Getting Shrunk

I'm off this week to get my head examined, so am taking a break from using it.  This would be your opportunity to examine the many features of Prozac Monologues.  Here is a brief tour of the site and some tips for cyber-dinosaurs.

The basic breakdown: on the left are mental health and medication resources.  To your right are helps to navigate around the site, plus some fun stuff.

Text that appears in tan is a link to somewhere else.  The links on the left are to sites outside Prozac Monologues.  Most on the right go somewhere on the blog itself.  Notice in particular the feature called Labels.  If you click on a word in that list, several past posts on the same subject will appear.  The bigger the word, the more often I have written on it.  The right side also includes videos that change occasionally and sometimes coordinate with the current post, and sometimes not.  Ditto the Word of the Week.

The text in the middle is the new stuff I try to write once a week, weather and brain waves permitting.  Again, the tan text links to something else.  It could be a research article, an Amazon.com review, another blog, or an earlier Prozac Monologues post.

Below each post are some icons.  Click on comments to read other peoples' comments or add one of your own.  Click on the envelope to email the post to somebody else.  Click on one of the letters to share the post with whatever social media you use.  Click on the number to bring the post to the attention of the cyber world.  I don't actually know how that feature works.  Can somebody tell me?  Then there are more labels, links to other posts that deal with similar matters.  At least, I think they are similar matters.

That's enough to keep you busy while I spend the week filling out bubbles on instruments of torture devised by psychologists, and telling my tale of woe to psychiatrists who have heard worse, even if I can't imagine it, and who think they can come up with a new idea that my own doctor hasn't come up with, though I can't imagine that either.

Catch you later...

flair from facebook.com

Mental Health Day -- The Funner Version of Advocacy


I blog for World Mental Health DayLast week it was Mental Illness Awareness Week, according to NAMI.  So today it's World Mental Health Day, according to WHO.  The World Health Organization, that's WHO.

That's a week for mental illness, a day for mental health.  Whoever organizes these things must be reading my mood chart.

I cycle within cycles.  In the larger circle, I have been able to maintain a stable state for a while now -- the state of jaded, that is.  So I take up this week where I left off last week, continuing the repost of a series on the sorry state of mental health advocacy.  This second post takes a glass-half-full approach.

Not exactly mental health, but at least the upside of mentally interesting.  I mean, we got these diseases for life.  We might as well learn to make them work for us.

Mental Illness Awareness Week - Because We Are Really Good at Delusional


Imagine this -- Somebody from NAMI attends one of those campaign events and gets to the microphone.  Intending to ask about the candidate's views on funding for community mental health, this poor parent begins with a statement: 

People with severe mental illness die on average twenty-five years before everybody else.  They have the expected lifespan of Somalia. 

Nowadays the crowd will cheer.  But that particular youtube wouldn't go viral.


I am jaded about this Mental Illness Awareness thing.  It will not be subjected to any Best Practices evaluation.  NAMI and the pharmaceutical industry have been making us more aware of mental illness for decades now.  The numbers on prejudice have not budged.  They have not budged.

That negativity -- does it mean I am currently displaying symptoms or that I have done my research?  Both, actually.

I'll cop to the irony here.  I myself was a speaker at one of those Mental Illness Awareness Week events once, held on a Sunday night in a not-much-traveled portion of a university campus.

It was very moving, the candles and all that.  And it did raise awareness, in the sense that it made those of us who were there, people with mental illness and those who love us aware that we are not alone.  But did it increase funding for research and treatment?  Did it reduce prejudice?  I don't think so.

Let me answer that another way.  Did it increase funding for research and treatment?  Did it reduce prejudice?

Nope.

So symptoms, research, irony and all, my contribution to Mental Illness Awareness Week is a repost of what I think we ought to be doing this week.  And next.  And next. 

From Friday, March 11, 2011:

Ignore/Laugh/Fight/ -- Mental Health Advocacy That Wins


If they don't want to employ you, if they are afraid of you, if there are four times as many of you in jail as in the hospital, then it's not just stigma.  It is prejudice and it is oppression.
The twentieth century offered a whole degree program in prejudice and oppression.  Others have made progress against what beat them down.  Though we are now stalled and falling behind, we can move forward when we adopt their methods.

