Columns

First Person: Lifestyles of the Mentally Ill

By Jack Bragen
Thursday May 13, 2010 - 11:05:00 PM

Americans are taught to think of mentally ill people as freaks or misfits. Usage of the word, “psychotic,” as a noun to designate a mentally ill person, is widespread. You may not realize that such a usage is hurtful and insulting to people who have to deal with these illnesses on a day-to-day basis. The word “psychotic” in correct English is an adjective that describes some of the symptoms mentally ill people must endure. 

The symptoms of a major mental illness, as you might have guessed, are no stroll on the beach. Being medicated is the somewhat lesser of the two evils, the alternative being an uncontrolled disease that sweeps away reason and any type of normality. Medications can reduce the symptoms of a major mental illness so that we can then function in society, (even if forced to be on the fringes of society). In the absence of medication, the symptoms of the illness can induce an astronomical level of suffering and can cause death due to either excessive stress on the body, or because of an incorrect action due to suicidal impulses or due to being delusional. 

If mentally ill people seem to behave in a bizarre manner, it may be because of dealing with a major malfunction in the brain. The phenomenon of severe mental illness defies many people’s common sense. When someone has two arms, two legs, eyes, a nose and a mouth, people often expect that they should behave normally. The idea of a brain malfunction causing bizarre, suicidal, or strange behavior goes against how people often perceive people, including themselves. Most people take sane, safe and normal behavior for granted. This expectation contributes to the perception that a mentally ill person is an abnormal person when one is encountered. 

The mentally ill man or woman must deal with several types of adversity. Most of society seems to have a negative view of those with mental illness, and this contributes to adverse treatment. Many people believe mentally ill persons lack intelligence. Many people may believe mentally ill persons do not experience pain, suffering and other emotions the same as they. These two perceptions aren’t accurate. The erroneous belief that the mentally ill don’t experience pain often leads to cruel treatment toward the mentally ill by members of the general public or by some caregivers. 

Many in the public believe that persons with a mental illness are sick and depraved people. The poor grooming and appearance of many mentally ill people could foster this misconception. (When someone is struggling just to make it through the day, grooming sometimes falls by the wayside.) 

While these illnesses can cause some afflicted people to break some laws while in a state of delusion or disorientation, most needn’t be regarded with fear or perceived as criminals. Having a criminal mind is a different category of sickness than the one I am discussing in this paper. 

Aside from our “bad rap” with the public, there are several other types of adversity that a mentally ill person must deal with. The medical and legal establishments mandate that mentally ill people be medicated. Other forms of treatment are not being explored, and this may be in part because of the powerful lobby of the drug companies. When mentally ill people go off medication, the result is usually disastrous. This convinces many people that medication is the one and only solution to these illnesses. If some type of mental training were introduced, it would have to be done at the onset of the illness to have a chance of working. However, this hasn’t been tried, so far as I have heard. Thus, mentally ill people are stuck being medicated for the rest of our lives. 

Whether or not an alternative treatment would work doesn’t alter the fact that the side effects of these medications are hard to endure. Some of the anti-psychotic medications induce physical suffering and at the same time block the capacity for transcendent functioning. It is only transcendence that could hypothetically ease such suffering and make the life of a mentally ill person tolerable. 

Side effects of the medications include, but are not limited to: physical restlessness; stiffness in the body; depression; lethargy; weight gain; involuntary and irreversible spasms of the mouth and upper body; diabetes; dry mouth; “drugged” feeling; and sometimes death. The existence of these side effects may explain to you why you have seen people displaying some of the above characteristics. You may have learned to automatically avoid such a person. 

Much suffering arises due to the side effects I have listed above. Medication side effects are one reason why it is sometimes hard to get a psychiatric patient to cooperate with their medication regime. Also known as “noncompliance” the non-cooperation with doctors is also caused by a lack of insight about having a psychiatric illness. The insight can only come to the patient when they are in recovery and can then think with some amount of clarity. 

Denial of one’s condition is a major reason why many psychiatric consumers get repeated hospitalizations and never make significant progress in their lives. It requires a lot of ego strength to acknowledge having an imperfection like schizophrenia or bipolar, and this type of strength is not always the most common. 

Another challenge in life for the mentally ill person is the likelihood of being unemployable. While there are people with major mental illnesses who work and who hold high level professional employment, there are also those who find work to be nearly impracticable. Their mental condition in combination with the hindering effects of medications and some other factors, such as possible PTSD, and the possibility of having a poor work history due to failed work attempts, add up to the improbability of working. 

Without being able to hold a job, the mental health consumer must rely on public benefits and on the generosity of parents. Numerous mentally ill people for this reason live in comparative poverty. 

People with mental illness are more likely to have additional health risks. Smoking and obesity are very common for the mental health consumer, and so are the related medical conditions. The medication we must take slows the metabolism, increases appetite, and often produces an amount of lethargy that makes exercise improbable. It is not uncommon for people starting these medications to gain a hundred pounds or more in the first year of treatment. For any other condition besides mental illness being treated, such as cancer, a treatment that causes this type of weight gain would be considered by the medical establishment to be absolutely unacceptable. 

Smoking is very common among mentally ill people, especially those who suffer from a psychotic type disorder. There is evidence that nicotine helps the brains of schizophrenic people function better. It is harder for mentally ill people to quit smoking than for those not afflicted. 

Yet, mentally ill people are unlikely to get coronary bypass surgery when needed. Instead, the person with major mental illness has the tendency to become deceased. The lifespan of the person with a major mental illness is about twenty years less than the average lifespan in the U.S. 

Numerous persons with mental illnesses never, in their adult lives, learn to think with a good amount of clarity. It is only by thinking with this clarity that people can make the right decisions in life, or can formulate plans to achieve a goal. Mental clarity is also good for handling challenging situations that periodically arise in life. By never reaching clarity, a mentally ill person might never see their way to a substantial adaptation to life. I’m using the word “adaptation” here as a replacement for the word, “recovery.” These illnesses never really go away; it is always necessary to keep on top of symptoms to prevent a relapse. So, in the absence of recovery, there is adaptation, something that happens when the illness no longer dictates the life conditions for the mentally ill person. 

Also, when someone has clear thinking, it becomes possible to have power over one’s behavior. A person is no longer necessarily subject to any impulses that arise. One can decide how they want to behave, and can implement that decision. 

Clear and organized thought isn’t exactly the trademark of a schizophrenic person. However, clear thinking can be learned through deliberate mental exercises. The schizophrenic person needs to start by developing a system whereby they can identify and negate their delusions, while on medication. Yet the same rule still applies to a psychiatric consumer who has done mental exercises; medication and other treatment are still necessary. 

Many mentally ill persons whom I know frequently feel alone and often suffer from bouts of intense anxiety. Many mentally ill people don’t know what to do to fill up their time, and this can be a source of agitation. 

The mentally ill are often denied many of the finer things in life that the average individual may take for granted. And this deprivation seems to be totally unfair. 

Mentally ill people often get a number of thoughts and feelings that are negative or disorganized, and that cannot be controlled via willpower. Some times, the afflicted persons actions are beyond their control. 

We often have numerous sources of suffering on our plate; and this can create hopelessness. And yet most of us, but not all, somehow find a way to keep going.