Monday, July 12, 2010

Mental Illness In the Media

Recently, I have seen episodes that deal with mental illness on a couple of favourite shows. The first one, an episode of Doctor Who involving Vincent Van Gogh, was absolutely spot-on. The second, an episode of Drop Dead Diva in which Jane's mother is arrested for erratic behaviour and diagnosed with bipolar disorder, both wins and fails horribly.

Vincent Van Gogh, for those of you who do not have an interest in history, art, or art history, was a Dutch painter whose art was not recognised or appreciated during his lifetime. He is now considered one of the most influential painters of all time, and his style influenced a number of expressionist and modernist artists. Van Gogh is the dude who chopped off his earlobe and gave it to a prostitute after a falling-out with a fellow painter. He is known to have suffered bouts of mental illness, growing in intensity and frequency towards the end of his life. He committed suicide in 1890.

In the Doctor Who episode "Vincent and the Doctor" (link contains spoilers), Van Gogh is seen enduring extreme mood shifts, moving from apathy to melancholy to wonder and delight to irrational anger to deep existential despair, and so on. The Doctor does not seem to scorn or pity him, but rather treats him with compassion. Through the events of the episode, Van Gogh falls sort of wryly in love with Amy, the Doctor's companion, and what one would presume to be the hallucinations of a man grappling with schizophrenia or an over-fondness for absinthe are shown to actually be an invisible homicidal alien whom only Van Gogh can see. After the thing with the alien is resolved, and Van Gogh is treated to a glimpse of his future fame and popularity, Amy eagerly rushes back to the art museum to see if there are new paintings there. She thought that their twenty-four hours of good times and happiness would have magically cured Van Gogh's malady and prevented his suicide. Much to her dismay, Van Gogh's suicide still occurred. The Doctor, while consoling her, says "The way I see it, every life is a pile of good things and bad things. The good things don’t always soften the bad things, but vice versa the bad things don’t always spoil the good things and make them unimportant. And we definitely added to his pile of good things."

Apparently some have criticized the episode's ending as "utterly pointless" or unnecessarily emotional. I have to say that I was greatly impressed with the fact that Van Gogh was not miraculously cured in one day, as so often happens in tv shows or movies. He has a great day, and gets to see amazing possibilities in the universe. He sees that his legacy is much more far-reaching than he ever could have dreamt. But none of that changes what is ultimately an organic disorder. His neurotransmitters are still messed up. His brain still is not functioning typically, and he is not able to regulate or temper his moods. The thing about mental illness is that it is not rational. If we could just decide to feel better, or if we could just have one wonderfully joyful day, and that would magically make our neurons fire properly and our bodies produce the correct balance of chemicals to make us feel emotions appropriate to the situation, those of us living with mental illnesses would gladly pursue such options! The Doctor's little speech is also very important; just because life is filled with such persistent darkness and despair for so many of us, that doesn't mean that wonder and joy are not also present. And it also doesn't mean that the wonder and joy are able to dispel the darkness. Neither does it mean that the darkness makes the wonder and joy shine any less brightly, nor does the darkness diminish their significance and importance. The end of the episode conveys an important message to the family and friends of people who grapple daily with mood disorders and mental illnesses: Everything you do to shine some light and happiness into our lives is important. We need your joy and compassion and encouragement. However, there are times when nothing you can do is able to make us feel better. Sometimes, it might seem like nothing you do can help or make any difference. This is not your fault. This is not our fault. It simply is what it is. And never believe that your kindness and love are in vain; they matter greatly to us.

Right. I got kind of wrapped up in rambling/ranting over Doctor Who for a bit there. Sorry. The second episode I want to mention, the latest Drop Dead Diva episode, was kind of a disappointment in contrast. Don't get me wrong, it actually started out pretty good; it just falls short, as so many of the series's episodes do, of escaping the morass of popular perception.

