Mental Illness and Physical Pain: When the Brain Destroys the Body

My body is a clunker! And a great deal of the reason is that mental illness and physical pain are inextricably intertwined. Unlike most other illnesses, which are contained in one part of the body, mental illness sabotages the whole organism, much like the flu.

When I was about thirteen or fourteen, maybe even younger, I was at the dentist. He noticed that my canine teeth (the sharp ones that would look like fangs if they were longer) were completely flat. He was stunned that at my young age, I had already done that much damage to my teeth. His first question, asked almost in a joking tone, was, “Are you stressed out or something?” I sheepishly nodded “yes,” and he almost chuckled and asked, “What does a guy your age have to be stressed about?!” I wanted to say, “Everything in the whole world!” but by then I had learned that my obsessive brain made me weird, and so rather than answer him, I just nodded and gave him a you’re-right-my-life-is-blissful smile.

Grinding my teeth was only the first physical symptom of mental illness and physical pain joining forces in my body. Throughout high school, every doctor or PE teacher who has ever tested my flexibility (that sounds naughty if you have a brain like mine) has concluded the same thing: “Wow, Tim, you’re really tight!” As a kid taking the Presidential Fitness Test, I never thought anything of this consistent observation. It just seemed to be the way I was.

Then, two years ago, I developed severe tendenitis in my elbows. I tried to ignore it for awhile, but eventually I reached out to pick up my phone, and the twinge of pain was more than I could stand, so I dropped it. This seemed like a good time to call a doctor, which I did, and before long, I had my first doses of cortisone in each elbow. Over time, I would have 5 more between the two elbows. Oh, and one surgery with another soon to follow. I would put some good money that my tightness and my elbows were/are symptoms of my brain’s problems. My body simply shouldn’t be breaking down like this at my age.

There are plenty more examples where mental illness and physical pain intersect, such as my chronically bad back and persistent headaches, but the last one I want to mention is a horrible way that the brain harms the body in a very literal and deliberate sense: self-harm. On the inside of my upper left bicep – the most tender part – there are 8 prominent scars, slightly raised, looking like organized rows in a garden.

On my inner right forearm there are countless smaller and less conspicuous similar scars. That night the inner pain wasn’t quite so all consuming and I didn’t feel the need to be as aggressive in my pain seeking. I both cut and burned that time, but none of the scars show unless you look quite closely.

And on my inner right thigh, there are two red marks that have taken over a year to fade to skin color. Those are my most recent episodes of self-harm, brought on when someone I considered a friend reached out to tell me that she had unfriended me on Facebook because what I said was too negative for her. Already nearing desperation, I broke. I got my knife and lighter and decided to see how hot I could make the knife and how long I could touch it to my skin.

The first examples are about the unconscious harm our brains do to our bodies, while the self-harm examples demonstrate that sometimes our brains come out of hiding and demand that we do ourselves harm. It’s quite literally insane that anyone could get twisted up enough to start hurting himself. No one does it for fun. People do it because, in an odd way that no one could understand unless they had done themselves harm, it alleviates the horror of that particular moment. Imagine the despair of a brain seeking to inflict harm on the body that houses it, like a car that flattens its own tire.

Mental illness doesn’t make sense. It doesn’t follow the rules of logic or normalcy, and that’s why many people call us “crazy.” For those who suffer from any form of bodily harm at the mercy of your brain, I wish for you the ability to love your broken self. I hope you will see that broken people are the best part of being on this earth. We are the ones who are forced to do what some others will never learn to do: love ourselves, forgive ourselves, and accept ourselves.

And for those of you who are trying your best to support us but get tired of our incessant aches and pains, do your best to put yourself in our shoes. Imagine having a stroke. Suddenly the right side of your body is worthless. But neither you nor any of your friends think you’re faking it because it can be seen on an X-ray. The only difference is you’ll have to trust us and the doctors who diagnose us that there really is something very wrong in our brains. Our bodily symptoms are no different than stroke symptoms: the brain turning on the body.

And for all of you, please know that you are never alone. I am here for you, always available on this page or at toknowwearenotalone@gmail.com. And I hope that if you don’t already have them, you will find friends who speak the language of mental illness.

And supporters, you, too, can email me. And I urge you, too, to find friends who have a similar situation as your own. You need grace and kindness for yourselves as well. This is very hard; no one fully understands it.

We are all driving through a 5-mile, pitch-black tunnel without working headlights. The least we can do is to pile in the same car and face our fate together.
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I write this blog because I want people to feel encouraged that they are not alone. Please share it with someone who might need to read it. Thanks!

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Mental Illness and Addiction: Changing the Narrative

I’m finishing up a popular memoir called Hillbilly Elegy, by J.D. Vance, and while the book isn’t about mental illness and addiction, per se, Vance’s story of unlikely success grows out of his disgust toward his mother’s endless addictions to both men and drugs. Over the course of Vance’s 31 year life, his mother has been married five times and her drug habits have gradually devolved to the point of entering rehab for heroin use.

The mental illness in Vance’s family is undiagnosed, mostly because “hillbillys” are highly unlikely to talk to a therapist about their problems. But as a child, Vance’s mother seemed most negatively impacted by her own parents’ screaming matches and her father’s alcoholism. While her two siblings stood up to the chaos without losing a sense of self, Vance’s mom would cower on the floor and cover her ears, much like she would do when yet another man left her. One could certainly diagnose PTSD and inevitably, there would be other valid mental and emotional disabilities to be medicated or counseled. So, while I know I’m painting with a broad brush, for the purposes of what I want to say here, I’m going to simplify matters and say that in Vance’s life, in my life, and in so many other lives, mental illness and addiction go hand in hand and are culturally regarded in very much the same way.

