My New Hero: Glenn Close

Not because she’s a phenomenal actor, which she is, but because she’s just initiated a new project to banish stigma. The project is highly personal, as she explains on Huffington Post:

As I’ve written and spoken about before, my sister suffers from a bipolar disorder and my nephew from schizoaffective disorder. There has, in fact, been a lot of depression and alcoholism in my family and, traditionally, no one ever spoke about it. It just wasn’t done. The stigma is toxic. And, like millions of others who live with mental illness in their families, I’ve seen what they endure: the struggle of just getting through the day, and the hurt caused every time someone casually describes someone as “crazy,” “nuts,” or “psycho”.

What’s remarkable is not her frankness about this personal history, but her motivation to act, which seems almost like a wholesale rethinking of her career and what it’s meant in popular culture. In Fatal Attraction, for example, she played a woman obsessed with Michael Douglas (those were the days, right Michael?). She loses control of the obsession and becomes terrifying. As Close writes, the movie was a great success, and audiences loved to hate her character.

Alex Forrest is considered by most people to be evil incarnate. People still come up to me saying how much she terrified them. Yet in my research into her behavior, I only ended up empathizing with her. She was a human being in great psychological pain who definitely needed meds. I consulted with several psychiatrists to better understand the “whys” of what she did and learned that she was far more dangerous to herself than to others.

The original ending of Fatal Attraction actually had Alex commit suicide. But that didn’t “test” well. Alex had terrified the audiences and they wanted her punished for it. A tortured and self-destructive Alex was too upsetting. She had to be blown away.

So, we went back and shot the now famous bathroom scene. A knife was put into Alex’s hand, making her a dangerous psychopath. When the wife shot her in self-defense, the audience was given catharsis through bloodshed — Alex’s blood. And everyone felt safe again.

The ending worked. It was thrilling and the movie was a big hit. But it sent a misleading message about the reality of mental illness.

This is a bold admission from a woman who derived so much success from this role, but there’s no escaping what she says. It has long bothered me — and, I suspect, other advocates — that the message there is one of terror and fear.

Not only does Close take on her role in that film, she assesses the entertainment industry as a whole:

Whether it is Norman Bates in Psycho, Jack Torrance in The Shining, or Kathy Bates’ portrayal of Annie Wilkes in Misery, scriptwriters invariably tell us that the mentally ill are dangerous threats who must be contained, if not destroyed. It makes for thrilling entertainment.

There are some notable exceptions, of course — Dustin Hoffman in Rainman, or Russell Crowe’s portrayal of John Nash in A Beautiful Mind. But more often than not, the movie or TV version of someone suffering from a mental disorder is a sociopath who must be stopped.

I like to think that her speaking out will change this. As she so eloquently says, silence is the problem. Read more of her elegant prose here. It is well worth it. There you’ll find links to the initiative she’s promoting.

Thank you, Glenn, for speaking out against silence. You rock.

liz | 10:30 AM | SCHIZOPHRENIA, bipolar disorder, celebrities, depression, media, meds

A Message to Patrick Kennedy

First of all:

Ted Kennedy’s Health Care Legacy

The Cause of Ted Kennedy’s Life

Patrick, my condolences on your father’s passing. When your dad’s brothers died, he had to get himself together and stop being an irresponsible, drunken frat boy. He had to become a leader who espoused what they did: social justice, pacifism, equal rights, etc. You have a head start: You made mental health parity happen, and you’ve been engaged in fighting the good fight since the beginning. You’re my hero.

But I also know you’re flawed and troubled, like your dad was, like we all are. The politicians who pretend to be saints tend to fail us, so you just go on being imperfect. And if you need support in your time of grief, just think of us out here, rooting for you to do well. We support you because you’re our voice now. And because we know what it’s like to live with loss. We believe in you. Carry on.

liz | 3:19 PM | bipolar disorder, celebrities, depression

Liveblogging Primetime Outsiders

All the below is about this show.

