Mental illness and the problems with treatment adherence

  I have posted here about my battles with bipolar disorder and it's role in my life. I have always had good adherence to the treatment of my disorder and good awareness of it's impact on my life and others should I not be diligent in my self-management. Perhaps this comes from being raised by two parents with mental illnesses so I was aware of it and it's existence from an early age. When I began to have some issues with this illness I was not unprepared for the symptoms and also was aware of the impact an uncontrolled illness had on one's family and social circle.
   The number one reason that individuals with mental illness are not adherent to treatment is because of Anosognosia or an unawareness of being sick. It is due to damage to the part of the brain in which we think about ourselves. People with Anosognosia will come up with many, many reasons for their behaviors and symptoms rather than knowing they have a serious mental illness.
   The problem with non-adherence is devastating. Non-adherence is the number one reason for relapse, re-hospitalization, job loss, homelessness and other problems like incarceration for crimes committed while under the influence of rampant symptoms.
    The number two reason is concurrent drug abuse which can be used as self-medicating and can hide symptoms behind a mask of drug-induced behaviors. Many of those with mental illness use drug and alcohol as a way to either dampen or heighten their symptoms. A person who is depressed might take a stimulating drug as a way to deal with that. Someone who is having hyper active symptoms such as mania may use sedatives as a way to control that internal feeling.
    Another reason, and this is seen in bi-polar individuals primarily, is that you want the "high" that being hypomanic or manic provides. Being able to go without sleep, be more socially dynamic, more productive and more creative can certainly have it's lure. However untreated mania can cause havoc for people. The processes of the mind that have to do with impulse control and decision-making are dampened and can lead someone to do some dangerous things such as commit crimes, be promiscuous, overspend money, drive recklessly or engage in other damaging acts. 

    For me I believe it is not my fault I was born with a chemical problem which creates mood problems and symptoms however if I am aware of my illness and am just defiant in adhering to my treatment then it becomes my problem. I should not subject my friends, family and co-workers to the actions of an uncontrolled mood disorder when there are proven treatments for it. Constant mood crisis and acting out tires and overwhelms our family and friends. It is unfair of us once we are both aware we have an illness, and are given a way to manage it, to defy that treatment and be a roller coaster of out-of-control behaviors and constant crisis that we make others deal with for us.

           “It took me far too long to realize that lost years and relationships cannot be recovered. That damage done to oneself and others cannot always be put right again.”
― Kay Redfield Jamison, An Unquiet Mind: A Memoir of Moods and Madness

         

The Heart in it's Wildness

 
        The nature of attachment: What does that mean? For some it means attachment to material items. For some it means attachment to people or ideals or political beliefs or religious beliefs. Attachment means that something Connects you to something else--or someone else.
         The thing about attachment is that it brings with it an expectation of reciprocal attachment. The expectations are what lead to unhappiness as the one partner feels like they are not being met with the same quantity of love as they are giving out.
        But love is not finite. Love doesn't have boundaries or borders or a designated amount and then there is no more. Real love is detachment. It is being happy that others have love in their lives and willing to share in their happiness. Real love is letting others go and do whatever brings them joy and fulfillment and makes their lives worth living. Love is not like money in a wallet that you spend and then there is no more. It keeps coming and the more of it you spend the more of it you have to share.
       A heart is a bottomless well with depth and clarity and secret pockets of light. A heart is a wind which takes with it all that makes you real. A heart is a night sky alight with stars that burst and swirl and inflame each other and the space around them--a holy grail of graciousness.
    So BE BOLD with your heart. Detach from expectations and desires and wishes and needs. Let it flow around and with others and guide them to you and let them go back out again like a boat on a current.

The Flight of Her

Arms up like tall grass in the field

   Wanting to fly—a butterfly in the breeze—

Feet planted to the ground like roots—

   Beckoning to stand and hold still.

  

But still there are stars where she wants to go

     And the moon beats like her heart—all pale and glowing

Lifting from that solid ground she can be swept up

A bit of fluff—a  small leaf—borne to the windswept

     Upper reaches and there to hover—

The ground so far below and she doesn’t care.

She is where the sun and stars gather—

        There is nothing else she would rather be

Than this.  Herself free.

Heather Lake, 2014, Summer Solstice