The Mental Feminist

Sorry, y’all. I know it’s been almost two months. I was out of town, and then I moved back to my university, and then everything got out of hand and I’ve barely had time to sleep, let alone blog.

In good news, I found a psychiatrist here who seems to be nice, if a little airheaded. (He said at one point, “Are you sure your diagnosis was correct?” Me: “Uh, yeah, why?” Him: “You seem so normal!” Me: “Yeah, well, I’m taking 900 mg of lithium and 200 mg of Lamictal and exercising and not drinking, smoking, or consuming caffeine.” Him: “…Touche.”)  Seriously, whattttt? You seem so normal?! Well, I would sure hope so, because that’s the goal! This was after I had explained my long personal history, hospitalization, and lengthy family history of bipolar disorder. I am definitely not letting this guy touch my medication levels unless it’s an emergency. I trust my psychiatrist back home way more.

In bad news, my disorder seems to be “contagious.” My boyfriend, as I said before, was diagnosed with bipolar II over the summer. Now my best friend, previously thought to have major depression, was diagnosed with bipolar III/NOS. I know there’s a lot of debate over this diagnosis, because it’s not in the DSM, and I know there’s a lot of people who would like to keep it out, and I agree that the diagnosis might be overused, but I feel that it definitely applies in her case. She’s been having hypomania and mixed states cycling with depression, and she’s on Lamictal, which seems to be working a tad. My personal feelings are that since bipolar I and II manifest differently in people, that it’s entirely possible that there are other bipolar variants which need to be diagnosed as such so that the treatment range, similar to the more classic bipolar treatment range, is prescribed accurately. (As opposed to sticking these people on an antidepressant and watching them go kaboom! when the hypomania/mania/mixed state sets in.)

Also, I’m now working on a research paper for my “women and the law” class about postpartum depression and the law. I’ll keep you updated.

First of all, I just want to say that this was a very difficult post to make for me, because I can see both sides of the argument very clearly. So, in the end, I’m presenting both sides as well as I can. I suppose that way I’m leaving it up to you, though I do state an opinion. I’d also like to say that this is meant as food for thought, and in no way constitutes what I think should be policy.

Anyway. This post started out as an AIM conversation between my best friend and me. We’re both feminists to one extent or another (with differing levels of comfort with the word) and we’ve both taken women’s studies classes at our university. In fact, I’m about to take one she took last semester, called “Women and the Law,” which focuses on women’s interactions with the law and things such as abortion, rape, etc. So, with this background, we tend to have frequent conversations about feminist issues, and one topic that she (a reader of this blog) suggested I write about was the issue of mental health and sexual consent: 

Namely, should there or shouldn’t there be a clause in rape laws stating that if a person is not in his or her “right mind,” such as in a manic state, that they cannot consent to sex?

I know I had a quick-trigger reaction to that question, and I’m sure you did too. But, let me present both sides.

On the one hand, one could argue that this is already covered under existing rape law, in that someone who is incapacitated cannot consent. But, this does not cover mental health very well, especially not transitory states like mania. One can be declared incapacitated by a court, but that’s generally when one permanently cannot care for oneself. And, one could be incapacitated by alcohol, but even in that case, sometimes incapacitation is too difficult to prove. As someone who has made illogical decisions while in a manic (or even depressed) state, I can certainly say that I’m not in my right mind then, and I’ve made decisions I have regretted later when normal. Am I really capable of informed consent in these states?

Another issue this raises is the problem in general with violence against those with mental illness. This would be one additional way to prosecute those who prey on vulnerable members of our society, and to raise awareness about the problems faced by those with mental illness.

BUT, I think the negatives do outweigh the positives. First of all, there’s the glaringly obvious issue of determining when someone’s in a state that’s bad enough that they’re incapacitated. It’s not like there’s a blood test or something that can be administered. It’s all subjective. Hypomania is considered abnormal, but would it prevent someone from being rational? Who knows? And then there’s the issue of those with illnesses that are undiagnosed. Would one be able to declare retroactive rape?

The biggest issue to me, though, is the infantilization of those with mental illness. If this ever became law, it would be a great way to prove that people with mental illness are incapable of being rational adults. There are plenty of people who are “sane” and totally irrational. Having a diagnosis (or a lack thereof) doesn’t make you magically (not) a capable person. And that is why, ultimately, I can’t even entertain the idea of such a proposal, no matter how theoretical.

What do you think? Is there anything on either side I missed?

Over 1,000 hits in six weeks. To me, that is incredible for a first-time blogging venture. Thank you to everyone who reads, comments, links me, tells their friends, etc. You’ve really been a big help in making me feel less alone in this whole thing.