Madigan: They didn’t flatter you with that lighting.

David Oaks: You’re looking so handsome! I had no idea. Your eyebrows are very sexy. (I’m completely sincere.)

“But critics worry …” That’s journalism-speak for “We don’t have any specific sources who say this, but we’ll generalize it so we have reason to focus on …”

… violence. That’s what they’re focusing on. Why am I not surprised?

So of all the things they could talk about related to Mad Pride — and related to mental health — this is what they’ve come up with: criminals and violent crime. Ugh. TV is so predictable and depressing.

Okay, so now we’re telling the story of a kid with hallucinations and delusions (the CIA, yadda yadda) who KILLS HIS MOTHER? Does the average American viewer understand how fucking rare this kind of thing is? That it’s not the necessary result of deciding not to take meds?

On to the withdrawal story: Clearly, the program wasn’t looking for a success story. This poor woman who decided to do the show so they could feed off her misery — I knew that’s what they wanted. Is she doing the withdrawal in conjunction with a doctor? Who the hell knows? The show doesn’t tell you. It hardly tells you her name. And …

Oh! There it is again: “Critics worry … ” (that she’s going to be “a time bomb” without her meds). Who are these critics worrying about this girl? Frank Rich? David Denby? I’d love to know.

“Violence is unpredictable with or without drugs.” Brilliant script.

Blurry homeless images. Madigan cello-ing. … This show is so bad, it’s like a joke. I guess it all goes back to what producer Ia Robinson told me, when we discussed my being on the show: She doesn’t have any friends or family who have mental problems, so the whole topic was like “walking on the moon.” Yes, that’s the phrase she used. The show should’ve been blasted out to Mars.

Except Joey P. He’s delightful and a voice of reason.

liz | 9:34 PM | SCHIZOPHRENIA, alternative treatments, bipolar disorder, celebrities, criminal justice system, depression, hospitals / hospitalization, meds, philadelphia, side effects, stigma, suicide, violence

Lost to Illness?

This film came out in 2007, but I haven’t heard much about how the subject of the film is faring. The filmmaker can still be found, but where is Sam?

liz | 12:03 PM | bipolar disorder, media

People First Language

One of the biggest challenges I’ve had in the 10 years I’ve been writing on the subject of mental illness is the evolving use of language around disabilities. Sometimes I’ve been relieved by change; other times I’ve been frustrated. I recently had the opportunity to start thinking about this again because I accidentally let a writer use the phrase “wheelchair-bound” in an article I edited. Afterward, the subject of the article objected, and I felt terrible. I wasn’t hip to that particular change, but in the future I won’t use it again.

Often, the lack of a consensus stymies writers and members of the media. In my case, I’m sort of okay if you call me “bipolar,” but there are many other people who think that’s terrible — and that you should only say “person with bipolar disorder” or “person who has been diagnosed with bipolar disorder.” As a writer concerned with rhythm and clarity, I have to object to the latter for myself. Yes, I’ve been diagnosed that way, but given that I concur with the diagnosis, I’m comfortable saying “I have bipolar disorder.” A lot of people object to “a person who suffers from bipolar disorder,” but I remember just a couple years ago when that was absolutely the most appropriate language.

One thing I feel we’ve mostly agreed upon: To call a person schizophrenic is really out of date. As in: “I think he’s schizophrenic.” In clinical contexts that emphasize recovery, people definitely say, “I think he has schizophrenia,” if not something more progressive, like the examples above. There’s something historically uncomfortable about the word “schizophrenic” that hasn’t yet accrued to “bipolar,” if only because the illness (oops) only recently shifted from “manic-depression.”

And now to that oops — some people no longer like to say “mental illness.” Some prefer “brain disorders” but others like to go in the opposite direction and say, well, I’m not even sure anymore. Because I subscribe to some of the horrors that many people rail against (like that my symptoms are part of an illness; that medication can work; that not all of the DSM-IV isn’t balderdash), my language may, at times, be less People First-ian than that of others.