Toward the end of the book, Vance does an informal survey of his extended family about why his mom’s struggles ruined her. He primarily wanted the opinion of his mom’s two siblings. Both of them take the attitude toward their sister that typifies what I perceive to be our national attitude toward both mental illness and addiction: “Yes, these are real ‘diseases,’ but the cure for them is primarily to quit whining and get your life together. The struggle is probably real, but the cure is willpower.”

Some examples:

1. The Atlanta Falcons recently hired a new Offensive Coordinator who lost his last job because of multiple alcohol related incidents, including showing up to his head coaching job drunk. On TV, a sports commentator’s jaw was nearly on the floor with disbelief that anyone would hire this man. But if alcoholism is a disease, shouldn’t the attitude be different – something more like, “I’m thrilled that this man is back on his feet and is doing what he needs to to stay healthy.” If he had come to work and passed out from not tending to his diabetes, would anyone guffaw that he could get another job after such irresponsibility?

2. A friend of mine suffers from crippling depression; she hasn’t worked in years. Her very gracious brother supports her financially, but he also incessantly tells her she needs to exercise and volunteer. Those are, in fact, very good suggestions. However, they are coming from a place that misunderstands the hurdles that have to be jumped to get to the gym or to sign up to volunteer. This is a woman who has a PhD, who adopted a child as a single mother, and who has held many high-powered jobs over a forty year career. She didn’t become lazy all of a sudden. Something changed in her brain, and getting to the gym for her can be like asking someone who’s petrified of heights to jump out of a plane – unless there’s someone strapped to their back, they ain’t jumping out of that plane.

I can hear the objections to my points through the internet waves. Or maybe it’s just that I have those same objections buried in my own brain from a lifetime of training. They are saying to me: “Tim, you’re letting people off too easy. Are you saying that we have no power over mental illness and addiction? Are you saying we can all excuse our bad behavior because we’re “just wired this way”? Are you saying we should let people come to work drunk and hold their hair back while they puke in the trashcan during an important meeting? To which I say, “Of course not! Alcoholics should wear their hair in a bun.”

But really, I am not saying that. People, even those with mental illness and addiction problems, have a responsibility to manage their conditions. Our treatments for these ailments are embarrassingly rudimentary, but people who suffer still need to seek treatment until they’ve run out of options (and many do, sadly). What I’m addressing here isn’t so much how some boss should handle an employee’s first absence due to depression or anxiety. I’m more interested in the systemic attitude that I hear from Vance’s aunt and uncle about their sister…as well as from many of my own family and friends. Essentially, they say this, “We grew up in the same house/school/town/neighborhood; we made it and succeeded; what’s YOUR problem?”

That is the misguided attitude that has to change.

It’s the same attitude you see in rich, white people toward inner city black kids who “aren’t taking advantages of their opportunities.” At first glance, it seems like a brash, arrogant attitude. But in reality, I think it is a fearful and defensive one. We all want to believe that our successes are because of our own merit – that anyone could do what we have done but we wanted it more, had a better work ethic, or slayed a few more dragons by their bravery. It’s scary and unsettling to think that our success of which we are so proud might have a good bit less to do with our own acts of will than we think. So we call others, those who do not have what we have, weak, broken, or even depraved. That allows us to remain the “good guy” who has it all together by the strength of her own will.

Another way of putting it: Michael Jordan isn’t just tall and athletic; he was also wired for endless hours in the gym and for intense competition. I could have the same exact physique as him or I could have the same intensity or the same competitive spirit, but unless I had all of them combined, I could never be as good as he was. But if I looked just like him and had the same athleticism, inevitably people would say I had wasted my talent. If I’m not wired for all those hours in the gym, though, and like to read instead, does that make me a wasted, would-be Michael Jordan? I think that’s far too simplistic. It’s the same with mental illness and addiction. What looks one way might be something starkly different.

Maybe I’m only making this argument because I’m a forty-year-old, privileged, white man who is trying to start over. Maybe I just don’t want to believe that I failed and that it’s my fault. Maybe the masses are right about me and every other addict and mentally ill person: Sure we have a real illness on our hands, but if we were strong enough people, we’d fight our way out of the messes we find ourselves in. Are all of us just weaker – sure to be destroyed evolutionary principles that cause the fittest, not the weakest, to survive: Slowly, we’ll annihilate ourselves by suicide, overdoses, and a lack of desire to pass on genes. Is that what’s happening here?

I’ll leave that to you to answer, but I ask you to think twice the next time you think that someone needs to just get her act together. People say we need to walk a mile in each other’s shoes, but I don’t think that would do the trick. What we really need is to actually walk a mile in that person’s DNA – to think their thoughts, to feel their fears, to be haunted by their traumas, and, of course, to have their experiences. This might enable us to offer more grace to others, not only who are haunted by mental illness and addiction, but also our plain old, every day brothers, sisters, friends, and family.

For further reading:

A good piece about attitudes toward addiction: http://www.cmaj.ca/content/184/2/155
And one about attitudes toward mental illness: https://www.rethink.org/news-views/2013/11/attitudes-to-mental-illness

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I write this blog because I want people to feel encouraged that they are not alone. Please share it with someone who might need to read it. Thanks!

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These Only Go to 7: Mood Disorders and Healthy Expectations

In the cult classic “mockumentary”, “This is Spinal Tap,” there’s a famous scene where a would-be rock star explains to an interviewer why his amplifiers go to 11, not the usual 10. Rather than try to capture the magic for you, I’ll let you watch for yourself…

I haven’t seen that movie in over twenty years, but I still regularly say “these go to 11” just about every time I am stumped and don’t have a proper response.

