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  1. #1
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    Dec. 21, 2005
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    Default Mental health and asking for help

    Recent events in my family and an article about the new DSM-5 have gotten me thinking about our system of mental health care.

    My 17 y.o. nephew was recently hospitalized for a week because he causally mentioned to his GF that he had thought about killing himself during a suicide awareness event at their school. She probably did the right thing in telling his mom, but from there my nephew was rapidly committed. He was locked up in a mental ward, isolated from his friends with no phone and missed several days of school. He is now home, angry about how everyone over reacted and how he has to catch up at school. He is not permitted to take as much as a Tylenol without his mother's permission, and his hopes of joining the Navy may be over, all for being honest.

    The new DSM-5 is being criticized for making it too easy to label a person with a mental disorder. Apathy syndrome is now a recognized disorder, as are many changes which afflict the elderly. Those petitioning to have the DSM altered fear over medication of people who are really just aging or growing up. Over prescription of anti-depressants is rampant and a lot of people don't understand the potential side effects.

    Are we becoming to eager to slap a label on everyone these days? Documented treatment of a mental illness can haunt a person for a long time, even effecting careers. I decided very young that my feelings needed to be carefully hidden for fear of being stigmatized and locked up, even if it meant probably putting myself in danger. I was on ADs for a few months after my daughter was born (I figured PPD was an "acceptable" problem) and they scared the hell out of me. I swore I would never take them again.

    So, what does everyone else think?
    "Is it ignorance or apathy? Hey, I don't know and I don't care." ~Jimmy Buffett



  2. #2
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    Jan. 27, 2010
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    Default

    Well, for myself, I decided that it didn't matter if I couldn't join the peace corps or work for the CIA or the military or the state department or be a paramedic or . . . whatever. Wanting to get out of the bed in the morning is more important than claiming any sort of career success. And realistically speaking, even if I weren't diagnosed with depression, anxiety, and ADD, and managed to get those jobs, I probably wouldn't be able to keep them for long. Getting treatment is the most important thing, and as for all the rest, there's innovation and advocacy.

    I'm tired of being ashamed for being sick, and I'm tired of trying to hide what's going on. If I experience a trigger, I don't have a problem sharing my diagnosis and explaining what is going on in that moment and asking for help if I need it. I've found that people are a whole lot cooler about it than I ever expected. People are much more willing to help you get through a near-panic attack than they are willing to try to engage you when you're sullen-faced and turned away from the group, you know?



  3. #3
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    Jul. 24, 2008
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    It's true that once you have a history of mental illness, that history will follow you for life. I see it being dragged out regularly in all kinds of court proceedings (we're talking custody battles and one party being depressed 15 years ago). Not too long ago, there was a story in the news about a lady who was not allowed to board an airplane, because she had attempted suicide many years prior.



  4. #4
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    Feb. 14, 2010
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    I see mental health completely different than most people. See I have grown up knowing that I would never be normal. It just isn't possible. My family genetics prevent it. My mother was the first to not go to a mental hospital. My brother and I are second generation of not going to the mental hospital, but they could also be the changing of the times. I could give you the list of my diagnoses... but what's the point other than to prove that I am certified crazy! I don't see it as a "label" so much but more as who I am. I tell my friends and any boyfriends so that they can choose to be around a crazy person or not. Apparently the ex hubby changed his mind when the going got tough. Current SO says it doesn't bother him one way or another. That he is there for me when I'm ready. (keeper!!!!!!!!!)


    As for your nephew, I think they jumped the gun majorly!!!!!! This coming from someone who at one point in time or more thought about suicide. What should have happened was that he attended therapy with a certified therapist who could determine the risk level. And then treat appropriately from there.

    But then on the other hand, I know that one of my great uncles went to the doctor, told the doctor everything was fine, went home and shot himself dead. As for hurting my career, not really. I do inform my future employees that I have a disability and that it doesn't inter-fer with my working (usually it doesn't). So far I have never had an employer ask what my disability is or inquire about my mental health (law suit anyone?).

