The Coals of Stigma

Posted on October 6, 2005 in Bipolar Disorder Compassion

I’ve been under spam attack for the last two days, just like everyone else in the blogoverse. (Ooooo! Look at me! Using a trendy neologism!) What’s been missing are your comments….Am I getting boring again or is it just more fun to whine and kvetch about Bush and the rest of the world? Can Harriet Miers really be better looking than me?

The room filled up so quickly that the volunteers prowled the halls of the Northeast Building at St. Joseph’s Hospital in Orange looking for extra chairs. If someone had called the fire marshal, he might have cited the hospital. The crowd could not be stopped because this year bipolar illness was the in-topic and no one wanted to miss the lecture by locally renowned Dr. Hirimasi Da Silva.

Dr. Da Silva was introduced by a silver-haired man with a Falwellesque belly and the air of an administrator (which he was). When I mentioned the NAMI Family to Family program, this second fellow freaked and quickly mentioned that the lecture was co-sponsored by DBSA. I thought: I never knew they were at war.

By the questions and the comments, I gathered that the audience consisted of slightly more family members than patients. The patients tried to tell the family members how it was to suffer from this disease. The family members were desperate to know how they could control their bipolar members. I thought — but could not say to them — there’s the nub: you are asking them to give their lives entirely over to you.

What person wants to do this aside from the fictional bondage slave who gives her all so that she may have the “freedom” of “no decisions”? Dignity depends on participation. Healers and caretakers work with the ill to alleviate suffering and preserve their sense of self-possession.

When everyone around you is shamed by your illness, why acknowledge it? To admit to being sick is to give in to their sense of what is good for you. And so you fight it, resist their attempts to put you on medications.

In the play Camelot, Arthur recounts how he struggled to know “how to handle a woman”. And the way was “to love her”. That holds true for the bipolar patient: don’t attempt to manhandle us. Love us and see us through wherever the course may take us.

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Dr. Da Silva made the remark that in depression the patient endangers himself and in mania he endangers his family. I don’t think the division can be made so neatly. It is maniacs who have done the greatest harm to themselves what with their reckless driving, spending sprees, death-defying hobbies, and substance abuse. I have known maniacs to cross four lanes of the freeway or skip town with dubious characters who have exploited them. Depressives live in bed saying “I want to die, I want to die.” They wait for God and starvation to finish them off.

You may wish to envision the continuum as a ladder. Normal ups and downs are climbing the ladder. In depression, you kick open a pit at the bottom of the ladder and hide in it. In mania, you get to the top rung and you keep on climbing.

* * * * *

Flat-lining is the goal many families and more than a few psychiatrists think to be the optimum: never having sadness or joy. No bad days or fantastic ones. Just moving along like an Amish cart and never startling the horses.

The so-called normal people don’t flat-line. They go up and down. If that is health, why then do they want us live in a state of unhealthiness?

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Someone mentioned Laura’s Law last night, so I looked it up. Despite what some patients’ rights organizations have claimed, Laura’s Law is not focused on people like me who are mostly law-abiding and who take their meds faithfully. It specifically targets those who repeatedly refuse to be compliant and who continually pose a threat to themselves or others. Laura’s Law focuses on outpatient therapy: you show up every day for three months and take your meds. It is not a return to the past, but a move to protect people in psychosis. Their dignity is ultimately protected and their lives preserved.

* * * * *

My search led me to the San Bernardino Sun Telegram’s 2003 series Lost Among Us: How Society Failed the Mentally Ill:

They smell bad and look worse. They talk differently … sometimes with passion … obscenities flying from their mouths. They fling their arms about fighting off invisible demons and daring arrest. Sometimes it’s the bag lady pushing a shopping cart around town. These are the mentally ill of today.

That quote, alone, shows how society fails the mentally ill, by blowing on the coals of stigma and using them to dry the tears.