Tuesday, December 28, 2010

Defining Normal

It happens sometimes that people get sidetracked into the swamp of defining what 'sanity' is, what ‘normal’ is. Usually they just leave the question hanging. If we are going to accurately monitor ourselves, however, we need a benchmark for sanity. We need to have some way to know when we have gone off the rails, when it is time to curb our behavior. We can’t decide what to do about psychosis, if we don’t know we are psychotic! The real question is, what does sanity feel like to YOU?

A lot depends on the age at which we became mentally ill. Obviously, if disease struck you at age 26, you have some kind of memory of what ‘sanity’ felt like, however you may define sanity. The world felt different. Perceptions were different. You can remember. You can compare. But what about those of us who started early? Some of us have never experienced adult ‘sanity’. We were kids, and then we were insane. No ‘before’ picture to measure by. Some of us were even insane as kids. What do you do then? How can you tell that things have gone further south than usual?

Well, if you’re lucky, at some point your medications will stabilize you – even if only for a little while – and that can become your measure of what adult normal feels like. I had to wait until I was 34, myself. But once I knew, I had a reliable way of telling when I had got too far from the beaten path. We have to pay attention to our bodies as well as our minds. There are certain sensations I associate with mental illness – a sort of tight, closed-in feeling, as if only my mind exists and my body is locked in a box, and I literally CANNOT notice what is around me, or change the topic my brain is stuck on, no matter how hard I try. I feel overwhelmed, over-stimulated, a little panicked, a little trapped. I cannot listen – the words inside me must be spewed out. I cannot calm down – there is a firestorm in my head that often turns into a very real physical headache. I certainly am not breathing very deeply. The irritation and tightness that accompany this are clues that I am losing it, and should go lie down.

If you observe yourself for a while, you will learn your own cues.

If your meds have never graced you with adult ‘normal’, it is trickier. You have to judge by lesser or greater, with no absolute benchmark. And you have to depend a lot on the reactions of other people. If everybody around you is concerned or hostile or telling you to stop or shut up, chances are real good you’ve crossed the line. You might want to set up a verbal or visual signal with someone you trust, a simple phrase like, “Honey, you don’t seem like your usual self today.” Something simple and inoffensive that will not set you off all by itself. And you will have to surround yourself with people that you trust.

This can be tricky, too. It is to easy for those who are not sick to label anything they do not like or understand as ‘insanity.’  Holding dissenting opinions is not insanity. Having an unusual idea is not insanity. Insanity is operating from a non-standard reality, and not knowing you are doing so. That doesn’t happen every day, for most of us. We need intimates who allow us to be our disparate selves, and this can be a challenge. New Year's Resolution: surround yourself with people you can trust.

It is difficult to be mentally ill partly because of the way it messes with our fundamental belief that we are right. A person with a mental disorder has to be ready to concede, at any given moment, that they may be wrong about virtually anything, even the smells wafting into their nostrils! The least we can do for ourselves is make sure those around us can be trusted to have a sense of what is our illness, and what is simple idiosyncrasy on our part.

There are individuals like that out there. Go and find them, and happy hunting.

Deborah Fruchey
Deborah's new book, Is There Room For Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness, is now available on Amazon.com, Kindle Editions, and Apple's iBookstore. See the above link for an introductory video.

Thursday, December 9, 2010

Top Ten Tips for Surviving the Hoidays

Everywhere we go at this time of year, people are insisting that we be happy, have good cheer, and enjoy the holidays. For the mentally ill, this can be a problem. Some of us become more depressed than usual. Some of us come apart due to the stress. Some of us, living poverty-stricken or isolated lives, will feel more alone and broke than ever. It’s not easy to give neat presents on the fixed income of Disability, or the pittance of SSI.

Holiday blues can happen to anybody, but for the mentally ill, who live so close to their emotions and the negative critics inside their heads, it can be enough to bring on a whole slew of symptoms we’d rather do without. So here are some of the tricks I’ve learned to make it through. Apply as needed.

1. You do not have to break the bank buying presents. Try out a flea market or thrift shop for gifts. The chief thing a gift is supposed to do is show someone you thought about them. If you buy thoughtfully, fitting gift to personality, you can come out on top without a lot of bucks. Remind yourself that it is retailers who have made Christmas into a shoppers feeding frenzy; the season, whatever your religion, is actually not about gifts but connecting to loved ones at this dark time of year and showing them we care. (In January, you can start setting aside a small amount every month so you won’t be caught flatfooted by the next ‘season of giving’.)

2. Or you can make things, write things, hand-paint cards – use whatever creativity you have to manufacture your own gifts. I know a woman who buys ugly bead necklaces at flea markets, takes them apart, and then puts together her own stunning necklaces in much better combinations, choosing the best colors for the individual she’s giving to. She has an eye, and people love her personal jewelry gifts. The money investment is tiny. Besides, it is illegal in most parts of the world to criticize a handcrafted gift made with obvious care. ; )

3. Stay out of the malls and stores. Mass crowds at Christmas can get absolutely rabid, growling and elbowing and making for long lines and grouchy sales clerks. If your sanity is fragile at the best of times, you do NOT need to be in places like this. (The parking alone is enough to give me spontaneous attacks of rage).

4. If you do have some money, or an accommodating charge account, a good bet is buying from offbeat catalogs. If you sign up for just one, they will propagate and you will have dozens to choose from next year. Some of the best buys can come from organizations such as SERV, which gathers fair-trade items that are handmade and relatively inexpensive, from needy economies all over the world. The advantages here are staying out of the stores (see above), finding unique items that nobody else in your family has seen, and if you can afford it, even having them gift-wrapped and mailed straight from the merchant to your family members. All of this adds up to a very low-stress holiday season. The downside: these catalogue items tend to be not-so- cheap, and you will get nailed on the shipping. Also, you must order early enough for on-time delivery.

