Monday, October 29, 2012

For Gals Only



I know I promised a further exploration of Anosognosia, but I’m taking time out for a medical heads-up. Ladies, menopause may be dangerous to your mental health, and going hormone-free might not be one of your viable options.

I noticed a couple of years ago that I was destabilizing rapidly and had no idea why. In a few months, it felt like I had been dropped back into hell - I was in total misery, as vulnerable to symptoms as if I were taking no medications at all. When I started feeling suicidal, my husband and I talked it over. We determined that the only physical change in the last few months had been the cessation of my periods. This meant a massive drop in hormone levels, which might reasonably be responsible for what I was experiencing. So I started on a small dose of hormone replacement therapy, and Bingo! Within two weeks my symptoms receded to previous levels.

Here’s the kicker: it looks like I may not be able to get off them. Just recently my new GP reminded me of the possible link between certain cancers and HRT, and asked me to cut my dose in half to see if I could tolerate it. Within days, I began to feel depressed and experience anhedonia. In less than a month, I was suicidal once more. So much for that experiment.

I know there are a lot of women who just don’t want HRT, or only for a short while at most. They may be justly worried about long term effects, or they may simply want to go the natural route. This may be a choice you will have to face: which do you want to preserve, your mind or your body? It is a very personal dilemma.

For myself, I would rather have cancer temporarily, at the end of my life, even if it shortens my life, than the torture of psychiatric symptoms in a healthy body for years on end. I would rather be in a medical hospital at the end of my life than in a mental hospital for large portions of my golden years. You may feel differently. That’s fine. But I am already accustomed to a permanent regime of pills that may be harmful to various parts of my body. I find that one more risk is acceptable to me. I made my choice long ago: I would rather be sane. No matter what.

I’m not trying to influence anybody in this decision. Just be aware that if you are female, and you live long enough, this choice may be coming your way. Hormones can have a profound effect on our mental condition. One way or another, expect some rocks in the road.

Deborah is a public speaker and the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness. She is currently recording it as an audiobook and CD set.  Her books are available at Amazon.com, Kindle Editions, iBookstore, and other major vendors. Visit her web page at www.lafruche.net, or see her catalog at www.lastlaughproductions.net. She has also narrated a guided meditation CD with her husband, musician Robert Hamaker. Check out sound samples at www.islandjourneyCD.com.

Thursday, October 11, 2012

“I’m NOT sick!”



I’ve been out of town, which made this blog very late - but when I came home and checked my mail, I learned something very interesting. My monthly NAMI newsletter had an article on a mental health condition I did not know existed.

Whenever I speak in public, I am sure to meet at least one audience member who tells me a variation of this sad story: My son/sister/brother has been schizophrenic/bipolar for 20 years. He/she won’t take medicine or go to the doctor, no matter what we do. How can we get through to him or her? We’ve tried everything!

I’ve never had a good answer. I still don’t. But at least now I can tell them what’s going on. It’s a neurological syndrome called anosognosia. The name means “to not know an illness” and it is often nicknamed “lack of insight.” People with anosognosia have actual physical damage to one or more structures in their brains which prevent them from being able to understand that anything is wrong with them.  It is not denial, stubbornness, or fear of stigma. It is anatomical damage to one or more parts of the brain and/or the connections between them - specifically, the part that allows you to think about or observe yourself. And it is NOT caused by medications: it is caused by the disease itself.

Anosognosia is also a problem with other brain dysfunctions, such as stroke, Alzheimer’s, Huntington’s or certain brain tumors. A stroke patient with anosognosia will literally swear that nothing is wrong with him even though the entire left side of his body is paralyzed! This is not a new problem or a new finding; the only new element is acknowledging that it happens to the mentally ill, as a result of the many studies that have taken place since the late 1990’s.

The damage seems to be connected to the experience of psychosis. Current figures show that it affects 50% of schizophrenics and 40% of bipolar patients with psychotic features. That is a whopping percentage! And it explains a whole lot.

Think about it. All of these people are UNABLE to comprehend that they are ill, therefore they are UNABLE to consent to or carry out treatment. According to recent surveys, this condition is the number one reason for medication noncompliance, number two being substance abuse - not side effects or lack of access, which lurk somewhere around fourth or fifth on the list.

Naturally this has profound implications for mental health policy and practices, which I intend to take up in a later blog. It is enough to point out now that when patients are given mandatory medication, they are sometimes able to regain some ability to understand their illness. Stop treatment, and that benefit goes away. So where does that leave the debate on the unfairness of mandating treatment for people who don’t want it? What does that mean for the opponents of Laura’s Law?

I’ll leave you with a great website for more information, and add it to my links:
www.treatmentadvocacycenter.org/problem/anosognosia

Please check out this very enlightening series of pages.

Deborah is a public speaker and the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness. She is currently recording it as an audiobook and CD set.  Deborah has also published two novels. Her books are available at Amazon.com, Kindle Editions, iBookstore, and other major vendors; or you can order them from your local bookstore. Visit her web page at www.lafruche.net, or see her catalog at www.lastlaughproductions.net. She has also narrated a guided meditation CD with her husband, musician Robert Hamaker. Check out sound samples at www.islandjourneyCD.com.