For example, I wear two hearing aids and have been, for some years … hearing-impaired? Suffering from hearing loss … ? Partially deaf .. ? (I am not, however, Deaf. That I know for sure.) My friend and I talk about this sometimes because she is partially deaf (with much more impairment than I have) and has been so since childhood. But even she doesn’t know what the hell to call it. If she meets someone who’s like a bit more deaf than she is (but not Deaf), she doesn’t know what to say to contextualize herself. It’s so weird.

Maybe because I was a translation scholar, I love this kind of discussion. I’d be interested to hear (but talk loud! Heh.) what you all think of People First language, in all its permutations.

[Button (that I should really get for public situations) available here.]

liz | 2:55 PM | DISABILITY, SCHIZOPHRENIA, bipolar disorder, stigma

Mental Illness and Migraines

This weekend I was asked by some people how mental illness fits into my life nowadays, and I had a realization that was both reassuring and depressing: migraines are a bigger factor in my everyday existence now than bipolar disorder is. I’m glad to be so recovered (despite not exercising and eating poorly — take that, health gurus!) but fuck! These migraines are miserable and constant and not responding to daily dosages of Topomax or Imitrex or Zomig. They have become like alien possessors. I hate them.

This guy knows my pain, and articulates it well: Go here to hear author Andrew Levy talk about said migraines on Radio Times. The book sounds fascinating.

liz | 3:55 PM | bipolar disorder

Yesterday Was My Birthday. I Am Next to Normal.

It feels really different being 25. I can’t imagine how an old person — like 41 — would feel.

Ahem.

This weekend I went to NYC and saw Next to Normal, a Broadway musical about a woman who’s been diagnosed with the kind of bipolar disorder I have — depressive with psychotic features. In the play, she gets ECT, as I did. Safe to say it all hit close to home, but it didn’t upset me. It was such a rockin’ score and fun good time that I really enjoyed it.

liz | 11:34 AM | bipolar disorder, celebrities

Codey Will Transform System?

The headline at NJPoliticker.com reads: “CODEY BILLS WOULD TRANSFORM PATIENT CARE AT STATE PSYCHIATRIC HOSPITALS”

Explanation:

A package of bills sponsored by Senate President Richard J. Codey that are designed to protect patient safety and improve employee training and oversight at state psychiatric hospitals was approved yesterday by the Senate Health, Human Services and Senior Citizens Committee. … Sen. Codey worked closely with the Public Advocate’s office in drafting these bills, in part, to address a number of injuries and deaths that had arisen recently at state facilities such as Ancora Psychiatric Hospital.
Bill S2492, would require the Department of Human Services (DHS) to establish a training program for staff members who work directly with patients at state psychiatric hospitals in order to ensure the delivery of safe, secure, and therapeutic care.  Utilizing best practices in patient treatment, the curriculum would include topics such as state and federal reporting requirements, patient safety, disease prevention, health wellness activities, anger management, skilled decision-making and how to deal effectively with life-threatening emergencies. … The bill would require DHS to establish an on-site educational assessment and remedial instruction program at each state psychiatric hospital in order to evaluate the proficiency of all staff members who work directly with patients.

The bill would also require the commissioner of DHS to establish minimum educational standards for staff members at a hospital who work or will work directly with patients. … Employees already working directly with patients at the time of the bill’s enactment would be required to undergo an evaluation to determine if they meet the educational standards or require remedial instruction through the on-site education program.Any employee that refuses to participate in the training program or fails to meet the educational standards and refuses to participate in remedial instruction, would be terminated from employment at the hospital. …

The second bill, S2493, would require current and future employees of state psychiatric hospitals, developmental centers and veterans’ memorial homes to undergo drug testing for controlled dangerous substances as a condition of employment.