Over the past few years, I’ve had so many doctors ask me to use the 1-10 scale to tell them how I’m doing with my mood disorders that I’ve become accustomed to thinking in those terms. I’ve certainly never made it to 11, but the truth is that I rarely live above a 5. What got me thinking was a great evening I had the other night. Ann went out with some friends, so I took my kids out for pizza and ice cream. A lot of times, sitting around the dinner table, trying to figure out how to have a meaningful dialogue with small children can be hard for me. I tend to feel like I’m failing unless we’re discussing the pros and cons of universal healthcare or something like that. But they had recently downloaded the game Family Feud on my phone. Just like the TV version, the game we were playing gave us a certain amount of time to guess what the top answers were to some random question.

We had a blast playing this game while we waited for our food. Everyone was happy, even me. Then the pizza came and it was delicious. Afterwards we walked across the street for ice cream. We got in the car; no one spilled their ice cream; I don’t think I had to referee even one argument for the entire evening. Once we were home, everyone did their own thing for a bit, and then I put my babies to bed.

A perfect daddy/kids date night, right?!

Well, almost. Ish. I mean I hate to say no, but the truth is that I’d rate the night about a 7. The reason for the 3 docked points? Simple: my mood-disorder-laden brain.

My brain that, even while playing Family Feud was racing with all the possible negative outcomes for the evening or just for life in general. I couldn’t help but psychoanalyze the picture perfect family in the corner, knowing that, as with all such families, it takes a lot of work to seem so put together, to pretend so hard. And every time someone wandered through the door, there was my grim, obsessive reminder that all mass shootings begin with someone innocently walking through a door. I played out scenarios in my head, wondering what I’d do. Would I be able to protect my kids? What if I turned out to be a coward and got one of my kids killed? Would I kill myself? And of course, there was the meta analysis of my own situation: I wondered why I couldn’t just relax. I chastised myself for failing to relax. I took some deep breaths. But nothing calmed my uncalmable brain.

We boxed up our left-over pizza and headed for ice cream. It was delicious. My daughter asked for a taste of the flavor I always get and then ordered herself a cup. She seemed so grown up, ordering something other than chocolate ice cream with sprinkles. So I began thinking of how much I want to hold onto her and keep her safe. I thought about the mean girls and mean boys that are just starting to enter her social world. I thought of how much harder it will get in a few years when the hormones knock all of us upside the head for a few years. I just love her so much; can’t I keep her from getting hurt in any way, shape, or form? Please! Grant me this one power!

And I thought about my little boy who is still every bit a little boy, naive to all the complex realities of life that his sister is starting to taste. He likes Legos and Hot Wheels. And I adore him and want him to stay like he is. But I also want to help him grow up. What if I’m not up to the task?

So by the time we arrived home I was far off in a distant land, pondering the same things I ponder day in and day out, worrying about the same things, obsessing over the same things…scared of letting my family down, but also wanting a massive stroke to take me out any day now so I can be done with this incessant pain.

When I thought about our perfect evening together, I realized I’d probably give it a 7. Not because anything was wrong, but because for me, even when everything is right, the broken wires in my brain tell me not to get too comfortable because that’s when disaster strikes. The broken wires force me to feel like some futuristic movie robot who is constantly receiving a Google search’s worth of information about everything I lay eyes on. Maybe in an ideal world, I could shift my expectations and just accept that, for me, what I experienced that night was, in fact, a 10. Hell, you can call 10 whatever you want to, just like the Spinal Tap so wisely teaches us.

But not really, unfortunately. There’s something in the human brain…or even in an animal’s brain come to think of it…that knows when things aren’t quite right. No amount of wishing or wanting has enabled my brain to simply accept reality on its own terms, to embrace an evening that is a “Perfect 7”. Plain and simple, there is just something broken: call it depression or bi-polar disorder or the more vague-sounding “mood disorder”…Whatever it is, it won’t let me turn the nob past seven.

And this is my message yet again. It will be the same message in 20 years I’m sure: People with a mental illness deserve some grace just as much as people who are in a wheelchair or bald with terminal cancer. Life is different for us…fundamentally and irrevocably different. I even had a therapist balk at this concept one time – the idea that a mental illness qualifies as a disability. She didn’t want me thinking I could just get away with a poor-me attitude all the time. And I get that. That’s not helpful for someone who has cancer or is in a wheelchair or who has a mental illness.

On the other hand, I think it can be very helpful to recognize that we are in fact different and we have different needs and capabilities because of our broken parts. For me at least, this doesn’t lead to a woe-is-me mentality as much as it leads me to have grace for myself when I need more time alone than others or when I can’t handle a chaotic restaurant or when I feel both joyful and profoundly sad when I spend time with my kids because my brain won’t let me forget how temporary this all is. I’ve spent my whole life chastising myself for not being able to “just get over” certain things. But when I treat myself with respect and grace and kindness, seeing the unique ways that my brokenness comes with a flip side of compassion and understanding for others, I can treat my “weakness” a bit differently.

I’m still sad that my amps only go to 7. Very sad. Devastated, actually. But having compassion for myself inches me a bit closer to feeling like that 7 is something to be excited about, even though it will never be a 10 (or 11).

 
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I write this blog to let people know they are not alone. If you know someone who might need to read something like this, please pass it along or encourage them to email me at toknowwearenotalone@gmail.com.
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To Know We Are Not Alone is now an official 501c3 entity. Our mission is to educate, encourage, and connect people who suffer from mental illnesses. Please help with a small (or large) donation if you can. You can do so here.

More importantly, if you know someone who needs to know that they are not alone in their struggle with relationships or mental illness, please share this post/blog with them. Thank you!

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Anger and Mental Illness

I’ve been told many times that I might have a teeny tiny tendency to fly off the handle in the midst of conflict. To which I say: “Guilty as charged!” I have anger issues.

