I found out via Jen’s Place in the Blogosphere that it was National Invisible Chronic Illness Awareness Week a couple weeks ago. I am (as I am usually) a little late to this party, but given that awareness is one of those things that shouldn’t really be limited to a week, I figure there’s no harm in suggesting you bloggers out there contribute your thoughts via this 30-point meme.

[PS — The new and improved DF layout lets me post “asides” in addition to full-blown entries. Pretty cool, right?]


Insurance Ad, 1935 (Click for source)

Without going into too much boring detail, let’s just say that I’m in the middle of two completely separate health insurance problems, with completely separate insurance companies. On one hand, I’m trying to resolve a series of claims with my previous insurance company from last year with regard to which that company is exhibiting some of the most asshole-ish, unprofessional, and borderline illegal behavior I’ve seen in a long while. On the other hand, I’m trying to establish new coverage with a different company that is clearly operating in some sort of discriminatory loophole.

So, I gotta ask: How do you pay for your mental health care? If you are insured, do the technicalities of your insurance plan have an effect on your care? (Does it affect your visits, your provider choices, which medications you take?) If you are uninsured, how do you manage?

On top of all that, shall we start a discussion on mental health parity in general? It’s no secret that mental health care is really very expensive. It’s also no secret that more often than not mental illness impedes one’s ability to work. Further, it’s no secret that pharmaceutical companies are out there to ruthlessly gouge whomever will pay and that insurance companies really don’t feel like being gouged. Tack on the stigma that suggests that mental health disorders aren’t “real” illnesses…and we’re looking at some serious problems, in the middle of which I am currently sitting.

Here we go — a real, nuts-and-bolts discussion topic. One I’m hopeful we all have some suggestion or method or useful tip to offer.

Our friend Dave asked today Does anyone have any tips or suggestions about how to motivate yourself when depressed or when you don’t feel like doing anything?

We’ve never outright had a brainstorming session on what we do when we don’t, won’t, or can’t do anything. So…whatcha got?




[Complete side note as evidenced by the number of times I just hit “Enter”: Clearly I have a new image strategy: For the time being, I’m searching the Flickr Commons (public domain photographs from various library-type sources) for some key words from each post. Easy!]

Coming Clean (click for source)

Sometimes (perhaps if and when we are so lucky) there comes a time and a need to tell some (perhaps unsuspecting) soul about the things we think, the things we feel, the things we hear, the meds we may or may not take. My hunch is that it’s a conversation that some of us have practiced and that others have for the first time each time. Maybe there are long versions and short versions we tell. Maybe it’s something some of us have done more than a few times and something some of us have never really done.

To whom, when, and how do you come clean?

Regardless of the differences, it’s not easy. And wrapped up in its difficulty are fears and misconceptions and persistent stigma and questions of responsibility. Compounding that difficulty is the understanding that this conversation crosses multiple thresholds, all of which constitute points of no return. Nothing said can ever be unsaid — and whether it’s with a friend or colleague or someone we’re starting to date, if a relationship will change after mental illness is disclosed, it will stay changed. We cross our fingers and hope for the best.

As I wrote “…and hope for the best,” I realized I have spent most of my adult life not knowing what it is that I’m hoping for in that conversation, not knowing what I thought the “best case scenario” really looks like. And, so I want to ask: What is it you hope for when you come clean?

To take that question just a tad further, For whose benefit do we talk about our illnesses? And what do you personally gain from it?

Over the next couple weeks, Define Functioning will be rolling out a few changes. Some are organization (e.g., the Current Reading list has been moved to the Reading Room, where it probably makes more sense). Some will be more content-oriented, aiming for new and continually improving discussions. At the end of that process the “Beta” notice on the uppermost part of the right column will disappear. So, as I execute the tweaks I’ve gathered during the Beta stage, any and all suggestions you may have are more than welcome!

Last May, Define Functioning ran a little experiment and asked what you want people to know about mental health and mental illness. The results were amazing. So amazing, in fact, that it has presented a small conundrum for the book that will compile the responses: We are just in between a “put it in your pocket” sized book and a “put it in your bag” sized book. And as these things go, it’s not really an option to be “in between.” (It’s actually too big for a pocket-sized book…and looks silly as something bigger right now.)

So, I’ve concocted a way to fix that: I’m extending submissions through 2011 in order to have a book finished and ready for Mental Health Awareness Month (May) in 2012. I’ll be adding a new Project page to the site to collect submissions (part of the aforementioned changes). Until then, please feel free to add comments to the previous discussion post or email them to me at definefunctioning [at] gmail [dot] com.

Last thing: I’ve been unforgivably negligent when it comes to providing any sort of imagery with recent posts. So, in some super lazy brainstorm, I thought I’d screen clip whatever happened when I googled any given phrase. The Universe seemed to smile down on this plan, because when I did she offered this:

For those who don’t know, I’m a sports fan. That may or may not have anything to do with this article.