I have been watching Drop Dead Diva in the hopes that it will somehow become less shallow and live up to its glimmer of potential. The first few episodes were great, if you ignore the theological implications; an aspiring model is on the brink of success, dies ironically, has a temper tantrum at the pearly gates, and hits the "Return" key on the keyboard, which apparently returns her to life on Earth -- except she wakes up in the body of Jane Bingham, a brilliant, selfless, overweight lawyer. The series wonderfully addresses the fact that body chemistry plays a part in things like food cravings; Jane thinks that her willpower can whip this body into shape in no time, but finds that things she would have shunned in her previous life (like doughnuts) overwhelmingly irresistible.

In this episode, Jane's (new to her) mother is arrested at a shopping mall, and in the course of getting her out of jail and dealing with the charges, Jane has to deal with her outrageous behaviour. When drug and alcohol tests come back clean, the judge orders a psychiatric assessment, which turns up a diagnosis of bipolar disorder. A lot of what is portrayed can be part of an accurate picture of bipolar disorder. The mother is intent upon having fun, despite possible consequences; in fact, she behaves as if the consequences do not apply to her. She has a hair-trigger temper, and is extremely defensive about her condition. It turns out she was actually diagnosed fifteen years prior, but did not like how the medication made her feel. She describes looking in the mirror and not recognizing the person she saw there. The prosecuting attorney mentions that she has escitalopram (brand name Lexapro or Cipralex) in her blood, as detected by the aforementioned drug test, and claims that the medication is known to induce a manic episode in patients with bipolar disorder. It turns out the mother had asked for the antidepressant, presumably because she preferred to avoid her depressive states. The mother agrees to follow a course of treatment involving medication, outpatient therapy, and exercise, and is released into the custody of her ex-husband (Jane's dad, of course) who wants to get back together with her as long as she takes her medicine. The major focus immediately shifts to medication therapy. Later, presumably that evening, the mother is portrayed as being magically back to normal, even though medications used to treat bipolar and other mood disorders typically take weeks or months to take full effect. There is an unspoken implication that the mom is now cured.

I cannot even begin to address how bad and wrong and awful this is! The world needs to see realistic portrayals of mental illness and its treatment, not this stupid fairy tale.

Today, the score is Drop Dead Diva: 0, Doctor Who: >9000.

Saturday, July 11, 2009

ADHD and me: the perpetual klutz.

So I don't know if anyone else has this problem, but I'm guessing yes. As I type this, I keep checking my wounds to see if they actually need band-aids -- I recently parted company with a little bit of skin on the palm of my left hand, the back of my left forearm (I'm talented like that!) and my left knee (and even a tiny bit on my right knee... but not nearly so bad as the left). All three of these locations are grotesquely swollen and beginning to turn interesting colours like green and purple and blue. My head hurts something fierce, and my neck is sore enough I suspect I've inflicted a minor case of whiplash upon myself. What did I do?

I didn't fall off my bike/rollerblades/skateboard. I didn't get hit by a car (did that once, came away with FAR less damage than I have now!) or a freight train, although it sure feels like it. No, I fell off my feet. That's right. I was dropped off across the street by a friend. I looked both ways to ensure there was no traffic. Then I took about two steps, tripped on the open pavement, stumbled forward rather quickly, realised there was no recovering from this, fell, caught myself with my hands, and then kept falling forward with my arm underneath my body. I actually bounced. Too bad no one was videotaping, I could have been famous in an AFV falling down montage. Oh yeah, the swelling happened immediately, and the bruising... well this happened less than an hour ago and already I am colourful.

So how in the world does one trip on nothing? Someone please tell me, because this is not the first time I have done it! I sprained my ankle on two separate occasions doing the very same thing (the other two times, I stepped in holes), and I feel very proud of myself to have made all my appendages go in the right directions to avoid another sprain. I think. The jury is still out on my arm, but if you had a 300lb+ woman land on you and skid forward, you would be swollen and black and blue too, I imagine.

