Tuesday, August 20, 2013

How is stigma subtle in words and actions?

"A mark of shame associated with something"
Stigma can be something that is outright: "Did you see that (any mental illness ie:) "schizo" on the street?" (using slang terms is also a form of stigma, along with using the illness before the person, it should be "person with schizophrenia")

I have one personal story to share about stigma. Although this is not "outright" that was "outrageous" stigma, however, this comment stuck with me in a weird kind of stigma way.
I had one day in graduate school where I did a brief lecture on research in mental illness to  students. After the lecture, the professor thank me and said "it was great that I was such an advocate". I briefly told her that I had depression and she said "Wow! You are so high functioning for having depression"....

Okay, is it stigma? Yes I believe so, this is implying that everyone with depression must have an outward appearance of not functioning. ( to be diagnosed with clinical depression it includes an aspect of lower functioning in various aspects of your life.) However, depression is a mental illness that you recover from, you can be "high functioning" when you are on medication/therapy/in treatment and have an outward appearance to world of being "high functioning" but honestly, inside, I still feel as though I have a long ways to go. At this time, I was sleeping, 12-14 hours a day that included naps/actual night sleeping due to my depression and only going to the grocery store 1x a month. In my head when she made this comment, I felt a few things, I felt gratitude that she thought my depression was under control, although it felt not very in control to me, and then again I felt stigma because this implied that everyone with depression must have an outward appearance of not functioning. Although I suffer from depression, I am high functioning, and I do not think that "high functioning" is a proper word to use. Many others suffer from depression and a comment like this shows lack of awareness of how widespread mental illness is and how it can effect so many people that we like to think are "high functioning"

Okay-off my soapbox. This may be an awkward article to some, and might not make the most of sense but it's just something that hit a chord with me.

Any stories anyone would like to share would be appreciated.

Monday, August 19, 2013

Isolation and depression, as a friend or family member, how does depression effect you?

As I have talked to people with various addictions, one thing I heard that rings true is "Isolating myself from others so they don't know how bad it really is". I guess the it could be many things, "it" could be a substance such as substances or "it" could be taken a different way, such as the symptoms of depression.

I feel that sometimes I am isolating myself because I don't want to discuss "it": how I am doing in general with my everyday activities. I sometimes feel very silly because things are going "so right" in my life and I still tend to feel down. But once again, this is due to depression, and the few people I discuss it with, mostly do not understand. They may say things like "Why don't you come out?" or "You have so much to be happy for! How could you feel down?" I have had friends even get mad at me  and lost many friendships over isolating myself. The only true friends I have are ones who are able to keep coming back to me. It is almost as if I have the "All of nothing" complex. If I want to be with my friends, they are my world. When I am in my "depression" world, my friends are "out of site out of mind". Obviously, I am not being a very good friend. Although it is not an excuse, active clinical depression, in research, is linked to worse relationships in regards to all types of relationships. It makes me even sadder writing this, but it's something that I feel everyday.

OT Thoughts:
If someone you know is suffering from depression, you may feel effected too & this is entirely normal. 
You should always understand that your safety and your mental health is important, even if you don't have a mental illness. Sometimes it is easier to blame ourselves for how someone acts with a mental illness then recognize that it is the illness and not you or the person with the illness who is pushing you away. Different things can be helpful for different people. I don't have all the answers and I don't claim too, but here are some good ideas/resources...

These 15 ideas are taken directly from: "15 ways to support a loved one with a mental illness."by: By MARGARITA TARTAKOVSKY, M.S. Read more indepth here:

1. Educate yourself about the illness
2. Seek out resources
3. Have realistic expectations
4. Reach out for support
5. Work with your loved ones treatment team
6. Let your loved one have control
7.Encourage them to talk to their mental health professionals
8. Set appropriate limits
9. Establish equality
10. Realize feelings of guilt and shame are normal
11. Recognize your loved ones courage
12. Help yourself
13. Be calm
14. Convey hope
15. Get political

Here are a list of websites for support for families/friends of someone with a mental illness:
http://www.ouhsc.edu/safeprogram/ - All about mental illness and impact on families. This section is specifically for depression: http://www.ouhsc.edu/safeprogram/02Depression.pdf
Mental health support groups for people with illness & families: http://www.mentalhealthamerica.net/go/find_support_group
15 ways to support a loved one with a mental illness

Monday, August 12, 2013

My experience with my IEP for depression as a child & OT: How do we help children combat stigma of IEP/mental illness?

