The Way We Think

Some people have a positive outlook in life, always hopeful and free of worries. Some people are always negative, seeing the worse in every situation. We might think it's because they are who they are, it has to do with this person's personality, character, or the experience they have gone through. It's true, maybe. But the chemical makeups in our brain can also affect the way we think, the perspectives we take, and whether or not we see a glass as half-full or half-empty. In other words, we may or may not have control over how we think.

Have you met such person, or are you that person? When you fly somewhere, you always fear that the plane is gonna crash. Or when your loved one is ridiculously late, you think that they must be in some kind of accident. If the reason or the outcome is unknown, you always think about the negative, you can't help it, you just cannot help it. That is all that you think about in your head.

I used to be like that, for the first 22 years of my life. Even when I was a child, I was lacking the naiveness of people my age. I would be so worry-sick whenever my parents had to go on a business trip. As I got older, things just got much worse. I would even lose sleep at night thinking about all the scenarios that would go wrong. I had heard all kinds of inspirational quotes, but I was incapable of thinking that way.

After being on the right medication and eventually figured out the right amount (after 2 years), I have since become a really positive person. Being optimistic is a default, it's effortless. My personality has also changed. I cannot even relate to the person that I used to be. A friend from high school reunited with me recently and she could tell the changes by just looking at "my expressions". Another thing I find it interesting is the fact that I used to LOVE to watch horror films. But now, it would haunt me for days. It's the only type of movie that I would not watch.

On the other hand, my mom said that she used to be a fearless and sassy young lady. She would walk ahead of my dad when they were venturing into an unknown territory. But after menopause, and after her health has declined because of aging, she has become an introvert, not knowing what to say in a social gathering and mildly pessimistic in almost everything. Only the fact can change her previous feeling and perspective toward uncertainties.

How to Improve Mental Health

A lot of people have tried medications, but the side effects have discouraged them from continually taking them. For others, they have "bad days" and "good days", perhaps their condition is not that severe that they probably can still function without medications. In these two cases, the only alternative "treatment" to improve their mental health is to improve their overall physical health.

When a person is already aware of the fact that they have a mental health condition, it's important to avoid drinking, smoking and taking any substances that would alter the chemical makeups in their brain. For me, I can't and I don't even drink regular coffee. It would make the quality of my sleep poorer and shallower. Often times, when a person is depressed, they tend to abuse alcohol or other substances as a coping mechanism. Unfortunately, it would only worsen their condition.

It's so trite to say, "we should drink 8 glasses of water each day, eat a lot of veggies and fruits, stop eating junk food, exercise regularly, have at least 6 to 8 hours of sleep each day, have a healthy lifestyle, etc. etc. " The truth is, they really are the keys to maintain and improve a person's mental health in a way that most people are not consciously aware of. The positive changes are slow and gradual, but once our physical body is clear of all the toxic substances and is well nourished, we will feel much better mentally. On the other hand, it takes extra amount of effect and energy for a depressed person to start making positive changes. It's easy to get pulled down but hard to bounce back. The effects are not immediate and it can be discouraging, but you gotta persist and not give up. It's worth the strive.

Mental Illness and Substance Abuse

Mental illness can be triggered and worsened by taking recreational drugs, especially if you already have a genetic predisposition that you might not know of. I heard a story of a teenage boy who used to be a happy and popular high school student. He went to a party and took two pills he didn’t even know what it was. He became psychotic for the next few days. People told him to drink a lot of water in the hope that the drug would just pee out of his system. Unfortunately, after the psychosis had subsided, he fell into a depression and eventually committed suicide. Therefore, really be careful with the choices you make in life. Drugs and alcohol abuse can also worsen a mental illness. Think about it, they can mess up a healthy person’s brain; imagine the damage it could make on a mentally unhealthy person. In addition, they can also offset the effects of psychotropic medications. Therefore, if you want to recover from a mental illness, get sober first!

Questions from You

Do you have to be on medications for the rest of your life?

The short answer is Yes. I always make sure I pack my medications in two different suitcases when I travel. If I skip a dosage, I would probably know right away as the pace of my thoughts will pick up at night and I am unable to fall asleep. Without a night of sleep, my heart will beat faster and I am a little bit more emotional and neurotic the next day. But as soon as I take my medications, all will go back to normal and I am myself again.

I have developed a dependency on my medications, perhaps you can compare that to an addict who cannot live without their drugs. However, I would define mine as healthy and normal. Just like someone who is born with type I diabetes, they need to rely on Insulin for the rest of their life. Having a bipolar disorder is innate and I need to rely on something extra to keep me balanced and functional. But unlike someone who has diabetes, they have to watch what they eat and change their lifestyle accordingly, when I stay on my medications, my life is perfectly normal. Right now, I am on a minimal dosage, which doesn't give me any side effects. But as to the long term consequences, I am not worry about it at this time.