The Map to Liberation

Mahatma Gandhi was not the first freedom fighter.  But he is the great theoretician.  He gave us the map.


First they ignore you.
Then they laugh at you.
Then they fight you. 
Then you win. 

Four simple steps.  The good news -- we have already taken the first.  Got that one down pat.

Liberation 101: 

We are in charge of the map.  The oppressor doesn't decide that oppression will end.  It endures until the oppressed decide that it will end.

What we have to do is provoke the next step.

Then they laugh at you.

Well, that's where we are stuck, because we are unwilling to be laughed at.  Last month's NAMI meeting was about Iowa's upcoming budget cuts.  Somebody said, When we complain, they say we are crazy.  I think she is a therapist.  She has that therapist look, if you know what I mean.

Therapists say the funniest things.  When we complain about how we are treated, they say we are crazy.

But we are crazy!  We start off ahead of all the other liberation movements that had to get crazy to take it to Gandhi's next step.

Think Martin Luther King.  Think Nelson Mandela.  Freedom?  People called them communists.  Either that or just plain nuts. 

Like these other movements, we have to find a spiritual taproot deep enough that we can endure being laughed at.  Just like the tree, standing by the water... 

The spiritual work will be impossible if we expect our care providers to lead.  They get twitchy if we talk spirituality.  I will address that work another time.  Right now I will sketch out how we break beyond First they ignore you, and move to Then they laugh at you.

What that means more precisely is, we have to do things to make people think we are nuts.  Like, DEMAND that we receive funding for research and treatment, DEMAND that we have the same access to health care as anybody else, DEMAND that we receive our health care in health care facilities, not in jails.

It's all about budget cuts right now.  Corporate tax cuts -- that's a given.  Corporations spent good money for our current crop of legislators, and they expect a return on investment.

So who will pay for these tax cuts, the people with mental retardation or the people with mental illness?  The Iowa State legislature has a committee that has asked us to decide.  Well, isn't that special.

We have to DEMAND that they change the rules of this game.  We have to REFUSE to play Survivor.  We have to refuse LOUDLY.


How?  African Americans sat down.  That is when they moved off Step One, when they REFUSED to be ignored any more.

So how about we lie down?


Lie In/Die In

Picture this.  The next Loonie Lobby Day at the state legislature, we don't get all showered and neatly normaled up and go have sincere conversations with our legislators who are really sympathetic (their brother has depression, so they know what we are up against, but their hands are tied by that pesky deficit...)

Instead, we stand in the rotunda and read off the names of their constituents who have committed suicide.  Each time a name is read, somebody falls down.  They have to step over our bodies to get out of the building.

Mental Health "Parity"
 
The Mental Health Parity and Addiction Equity Act would be better called the Swiss Cheese Mental Health Act.

1) Only large employers are affected.

2) If they can demonstrate it causes them financial hardship, they can get an exemption.

3) Parity is a laugh anyhow, if reimbursement rates are so low you can't find a provider who accepts your insurance.

4) The provisions of even this piss poor legislation that address reimbursement rates are now the top of the list on Congress's chopping block.

So off we head to Washington.  There are 13,000,000 million of us with serious mental illnesses in the US, including 5.7 million with bipolar, 2.4 million with schizophrenia and 7.7 million with PTSD.  The numbers add up to more than 13,000,000, because some of us get to double dip.  Piece of cake to pull together 34,000 to do a die-in around the steps of Congress, representing one year's worth of the deaths by suicide in the US.  We will drape American flags over the bodies of the vets.

Yes, we are dying out here.  Let them step over us.

How nuts are we to think we can turn around this systemic discrimination?  In this political climate?

Progress Report

Remember, When we complain about how we are treated, they say we are crazyBy now some of my readers seriously want me to reconsider Seroquel.  Others -- if you are still reading, your doc wants you to up your dose.  This means we are making progress.

At some point, laughter becomes a cover for scared.  Then it's time for the next step.

Then they fight you.

