Baco: On The Bus

Row,row, row your boat....

How real is reality?
We feel, touch, taste, smell, and see. It seems pretty real. From a practical point of view, all of these experiences are interactions with things we know to exist. More precisely, they are interaction between energy fields! I'm getting weird? Hang on! It gets weirder before it makes sense!

We are all taught that things are made up of molecules, molecules from atoms, atoms from sub particles, and these particles are made from yet even smaller particles. Can these smallest particles be subdivided further? Maybe! They all have this unusual quality, they don't stay the same! They change from one type of particle to another. Sometimes they don't exist at all, then they exist again! They can't be seen. Only the energy we bounce off of them can be recorded, and we can see those recordings. They must be real! Or are they?

We can't see an electron. You can't hold an electron "still", and look at it. Partially because the entire universe(appears) to be in motion, and "still" is a relative concept. But also because motion is an inherent and exclusive quality that makes it an electron. If you could hold one "still", in the relative sense, you would either have to move along with it at tremendous velocity, or it would yet appear to go whizzing by as you moved with rest of creation! More importantly, it would cease to be an electron. It would become something else
Protons an neutrons(the stuff the nucleus of atoms is made of) have the same problem. They are always in motion. Protons cease to exist, then suddenly reappear as neutrons and electrons neutron combine with electrons, cease to exist, the reappear as protons. Once again, they can't be held "still", and we can only see the recordings of the energy we can bounce off of them.

No one is really sure if these things exist or not. They are essentially mathematical constructs that fulfill the requirements of more observable properties of matter and energy. But we believe them to be real, virtually all of modern science is based on that belief, and for practical purposes, it works.

Gently Down The Stream......

We are all familiar with the saga of Micheal Jackson, great talent, singer, and dancer. He experienced a lot of surgery, an abusive family life, and a childhood in show business that likely produced a lot of pain. He used pain killers to deal with it.
Our own bodies produce pain killers. That is why sometimes, when we have an injury, it can hurt tremendously for a while, then not hurt very much, and then hurt a lot again. The pain transmitting neurons fire until they run out of stuff, then the pain inhibiting ones take over until they run out. Then it starts all over again. Much like a golf swing, the more a system of neurons gets used, the better they get at it. In golf its called muscle memory. So the pain firing neurons get good. And the pain inhibiting neurons get equally good. However, when pain killers are introduced into the equation, the pain inhibiting neurons do not get used. They never get good.

Unfortunately, as we get older, more things hurt. Things that you never knew you had before, start to hurt. If you do not have effective pain killing neural pathways, more and more, stronger and stronger pain killing medication is required to dull the pain. And we all know what happened.
Micheal never really learned a good golf swing. He kept practicing the wrong swing, and thats what he knew. When the time came that he really needed to hit a good shot, he couldn't hit a golf ball to save his life. Literally!

Merrily,Merrily, Merrily,.......

People who suffer from mental illness's experience delusions, or more apropriatley, delusional thinking. They believe things are true when they are not. And they similarly believe that things are false when they are true. The facts that deny the delusion are ignored, while the facts that support the delusion are part of the delusion. The delusion creating neural pathways are used over and over. They get stronger and stronger, while other pathways that might support a more rational veiwpoint become weaker and weaker. If this continues for a long time, a mentally ill person can completely loose contact with reality. The delusion becomes the reality. The golf swing becomes so bad that it is impossible to play and they give up the game altogether.

Everything in this reality works. The facts all mesh. The problems arise when the “other” reality tries to interface. The rest of the world seems to operate by a completely different set of rules. The mentally ill person has problems functioning in the other reality that does not conform to his or her self created rules.

We have all heard the expression, “Insanity is doing the same thing over and over again, expecting different results.“ And there is really a lot to that. We do the same things over and over again, reinforcing the same neural pathways. They get stronger and stronger. that is just one of the reasons to continually try new things. To create a lot of experienced pathways.
In this way we can create our own reality, one that works, and conforms to the reality that the rest of the world lives by. If reality is your fantasy, then its not a fantasy at all!

Life Is But A Dream!
Make it a good one!

Wednesday, Dec. 03, 2008
Why Do the Mentally Ill Die Younger?
By Kate Torgovnick

Cynthia Scott is your average health conscious 56-year-old. She watches
what she eats, drinks lots of water and takes a multivitamin every
morning. She goes for frequent walks and visits her doctor regularly for
check-ups, including cholesterol and diabetes screenings.