Therapists say that anger is a “secondary emotion,” meaning that there’s an underlying cause, which is the actual problem. So when someone gets angry, it’s really hurt or fear or sadness manifesting itself as anger. Unfortunately, anger, at least for a man, is more socially appropriate that sadness or fear or hurt feelings – not that those are the only three things that become anger, but those are the top three for me.

I hate to brag, but part of my problem is that I’m often way ahead of people, but not in a I-already-looked-up-the-directions-to-the-restaurant sort of way (I never look up directions until I’ve actually started moving in the car). My way-ahead-of-you-ness is more like this: When you pissed me off yesterday by saying something that you thought was no big deal but I was upset by because I’m hyper-sensitive, I started having a conversation in my head that involved all the possible things you might say to me, and if you say x, y, or z, I’m going to lose it because there’s a backstory to why those sorts of comments infuriate me going all the way back to fourth grade, but there you went and said that very thing, and now I’m as pissed as if you punched my wife in the face, so please forgive me while I slash your tires because you said THAT.

I’ve never actually slashed anyone’s tires, and for the record, I’ve never punched anyone, slapped anyone, or even grabbed anyone by the hair and swung them around just to scare them. Never. Basically, when I’m mad, I become the world’s best arguer, you see, because I’ve already had this conversation 64 times before we got started. I did not want to have this conversation 64 times, but my feelings were hurt, and I have these overwhelming abandonment issues, you see, so the second things go awry, I’m basically a little child who is scared.

And like a scared little child, I lie awake and think of all the awful things that might happen mixed with all the awful things that have already happened, and I’m inconsolable. I just happen to be a grown man with a pretty good handle on the English language so that makes me a little child who is good at making you feel pretty bad about yourself. And because I’m a grown man, I’m not allowed to do what kids do: ask incessant questions to try to feel safe…or cry to the person who upset them because they haven’t learned the stupid social code that tells them not to admit weakness…or even just sulk until someone drags it out of them. Nope, I just start putting up the defenses, which involve an angry tone of voice, body language, and words.

Certainly not all folks with a mental illness respond to the world around them in anger. However, all mentally ill people I know struggle mightily with feeling misunderstood. Because our brains won’t cooperate, we respond to situations in extreme ways. Here’s a metaphor: We’ve all had that road rage encounter where something very minor goes awry, and another driver absolutely loses it – honking, shooting the bird, maybe even pointing a finger gun at you and pretending to kill you, as I once had happen. The natural reaction, of course, is to think, “What has humankind come to? What kind of crazy people are out here wandering the streets? I hope that guy accidentally cuts all of his fingernails way too short and lives in pain for a week.”

But we also, hopefully, know that whatever happened in that moment is certainly not the whole story…that the healthier reaction, if we could sit down with Road Rage Man would be to ask, “What’s going on that something so minor upset you so much?” For our own sanity and the sanity of the world at large, the better reaction would be to feel sorry for someone who overreacted so badly. No one overreacts without cause, and who knows what justifiable reasons that driver actually has to pretend to kill you just because you moved over a lane when he wanted that empty space to himself?

I assume the analogy is clear, but I like overstating the case, so I’ll spell it out for you: Mentally ill people (and plenty of others, too!) are the angry driver. Are they overreacting? Of course. Are they far too angry about the situation at hand? Definitely. But might they have a very good reason? Yes.

That doesn’t mean you allow people to walk all over you or yell at you unnecessarily. But it means you will improve your relationship with your mentally ill loved one if you can learn to see past the surface behavior and try to understand what’s at the root of said behavior. For my part, I know I’m angry. That’s not news to me any more than my awareness that I’m male. But it’s also true that, when someone will stick around long enough to get past my fit of rage, they will realize that I’m actually just sad and fearful and broken. And those emotions are far easier for most people to interact with than anger.

So for those on the “giving” end of the anger, you’re not alone, and mercifully, I’ve discovered that there are some people out there in the world who can see past your anger. Try not to shut them out the first time they infuriate you. Many of them really do want what’s best for you. And for those on the “receiving” end of the anger, take deep breaths; try to be patient; and try to see that your loved one might not mean to fire finger guns at you; they’ve just been sitting in traffic for a long, long time.

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Well, the time has come to ask what I hate asking because I am pathologically afraid of annoying people. But the reality is that this endeavor has grown beyond a simple blog. I’m already spending a couple of thousand dollars a year now that I’m podcasting and doing some advertising (promoting) on Facebook. In the near future, I also plan to start at least one and hopefully multiple small groups dedicated specifically to helping mentally ill people know they have company. That, too, will require time and money. Long story short, I need some additional resources. Now that I have 501(c)(3) status, I can ask you for help while at the very least offering you a tax deduction. There are 3 ways to donate:

  1. You can transfer money directly from your bank via PayPal donations (seriously, why don’t you have a PayPal account by now, people?!).
  2. You can use PayPal to make a credit card donation.
  3. FOR THE TWO ABOVE, YOU CAN MAKE THEM RECURRING MONTHLY IF YOU’D LIKE TO. Just check the box to this effect.

  4. You can write an old-school checks (ask your grandmother to show you how to write one, and then email me at toknowwearenotalone@gmail.com for the mailing address).

All covering-up-my-discomfort-with-humor aside, I want to grow this endeavor into something that helps more people and helps them in more of a variety of ways. Anything you can contribute would be profoundly appreciated.

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More importantly, if you know someone who needs to know that they are not alone in their struggle with anger or mental illness, please share this post/blog with them. Thank you!