Remember, this is our map.  We are the ones who push it forward.  Nobody else will.  And if I am scaring you, look at it this way.  If we aren't scared already, we'd have to be crazy.

Until we change our advocacy, we will continue to lose psychiatrists.  We currently have less than half the psychiatrists we need to provide a even a shoddy level of token med checks.  In Iowa, we have one fourth.  While demand is going up (think Iraq, think Afghanistan), supply is going down, as retiring psychiatrists are not replaced by new doctors.  Why go that far in debt to get through med school and then choose a specialty with the lowest pay scale on the block?

Until we change our advocacy, we will continue to lose community mental health centers.  Remember community mental health centers?  The places we were supposed to go when they kicked us out of the hospital?  They are disappearing already.  Here are the Kansas numbers.  You can find the same story for any state you google.

Until we change our advocacy, we will lose what parity was promised.  Again, all employers have to do to avoid it is demonstrate that it costs them money to provide it.

Until we change our advocacy, we will lose even the programs that jails now provide.  Why should criminals be coddled?

Desperate Times Call For Futile Gestures

What were we thinking?  That public demonstrations would make a difference to cold hard facts?  Were we nuts?  (By the way, what have we been thinking, that talking would make a difference?)




After the strategies designed for Then they laugh at you prove futile, we up the ante.  In place of our bodies, we substitute urns full of ashes and dump them on the floor of the assembly halls.

In 1987 AIDS activists entered the New York Stock Exchange.  Seven people unobtrusively chained themselves and a banner to the rail overlooking the trading floor.  At the opening bell they unfurled their banner and blew fog horns.  They drowned out the opening bell, and prevented traders from trading, while they brought national attention to their demand that pharmaceutical companies stop profiteering at the cost of their lives.

Wall Street is our audience, too -- all the businesses that insure some of their employees but not us, all the health care companies that pay reasonable reimbursement to some doctors but not ours.  How about we bring ambulance sirens? 

A Day Without Mental Health Care 

Next we head to Main Street.

The 2004 film A Day Without A Mexican imagined what would happen if one day everybody in the US from Mexico, Guatemala, Honduras, Nicaragua, et al disappeared.  Economic havoc, that's what.  A few years later, the movie inspired a political demonstration.  Workers stayed home for a day.  In some places, restaurants simply closed for the day, unable to serve their customers.

So last week the Wall Street Journal reported a survey by Workplace Options.  The survey discovered that 41% of workers polled had taken 4-9 days off work in the previous year to care for their own, their friends', their coworkers' or family members' mental health issue.  Half work in offices with no benefits, support or services to deal with mental health issues.

They think they can't afford to provide services?  They haven't a clue how much it already costs them not to. 

There you have it, a National Day Without Mental Health Care.  Everybody who has a mental illness or loves somebody who does -- stay home.  I'm thinking Monday -- to make that moon connection, and maybe even disrupt Monday Night Football?

Going To Jail

At this point, we are littering, destroying property and generally disturbing the peace.  We are going to jail.

Everybody on a three-month wait list for an intake interview,

Everybody on a two-year wait list for the judicial review of an SSDI application,

Everybody on a four-year wait list for sheltered housing,

Everybody who had been doing okay, but stopped taking meds when the day program closed,

Everybody who can't afford the copay for that third tier prescription anyway,

Everybody who doesn't have health insurance at all,

Everybody who is homeless,

Go downtown and set a trash can on fire.

We Need Some Coordination Here

No, not everybody.  Jail is not a good place for people with OCD, PTSD, nor Borderline.  You all, your part is to run right down to the courthouse, legal brief in hand, to make sure the police department fulfills its obligation to get the rest of us our meds.

Prejudice And Oppression -- Some Observations

This post has been about fighting oppression, the institutional arrangements that support an unjust system.  Oppression is weighty.  It is fierce.  It does not respond to reason.  Power yields only to power.  The strategies and actions I have described are the power of anger that has been organized.

Our families and our care providers are just as scared as everybody else of our anger.  So they will not help us here.  They want to address prejudice, not oppression. 

Prejudice is the irrational thoughts and feelings of individuals.  Well, prejudice also needs to be addressed.  There is work enough for everybody.  Think of differential diagnoses as differential skill sets for the differential tasks of freedom-fighting.

