Psychological problems come to all castes and classes in our society, and no group, whether rich, poor, educated, or not, handles mental illness well. However, such problems are especially daunting if you are poor.
This is the first of what I hope will be a series of pieces on mental health in the U.S., emphasizing difficulties for poor persons. In my last piece – if I get that far – I’ll discuss some policy concerns and propose a few solutions. First, however, I want to lay out the difficulties that some specific people have faced.
*****
One of my former students phones me, saying that she is terribly depressed, thinking strongly of suicide. I’m worried; she is not one to make a bad joke about suicide. I ask, and she says yes, she has the means to end her life: a supply of sleeping pills, alcohol, and painkillers are at the ready. Even worse, her mother and her sons are away for the day. Now I’m very worried. She has all the signs of being ready to end her life, except for calling me – a cry for help, certainly. She needs to see someone very quickly, who can hospitalize her if necessary, and give her medication.
A bit of background: my student is a senior, in her last semester of college, living on a small scholarship and welfare. She is divorced (her husband ran off with another woman), with two boys in elementary school.
I talk with her, and get her to agree to let me help her. She is adamant that she will not go to an Emergency Room with or without me. (And she knows what to say if I could get her there: ERs are not looking to hospitalize anyone who comes in with mental health problems, especially if such a person denies she is suicidal and acts perfectly sane – they don’t have the beds available, a topic for another day.)
The county’s community mental health center has a 6 month waiting list. Oh, but she has health insurance that covers mental health problems! Wonderful! Medicare, thanks to welfare, has assigned her family to a local HMO. She has no regular doctor but sees whoever is present at the clinic they go to when they are ill. She doesn’t feel up to making any effort to contact her HMO, however she will let me contact them on her behalf. She agrees to see a psychiatrist within 24 hours if I can make the arrangements.
Surely I can manage this, and keep her from doing anything harmful to herself for a few hours until she can see a physician with psychiatric training. I call her HMO and eventually talk to their intake worker for mental health. I describe my student’s situation, how desperate it is, how she has intentions, a plan, and means to carry out her plans for killing herself. I lay all my professional credentials on the line – psychologist, prof, depression expert, etc. to convince her I know what I see.
I insist that my student must see a psychiatrist within 24 hours – she is suicidal. I’m told there is a 6-week wait, otherwise go to an emergency room. However, the intake worker has a suggestion: “She’s not crazy, is she? Then why don’t you write her a little scrip (prescription) for a few antidepressants to tide her over until she can get an appointment? You know, just something to make her feel good right now? And then she probably won’t even need to come in at all.”
I am appalled! The intake worker doesn’t know that 1) psychologists do not prescribe medication (there are a very few exceptions to this, and my state is not one of them), 2) even though they work faster than therapy, antidepressants are not fast acting, and 3) depression doesn’t “go away” in 6 weeks or so! And 4), the biggie: this person doesn’t recognize classic signs of high suicide risk!
Eventually I talk to the intake worker’s supervisor and I do get a psychiatrist’s appointment for my student for the next morning. My student seems relieved, and we make arrangements for some of us to stay with her in shifts until she sees the psychiatrist.
Story over. What people need is a good mental health advocate, right? No.
When my student arrived for her appointment the next morning, the person she saw was not a psychiatrist. Rather, he introduced himself as a social worker.
This social worker asked her about her symptoms, and then what was going on in her life at the moment. My student had a long list: welfare agency hounding her to quit school in her final semester and take a job clerking at a store as part of the new welfare-to-work rules; bill collectors hounding her for a debt her ex-husband had run out on; her old car broken completely, her rent-controlled apartment being sold for a tear-down in two months, her son being taunted and picked on at the school he attended. . .
The social worker’s response was sympathetic but brisk. He told my student that it was no wonder she was depressed. Anyone in those circumstances would be depressed – she was just a typical poor person. Therefore, she did not need to see a psychiatrist, and would not be seeing one that day. He suggested that she see her pastor instead, and spend some time praying, because prayer was about the only thing that would help someone in her situation. Having given his advice, my student was dismissed.
And that was mental health assistance via Medicare for one poor person in my fair state.
A couple more things about this person: She did get help from a psychiatrist friend of mine and eventually she made it through depression and was fine. She graduated, got a good job and is doing very well.
