Posts Tagged ‘bipolar disorder’

Some Good News for Mental Health Parity

January 30, 2010 Leave a comment

The New York Times reported on Friday that the administration has issued new rules that will ensure mental health coverage for more than 140 million people.

In general, under the rules, employers and group health plans cannot provide less coverage for mental health care than for the treatment of physical conditions like cancer and heart disease.

Insurers cannot set higher co-payments and deductibles or stricter limits on treatment for mental illness and addiction disorders. Nor can they establish separate deductibles for mental health care and for the treatment of physical illnesses.

This law is named for the late Sen. Paul Wellstone (D-Minn.) and Sen. Pete Domenici (R-NM), both of whom are great advocates for mental health and who worked together for quite some time to get mental health parity passed.

It’s comforting to know that come July 1, there will be more of a safety net for Jim and myself. We won’t expect surprise hospital bills in the mail like we did this month for a hospital visit that happened more than a year ago! We’re still trying to figure out why we got the bill, but suffice it to say that since the visit had to do with a mental health issue, the insurance company decided we should bear more of the brunt of the bill.

Unfortunately, the rules do nothing for the millions more who are still uninsured or who can’t work because of their mental illness. Remember, this rule affects those who are employed at organizations with 50 or more employees. It also doesn’t apply to the individual marketplace, which is still something like shopping for coverage in the wild west.

Now can we have health care?

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What Can Happen When Mental Illness is Ignored

December 31, 2009 Leave a comment

I came across a fascinating piece about mental hospitals and the role conscientious objectors to WWII played in exposing the deplorable conditions of said hospitals.

The story focuses on Philadelphia State Hospital, also known as Byberry. More than 3,000 conscientious objectors, or CO’s, were assigned to work at mental hospitals across the country instead of being drafted to fight overseas. What the men assigned to Byberry found were conditions that seemed like something out of a Nazi concentration camp. They also witnessed much abuse from the attendants who were hired to care for the patients.

The “incontinent ward” was what the men called A Building. It was a large open room with a concrete slab for a floor. There were no chairs. There were no activities, no therapy, not even a radio to listen to. So hundreds of men — most of them naked — walked about aimlessly or hunched on the floor and huddled against the filthy bare walls.

Nearby was B Building; it was called the “violent ward” or the “death house,” because angry men sometimes violently attacked one another. In one room, rows and rows of men were strapped and shackled to their bed frames.

The story also includes photos from Charlie Lord. A CO who sneaked a camera into the hospital to document the things going on there.  Check out the slideshow. Lord and the other CO’s featured in the piece were instrumental in improving conditions for mental health hospitals all over the country. They even got a skeptical Eleanor Roosevelt to pay attention to the issue.

According to Steven Taylor, a professor of disability studies at Syracuse University, Roosevelt assumed these were photos from some institution in the South. She said she knew about those kinds of conditions in Mississippi or Alabama. When told that they had actually been taken at an institution in Philadelphia, Roosevelt then promised to support the reform campaign and wrote about what she’d seen to government health officials and journalists.

I can’t say I have much experience with state mental hospitals, but I do have experience with the psych wings of two hospitals. Jim has been hospitalized twice for his bipolar disorder.  I’m glad that the conditions at these hospitals was nothing like what is documented in the NPR story, but I was moved when reading it as I’ve become more sensitive in the last couple of years to mental illness.

The story is a good reminder of what can happen when we forget about our most delicate citizens. It should also serve as a wake-up call to America and Congress to increase funding for mental health hospitals and institutions. At a time when states are facing massive budget shortfalls, it is imperative that resources for these hospitals are kept intact.

Another Byberry is completely beyond the realm of possibility, especially as more and more mental hospitals are forced to close.

The health care reform deal that will be hammered out next week must include increased funding for the states so they can keep their mental hospitals open and so they can provide high quality mental health care to those in need of it most.

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In Sickness and in Health

December 16, 2009 Leave a comment

(cross-posted from The Bilerico Project)

I’ve never been prouder to live in Washington, D.C. than this week when the DC Council voted to recognize same-sex marriages. Come next spring, D.C. will be this country’s only major city in which marriage equality is the law, Congress’ intervention notwithstanding.

It was with great anticipation that we attended a rally on eve of the historic vote, as my friends and I have been following this closely for the past year. It was inspiring to hear our elected officials talk about their support for marriage equality, especially the members who took a political risk for such support. I was also smacked with a dose of reality when I though about my own very long engagement to Jim. This is actually going to happen, I kept thinking. No more excuses, he is yours and you are his and you’re going to be married.