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Podcast: Self Harm

Show Notes:

  • Statistics taken from: http://www.healthyplace.com/abuse/self-injury/self-injury-self-harm-statistics-and-facts/
  • Self-harm is more an act of self-preservation than self-destruction.
  • Aron Ralston: https://en.wikipedia.org/wiki/Aron_Ralston
  • Tim shares first-hand stories from 3 people’s self-harm experiences.
  • Tim discusses Dialectical Behavioral Therapy: https://en.wikipedia.org/wiki/Dialectical_behavior_therapy 
     
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    Friends, I need your help growing the reach of TKWANA. Its aims are to 1. encourage 2. educate and 3. connect people with mental illnesses and their supporters. Beyond blogging, podcasting, and speaking, I ultimately hope to develop a small-group model for those with mental illnesses – something not too different from what AA is for alcoholics. If you see the value in this endeavor, please consider sharing TKWANA with your Facebook friends or with someone in particular who might need it. Thank you!

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When You’re Not “Fine” (Attempt 2)

A few nights ago, I posted a version of what’s below. Within about fifteen minutes I had gotten enough “Tim, don’t kill yourself!” emails that I took the post down. So I thought I’d try again. Here goes…

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“How are you?”

My least favorite question.

Sometimes, mercifully, the answer really is “fine.” Some of the time, the answer is more like this: “barely putting one foot in front of the other; feel like crying all the time; want to lash out in anger at most of the people I know for one reason or another.” Worse yet, sometimes this would be the honest answer: “barely surviving…if I told you how badly I want to die, you’d put me in the mental hospital right this second. I fantasize about ways to kill myself. Better yet, I long for something/someone else to do the job for me so no one has to live with all the what-could-I-have-done guilt. If only I could get into a car wreck that looked like a true accident, one that would be guaranteed to kill me. Ahhhh, now that would be the ticket.”

If I told you how often I think like this, you’d probably have me committed. But I also know enough people who think like me to know that I’m not alone and that thoughts like these are not at all abnormal for those who are mentally ill. However, those of us who actually think these things aren’t allowed to verbalize them. Understandably, people are not prepared to hear someone else say they are longing for death. My purpose in writing this post is to encourage those of you who support someone who is mentally ill to understand the difference between wanting to die and being suicidal.

The truth is that all of the mentally ill people I know think about dark things far more often than you would want to know about. We are at war with our brains…constantly. No matter how much we want peace, it won’t come. No matter how much we want to get over our emotional pain, it won’t heal.

Here’s an example of my brain’s incessant negativity even about the smallest things: A friend introduced me to someone who has become one of my favorite musicians EVER (Sturgill Simpson). We were talking about him and I made some analogy comparing Simpson’s song-writing to my blog writing. I was by no means comparing our writing skills, but my friend laughed and said something like, “If only you could write as well as he does.” He didn’t mean anything harmful by it, and I understood his point, but here’s the rub: every damn time I listen to Sturgill Simpson, his songs are poisoned by my hurt feelings because of what my friend said. My brain won’t let it go. Trust me, I don’t want to hold on to these things; why would I want to hold on to something that hurts me and that I can’t do anything about? I can’t go back and confront my friend because he didn’t mean anything by it. I can’t prove him wrong because how would I do that? How would I prove that I’m as good a writer as Sturgill Simpson is? I’m probably not, but that’s not the point. The point is that, when Simpson’s songs play (and I have all of his albums so I hear him a lot even when I hit shuffle), I have a wound that won’t heal. I hear it over and over in my head: “You’re not as good as him; you won’t ever amount to anything as a writer, Tim. You’ll never impact people the way he does.” Maybe that’s not what my friend meant but it doesn’t matter. Whether I want to or not, that’s the “song” that plays on repeat in my head when Sturgill Simpson plays on my iPhone.

Our brains are broken, irreparably. In order to support someone who is mentally ill, you need to brace yourself for the ugliness of what we have to share. If I were to share the above with someone, most likely, they would say, “You’ve got to let go of that, man!” And I would say, “No shit. I want to let it go more than you can possibly imagine. I would give ANYTHING to be able to let it go.” But someone who tells us to “let it go” doesn’t understand the battle. We have bled, sweat, and cried, “Please help us let it go!” to no avail. And if you are going to be our supporter, you are going to have to reconcile yourself to the fact that we aren’t able to control our brains in the same way that you are. “Let it go” or “think positive” are meaningless to us. It’s not that we don’t want to; we can’t. Can a cancer patient make her hair grow back by thinking positively? Can a paraplegic make his legs start working again by letting go of negative thoughts? Obviously, no. And those of us with mental illness can’t quit thinking negative thoughts no matter how hard we try. Trust me, I would give literally anything to be able to let go of negative thoughts. Yet, the truth is, negative thought essentially consume my brain 24/7. I don’t want that to be the case. But it is.

So what should you do to support your friend who is mentally ill? You should prepare yourself for a very ugly reality. Instead of saying, “think positive,” you should just say, “I’m sorry” or “I will listen for as long as you want to talk” or, “tell me everything and I promise not to judge or freak out” or, “what’s your favorite mixed drink and I’ll make you five of them.” Better yet, in a peaceful moment, ask your loved one what they want you to say to them, and say that.

People talk all the time about “removing the stigma” of mental illness. Well if we are ever going to do that, there have to be people in our lives who see it all, know it all, hear it all, and still treat us with dignity…without minimizing our pain as if it were something that a clever phrase or new perspective could help us overcome. Our brains are broken. Allow us to tell you about our real, raw experience.