    But thats my .02.



  5. #5
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    Jul. 19, 2007
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    Default

    Quote Originally Posted by Curb Appeal View Post
    Are we becoming to eager to slap a label on everyone these days?
    Yes.



  6. #6
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    Jan. 25, 2011
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    Wait... So they committed him because he said he'd considered it? Did they even ask WHEN he'd considered it or send him to a reputable counselor first? Sounds like a bit of a hasty reaction, to me anyways...
    I've heard there's more to life than an FEI tent and hotel rooms, so I'm trying it.



  7. #7
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    Jan. 14, 2003
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    Quote Originally Posted by Curb Appeal View Post
    My 17 y.o. nephew was recently hospitalized for a week because he causally mentioned to his GF that he had thought about killing himself during a suicide awareness event at their school.
    Is it possible his mother is sugar coating the story in an attempt to make it protect her son, who might be self conscious or embarrassed to have people know?

    The mental health system doesn't admit people so easily. Typically to actually be admitted to the hospital there has to be some pretty strong stuff going on regarding intent.



  8. #8
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    Mar. 27, 2011
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    If someone hasn't at one point or another thought about suicide, then chances are that person isn't thinking. We live in a morbid, death-obsessed society. Such musings are natural, if not healthy in moderation.
    And this is the story of your red right ankle.



  9. #9
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    I have really mixed feelings about this whole issue.

    My stepson is really and truly mentally ill, no question about it. I've seen him out and out psychotic. Without meds, he's scary and scared and completely nonfunctional. I would never, ever question the existence of true mental illness, it most certainly exists and sometimes medication is the only way for the person to have even a remote chance at a normal life.

    On the flip side, I do think there is more "medicalization" of normal human emotions than is good for us

    The hard part is knowing where the line is between an emotional state that is very uncomfortable, but normal and appropriate, and something pathological when there's not something very obviously, and outwardly, unusual going on. Sometimes life sucks and it's appropriate to feel depressed or anxious, knowing when the depression and anxiety is inappropriate and uncontrollable might be hard.

    And, what Catosis says makes some sense. My understanding (and I am NO mental health professional, so I don't know what I"m talking about ) is that passing, generic, thoughts of suicide can be normal...it's when one starts thinking concretely about a method and a plan that it's vital to seek help.



  10. #10
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    Documented treatment of a mental illness can haunt a person for a long time, even effecting careers.
    well, If you are sick and get treated and are now fine to live life, why should it "haunt" you? if you have diabetes or high blood pressure or arthritis or any other chronic medical condition how different is that from a diagnosed, treated, under control illness of the brain?

    over- and incorrect- diagnosis and treatment is an entirely different problem.



  11. #11
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    Quote Originally Posted by Canaqua View Post
    I have really mixed feelings about this whole issue.

    My stepson is really and truly mentally ill, no question about it. I've seen him out and out psychotic. Without meds, he's scary and scared and completely nonfunctional. I would never, ever question the existence of true mental illness, it most certainly exists and sometimes medication is the only way for the person to have even a remote chance at a normal life.

    On the flip side, I do think there is more "medicalization" of normal human emotions than is good for us.
    Exactly. I have seen ONE child (through various jobs I have had contact with hundreds of elementary-age children and detailed contact with dozens) where he was genuinely out of control and a danger to himself and others.

    But I've known far more people (myself included) who have been giving this drug or that drug when what they most needed to hear was "Suck it up. No one gets to be happy all the time." It's a lot easier to say someone's depressed and give them a pill so they think they're 'normal' rather than teach them to deal with it. There's a difference between "so depressed you are sincerely unable to get out of bed and are seriously contemplating death" and "I'm just not happy." And people who are sincerely introverted and shy are being lumped in with people who are truly phobic about going out in public. It's like there is some kind of decision that everyone has to meet a standard of generic normal and they're diseased if they don't.



