The Story Of Miriam Carey: A Preventable Tragedy?

Delirium Today | By: +Maria Y
Posted: 12/31/2013

It's been [over] two months now since the Washington DC incident with Miriam Carey, who tried to drive up to the White House, was chased away by the police, led them on a high speed chase and was then shot. Tragically, she had her child in the backseat. It later came out that Carey was suffering from severe postpartum depression, and had been battling mental illness for quite a while. She apparently believed that President Obama was stalking her because she was the "prophet of Stamford" (Stamford Connecticut, where she was from) and thought that people were videotaping her through her windows. She had even made a 911 called to this effect and was apparently hearing voices and trying to get to the President. She also had recently lost her job, suffered a bad fall, and was in serious financial trouble. Naturally there was the obligatory misogyny, racism, and making fun of mental illness all over the Internet; unfortunately that's come to be expected whenever something like this happens.

But the incident also sparked several discussions on mental illness and lack of adequate care for those who are mentally ill; especially women and minorities. It's become common knowledge that her family, especially her boyfriend, wanted her to get more help and feared for her and their baby, even worrying that she might hurt the baby. He called and reported these concerns to the cops, which resulted in them coming over to place the baby [in] temporary care. Carey however, did not want to let them have the baby; as she was afraid that the whole thing was being broadcast on national television. As a result she was cuffed and taken to the hospital, but didn't stay there very long before she was released, reported by The Daily Beast.

Her family, seemingly out of embarrassment, now denies having any type of mental disorder, and now wants the FBI to investigate the incident. Yet it was common knowledge among her family and friends that she was having trouble, and even now they still say she was a "troubled soul."

Several members of her family had encouraged her to get help. She did get some [help it seemed] -- when they searched her home, they found all sorts of mood medications and medications for schizophrenia.  The meds apparently had helped some [it was reported and she had a] brief hospitalization, but when she stopped taking her meds, things may have spiraled out of control.

Not long after this incident, I remember participating in a discussion where people were debating: "Should her family have forced her to get care?" Some said they were negligent for not doing so; which isn't exactly fair because they could hardly have predicted what would happen. Others talked about free will, is it fair to force someone to get help? Carey was not violent in any way.

Another defining question of this whole incident was: why was she shot? That was something that I myself wondered. I understand security is tight, that someone trying to get near the president is of course a concern; but this was not an armed terrorist, and it became clear pretty quickly that the woman was unarmed and she had a child in the backseat. Instead of shooting her, why didn't they shoot out the tires of her car so she couldn't drive off and come and get her? She could've been sedated, taken to the hospital, and given care.  It may not of been the best scenario, but she would've been alive. Now her child is not only going to have to grow up without a mother, everyone is going to know how her mother died and how sick she was. It seems that too often, the police shoot first and ask questions later, [especially in mental health cases]; even nonviolent ones. Well in this case (which was unique because of the presidential factor), supposedly it was mostly because of the security issue, and them worrying that she might have a car bomb, reported by MSNBC.

Surely something could've been done differently to help this poor woman. I'm sure it became obvious to her doctors after she gave birth that she had postpartum depression, which is not exactly an uncommon problem. Why was she not given more counseling? Was there a follow up? In some hospitals, counseling after birth to ascertain a woman's mental health status is mandatory. Would that have saved Carey? Had her family had been more forceful about her getting help more consistently, had the police not acted as rashly, would she still be with us?

No one can definitively answer these questions, but our entire society should treat this experience as a learning one, and use it as an excuse to change police reactions and take a look at the status of mental health care in this country, especially for postpartum women, the disabled, the poor, LGBT, minorities, etc. We should work to reduce the stigma around mental health. I'm sure this was at least one of the reasons Carey feared getting consistent mental health care. The new Affordable Care Act (Obamacare) has provisions that are finally going to make mental disorders more affordable;  a definite step in the right direction.