Although my blog is typically about depression, today I am going to discuss a little bit about my experiences with IEPs.

I had an IEP since I was in middle school due to being hospitalized due to depression and missing approximately 100 days due to depression in 1 year. At 12, I was unable to "attend" my first IEP meeting. However, in the future, as a student, it felt very awkward. When I didn't go to class due to an IEP meeting or having resource, I felt as though I had to make up excuses. Most people did not know I had resource or was in "special ed". Being in high school, I felt I had to lie to my friends about my schedule having resource on it or missing class to go to the social worker. Since outwardly I came across as a "typical" student, the stigma of a mental illness was too much for me to discuss with peers.

(OT perspective)
I know now that the only way to combat the stigma of a mental illness is to discuss it and educate people. However, when you are a teenager, how do you take on this responsibility? Middle school, high school, those are very hard times. Students already feel different and awkward and it's even harder when we feel as though we have to hide from other students and carry a deep dark secret. This dark secret is due to the fact that the stigma of having a mental illness still exists, especially around children, because mental illness is something hard to understand.  The stigma of all illnesses must be extinguished. We, as professionals, aim to educate all children about disabilities. This means all disabilities, including disabilities that are visible and those that are not visible.  

Some ideas:

  • Discuss with a student on your caseload, if appropriate, about feelings about special education.
  • Aim to do an inservice for teachers on incorporating barriers to breaking stigma into teaching
  • Work with other professionals to develop skill groups/after school/extra curricular groups promoting mental health and healthy living
  • Ask your students what would be most helpful
  • Arrange with local organizations/speakers come in who have a mental illness to talk about their experiences and life (Some local organizations do this to combat stigma)
  • Please comment and write your thoughts. I would love to hear anything you have done.

Sunday, August 11, 2013

Depression: coming to terms with myself & the elephant in the room

Being diagnosed with depression at the age of 11 is something that is mind baffling to me... I am sure it was to my family as well, however, I can only speak from the view I had when I was diagnosed.

Depression was something that was a secret in our house. We never talked about "it" (depression = silence in my world), everyday life was normal: going to a therapist, being hospitalized, taking medication every morning, checking for cuts...

Somehow "it" became so normal that "it" was something that was abstract and broad in my mind. I am diagnosed with depression, I had an IEP from being depressed, however, it was never discussed in my family. I am not sure why. That is why when I used to look in the mirror growing up, I would see a girl who I didn't know. I didn't really understand my depression and I never really understood how it came about.
I never thought that my depression was real. Somehow in my mind it was a phase I was going through. It was something that was normal, since my parents treated my depression as if it was nothing. I wanted to believe it was something I could control. I really thought that everyone was overreacting and it was something everyoe experienced.

Not going to school because you're too depressed is not healthy. Wanting to hurt yourself is also not healthy. However, in my mind I validated these things as things that were "everyday experiences"

Although I am slowly coming to terms with my depression, to this day, 14 years later, it is still a secret in my family. Every once in awhile my parents will ask me "Do you need that medication? you should get off it" And that is about the extent of our conversation about my depression.

This post-I don't really know what I am trying to say. It is just that to me depression is something that is hard to comprehend to all- from a child to an adult. I can't say I am at terms with my depression now. But I know it is a life long challenge.

OT Perspective:
Client education is tremendously important. Education on what it means to have depression and how it effects ADLs/everyday routines/life and also family education on what depression is.
This type of treatment is important to be a part of the team with therapists/psychiatrists to really make sure that everyone is getting the help that they need to understand this diagnosis.