That's coming next week...

banner from nami.org
image of prison bars from microsoft
photo of Mahatma Gandhi in public domain 
flair from facebook
forest photo by Maylene Thyssen used under the GNU Free Documentation license
sit in at Walgreen's in Nashville, Tennesee, March 25, 1960, in public domain
photo of die in casualties by Brendan Themes and used under the Creative Commons Attribution 2.0 Generic license
fist graphic in public domain

Manifesto: The Mad Farmer, Consumer, Blogger, Whatever

As in the days of Amos, John of Patmos, John of the Cross, it's the poets who will save us, those of us who have ears to hear.  For the rest, it's the poets who will preserve the evidence, in hope that there will yet be ears to hear.

So today, Wendell Berry's Manifesto: The Mad Farmer Liberation Front.

First, one liner note: Your mind will be punched in a card and shut away in a drawer.  In the early days of computers, data was recorded by punching holes into cards, literally, card stock, roughly 3"x7".  This was before web crawlers could find the word bread in a Facebook comment and then put up ads for kitchenware on your page.  The line in the poem, first published in 1970, is truer than ever.  The technology has simply got more efficient.

Manifesto: The Mad Farmer Liberation Front

Love the quick profit, the annual raise,
vacation with pay.  Want more
of everything ready-made.  Be afraid
to know your neighbors and to die.
And you will have a window in your head.
Not even your future will be a mystery
any more.  Your mind will be punched in a card
and shut away in a little drawer.
When they want you to buy something
they will call you.  When they want you
to die for profit they will let you know.









 

So, friends, every day do something
that won't compute.  Love the Lord.
Love the world.  Work for nothing.
Take all that you have and be poor.
Love somebody who does not deserve it.
Denounce the government and embrace
the flag.  Hope to live in that free
republic for which it stands.
Give your approval to all you cannot
understand.  Praise ignorance, for what man
has not encountered he has not destroyed.

Ask the questions that have no answers.
Invest in the millennium.  Plant sequoias.
Say that your main crop is the forest
that you did not plant,
that you will not live to harvest.
Say that the leaves are harvested
when they have rotted into the mold.
Call that profit.  Prophesy such returns.


Put your faith in the two inches of humus
that will build under the trees every thousand years.
Listen to carrion - put your ear
close, and hear the faint chattering
of the songs that are to come.
Expect the end of the world.  Laugh.
Laughter is immeasurable.  Be joyful
though you have considered all the facts.
So long as women do not go cheap
for power, please women more than men.
Ask yourself: Will this satisfy
a woman satisfied to bear a child?
Will this disturb the sleep of a woman near to giving birth?


Go with your love to the fields.
Lie down in the shade.  Rest your head
in her lap.  Swear allegiance
to what is nighest your thoughts.
As soon as the generals and the politicos
can predict the motions of your mind,
lose it.  Leave it as a sign
to mark the false trail, the way
you didn't go.  Be like the fox
who makes more tracks than necessary,
some in the wrong direction.
Practice resurrection.

from The Selected Poems of Wendell Berry



And your homework for this week, gentle reader --

What does it mean to Practice resurrection?  What tuition will you pay?


Johannes der Evangelist in Patmos from a triptych by Hans Memling, 1479
photo of punched computer card by Litrefs used under the Creative CommonsAttribution-Share Alike 3.0 Unported license
photo of Immortal Tree, Humboldt Redwood State Park by Jan Kronsell, public domain
photo of fox from US Department of Interior, public domain
book cover from amazon.com

Differently Abled - More, Please

It's like he is in a world of his own. The first grade teacher, old school, same worksheets for the last thirty years, did not mean it as a complement.

The mom was confused. She asked her son's Montessori preschool teachers for their take on it. They, too were confused. Then the light dawned. The way they put it was, He has immense powers of concentration. They thought he was marvelous.

The problem was, he was still absorbed by the story he was writing, when the first grade teacher had moved on from writing to math. The world he was in was not her world.

His second grade teacher recommended him for the Talented and Gifted program.

His fifth grade teacher thought he had ADHD.

