Columns

People suffering from schizophrenia, depression, or bipolar are not as able to gain benefit from stretching our limits compared to someone not afflicted. The old saying that you should "lift yourself by your bootstraps" should not be generously applied to persons with severe mental disabilities. "Tough love" does not always work for mentally ill people.

It is said that for a number of persons with mental illness, including some suffering from "dual-diagnosis" (which is a substance abuse problem combined with a psychiatric disorder) death may happen before a person "hits bottom."

But today's column isn't really about substance abuse. I am talking about, in general, how people are expected to sink or swim, or where a bird is shoved out of the nest and expected to fly. This strategy shouldn't necessarily be applied to persons with psych disabilities.  

A person with a psychiatric disability may not be as resilient as someone without. A family member believes I am capable of anything because of the fact that I have done a few things that were impressive. Yet, I can not in all situations rise to the occasion when challenged. I have limits and I pretty well know what they are.  

This is not to say that family shouldn't have boundaries. It is not to say that parents should expect nothing and give everything. There needs to be some kind of in-between, one in which someone with a psychiatric disability is challenged, but not to an overwhelming extent.  

Going too far past the psychological, neurological, or other limits of someone with a psychiatric disability could possibly cause lasting damage. It could trigger a relapse of acute symptoms, and/or it could cause the individual to be more impaired in ensuing years.  

For someone with a psychiatric disability, some amount of comfort is a necessity, not a luxury. It is when we are comfortable that we can sift through the thoughts, to figure out which ones are erroneous, which ones are outright delusional, which ones are unnecessary, and which ones are helpful.  

Comfort to me means for example, that I don't have to brave the elements for up to three hours while waiting for a bus in Contra Costa County, a place in which the bus service isn't at all good. Comfort means having an air conditioned apartment and car. Comfort means not having to go without food or medication. Comfort to me means that I don't have to work to survive.  

Persons with psychiatric problems often have corollary medical conditions. Many have hypertension and/or diabetes. In addition, a number of medications make us less able to survive physical hardship, such as extremes of temperature, dehydration, or too much physical exertion. This is especially true of persons with psych problems who are a little bit older. Yet, mishaps due to extreme conditions can definitely happen to young people.  

I have heard of psychiatric patients at the Atascadero facility dying due to a combination of extreme temperatures and being given antipsychotics, which are a class of drugs that may make people less tolerant of hot weather.  

Excessive psychological stressors, excessive stimulation, or too much physical discomfort can cause mentally ill persons to have a resurgence of symptoms of their psychiatric condition.  

Comfort means having safe, peaceful housing, a unit that isn't substandard, and having neighbors who are not assaultive and who do not throw wild parties. It means not being subject to intimidation, whether this is from some branch of the government, some private agency, or an individual.  

When persons with mental illness are put into a situation of "sink or swim" or "being kicked out of the nest" it isn't the same as when done to a nondisabled person. Many of us aren't able to rise to the challenge. In these instances, the results can be dire.  

Recovery can happen when there is an absence of threat, and an absence of physical or psychological hardship. Recovery happens in a peaceful, safe environment. Recovery sometimes happens when we have some time on our hands, in the absence of external demands, allowing us to think, and to gain insight about ourselves, our past mistakes, and about what is needed in order for us to make things better for ourselves.  

Call us crybabies, but mentally ill people require gentler treatment and more help. Yet, oftentimes, the comfort I speak of is absent, and the ill individual suffers as a result.