The last bill in the package, S2494, would require DHS to report the number of physical assaults and deaths that occur at state psychiatric hospitals. The report would be a public record, posted on the official DHS website, and updated quarterly, but would not contain any identifying information about patients or staff members.

As a longtime fan of Sen. Codey’s commitment to mental health matters, I do think it’s a good move. But is it transformative? As an astute TTWS reader notes:

It’s hard to see how these three bills alone will transform patient care at New Jersey’s state psychiatric hospitals which includes Ancora, let alone insure the care long required by law, New Jersey Statutes Annotated 30:4-27.1(c), It is the policy of this State that persons in the public mental health system receive inpatient treatment and rehabilitation services in accordance with the highest professional standards and which will enable those hospitalized persons to return to their community as soon as it is clinically appropriate.

Too often words and deeds fail to intersect at our nation’s psychiatric hospitals. Transform and its variants are now used so frequently that any change is considered transformative. More recently at another New Jersey state psychiatric hospital where a new building was going to lead to transformation (click here, paragraph 5), the reality belied the representations, ex. Developing therapeutic alliances between patients and staff remains a challenge, with differences in race, ethnicity, social class and education creating a ‘them versus us’ scenario.

“When I use a word it means just what I choose it to mean — neither more nor less.” Humpty Dumpty

liz | 1:05 PM | DISABILITY, SCHIZOPHRENIA, bipolar disorder, depression, hospitals / hospitalization, media, meds, politics

Is Driving a Civil Rights Issue?

Thanks to Joe for sending me this article about a man who wanted a driver’s license despite being diagnosed with schizophrenia. In my experience in community mental health, getting a driver’s license was basically impossible with such a diagnosis; psychiatrists didn’t want to sign the paperwork allowing a person to apply for a license. It was something that distressed me to no end. When I reported the problem to the city authorities, they were appropriately appalled. But nothing changed. A man would go in, ask for a signature that would allow him to simply take a permit test, and be rejected. Yet at the same time he was being told not to define himself by his diagnosis; what a mixed message. He was being told he could recover and lead a “normal” life. But what kind of life is it without being “allowed” to drive?

What made me angry is that I know plenty of incompetent drivers who shouldn’t be on the road, and they don’t suffer from mental illness. I also know drivers who have severe mental illnesses who acquit themselves quite admirably on the roadways (myself included). It’s a violation, in my opinion, of a person’s civil rights to prevent them from applying to get a license.

One woman who did get approval was empowered by it. She failed the permit test again and again, but it never ceased to be a goal, which fit in with the messages given by the community health center: Make sure the clients set goals for themselves; it gives them hope. Perhaps it was an unrealistic goal for her. I don’t think she’ll ever drive. But it was the trying that mattered, and if she ever gets behind the wheel, I hope she drives far away into the sunset with a great song on the radio. Just for fun.

A Guy, a Car: Beyond Schizophrenia by Ronald Pies M.D.

liz | 9:01 AM | DISABILITY, SCHIZOPHRENIA, bipolar disorder, depression, hospitals / hospitalization, meds, side effects, stigma

Cribbing From Craigslist

I get a lot of emails from people asking me for advice. Much of the time I don’t have good advice. The main thing I want to say is, Find a doctor you’re comfortable with. That’s the best thing you can do for yourself.

But there is power in numbers. So I’m going to suggest that those in the Philadelphia area think about reaching out. From Craigslist:

There is a group that meets every Tuesday from 7pm to 9pm at the Belmont Center for Comprehensive Treatment located at 4200 Monument Rd, Philadelphia, 19131 (near the intersection of Ford and Monument Rd 1.0 miles from City Ave and Monument Rd). People who suffer from Depression or Bipolar Disorder are encouraged to attend these self help meetings. The group also offers care and share sessions for family and friends of those with Depression or Bipolar Disorder. For more information you can call Belmont at 215-581-3887 or contact Jerry at yeli647@yahoo.com.

It’s really worth going.

liz | 12:11 PM | bipolar disorder, depression