Although I had to resist my impulse to drive to the HMO center and personally throttle the mental health staff there (not a good thing to do), the social worker was correct about one thing: depression is terrible common among single mothers who are poor – about 40% show serious signs of depression. (That doesn’t mean they don’t need or benefit from treatment, however!).
I will appreciate whatever comments you have about this, if it’s of interest. I have to go away for a while, however, and can’t respond immediately.
What a great untapped market for the drug companies! Antidepressants for every depressed low income single mother – paid for by the government! It’s obvious who we need to lobby to get the poor decent mental health care.
I’m glad you were there for this person. I know first hand how easy it can be, when you’ve got serious money troubles, to slide into depression… which it is then very hard to get out of, because how can you solve your money troubles in that state?
It’s so hard – especially when, if you DO get treatment, you run the risk of being told you have this Big Thing wrong with your brain that will need to be medicated and treated with therapy for the rest of your life. When really all that’s wrong is, hello, you can’t catch a break and it’s overwhelming.
Mental health care is fucked up.
Actually, I worked as a pharmacist in a low-income neighborhood for several years, and you might be surprised at how many of the people receiving public assistance are also on some sort of psychotropic medication. As SN said below, living below the poverty line is enough to send anyone into a depression.
I always thought that many of those people needed a chance at something more in their lives, more than they needed medication. But I guess the government sees antidepressants as cheaper than education and the opportuniy to earn a living wage.
There is great variation in this. Yes, meds are given in preference to therapy for lots of psychological problems, but the scope of the difficulties is much wider than the amounts of meds prescribed.
Nationwide, the situation you observed is not what is typical, either. What more often happens is that people are given prescriptions for a single round of the cheapest and most side-effect laden antidepressants, without much education as to how they work. Many people expect antidepressants to work like valium or crack or other “feel good” drugs. (That’s also why a lot of people are against psychiatric medication). So they take it when they don’t feel good one day, and skip it when they feel better. That isn’t how antidepressants work (you know this, but not everyone does).
We run a clinic for the poor, and I live in the heart of a big, broken city. Standing in line at our local drugstores is an education in itself, even without knowing the national trends.
But I’m getting ahead of myself. The magnitude is the issue here: 40% of poor women with children. That is an enormous number of people, not to mention their families. We are not beginning to reach that number of poor women with any kind of assistance, whether medication or what-have-you. It is a travesty.
I’ve never really thought about it, but I always assumed that there was little or no counseling available for the poor. What I saw was a lot of family medicine docs prescribing antidepressants and anxiolytics for their DPA patients. And many of them were poor single mothers, with no hope for anything better.
As you said, 40% is incredibly high; isn’t the prevalence of depression around 10-15% in the general population? Scary, when you realize that we are standing on the edge of a cliff in terms of where the US economy is going.
Yes, the prevalence rates nationally are about 10 to 15, but higher among women in general and among the poor in general. And economic downturns, unemployment, bankruptcy, etc. increases depression.
See…if she just found another husband then all would be well.
Seriously, that is our “social policy”–get a husband. Of course, these right-wing cretins don’t have an answer for you when life happens or you realize too late that the person you married is a bastard. (This is all beneath them, too blue collar for them anyway.) I mean really, WTF–quit school in your last semester? Seriously?
This is not civilized. This is deranged. Who’s crazy, again?
Yes, this was the most bone-headed thing I had ever heard of. The welfare watchers, in their infinite wisdom, have decreed, at least in our state, that getting a college education is not an appropriate thing for parents on welfare to do. NO! they are to work – not loll around in some classroom. I was enraged that they were risking this very fine person’s graduation by insisting that she interview for jobs at minimum wage. She had to be good enough to appear to be trying, yet not good enough to be offered a job that would keep her away from her classes. Her worker was so fixed on her going to work – it was obvious that my student was quite capable – that they accused her of lying about going on the interviews.
It was a stupid stupid policy. And several suggestions were made that she really should get back together with her husband.
I’m not surprised.
“Morality” is for the poor suckers who can’t opt out of it.
Poor women need to work. Middle and upper class women need to stop work and have babies.
We can’t have quality daycare, equal pay and a repaired safety net that will help people because it will get some fundamentalist’s draws in a bunch–and the greed monsters are perfectly content to go along with this.