I think it’s a tad early to start planning any ceremony, and I know Jim would agree that our ceremony will probably bear little resemblance to any traditional straight ceremony, including the exchanging of vows. There is one tradition, though, I want to incorporate into our ceremony: the promise to support Jim in sickness and in health.

We have been together for more than four years now, but the last two years have been the most intense and integral years of our relationship. In this time, we have moved across the country, endured job losses, two hospitalizations and soon an up-coming marriage. I think my commitment to Jim is more than clear, especially when it comes to supporting him while sick. Now I get to express that commitment in front of the folks I love most.

It isn’t that I’m glad we have had to endure the battle with bipolar. I would be remiss, though, if I didn’t acknowledge the fact that our struggle to live with it has brought us closer together. There have been times when I thought I should leave because I was unequipped to deal with it. Other times, I was just so angry that this was a reality in my life. I was even incredulous to bipolar’s existence, though that was largely a fleeting thought.

Then the thought of being without Jim would surface and suddenly the bipolar disorder seemed less important, less scary. After all, what kind of a man would I be if I left him when he was at his weakest. Where was the passion in me to fight for those I love? Was a sickness going to keep me from being with the one person who made me happiest?

Obviously we have stayed together and we continue to learn from each other. We also continue to learn how to live with bipolar and how to cope with the inevitable ups and downs. I think we have both proven to each other that we are willing to stay with each other in sickness and in health.

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Finding Happiness at Halloween: Lifting the Veil off Mental Health

October 31, 2009 Leave a comment

(cross-posted from The Bilerico Project)

Halloween is my partner Jim’s favorite holiday. He loves it more than Thanksgiving and more than Christmas. Around this time of year, it’s not uncommon for our apartment to smell of baked pumpkin seeds and hot cider infused with mulling spices. Indeed, fall is when Jim seems to be the happiest.

But what if that which normally brings happiness and joy fails to do so? How do we reclaim that feeling? What if the only way to feel happiness seems to be only through unhealthy means?

I have been asking myself these questions because I have been helping Jim reclaim that feeling about Halloween. This holiday season has been a little bittersweet since it has arrived on the heels of a mild manic episode. As he has been coming down, he has become almost nostalgic for the time when he wasn’t in treatment and when his mania seemed to run wild.

Halloween is a perfect holiday to feed that mania as revelry and mischief are in the air and all around us. Jim’s drug regiment and treatment, however, preclude him from indulging too much in that revelry and this has caused some anxiety for us both.

According to Jim, being manic is like having the best “high” he can ever hope for. He feels invincible, special, sexy, creative, fun…and happy. In short, being manic for Jim is sort of fun, the subsequent crash notwithstanding. He craves happiness and joy the way we all do, but in his case (and, I presume, in the case for many who have experienced mania) joy in its most potent form has only been discovered while manic.

Happiness is a drug that makes us feel great so I can understand why Jim would want to get back to a place that seems to provide ample amounts of it. My struggle has been to help him find other sources of joy that do not involve a manic high. Recently, we talked about which aspects of Halloween make him happiest. The costumes are certainly at the top of his list.

But then there was the drinking, the parties, the sex…the drinking. These are all fun, to be sure, but doing these things whilst manic has in the past resulted in blackouts and questionable behavior. For Jim, drinking was fun, but not when it involved him disappearing for hours or when he couldn’t remember where he was. And the forceful downward swings that it often caused were not fun for either of us.

We have slowly realized together that his illness has forced us to redefine what fun is and what makes us both happy. We are still in that process and this Halloween will certainly be a test, but I am confident in him. He is more stable than ever before in his life and his outlook is generally positive.

His laments over his mania are just that, laments, and it is important for me to remember that he is still human and, like all of us, he just wants to have fun and be happy.

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Lifting the Veil off Mental Health: Labor Day Lessons

September 6, 2009 Leave a comment

Labor day has arrived, which marks the end of summer, but we all have one last weekend to celebrate the season before getting back to work and settling down for the cold months.

This weekend we will be a spending our final summer holiday on the Delaware shore, a popular destination for many Washingtonians. We were lucky enough to be invited once again to a friend’s house, and the rest of the group making their way to the beach will surely make the weekend a success.

While getting ready for our beach getaway, I started thinking about how different things are this year versus last. This time last year, Jim was still reeling from the effects of a week in the hospital, and we were both trying to figure out what his illness meant for us. Jim’s new medication regiment was also still fairly new, and he was dealing with the side effects that inevitably come with such drugs. I was also busy thinking about what I should change about myself.

Much has happened in the past year and as we say goodbye to summer 2009, I would like to reflect on a couple of things I have learned.