Scott also has schizoaffective bipolar disorder, a mental illness she
keeps in check with a low dose of Zyprexa. If you ask Scott, she would
say she is overall a healthy person. So she was shocked when the
National Association of State Mental Health Program Directors (NASMPHD)
published a study two years ago called, "Morbidity and Mortality in
People with Serious Mental Illness." The report analyzed data from 16
states, and found that, on average, people with severe mental illness
die 25 years earlier than the general population. "Hearing that made me
so sad," says Scott. (See the Year in Health, from A to Z.)

The findings were a bombshell for the rest of the mental health
community. "The study jarred the field," says Dr. Bob Glover, the
executive director of NASMPHD. After the 2006 report came out, many
mental health agencies in the U.S. made it an immediate priority to
figure out why their patients die sooner, and how to improve their
longevity. Says Glover, "Mental health has been late to the dance in
terms of looking at the connections between mental health and physical
health. It may be moot what you're doing for mental health needs if
people are dying so early from physical causes."

Indeed, the causes of physical illness and death among psychiatric
patients are much the same as those in other groups — cigarette
smoking, obesity, diabetes — and treatable. The problem is that people
with serious mental illness tend to be low on the socioeconomic totem
pole and don't often get the best available health care. Often, their
own doctors pay little heed to their patients' physical health. "Medical
doctors think, 'Well, they're crazy,' so don't take their concerns
seriously," says Wendy Brennan, executive director of the National
Alliance on Mental Illness (NAMI) in New York City. "Their very real
physical symptoms are often dismissed."

One of the commonest contributors to early death among mentally ill
patients, for instance, is smoking. While about 22% of the general
population smokes, more than 75% of people with severe mental illness
are tobacco dependent. According to Glover, a study conducted by NASMPHD
after it published the mortality study found that 44% of all cigarettes
in the United States are consumed by people with psychiatric histories.
"I used to run state hospitals and we'd use cigarettes as reinforcement
— 'You did good, you get a cigarette,'" he says. "When people didn't
do well, we took away their tobacco privileges. We were part of the
problem." The agency is now working to make state mental hospitals
smoke-free by 2011.

Obesity is another big risk factor. People with depression or bipolar
disorder are about twice as likely to be obese as the general
population; in people with schizophrenia, that risk spikes to three
times higher. This is in part because so many psychotropic medications
cause weight gain. At many state hospitals, says Glover, "you'd see a
woman be admitted at 120 lbs. Three to six months later, she'd weigh
200."

Obesity-related illnesses like diabetes are so prevalent among the
mentally ill that health officials call it an epidemic within an
epidemic — for example, about 13% of schizophrenic adults in their 50s
have been diagnosed with diabetes, compared to 8% of the general
population of the same age. In October, the NASMPHD released another
report with recommendations for treating the particular problem of
obesity, including giving those with severe mental illness better access
to dietary consultations and promoting the prescription of low weight
gain antipsychotics. They are currently working on creating a toolkit
for federal health-care providers to better inform them on the issue.

At NAMI-New York City, health workers held focus groups, after reading
the 2006 mortality report, to assess their patients' health concerns.
There were many — foremost among them, the simple desire to feel
deserving of good health. "The most shocking thing was that people
really wanted to be healthy, but there was a disconnect," says program
associate Katie Linn, who ran the focus groups. "A lot of it came down
to self worth — they didn't feel like they were worthy of taking care
of themselves."

Based on the participants' responses, NAMI created a program called Six
Weeks to Wellness, a once-a-week class that teaches everything from
proper nutrition to controlling anxiety through yoga and meditation.
"It's been wildly popular," says Linn. "It helps to say, 'Your health is
important to us.' They've never heard that before."

For the NASMPHD, the next logical step is to educate the doctors who
care for the mentally ill. This month, the agency will release
guidelines for standardizing the medical tests, assessments and care
given to mental health patients in the public system. The
recommendations include taking regular measurements of patients' height
and weight, checking their glucose levels and carefully evaluating their
medication history. Psychiatrists, likewise, are not exempt. According
to Mental Heath America, based in Virginia, a recent survey of people
with schizophrenia revealed that they rarely discussed physical health
with their psychiatrists. So, the organization is now working on an
initiative, with the American Psychological Association, to better
educate mental health specialists about the physical concerns facing
patients with serious mental illness.

As for Cynthia Scott, for the past two years, she's taken her health
consciousness to a whole new level, regularly attending NAMI's yoga
workshops in New York. "I'm big on taking care of myself," she says.

Editors Note: Baco informed us that he wasn't feeling well enough to write On The Bus this month, so he stole one.