  12. #12
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    I can assure you this did not happen the way it has been portrayed due to the basics of "least restrictive" care. I do not know of any private insurance that would pay for suicidal ideation without a solid and RECENT plan. I used to do planned admits on a regular basis, and I can assure you, the way you have described it, there is not a single hospital that could or would take him.

    The DSM-V is NOT going to make it "easier" to label someone - in fact, it is taking away some Dx that I am not sure is good - the hospital I worked for had us meet for some research on the new Dx - the nice thing about the new one is it eliminates some Axis and gets us more in line with ICD and WHO.
    Horse sense is the thing a horse has which keeps it from betting on people.
    W. C. Fields



  13. #13
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    Jan. 12, 2010
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    Quote Originally Posted by saultgirl View Post
    It's true that once you have a history of mental illness, that history will follow you for life. I see it being dragged out regularly in all kinds of court proceedings (we're talking custody battles and one party being depressed 15 years ago).
    This is one example I can understand, but unless one is going for a classified job, mental health issues are an issue for the employee. Period. Provided one deals with them and performs his/her job, most employers neither know nor care.

    If your mental health would prevent you from doing a given job, don't try to do it! I dislike heights and probably couldn't manhandle steel I-beams. Is it my employer's fault that I would be a sh*tty construction worker on a skyscraper? One has to learn herself, her limitations and abilities, regarding physical, mental and emotional realms. Mental health isn't so much different from a bad back or knee, limitation to jobs-wise, IYKWIM.

    Quote Originally Posted by saultgirl View Post
    Not too long ago, there was a story in the news about a lady who was not allowed to board an airplane, because she had attempted suicide many years prior.
    What the h*ll? How would an airline even know, and seriously, why would they care?

    (Saultgirl, my belligerence isn't directed towards you. I'm just feeling belligerent.)
    I'm not really at the top of my game today. I'm not even exactly sure what game I'm supposed to be playing, in fact... or where it's being held...

    My horse's antics iamboyfriend.com



  14. #14
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    Feb. 22, 2007
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    My biggest problem with our current system is that it can be very easy to get on medication without having to be in therapy. In fact it can be easy to get medication (often you just have to go to your GP and ask for ADs) but finding an affordable therapist that is covered by your insurance can be very difficult. And then the people who really need the medication because they're so ill they are having trouble functioning can have a hard time even getting the meds because they often don't have insurance.

    I've dealt with mental illness since I was a young teenager and tried everything from "sucking it up" (I can force myself to function for awhile, but nothing makes me happy and eventually I break down) to medication alone, therapy alone, and various combinations. What works best for me is a combination of medication and therapy. It is also very likely that it is genetic since my family has a serious history of mental illness.

    I also doubt the story in the OP happened exactly like they are saying. I have been hospitalized (sometimes it is the best way to find resources to help you, honestly) and it actually can be difficult to be admitted voluntarily, much less against your will. If that did happen like they say it did, then it's a fluke and shouldn't be taken as indicative of the mental health system as a whole. But I think it's likely that they aren't giving all the details. There is a huge stigma around mental illness and particularly suicide so IME many families won't share all the details with even very close friends and family.

    FWIW I've felt suicidal on several occasions both due to bad medication effects and when my illness wasn't under control, and I've never been involuntarily hospitalized even though I shared that with my doctors. They pretty much only commit you (or even really recommend hospitalization IME) if you have a plan and they think you're likely to harm yourself. Just thinking about suicide, even if you do so persistently, isn't enough.



  15. #15
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    Quote Originally Posted by Bif View Post
    What the h*ll? How would an airline even know, and seriously, why would they care?
    Here's the link to the story. http://www.thestar.com/news/article/...uicide-attempt



  16. #16
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    Here is a gross example of how the mental health system does NOT work:

    Have a client with an adult child living at home; adult child is showing distinctive signs of paranoid schizophrenia. He has become highly verbally aggressive and has accused his very small-framed mother of all manner of things. Out of love and concern for how his Bx may harm him in public, she allows him to stay home.