People who are different get diagnosed. The Diagnostic and Statistical Manual (DSM) is all about describing the various ways we don't fit. But if you can pass for normal, you don't have a disability. If they can pick you out in that One of These Things is Not Like the Others game, then you do.

Survival - Three Things Learned From Danny MacAskill

1.  To keep your audience, edit out most of the falls.

2.  To help your audience, keep some of the falls.

3.  Find the Iron Rule and do not break it.  In MacAskill's case -- the front wheel is for steering; you want to land on the back wheel.  In my case -- the frontal cortex is for steering; I will inevitably land on the amygdala.

A repeat from:

Thursday August 26, 2010

Tribute To Survival

This is dedicated to those who are surviving the Chemistry Experiment, and to those who hang in there with us.

Bring your courage and your hope, whatever you can manage.

And your helmet.




Thanks to Danny MacAskill and Band of Horses.

Prozac Monologues - How It Began

First conceived as a stand up comedy routine, birthed as a book, morphed into a blog, on August 29, 2011 Prozac Monologues came full circle at Happy Hour at the Pato Loco, Playas del Coco, Costa Rica.  This was the very spot where in January 2005, the book was originally written over the course of eight heavenly (my wife wouldn't use that word), hypomanic days.  Micah pulled out his laptop.  Patricia set it up on top of a bar stool.  And I held forth.


You can hear a bit of our little beach town's rush hour in the background.  So here is the text:

Prozac Monologues - How It Began

2004 was not a good year for me.  My doctor tried to make it better by prescribing Prozac for major depression.  Only Prozac didn't make it better.  So she prescribed more Prozac.  And that made it so much more not better that I concluded the only way I could describe how much more not better would be a stand-up comedy routine.  And thus was planted the seed for what has become Prozac Monologues.

So I went off Prozac, and on January 25, 2005, I boarded an airplane for Costa Rica, armed with a yellow legal pad and a ball point pen. 

Hypomania In Action

For eight days in beautiful, tropical Costa Rica, my wife went to the beach, explored neighborhoods, visited with family, tried new foods, while I wrote.  And wrote.  And wrote.  When I filled up one side of the yellow legal pad, I wrote on the back.  When I filled up the back, I wrote in the margins.  When I filled up the margins, I wrote between the lines.

I came home with seven chapters.  Two weeks later, the book was done.

I told my doctor about my book and maniacally writing it.  That word maniacally raised a red flag.  So she screened for bipolar.  She said, Are you manic?

I said what anybody who thought she was Jesus Christ come back as Jessica Christ might have said, I'm not manic.  I'm excited!

Oh.  Okay.  So she prescribed the second antidepressant, and began what will have to become a new book, but I haven't recovered enough to write it yet.

Was I manic?  No, I was hypomanic.  But I didn't know that word.  And maybe you don't know it either.  So I submit for definition and for evidence the first four pages of

Prozac Monologues

by
Willa Goodfellow

Chapter One
Bizarre: In which I decide to write a book

Okay, let's start with the basic Prozac dilemma.  Just who is the crazy one around here?  If, after you read the morning paper, you are happy, content, secure, at peace, able to get up, go out and carry on your activities of daily living, full of confidence and a sense of purpose, then tell me -- are you pathologically delusional?

Or are you on Prozac?

Citizens of the United States of America (called Americans and thereby hijacking the identities of thirty-eight other nations in the Western Hemisphere -- Remember Canada?  Every heard of Paraguay?) make up 5% of the population of the planet and consume 24% of its energy resources.  We spend more on trash bags than the gross national product of 90 of the world's 130 nations.

What was that?


We spend more on trash bags than the whole gross national product of 90 nations.

So who is the crazy one around here? 


The Crazy Delusion 

We get such a sliver of time to enjoy this wildly extravagant planet, and we spend precious moments of it, watching couples on TV compete for cash prizes on the basis of how many maggots they can eat. 

Until the maggot-eating is interrupted by somebody who wants to sell you an air freshener that uses an electronically operated fan to circulate chemical compounds around your living room to make you think you are out of doors. 