An innocent women who is guilty of nothing more than being a victim of an illness is dead. Her death need not be in vain, but we as a society have to start constructively talking about this, and to listen to the lessons such circumstances teach us. How many more Miriam Carey's have to die before we take Mental Health Care seriously?

Read More

Degrees Of Mental Illness: Is There a Sliding Scale?

Big roller coaster vs. smaller one; "major mental" illness vs. "more moderate"
one; is one really less serious/dangerous than the other?

Minor mental illness—is there actually such a thing? Personally, I would say no. To hear such a thing as more minor mental illness (as compared to more severe mental illnesses), but I would never say any mental illnesses are "minor." It's never a good idea to judge somebody else's illnesses as minor.

  

Still, American Psychological Association, too many mental health workers, and people in general consider certain mental illnesses [to be] worse than others. Schizophrenia  and Schizoaffective disorder for example are considered among the worst, and anything with the word "schizo" is just consider horrifying, even if the person's symptoms aren't. Personality disorders such as Antisocial personality disorder are truly at the bottom; and many people wonder if they even belong in the psychological dichotomy, or if they are just character issues. Depression seems to have become more mainstream overall, especially after the Prozac craze. Not to say that it is becoming easier for people with Depression symptom wise, but the disorder is more well known and more accepted, even if not fully understood by mainstream culture. 




Bipolar disorder is sometimes co-opted by celebrities and used as an excuse for drug use, and is sometimes thought of as a "fun, creative diagnosis" by those that don't know [all the facts]. Even with this gross misunderstanding, enough famous people have actually [helping these] disorders become mainstream in local, national and social media outlets. Most people with Depression and Bipolar disorder are not viewed as having a great potential for violence. This definitely doesn't hold true for diseases like Schizophrenia even though only one percent of schizophrenics show violent symptoms (personality disorders on the other hand often have a legitimate link with violence unfortunately). There are also many degrees of different types of mental illness which can become more or less severe overtime, especially if there's a genetic component. 




In high school, I developed Cyclothymia, which considered a more minor version of Bipolar disorder . The mood swings of Cyclothymia go between Dysthymia and [Hypomania] instead of severe Depression and Mania. I later found out that both my father and my grandfather suffered from this as well. As 50 percent of people with Cyclothymia go on to develop full blown Bipolar, I've developed full blown Bipolar II with Cyclothymic features (it's possible to have both). People with Bipolar disorder are also much more likely to have at least one relative with Cyclothymia.




Cyclothymia (which may be renamed Bipolar III—a move I wholly support), as well as other more "minor" mental illnesses, (Dysthymia, lighter versions of Schizophrenia, etc.) are not well known, sometimes not even by those in the mental health industry. Consequently, because people with these are often more high functioning than their counterparts with more severe mental illness, and are better at hiding it (I know I did for years but it wasn't easy), these illnesses are too often dismissed as "easy to deal with." From my own personal experience, I know that while they may be "easier" to deal with, they are definitely not easy. This [mindset] encourages a culture of silence, and also sets a dangerous precedent. 




People with [a] more minor mental illness often do not get help, raising their chances of developing a [serious outcome to] mental [health] down the road. I know that turned out to be the case with me and friends who have been in similar situations. I didn't feel that I have very many people to turn to. I was able to do some research, and I suspected that what I had was a more minor version of Bipolar, but I couldn't find a name for it, or any information indicating that it was a good idea to get help. Most people I talked to also did not know this, and I was encouraged by both well meaning and not well meaning people to "just deal with it". If at least one of us had known better and I reached out for some kind of treatment back then, perhaps I I may not have gone on to develop any other mental illnesses.




Many of those with [varying degrees] of mental health issues wind up going into the mental health profession because they want to help others like themselves and those that have more severe illnesses; they also tend to be more sympathetic of mental illness in general. I know my experiences definitely made me more sympathetic and willing to listen.