It’s classist, misogynist, often racist, and just plain disgusting, this mindset.
And to show that he was a moderate not beholden to “those” people (blacks, women, liberals, etc.) Clinton signed welfare deform–which of course, was the dry run for the biggie, social security deform.
But hey–don’t disturb us while we’re looking down our nose at those “immoral” women, feeling all high and mighty. McDonald’s and Nannies R Us beckons.
Andrew Sullivan has made your exact suggestion. He was serious, however. Give antidepressants to poor women who are depressed.
I partly agree with him, mostly because of the terrible toll that depression extracts from the lives of children with depressed parents. However, pills are not enough; they are barely a first start even (and not where I’d start, obviously!) Clearly, a lot of poor women who become depressed would never suffer from depression if they had a good support system, adequate income to sustain a real life for themselves and their families, and some respect and good prospects for their future. But economically, a lot of folks see such women (and men) as as having no worth in society, dragging it down. We are clearly in a time of blaming the poor for being poor.
To our shame. And our sorrow, as we shall surely see in coming years.
And I forgot to say: Thank you for saving a life. That’s awesome.
Bless you for being who you are and doing what you do and caring so much! The whole situation with mental health care pisses me off so much I cannot even begin to go there. Of course the poor get the very worst of it, although no one in my acquaintance gets a whole lot better regardless, unless they actually can afford to pay for it themselves.
And there are consequences. Back 20 yrs ago when I sought a therapists help so I could learn some skills to better help me in my intimate relations with others. . .and as it turned out stop drinking. . .I lost my disability insurance through work because I was seeing a therapist. That was a nice little extra. Because I was getting really healthy, they did not want to risk insuring me for disability. (I did not apply for or use any disability assistance, I wasn’t disabled, I just wanted to be really healthy.)
Now I was not crazy. I was not depressed in the clinical sense, I was not actually all that dysfunctional. I was at the end of my rope emotionally at how to handle relationships. But the thought. . .we ran it through my health Insurance as Adult Child of dysfunctional. . .etc., etc., the very thought that I might be off work was too much for them. And they by gosh were not going to take any risk that I would be off work due to any “mental” incapacity. I didn’t miss any work because of this, but that being canceled sure did piss me off. Insurance it seems often is only good if you don’t need it or use it. [And it is nice to know how one insurance co SHARES your info with another insurance co. . .without your approval or permission]
Anyway. . .sorry to get carried away here. I am the biggest supporter of good mental health care for everyone, just as I am for good physical health care for everyone. I will be looking forward to your series. Very important stuff. And I want to hear your suggestions for a solution.
Shirl
for saving a life!
I think I have told this story before, probably in a reply to one of your postings, but claiming the prerogative of the old, I will tell it again:
A psychologist I know, who spent her entire career working in a state mental health department, said when she retired that she was glad to do so, she felt she had “burned out,” because 99% of the problems faced by the patients who came to her could be solved by money – not wealth, just adequate income to meet basic expenses.
I am glad that your student made it. We have no way of knowing how many people in her situation who do not have you, or someone with your commitment and aggressiveness to help them do kill themselves, or sink quietly into despair and even worse conditions.
This reminds me of BostonJoe’s diary the other day, and the ensuing discussions..
Excellent diary! There are so many issues with medical care and mental health. A friend of mine’s adult daughter is bi-polar and has attempted suicide a number of times. This young woman is fortunate because, although she has no job and, thus, no medical plan, she has parents who love her. But her parents, while upper middle class, are not made of money and have their own issues because they are nearly reaching retirement age. If she didn’t have them, however, I’m sure she would be dead by now.
Persons with bipolar are particularly vulnerable to suicide. And it can take several years to get the disorder under control. If the person can find the right combination of doctors, therapists, medicine, and support systems, however, life can be quite good. Bipolar often goes with creativity, and need not be a sentence to life long disability.
I hope your friend’s daughter can find what she needs eventually, and before her parents can no longer be her support system.
I have been there. The stress and heartache of living below the poverty level are enough to plunge even the most optimistic among us into a depression, and without good medical insurance it isn’t easy to get help. Plus, the very symptoms of depression make it extremely unlikely that the person will seek help on her own unless someone close to her recognizes the signs and steps in. In my case, no one did and it went untreated for an unmercifully long time. In the meantime, it stole my kids’ childhoods from them.