Here’s the truth: just because we think constantly about death, doesn’t mean we are suicidal. Those of us who think of death as a welcomed relief need people who can listen without freaking out when we talk about longing for death. These thoughts are the fundamental reality of our lives. Our lives are hard…so hard that we want to die. This doesn’t mean we are suicidal; it just means we are mentally ill. It just means that our brains are broken beyond repair. We’ll keep trying; we’ll keep fighting. But if you want to be part of our support system, you’ll have to accept that our reality is a dark one. And the best thing you can do for us is to listen without judgment…even when we tell you we want to die.

 
*****
 
Friends, I need your help growing the reach of TKWANA. Its aims are to 1. encourage 2. educate and 3. connect people with mental illnesses and their supporters. Beyond blogging, podcasting, and speaking, I ultimately hope to develop a small-group model for those with mental illnesses – something not too different from what AA is for alcoholics. If you see the value in this endeavor, please consider sharing TKWANA with your Facebook friends or with someone in particular who might need it. Thank you!
 
*****
 
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Wait, Don’t Shut Up

My last post (which I have now deleted because I didn’t like the tone) was, well, an angry post. You see, I’ve been on the part of my own mental health roller coaster when I start to feel, quite tangibly, crazy. This comes after a prolonged period of feeling “on a high,” or hypomanic in bi-polar II parlance. I know the crash is coming, but I can’t stop it. I even know the behavior that leads up to it. But I can’t stop it. This might be the most frustrating thing of all: to watch your own self-destruction without being able to stop the self part of the equation. Or the destruction part.

So here I am. I’m angry. I’m not angry at anyone or anything other than everyone and everything. That’s all. If the entire world would just leave me alone, I’d be much nicer to everyone. If the breeze would be a little stronger when I’m hot or if the person in front of me would drive 64 instead of 62, maybe I wouldn’t want to Google “how to build a hand grenade” (okay, lots of hand grenades). I hate feeling this angry as much as you hate feeling constipated with only a 9-year-old port-a-potty available to crap in. But alas, it’s how I have felt for much of the past few weeks, and I pity the people who have experienced my over-reactions.

So in an effort to balance the karmic effect of my words, I’d like to offer the counter-post to my previous post…I’d like to say thank you to the people who stick by me, who stick by “us”, as we navigate our impossible ups and downs while we battle our brains to the death.

So thank you to our families who DON’T understand but who try their best to learn how to understand. Thank you for asking questions, for gently telling us to calm down, for giving us space to kick and scream like toddlers, for going with us to the doctor or hospital, for defending us to the extended family who thinks what we need is to be kicked out of the house, for forgiving us…AGAIN. Thank you for going to therapy with us, for going to therapy without us while you try to stay sane because of us, for reminding us to take our meds, and for answering the phone after you’ve already gone to bed because you know we really need to hear your voice. Thank you for modeling what love really is: an action, not a feeling.

And thank you to our friends who don’t run away when the friendship quits being as fun as it used to be. Thank you for talking things through when we hurt your feelings, again. Or when we get our feelings hurt, again. Thank you for seeing our worst and still not unfriending us on Facebook, or in real life. Thank you for letting us rehash the same struggles over and over and over and over. It’s perfectly fine if you’re thinking about where you should vacation next summer…thanks for smiling and nodding because sometimes we just need to feel heard or we just need to hash it all out again, trying to solve the unsolvable puzzle that is mental illness.

And thank you to our kids who are too young to understand but still try to grasp the concept of “Daddy’s brain hurting” without flipping out. Thank you for forgiving us for the thousandth time when we speak to you a bit more harshly than your behavior deserved. Thank you for still wanting to hang out with us (assuming you’re not teenagers) even though we don’t have nearly enough emotional energy for your non-stop needs and wants. We want to hang out with you, too, I promise. It’s just that the head-demons make it a little more trying than we might like it to be. But we love you more than anything. Absolutely ANYTHING.

I’m not going to whine, but being mentally ill is really hard. The more friends I make with mental illnesses, the more I realize that we all struggle so similarly, even with different diagnoses. Basically, we’re at war with our own operating system. The very thing that’s telling us how we should react is keeping us from reacting that way. We see it, we feel it, and we can’t change it no matter how hard we try. But friends, family, all of you: We are trying. We adore you for putting up with us. We promise to keep trying. Please keep sticking with us. We love you more than we know how to say.
 
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Please Stop Saying That

Hang in there Fuck You

If you’ve ever put your foot in your mouth around someone with a mental illness, this one’s for you, friend. (Disclaimer: These are not my personal gripes. I took a poll on Facebook looking for common things that people with a mental illness get told. These aren’t directed at anyone specific out there who might have said one of these, I promise.)

Hmmm, where to start. I think with the guy who, after I had told him I had OCD, told me that he LOVED hiring “those people” in his business because they were so organized and meticulous. When I tried to stop him, he went on: “That’s a great quality to have, man, in the right scenario!” I chose not to physically harm him, but I wanted to. I just seethed because it was so invalidating: him saying that this disorder which has taken so much life from me is actually an enviable quality in the workplace. You wouldn’t tell someone with cancer that they would make a great hat salesman what with the bald head and all, would you? Yeah, so please don’t say that sort of thing to someone who’s mentally ill.

Then there’s the good natured, rampant suggestions that those of us with mental illnesses should focus more on our physical health: exercise more, eat more barley, try the latest cleanse, quit eating cheese pizza that uses GMOHGTLMNOP in the sauce, etc. A few years ago, my boss pulled this one on me very unexpectedly. I went into his office to talk about who knows what – NOT mental health. Somehow the conversation meandered around to anxiety, from which he also suffered. But his was the sort that one can get rid of by running around the block. So, kindly, he suggested that I should exercise more regularly. I thanked him, told him I’d give it a shot, and ran…to McDonald’s. Okay, I had two. Then I slashed his tires. But really, I’m quite sure that physical health has plenty to do with mental health. However, I have yet to find someone who is severely mentally ill who has been cured by running a marathon. Most of us have tried that to no avail (for the record, I’ve gone through prolonged periods of exercising many times a week, but I’ve never seen an improvement in my mental health from it). It’s not that we don’t know that you exercisers mean well; it’s just that it feels like you’re telling an amputee that taking fish oil might turn them into a mermaid/merman, thus effectively replacing their legs.