It is the responsibility of everybody in the mental health field to educate ourselves as well as mainstream culture about all mental illnesses and their various degrees. There is no such thing as a "minor mental illness," and knowing that can mean the difference between developing something more severe later, and getting necessary help in the present. We owe each other that.

Note: All opinions expressed on Delirium Today are the feelings/ideas of our columnist, mental health professionals or experts. Our goal is to see different points-of-views in the lives of people that are living with mental health issues—we are here to tell their stories. 

Read More

The Mysteries Of Obsession

Glenn Close, Michael Douglas, and Ann Archer in the popular movie Fatal Attraction, 

about a woman who becomes dangerously obsessed with her married ex-lover. Image by: AMCTV.

Obsession--the very word [can] evoke images of curiosity, passion, madness, and occasionally, stalkers. It’s been used as a popular romantic perfume, as well as a plot for several movies, both romantic and not, though there isn’t much that’s romantic about it. There are two big categories (which include several subcategories) of obsession: Obsessive-Compulsive Disorder (OCD) and Fixational Obsession.

While it can also be a symptom of several different forms of mental illness, OCD is the most common. OCD is officially defined as an anxiety disorder characterized by intrusive thoughts that produce uneasiness, apprehension, fear, or worry; by repetitive behaviors aimed at reducing the associated anxiety; or by a combination of such obsessions and compulsions.

Fixational Obsession is defined as a state in which an individual becomes obsessed or fixated with an attachment to another person, being or object.

Having seen both forms, I've often wondered what makes one different from the other. Why are symptoms of usually the OCD considered eccentric while a fixation can wind up being dangerous? And how does the brain cause and tell the difference?

OCD is thought to be caused by overactive neurons in the brain that [continuously] focus on executive function and cause excessive complex thinking patterns to form [more than] the average person. Most forms [of the disorder can] cause a person to feel that he or she has to perform some type of ritual [over and over]; example, washing your hands ten times, locking the door five times—otherwise the person feels something terrible will happen to them. Having lived with a moderate form of OCD that is now mostly under control, for me it was always about counting things, touching certain things a particular number of times, making sure all the doors were locked and that all the light switches were in an off position.  If I didn’t do these, I feared I’d have a bad day. More severe forms of OCD have people dealing with rituals and fears that literally mean life or death to them, such as the fear of germs. Managing it usually involves a combination of medication and therapy, with a pretty decent success rate, if the person can realize rationally that the ritual does not cause anything one way or the other. While OCD is usually considered eccentric; it is often considered harmful only to the person who has it and rarely to anyone else.

The obsession, or fixation, is often focused towards beings, objects, or other people. An obsession in a movie, book, or things of that sort are no big deal. An obsession with another person though, is often considered by most people to be dangerous at least to some degree. It can happen in romantic relationships, friendships, or even between people who don't know each other (example: obsessions with movie stars).  It is thought that early and often traumatic experience in one’s life makes someone prone to being obsessive; as these early experiences cause stress hormones to be released in the brain. This kind of obsession doesn't involve a ritual; it centers on something or someone; in extreme cases, it can manifest as an imaginary relationship or a quest for revenge for perceived not returned affections. Such obsessions can form surprisingly quickly.

Obsession can also be a symptom of a particular mental illness, such as Borderline Personality Disorder, which is defined as whose essential features are a pattern of marked impulsivity and instability of affects, interpersonal relationships, and self image. These symptoms too, are often caused by early lifetime traumatic experiences and exposure to extreme stress. These kinds of obsessive people have a tendency to blow things such as an argument or small snub out of proportion, turning them into life or death scenarios much like those with severe OCD with their rituals.  Treatment revolves around meds and therapy, and in extreme cases, confinement of some kind.

Both major forms of obsession involve some degree of fixation on something. Both involve a degree of control either over oneself, or someone or something else. In small degrees, this kind of obsession can be good, as in a reporter's obsession to find the truth, a scientist’s obsession to find a cure, etc.  It’s when they get out of control that they can seriously ruin peoples’ lives.

