The Craziness of Mental Health

I’ve read about the mental healthcare systems abroad, some of the “things” that are available (like therapy) and thought a lot about ours.  I’m not suggesting that things are rosy everywhere else, but merely to reflect on the system we have here.  I live in South Africa and most of the laws and policies here are like Nelson Mandela authored.  We put the D in democracy and the humane into human rights, thereotically.  In practice, it doesn’t work that way.

For example, I once “trained” a group of women in a rural area in our country on the beautiful domestic violence act we have.  Thereotically the police can intervene, you can obtain a protection order, and again thereotically, be protected.  In your home.  In your house with your children.  They listened, dilligently took notes and smiled when I paused.  When I found their silence too much I asked why they weren’t talking / participating.  One of the older women stood up and said:  “The closest police station is at least 300 km away for most of us.  The court is even further.  And you’d be lucky if they serviced you on the same day, IF you have transport money to spare / get there.  We have our own act.  If your partner is threatening violence, we hang a certain item of clothing on the line, which means I need help.  The woman who sees it alerts others in the street, and we all come for “tea”.  We stay there, with endless conversation, until the situation is diffused. Sometimes it works and sometimes it doesn’t.  But that’s what really helps us”.

I kept quiet.  I was humbled by what these women went through and how they tried to help each other.  But that didn’t mean that they shouldn’t be helped more, and that resources and attention shouldn’t immediately be directed to make their lives better.  In the context of mental healthcare things are even more ominous.  There are people with chronic mental illness who died because they were dehydrated.  Yes, there were other factors, but dehydration?  Not being fed?  If I consider what it’s like to have mental illness and to die for these or ANY reasons just isn’t ok.  No matter how we try to dissect it.  If you don’t have the money for private health care (it cost me about 800 US Dollars for myself and my children on private medical aid per month) you will find that there aren’t any services that are responsive enough to cater for people with mental illness, no matter how ill they are.

For example, you can’t get into a psychiatric ward without being suicidal.  This based on my own and other people’s experience has meant that you need to have tried to commit suicide and required immediate hospitalisation / care.  Not if you were intending to.  No, preventative is nice.  We don’t (although there are a few attempts) have a sufficient suicide call in number for people who feel suicidal, or their families who are a concerned.  And I will not go onto describe the ambulance service, which as the rural women teacher taught me, is just not realistic in some parts of our country.   There are frequent drug stockouts, a lack of psychiatrists in the public health system and therapy is a luxury.

I have to face the reality of this system now.  I was retrenched and do not have the resources for private healthcare.  My psychiatrist costs $150 per session, my therapist $80 and private psychiatric hospitals (which are funnily still like jails) are thousands and thousands.  The implementation of our far-reaching mental healthcare act, like the domestic violence act is failing the people who it was designed to poetically protect.  And most people with mental illness do not in our country, have communities of support where they can hang the “I need help underpants” on the line.  We need to draw attention to the state of the system (or perhaps the lack of it), the way people with mental illness are treated and the services they are subjected to, and the not so silent genocide of people with mental illness in our country.  I intend to.  Be part of those who support us as opposed to those who don’t.  I am 4 M’s Bipolar Mom.

To Be(er), Or Not To Be(er)

“Please Drink Responsibly” is the phrase slapped across every product you must be twenty-one years of age to purchase in the United States. Alcohol has been, is, and always will be one of the most controversial matters in history for many reasons. Our grandfathers’ fathers made it hidden in the south eastern mountains to provide for their families in the most lucrative way they could. A tradition has been made out of its’ recipes and stories of bootlegging and prohibition. It’s the one thing that even the United States government couldn’t stop.

As with anything however, where there are pros, there are cons. As with anything, if enjoyed in excess there are many debilitating effects it can cause on your health and the health of others. Poor judgements and decisions are made which can impact many people for the rest of their lives. If you live just below the Bible belt as I do, don’t be surprised if some mega church preacher attempts to release you from the grasp of the Devils’ nectar as he lovingly embraces you while reaching for your wallet and groping every square inch of your wife with his eyes.

The point I am trying to make is that we live in a society that welcomes the use of alcohol like an old family friend. It’s as American as apple pie, baseball, McDonald’s, and this messed up obsession we all have over reality television. So if no one else seems to have a problem, and it all just is a natural part of life, do I really have as big of a problem as I think I do?

If you have followed me or my blog for any amount of time, you may have stumbled across my introduction or several works about alcohol and my battle with the bottle. Today I want to give you a little background about it, as the subject weighs heavily on my mind lately. I have been drinking since I was fourteen years old. It started out as simply as it typically would. Tall bottles of Smirnoff Ice which eventually led my curious tongue to tall cans of malt liquor. I drank A LOT of gut rot, gas station specials as an early teenager such as Steel Reserve 211 and the likes, until I finally calmed down into normal domestic beers.