We’ve probably all seen the top 10 myths of health (like that we need 8 glasses of water per day or that we only use 10% of our brain). So that got me to thinking… What are the top 10 myths of mental illness and mental health? I compiled some of my favorites below.

While many advocacy organizations and pharmaceutical companies try to imply that mental illness is just a “brain disease,” the truth is that scientists still don’t know what causes mental illness. Furthermore, of the hundreds of research studies done on the brain and the brain’s neurochemistry, not a single one has implicated a single source or cause of any mental disorder. In other words, it’s far more complicated than you know.

Many mental health experts believe in the “bio-psycho-social” model of mental disorders. That is, there are multiple, connected components of most people’s mental illness that include three distinct, yet connected, spheres: (1) the biological and our genetics; (2) the psychological and our personalities; and (3) the social and our environment. All three seem to play an important role in most people’s development of a mental disorder.

Psychiatric medications have been prescribed for decades and are generally proven safe and effective in the treatment of most common mental disorders. However, medications are rarely the treatment option that most people should stop at. While taking a pill a day is the easiest treatment option, a pill can only do so much. That’s because mental illness is not like any ordinal medical disease (see Myth #1).

Other treatments — like support groups, psychotherapy, self-help books, etc. – should always be considered by virtually everyone diagnosed with a mental illness. Medications are often the first thing offered, but are best seen as a way to help get a person jump-started in their treatment efforts.

3. If a medication or psychotherapy doesn’t work, that means your situation is hopeless.

Psychiatric medications are a hit-or-miss proposition. For instance, there are over a dozen different antidepressant medications a doctor can prescribe, and the doctor has no idea which one is going to work best for you. So virtually all psychiatric medications are prescribed on a trial-and-error basis – “We’ll see how you do on this, and if need be either increase the dose or switch to a different medication.” Reasons for switching or changing the dose usually include intolerable side effects for the patient, or the medication simply isn’t offering any therapeutic relief.

Just as one may need to try a number of different medications before finding the one that fits “just right,” one may also need to try a number of different therapists before finding one that they feel comfortable and productive with for psychotherapy. There is no “best” way to do this, other than to take therapists through a trial-and-error process too, trying them out one at a time for a few sessions until you find one that you seem to have a positive relationship with.

4. Therapists don’t care about you – they only pretend to care because you pay them.

This is a thought that goes through many people’s head, whether they’re just starting therapy for the first time or they’ve been in therapy for years. The psychotherapy relationship is an odd one, not quite replicated anywhere else in society. It is a professional relationship that will be emotionally intimate, a characteristic most people don’t have much experience with.

The vast majority of therapists, however, don’t go into the psychotherapy profession for the money (because it is one of the poorest paying professions one can be in). Most therapists get into the profession much for the same reason as most doctors or teachers do – they see it as a calling: “People are in need of help and I can help them.” Although it may not seem like that when you’re on the other side of the couch, most psychotherapists do therapy because they genuinely enjoy helping others work through life’s tough problems.

Some people believe that mental illness is really just about “crazy people” — you know, people with schizophrenia who hear voices all the time. But it’s not; mental disorders encompass a wide range of problems in life, including being depressed for no reason for weeks at a time (depression) or being unable to concentrate on any single task for more than a few minutes at a time (ADHD).

A mental disorder doesn’t have to be life-threatening or make you unemployed and homeless in order to have a serious impact on your life. Even mild depression, left untreated for years, can turn into a chronic condition that significantly could impact your quality of life and your relationships

6. Psychology and psychiatry aren’t “real sciences.” They’re supported only by fuzzy research and contradictory findings.

Research into mental illness tries to understand where it comes from and what treatments are most effective in helping people cope. Psychological research dates back more than a century, starting around the same time that modern research began in medicine and our better understanding the human body. Its rich history and scientific methods are far more complex than the simple, popular image of Sigmund Freud sitting in his office listening to patients as they lie on a couch.

Some who argue this point come from different scientific backgrounds and use different yardsticks from those fields to try and “measure” psychology, psychiatry and the neurosciences by. Unfortunately, that’s like comparing apples to oranges and then coming away upset that because they taste so different from one another, these two couldn’t possibly both be fruits. Psychology and its related sciences are indeed “real science,” using well-accepted scientific methods and methodologies that have been time-tested and that produce real, verifiable, and actionable results.

7. Mental illness is a myth, based upon arbitrary societal definitions designed only to sell you drugs or psychotherapy.

This is one of the most difficult myths to challenge because there is some truth to it. Much of how we define mental illness today is based upon definitions we humans created while observing sets of symptoms that seemed to cluster together when people presented with certain concerns. People’s suffering is no myth, but arriving at how we understand that suffering and then helping the person through it is open to a wide range of interpretations and options.

