Pro-psychiatry vs. anti-psychiatry
A couple days ago George Ebert posted a message on this site:
I am confused. Are you about mental illness or mental wellness? You sure do seem to worship psychiatry. I don’t. Psychiatrists diagnosed me, incarcerated me, secluded me, drugged me and shocked me. Psychiatrists dehumanized and disabled me and stigmatized me as mentally ill.
You, however, seem to have found comfort in their industry, labels and treatments. Me, I am targeted as a notorious non-compliant paranoid schizophrenic. Take the cure! Goggle me, or check out recoveryisreal.org.
I’m familiar, of course, with the psychiatric survivor movement, and though some people object to the use of the term “survivor” in such a context, I don’t. People have suffered through horrible abuses in the name of psychiatry, most often in an institutional setting. I am adamantly opposed to forced ECT and the use of restraints, two issues I know are important to the survivor movement. I am always saddened to hear the stories of people who were kept in psych hospitals for months against their will. I think the poor and disadvantaged are absolutely more subject to such abuses, and I’m disgusted by the disregard of such people by the callousness of the health and judicial systems.
All that being said, in my career both as a psychiatric patient—including ECT, hospitalizations, inappropriately administered meds, etc.—and as a journalist, I have found that true wellness for severely mentally ill people almost always involves competent psychiatric treatment. This statement is not referring, obviously, to people who were misdiagnosed, and were called “mentally ill” when in fact they had no illness. I’m saying that for those who legitimately have the illnesses, superb psychiatric practice can be the first step on the road to recovery.
Some people characterize themselves as “anti-psychiatry.” That seems stubbornly reductionist to me. It’d be like saying you’re “anti-opthomology.” Psychiatry is a field of medicine, and as such it can be practiced well or practiced badly. I might not like my eye doctor, for instance, but I’m not going to give up on glasses. Instead I’m going to change eye doctors. There’s no need to tar the entire field with the same brush.
It would be ridiculous to “worship” any field of medicine. It’s not a question of emotion. I take pragmatic advantage of the medical services available to me—in every context. I treat my asthma the same way I treat my psychiatric illness: When I have a problem, I address it with a trained professional. I haven’t been schooled in how to treat lung disease, so I rely on my doctor. If my medication is causing unacceptable side effects (my old inhaler gave me oral thrush), I go for a medical consultation and we adjust the treatment. I approach psychiatry in exactly the same way.
In my experience—and I’ve only been doing the journalism thing for seven years, so I still have a lot to learn—I have literally never met a person with schizophrenia or bipolar disorder who was able to be medication-free for a lifetime and still maintain the kind of life that worked for them and for others. I have seen many people who were medication-free but still plagued by demons, or at least compromised in some way by the illness. This isn’t to say there’s no other way. It’s to say that’s been my experience as a journalist, patient, friend and family member.
As for labels, I happily embrace mine because it allowed me to get better. How many times was I told by psychiatrists I was just neurotic or anxious? It wasn’t until I was given a diagnosis—a label—that I was able to get the help I needed. The label also opened up a world of consumer support to me. I was able to access listserves and websites written by other people with my symptoms. I still rely on the great supportive network across the country, and am consistently amazed by the generosity in the consumer movement.
That’s all for now. These are some of my beliefs, and maybe they’ll alienate some of you. I hope not because I think this dialogue is important. Let’s keep the lines of communication open, and talk to each other with respect and sympathy. Harsh words do nothing to clarify things.
liz | 12:45 PM | Uncategorized
Blogorama: Monday, June 26, 2006
It’s pouring here, but I couldn’t find an umbrella this morning. There’s an umbrella hook in the closet, but it was sadly naked. I stared at it for a few minutes, waiting for an umbrella to materialize, but nothing happened. So I walked to the trolley with my laptop stuffed underneath my shirt. I’ve rarely been so intimate with my computer.
I noticed other people with capacious umbrellas at the bus stop and was jealous. One in particular was a cute clear plastic dome with blue piping. It was very quirky-Holly Golightly. When I got to the train station I bought the “jumbo New York” umbrella, which I guess pays tribute to those enormous doorman umbrellas people always marvel at. This one was so jumbo, I could’ve fit several hobbits under there with me and we’d have plenty of room. I’m never losing this umbrella. (Famous last words.)
Over the weekend many of you sent in links to other mental-health-type blogs. I appreciate that. I’m going through them slowly, only because I want to point you in the right direction. Here are two (courtesy Sachin) that I like. More to come!