Unfortunately, though many symptoms can be managed to some degree, we're still not at the level where we can fully cure illnesses that cause obsessive symptoms. However, new research is being done all the time, and it is hopeful that soon it will bear some sort of fruit. Now that’s something that’s worth getting fixated on.

Read More

Bipolar Disorder In Popular Culture

Contributing Columnist: +Maria Y 

Bradley Cooper and Jennifer Lawrence - Image: The Weinstein Company

“I’m so up and down, I must be bipolar!” “Being manic sounds fun, you’re happy all the time!” “Oh yeah, doesn’t (random celebrity) supposedly have Bipolar?” “Doesn’t he/she take a lot of drugs because of Bipolar?” “Aren’t most creative people Bipolar?” “Isn’t Bipolar in vogue now?” “I wouldn’t give up being Bipolar for anything as I’ve felt like I’ve walked with angels when I’m up." Only that last quote was said by a bipolar person, in the documentary The Secret Life Of The Manic Depressive. The other quotes make you wonder, do these people have any idea what they’re saying? Is this the version of Bipolar Disorder most people think of? Is it being portrayed as “glamorous and creative” in the media? It’s not at all glamorous, nor is the “Hollywood version” of it we often hear about realisticly.


 
One example is the movie Silver Linings Playbook. Overall, the film made some great strides towards portraying mental illness in a positive way and portraying people who deal with it as rich, well-rounded characters with lives outside of their illnesses. Yet, unfortunately its ending was not very realistic. The two main characters, who are both Bipolar, fall in love, and the film seems to give the message that all you need to live with Bipolar Disorder is love, not meds, not much therapy, not anything else--which considering most Bipolar people either use some combination of one or both, is not the best message to send.

There’s an emphasis on how much “fun” manias and hypomanias can be popular culture. Unfortunately this isn’t only restricted to those who don’t deal with mental illness. “Hypomania sounds fun, you’re happy all the time” was what I frequently heard from someone who suffered from Depression. This person thought that even after seeing my “black hypomanias” and/or “mixed states. There is the “life of the party” stereotype of mania/hypomania, but not the angry, racing, sometimes even psychotic side. While it can inspire creativity (a good example being Leonardo DiVinci), full mania, which often starts out feeling good, can quickly escalate out of control. Hypomania is harder to catch; it often comes off as someone just being hyper productive, and usually doesn’t involve loosing touch with reality. But it can still get one in trouble (spending sprees, promiscuity, fights, little sleep, talking fast, substance abuse, and more).

The popular version of Bipolar also encompasses only part of the symptoms of one type of the disorder on the Bipolar spectrum, completely ignoring the other types. It’s also become the “diagnosis” for any bad behavior from celebrities. Got drunk and made a bigoted remark? Maybe you are Bipolar. Suffer from substance abuse problems? You must be Bipolar (Robert Downey Jr. has repeatedly said his past substance abuse had nothing to do with Bipolar, which he doesn’t have, but still rumors persist). Britney Spears and Lindsey Lohan behaving badly? They must be Bipolar. While of course there is a correlation between creative actors and Bipolar Disorder (Stephen Fry, Catherine Zeta Jones, Robin Williams, and many others), every celebrity who misbehaves is not Bipolar; not only does this trivialize the disorder, it associates it with bad behavior and violence; giving rise to more stereotypes.

While some progress has been made, we have a long way to go challenging the “mainstream” definition of Bipolar Disorder, and mental illness in general. It’s good that society is talking about it; but the conversation needs to be realistic. One way to contribute is to counter statements like the ones in the first paragraph when we hear them. It may only make a small difference at the time, but a long journey always begins with a single step.