The most common method in science is to identify similar groupings of symptoms, give them a label, and then discover what kinds of interventions work best in helping a person feel relieved of those symptoms. Some of this is steeped in rigorous scientific method, but some of it feels (and perhaps is) more arbitrary and political. Mental illness is no myth, but some of our definitions could be a lot better and more discrete. And, for the record, defining mental illness came long before the practical, modern profession of psychotherapy and pharmaceutical companies.

There is a whole category in the official diagnostic manual of mental disorders for children’s mental disorders, some of which are well-known, diagnosed, and treated, such as attention deficit disorder (ADHD) and autism. But in the past decade or so, some researchers and professionals are suggesting that many adult mental disorders are also possibly found (and perhaps even widespread) in children.

The jury is still out whether it’s legitimate to diagnose a 3- or 4-year old child with adult bipolar disorder (how one discriminates mood swings typical of normal childhood at this age versus a disorder is beyond me), but it’s a possibility. The debate centers around scientifically distinguishing expected, normal childhood behaviors (even when they span a wide continuum) from serious adult-like mental disorders that need their own specific treatment plan. More research is needed before a conclusion can be made.

Just as in a lawyer/client relationship, confidentiality between a doctor and his or her patient, or a therapist and his or her client, is not absolute. While it is a legally protected relationship much like a lawyer/client relationship, there are times when in most states a therapist can be compelled by a court to testify about something said in session or about a client’s background. These exceptions are extremely limited, however, to specific circumstances, usually involving the health or safety of a child.

There are other times when a therapist may need to violate the confidentiality of a relationship as well. Most therapists go through these circumstances with their clients at the start of the therapy relationship. Instances of such disclosures might include if the client is in imminent harm to themselves or others, or if the therapist becomes aware of child or elder abuse. Outside of these exceptions, however, confidentiality is always maintained by a professional.

I wish this were a myth, but sadly, it is not yet. Mental illness in most societies throughout the world is still badly stigmatized and looked down upon. In some societies, even admitting to a possible mental health concern can make you ostracized from your family, coworkers, and the rest of society.

In the U.S., we’ve come a long way in the past two decades with significantly more research, and increased understanding and acceptance of mental illness. While still not as accepted as having a common medical condition like diabetes, most people view common mental illnesses such as depression or ADHD as just another one of those concerns of modern life. Someday, I hope this is true in the rest of the world as well.

When I was first diagnosed, I had never heard of WRAP. I formulated something that I call “Manual Override”. I came to the conclusion that I was an educated, intelligent guy and I would use my intellect to over come my illness.

Essentially, manual override is about recognizing your symptomatic thoughts and behaviors and differentiating them from who you are and who you want to be. Symptomatic behaviors are fairly obvious: Eating too much or too little, sleeping too much or too little, poor personal hygiene, compulsive gambling, drinking, and substance abuse, etc. The thoughts should be obvious also. Some people call them voices. Others call them tapes (Time to upgrade to CDs or memory chips!). Common ones are sexually perverted stuff, thoughts of violence and destruction, and of course, everyone’s favorite, the winner and still champion, “I am worthless, there is no reason to go on living, I should kill myself!” (And you thought you were the only one!)

For those of us who suffer from a mental illness, it is easy to have these thoughts and behaviors. It should be simple to recognize them for yourself as the thoughts and behaviors of a mentally ill person and stop doing them. Simple yes. Easy no! It takes practice, and practice you must. You aren’t going to just pick up a golf club and play on the pro tour! You aren’t going to master manual override on the first try either. But if you want to do it, you have to keep trying.

Manual override is something that I do in my mind. WRAP is different. It is a written plan for you, the people around you, and your healthcare professionals. The parts of WRAP are: The things to maintain your wellness on a daily basis, The primary indicators that you are about to have a problem, The things that you and others need to do when you become episodic, What to do when things really go bad, and What you think are the indicators that you are improving, able to handle the situation on your own, and what other people can do to help. In the best scenario, it is way to get better and maintain yourself. In the worst case, it gives you a voice when you cannot speak for yourself.

Some of you may have an issue with the word recovery. Recovery is not recovered! Recovery is an ongoing process. I don’t think it ever ends. Maybe management is a better word, but it doesn’t make as nice an acronym!

FYI! I am not a trained WRAP instructor. I can only give you a brief overview of the course and plan. There is a website;http://www.mentalhealthrecovery.com that I’m sure has a more detailed description of the course and plan. Much like a support group, I believe it is much more beneficial to actually attend the class in person, than it is to view it on a computer screen. The course that I took was a four day/three hour class. I’ve heard of it being offered as one, two, and three day courses of varying lengths.