5. Consider buying your tree, if you need one, the night before Christmas. If the local tree lot is trying to get rid of the last stragglers, they might give you a hell of a deal. These won’t be the shapeliest or best trees, but if you’ve collected enough ornaments or have bushy garlands, it may not matter. Or consider a mini-sized, tabletop tree, which will be in a low price range. Lots of people make trimming the tree on Christmas eve part of their yearly ritual, even opening their presents the night before, and wouldn’t have it any other way.

6. Spend time with your friends. If everybody is busy, or far away, spend time with them on the phone. This is especially important if you don’t have family any more. It is supposed to be a season of love, and if you have had some contact with everyone you love, you will not feel so deprived.

7. Be sure you take in plenty of music that makes you feel good. That does not always mean Christmas music – some of us abominate carols – and it doesn’t always even mean cheerful music. Maybe melancholy classical pieces give you a sense of order in the world. Music does not have to cost a lot. You can pick up any number of old vinyl records and cassette tapes for pennies on the dollar. Music is one of the best and easiest mood-altering substances known to mankind.

8. Establish special rituals for the season, so you can feel festive even if you are alone and sick. Drinking hot chocolate, for instance; decorating the house if you like that; taping up any Christmas cards you receive into a tree-shape on the back of a door. Or have a festival of old holiday movies that you borrow for free from the library. Read The Night Before Christmas out loud to yourself (by a fire if possible).  These are things that will help you feel connected to the mood, or just make you feel it is a special time. (Conversely, if you do not celebrate Christmas, some special non-Christmas rituals will help buttress you against skepticism, disgust, or too much of a left-out feeling).

9. Make sure you have plenty of all your medicines. This is not the time to run out and start spiraling down. Don’t wind up spending Christmas or New Year’s in the hospital. Add extra therapy visits if things are tough. If you can stay connected to even one person who listens to and accepts your icky, non-festive feelings, you will probably be able to squeak through. 

10. Remember that Christmas is ultimately a man-made made holiday, one that the Catholic Church frankly appropriated and reframed to help increase conversion rates. Even if you believe in the story of Christ's birth, historians are pretty sure he was not born on Christmas day proper. This holiday is not ordained by God - there is nothing you have to accomplish and no reason to feel you have not "measured up" if you do things differently from the mainstream. You can choose to celebrate, or you can choose to retreat into your own quiet space. There is nothing wrong with that.

And if you get tired of all that insistence that you should be having a joyous time, remember that at least 50% of the people who are telling you that are faking it, even to themselves. You have plenty of company.

Wednesday, December 1, 2010

Compared to What?

Self-esteem is a perennial problem for the mentally ill. We have to live our lives at a different pace from the mainstream, with generally scaled-down goals, and sometimes it is impossible not to feel “less than.”  In addition, it’s my sneaking suspicion that we just have to spend more time than most people with the critical voice in our heads, and it’s a louder, more insistent voice. Especially if we are surrounded by “normies”, we can wind up feeling inadequate, to say the least.

It is a truism to say, “you shouldn’t  compare  yourself to others,” and it’s silly. People are going to compare. They are supposed to compare! This is how the human mind works! The brain takes any image or concept, scans through the memory banks to find something similar, and says, “Ah, this is like such-and-such, only bigger or smaller or more colorful.” It lists the differences. That’s how it operates. That is why a good teacher will go at a new concept from several angles and maybe with a couple of stories or similes, looking for the ‘hook’ to previous ideas which will allow students to process something new.

The thing we need to understand is that we are no longer measurable by the old rules.  By definition, we are not part of the mainstream.
We are dealing with tremendous extra pressures and challenges they could not conceive. We are carrying a heavier load, every day. We are going to perform differently. So we will do a lot better if we compare ourselves to our peers, or just to our own levels of functioning. (And anyway, let’s be real – is that mainstream, with its frenzied ideas of materialism and power trips, so totally sane and admirable that we want to copy it?)

Here’s an example. I sometimes pick at myself for taking so much medicine every night. It’s uncool. It’s like being an elderly woman, or an invalid. Then I remind myself that over the years I have cut down on my meds by about half.  I am actually getting better. Another self-critical issue for me is work and earnings. I used to feel bad that I could only work 15 hours a week. Then my doctor told me that at my level of severity, 90% of people could not hold a job – any job – for more than 6 months. I had been working at the library about 5 years by then. Instantly, that 15 hours looked better. And as for money, it takes a lot of skill to live on the miniature amounts you get from the government. It takes a lot of skill even to get them. Can you congratulate yourself on making that work? I’ll bet most of your salaried friends could not do it.

Never mind how the up-and-comers are doing. How are your colleagues doing? Go to a support group and see what is realistically going on for the people there. Maybe you are well off because you are the only one who sleeps through the whole night. Maybe you are on top of your paperwork, or have a more reasonable social life or romantic relationship than half the people in the circle. But you won’t know that until you look at others like you. At least read about them, if there are no groups nearby. You don’t need to reach the upper limits of human achievement! You just have to do okay on one or two items that matter today.

Take time out from your self-flagellation to tot up your small achievements. Anything can count, from taking your medicine more regularly to getting out of bed during a depression. Little things are important. I do not have to be Tolstoy. You do not have to be Steve Jobs. Just pat your bruised self on the back for the things you did right today. You deserve the appreciation.

Deborah Fruchey
You can get her book, Is There Room for Me, Too? 12 Steps &12 Strategies to Coping with Mentally Illness, at Amazon.com, Createspace.com, Kindle Editions, Apple's iBookstore, and Lulu.com. Those last three sources will download a free chapter or two to you!