Shrinkette: A psychiatrist in the Pacific Northwest nicely straddles the balance between not giving medical advice online and providing information you’d like to know.
Psychiatry, Medicine, Philosophy, Poetry, Music: Wide-ranging notes by a psychiatrist who’s unafraid to use medical jargon. Good conversation about ECT on there right now.
liz | 11:26 AM | Uncategorized
Doctor’s appt.
Well, I’m off to see my GP now to talk more about my night sweats, my fatigue, and some other less palatable symptoms. The chances are that all my complaints can be explained by the Effexor, but in a weird way I’m hoping there’s something physically wrong so I don’t have to stop taking the drug. Last night I dreamt I gained 300 pounds from it, so obviously the anxiety is percolating.
After the doctor I’m off to Long Beach Island for a birthday weekend, so I’ll be in transit and won’t be blogging. I’ll miss you all, but I need the break. So I’ll see you all on Monday!
liz | 10:46 AM | Uncategorized
Celebrity revelation: Katherine McPhee
I confess I didn’t find this link myself; my co-worker at PW, Daniel McQuade did. The reason for that is that I haven’t watched American Idol more than once, which I know makes me a freak in this culture, and I don’t in fact know who Katherine McPhee is. I gather she’s quite popular, though.
McPhee shared her “secret struggle” with People magazine. At her worst, McPhee was purging seven times a day, which is like “taking a sledgehammer to your vocal chords,” she says. McPhee’s experience should be a lesson for young girls who thinking purging will make them lose weight. At the height of her illness, McPhee weighed 160 pounds. After participating in a three-month eating disorder program, she’s now free of the bulimia, and she weighs 135 pounds. You hear that, girls? It’s not going to work.
Anyway, McPhee’s revelation will certainly help shed light on the issue, if this CNN article is any indicator. On the other hand, since her coming out, as it were, McPhee has canceled a slew of interviews and appearances, presumably because she doesn’t want to talk about it. Maybe she regrets being so candid.
McPhee one of millions with bulimia
liz | 10:49 AM | Uncategorized
Blogorama: Thursday, June 22, 2006
For a while there I thought I was posting into the ether; I couldn’t find many mental health blogs other than Furious Seasons, by fellow alt-weekly journalist Philip Dawdy.
But lately I’ve become aware of some others that you might want to know about. I mean, if you find my blather interesting, you might find theirs appealing as well. The problem is that I can’t tell who’s really good at this stuff without spending all my time reading, and I do have a day job. Sometimes I’ll be reading a blog that I think is clever and compelling, and then I’ll notice some weird flag saying “Zionist Extremism Is My Bag” or a link to a site for Republican Jehovah’s Witness bumper stickers, and I have to quickly click away.
Below are a few that I think are worth checking in with, though I’m not endorsing anything specifically because that seems to get journalists in trouble. I’ll try to do this every few days. If you know of a blog related to mental health (or write one) that you’d like featured here, let me know.
Dr. Deborah Serani: Blog by a psychologist who specializes in trauma and depression. Breezy and very informational.
Treatment Online’s Anxiety, Addiction and Depression Treatments: This is extremely newsy and filled with good links. The “about” section says some of the writers for the blog are pharmaceutical salespeople, which makes me nervous—perhaps unfairly. Either way, the site is a remarkable motherlode of info.
Spanglemonkey: First person diary by a person with mental illness. If your interested in first-person accounts of dealing with the illness with family members, there’s some good stuff.
Dr. Helen: Blog by a forensic psychologist in Knoxville, Tenn. Right now there’s a handy guide to Borderline Personality Disorder posted, which might be helpful to those dealing with friends or relatives with BPD. That’s always tricky.
liz | 4:12 PM | Uncategorized
Celebrity revelation: Eminem!
So that’s why Marshall Mathers has been so quiet: He’s been depressed. His best friend was shot in the head (which could bring anyone down), and he divorced his wife, Kim, for a second time. (Which, BTW, is just another example of why the institution of marriage is kind of ridiculous.)
The resulting depression sent Em indoors and caused him to gain weight (sound familiar?). But now that he’s taking antidepressants (allegedly; his PR person is denying he’s taking them. Why?), he’s feeling better, and is set to star in a movie-type thing that’ll surely be violent and silly.
But it’s nice to have him back. Apart from the homophobia (no small thing), I have a little bit of a weakness for Eminem’s music. I think he’s kind of talented, and come to think of it, not really that much more homophobic than all the other rappers out there. Lovely!