WRAP is open book! You can use whatever resources you want to formulate it. You can ask for help, and use other peoples ideas. You can change it later if you want. No penalty! No extra Charge! It might be best not to try to do this all in one sitting. Do a little each day. Go back and review what you have written before forging onward. Let’s begin.

I. Write down a story or make a list of things that you already do to take personal responsibility for your own wellness. Then write down some things that you would like to do to claim more responsibility for your own wellness.

II. Make a list of the people you count on for support. Make another list of the people that you support what qualities do you like most in your supporters and what do you have to offer others.

III. Who are your professional healthcare supporters? What do you like and dislike about them? Is there anything new you would like to try, and what do you think you need to do to accomplish that goal?

IV. Write down your own medical history. Include you family members and any current conditions and treatments. Don’t be afraid to make a list of the questions you would like to ask your professionals.

Important parts of the course are some exercises to help you to fill out the plan. Make a list of some positive things about yourself. Also, make a list of some of the negative thoughts. Examine them critically, look for evidence, to see if they are true. If in fact they are true, write down some things that you think you can do to change them.

V. Make a list of things that commonly (or uncommonly) trigger you. Do you ever have preliminary symptoms that indicate the onset of an episode? Write those down as well.

VI. Maybe your symptoms have become very severe, or they have gone on for longer than usual. How severe? What kind of behaviors will you be doing?

How long is critical? How well have you done before. Do I want to see a doctor? Go to the ER? Write all that down.

VII. Either you think that everything is Ok, the sky is falling, or you don’t think anything at all. What are some indicators, particularly to other people, that it is time for them to take over? What things need to be done? who do you want to do what? Who do I want to see and talk to/ don’t want to see or speak to? Is there a particular doctor or hospital you like/ Don’t like? I there a particular drug or therapy that you think would be effective/ not effective/ dislike intensely? It is important to plan out these last two stages when you are thinking clearly. Do not wait until you are having a problem! Remember, you can always change it!

VIII. Lastly, what are some good indicators that you are doing better and ready to care of some/all of your responsibilities? Are you going to need some help? From who? And with what?

Once you have completed writing out your plan, it is recommended that you review it regularly. Weekly is what is recommended, but I’m sure that monthly is equally good. It is after all a recovery/maintenance tool. You may change you mind, think of something new, or the mental health journaler’s lament, “I wrote that! I must have been crazy!” you are supposed to make copies and give them to friends, family members, and you physician. Some of this stuff may be very personal and you may not want it widely distributed. You ought to give a copy to at least one other person. Failing that, leave a copy somewhere that someone else can find it if needed.

All of us either have some form of mental illness, or know someone else who does. Are we crazy? Are we different from normal people?

Almost everybody knows someone with a mental illness. It is unfortunately all too common. Crazy and normal are really a poor choices of words. Healthy and ill are better choices. But even then they are variable terms. A person can have a broken leg and still be healthy. Likewise, a person can have diabetes or even cancer and still be considered healthy. Conversely, a person can have the common cold and be terribly ill!

The question that all of us have asked ourselves is, “Why me?” Why are we ill and others are healthy? Why do we have these thoughts that make us say and do the things we do?

Something happened to each of us, something not very good. Yet these same things happen to other people, and they do not become mentally ill. Or at least they do not let it affect their lives.

There is a body of evidence that abusive and dysfunctional homes are not the cause of mental illness. I have no idea how they came to that conclusion, but try explaining that to someone who has lived that experience! Yet some people do survive this kind of experience and go on the lead happy, healthy, and successful lives. They must represent a statistical majority, although I have met very few people that can say they are one of them!

There is obviously a biochemical component to mental illness. Adding certain chemicals and using other chemicals to impede or enhance our body’s own chemicals do make a difference in how we think, act, and feel. For some people, some of these chemicals work very well, for some, with varying degrees, and others, not at all!

There is considerable research into the genetic component of mental illness. In wild animals, where most of their behaviors are instinctive, almost all of these behaviors are genetically encoded. Many of these encoded behaviors lie dormant until environmental conditions predicate that they engage. We do not like to think of ourselves on the same level as the animal world, but we most certainly are. We also must certainly have genetically encoded instincts and behaviors that become triggered by environmental conditions. Many of the selective pressures under which our ancestors have evolved have diminished in importance to our survival. From a purely parochial scientific viewpoint, many people who would not have survived under the old pressures have survived to produce offspring. Much of this encoded information may have been intensified, altered, diminished, or out bred altogether!