It really is hard to know you’re depressed – I have been depressed and I know how difficult it is, because it is who you are, not like some kind of infection that you have. And the difficult thing is that depression does not respect it’s causes: whether brought on by terrible circumstances or by pure genetic causes, it works the same way in our heads and hearts. That’s another thing that is difficult for people to understand.
You are right, too that it takes a toll on children. I hope that your kids can understand that looking back with some knowledge. Thanks for talking about it; few people do and so it remains too hidden and therefore feared more than helped.
Thanks so much for this diary Kidspeak and all the comments so far. This is a huge issue-depression in all it’s various forms and bipolar also and how in particular the poor are effected and treated or not treated..which is a complete and utter national disgrace. Not only that is the fact that I’m sure thousands and thousands are literally dying from not getting the help they need. Or ending up in jail due to their behavior due to the depression or extreme bipolar episodes.
There still is a huge stigma attached to depression and to few people including so called health care people understand it or more particularly want to bother with the mental health problems of poor people.
Once again it’s getting late here but my oldest nephews finally was diagnosed with being bipolar—after over ten years…that due mostly to not having insurance and not being able to get any real help even when he had attempted suicide, more than once. One asshole doctor(more than one really)told him he was just a selfish bastard and he just needed to stop thinking of himself and think of his family(he has 5 kids)get a job and get over himself. Add to that the fact that his wife is a major fundie christian and believes he just doesn’t pray enough because that will solve all his problems and didn’t have any sympathy at all for all the hell he was going through for so many many years…
Even though he’s been diagnosed he still gets very little care for his bipolar disease…and while he hasn’t been tested for this hereditary neuro disease it’s obvious he has suffered great pain since a teen due to this…and all this has gone unacknowledged also…another doctor simply told him he was young and couldn’t be in pain and must be a big baby or a hypochondriac. I honestly don’t know how he manages to get through each day still.
The whole system for mental health for the poor is laughable at best and it’s really no laughing matter. It’s more often than not a life or death matter.
Thank you, Chocolate Ink.
I am very saddened by your nephew’s situation. One of the difficulties is that M.D.’s who are not psychiatrists get almost no psychiatric training – often only a few weeks of lecture. And psychiatry has very low status in medicine; it’s where weak medical students are often encouraged to go rather than being told to leave medicine altogether. (Of course, there are many dedicated, excellent physicians in psychiatry, just not enough of them.) So many people go first, with few other choices, to their family practitioner, GP, or internist. And those folks often do not understand psychiatric disorders as well as they might.
It is a loss for us all that there is such prejudice against mental illness. The contributions of people who suffer from bipolar disorder, for example, would far outstrip the cost in time and money to figure out how best to manage their difficulties. But as a society, we don’t see this, we are still stigmatizing these folks, as we used to stigmatize people who had cancer in their families. Eventually, I hope, this will change.
Hey kid, you’re certainly right in saying that people who can’t/don’t get decent treatment for their various mental problems are a great loss to society especially I think in the creative area. My nephew(who is 35 now)is an incredibly talented artist(and I’m very objective about his talents) if he could pursue that I could easily see him being on the cutting edge along the lines of the Japanese animation…he also has written way to many songs to count and is just an incredibly creative person-just amazing. And has no outlet or resources to be able to pursue any of this. Instead he just stuggles every day to try and be a good dad and get through the day. This in turn also fuels his guilt that he doesn’t work and right now he is again self medicating as he was taken off the one prescription that was helping the terrible physical pain he is in(due to his having the neuro disease)….while his wife continues to believe as I said and makes him feel doubly guilty that he just isn’t praying enough to make his ‘problems’ go away. Anyone having to deal with the medical profession even with insurance relating to depression/bi-polar is pretty much a nightmare.
I just thought about this…
It seems that lots of folks rather believe that they can be “cured” by prayer than know they can be treated by a professional who is trained to treat it.
It’s bizarre, and I say this as a God-fearing (though ambivalent about the church) person.
What shows more strength: Getting treated, learning how to deal with every day that comes, or just praying that one day it will all be gone? It’s hoping prayer will help you win the free-from-mental-illness jackpot.