Medication --- the Right Type and the Right Dosage

A lot of mentally ill person refuses to take medication or stay on a medication, they think that they are either ineffective or they are doing even more damages. This is actually true. It is very difficult to find the right type of medication that suits a particular person. The first medication I took makes me gain 60 lbs by the time I was discharged from the hospital. It was an anti-depressant medication. Two years later, I was hospitalized again for a Manic episode. It was then that I was correctly diagnosed with Bipolar Disorder. The anti-Depressant medication was actually the trigger of my Mania.

I was prescribed with Lithium Carbonate, which is a primary treatment for Bipolar Disorder. However this medication gave me severe acne to a point that my face was disfigured. It did not do any good to my mental health.

In 2007, my psychiatrist decided to put me on Epival, it is primarily an anti-seizure medication. Amazingly, after a month, I woke up one day and felt like I was different. I couldn’t explain in what way, but I was just happier for no reason. I never felt that way in the first 22 years of my life. As I took that medication more and more, I realized I finally knew what it feels like to be a “normal” human. 

Now, my personality changed, I used to be an introvert, but I am now a very outgoing and positive person. I don’t have phobias anymore and I sleep like a baby every night. My musical and artistic ability have also enhanced. I have truly reached my potential as a person and a human being because of this medication.

Though finding the right type of medication is the key in treatment, it is still not enough. The right dosage is equally important. For instance, not every middle-age female, weighs around 160lbs should be prescribed with the same dosage of medication --- everyone has a different metabolic rate. It took me about 2 years of experiment to figure out the right amount of medication for me. There was one time, my pharmacy ran out of pills in 125mg, instead, they gave me pills in 250mg. Without knowing the difference, I mistakenly took twice the usual amount for over a month. During that month, I felt so odd. I became lazy and moody, I didn’t want to do exercise and I was hungry all the time. I gained 15lbs by the end of the month. Then, my mom discovered the mistake. Within a week being back on the right amount of meds, I was myself again. Therefore, it’s important to be on the exact amount of medication that’s custom to that particular person.

Why Is Mental Illness so Hard to Treat?

In my perspective, I think that every mentally ill person is potentially treatable. However, it is the most difficult illness to treat, for the following reasons:

1)      It is a very subjective illness. It cannot be detected by blood test, x-ray, MRI or other methods to diagnose an illness. Even the psychiatrists have a lot of limitations in knowing how each patient feels and what type of illness they actually have. Like me, I was not correctly diagnosed until 3 years after my injury.  Therefore, patients are the only ones who can access their own inner state, but most of them are too sick to even think and too easy to give up. And most importantly, they lack the knowledge and insight to help themselves.

2)      It’s hard to find the right type of medication, the right combination of medications and the right dosage. The side effects of some medications can even worsen the symptoms and make a person even more suicidal. Other side effects, such as appetite change, weight gain, acne, aloofness, etc. are big deals to most people. They could become the very cause of depression. Therefore, if one medication doesn’t work, keep on looking and trying on other types of medication. Do not give up on meds. Do not stop taking meds even if you are feeling better. My condition is treatable but I don’t think it’s curable. I’ll take my meds unconditionally every day for the rest of my life. I might compromise my chances of having my biological child, but nothing is more important than the quality of my mental health.

3)      The lack of social support is also a big problem for the mentally ill. When you are crazy and lose your mind, you really need someone to take you to a psychiatric facility and act on your behalf. But unfortunately, in many cases, when someone is mentally ill, people walk away from their life when they need social support the most. When a person lost their job, their romantic partner and other meaningful possessions during their acute state, how would they be able to feel happy again even if they are bio-chemically restored?

Questions from You

1)     Did you think of hurting an innocent person?

I did attempt to kill my dad. At that time, I was incapable of feeling love and sympathy. The illness turned me into a sociopath, literally. My nature and the basic elements of my humanity were taken away by my illness. I’d do anything to kill myself and because my parents were protecting me, I was about to kill them as well. This explains why we hear stories of mother killing their own children when they were depressed.

2)     What do you think of the school shootings in the U.S. perpetrated by people who are mentally ill?

I can’t understand their action, but I can definitely relate to their mentality. When a person is at the end of their rope, they’d feel jealous of people who are better off than they are. That’s why those shootings always take place in a school, they seldom happen in a nursing home. Secondly, killing one’s self is a huge commitment. It takes a lot of guts to do it. By committing a horrible crime, they basically leave themselves with no choice but to kill themselves, better yet, the police could do the job for them. Again, a mental illness can strip a person off their humanity. I don’t think all of them are pure evil, they are sick and they don’t believe that they are treatable. If gun control is not possible, then extensive levels of education on mental illness might be the solution to prevent more tragedies from happening.

Questions from You

Did you seek for professional help during your acute stage? And are they helpful?