    She wants him to get the help he needs DESPERATELY, however:

    1. If he knows she is driving him to a therapist of any kind, he may attack her, based on recent verbalizations and posturing;

    2. Legally, EVEN IF SHE CALLS IN THE MIDST OF A DANGEROUS EVENT, he cannot be forcibly admitted unless he agrees - you DO see the issue with HIM making the decision, correct?;

    3. The ONLY option to force anyone over the age of 17 is to call the cops - and their protocol dictates that if THEY come take the person for a forced admission, a judge has to sign orders based on their report AND the person MUST be handcuffed, NO EXCEPTIONS.

    Now, tell me how easy it is for people to get the help they need when and how they need it.

    I agree that people ought not be on meds MOST of the time sans Tx, but that is up to the prescribing PCP or Psychiatrist. I have seen all styles by psychiatrists, and while I mostly agree that most people need talk Tx, some either have already had it and are stabilized OR will refuse to talk, and I cannot see withholding a medication that can help them live a more healthy life.

    I am all for best pratices being employed in any mental health setting; I am also for least restrictive. I come from a conservative medical model of Tx, and employ Cognitive Behavioral Therapy along with other styles as they apply, but I can tell you, there are some therapists that encourage heavy medication and can convince a psychiatrist that someone is psychotic, when in fact, they are having a "psychotic break" due to stressors and this does NOT demand the use of anti-psychotics!
    Horse sense is the thing a horse has which keeps it from betting on people.
    W. C. Fields



  17. #17
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    Just to be clear (because I think I wasn't, I had just woken up) I wasn't suggesting that people shouldn't have access to medication unless they were in therapy or anything like that. I was trying to get at the fact that it can be very easy to get medication prescribed by a GP and very difficult to find an affordable therapist or psychiatrist, at least in my experience. I agree that if someone needs meds they should be on them regardless of other factors, and that not all therapists are created equal--took me 4 tries to find one I could work with. But I do think that more affordable access to mental health specialists would help a lot of people. GPs in my experience will prescribe the medication but there isn't the same level of knowledge there about mental health issues (of course, because they're GPs and not psychiatrists).



  18. #18
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    I gotcha!
    Horse sense is the thing a horse has which keeps it from betting on people.
    W. C. Fields



  19. #19
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    Feb. 14, 2010
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    Quote Originally Posted by Eye in the Sky View Post
    Here is a gross example of how the mental health system does NOT work:

    Have a client with an adult child living at home; adult child is showing distinctive signs of paranoid schizophrenia. He has become highly verbally aggressive and has accused his very small-framed mother of all manner of things. Out of love and concern for how his Bx may harm him in public, she allows him to stay home.

    She wants him to get the help he needs DESPERATELY, however:

    1. If he knows she is driving him to a therapist of any kind, he may attack her, based on recent verbalizations and posturing;

    2. Legally, EVEN IF SHE CALLS IN THE MIDST OF A DANGEROUS EVENT, he cannot be forcibly admitted unless he agrees - you DO see the issue with HIM making the decision, correct?;

    3. The ONLY option to force anyone over the age of 17 is to call the cops - and their protocol dictates that if THEY come take the person for a forced admission, a judge has to sign orders based on their report AND the person MUST be handcuffed, NO EXCEPTIONS.

    Now, tell me how easy it is for people to get the help they need when and how they need it.
    She should to move to NC. A family member can have another family member committed for 72 hours for mental disturbances. And from there they can stay committed or can be released depending on the doctor's orders. How do I know this? I had my ex husband committed. We hadn't divorced yet, so I was able to do it. The rest of his family wouldn't do it and still don't like what I did that day. But I felt that it was the best solution to the problem.

    He actually pulled the trigger and the bullet jammed. But yet to this day him and his family claim he was never depressed or suicidal. I walked away from that day covered in bruises and cuts and scrapes and a finally broken heart. He walked away with 10 stitches where his dad cold clocked him to knock sense into him and 72 hours in the mental hospital where he went through withdrawals for alcohol abuse (but he doesn't/didn't have a problem with alcohol). And they call me crazy (at least I don't deny!).