Pardon me, but that’s insane.
I mean, why not say that God put mental health professionals here for a reason, if that’s what you need to get treatment?
It’s like the old joke about a pastor in the storm:
When the rain seemed endless, some neighbors came by in a car and urged him to get in.
No. God will save me.
When the water rose above the door, his neighbors came by in a boat and urged him to get in.
No. God will save me.
When the water rose to his roof, rescuers came by helicopter. “You must get in, or you’ll drown!”
No. God will save me.
The good pastor drowns, and indeed goes to heaven. Though happy, he’s perplexed–why didn’t God save him?
And God replied: I did. I sent a car, a boat and a helicopter and you refused.
(My apologies if I’ve shared this joke before.)
Your right and I think that part of the problem for many people who think mental health is just a made up or self indulgent or laziness thing is that they can’t ‘see’ the problem like you can a broken leg for instance.
Anytime I’ve had some idiot start saying there is no such thing as mental health problems I first off ask them then why don’t they just tell people with a broken leg to pray the broken leg away and make it all better and they look at me like I’m ‘crazy’…
There’s no logic to people who don’t believe in mental health problems. If the rest of the body can get millions of diseases or broken bones, etc then why exactly is the brain completely off limits to any kind of mental health problem…these people believe in brain tumors and other medical brain problems so why is it so fucken hard to believe that there are things in that brain that aren’t wired right and make people bi-polar or have various depressions..not logical.
Wishing something away doesn’t make you stronger–it just keeps you in denial. It keeps you from doing the work you need to do to make it better.
I always learned that God helps those who help themselves. Sure, pray first, but do second. So you go to church every Sunday, are in Bible study every Tues., choir rehearsal every Thurs and pray every night–and? Still haven’t dealt with the problem. You are, however, doing your level best to imprss everyone else.
I just don’t understand how folks live their lives under the “shut your eyes and pretend it doesn’t exist” scenario. It’s immature and childish.
Oh, and it doesn’t work.
Even with insurance, I’ve found it pretty much impossible to find effective treatment for my dysthymia (chronic mild depression) or for the occasional bouts of major depression.
During one period when I found it impossible to get out of bed and go to work, the idiot psychiatrist that my HMO sent me to recommended that I take a leave of absence from my teaching job, then (probably because she was worried about getting paid) she followed up with a recommendation that I go to work for a local supermarket chain. She thought I wouldn’t have any trouble finding a job as a checker because the checkers’ union was on strike at the time. Hey, nothing stressful about crossing a picket line!
The same idiot had me discharged from a hospital’s mental health unit at 10 p.m. one night after finding out that it was questionable as to whether my insurance would cover another day’s stay. She may have done me a favor, however, because the place was just plain scary.
So I’m not a bit surprised that someone without means would find it utterly impossible to get prompt or competent mental health care. As bad as the state of medical care for physical ailments is in this country (and it’s damned pitiful), the state of mental health care is infinitely worse. I attribute it in large part to that peculiar strain of American puritanism that insists that there’s no such thing as mental illness and that we depressed folks should just cowboy up and get on with our lives.
I have dysthymia as well as occasional bouts of major depression. The problem with chronic depression is that many professionals view dysthymia as a lifestyle choice rather than a legitimate medical problem, and this can make seeking treatment a rather humiliating experience. Lots of condescending nods and pats on the head. Have you found this to be true as well?
Yep, I’ve run into that–along with a whole lotta cluelessness. I’ve had two or three therapists who tried to push me into cognitive therapy, which just doesn’t work for me (it always feels like I’m trying to fool myself). And everybody throws drugs at the problem, although dysthymia seems pretty drug-resistant.
An ex-boyfriend was convinced that my depression was a lifestyle choice (damn strange concept given that he was bipolar). Asshole.
And I have had two years of cognitive therapy in dealing with my SAD. We have a family counselor right now dealing with our teenager and he gave me a personality test last month. I was late starting my meds for winter here, I was unsure when it was really going to kick in. I was depressed the day I took the test and told him so. When the results came back he told me that he was very puzzled because I said that I felt like hell and depressed that day (probably my health problems adding to it too there), but my test scores came back that I was well adjusted and capable of handling stress very well even though I seemed to have a lack of “happy” feelings. Fer fucks sake man, I told him that I had had two years of cognitive therapy to help me deal with the depressed times. I become flexible and consistently choose a brighter outlook because I know I’m only depressed and it is only me and focusing on the brighter more positive outlook helps me to at least feel a little better. It’s friggin frustrating though when you do what they want and then move and someone else feels like you’re lying or you are a real headcase or something because your general feelings and your belief system aren’t matching up. It’s funny too but really fucking frustrating also!