The fan is the latest advance in civilization which will enable you to stop feeding your Shiatsu little treats, which you previously had to do to get it to wag its tail to disperse the chemical compounds around your living room. 

So now you have to take Prozac, so you can get yourself up off the sofa where you have been sitting in a semi-catatonic state, watching the maggot-eating and dog-treating, out of your pajamas and into your four-wheel drive SUV, which you were compelled to purchase after viewing those commercials of SUV’s climbing over mountainous terrain beside raging rivers,

But which you happen to use to commute an hour and forty-five minutes on some freeway to work in a cubicle with a picture of mountainous terrain and raging rivers and some motivational caption underneath, so you can buy the air freshener with its self-contained and electrically-operated fan that disperses the chemicals that make you think you are out of doors, because you wouldn’t want actually to go out of doors – the air is so nasty from the fumes of your SUV.  Who is the crazy one around here? 

And don’t even get me started on the taxes you will pay from your job in your cubicle to fund somebody’s research into that missile that can shoot another missile out of the sky, to protect us from the bad guys who can bring down two 100-story buildings armed with the equivalent of a Swiss Army knife.  If it’s your job to figure out how to shoot that missile out of the sky, stop taking Prozac and go do something else to do with your life.  Or just go back to your sofa.  Please. 

Okay, now I sound like Michael Moore.  Let’s just call this the Crazy Delusion, a concept not original to me, and of which you can think of your own examples, so I don’t need to continue this rant which is not really the point of this book, but only the context of our consideration of the title of its first chapter.

In short –

It’s hard to know whether depression is a problem of distorted thinking or the result of clarity. 

In either case, sitting on the sofa in your pajamas does not turn the economic engine of this great nation, no matter what you’re watching.

Except for the pharmaceutical industry’s economic engine.  They keep making money, as long as they are able to sell you images of people who are happy and confident, popping their Prozac, (nowadays it’s Abilify), which you really start to believe when you’re still sitting on that sofa, watching those images over and over and over again. 

Ads For Antidepressants

Have you noticed how all the ads for antidepressants run during the afternoon soaps?  (If you are not depressed, you haven’t noticed, because you’re off at work, turning that economic engine.)  No, those pharmaceutical guys know where to find their audience, and when, on the sofa, in our pajamas, in the middle of the afternoon. 

Now I’m talking to you, the one in the pajamas.  You thought you might get up and go for a walk, like you promised your sweetie (who has gone to work) that you would.  But here it is, two o’clock in the afternoon.  The recap of yesterday’s episode comes on, and before you can find the remote to turn it off after the last soap, that theme song begins.  It sounds inspirational, but for some reason, you start to cry. 

After the theme song, and before the start of today’s episode, it’s time for that gentle, compassionate voice, who lists all your symptoms, including another one you have, now that the voice mentions it, but up until now you didn’t realize that it also is on the list, so you must be even sicker than you thought.  Who is that voice that understands you so well, better than your doctor, it seems, and so must know exactly what you need to ask your doctor to prescribe.

Symptoms Of Depression

Here is that list, by the way: sadness (no duh!), sleep disturbance (too much, too little ) weight gain (or loss), lack of energy, loss of interest in the things you used to like to do, loss of motivation (hence, all that time on the sofa), slowed pace, poor memory, poor concentration (they don’t want you at work anyway – you might break something), loss of self-confidence (like, they really don’t want you at work – you might break something), guilt, feelings of worthlessness, suicidal thoughts or attempts.

If you have been sad or lost interest in things for at least two weeks, plus four of the others, I’m talking about you.  You and 12% of the population who will experience an episode of depression sometime in their life (that’s major depression), plus another 6% who just feel lousy all the time (that’s dysthemia), and another 6.4 who sometimes are way up and sometimes way down (that’s bipolar), or …

One in twenty people in any given month.

When you have so much company, how is it you feel so alone?

You are not alone. 

Prozac Monologues 

photo of Playas del Coco by Helen Keefe, used by permission
photo of trash bags by Yuyudevil, in public domain
photo of Cubicle Land by Larsinio, in public domain
photo of prozac by Tom Varco, used by permission
photo "Loneliness" by graur razvan ionut

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