Eminem ‘recovering from depression
liz | 2:14 PM | Uncategorized
Speaking of photos…
A couple weeks ago PW’s staff photographer Jeff Fusco went to the site called Byberry in Northeast Philadelphia. It’s a collection of crumbling buildings that were once a state hospital for the insane. It was, according to the horror stories, a real snake pit—the kind of place that made deinstitutionalization necessary.
Urban spelunkers have long been sneaking into Byberry’s haunting buildings, as have ghost watchers, who insist the spirits of the dead remain there. I once wrote an article about it, asking people in the area to write to me with their Byberry stories. I got letters and emails that told of abuse but no one wanted their names used. All these years after it was closed, people are still afraid to talk about it. So I never wrote an article.
Now they’re going to turn the site into an office park. It’s a huge project, and a bit of a tragedy for those who want to preserve the decaying beauty of the buildings. For a sense of what it’s like inside, go here: Some of the images are beautiful.
For a sense of the exterior, I’m trying to upload some of Jeff Fusco’s amazing photos, but they’re too big. Meanwhile, this is my last call for stories about Byberry. Please do write if you’ve got something to say about it. And if anyone can get me in there, I’d love to go.
liz | 11:22 AM | Uncategorized
Loss of perspective, part II
Today there’s an article in the Metro, a daily newspaper in Philadelphia, about this blog. The guy who wrote the piece, Josh Cornfield, was very nice and professional. I enjoyed talking to him even though I knew I was being less articulate than I wanted to be because I was distracted. Vince was waiting for me in the car outside, and I felt like I had to speak very quickly. I figured, “Well, maybe Josh isn’t a fast typist, in which case maybe he’ll only get a few things I’m saying.” I assumed the piece would be very tiny. (What I learned today is that Josh is indeed a very fast typist.)
Then he asked if a Metro photographer could come take my photo—while Vince waited in the car some more. (Vince had to be nice about it because it was my birthday, and on my birthday he has to be in a good mood no matter what.) I was wearing an unflattering bra, my hair was frizzed out, I had no makeup on and I was bloated from snack foods consumed during my computer training. I said, “Well, I’m kind of having a bad hair day,” but I knew I’d have to get the photo taken. I’m a journalist. I know how the game is played. I hoped it would run as small as a postage stamp.
Instead the photo is 3 1/2 by 7. It’s huge. I’m facing away from the camera, making my chin lose all definition. My arms bulge like sausages against the photo’s frame. My boobs are a shelf. My hair looks like it was cut by a blind man. It looks better online, but the printed version, which is cropped against those arms, is washed out and ill-defined. If I were photographer Rikard Larma, I’d be frustrated by how my shots looked on newsprint.
I asked a co-worker if that’s what I look like. He said I looked fat in the photo but that I don’t look like that in real life. Well, at least someone knows the truth. I feel badly to learn how shallow I am. Why should I care what the photo looks like? But I look at it and I think, “Who’s going to go to that blog? The blog of Sausage Arms?”
Yesterday I was able to contextualize to make myself feel better. But today I’m kind of worried, from a medication standpoint. If it’s the Effexor that’s causing this weight gain, what will I do? Is it a side effect I can live with? It seems incredibly depressing to me to be overweight, but not clinically depressing. Effexor brought me back from an abyss that I simply can’t afford to slip into again. And I’m willing to deal with its side effects, whether loss of libido or night sweats. But am I going to be fat? I’m not sure I can handle that.
Many people who take psychotropic meds complain about weight gain. And many prescribing doctors deride their concerns. But what could be more essentially important than one’s appearance? When the meds are working, we forget how horrible it was to be without them, and problems like weight gain come to the foreground.
I’ll never again say, “What’s 10 or 20 pounds if you stop hallucinating?” It’s not always an acceptable tradeoff.
Blog’s aim: Break down stigma of mental illness
liz | 10:34 AM | Uncategorized
I was out
Thanks to everyone who sent me birthday wishes, and sorry I didn’t get back to you. I’ve been out all day at a software training, which is pretty much how everyone wants to spend a birthday, I know. I apologize for the lack of post-age, but I’ll be back full-force tomorrow.
liz | 5:58 PM | Uncategorized
Birthday reflections
Today is my birthday (I’m 18!), and aside from getting to joke around about my real age (I’m 22!), which I won’t disclose here (but is closer, say, to 30 ((ahem))), I also get to indulge in some mildly self-pitying reflection, which I generally eschew. (Self-reflection is de riguer, of course; it’s the self-pity I try to avoid.)