You are talking about a classic problem that I’ve observed a lot, and personally, too. Docs know the symptoms, and the meds. They don’t know the mixture of how people work with therapy in combination with meds in those who are very self-aware (which is what cognitive therapy requires, anyway). And if you do the cognitive stuff to control those depressive thoughts, you appear healthier than you really feel, and the docs just too often don’t know how to deal with this. I’ve taught psychiatric residents, and the medical side is so emphasized that the real world stuff just isn’t there enough. It is damnably frustrating.
I have worked hard in dealing with the winter months and doing everything I can to get the most life out of them even though I feel like hibernating. I know that the counselor is very very busy, his office is always packed. I did feel a little bit put out though that I did give him my own clear history and somehow he seemed to either forget or I guess he figured that my counselor couldn’t have done that great of a job or we wouldn’t be having such large problems with my daughter. My daughter is now taking an antidepressant and is doing much better. I would place my bet that along with all the really great genes I gave her that I also shared my SAD. I have been reluctant to “diagnose” her based on my perceptions though, but I think we may find in time that along with the regular teenage stuff she also has this going on right now too.
There hasn’t been enough study of dysthymia, in my opinion. I talk about it a lot in my classes, and I’m going to talk more about it in one of my pieces to come. It is a very big problem, and you are so right, both of you, in how badly it is treated.
By the way, though I have been trained in cogntive therapy, among several kinds, I also do not like it. I think it suits some people very well, others not at all well. There are other kinds proved effective, e.g. interpersonal therapy, that might be a better fit. What we need is a way to shop for therapy, as we do for other things. Our insurance, if we have it, often sends us to one person and one only, however. I have a family member who got sent to a counselor who literally slept through some sessions!
I’ll be watching for your dysthymia discussion. I’m sure I’ll learn more from your diary than I have from all the therapists I’ve seen put together.
Shhh…
Didn’t you hear?
We’re not supposed to talk about these things in this country. We’re too strong and independent for that.
Without getting too specific about my own family, I can say that I have dealt with most of the situations you mention and the in other’s comments here. Either as the one in need or the one seeking to help the one in need. I’m especially concerned about the effects on kids of having to live with a parent who is chronically depressed or even worse.
It’s so true that all it takes is a little money to prevent so much of the underlying causes. Other times it takes a lot of money once someone gets past the point of mild depression. Certainly dealing with a diagnosed mental disorder can be extremely costly. Not to mention the toll it takes on the family once it gets to that point. It’s like everything else in the way medical issues are addressed here in this country. Never any prevention, but plenty of help, if you can afford it, once you’ve reached a crisis.
It’s all so wrong and all so backwards.
The truth is, for me at least, that this country is no better, or even less, at taking care of it’s citizens than any third (pardon) world country. We’re all so very expendable.
Your student is so fortunate to have you Kidspeak.
Peace
you mentioned kids and that is the other hidden tragedy of living with a parent who suffers from any kind of depression. And no one really knows until those kids get older how this will really have shaped those kids and their perceptions of life…or what problems it will cause for them in their own life.
I mentioned my nephew above and as I said he has 5 kids(15 and under as of right now)who have lived and are living with someone who struggles daily and have witnessed him trying to kill himself etc. My other nephew-his younger brother who worshiped his older brother had gone to live with my oldest nephew when he was just 17 and found out that the brother he worshiped was pretty messed up..and in fact one day found him hanging in the bathroom -luckily he got him down before it was all over for him. He doesn’t talk about that much but I can only imagine how that has effected him also. Depression and mental problems effect the entire family, not just the person whose living in the hell of their own minds.
My nephew(the youngest-25) happens to be living with me right now and this subject is hard for me as I have always been more of their other mother instead of just an Aunt.
Hi Chocolate,
I think it’s all a lot more pervasive within families that we even know. Especially considering that the subject is so taboo. I could share a lot about my own family to attest to it but here isn’t the place.