I’ve not posted much the past few days because I’ve been out and about in the real world. Ever since the Geodon left my system, I’ve been hungry and awake for the first time in a month. I lost eight pounds in the month that I was on Geodon, a big deal on my frame. I went down almost two pants sizes, as a matter of fact.  Also, it’s nice to be a morning person again. I love being able to wake up before 8 am without an alarm clock and feel refreshed and ready to go. So, I’ve been taking advantage of both my hunger and my lack of lethargy and I’ve been doing stuff around the house, working on projects, and chatting with people. I currently have several sewing projects in progress, a knitting project, and I’m working on some fiction writing as well as blog posts.

The blog post I currently have in progress is one about mental illness and consent laws (sexual consent, that is).  I’m not quite done with it yet, because I keep thinking of things to add. It should be up this weekend.

Thank you to all who have commented so far on my last post. Your words mean a lot to me. Also, I’m getting a lot of traffic from HoP’s Google group, so hi all of you! I’m already in another support group online, or I would join, but I only have so much time to devote to thinking about this stuff.

So, I finally saw my pdoc this morning, and I am to discontinue Geodon and start Lamictal immediately. That brings me to 900 mg of lithium and (titrating up to) 200 mg of Lamictal. If I do well, I might get to be removed from the lithium later this fall. Honestly, I don’t care how many pills I have to pop as long as I have a combination that works, so it makes no difference to me whether or not I stay on lithium too, since it’s not causing any of the horrible side effects it seems to for other people. I’m just thrilled to be off the Geodon, because it’s made me so sleepy I’m afraid to drive. I fell asleep in the car this morning on the way to the pdoc, so it’s a good thing I didn’t drive!

I have something else of substance for all of you: an indie-pop bipolar mix CD! Some bands repeat, but the songs were just too appropriate to not include.

1) Here It Goes Again, OK Go

Mania:
2) Mr. Blue Sky, Electric Light Orchestra
3) Take It Off, The Donnas
4) Born For This, Paramore
5) Hit Me!, The Sounds
6) It’s a Disaster, OK Go

7) Circles, Incubus

Depression:
8) A Lack of Color, Death Cab for Cutie
9) The District Sleeps Alone, The Postal Service
10) The Execution of All Things, Rilo Kiley
11) Hard Times, Bob Dylan
12) You Could Be Happy, Snow Patrol

13) A Better Son/Daughter, Rilo Kiley

If you download just one of these songs, get the last one. It basically reads as an anthem for those with bipolar disorder, in my opinion.

I had to wait until I calmed down enough to post about this, but the moral of my extended family visiting was basically this: don’t visit them ever again.

My uncle, who knows I have bipolar, stared at me the entire week. STARED. Like one might stare at a riveting horror-filled TV show or at a car wreck on the side of the interstate. He didn’t even have enough shame to be embarrassed when I started hostilely staring back at him.

My grandmother, on the other hand, does not know I have bipolar, and so I had to hide it from her all week because she’s one of the people who just would Not Get It if I tried to tell her. Between the pressure of that and my rage at being stared at (and also being treated like I was stupid or something, because haha, we all know mentally ill people are ALL DUMB), I was manic like I’ve never been before in my life. I’m amazed she didn’t figure anything out, because I was shaking uncontrollably, crying, and basically incoherent all week. The day after I got home, though? Mild hypomania. Today? Fine.

Maybe the real moral of the story is: this is what they mean when they say extreme stress worsens our conditions. Definitely something for me to keep in mind in future. And, I refuse to see the grandmother and uncle again any time soon.

I’ll be back to posting by Friday, but I’m currently stuck at my extended family’s house with only a 26.4 K dial-up connection. How am I supposed to research on that? It took about five minutes for this page to load so I could post this. In this kind of mania, that just is too slow for me. See you on the flip side!

Personal stories time! I said in my last post that I’d talk about incorrect diagnoses. My boyfriend, Alex (the same one who has commented here previously), is a probable misdiagnosis. We’ll know for sure in a week and a half or so. He’s currently diagnosed with depression and ADHD (has been since he was young), but we’re fairly confident he has either just bipolar disorder of some kind or bipolar and ADHD. Let me tell you, a relationship with two people with bipolar is never dull. Right now, I’m up, he’s down. In March, I was down, he was up. Even though our states differ, we still understand each other in a way that no one else we’ve dated can. He knows what the lowest of depression feels like, and I know how frustrating it is to not be able to sit still and concentrate because your mind is racing and you can’t shut up.