And here’s one that all of us who have been depressed have probably heard: “Just think of all you have going for you! You’ve got this and this and this and this to be thankful for. You’re looking at it all wrong!” When I was suffering from my worst (and first) bout of depression ever, I was basically on suicide watch. I didn’t even feel safe being in a different room of the house from my family. During this time, a friend of mine thought he’d do me a favor by suggesting how much worse off I could be. He shared with me about his friend who was currently in Hawaii. Well, good for him, I thought. Then he shared the reason: his daughter was dying of cancer and it was her Make-a-Wish request. Surprisingly, this did not help with my suicidal depression. In fact, it heightened the urge to find that cyanide pill I had hidden somewhere. If you take nothing else away from this post, try to remember this: mental illness is not about someone’s unwillingness to see things in a positive light…or the “right” light. It’s about THEIR INABILITY to do so. Depressed people are fully capable of understanding that something should make them happy. But they still can’t feel happy. Anorexic people are just as aware as you are what an appropriate meal consists of. But their brains won’t let them act on that knowledge. People with OCD know their obsessions are idiotic. But that’s all they think about, night and day, until, sometimes, they end their lives to make the unwanted thoughts stop. Think of it this way: People who are paralyzed understand how walking works, and they most likely want to walk. But they can’t. A pathway is broken, and we simply don’t know how to fix it just yet.

This last one (for now…there’s plenty more out there) is tricky because it’s been said to me so many times by so many really, really, really thoughtful and well-meaning people. But still, it’s warped. Here it is (well-meaning friend speaking to me): “Ann (my wife) must really be a saint, Tim.” First of all, these people are absolutely right: she is a saint. Ask anyone who knows her; she’s probably the best human on earth. I mean that whole-heartedly. I wrote in my book five years ago that I would’ve left me a long time ago, so let me just say that first. So what’s so wrong with saying that, then? Well, would you say it to someone with cancer whose spouse stayed with him even though it was a terrible road to walk? You might say it to the spouse in private, and that would indeed be appropriate encouragement. But you wouldn’t say it to the cancer patient because that would make him feel like shit, obviously. You might as well say, “Dude, you’re a fucking burden.” On this one, we mentally ill folks don’t even help ourselves because I think most of us feel like a burden and even push our loved ones away so as not to be a burden on them. I know I do that a lot. I feel ashamed and worthless when I can’t earn as much money as I used to or help as much with the kids as I’d like to. Still, please, I beg you, don’t tell me what a saint my wife is unless you want to make me (and others) feel like a pile of maggot diarrhea. Tell our spouses, our parents, our friends what saints they are. Just don’t tell us.

As I finish this post, I feel a bit like a jerk for pointing these things out. I was hoping for a funny tone but fear I’ve landed more on derisive. Take me with a grain of salt, though. Remember, I’m just a mentally ill guy who’s not doing a good job of thinking happy thoughts (oops, was that derisive, too?). Oh well, if you’re still reading, thanks for sticking with me as I try to make this point. And if I’ve offended you, now you can write a post called Things Not to Say to Someone Who’s Just Trying to Help. Be sure to tag me so I can read it!

Other things that I don’t have the time or energy to address right now:

  • I’m praying for you.
  • I’m a little OCD, too.
  • You shouldn’t cut yourself because you won’t like those scars on your arms.
  • Please add more in the comments section below!

EXCITING NEWS: Tim’s new podcast called, cleverly, To Know We Are Not Alone, is now available on this site or on iTunes.

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An Open Letter to the Parents of a Kid Who MIGHT Have a Mental Illness

suicide teenDear Parent of a kid who might have a mental illness,

Yeah, I know, I’ve heard your excuses a million times: “It might just be a phase that s/he’ll grow out of…no one wants to slap a diagnosis on their child…no school counselor is going to tell me how to parent my kid…no shrink is going to prescribe some pill my kid pops so s/he’s magically calm and focused.” And I know that, back in our day, the kids who took Ritalin probably just needed better parenting and firmer discipline…I know that, when you were a teenager, you went through plenty of times when you were “depressed,” and you pulled yourself up by your bootstraps…pumped some iron, got a new boyfriend who was a great kisser, made the basketball team, or just listened to some great music, and voila! All better in a week or two…your kid should do the same. I know, I know.

Maybe you’re right, Parent. Maybe your kid needs to get his/her act together the good old fashioned way. That’s entirely possible. But bear with me while I pose a simple question from two different angles. Then I’ll get off my high horse.

First question: What’s the worst that can happen if you get your maybe-not-mentally-ill child some professional help?

I know you’re worried about the horror stories you’ve heard regarding antidepressants. I’ve lived some of them first-hand. But they’ve also saved my life. The truth is, when used properly, anti-depressants are very, very safe. If you just go slow and talk to your kid about how s/he’s feeling, you’ll be just fine. And, people don’t get addicted to anti-depressants, so there’s nothing to worry about there. Sure, there are some psychiatric meds that can be addictive and dangerous, but you’re a lot safer getting your kid started while they’re still under your watchful eye than if they start taking some of the more dangerous drugs when they’re out on their own.