At around the age of eighteen I began to indulge in liquor. Trying a little bit of anything I could get my hands on, I quickly discovered that vodka and gin were two of my least favorite liquors. As stereotypical as it will sound, I was a bourbon guy through and through just like my father. The smoky taste, the warm burn of eighty proof tingling down your throat, and that decadent smell of oak as it swirled around in my glass could make my mouth water with every sip. I had made it my mission to become a connoisseur of bottom shelf bourbon. Even when I moved out on my own, the only things I had to my name were a few pots and pans, a record player, a futon mattress, and most importantly… a bottle of rye whisky.

It wasn’t until last year in September that a panic attack made me really look at myself and question my life. Once I began my journey for better mental health, I realized I was using the alcohol to self medicate my anxieties and possibly even some of my bipolar tendencies when I look back in retrospect. I made a lot of changes to my lifestyle with help from my wife. I decided to not keep beer in the apartment we share and she agrees because she feels it’s a waste of money. We agree to only drink when we go to restaurants or concerts and I stopped buying liquor all together because if it’s in my reach, I will drink it.

It’s not uncommon for me to become my own worst enemy. I am my worst critic, my worst judge of character, and the last person I ever want to have to confront. Lately if I’m out somewhere and decide to have a beer, I look at myself in shame and feel regret over my decision. I feel as though I’m letting myself down and even you down. Even though I don’t drink for the same reason anymore, enjoying one beer throws so many questions into my mind, it almost makes me wonder if it’s worth it. On the other hand, I’m not drinking for the same reason anymore. I enjoy beer as a craft and a beverage. Taking barley and hops and creating a flavorful masterpiece is a skill I am honestly envious of. There are so many good things about beer that go far beyond alcohol content.

Everyone has a story. Everyone has a situation that is different. I am not writing this to sway someone who is struggling with addiction to drink. If you are someone who is on the fence, I encourage you to please take the plunge and reach out to your local alcoholics anonymous program or outpatient rehabilitation center. What I am writing this for is to tell my story and to pose a question to my friends, the readers.

With the habits I continue to follow, I find myself wondering if I really have as big of a problem as I think I do. Am I more in control than I realize? Am I blowing this entirely out of proportion? If no one else seems to have an issue, then what is my problem? I am fine with not buying liquor, but am I wrong if I buy beer from time to time? What are your thoughts, and do you struggle this as well?

Memories and Dreams

I dream a lot. In fact, I dream almost every time I sleep.

I also sleep a lot.

Sleeping used to be the way for me to escape the awfulness of being alive, back during the darkest days of my depression. As my illness mutated and changed and I found medications to keep me balanced, the sleep followed me. I sleep at night, without difficulty. I sleep when I’m not at work. I sleep during the day, often for hours at a time. I take naps, snooze, drift off … you get the picture.

And when I sleep, the dreams come. They aren’t bad dreams; nor are they particularly good. In fact, most of my dreams involve mundane, everyday things, like brushing my teeth or driving to work. I can even remember some of them, long after the initial grogginess of waking has left me.

I am also—sometimes—aware that I’m dreaming of the dream. Not necessarily to the extent that I think to myself, “what an interesting dream”, but because the continuity of my dreams fluctuates, and when it morphs from one location to another, and one scenario to another, a part of my mind that keeps track shouts out, “this isn’t where we were just a moment ago!”

But the clarity of the dreams is, as usual, somewhat opaque. Through a fog of distance and sleep, they return to my waking mind as a faint memory of an event that may or may not have taken place. I think most dreams are this way.

But for me—perhaps because of my illness or the medications, or just because of my own perception—this becomes a difficult thing in my head. You see, I often find that I can’t distinguish between the memory of a real event and the memory of a dreaded event. When the event is terribly fantastical and otherworldly, yes—it’s easier. But since so many of my dreams involve things I actually do every day, I find I can’t recall if I actually did something or not.

This is apparently more common than I realized, but when I suggest to my wife that I definitely turned the heat down before going to bed, yet in the morning it’s still on 70°, it’s still disorienting. She appears not to suffer from this problem; nor does anyone I talk to about it.

Dreams, of course, are experiential, just as are actual events—we generally believe they are happening when we’re dreaming—but upon waking, they usually disappear rapidly, or are relegated to a memory state separate from reality. For example, I can recall a memory from very early childhood: taking a bite of a hotdog. And I remember that it was, in fact, a dream, because I remember waking up and thinking that it was funny how in my head only a moment had passed, when in the world outside the whole night had come and gone.

But I also remember images and events—great castles in the fog, ski accidents, conversations with friends—that I have no basis for comparison. These are all things that definitely might have happened because in the past I’ve seen or done all those things. Yet I can’t be certain because I so frequently dream of those things as well.

It’s disturbing to see someone at work, or in your own home, and remember some bit of knowledge about them—only to find that you don’t actually know it because you’ve never actually discussed it.

It’s equally disturbing to think you’ve driven your wife to work and returned home, only to wake up in bed. And when memories of dreams begin to intersect with memories of reality, it brings the whole nature of reality into question. What’s real? What isn’t? And what, if anything, can be trusted?

I don’t know if this is an aspect of mental illness or something that everyone experiences, but it’s disturbing nonetheless, and something I wish I had a better grasp on.

What are your thoughts? Do you remember dreams as dreams, or do you also sometimes confuse them with memories of actual events?