Read More

After a Diagnosis, Life Goes On

Contributing Columnist: +Jen Stone 

For most, the prognosis after a mental health diagnosis appears slim. The phrase “mental health illness” seems to come with a huge black cloud. News flash: it doesn’t have to.

Look at Michael Kearney. He is a 29-year-old accomplished professor who graduated college at the age of ten and received his master’s degree in biochemistry at age fourteen. He did all this after being told he has severe Attention Deficit Hyperactivity Disorder (ADHD). While I do not expect everyone to become a child prodigy after being diagnosed with a behavioral or mental disorder, I do hope that we can look at Michael’s story and see that there are possibilities other than failure.

Something that I’ve noticed in my short life is that one failure can derail us as it undermines our confidence and sets up to believe that all we will ever encounter is failure.  It is this attitude, more than anything that fuels the cycle of failure to occur. What would happen if we looked at a failure not as the beginning of a series of challenges, but the end of a difficult time? If it is the end, then the next thing to come must be better.

With any type of health issue, there are always additional obstacles to overcome. If one prepares for these obstacles before they derail us, then they become points to build off from instead of points of debilitation. For instance, an incoming college student with ADHD can expect it to take him three times as long to study for something compared to someone without ADHD. By implementing an early study plan a few weeks prior to an exam, a once daunting exam becomes manageable. No longer does this student have to view ADHD as an impossible challenge, but more as a catapult for creating great study habits and life-skills.

Organization, preparation, and realistic goals seem to be the base for success for anyone, but especially when combating additional obstacles such as ADHD. Success doesn’t have to be an ideal; it can be a reality.

++
Jen Stone was born in the city of Chicago and attended college at Brown University where she concentrated in Human Biology. Upon graduation, Jen embarked on her Masters degree in Medical Sciences at Loyola University Chicago. Between graduate school, working at a free clinic on the west side, and teaching health education classes at the Lincoln Park Community Shelter—Jen found her niche and built upon her interest of helping the underserved. After graduating in May 2012 with her Master of Arts degree, she began working as a clinical research assistant in orthopedic surgery. Jen will be attending medical school beginning in August 2013, and plans to specialize in emergency medicine.

Read More

All Doomed & Delinquents: The Epidemic of Attention Deficit Disorder

Contributing Columnist: +Jen Stone 

Understanding Attention Deficit Disorder

I am very excited to be joining the community at Delirium Today. The mission of Delirium Today is to educate, support and empower—is something that I genuinely believe in, and which takes precedence in my decision to become a physician.

My oldest brother, and biggest love, was diagnosed at a young age with Attention Deficit Disorder (ADD). ADD presents with inattention, distractibility, disorganization, procrastination, and forgetfulness. Yes, this applies to him, and yes, I believe he has a textbook case of ADD, but based on these symptoms, doesn’t everyone? As someone with severe anxiety, that I now successfully treat with medication, I know how a chemical imbalance can drastically effect one’s attitude, relationship with others, and ultimate success. There are lots of opinions about the over diagnosis of ADD in our society. I may agree with some of them, but I also know that there are people, like my brother and myself, that truly are plagued by a condition that they have absolutely no control over. My goal is to address this dichotomy of over-diagnosis and true health ailment—with ADD and other mental health issues.

This will be as much of a learning experience for me as it is for my readers, and I welcome intelligent comments and probing questions to help us delve deeper into this controversial subject.

*** 

Jen Stone was born in the city of Chicago and attended college at Brown University where she concentrated in Human Biology. Upon graduation, Jen embarked on her Masters degree in Medical Sciences at Loyola University Chicago. Between graduate school, working at a free clinic on the west side, and teaching health education classes at the Lincoln Park Community Shelter—Jen found her niche and built upon her interest of helping the underserved. After graduating in May 2012 with her Master of Arts degree, she began working as a clinical research assistant in orthopedic surgery. Jen will be attending medical school beginning in August 2013, and plans to specialize in emergency medicine.