I have learned how to be more empathetic. This lesson has been hard won and in many ways I think I am still learning, but I have made great strides since last summer. Well before Jim was hospitalized, I often found myself frustrated with him when he mentioned feeling anxious or when his mood suddenly changed without warning and for no reason. This frustration turned into resentment and often escalated into unnecessary arguments. I could not understand what was happening when Jim had to leave dinner with friends suddenly or why leaving the house was not an option on any given day.

During dinner at home one night, though, I finally felt what Jim was feeling. It was a simple dinner and we were watching a movie when suddenly Jim’s demeanor changed and he had to put his head into his hands shaking it back and forth. Naturally, I was concerned and asked what was wrong or what I could do. “Nothing,” he answered. “I’m fine. I know what to do. Just imagine your ‘fight or flight’ instinct being triggered for no reason. That’s what’s happening to me right now and it’s terrifying.” There was nothing I could do to help and trying to would have only worsened the situation. I felt so bad for him and tried to imagine what he was going through. Indeed, empathy was all I could offer at that point. I understood his illness better that day, though it was just one tiny sliver of what he endures on a daily basis.

I have also learned that I don’t have to try so hard. Last summer, I was doing everything I could to make sure Jim had what he needed to the point of exhaustion. I constantly asked how he was feeling, what I could be doing for him. An announcement from him of the slightest discomfort would result in myriad questions about what he was thinking. I wanted to be the perfect supporter to show him that he was not alone. I was still learning about bipolar and had overlooked the fact that often what Jim needed was just for me to be there and listen. He loved what I was trying to do for him, but it wasn’t always helpful and he didn’t always want to answer questions about his moods or about his meds. I learned that sometimes, all he needs is to sit with me or hold me. Usually, I don’t have to say anything. I have learned that the best thing I can do to take Jim’s mind off of his illness is just to be his partner and not his caregiver. And, I am more than happy to be that for him.

So with that, I say goodbye to the summer of 2009 and hello to the fall season. I’m already looking forward to the lessons to be learned this weekend.

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Lifting the Veil off Mental Health: The Art of Negotiation

July 29, 2009 Leave a comment

(cross-posted from The Bilerico Project)

I don’t think I’m going out on a limb when I say that negotiation is a part of every romantic relationship. That dynamic changes quite dramatically, however, when one of the parties involved is bipolar.

One of the questions both Jim and I have been fielding a lot lately has to do with how we negotiated doing this project. There is very obviously a level of disclosure that could create stress for all involved and I am always mindful of that whenever I sit down to write.

Where this blogging project is concerned, though, the negotiation process was fairly benign and focused more on what I should say rather than what I should not. Like I said in my last post, this is part of my pursuit of understanding bipolar disorder. And, if there is one thing that Jim wants from me it is empathy for how he feels and an understanding of why his moods are sometimes out of his control. This idea, while it required Jim’s permission, was not as contentious as those questioning may have thought and it has provided the perfect platform for the outcome Jim and I have both been working toward.

These questions did get me thinking, however, about how the both of us negotiate and make compromises on other issues. The issues may appear to be trivial in nature, but in a relationship made up of two men, one of whom is bipolar (and both of whom are stubborn), these “trivial” negotiations suddenly become much more meaningful.

A perfect example of this involves my reputation for spontaneity and Jim’s necessity for planning. Part of this need for planning has to do with his need for routines. For someone who is bipolar, a regular routine is crucial because it provides stability and structure. This is integral to maintaining a happy medium for the brain. If that routine is disrupted in some way, it can be bad news for themselves and for those around them, especially if they are in the midst of an episode.

I can’t tell you how many routines Jim has, as there are probably a number of different ones for different situations. They are all very personal and I trust that I know of the ones I need to know about.

One such routine that I learned to accept as necessary is that which requires him to know what we are doing before we leave the house on any given day. I don’t just mean an idea of what we are doing or where we are going. I mean a plan. Specifics. Where are we going first? What do we plan to do when we get there? How will we be there? How does this plan mesh with any later plans we have in the evening? As you can tell, there may be any number of questions depending on the situation and they must be answered before we walk out the door.

For my part, I have never required much planning, especially when it concerns what I’ll be doing for any random Saturday or Sunday. Part of the allure of a free weekend has always been what unknown adventures lie ahead. In the first couple of years of our relationship, we both engaged in some pretty bad arguments that stemmed from my obstinacy to making a plan and from our mutual ignorance of Jim’s condition, which was keeping both of us from talking about the real issue at hand.