What you’re probably more worried about is the stigma and the label of having a kid who sees a shrink. I suppose your kid could develop some weirdo reputation. Worse yet, you might get labeled the parent who couldn’t help his own kid get his shit together. Forgive me for being slightly confrontational here, but…well…your kid may well already have a weirdo reputation. And you may already be seen as the parent who could stand to pay a bit more attention to what’s happening under your nose. Truly, having a kid who is a medicated and treated weirdo is highly preferable to having an unmedicated/untreated weirdo on your hands. And as for your reputation, well, you’re better than that. Living vicariously through one’s kids is never a good look. Be the parent who puts his kid above his reputation.

Second question: What’s the worst that can happen if you DON’T get your maybe-not-mentally-ill child some professional help. I’m tempted to scare the hell out of you by referencing every school shooting ever, but I’ll skip the scare tactics…Actually, no I won’t. Google Dylan Klebold’s mom. She’s the mother of one of the Columbine shooters, Dylan Klebold. This brave lady has recently begun to speak openly about the situation, and her main message is the exact same as every parent of every kid who’s ever pulled a trigger, taken too many drugs, or acted out in some overly dramatic way: she wishes she had said something other than, “I’m sure he’ll be fine; it’s just a phase.” You, Parent, still have an opportunity to, at the very least, always be able to say, “I did everything for my child.”

Much more likely than a scenario like the ones above is that your child will end up like countless students of mine, and like me: feeling very lonely and very confused and very scared. They’ll spend years, even decades, wondering why they are different from others, thinking they might need to see a doctor but scared of disappointing you, scared of telling their friends because they already feel enough like a weirdo or a psycho. They’ll probably, like most of us with a mental illness, try to self-medicate. It’ll probably be drugs or alcohol. Or it could be something “healthier” like work or fitness. Maybe it will be sex. It’ll be something. It’s called a coping mechanism, and all coping mechanisms do the trick, at least in the short term. But we all know that these coping mechanisms don’t work forever. Some people get on a slippery slope of coping mechanisms and end up face down and unresponsive in the ditch at the end of the slide. Some can be revived; some can’t. If your kid is one of the lucky ones who survives the slide, they’ll land in a psychiatrist’s office, scared to death but grateful to still have a fighting chance at a life worth living. If you wait…If you don’t get your child some help now,  s/he may well survive, but by the time they land in that shrink’s office, the scars they’ll bear will be permanently disfiguring.

The greatest news, here at the end of this preachy letter, is that you hold the power of God, at least for now, in your hands when it comes to your children. You get to say what they’re allowed to try in terms of getting help. The one absolute certainty is that they will try SOMETHING. It might be pot or beer or meth. Or it might be Prozac or Lithium or Vyvanse. I can’t guarantee you that the latter three will help your child. But I can guarantee you than the former three won’t. So, please, I beg you, be a hero who is humble enough to set aside your fears of a ruined reputation so your child can at least have a chance at his/her healthiest possible life.

High horse dismounted,

Tim

 

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Bubble Boy

bubble boy

A friend of mine got a call earlier this week from a friend who was suicidal…as in he had picked a day to kill himself and had been cutting himself on the wrists. My friend, like most people, didn’t know what exactly to do. He didn’t want to interfere or to butt in, but he didn’t want to leave the guy hanging either (eesh, terrible unintended pun). Brad, my friend, did the right thing: he went over to the guy’s house. But once he got there, he had no clue what to do. Here’s what he wrote to me the following day:

“So I walk into this room and my friend is inside a clear bubble. He hears and sees the outside of the bubble but the laws of nature inside the bubble are not the same as those outside. There is no sense in even attempting to reconcile the world inside vs. outside. What is worse is that I can see that my friend is in tremendous pain. But the bubble eliminates all possibility of rendering aid. So all I could do was sit there, listen, and talk on occasion…provide a momentary break from the monotony of pain inside the bubble. It sucked in the worst way.”

And there you have it: the perfect descriptions of what both a depressed person and their allies must face. Being depressed is like living in a bubble. I’ve often said I feel like I’m floating in space, watching everyone else from miles away, aware of their existence but unable to break through into their world. And I’ve been outside the bubble, too. It’s the same sort of helpless feeling – like being the ghost in some movie who wants to shout a word of warning to their still-alive friend, but no matter how loudly they yell, their voice won’t reach the land of the living.

All that being said, my friend Brad still did the right thing, unquestionably. He did the brave thing: he faced the feelings of helplessness and concern head-on rather than excusing himself from the pain of involvement by “not wanting to interfere” or “leaving matters in the hands of his friends’ family members.” It’s easier not to get involved, and there are always excuses available to stay out of such situations.

But staying out of them is ALWAYS the wrong thing to do. What’s the worst that can happen by getting involved? The person might be mad at you and unfriend you on Facebook. Ok, but what’s the worst thing that can happen if you don’t get involved? Your friend might kill himself; his children will be orphaned, his wife widowed, and you will be left wondering if you could’ve helped. For the rest of your life.

Am I being heavy-handed here? Maybe. But these aren’t “light-handed” sorts of issues. Just remember: The consequences of doing SOMETHING will always be better than the potential consequences of doing nothing. People who are depressed don’t have a damn clue what they need. You wouldn’t expect someone lying on the beaches of Normandy without his legs to rationally tell you how to doctor his wounds, would you? No, you’d take charge, comfort him, and do what you – the rational one – believed was the right thing. You wouldn’t leave him lying there, excusing yourself because you’re not a trained doctor (I hope). You wouldn’t listen to his shock-induced rants or even to his cries of pain. You’d act. And you’d hope your actions were of some use.

It’s no different with someone who’s deeply depressed. They’re lying on the beaches of Normandy without a clue what they need or want. If they’re still alive, they still want and need help, no matter what words are coming out of their mouths. Who cares if you don’t quite tie the tourniquet perfectly. Just tie the damn thing.

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