Living With Schizoaffective Disorder
What To Do If You Think You're Mentally Ill
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If you feel you may be suffering from a mental illness, I urge you in the strongest terms to seek the
advice of an experienced mental health professional - a
psychologist or psychiatrist.
(Psychiatrists are medical doctors who specialize in mental illness. They
have M.D. degrees and are licensed to prescribe medicine. Psychologists hold
graduate degrees and practice "talk therapy".)
This is important for more reasons than to simply relieve your suffering.
As I said before, if left untreated a mental illness can cause permanent
damage. Besides the kindling that occurs with untreated manic depression,
there is the damage that bad decisions or the inability to maintain
relationships can do to your life. If you get severely depressed, there is
the danger of suicide. It is much easier to deal with a mental illness
before you become desperately ill. Look at it this way: an office visit
is much cheaper than a hospital stay.
Accurate diagnosis is important. It is difficult to diagnose many mental
disorders, and if you're misdiagnosed you may not receive the treatment you
need. It is common to mistake manic depression for schizophrenia and vice
versa. Other illnesses that can be confused with manic depression include
Attention Deficit Disorder and Borderline Personality Disorder.
There is the danger that antidepressants may cause one to become manic.
An occurrence of even one manic episode in your lifetime is enough for a
diagnosis of manic depression. I feel the history of every patient
who receives antidepressants for the first time should be investigated to
determine the danger that their medicine may cause mania. Although general
practitioners - regular medical doctors - may legally prescribe
antidepressants, I am strongly of the opinion that it is unethical for them
to do so except in emergencies, as they do not have the training or
experience to determine whether one might be manic-depressive.
Fooling Yourself With Self-Diagnosis
Do not engage in the self-deception of self-diagnosis. It is common for
people to hear about illnesses of all sorts on Oprah or Donahue (or the
Internet!) and to then fool themselves into thinking they share the
diagnosis with the talk show guest. If you research an illness carefully
enough before you consult a doctor, you can even fool him into agreeing with
your diagnosis.
Failure to diagnose correctly can be life threatening. A number of
serious medical conditions cause disturbances in thought and affect, for
example stroke, brain injury as well as cancer of the brain, thyroid or
adrenal gland. When the grandmother of Mindfulness author Ellen J. Langer
complained to her doctor that a snake living in her head was giving her
headaches, he diagnosed her as senile and refused to investigate further. It
was only after her death that an autopsy found the brain tumour that killed
her.
Mental disturbance can be caused by heavy metal poisoning - the Mad
Hatter in Alice in Wonderland was inspired by real hat makers who
were sickened by the mercury used in the manufacture of felt hats.
Drugs of abuse can cause mental disturbances that last long after the
drug itself has worn off. Besides the damage that addiction can do to your
life and that of your loved ones, drugs, including alcohol, can cause such
things as paranoia, anxiety and depression.
It is common for people with psychiatric illnesses to "self-medicate",
but this ultimately causes more problems than it solves. Besides the
alcoholic drowning their sorrows with drink, I have heard that alcohol
suppresses hallucinations for the schizophrenic. Many times I have been
warned by my doctors of the tempting danger that drugs hold especially for
the manic-depressive.
Neuroses can be caused by unresolved traumas early in life. For example
childhood sexual abuse and violence, or living through times of famine and
war. Having an addicted family member usually causes the entire family to
behave in dysfunctional ways that leave lasting scars on everyone.
Perhaps you carry a terrible secret, a secret that you've never told
anyone. Carrying the memory of childhood trauma continues to cause damage in
adulthood far out of proportion to the original injury. Perhaps it is time
to find someone you can trust to share your secret with. The injury you
suffered can never be undone, but it is within your power to change how you
live with it today.
Diagnosing Mental Illness
Mental illnesses can be mistaken as physiological ones: I have heard of a
woman who was diagnosed and treated as epileptic when she was a young girl,
then suffered for years because the medicine did not relieve her symptoms.
It was only when she turned 16 and wanted to get a driver's license that
further investigation found she really suffered from anxiety.
My diagnosis at Alhambra CPC included CAT scans of my head, blood and
urine tests, an electroencephalogram and neurological tests to rule out such
things as tumours and poisoning. A psychiatrist will usually do a thyroid
panel before treating someone for manic depression. (There was another
patient at Alhambra who arrived in a catatonic stupour and slowly awakened
during our time there. It turned out that he had a physiological condition
that caused the buildup of ammonia in his blood.)
However, there is no blood test for psychiatric illness; at best blood
tests can rule out other physiological conditions. Tests such as Positron
Emission Tomography can detect such things as the excessive metabolization
of sugar in the right brain hemispheres of manic people, but PET scans are
very expensive and so only commonly performed for research purposes.
Diagnosis of a mental disorder is made from the patient's history,
observation of the patient's current behaviour, talking with the patient,
and psychological diagnostic tests.
I had the Rorschach
Inkblot Test, the
Thematic Apperception Test, in which I explained what I thought to be
happening in some pictures, and the
Minnesota Multiphasic Personality Inventory in which I answered a
lengthy questionnaire about my thoughts and feelings.
I also took an IQ test. Being manic I was feeling quite intelligent, so I
was appalled to find that my score was off about 20 points from the two IQ
tests that school psychologists had given me as a child. The psychologist
who tested me in the hospital reassured me that my brain was not
degenerating, but that psychosis caused a temporary decrease in
intelligence. She said my intelligence would recover when the episode
passed. However she warned me that my intelligence would fail to recover
fully if I had repeated manic episodes.
Need Help Paying for Mental Health Treatment?
If you don't have the money to pay for treatment you may still have
options depending on where you live. Even in the United States, which does
not have publicly funded health care for most illnesses, there are
government-supported mental health clinics in many communities, as well as
private non-profit clinics that charge their patients based on their ability
to pay.
Many psychologists and psychiatrists offer sliding scales, where they
charge lower income patients less money. Not everyone offers this, so you
have to call around.
Some psychiatric medications are expensive; treatment with clozapine for
schizophrenia, for instance, costs thousands of dollars a year. The government might assist
in the cost of your medicine and some drug companies offer "compassionate
drug plans" in which qualifying patients receive their medicine free of
charge directly from the drug company. In addition the drug companies often
give psychiatrists free advertising sample packs of drugs, which the
psychiatrists then give to their patients who cannot afford to buy them.
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