We all do what we can within our families to help each other as much as possible like you are your nephew’s sort of surrogate mother. With little or no money or resources available it’s such a crap shoot sometimes hoping that things don’t go completely off the rails.
Peace
It’s good that your nephew has you to be around. It is very hard, but important to talk about a suicide in the family, as a suicide makes other people at risk, especially teens and younger adults who are isolated. Especially dangerous is the combination of alcohol plus a little to a lot of depression. People do things under the influence of alcohol that they would never do if sober, and that includes trying to end their lives.
Depression is one of those things that should be mentioned matter-of-factly to kids as they grow up and to them more when they have kids,etc., as we would if, for example some other kind of problem ran in our family, e.g. high risk for melanoma, or high blood pressure, diabetes, and so on. Mostly we don’t shy away from those things. Knowing the possibilities are there really helps people feel that its ok to get help sooner(unless, of course, talking about it is to shush it up “Don’t tell anyone, etc.
I’m a big big believer in telling kids things such as a family problem like depression-in age appropriate language-and not have parents try and cover up stuff-that’s so incredibly damaging. Too many grownups want their kids to do this or that but don’t treat them with the respect they give their dogs.
Thanks for what you did for this young woman Kidspeak, and for this diary as well. As you may remember from other comments, I work at an urban non-profit where we help kids who are starting to get in trouble. Many of the mothers we see are in that 40% who are suffering from depression, not just due to the circumstances of their lives, but as a result of generations that have been left out and forgotten. As their kids start to get in trouble in the schools and court systems, we tend to blame them for the problems and their lack of engagement, which only exacerbates the problem.
I’m looking forward to your series, because I have a LOT of ambivalence about how our mental health system both works and doesn’t work for these kids and their families. Often my concern is about the overuse of both the medical model and medications to address these concerns. While I know they are helpful, I don’t get the sense that we really know what we’re doing in most instances. I’ll appreciate both your thoughts and those of others on this.
I’ve been thinking about this in connection with your diary. I was never a Ronald Reagan fan but I felt no emotional antipathy for him at first. But I know the day I began to hate him.
I had spent two years going to school in DC from 1978-1980. I left when Reagan was elected — although that wasn’t the reason! I returned for a visit in 1985. When I left the city for the midwest, it was beautiful. A gleaming city made of marble with large expanses of green. Sure there was a lot of poverty, but the tourist areas were beautiful. When I returned, I was staying with a friend in Alexandria. She went to work the first day and I went museum hopping. I took the Metro down to the mall and came up the escalator in the middle of the mall. And saw all the homeless people. They were everywhere.
Where did they come from? They were mostly the mentally impaired people who Reagan had “let out”. But they needed their meds and they could not take care of themselves. And at that moment I hated Ronald Reagan. How you could live in a city and not see the day to day change as more and more people were living on the street; people who clearly had emotional and/or mental problems; people who needed our help but instead were put out on the streets to live. What kind of person could drive by in their motorcade day after day after day and see these people and yet continue to advocate the very policies that put those people there.
That was my moment. I’ve never forgotten it, but I’ve been thinking about it quite a bit since you posted this diary.
Whew. Now I can get back to work.
A republican is the kind of person who can’t notice or care about the homeless person right in front of their own face. All they can do is heap scorn on them for not pulling themselves out of their self made misery </sarcasm>
The homeless people wandering the streets of this country’s capitol are forgotten by their own people.
And many of those homeless are veterans that their country threw away once they used them for their purpose.
you’re so right. I remember that also and that is what has directly contributed and fostered the incredible rise in homelessness and people not getting treated or having a place to go for mental health problems.
Reagan cut the budget for Hud Housing to almost nothing and it has never been restored the levels pre-Reagan…he is hopefully rotting in hell for that…or if reincarnated, living in a cardboard box somewhere.
I resonate to what you are saying! Jimmy Carter did so much for mental health (mostly unnoticed), and Reagan came in and undid it all.
I think we are in for more homeless people with the souring economy for the lower levels of our citizenry. . .