In the last year, I have come to better understand why Jim needs these details. I have made compromises and I have become much more amenable to making plans for our days. Where before I would pop out of bed and be rearing to get out the door, now I take my time and come up with a number of ideas to float by Jim that we can talk about together. Then, I let him know when I think we should be out the door, what bus or metro we will take to get there and what we should do when we arrive. I know things are good when I hear Jim say “I think that will work.” This is the process we have negotiated and it has worked well for us for quite some time. Of course, it would be dishonest of me to say that I’ve learned all I need about how to deal with this one aspect of bipolar disorder. Relationships are organic and require constant vigilance. In short, we’re both still learning.

This is merely one negotiation we have made, but it has mitigated one of the more pernicious aspects of bipolar disorder. It is only negotiation, but it has brought us closer to a more peaceful and happier life.

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Lifting the Veil of Mental Health: Life with a Bipolar Partner

July 12, 2009 Leave a comment

(cross-posted from The Bilerico Project)

Bil announced a couple of weeks ago that I was going to be blogging here about my experience living with my partner, Jim, who suffers from bipolar disorder.

Since Jim’s first hospitalization, I’ve been on a personal journey to better understand my partner and this illness. I’m still learning and there are still trying moments when I have to do my best to remember it’s Jim’s bipolar talking, not him. It’s a day-to-day process, but hopefully, my thoughts here will help other couples (especially the spouses who aren’t bipolar), gay or straight, who are also doing their best to learn to live with this illness.

To fully appreciate how I arrived at the start of this journey to understanding, I think it’s best to start from the beginning.

I knew Jim was diagnosed with bipolar disorder when I met him, but I knew very little about the illness and he seemed to be in good health so it didn’t deter me from wanting to date him. He was a breath of fresh air for me and I appreciated his honesty about his affliction.

Our relationship moved quickly and before long we were living together. Jim mentioned to me when we started dating that he was no longer on medication and he wasn’t in therapy.

His reasons for getting off medication seemed logical to me. He couldn’t afford health insurance and the university’s student health center was his only available resource. Their approach, however, involved drugging the hell out of him and after a year of overmedication that resulted in lethargy, a diminished sex drive and exhaustion, Jim decided he’d rather deal with the consequences than to be a zombie. He was 20 years old by this time.

Jim loved a good party and he loved to drink. We’re kindred that way, but after a few months of living together I realized his moods could be very erratic and his irrational behavior was often unbearable. Add in my stubbornness and my penchant for being argumentative and you’ve got the recipe for a powder keg of fights!

We had many arguments over the first two years of our relationship, but I never suspected that part of the problem could be chocked up to bipolar symptoms that were just starting to manifest themselves, as it tends to do in folks in their early 20s. Plus, I just figured that most couples had their fair share of disagreements

Things really came to a head a year ago when a fun evening of wine drinking and show tunes suddenly turned ugly. I don’t even recall what sparked the anger anymore, nor does it matter, but I do know that one moment we were laughing and the next I had wine thrown in my face and there was glass shattered against the walls. Jim also got physical and my immediate instinct was to call 911 as I feared for my safety.

In the hospital ER he was sedated and we waited there through the night until a bed in the psychiatric unit opened up. The next morning, I was told that it was best for Jim to stay there for an undetermined amount of time.

I couldn’t make the decision for him, but I did counsel him and told him he should probably listen and stay. Soon after the decision was made it was time for me to go home. Alone. As I got up to leave, Jim’s last words to me were, “Are you happy now? You’ve locked me up. Thank you.” I wouldn’t talk to him again until the next day.

That was the moment this illness became real for me and, I suspect, for Jim as well. Over the course of the next week, I spent my nights alone with my thoughts confused about what had happened and frightened for what lay ahead for both of us. I could not talk to him on the phone and I could not sleep with him at night.

It was awful, but I took solace in the fact that he was getting help. By the end of that week, he was home and we both talked about what was going to have to happen if we wanted to stay together.

Since then, our lives have changed dramatically. He’s been in therapy ever since and, with the help of his doctors, has found the medications and dosages that work for him. About six months after this ordeal, I entered therapy myself.

Jim has effectively quit drinking and made marvelous progress in maintaining a healthy lifestyle. I admire him for that. And after some slow learning, I have made strides to curb my drinking in order to foster an environment in which we can both live more easily.

This brings us full circle to where we are today. My own progress has been steady and I learn something from Jim every day. I’ve taken an active role in talking about how he feels and I ask him for what I should be vigilant of in his behavior.

It is a responsibility that has taken me some time to accept, but I am happy to do it if it means our relationship will survive and if it makes it easier for Jim to stay healthy.

In future posts, I’ll be blogging more about my current daily life with a bipolar partner and about mental health news as well. In the meantime, if you are bipolar or live with someone who is, check out these resources for more information about how to cope with this illness.

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