I was seen by one social worker, one family doctor and two psychiatrists before my injury. They were not very helpful. The social worker and the family doctor were not specially trained in severe psychiatric conditions. Again, like everyone else they were trying to talk me out of my depression. I mean, can you talk someone out of their diabetes? They failed to understand that my condition is a medical problem. As to the two psychiatrists, one of them wrote me a note saying I am not mentally capable of completing my high school exams. The other psychiatrist prescribed me with anti-depressant and discharged me back to the community after 3 days I overdosed myself with sleeping pills. I felt like they could have explained to me what was really going on and gave me more assurance that this was a treatable condition. When the anti-depressant didn’t start working right away, I quickly lost faith on the meds, and lost faith on doctors as a whole thinking if they could not even help me, who could? I thought I would remain crazy for the rest of my life and that was my last straw. After my injury, I saw my Psychiatrist Dr. Mccullagh for the first time. He was my doctor for the next ten years. Right away, he was different from others. He was compassionate. Had I met someone like him prior to my injury, I wonder if it would have made the difference. I think a good doctor should have the heart of a parent, when they treat their patients as if they were their child, not only are they a good doctor, but they are a great human being.

Questions from You

If my love one is depressed and suicidal, what should I do for them? 
 

Take them to a psychiatric facility to prevent this person from hurting themselves and other people. I have heard so many stories of family members trying so hard to prevent their child from committing suicide. They take turns to watch the person to a point where everyone is extremely exhausted. At the end, they still could not prevent tragedies from happening. Lock a person up in a psychiatric facility is the safest place. All of those psychotropic medications take at least 3 weeks to feel the different, I don’t even mean “effective”, but it takes at least 3 weeks to kick in. During this important period, a person has to be monitored to prevent self-inflicted harm.

This might only apply to people living in countries where a psychiatric facility is an ideal place for rehabilitation. But in other less developed countries, this might not be the solution. I will write about that in another post.

The Big Misconception

When I was deeply suicidal, the one question people asked me the most was why would you kill yourself for someone you dated for only 4 weeks? They tried to talk me out of my depression by saying “oh get over him”, or “this girl got dumped after being with this guy for 7 years, she moved on, you should too.” People thought that I wanted to die because of “love”, which in my case was a very petty reason. In fact, when someone just committed suicide, the biggest question is why, it seems like they need to have a reason to end their life, the reason has to be huge in order to be understandable, such as the death of a child or a bankruptcy. Well, this is a big misconception.

I am pretty sure many of you have felt depressed before. But would you say, your depression was caused by situational factors? And once the external problems have been dealt with, you would feel better right away. In such case depression is a mental state. It is temporary. It’s relatively easy to treat, or for some people, they go away on a vacation and come back being happy again.  Depression of such nature is like a cold; our body is able to recover from it spontaneously. On the other hand, Depression with a strong genetic predisposition, like the one I have, is a mental illness. It is an illness that has a name, Major Depression (Unipolar Disorder) or Manic Depression (Bipolar Disorder).  It is a permanent condition that cannot be cured but can only be treated by medication. 

There are many differences between the two.

1)      Trigger of Depression. For common depression, people usually have a good reason to be depressed, whereas for a Depression Disorder, people do not need to have a reason to commit suicide. Some person would feel suicidal simply because they do not have a healthy lifestyle. They smoke and drink excessively, they lack sleep on a regular basis and party all the time. If there is a genetic predisposition, their Depression will be easily triggered when a trivial obstacle comes their way.

2)      Differences in the severity of symptoms. For common depression, the symptoms are emotional and psychological; it has to do with people’s feelings being hurt. People want to die, but they have a choice, they could choose to end their life or carry on living. That was the case in my second episode of Depression. The reason of my Depression was mainly about my physical disability, though the symptoms were severe, I still had control over them, and thankfully, I did not hurt myself again. Whereas for a depression disorder, the symptoms are much more physical and medical in nature, the symptoms are impossible to be conquered by will powers. During my first episode of Depression, I didn’t just want to die, I need to die. My body was shutting down after not being able to sleep at all for over 2 months.

3)      Family History. A depression disorder usually has a family history of mental illness, any type of mental illness. In my case, everyone on my father’s side is perfectly healthy. They are happy and optimistic people. The person that has a problem is my mom’s mom. My maternal grandma suffers from anxiety disorder, her thoughts are always irrational and she doesn’t sleep very much, averagely 3 or 4 hours a day.

4)      Age of onset. Common depression really depends on the onset of a stressor. But for mental illnesses, the typical age of onset of a full-blown episode is between 18 to 24 years old, the ages when hormones are going viral; though more and more kids as young as 8 or 9 years old have reported of feeling suicidal. Depression is also prevalent among women who have just given birth or during menopause. It always happens when our body is going through changes. Mental health is part of a person’s physical health. When the rest of our body is healthy, we sleep well, eat well and do exercise; our mental health will also improve.

5)      Treatment. To treat a common depression, a person might be temporarily placed on anti-depressant or receive psychotherapy or consulting. For some people “time is the best remedy”. Whereas in my case, I personally think that medication is the only effective treatment. Because it is a medical condition, it is not a psychological condition. It’s like someone who is born with type 1 diabetes and they have to rely on insulin for life. People like me, we are born with a deficient, and therefore we need to rely on psychotropic medication to restore our mental health.