    I was later told that if it hadn't come across the radio that I had the mental health order signed, the cops would have shot them. He had already fired one shot at me and the cop in the front yard before I left to race to the magistrate to sign the papers. Apparently, that meant a back up call and 5 other sheriffs showed up including a sniper.



  20. #20
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    Curb Appeal, I am sorry about the young man who was taken in for eval due to comments about suicide, but let me tell you what it's like when the hospital takes a treat and street approach.

    My sister was terrified of her soon to be ex husband. She told me on repeated occasions that she was afraid he was going to harm her or my parents, that he was 'the devil' and that I had no idea what he was capable of. My family never knew that side of him, but it all came out in the span of one month when a town busybody approached my sister in the pickup line at school to announce that her husband was having an affair with a woman who lived less than a mile from their home. Nice of her.

    Within days, stories about his behavior: lies about his background, education, fathering another child out of wedlock in the next town, theft, forgery, you name it..Mr. Upstanding Citizen turned out to be a real monster.

    She fled and came to stay with me with her children and her puppy. She was absolutely terrified of him. Evidently, he told her that he found a 'special lawyer' who specialized in taking homes and children away from their mothers and she was actually afraid for her life. When she mentioned suicide to me, I called her doctor. The nurse on the phone refused to let me bring her in or even put the doctor who prescribed Lexapro to her a few weeks before on the phone. I begged the nurse but she refused and said she would call ahead to the local ER. I learned later that she never made that call, so my sister didn't receive the priority treatment she should have had.

    I took my sister to the ER and we spent 5 hourse there. My other sister joined us and we gave the triage nurse a full record of what was going on and my sister reiterated her suicidal thoughts and fear of her husband.

    The case manager made me leave the room and spent another hour and a half with her before I found the nurse and asked to see her. We wanted her to be taken in for evaluation and kept overnight. Instead, they told me that she 'just had a bad case of the what ifs' and sent her home with me. She did seem better, and I was hugely relieved. She had been afraid that the stress and lexapro were causing her to lose her mind. This is a woman who, three weeks before, had been doing carpools, taking kids to dance, living a seemingly 'normal' life. She had a high IQ, a great sense of humor and was a very solid, kind, person. We talked until late in the night about her situation, that she felt stronger and more ready to move forward with her life and I was so relieved that she seemed ok.

    The next day, I had to go to jury duty and she was to meet my sister for breakfast and shopping until I could get out of my commitment. She told me that she didn't want anyone looking over her shoulder, that she was 'really ok' and even put her hand on her heart to prove it to me in a promise.

    Before she left, I told her that she looked beautiful, that I loved her and couldn't live without her and that we would help her through whatever lay ahead. We promised to meet up for lunch with my other sister. I never saw her again.

    Her evil monster husband told my sister's neighbor that morning that he couldn't wait to tell Pam about the lawyer he found who was in the process of preparing the paperwork to take the house and children away from her for 'abandonment' because she fled their home.

    We are now sure he got to her that morning somehow, because she broke plans with my other sister, saying that she was going to meet a mutual friend instead.

    At 12:35, she jumped, fell, or was pushed from a parking garage with no security cameras in Boston, 30 miles from my house.

    Did she give up and kill herself? Did her monster husband who refused to go into the city to identify her body, or allow my elderly parents or me to id her, have a hand in her death? He certainly did, whether he was right there in that parking garage with her or not. Would she have lived if they had admitted her at the hospital instead of patting her on the head and shoving her out the door? Is it just a coincidence that the owner of the parking garage is someone who my evil brother in law had been involved with in the past?

    I will tell you that it is one million times better to be safe than sorry. If someone even mentions suicide, their loved ones should move Heaven and Earth to get them help and make the doctors do their job. If your intuituion is telling you they are wrong, make a fuss and don't back down. If the person is mad at you or upset because you got involved, so be it. Because sorry lasts an eternity.



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