of the spectrum are the "healthy" and on the other are the clearly ill, those experiencing hallucinations or who simply cannot function at even the most basic level. Between the extremes are the depressed, the bi-polar, the ADHD, the high-functioning Autistic.
To the extent that it is clear that their actions stem from their mental illness, those who are very ill are excused to an extent by society. Problems arise, however, when unraveling the actions of the less ill.
Certainly there are many among the mentally 'healthy' who make fools of themselves. The question arises then, whether the foolish actions of the marginally ill, such as a bi-polar person, stem from a manic episode or from the unfiltered poor judgment of the person. Is the depressed person merely lazy, or has that person's condition made it impossible to carry on? Even the affected person can find the question difficult to answer.
Looking back, I can see decisions made during my life that I feel were definitely made under a manic influence. Decisions made that I knew at the time to be completely out of character with my basic nature, but with which I felt compelled to proceed. Others foolish mistakes are more difficult to quantify. I cannot say definitively whether they were made under a manic influence, under my own poor judgment, or some combination of the two.
Of course, suffering from bi-polar, the opposite is true as well. There have been times where I have been paralyzed with inaction that I am quite sure have been linked to depressive episodes. But there also have been those times when I cannot say definitively that depression played a major role, or any role in my inaction. Even the most 'healthy' person can need a break or even just be lazy.
I know of no magical key that will allow me to open this mystery. Nonetheless, much of my life seems to rest on making this determination. If I cannot recognize and take active measures against a manic episode, how can I take the appropriate actions to minimize its influences? Likewise, if I cannot recognize in myself the depressive cycle, how can I expect myself to seek the required help? It is not logical for me to trust in the observation of others. My wife of 13 years could not truly detect these shifts. Apparently, within me is the ability to cover up and lie to one and all, including myself, when these episodes strike. I have hope that the modifications to my medication have taken sufficient hold that the extremes do not manifest themselves often or at all. But, can I be sure?
That is the Gordian Knot, the $60,000 question, the continuing hero's quest of self-realization -- whether I train myself to be sufficiently self-observant and disciplined to recognize and correct irrational mood swings. The answer to this question will determine whether the rest of my life will fulfill the promise behind this Blog, or whether my life will result in a smoking ruin.
To the extent that it is clear that their actions stem from their mental illness, those who are very ill are excused to an extent by society. Problems arise, however, when unraveling the actions of the less ill.
Certainly there are many among the mentally 'healthy' who make fools of themselves. The question arises then, whether the foolish actions of the marginally ill, such as a bi-polar person, stem from a manic episode or from the unfiltered poor judgment of the person. Is the depressed person merely lazy, or has that person's condition made it impossible to carry on? Even the affected person can find the question difficult to answer.
Looking back, I can see decisions made during my life that I feel were definitely made under a manic influence. Decisions made that I knew at the time to be completely out of character with my basic nature, but with which I felt compelled to proceed. Others foolish mistakes are more difficult to quantify. I cannot say definitively whether they were made under a manic influence, under my own poor judgment, or some combination of the two.
Of course, suffering from bi-polar, the opposite is true as well. There have been times where I have been paralyzed with inaction that I am quite sure have been linked to depressive episodes. But there also have been those times when I cannot say definitively that depression played a major role, or any role in my inaction. Even the most 'healthy' person can need a break or even just be lazy.
I know of no magical key that will allow me to open this mystery. Nonetheless, much of my life seems to rest on making this determination. If I cannot recognize and take active measures against a manic episode, how can I take the appropriate actions to minimize its influences? Likewise, if I cannot recognize in myself the depressive cycle, how can I expect myself to seek the required help? It is not logical for me to trust in the observation of others. My wife of 13 years could not truly detect these shifts. Apparently, within me is the ability to cover up and lie to one and all, including myself, when these episodes strike. I have hope that the modifications to my medication have taken sufficient hold that the extremes do not manifest themselves often or at all. But, can I be sure?
That is the Gordian Knot, the $60,000 question, the continuing hero's quest of self-realization -- whether I train myself to be sufficiently self-observant and disciplined to recognize and correct irrational mood swings. The answer to this question will determine whether the rest of my life will fulfill the promise behind this Blog, or whether my life will result in a smoking ruin.