Now these fucking lunatics and their fucking crazy Christian beliefs have invaded our health care system!!! Prayer?! Prayer is going to fix fucking what? I lost an Uncle to suicide seven months ago and I have been a single mom for a seven year period in my life and well know the stress that can just clobber you. Prayer? The poor woman needs to be looked after until her medication settles in. Because I have SAD and I have had it treated now for the past 14 years I well know that the newer medications can have an affect in about two weeks and sometimes less (big sometimes). I have to time my start of medication every single year or I have a gap in there that I get to spend depressed because I didn’t start soon enough. I have never been suicidal but I know people who have been and I know it takes a few days being monitored while starting the meds and then a person has to be monitored to a lesser extent for a couple of months after that because sometimes when the meds kick in they carry out there last thought that they were too tired to complete before the meds, which was suicide. It is so hard for a single mom on that cusp of success finally too…..successful women have to write their own book once they get there, for most of us our mom’s never went where we are going and it is scary and causes us to doubt everything. Passive weak women easily find “love” in our culture but if we are strong and smart and successful will anybody ever love us? We don’t know it because we haven’t seen or only seen it a precious very few times, and we need outside love when we raise kids because kids are takers and healthy kids get to take and parents refuel however they can. Success can only add to the fucking stress sometimes when we are about to “finally” get there. My heart goes out to her and all my love too. I am so glad that she has you because I know that somehow you will do what you can to be there for her while our health care system Prays that it’s patients will be okay!!!!! God I’m just fuming right now!
Tracy, I am trying to find a good therapist down here and one of the first questions I ask the person who answers the phone is whether the Dr. is a “christian counselor” because there are a bunch of those here and you don’t really know unless you ask. They use biblical principles to cure you of depression and anxiety.
I was very suspicious of the family counselor that we got because he is a also a minister (his credentials though were impeccable and all in order)….granted in a church that allows homosexuality, I was still a bit put out though and kept my views very reserved until I saw him action. The phone book here though is full of “Christian” counselors. I have yet had a counselor advise prayer for me and God help the stupid fucker who ever does! Biblical principles? A book written by a bunch of guys smoking some really good shit a lot of time and dug up and pasted together by who, when, where, why? And translated and rewritten by who, where, why?
They have a separate entry for Christian counselors, but there are regular old docs here that let their strong Christian views come through in their work. I run the other way. I don’t need someone telling me that God meant for me to do this or that. I didn’t run into that problem up north, but I never really was sensitized to either, so it might exist ther also. I kind of doubt it. So much of everyday life here revolves around Christianity. All through Dec. and even now, there is a sign up at a McDonalds that says “jesus is the reason for the season.” A McDonalds.
hey Tracy, I’m with you on this whole ‘christian counselor’ thing. There’s not anything wrong with being christian nor a counselor but once they start thinking that belief in god and prayer is a substitute for real counseling and medications then they should be kicked out of the profession. Or shorter comment would be that those counselors are fucked up asshole whackjobs.
I hope you are doing as well as you can regarding your Uncle’s suicide. Personal tragedies like this ripple out to the entire extended family-another casualty of the fucked up health care system.
tell those who believe in prayer will fix mental illness…
whether or not “prayer” helps them when they’re sitting on the crapper with a major case of the hershey squirts.
It’s the same as implying a person is “bad” or “evil” for being ill. I see no difference in someone having a broken foot, a broken spine or a broken brain.
Fuck it… we’re ALL BROKEN. 🙂 That’s why we’re supposed to help those that are more broken than we may be at a particular moment.
I’m speechles.. but sadly I’m not shocked.
They want to drug everyone. They want everyone poor and afraid. They make it downright nightmarish to even see a doctor of any kind.
Luckily they didn’t threaten to take her kids away for seeking help.
My thoughts and hopes are with you both.
From a Mother who saw her child deterioate due to this “great” country’s “health scare”.
xoxoxox
Well, they did threaten to end her kids health insurance if she didn’t take some low-paying job and quit school. Fortunately, she “found” a clerking job 3 days before graduation and gave them notice right after being hired. She had a good job waiting – but that did not count. Her worker actually accused her of lying about school (and she was Phi Beta Kappa!!). I wanted to strangle her caseworker along with the HMO staff.
This is so gdamn fucken maddening, heartbreaking and so incredibly counterproductive but proves once again how the government is set up to keep poor people poor…anyone who thinks otherwise is deluded.