Yesterday the link below was shared across the twitterverse and spurred an amazing conversation for me, in which I heard incredible insight about how the worst-case outcome for mental illness can or should be treated in the media as well as what role that coverage can or ought to serve for spurring discussions both within the mental health world and beyond those immediately affected. The article is not long, so please take a look and share your reactions.

Stigma Attached to Mental Health Issues by Carol Mulligan

Thanks so much to forum member Meredith for this Community Contribution Reading Response of Rebecca Shannonhouse’s (ed.) Out of Her Mind: Women Writing on Madness. As always, if you’re reading something you’d like to share with others, shoot ∃ an email at definefunctioning [at] gmail [dot] com. (I’ll add your reading to the Current Reading panel and post your Response when you’re finished.) What follows is Meredith’s response.

Shannonhouse Out of Her Mind: Women Writing on Madness by Rebecca Shannonhouse (Ed.) highlights many unpleasantries about being mentally ill, which can help validate persons struggling with such things and illustrates some of the ways in which the mental health industry has changed. Shannonhouse also chose more current stories depicting the ways in which that industry has not changed. The book confirmed my belief that we mentally ill must take a proactive approach to healing. While reading, I could empathize with all the women, and I recognized my good fortune to have had recent great support and success in living with bipolar. I have become passionate about my care, do research on my medications, stay in regular contact with my psychiatrist, and see my therapist often while working on changing my longstanding behaviors related to being bipolar. Shannonhouse’s book reminds me of the importance of fighting for ourselves and forcing the mental health community to not only see us as intelligent humans and partners in healing, but to alter the inconsistencies in their field.

Shannonhouse began her chronology with an excerpt from Margery Kempe’s The Book of Margery Kempe from 1436. Kempe’s recounting in the third person of a short but intense segment of her craziness is raw, including devils, flames, and being hauled about. Of course, in 1436, people considered crazy were banished to some of the most abhorrent places.

Those places did not change much from Kempe’s time to the 1800s when Dorothea Dix, a social reformer in Massachusetts, went from asylum to prison chronicling the state of the inhabitants to later discuss with the legislature. The despicable conditions of the institutions and other places they kept mentally ill people drove these women to rally for humanity. Though I have never experienced hospitalization, someone I know recently had an eye-opening experience after being checked in by her doctor. She was treated as if she was either five years old or an animal, and she had to fight to be released. And fight she did.

Meri Nana-Ama Danquah, in the excerpt from Willow Weep for Me (1998), very clearly described the painstaking life of a woman consumed with depression. She defined depression, she discussed it as we discuss it and other mental illnesses, and she tied it to social issues. The cyclical logic of being and staying depressed is something I have experienced for years, getting caught up in my own hopelessness and proliferating depression further. By enhancing my awareness of my thought processes and their effects (for better or worse) on my feelings, I have begun to mitigate the negativity as it arises. Early awareness is key.

Some of the more famous women included are Zelda Fitzgerald, who hardly wrote once deemed mentally ill, Sylvia Plath, and Charlotte Perkins Gilman who wrote “The Yellow Wallpaper” in 1892. Gilman’s vivid descriptions of her world around her, the one room in which she was confined due to a “nervous condition,” drew me into the wallpapered hell. I completely identified with her sense of being alone to fend for herself because no one would believe something was really wrong. I also entered her room as she described the living furniture and the woman behind the wallpaper. I could easily have been her. I had been in a similar relationship and for various reasons was, thankfully, able to get the help I needed to see straight, at least at times.

The stories collected remind me of The Snake Pit and others condemning the mentally ill to be at the mercy of others for always. I remember watching The Snake Pit and feeling the frustration of not being treated respectfully and the feeling of desperation at being at the mercy of others. It is certainly a way we can live, but I believe more and more of us are taking our illness into our own hands, doing the research, and questioning the practices of the mental health community. Most of Shannonhouse’s book reminds me why that is so important.

Feeling disconnected from my own mother and knowing I’ve stopped from killing myself because of my children and not wanting to cause them so much pain, Signe Hammer’s story along with Linda Sexton’s, drove home for me the pain, the identity issues, and the being wanted and being loved issues. They are powerful excerpts. All my wonderings about my children’s lives should I commit suicide were realized in those two stories alone. There is no doubt in my mind that I would leave them with much pain and lifelong scars. Even if I don’t keep from committing suicide for me, I keep from doing it for them, and sometimes that is enough.

There are stories about behaviors, those around medication, some with ECT, hospitals, and doctors, and stories with definitions coming from those who suffer. I found myself identifying with nearly every woman in the book on some level. There is an underlying strand of suffering and stigma in the stories of the past to which I certainly could relate with regard to the beginning of my healing journey. Being the daughter of a psychologist who offered no help in my teenage struggles, I internalized the stigma as many of these women did, and many more today do.

However, one of the identities I further developed in myself from reading Shannonhouse’s collection was that of advocate, at least for myself if not for others. The discussions I have with fellow mentally ill people do often center on the injustices of our general treatment by society and the mental health community. Some go on to speak on a more global level for which I am grateful. Making those connections with advocates keeps the torch afire for us to do our own work in managing our illnesses.