Read More

Stepping Into the World of Mental Illness

Contributing Columnist: +Maria Y 

Stepping Into the World of Mental Illness

My article title is ironic, because without realizing it, I stepped into the mental health world a long time ago and have rarely stepped out. I was a moody child, and growing up I noticed mood swings in my father. I later found that both he and his father (who died before I was born) struggled with Cyclothymia (a softer version of Bipolar Type I).

When I was 14 years old, I started having mood swings that were more pronounced. They were not the full ups and downs of Bipolar I, but they did make my life and my relationships difficult. I also developed hormonal problems and what I later found out was Polycystic Ovary Syndrome PCOS (which has been to found to have a correlation with Bipolar in women).  I heard about actress Patti Duke’s Bipolar Disorder. I wondered, since my swings were not as extreme as hers, could I even be Bipolar?  I asked my dad if someone could be “a little Bipolar;” he said, “he thought that he and my grandfather were, and that I might be too.”  He said, “he’d managed it without treatment, so I figured I should too.” I didn’t even think there was a name to describe it.

In college things escalated; I was treated for insomnia with antidepressants which gave me a worse hypomania [less severe mania], and then I went way down into the lowest depression ever for me.  I got therapy and it helped me manage it; I was totally against taking meds again. I still had the smaller mood swings I’d had before alternating with normalcy, then every few months I would get a worse hypomania (but never reaching full mania) and depression.  Being a Psychology major, I started doing research, and found that there was a name for what I had called Cyclothymia.  I also found out about Bipolar II disorder, which has hypomanias and lower depressions. I hadn’t heard of either, and I didn’t know that you could have Bipolar II with intermittent Cyclothymia, which is what my diagnosis turned out to be.  If I had known that diagnoses such as mine existed, maybe I would have gotten treatment earlier.

I learned to get all my schoolwork done during my high periods so I could rest during my lower ones. I went on to earn a Master’s Degree in Psychology and to work as a mental health counselor for three years; I seemed to be a natural born counselor and loved my job. I learned to hide my issues from everyone but closest friends. Having mental health issues is frowned on for those who work in the mental health industry. Hiding it wasn’t easy, but I managed enough and lived life based on cycles.

In 2005, I got very sick with Lyme disease, and almost died. This caused horrible physical effects and a psych symptom I’d never had before; severe anxiety. I went to a “highly recommended” psychiatrist that didn’t agree I was Bipolar (I had finally admitted it), and kept trying to put me on meds that made me fully manic. I stopped seeing her and got the Lyme disease treated, which got rid of the severe anxiety.  I’m now in remission, but I live with the chronic psychical after affects every day, and I had to go on disability and stop doing the work that I love.

After that, I finally decided to get my Bipolar treated. I found both a good psychiatrist and a good therapist, and got lucky.  Since I have my own knowledge of mental health, I was able to advocate for myself and do research.  My doctor was willing to work with me and let me try small doses of meds first.  I reacted very well to Lamictal; it literally changed my life. I’d forgotten what it was like to live without constant mood swings; it felt foreign at first, but I quickly grew to like it. It also enabled me to learn to set better boundaries with people; when you’re a counselor sometimes everyone wants you to fix their problems.

Presently, when not writing, I spend my time involved in activism and causes, mental health being at the forefront. I plan to write about the mental health system, treatments, diagnoses, counseling, education, mental health news in pop culture, and of course the spectrum of Bipolar Disorder.  The mental health system is in many ways broken, but helpful in others; experience varies widely depending on several factors. It’s time to try and make the world of mental health a better place.

 *****

Maria Yaworsky lives in the Washington DC Area. She graduated with a Master’s in Psychology and worked as a mental health counselor, while living with undiagnosed Cyclothymia/Bipolar II. In 2005 she developed a chronic physical illness, and eventually got her BP successfully treated, and is now involved in activism for various causes, Mental Health being at the forefront.

Read More