All of us, as children, imprint upon our parents. We speak the same language and use the same inflections. We learn to act like them in many ways. Maybe for a child growing up with a mentally ill parent, mental illness may be a learned behavior!

But! But! But! Normal people have all these same things, what makes them different and why cant I be like them? Normal is a setting on the dryer or air conditioner. Considering that there is an estimated 40 million undiagnosed and untreated mentally ill in this country, and the World Health Organization believes that mental illness is the worlds number one public health problem, there may not be anything such as normal! Much like flu or the common cold, even the healthiest person can have a “touch” of mental illness, and then it goes away. It doesn’t have to be forever.

For those of you who have not heard my mantra before, here it is again; “mental illness can be treated, managed, and controlled. Mentally ill people can lead happy and successful lives.” Essentially, they can become normal. Maybe the “normies”, unlike us, do not have to go to a doctor or therapist to learn to do these things. They devise their own strategies for dealing with their symptoms. When something doesn’t work, they try something else. They never give up!

In my youth, as a college student, I had the dubious privilege of being a student representative on the Biological Sciences Study Committee. This was only a couple years after Watson and Crick had published their book on DNA and the double helix. The science of using DNA to identify organisms was new. But this new evidence showed that many kinds of organisms that had been previously grouped together and thought to be related because of physical similarities, were not related at all and logically belong to another group of organisms. The change of names and categories resulted in mass confusion that lasted for several years. But there was a purpose and a goal; that all biologist would use the same updated nomenclature, and thus know what each other were talking about. The Banded Winged Grasshopper couldn’t care less what we called it!

It is kind of like that in the mental health community. The names of the various conditions, diagnoses, disorders, and symptoms are more for their professional use than our benefit.

Recently, I spoke to the mother of an individual who had been diagnosed as schizophrenic. He did not like this diagnosis and became episodic when it was used to describe his condition. He much preferred the term Bipolar. It did not change his disorder, just the name, and made it easier to get along with him.

Personally, as I read through the mental health literature, it appears that I have symptoms from across the spectrum of various illnesses. Though my diagnosis remains, “Chronic Recurrent Depression.”

The symptoms that indicate depression and mania are common to an entire host of both mental and physical ailments. This must be difficult for professionals. What appears on the surface to be a relatively simple and treatable disorder, may have terribly complicated undercurrents.

If you feel that you have been misdiagnosed, It may be that there is something that you have not told your doctor. Not intentionally, but it may be something that you think is normal, which your doctor may think is critical to your diagnosis and treatment.

http://psychcentral.com/diagnosis/, you will see a list of 75-80 different mental disorders and conditions. The author admits that it is by no means complete. The banded winged grasshopper doesn’t care what biologist calls it. It’s life didn’t change because some committee changed it‘s scientific name. It still has to eat leaves, avoid the birds, and make little grasshoppers! Do not get upset if your doctor gives you a label that you don’t like, or if they change your label from one thing to another. You are still the same person. You still have to follow your doctors directions, take your medication, and take care of yourself, grasshopper!

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I‘ve seen this movie before, but this the first time I’ve seen since I have been diagnosed. I saw the film in a whole new way. This is going to be a different kind of review. It’s not going to be about film making criteria, but about the mental health issues presented in the film.

Most of us who have suffered from, and have been treated for mental illness will empathize for the stories main character, Virginia Stewart Cunningham. Hopefully, the author, Mary Jane Ward, did some actual research on mental illness and it’s treatment before writing the book (1946), that was then made into a movie in 1948. We all can hope that things certainly were not actually that bad in mental hospitals of the time. But the film was so emotionally powerful that it change peoples attitude about the treatment of the mentally ill.

The Wards are numbered by the severity of the illness, lower numbers being the better patients, higher numbers being the more severe. At the time, she is housed in ward three. All of the patients are pretty disassociative, and even in ward one, are still fairly delusional. Patients within a ward are all together, even at night, and are not separated from one another. The facility itself is dark and dank. It has bare brick walls and is very prison like. The film is in black and white and this adds to the effect.

The first scene in the movie, Virginia is sitting on a park bench and hearing voices. She has actually been in the institution for five months and has no recollection of that time or the events that brought her there. Virginia is unsure of who and where she is, and is unable to have a coherent conversation with her doctor. He decides on electroshock therapy, of which Virginia gets several treatments. The break through comes when she realizes that she is ill and in an institution. She does however, slip back and forth between reality and delusion, and displays extreme anxiety over minor issues.