I always have a few bruises on my person. I walk into stuff, hit myself with things, trip over nothing, it seems like I am the clumsiest person on earth. My mom said she wants to wrap me up in cotton batting. I told her I would probably get rugburn from it or something.

At least since my diagnosis, I can blame it on something besides me being a colossal klutz -- I know that with ADHD comes a tendency to not notice certain things in my environment... such as that small bump in the pavement, or my proximity to the door I am about to yank open. Or the coffee table. Once I decided to walk to the back door at my grandpa's house (I was like... 11 at the time, so there is no excuse for this...) completely forgetting about the 3 stairs down to the landing. CRASH! I trip over the cracks in the sidewalk, too, even when they're spray painted with bright colours.

So, who wants to follow me around with a video camera to capture my epic spills on tape?

Cross-posted to ADDer World.

Thursday, April 23, 2009

Reflection on the close of the semester

So for the first time in my life, I finished an entire academic semester with full academic supports. I have my digital voice recorder with indexing to help me with my notes in class, I have permission to take notes on my laptop, I have text-to-speech software to help me stay focused while reading, and I have software to help me with the process of planning and organizing things. I have a good quality headset to use with my speech recognition software when writing papers. I have access to an academic strategist and a counselor. I have exam accommodations which allow me to write my exams in isolation on a computer, using my text-to-speech software to keep me on task. I have access to a note-taker if I need one.

Yesterday afternoon, for the first time in my life, I handed in the last of my assignments for the semester on the last day of the term. I did not miss any assignments and I did not Have to get an extension past when the term was over. Sure, one of them was overdue, but it's finished and I turned it in, which means I don't have to take an automatic fail in a class where I would otherwise be getting at least a B.

I was so happy yesterday!

After all that effort, I actually managed to successfully complete a semester of college. Amazing.

Today, I feel lost and deflated. No reason, I just do. I'm reminded of something in the book "Driven to Distraction" by Edward M. Hallowell, M.D. and John J. Ratey, M.D.

Expect depression after success. People with ADD commonly complain of feeling depressed, paradoxically, after a big success. This is because the high stimulus of the chase or the challenge or the preparation is over. The deed is done. Win or lose, the adult with ADD misses the conflict, the high stimulus, and feels depressed." (Hallowell and Ratey, p. 251)
On the one hand, this sounds absolutely crazy, but on the other it makes total sense. I tend to miss the chaos and the business of moving from one paper to another, group projects, deadlines, scrambling to make it to class on time, and all that good stuff. It's like the high-energy borderline gong show that is the opening night of a theatrical production. Now that I'm finished (at least until Monday), it's almost like my brain doesn't know what to do with itself if it's not juggling the 50 million tasks I give it on a normal basis.

The good news is I have an appointment with my therapist tomorrow (or maybe friday... I'd better phone and find out!) and I can maybe talk about all this. I just need to remember to railroad the session!

Hallowell and Ratey had things to say about how to deal with this "post success letdown," too:

Try to let a successful moment last and be remembered and become sustaining over time. You'll have to train yourself to do this because you'll naturally tend to forget your successes as you brood over your shortcomings or pessimistically anticipate the worst. (Hallowell and Ratey, p. 252)
Looks like maybe I have a new skill to practice, I guess I'll just add it to the rest! Blah. Must. Not. Get. Overwhelmed.

Speaking of, does anyone, anyone know of a doctor or a psychiatrist in Edmonton who has experience dealing with ADHD in adults? Anyone? I really want to see if medication will help me, but I don't know where to go, and I want to make sure whoever I'm dealing with knows what he or she is doing.

Quotations taken from "Driven to Distraction" by Edward M. Hallowell, M.D. and John J. Ratey, M.D. Published 1995 by Touchstone in New York, NY. Book can be found for purchase at Chapters.ca or Amazon.com; I really recommend it to anyone who is learning how to cope with ADHD, either themselves or in a family member.