Into The Rabbit Hole

Warning: this is a sensitive topic.

I feel like I’ve jumped head first into a deep sea of mental illness. This is such a sensitive topic, that I hesitate to address it, but know that for my own sake, I have to write about it. Somehow, in some way, if I can help someone else out with my thoughts, then I feel it necessary to post it. So, I will do my best to be sensitive about what I say. It is not my intention to divulge identities, nor is it my intention to spew forth drama or unnecessary stress… I just want to get some things straight in my head so that I can have a more solid stance on what/how I think and feel about this stressful situation.

I’ve studied psychology extensively. I’m at the end of the requirements of getting my bachelors degree in Psychology. I can honestly say that in no way, and by no means, has this education prepared me to understand how it feels to have someone you love be sick with a mental illness. Of course, it is because of the fact that I have several people close to me with mental illnesses that I became interested in the field of psychology, and it is because I have a passion for helping, an innate drive to solve problems, and a geeky fascination with science that I’ve decided to become a doctor, specializing in psychiatry. (Of course this path may evolve as I get deeper and deeper into my education.)

These things being said, I have a personal investment in the topic. Obviously this is something I have a great deal of passion for, otherwise I wouldn’t be putting these goals on the forefront of my plans for life. As much as I feel I have learned, I am still lost, and at a loss for words to understand exactly what it is that a person goes through when afflicted with a sickness that is difficult to diagnose, challenging to treat, and by no means understood by the scientific community– in fact, often scoffed at because it’s just not understood.

There are clinical diagnoses. There are specific criterion that need to be met in order to diagnose someone. Based upon the diagnosis, a person is treated– hopefully by someone who has successfully treated someone with similar symptoms in the past. Of course, the treatment relies upon– demands for– the honesty of the patient describing how they feel– what it’s like to be inside their head. Herein lies an incredible problem. What if the person doesn’t tell their doctor the whole story? The doctor cannot treat their patient for the illness at all– because frequently a patient has learned to say what it is that they think the doctor wants to hear in order to get their own personal desired outcome.

Yes, this is completely counterintuitive. Why on earth would a patient lie to the one doctor who is available to cure them from their ailments?  Fear.   Simply put, the patient is afraid of telling the doctor the whole truth– the magnitude of their symptoms– out of fear of the consequences of being diagnosed as “Crazy.” I’m afraid this probably happens at a much greater frequency than we as a scientific community want to admit. If a person goes in to see their doctor, and tells them the whole truth, then the doctor can hospitalize or instigate institutionalization of the person. Therefore, there is a front held up. Walls… the patient will tell the doctor only enough to be treated for the minute symptoms, leaving out the great big WHOLE picture of their experience. In turn, the patient is not treated for their ailments, and continues to live in misery.

Even if the patient WAS completely honest, there may not be a desirable outcome. Let’s say the patient is completely honest and isn’t at risk of institutionalization. Even in those cases, we don’t know why certain treatments work– or why some work for some people and why they wouldn’t work for another. Psychiatry is such an infant science that we really don’t know. That’s an awfully frightening fact considering the alternative to “being crazy” and “not treatable” is hospitalization.

What is hospitalization like for a sick person? I have no information to even begin to empathize, but I imagine it could be seriously frightening and probably feels to the sick person like taking a significant step backwards. A hospitalized person could lose everything they’ve worked so hard– harder than any “sane” person– to keep. They lose their independence–even if temporarily, can lose their job, have the social stigma of being “officially crazy” and could lose important social supports because of this association of being “crazy.”

If a person is spiraling downwards into the pits of mental illness hell– to the point where they’re not quite sure if they are a risk to themselves or to others, they have a great responsibility on their shoulders– a responsibility that even a mentally well person may not be able to handle. Is it, then, the responsibility of the people around them to know how to fix the situation? Even the doctors, the people who have dedicated their lives to knowing how to handle mental illness, do not necessarily know the answers. How could we possibly expect the family and friends know when to say when with their loved one’s illness? That’s an extremely tough call to make. What if family members do not agree on What Should Happen? Where are the boundaries? Whose responsibility is it? Even in that case, a person who makes that sort of call for their loved one faces the consequences amongst the survivors (so to speak)– the remaining people who also care for this person– who don’t agree that something like hospitalization would be the correct answer.

It’s a slippery slope. Even in the less extreme cases, where a mentally ill person can sort of “keep it together” well enough to function– with or without the help of their friends or family, there is extreme stress and vast chasms built upon the tenderfootedness necessary that comes with being part of a family or one of the friends with a loved one suffering from mental illness. Even with the most compassionate love one can conjure up in that situation, there is still stress of not knowing what to say or what to do that could or could not cause a negative reaction from either the person who is sick or the other people who love the person who is sick.

To make matters even more complicated, it’s imperative to understand some simple pieces of mental illness. One of the most significant yet most challenging concepts to grasp is that mental illness is not like cancer. It’s not like a disease that you’re necessarily always sick from. Sometimes one can be perfectly healthy for many years, and then, depending on an infinite variety of factors– most predominantly stress– a person’s mental wellness can drip away. For many, I believe that loss of self is something a person is well aware of, and it must be agonizing to know how one felt “normal” yesterday yet today can’t conjure up the nerve to get out of bed, go to the bathroom, bathe themselves, or feed themselves. How excruciating it is to experience the contrast of wellness versus mental illness in such a brief period of time! There are other cases, though, where the sickness takes a much longer time to rear its head. It could be weeks, months, or years before a person who is getting sick begins to realize just how far off the path they have wandered– until finally, they see that there are no familiar landmarks, and have no idea how they got this sick without realizing it. Lastly, (and probably ideally,) there are also instances when a person with a mental illness is able to monitor their wellness/sickness ratio and are able to maintain that experience so that they’re always teetering closer on the side of wellness than sickness. Again, this responsibility is extreme. how does one maintain such a fine balance, especially when there are so many things about our experience that are stressful? Life in its normal state can be stressful!

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I feel somewhat inconclusive as far as my words above have gone. I suppose there really are no pure answers when it comes to deciding how I feel about something that I am so emotionally attached to. Ultimately, I have to trust that I can make the right choices at the right times with regards to the mentally sick people I love and am close to. If nothing else, these challenges only solidify my passions and drive for becoming someone who will eventually truly be able to help people with their experiences with mental illness. Several of my loved ones are sick right now– major depression being the most popular illness lately. I keep thinking to myself that it must be the stress of the holidays and the lack of regular sunshine that must be behind the significant numbers of people I love feeling unwell… I am praying that all of them will make it through the next few months and will come out on top of their experience next spring. It’s frightening, and it’s stressful to know that so many people I love so dearly are in such a rough place mentally at this time. I guess I don’t really have to have all of the answers all of the time. I just wish I knew something that would work for all of them. Without further ado, carry on.