One other thing we both understand is mixed states. My hypomanias usually run to the irritable side, and my depressions are usually angry, and so I definitely know the mixed state very well when I’m in between the two. Alex is more rapid-cycle and seems to dwell between states most of the time. Resonance over at empirical insanity had an excellent post up about mixed states a couple of weeks ago, which linked to the Cyclothymia Collective’s list of mixed state symptoms, most of which we exhibit at any given time. I bet you’re thinking, “Boy, that sounds like a fun relationship!” It actually is, because we don’t even try to put on “normal” faces for each other.

For example, one evening when I was mixed state, we got all dressed up to go out, and then I lost the directions. We missed the bus, because even though I found the directions, I fell into a crying heap on the ground and bemoaned my horribleness. He calmly picked me up, held me, and then once I calmed down, we went to a closer place that I knew how to get to. We had a lovely dinner. Crisis averted. In return, I have listened to him bemoan his entire existence all summer because he is abroad and miserable. So, payback works out for us, or at least it has so far. We don’t exactly encourage each other’s moods, but we don’t ignore them either or try to “make” them go away, because we both know that’s not going to work out.

On another topic, my Geodon is not working, along with my lithium. All Geodon’s done has made me sleepy. My pdoc appointment didn’t happen because he cancelled on me for the fourth time in two months, so I’m out of luck until the 30th. Ridiculous. If he weren’t just my summer/holidays pdoc, I’d be looking for a new one. I am in the market for one for schooltime, but I have my university clinic to fall back on if I can’t find another one (compatible with insurance, that is).

There was an interesting New York Times article that I didn’t see mentioned elsewhere, really. Basically:

“Drug companies like to say that their most expensive products are fully worth their breathtaking prices. Now one company is putting its money where its mouth is — by offering a money-back guarantee.

“Johnson & Johnson has proposed that Britain’s national health service pay for the cancer drug Velcade, but only for people who benefit from the medicine, which can cost $48,000 a patient. The company would refund any money spent on patients whose tumors do not shrink sufficiently after a trial treatment.

“The groundbreaking proposal, along with less radical pricing experiments in this country and overseas, may signal the pharmaceutical industry’s willingness to edge toward a new pay-for-performance paradigm — in which a drug’s price would be based on how well it worked, and might be adjusted up or down as new evidence came in.”

Would they ever, ever do that to psychiatric drugs? I think not. Imagine the money they’d lose! We all know how many people have to try drug after drug before they find something that works, and we all could name drugs that seem to suck for many (if not most) people for whom they are prescribed. *cough*Zoloft!*cough*

I can’t imagine a scenario in which this sort of drug pricing would work for psychiatric drugs. At least, not until diagnoses can be more iron-clad. (More on that in my next post.) I was initially diagnosed incorrectly, I might even still be, and I’ve heard the average for bipolar patients is eight years of varying diagnoses before the verdict of “bipolar” is reached. Then there’s the bipolar variants, ADHD, SAD, PTSD, borderline, schizophrenia, degrees of depression… honestly, it’s a wonder they ever do settle on a label, so to speak, for all of us, with all the overlapping presentations these disorders take. And without a settled label, how could they judge effectiveness for one disorder? What about drugs that work well for some things, poorly for others? What about drugs who work fantastically for some people, but poorly for most?

Anyone disagree with me? Let me know.

I have six drafts awaiting, but no motivation for any of them. My hypomanic drive today is toward sewing. I’m less hypo than I was, though, which is good. The Geodon is working, but I must sleep nine hours a night, or I am impossibly groggy. I’m still fine-tuning that. The two things I wanted to bring to your attention:

• This post from Pole to Polar, entitled “The unwanted other in the relationship,” about the ways in which bipolarity interferes in her relationships. I can’t say I disagree, but my illness has become much more manageable, and I have friends and family who understand. All those years that it was untreated, though, have been hard on my family, and I’m only 20.

• The welcome news that the Army “plans to begin a program today to educate every soldier about traumatic brain injury and post-traumatic stress disorder.” YAY!!!11!, is all I have to say.

All right, back to your regularly scheduled programming. I’ll hopefully have a real post up by tomorrow, which is when I have another pdoc appointment.

After seeing that Ampersand linked me (which, OMG SQUEE, by the way. Just saying.) and then seeing Crazy Tracy’s response detailing her own ECT and how it’s been beneficial to her, and finally seeing flawedplan’s response to Amp and Tracy, I’ve been doing a lot of thinking about what I said, and what they said, and etc.