Monday, August 6, 2007
The Rational Insane
Insane. The word itself, literally, means one who is not sane -- implying that the person's basic mental processes have been compromised. Conventional thought is that an insane person is a person of lesser mental ability. This fact is self evident when observing the paranoid-schizophrenic skulking from place to place attempting to avoid the CIA, the delusional man walking down the street talking to his 'invisible' friend, or the lady who shrieks in terror and attempts to flee the non-existent monster. Society labels these actions as irrational and the person suffering from them to be insane.
The question is, how irrational are the actions of the 'insane'? If the CIA were actually chasing you, intent on doing you harm, would it not be logical -- necessary even -- to go into hiding in order to avoid this terrible fate? How irrational is it to talk to your friend as you walk down the street? Especially in an age of technology that produces many people who are similarly walking down the street talking to their friend via cell phone. If a great, blood-thirsty fiend were attacking you, would not the logical and rational response be to shriek in terror and attempt to flee? Apparently the producers of any number of horror movies think this is so.
The 'insane' person often is not compromised in the basic ability to rationally think. Rather, the insane person often suffers from some form of hallucination. The brain receives visual, auditory, or even tactile information that does not conform with the reality of the situation. Having this faulty information, the 'insane' person then goes on to make rational decisions based upon the sensory input received.
The brain is an amazing organ. As the 'seat of reason' it can maintain all of the complex functions of the body and, at the same time, provide for object recognition, language, creative thought, etc. But, like any other organ, it is susceptible to chemical imbalances and manipulations. An otherwise 'sane' person can experience hallucinations by altering the chemistry of the brain with substances such as LSD. Others choose to override the brain's current, logical level of pleasure-producing chemicals through the use of substances such as alcohol, cocaine, marijuana and methamphetamines. While under the influence of these substances it is not uncommon for an individual to engage in poor actions.
Society has a tendency to tolerate, or even forgive, the actions of a person under the voluntary influence of mind-altering substances. He or she was only "high" or "drunk" -- it is not like they were crazy. Should not the inverse be true? The 'insane' person has made no choice to have a brain with altered chemistry, whereas the sane person under the influence of voluntarily taken chemicals has made the conscious choice to have an altered brain chemistry.
Society has misplaced its priorities. More effort should be made to rehabilitate the insane person, who is arguably an otherwise rational person suffering from incorrect sensory inputs, and less effort in rehabilitation of individuals who have proven their intent to consciously and voluntarily alter their brain chemistry in an attempt to flee the very reality that the insane person longs to find.
The question is, how irrational are the actions of the 'insane'? If the CIA were actually chasing you, intent on doing you harm, would it not be logical -- necessary even -- to go into hiding in order to avoid this terrible fate? How irrational is it to talk to your friend as you walk down the street? Especially in an age of technology that produces many people who are similarly walking down the street talking to their friend via cell phone. If a great, blood-thirsty fiend were attacking you, would not the logical and rational response be to shriek in terror and attempt to flee? Apparently the producers of any number of horror movies think this is so.
The 'insane' person often is not compromised in the basic ability to rationally think. Rather, the insane person often suffers from some form of hallucination. The brain receives visual, auditory, or even tactile information that does not conform with the reality of the situation. Having this faulty information, the 'insane' person then goes on to make rational decisions based upon the sensory input received.
The brain is an amazing organ. As the 'seat of reason' it can maintain all of the complex functions of the body and, at the same time, provide for object recognition, language, creative thought, etc. But, like any other organ, it is susceptible to chemical imbalances and manipulations. An otherwise 'sane' person can experience hallucinations by altering the chemistry of the brain with substances such as LSD. Others choose to override the brain's current, logical level of pleasure-producing chemicals through the use of substances such as alcohol, cocaine, marijuana and methamphetamines. While under the influence of these substances it is not uncommon for an individual to engage in poor actions.
Society has a tendency to tolerate, or even forgive, the actions of a person under the voluntary influence of mind-altering substances. He or she was only "high" or "drunk" -- it is not like they were crazy. Should not the inverse be true? The 'insane' person has made no choice to have a brain with altered chemistry, whereas the sane person under the influence of voluntarily taken chemicals has made the conscious choice to have an altered brain chemistry.
Society has misplaced its priorities. More effort should be made to rehabilitate the insane person, who is arguably an otherwise rational person suffering from incorrect sensory inputs, and less effort in rehabilitation of individuals who have proven their intent to consciously and voluntarily alter their brain chemistry in an attempt to flee the very reality that the insane person longs to find.
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