The doctor then tries a drug induced hypnotic regression. Oddly, this was the only time during the film that any medications were administered. (I can only assume, that in 1948, drug therapy for mental illness consisted of a sub-lethal dose of barbiturates!) During this regression, the doctor finds some Freudian issues dealing with her ability to have a relationship with her husband, treats her based on that premise.

Another issue dealt with in the film is the nursing staff. The nurses complain that they have too many patients to deal with. They have an “I am doing my job“ attitude, “behave and follow the rules!” they are generally uncompassionate toward the plight of the patients. In one case, the charge nurse schedule Virginia for another shock treatment even though the doctor has has not ordered it, having failed to even look at the patients chart! In another case, this attitude causes Virginia to have an extreme anxiety attack which the nurses responded to by putting her in a straight jacket and shipping her off to ward 33! The role models for Nurse Cratchet in “Cukoo’s Nest.”

In ward 33, Virginia has an epiphany. Surround by the extremely ill, she realizes that she is one of them, though not quite as delusional. She becomes the friend of one of these women, Hester, and tries to help her. Over time, the Freudian based therapy appears to work and her family would like to take her home. She goes to “Staff”, where the doctors examine her prior to release. She is not ready. During the course of the exam, one doctor badgers her about remembering facts about her life in an unsympathetic manner. He shakes his cigar holding finger in her face. This causes another very severe attack, and its back to the wards.

The therapy continues and Virginia begins to realize that the causes of her illness are things that she cannot control and that she does not have to let them ruin her life. She passes through “Staff”, and makes a breakthrough with her friend Hester.

It’s a powerful movie. It won an academy award and was nominated for eight others. I’m sure in 1948 it was shocking and thought provoking. After the movie’s release, 26 states changed their laws on how the mentally ill should be treated. In great Britain, the censors required and introduction that pronounced that mental Hospitals in Great Britain bear no resemblance to the institution portrayed in the film.

The film does accurately portray Virginia’s progression through her illness toward wellness; grief and denial, acceptance and coping, to management and even advocacy. What is portrayed inaccurately , are the patients. While I am sure there are people like that, I do not believe that they make up the majority of the mentally ill. I also fear that the portrayal of the mentally ill and their treatment may have contributed to the stigma associated with the mentally ill, and the fear of seeking treatment. I can only hope that administrators, doctors and nurses in institutions are more compassionate and knowledgeable about the suffering of their patients, than those in the movie.

While in this case, the Freudian based therapy was successful, my sources tell that it is now considered to be overly simplistic. It does raise the question; why do these traumas send some people over the edge, and others are able to go on living normal lives? See the movie and think about it.

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People who suffer from mental illness’s and people with other handicaps are often the victims of stigmas. Personally, I did not know how bad it was to have mental illness, until I had it. The people who practice stigmatization probably aren’t bad, they just don’t know any better. It is up to us to educate them.

The very first thing you can and must do is be an advocate for yourself. Sometimes this may require “Coming Out“, and being open, honest, and public about your illness. But it can be as simple as doing those same things within the framework of your treatment professionals, and/or support groups. Say what you want! By that I don’t mean say anything, but stand up for yourself, and try to do it in a rational manner. If you are going to be critical, try to be specific and constructive. If your treatment isn’t working for you, ask what kind of changes can be made. Your doctor and support group may respond by asking you what changes you think you should make. You must also be prepared to take criticism.

OK! You’ve become a successful advocate for yourself. Congratulations! You have put yourself on the road to wellness and recovery. You may have noticed how other people have the same problems that you have dealt with, but are not doing so well at it. It’s time to be an advocate for others, and there are numerous ways of doing this.

Some people are very good at “Working the System”. They know what programs are available, where to go, and who to talk to. There is a large assortment of benefits available; low priced and free medication, low priced and free psychiatric care, housing, transportation, food, employment, general medical care, and even cash! Obviously, it can be very difficult to get well and manage your illness without some of these things.

Being supportive is both a talent and a skill. It comes naturally to some, but there are courses you can take that are very helpful. Saying the right thing at the right time to keep someone out of crisis, or pulling out someone who is in crisis, is invaluable to our community.

Knowing about medication can be a tricky subject. Everybody’s illness is different. Everybody’s brain chemistry is different. There may be co-occurring medical condition. What works for one person, may not work well for others. Be Careful! I know within the NAMI model, we are prohibited from suggesting medication. Too much like practicing medicine.

Take charge! “If you want something done right, do it yourself!” “If nobody else is going to do something, I will!” Assume a leadership role in your support group and community. Be politically active. Speak publicly. The general public needs to realize that the mentally ill need not be incompetent. Many of us are highly educated!