First, and I apologize if what I said could have been misinterpreted, I don’t want to crusade against ECT, and I don’t wish necessarily to end the practice entirely. However, I don’t think it (or any other treatment or medication) should be forced on anyone, and I do feel that people who voluntarily consent should at the very least be aware of the risks. I also do not wish to belittle or ignore anyone’s positive experience with the treatment.

Second, I really was intrigued by what flawedplan had to say about whether or not there is a cohesive mental health blogging community, and if there is, whether or not it could come together for activism or credibly lend its voice to the larger progressive community:

If progressives are to take up psychiatric rights it’s the stakeholder’s job to meet them halfway. We have to be directive, and “on message.” Maybe I’m kidding myself and there is no real c/s/x community, but for the sake of argument, let’s say we have something going on. How do we get out of the ghetto? What can we do? What are we doing?

It’s tricky to urge social activists to take up yet another cause, and when people with no stake in a battle do their homework, give it time and attention, promulgate the scholarship and rally around in agreement, it is to celebrate. Strength in numbers, the consolidation of power, hope and possibility springs up.

[...]

Standpoint theorists maintain that people in the same social group will share the same perspective.

Generally true, except when it isn’t. There’s nothing wrong with generalizing experience, the question is what to do with the fly in the ointment. There’s one in every crowd.

And the one right now in this crowd seems to be ECT. But, we have all sorts of other ones too, like pro-med/anti-med, pro-CBT/anti-CBT, even pro-disorder/anti-disorder. Yes, for those of you on the outside, some of us are still arguing about whether or not these disorders are even disorders!

However, then I think about the feminist community. You have pro-sex/anti-sex, pro-porn/anti-porn, pro-marriage/anti-marriage, and even pro-choice/pro-life battles still raging. People over there argue that those battles keep feminists from being recognized at large. And yet, Amanda Marcotte and Melissa McEwan get picked to work for John Edwards and Amanda has a book deal, Jessica Valenti is on The Colbert Report and has published a book, and Jill Filipovic blogs for the Huffington Post. Clearly, feminism works despite its internal differences.

What makes us different? As flawedplan says, “We’re a minority population, many have criminal justice histories, psychiatric abuse is below the radar, and engaging the material makes people uncomfortable.” There’s a huge stigma attached to many of us just because of who we are. However, there’s also stigma involved with being a racial minority, a religious minority, and any other minority one can name, and yet their concerns, the concerns of blacks, Hispanics, Muslims, transgendered people and gays, are on the radar. Why not ours? In my opinion, there’s only one reason: we are not a cohesive community yet. We can’t mobilize because we have no common creed.

I think part of the reason for that is because mental illness treatment is so individual and conditions manifest so differently in a lot of people. I also think that activism is a lot on top of the things we normally have to face. Does the physical disability blogging community also have these problems? I honestly don’t know, but I would guess they do.

So, I guess I’ll finish by saying that I share flawedplan’s sentiment. We cannot afford to divide because there aren’t enough of us who have the luxury of being activists. (Not that we all have to agree, but we can’t flounce away with our toys, so to speak.) We need to try to unite, even while we disagree, to work toward goals we all believe in.

Susan’s post about treatments for bipolar disorder, and her comment on my last post, reminded me that I really should clarify the “pro-medication” statement in my “about” section. Yes, I am in favor of medication when needed. I feel that it is necessary as a part of treatment for a lot of people, but not necessarily all. I feel that other treatments are necessary as well, including many she lists:

5. I believe that lifestyle has a huge impact on this illness. I strongly believe that exercise is critical and that every single bipolar person should be participating in an exercise program.

I am, in fact, taking swim lessons so I can lap swim for exercise, and I visit the gym 2-3 times a week. In the fall, I hope to make that more as I get more regulated on a schedule with school and all.

6. I believe that diet and nutrition are very important and every bipolar person should be given free nutritional counseling.

I’m (mostly) following my mom’s Weight Watchers “core” diet, which stresses low-fat or no-fat dairy, whole grains, no processed sugars, and healthy fats like plants or fish. (I’ve not lost any weight, but I didn’t need to. If you’re at your base, “natural” weight, the WW diet won’t change your weight at all.) In addition, I don’t drink alcohol or caffeinated beverages.

7. I believe it’s critical to know what your stressors are and how to alleviate them.

I’m still working on this one.

8. Personally, I believe in the following adjunctive therapies: music therapy, horticultural therapy, massage, exercise and movement therapy, pet therapy, counseling (or some sort of talk therapy), light therapy, prayer, positive thinking, humor therapy, expressive writing therapy, and a host of others.

I believe in all of these and participate in most, with the addition of art therapy. Art and crafting have always been releases for me, but never more so than now.