Last night I dreamt that PW’s old art director, Jeff, had long ago had a romantic relationship with my boyfriend, Vince. They’d lived together back in the ’80s or ’90s, but then Vince realized he wasn’t gay, so they split up.
But then they saw each other again, and spent time together, and Vince realized he was indeed gay, and would be moving back in with Jeff. Because I like Jeff so much, and because I’m very pro-gay, I felt I wasn’t allowed to have any of the emotions I might have had if Vince simply ran off with another woman. No, in this case I had to be generous and loving about it, and feel happy for Vince that he was finally discovering who he truly was. I thought about the great opportunity I’d be afforded for activism. I could write an article called “My Boyfriend Left Me Because He’s Gay—and I Support Him Completely!”
But despite my P.C. beliefs, I was devastated. Jeff understood how hard it was for me, and he took me into his house, where a friend fed me juniper berries to make me feel better. They comforted me, but I couldn’t stop crying. “I know it’s good that he’s gay and finally coming to terms with that,” I wailed verbosely. “But I’ll miss him!” And this would prompt an explosion of tears and the frantic consumption of more berries.
When I woke this morning my face was covered with tears and I was actually crying. Of course, in the light of the morning, the dream seemed ridiculous, and yet I still felt sad. And when I wake up crying, which is at least once a week, I can’t shake the sadness. It lingers for the rest of the day.
To make things worse, I did something a woman should never do on her birthday: I tried on a pair of pants to see if they still fit. Clearly, I was possessed by a demon at that moment. They were pants I don’t even want to wear till the fall, but I thought, “I feel like I’m gaining weight. Is it possible I’m not? I’ll try these tiny H&M pants to see.” Naturally, they didn’t fit. I pulled and scrunched until my eyeballs were ready to pop, and still no progress. Finally, I threw them on the floor and put on a different pair of H&M pants—linen ones, and we all know how forgiving linen is.
Between the dream and the pants I was ready to slit my throat, and it wasn’t even 9 a.m. I binged on peanut butter, straight from the jar, and gloomily read about the gloomy world in Newsweek and Time, thinking, “Dear God, I hope no one ever bans anonymous sources altogether. These magazines would have to fold.” This also bummed me out, unaccountably, as did a rotten blueberry I mistakenly ate.
To give myself some perspective on life, I did what I always do when I’m feeling down: contextualize. My pain isn’t any greater than anyone else’s, I thought. I’m lucky, and here’s why:
•I’m not on a German U-boat like the guys in Das Boot, a movie I watched last night.
•I’m not epileptic, as is a character in David B.’s graphic novel Epileptic, which I’m reading right now.
•I don’t have tardive dyskenisia, like the guy on the trolley I sometimes see whose head jerks uncontrollably.
•I’m not a soldier in Iraq, like the guy who wrote The Last True Story I’ll Ever Tell, which I recently read.
•I’m not Joan Didion, who in the last year lost both her husband and her daughter, and whose exquisitely rendered Year of Magical Thinking would make anyone think twice about self-pity.
•I’m not Britney Spears.
•I’m not in a psych hospital, homeless, drug addicted or grievously ill.
•I’m not in the ward they call “the Hood” in a Philadelphia hospital, which if you read PW’s cover story by Steven Wells, is like waking up on the wrong side of the bed in Jacob’s Ladder.
All true, yet not quite enough, believe it or not, to mitigate the pants incident. So I looked into the sugar glider cage to catch a glimpse of the babies that have just emerged from their mother’s pouch. They’re each the size of an index finger, maybe smaller, and they can’t open their eyes yet. They were squirming over each other, and grooming themselves, which I found somewhat amazing. They have no sense of the outside world, but their instinct tells them to keep clean, which I’m sure is to keep them healthy. I stared at them for a long time, and then one of them yawned, which was so cute, I had to do some deep breathing.
And that gave me some perspective. These two little lives—they know nothing of pants that don’t fit or journalists who rely too heavily on anonymous sources. They only know the essentials: breathing, health, fatigue, hunger, warmth. And I’m breathing. And I’m healthy—or at least well medicated. And I have a soft bed and a roof over my head and more food than I need (hence the pants) and even central air and heat.
For those things, I’m grateful. And aren’t those the things that really matter? The rest is gravy. (Preferably gravy on a cheesesteak.)
[My dad took this photo of me many years ago. I'm grateful that—except for the fact that I cut my hair more fashionably now—I look pretty much the same, even at 26! Tee hee.]
liz | 10:29 AM | Uncategorized