Being an advocate is good for you. I try to get people involved in our DBSA board. It’s not high stress, and it gives them a feeling of accomplishment. I took a peer facilitator course from NAMI. I’ve facilitated meetings for DBSA many times and it was easy for me. It was not so easy for others. It was not for some others. I would tell them, “ The first time you realize that you have helped someone, you’ll think to yourself,’ I can do this!’”

I cannot let this subject go without a big thank you to Edwina and Kelli, who started and run this chat room. They have continued to expand and improve it. It has turned into a valuable, international resource for the mentally ill. What an accomplishment! All of us know them both, some better than others. Like the rest of us, they have their own problems. But they both serve as a shining example of how you do not have to feel good all the time to be an advocate and help others. Hey, You can do it too!

Welcome bus riders.

We all come here to chat with one another. Each of us has our own reasons for coming here. And each of us has at one time or another, experienced some kind of behavior that we did not like.

There are some important things to remember. Everything that you post to the internet stays there. Forever! For anyone to read! I do not know what the copyright agreement is , whether our post belong to Edwina or Para chat and how protected they are. Also almost everyone who comes here to chat is mentally ill! Some more than others.

Trolls! If you are reading this, there may be hope for you. These may some of the most ill people that you encounter on the internet. They are just looking for attention, and are not particular what kind they get. In the mental health chat rooms they neither ask for, nor offer help. They do not even want to friends with people. Do not try to talk to them, argue with them, or even call them names. Operant conditioning! Ignore them. The “ignore” feature of this room helps. Click on the name to the left to highlight it, then click on the “ignore” button. Nuff said!

Troll-like behavior. These people too, may be seriously ill or episodic. They sometimes carry on a conversation with themselves, say irrational things, and fail to relate to others in the room by acknowledging their post. You might be able to start a conversation with one of these. Use your judgment. If it is someone you know, you may want to carry them. If not, you may want to direct them to this blog. Otherwise, ignore or sign off and come back later.

Then there is what I like to call, “The Lord of The Flies” effect. Simply put, it is mob rule. One person says something stupid, someone else jumps on their case, then everybody else has to jump in also. I’ve done it. It is easy to get caught up. Generally, the ensuing defecations and condemnations are even more stupid than the original remark! Try not to do this. The people that come to mental health chat rooms have an illness. JUST LIKE YOU! They may be having an episode and/or not completely in control. The things said in these lynch mobs can be more than just offensive, they can end friendships, and do long term damage to someone elses wellness and recovery.

The dating game. Most of us live so far apart there is hardly any chance of actually meeting that other person, let alone getting “horizontal” together. They have been a few happy cases of people who have found each other. Very rare! Generally, the mentally ill have lousy relationships. You could hurt someone , or get hurt yourself. Once again, screwing yours or that other persons wellness and recovery. Those may the only things that get screwed. There is an old saying, “don’t sleep with anyone who’s problems are worse than your own!” In this case, “don’t sleep with anyone who’s taking more medication than you!”

Hyper sexuality. This is an unfortunate symptom of Bi-polarity. When manic, people may actually believe that they are attractive and alluring. A lot of the sexual banter and “I love you’s‘” are tongue-in-cheek and “for entertainment purposes only.” Please, no wagering! I get a kick out the cyber suave de bon aire’s who actually think that they are going to get in the pants of some gal (or guy) a thousand miles away! I used to be one! If they are such a hot product, how come they are some geek on the internet, instead of out on the town with some hot bod? You silver-fingered-devils!

Chronic cacaphonia. Samuel Johnson used to say, “profanity is the refuge of the illiterate.” I’m no prude. I use it. But at times it is ridiculous. I like to compare to the cub scout troop that has just learned all these new, forbidden words.

Remember, this is a mental health chat room. Some people may be prone, from time to time, to say and do things that they regret later. If you have never done anything like that, you probably do not belong here! Everyone expects compassion for the mistakes that they make. But it seems hard for the same people to give it to others. If it is something you would not say with your mother in the room, in mixed company, or face-to-face with that other person, you probably should not say it here! Try to avoid cutting to the quick and doing permanent damage. The mentally ill can be very sensitive.

A couple thousand years ago, a famous rabbi is attributed to have said, “taking back words that have been said, is like removing the salt from water in which it has been mixed,” yet another famous rabbi said, “what is distasteful to yourself, do not do to others.” Much later it was paraphrased by anther famous rabbi, “Do unto others, as you would have others do unto you!”

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