9. I believe that dwelling on illness rather than seeking wellness makes people feel worse.

10. I believe that finding one’s life work makes a huge difference.

I totally agree with these two points. I’m trying to stay positive and search out what I’m meant to do with my life.

Finally, I believe that loving relationships with family members and friends makes life worth living.

Agreed. I am so lucky to have family and friends and a boyfriend who really understand this, some on a personal level.

I went to the friendly pdoc today, and he switched the Abilify for Geodon. The goal is to stabilize me somewhat this week, then move me to Lamictal, since I seem to be lithium-resistant, and I’ve had all the lithium my body can handle–I’m at the highest therapeutic dose that my size can take. Honestly, right now I don’t care what Big Pharma is selling me, as long as they make something that can make my situation better, because right now it is unlivable. I am irritable, paranoid, and anxious, and I’m hyperventilating. I hear Geodon’s good for mixed states, so hopefully that will help.

• Read 2 books, 3 magazines, and 2-3 newspapers (per day on the newspapers), plus following 20 blogs daily
• Learned to crochet and checked out 2 books from the library to read about it
• Organized all my bookmarks
• Posted in this blog!
• Started swim lessons
• Knit 10 rows on my tank top

All this… in less than four days. Almost makes me not want to see the doctor today. I wouldn’t, except that I can feel the bad half of the hypomania, the irritable half, right below the surface, simmering, seeking, and waiting. I’m not sure which med failed this time, the Abilify, the lithium, or both. It almost doesn’t matter.

A friend of mine sent me this video yesterday, an investigative report from Pittsburgh, where a new program has started that gives homeless people apartments. Okay, all well and good, but what has people in an uproar is that there’s no restrictions on alcohol use, so these homeless men are still buying alcohol and getting drunk, albeit slightly less frequently than before. (The video interviewed older homeless men, so I have no idea about homeless women and children and if they got these apartments or not, and so I’ll be talking about older homeless men for this post. Though I really think families, if there were any, should have been first in line for these apartments.)

My reactions, in the order that they happened to me:

1) (I’m ashamed of this one, but I’ll be honest.) “What the hell?! How can they keep allowing these drunks to sponge off the system? How is this helping them?”

2) (I’m also ashamed of the sentiment of this one.) “Well, it’s not illegal for a drunk to buy alcohol, so I guess there’s nothing they can do about it. At least people don’t have to trip over them on the sidewalk anymore. But still, how is this helping them?”

3) “WAIT A MINUTE.” *lightbulb goes off* “That guy said he was a Vietnam vet. In fact, all these guys look like they could be about that age. He probably has serious PTSD if he’s getting drunk every day. So, Pittsburgh is just shoving these people in apartments and wanting to forget about them? Couldn’t some therapy, maybe some meds, definitely some alcohol rehab actually help these men? How is this helping them now? …It’s not.”

My mom and I were talking this morning, and she thinks that the military should mandate therapy for every single troop coming back from duty. That way, the stigma would be removed. She says the military should fund the therapy and make therapy accessible by hiring therapists to work with them during a six-week (or more, depending on severity of trauma) deconditioning process on base (for which the troops would be paid) before they returned to their families. I can think of some holes in that plan, but I love that my mom, the former conservative, is now thinking outside the box.

Y’all, I am really sorry. This blog was supposed to explore the intersections between feminism and mental health, and so far it’s been a bunch of my personal medical problems. The issue went deeper than that, though–it’s because I’ve sort of fallen way out of the echo chamber part of the online feminist community. It’s really boring reading the same tripe every day, when nothing ever gets done about it. Blame the patriarchy, but never overthrow it, seems to be the unspoken motto of most. So, without further ado.

flawedplan shamed me (well, not me personally), but me in general, into posting about this. Simone D. is a woman who is a psychiatric inmate receiving forced electroconvulsive therapy, or ECT. You know, I didn’t know much about ECT. I did know that women are overwhelmingly diagnosed with mental health problems. Now, I personally think a partial reason for that is the stigma associated with men seeking psychiatric help (or medical care in general), but I also firmly believe that there is a bias against women in the mental health care system. Women are written off. Women are hysterical. Women are unstable. Women are just looking for attention. It’s not fair, and it’s not right. Then, you introduce ECT, something which works by causing brain damage and doesn’t work long-term for most people. How can one force something which causes brain damage on someone?! Why aren’t people up in arms about this? I suppose it’s because they don’t know, as I didn’t until flawedplan posted today. So, thanks. You’ve opened the eyes of someone who should have already known, and I hope this post sees a few more people.